KY Policy Blog

Eastern Kentucky Would Be Hardest Hit Place in Country by Job Loss from ACA Repeal, Report Says

By Dustin Pugel
March 30, 2017

The House proposal to repeal the Affordable Care Act (ACA) died last Friday, but House leaders say they hope to regroup and try again. Kentucky and especially eastern Kentucky would experience major job loss if the House ends up passing legislation like it considered last week, according to a report released in the midst of the debate.

Stripping away the Medicaid expansion, capping traditional Medicaid funding and rolling back the marketplace subsidies would cost jobs by taking federal dollars out of doctors’ offices, hospitals and local economies. The analysis by the Economic Policy Institute (EPI) using the specifics from the now-failed ACA repeal bill estimates that Kentucky would face potential loss of more than 85,000 jobs from the bill by 2022 – 2.2 percent of all jobs in the state. This constitutes the biggest share of state-wide job losses of any state but New Mexico.

EPI’s analysis also breaks down the potential job losses by congressional district. At over 20,000 jobs, the 5th district in eastern Kentucky, represented in Congress by Hal Rogers, would lose more jobs than any other district in the country. The number of potential lost jobs for the 5th district is approximately double the 10,000 coal jobs eastern Kentucky has lost since 2011. That scale of lost jobs would be crushing for a region that already has the 6th-highest poverty rate of all 435 congressional districts.

It’s also worth noting that Kentucky’s 1st congressional district in western Kentucky, represented by James Comer, would potentially lose the 8th largest number of jobs among the nation’s districts.


The Affordable Care Act resulted in billions of federal dollars flowing in Kentucky, especially through the Medicaid expansion. That not only cut our uninsured rate in more than half, but created jobs and boosted our economy. All of that plus the real health and economic security gains Kentuckians are experiencing would be at risk if Washington revives a repeal effort. Kentucky, and especially eastern Kentucky, would be the epicenter of the harm.

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