The latest delay in the Affordable Care Act means people enrolled in plans that don’t meet Obamacare’s stricter coverage standards can keep them for another two years. It could create a two-tiered system, because states will get to decide whether to allow the delay, says former Senator Ben Nelson, who now heads the National Association of Insurance Commissioners.

And because people in the plans that don’t comply with Obamacare tend to be healthier, not having them in the broader insurance pool means insurers have to shell out more money, and that cost will be passed to consumers. How much more?

Nelson says it’s too soon to pin down a figure, but he knows insurers can’t afford to take a bath, even as they try to court new customers.