How the AHCA could affect jobs in your state, mapped

The American Health Care Act (AHCA) could eliminate nearly one million jobs over the next decade—and three-quarters would be in health care, according to a new report from the Commonwealth Fund.

What does health care reform beyond the ACA look like? Join our new webconference series

The House approved the AHCA, which aims to repeal and replace large portions of the Affordable Care Act (ACA), in early May. The Senate is currently considering the measure.  

For the report, researchers projected changes in federal spending and revenue for each state for the period spanning 2018 to 2026. The researchers also projected estimated employment levels, state economic growth, and state business output under the AHCA as currently written.

Short-term gains, long-term losses, report says

The researchers projected that at the outset, the AHCA would stimulate the economy and boost employment in certain sectors by repealing certain taxes and increasing government spending. But over time, the bill would negatively affect the economy, reducing financial assistance for individuals to purchase health insurance.

Everything you need to know about the AHCA

Gross state product by 2026 would be $93 billion lower under the AHCA than it would be under current law, while business output would drop by $148 billion by 2026, the researchers said.

Moreover, according to the researchers, states that expanded Medicaid under the ACA would see bigger and faster economic declines than states that did not expand the program, though non-expansion states would experience losses as well.

In terms of job loss, the researchers projected that the AHCA would initially boost employment in many sectors, adding a projected 864,000 jobs in 2018. However, those gains would eventually be lost, and the bill by 2026 would ultimately eliminate 924,000 jobs. Moreover, the losses for the health care sector, according to the researchers, would begin immediately.

Specifically, the health care sector would lose an estimated 24,000 jobs in 2018, declining over time to an estimated 725,000 by 2026. According to the researchers, New York by 2026 would lose the most jobs of any state—86,100 total, with 61,800 coming from health care—followed by Pennsylvania, projected to lose 84,900 jobs, of which 52,500 would be in health care.

However, despite the overall projected job loss, the researchers said four states would see small job growth:

• Colorado;
• Hawaii;
• Utah; and
• Washington.

The researchers wrote that "the AHCA could accentuate job loss and economic contraction." They continued, "Combined with major increases in the number of uninsured, this could contribute to a period of economic and medical hardship in the United States," adding, "it may be more useful to develop countercyclical policies that strengthen employment and the economy during times of contraction" (Rappleye, Becker's Hospital Review, 6/15; Commonwealth Fund report, June 2017).