A new analysis from Goldman Sachs said that 500,000 of the jobs added to the healthcare sector since 2012 can be attributed to the Affordable Care Act (ACA)’s increasing of health insurance coverage.

The ACA has been credited with dropping the uninsured rate to its lowest level ever, hitting 8.8 percent through the first nine months of 2016, while simultaneously accelerating the spread of narrow networks and high-deductible health plans.

The nationwide increase in insurance coverage explained about 40 percent of the sector’s overall job growth in the past five years, according to Goldman. Based on its projection, for every 1 percentage point increase in insurance coverage, there was an associated increase in healthcare employment and healthcare consumption of 0.6 of a percentage point.

Those gains in coverage could be erased by a variety of plans to repeal and replace the ACA, and in turn reverse the increased employment.

“Substantial decline in insurance coverage would also likely be associated with a drag on health care employment and health care consumption,” the report said.

A January 2017 report from the Commonwealth Fund estimated the employment gains could be erased and then some depending on what parts of the law are changed. If both subsidies for buying health insurance and the expanded eligibility for Medicaid are eliminated, more than 1 million healthcare jobs could be lost by 2023.

Estimated losses were smaller if only the subsidies were axed (369,000 healthcare jobs would be lost in 2019) or if the Medicaid expansion were rolled back on its own (543,000 healthcare jobs).