The collateral damage of Obamacare repeal

Conservatives want to wipe out Obamacare's insurance regulations to make health coverage cheaper — but if they do, it could affect far more than the people who buy health insurance on their own. In a new analysis provided to Axios, the Century Foundation finds that if Republicans turn those regulations over to the states, 91 million Americans in "self-insured" employer plans would be hit too — and they'd probably have no way to get them restored.

Here's why:

• The goal would be to let the states decide whether to impose rules like making insurers cover pre-existing conditions, letting young adults stay on their parents' plans, covering preventive services, and requiring insurers to cover 10 categories of "essential benefits."
• That could work for the individual market, but not for employers that insure themselves — because those plans can only be regulated by the federal government.
• The hardest hit state would be Vice President Mike Pence's state of Indiana, where 76 percent of the state's residents who have private employer coverage are in self-insured plans.

The analysis by Jeanne Lambrew, a former health care adviser to President Barack Obama, and Ellen Montz also finds that letting the states define "essential benefits" could leave as many as 13 million individual market customers without maternity coverage, 7 million without substance abuse treatment, and 4 million without mental health services.

Between the lines: It's mainly the Freedom Caucus, along with outside conservative groups, that has been pushing to eliminate the insurance regulations. They argue that the regulations have made health insurance more expensive. But most other House Republicans have been resisting, and they may dig in harder as there's new evidence of the consequences.