The Better Care Reconciliation Act (BCRA) would eliminate one of every 22 healthcare jobs by 2026, according to a new study from George Washington University’s Milken Institute School of Public Health and the Commonwealth Fund.
The losses across all industries would total 1.45 million jobs, about 50 percent greater than estimates under the American Health Care Act (AHCA), the Affordable Care Act (ACA) replacement passed by the House in May.
“Although the Congressional Budget Office found that both the Senate and House bills had similar effects in increasing the number of uninsured, our analysis indicates that the Senate bill has the potential to be more damaging to states’ economies,” said Leighton Ku, PhD, director of Milken’s center for health policy research and the study’s lead author.
Outside of healthcare, the initial impact would be a rise in employment, with 753,000 jobs added in 2018. Within healthcare, however, there would be immediate job losses of 30,000, thanks to the estimated 15 million more people who would be uninsured under the BCRA. Losses would rise to 347,000 jobs by 2020, when the report said the reduction in federal funding for coverage would exceed the benefits of repealing ACA taxes.
“The reductions directly affect the health sector—hospitals, doctors’ offices, or pharmacies—but then flow out to other sectors,” the report said.
States which would see the worst job losses in their healthcare sectors would be California (95,300), New York (81,300) and Pennsylvania (62,800). Losses would be less severe in states which didn’t expand Medicaid eligibility, like Texas, which would initially add jobs in healthcare (8,600 more jobs by 2019) before losses begin in 2020, with 40,300 healthcare jobs lost by 2026.
Like the earlier AHCA estimates, some states would be see greater immediate job losses because of state laws which automatically cancel expanded Medicaid eligibility if the federal matching rates change. Michigan and Illinois would see the biggest job losses in 2018 if the BCRA became law, but at smaller amounts than under the AHCA.
Healthcare employment has been a principal area of growth in recent years, so the law would be a “major reversal” of those trends. This could have a significant impact on the national unemployment rate, the report said, with its effects being amplified if the country enters another economic downturn.
“Combined with major increases in the number of uninsured, this could contribute to a period of economic and medical hardship in the U.S.,” the report concluded. “The BCRA could distort both the highs and lows of the business cycle.”