For many Americans, the debate over repealing and replacing the Affordable Care Act (ACA) isn’t about political maneuvering or vote counting. For families, it’s about whether they will still have health coverage after the dust settles, and whether they will still be able to afford their prescription medications. For health care providers, it’s about being able to serve all the patients in their community without being overwhelmed by the costs of uncompensated care. For states, it’s also about preserving jobs and businesses, as well as having the resources needed to address the opioid crisis and other public health emergencies.

For nearly a century, The Commonwealth Fund has been evaluating policies and proposals with an eye toward whether or not they make it easier for more Americans to get high-quality health care.

Through work we’ve supported, we can project the impact that proposed changes, such as those in the American Health Care Act (the House bill) and the Better Care Reconciliation Act (the Senate bill) may have on people’s health care and on state economies. While any policy’s precise impact will vary greatly from state to state, the data on these two bills’ effects are pretty compelling. Click a state below to view a fact sheet with more information.

In particular, the projected impact of ACA repeal on state budgets and the overall job market highlight just how critical the health care sector is to the nation’s economy. The evidence reminds us to examine any changes under consideration for unintended consequences.

Other Commonwealth Fund research, including our long-running biennial health insurance survey, shows that people with Medicaid coverage are less likely to have cost-related problems accessing health care and enjoy more financial protections than are many Americans with private insurance.

From covering the majority of births to covering the bulk of long-term care provided at the end of life, Medicaid is inextricably woven into the fabric of the U.S. health care system. Click a state below to view a Medicaid fact sheet with more information.

All this research underlines the critical importance of grounding any plan to restructure U.S. health care in objective evidence. And it shows why proposed changes must be designed from the start to make the U.S. health care system work better for everyone.