A new effort to pass the Republican health care bill has been propelled by an amendment that would allow states to waive certain insurance regulations in Obamacare. We examined the probable effects when the idea surfaced in April. Now that those ideas have become part of the legislative package, we’ve updated our analysis.

Throughout the debate to repeal and replace the Affordable Care Act, President Trump and Republican congressional leaders have insisted they would retain a crucial, popular part of the health law: the promise that people can buy insurance even if they’ve had illnesses in the past.

Their efforts foundered in March, when a House health bill had to be pulled from the floor after it failed to attract enough support. But now, the bill appears back from the dead, because of a compromise meant to attract votes from the conservative Freedom Caucus. The proposed changes would effectively cast aside the Affordable Care Act’s protection of people with pre-existing conditions.

The terms of the new amendment, go something like this: States would have the option to jettison two major parts of the Affordable Care Act’s insurance regulations. They could decide to opt out of provisions that require insurers to cover a standard, minimum package of benefits, known as the essential health benefits. And they could decide to do away with a rule that requires insurance companies to charge the same price to everyone who is the same age, a provision called community rating. In exchange, states would be required to set up special arrangements for high-cost patients.