In addition to kicking 22 million people off of health insurance by 2026, the Senate Trumpcare bill—the Better Care Reconciliation Act (BCRA)—would also threaten the livelihood of millions and cause an economic downturn in every state in the nation except one.

A recent analysis of the economic consequences of the BCRA by researchers at George Washington University and the Commonwealth Fund found that the Senate Trumpcare plan would lead to a loss of 1.45 million jobs by 2026 and have a devastating impact on state economies. Gross state products (an aggregate measure of state economies) would drop by $162 billion, and business output would be $265 billion lower.

The majority of the job losses—919,000 jobs—would be in the healthcare industry, but there would be a ripple effect that could lead to a loss of half a million jobs in other sectors, including construction and real estate, finance, retail trade, and public employment.

The healthcare industry would take the largest hit, likely because of the deep and dangerous cuts to Medicaid included in the Senate Trumpcare plan. According to the Congressional Budget Office (CBO), the BCRA would cut Medicaid by 26 percent over 10 years—a cut of $770 billion. The cuts, however, would go substantially further over the next 10 years, amounting to a 35 percent cut to Medicaid by 2036. Some of the job losses would also flow from the reduction in the premium tax credits available to help individuals and families purchase affordable health insurance in the marketplaces.

Women, and in particular women of color, would be especially impacted by the projected job losses. Research by the National Women’s Law Center shows that women make up the vast majority of certain health care workers; women make up 88 percent of nursing, psychiatric, and home health aides, 80.3 percent of nursing home and residential care facility employees, 80 percent of ambulatory health care employees, and 76.6 percent of hospital employees. Medicaid creates jobs in all of these areas. The program pays health care providers who hire and pay staff and who purchase goods and services. By gutting Medicaid and capping federal funding, jobs will be lost, hospitals may be forced to close, and states will lose revenue.

Given the magnitude of the cuts to Medicaid, both states that have expanded Medicaid and states that have not will face job losses. The ten states that will experience the worst job losses, according to the George Washington University and Commonwealth Fund study are: New York, California, Pennsylvania, Ohio, Michigan, Florida, Illinois, New Jersey, Massachusetts, and Indiana. Medicaid supports women’s jobs in every state.

Some supporters of the Trumpcare plan have cited creating more flexibility for states as a justification for the dramatic changes to Medicaid. Yet, the conclusion of the George Washington University and Commonwealth Fund study should give lawmakers pause.

“The combination of more uninsured and more unemployed people will increase the demand for social assistance, but weaker state economies and federal reductions in Medicaid spending will make it more difficult for states to respond to those needs,” the authors write. They conclude, “States will confront painful choices between raising taxes or slashing services.”

It is no wonder that the Senate Trumpcare plan is so unpopular. The House Trumpcare plan was the most unpopular piece of major legislation in two decades, and the Senate version—which the authors of the George Washington University and Commonwealth Fund found to have even “harsher” economic consequences than the House version—is no better. A poll released last month by the Kaiser Family Foundation found not only that a majority of the public has an unfavorable view of the Trumpcare plan, but that a majority has a favorable view of the Affordable Care Act (ACA)—which Trumpcare seeks to dismantle—as well as Medicaid, which three-fourths of the public views favorably.

 

Media Resources: The Commonwealth Fund 7/6/17; Business Insider 7/5/17; Kaiser Family Foundation 6/23/17; National Women’s Law Center 6/17

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