Health

If the Affordable Care Act is repealed without a plan to replace it, Kentucky stands to lose 45,000 jobs. That’s according to a new report from the Commonwealth Fund, a nonpartisan health research group.

The state would also lose $700 million in state and local taxes, according to the report.

The estimated number of jobs lost is based on the current repeal plan in Congress that would immediately do away with the employer and individual mandate. In 2019, Medicaid expansion and tax subsidies to buy coverage on the individual market would also go away.

Because Republicans are still deciding on a replacement plan, the impact of what that might be wasn’t calculated for the report.

As reported by NPR, a poll released Friday by the Kaiser Family Foundation shows that 75 percent of Americans say they either want lawmakers to leave the ACA alone, or repeal it only when they can replace it with a new health care law.

The bulk of the jobs would be lost in areas where there are heavy concentrations of hospitals and other health care companies, like Louisville. That’s according to Leighton Ku, director of the Center for Health Policy Research at The George Washington University and lead author on the report.

“Congress has said they want pro-growth policies, and one of the first items on the agenda isn’t pro-growth at all and it’s at risk of having serious adverse affects for state economies and state budgets,” Ku said.

More than $23 billion is coming into the state via funds from the federal government to pay for Medicaid expansion enrollees’ care and for tax subsidies so people can get insurance on the exchange market.

Ku and his team used a model to trace where that federal money goes first and found hospitals, pharmacies, doctor’s offices and insurance companies are the first place it ends up. But then purchases are made for medical equipment, new construction, renovations and most of all, to pay employees.

“That flows to the employee, and they buy food, pay for housing, and the same thing happens when money goes to another business: the money trickles through the economy,” Ku said. “Because this is much a broad, sweeping law and it affects so much money, the repercussions are much broader.”

One-third of the jobs lost would be positions in health care. Here’s a breakdown of where the other job losses would come from, according to the report.

  • 6,000 retail jobs
  • 4,600 construction and real estate jobs
  • 13,500 other private employer jobs
  • 2,000 finance/insurance jobs
  • 1,400 state/local government jobs
Lisa Gillespie is WFPL's Health and Innovation Reporter.