A new report from the Commonwealth Fund and the George Washington University Milken Institute School of Public Health finds that if Congress allows enhanced premium tax credits to expire at the end of 2025, communities nationwide will experience significant economic repercussions.

The report projects that hundreds of thousands of jobs — many in the health care sector — would be lost, state economies would shrink by billions of dollars, and more than $2 billion in state and local tax revenue would disappear as people become uninsured and health insurers and health care providers lose revenue. All told, states would lose $26.1 billion in federal health insurance subsidies in 2026 alone, triggering widespread economic disruptions that would compound over time.

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