Repealing the Affordable Care Act’s federal premium tax credits and Medicaid expansion to low-income adults in 2019 would result in a $140 billion cut in federal funding for health care and 2.9 million job losses that year, according to a report from the Milken Institute School of Public Health at George Washington University and The Commonwealth Fund. “If replacement policies are not in position, state economic losses will rise,” the report adds. “From 2019 to 2023, there will be a cumulative $1.5 trillion loss in gross state products and a $2.6 trillion reduction in business output (combined transactions at the production, wholesale and retail levels). State and local taxes also will fall during this period, dropping by $48 billion.” The federal premium tax credits help low- and moderate-income Americans purchase coverage in the health insurance marketplaces. The federal government also covers most of the cost of covering newly eligible adults for states that expand Medicaid eligibility.