The amendment is rather plain in its language and what it seeks to accomplish. It would allow states to opt out of federal essential health benefits requirements for exchange plans and create their own requirements, which could allow more insurers to sell barebones plans on the tax-subsidized marketplaces. MacArthur’s amendment would also allow states that participate in the AHCA’s high-risk-pool funding mechanism to waive some parts of Obamacare’s “community rating,” including the parts that protect people from higher costs because of pre-existing conditions and limit the premium multiplier for older people. While the law doesn’t allow insurers to bar coverage for sick and elderly people, it doesn’t limit how much they can be charged, which means they can be functionally priced out of coverage.

While MacArthur’s provisions today gained the fealty of the troublesome Freedom Caucus, when leader Mark Meadows gave his stamp of approval to the amendment, they don’t actually address the issues that have turned public support and likely the majority of the Senate against the bill, and introduce some more potential process and policy snags.

To start, the AHCA’s main policy flaw—and one that seemed to blindside the Republicans who wrote it—was the fact that its combination of removing the cost controls and eliminating the income adjustment for the ACA’s insurance subsidies, and its allowance of a wider age-rating scheme that allows older people to be charged more for insurance would dramatically and almost comically inflate costs for older low-income people, sometimes by as much as ten times their current premium amounts. Since average statewide insurance costs are not accounted for in the original AHCA subsidy framework, the amount people are charged for insurance could differ by thousands of dollars simply based on their zip code. MacArthur’s amendment not only fails to address those issues, it makes them worse, as there is no hard limit to the age-rating or the other relaxations of insurance-rating schemes.

The ACA’s ban on denying people coverage for pre-existing conditions has long been a sticking point among voters, Democrats, and moderate Republicans, and this amendment also challenges that strong constituency. While it doesn’t quite overturn the ban, it does essentially allow states to do so by letting insurers price people with pre-existing conditions out of the market. This extreme is probably unlikely, since states would then have to deal with the resultant political backlash, but allowing insurers to charge more for sicker people would certainly be back on the table. These tend to be the older and lower-income people who would already be pushed to the margins by the AHCA’s rating schemes. Additionally, MacArthur plans to exempt members of Congress and their staffs from the provisions, which probably won’t play well politically.