A report by the Congressional Budget Office (CBO) concludes the Supreme Court’s ruling on the Affordable Care Act is likely to result in an increase in the number of uninsured Americans. The ruling will probably lead to a modest decrease in the cost to the federal government, compared with estimates made before the court ruled, according to The New York Times.

The CBO report states 33 million people originally had been expected to gain health care coverage under the law. Now three million fewer people are likely to get insurance because the court ruled that states are not required to expand Medicaid.

According to the CBO, six million fewer people will be insured by Medicaid, but half of them will probably obtain private insurance through health insurance exchanges that will be established in every state.

In total, the CBO estimates 30 million people will be uninsured in 2022, compared with its estimate of 27 million before the Supreme Court ruling. Currently, approximately 53 million people are uninsured. If the law were struck down, that number would rise to 60 million in 2022, the CBO states.

The law will now cost $84 billion less than previously predicted, because of changes that will occur as a result of the court ruling, the report notes. The total net cost will be $1.168 billion between 2012 and 2022.

The report predicts that many states will ask to partially or gradually expand Medicaid. The CBO also expects that some people will not be able to obtain health coverage because they will not be eligible for Medicaid or for insurance subsidies. Private insurance premiums will be 2 percent higher than previously estimated, because newly insured people will have lower average incomes, will be in poorer health, and will require more care than had been expected.