Almost 3 million jobs could be lost if Congress repeals important provisions of the Affordable Care Act, according to a study put out by the Commonwealth Fund and George Washington University. 

The study from the Commonwealth Fund and the Milken Institute examines the fallout from eliminating two ACA provisions through budget reconciliation. The first are the subsidies — in the form of premium tax credits — given to individuals with low to moderate income to purchase coverage in the health insurance marketplaces, or exchanges. The second are federal payments to the 31 states and the District of Columbia that have expanded their Medicaid programs under the ACA. Eliminating both these provisions would reduce federal spending by $140 billion in 2019, and by $807 billion through 2023.

Recent studies, such as one from the Urban Institute, have found that repealing portions of the ACA like these without any replacement plan could double the number of uninsured Americans (the law has extended coverage to some 20 million Americans). However, the Milken-Commonwealth study reports that a massive reduction in federal spending also would ripple through the economy, beginning with insurers and healthcare providers and continuing into other sectors. An estimated 2.6 million Americans would lose their jobs in 2019 if premium tax credits and federal funding for Medicaid expansion disappeared, according to the study.

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