By Alicia Adamczyk
June 14, 2017

The U.S. would lose nearly 1 million jobs over the next decade if the American Health Care Act, the Republican replacement plan for the Affordable Care Act that passed the House of Representatives last month. is implemented.

According to a new report from the Milken Institute School of Public Health at the George Washington University, employment would increase initially, but by 2026, “924,000 jobs would be lost, gross state products would be $93 billion lower, and business output would be $148 billion less” if the AHCA is passed in its current form. Healthcare was the top job growth sector in 2016, and this would likely reverse that trend.

But it’s not just the healthcare industry that would be impacted, in terms of job loss. Fewer funds for healthcare would also impact jobs in other sectors like construction, retail, and the restaurant industry, says Leighton Ku, health policy professor George Washington University and the lead author of the report. Ku notes that while much of the media attention around the AHCA has focused on the 23 million fewer people who will have insurance in 2026, the bill will also have ripple effects throughout the economy, affecting many more people in less-than-obvious ways.

“It’s the leading growth area in the economy,” says Ku. “It’s not as though you can pretend that taking away funding from health doesn’t take away jobs.”

For example, Ku notes that if a hospital has less funding, it may put off a construction project that then hurts the company it has a contract with. “Construction workers then have less money to go to the shopping mall,” he says.

The report details how the AHCA will change federal funds directed to the states and Washington D.C. over the next decade, based on the CBO score of the House bill, and estimates how those changes in federal funds will affect state economies. It finds that the states that expanded Medicaid coverage under the ACA will see the most job losses, as they will face the steepest funding cuts.

The authors note that the AHCA’s repeal of certain taxes— such as Medicare-related taxes, the Cadillac tax, or the medical device tax—would actually boost employment in 2018, which is in line with other reports on the effects of the AHCA; coupled with the coverage losses, however, the net effect is a decrease in employment opportunities and economic output.

For a sample of how many jobs different states would likely lose, check out the map below:

Source: L. Ku, E. Steinmetz, E. Brantley et al., The American Health Care Act: Economic and Employment Consequences for States, The Commonwealth Fund, June 2017.
courtesy of The Commonwealth Fund

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