If proposed Republican budget cuts to Medicaid and SNAP move forward, Colorado could lose 14,000 jobs and shrink the GDP by nearly $1.6 billion next year, according to a recent study.

Conducted by the Commonwealth Fund and George Washington University Milken Institute School of Public Health, the study examined what it described as far-reaching impact the proposed cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP) could have in a state-by-state analysis.

The Commonwealth Fund has claimed credit in helping lay the groundwork to pass the Affordable Care Act. It also provided grants to groups that supported the expansion of Medicaid under Obamacare.

While U.S. lawmakers have yet to identify where the $880 billion cuts will come from that the House Committee on Energy and Commerce has been tasked to figure out, Republicans pointed out the figure includes everything the committee oversees — not just health care, but also energy, environment and other areas.

Democrats, on the other hand, noted that Medicaid accounts for the lion’s share of spending under the committee’s jurisdiction and that cuts that deep will likely need to come from the nation’s health care safety net for the poor and disabled.

Medicaid spending has grown significantly since the Affordable Care Act — also known as “Obamacare” — expanded eligibility in 2014.

Most Americans have employer-sponsored health insurance.

The ACA was designed to expand health care access to millions of Americans shut out of coverage — particularly in low-wage industries — and to curb escalating health care costs.

The proposed cuts are being weighed against the backdrop of soaring national debt, which has skyrocketed to more than $36 trillion, according to the U.S. Treasury.

The study’s analysis relied on previous Republican proposals that have targeted the Affordable Care Act expansion.

Nationally, the proposed cuts could eliminate 1 million jobs and reduce states’ GDP by $112.6 billion in 2026 alone, according to the study.

SNAP nutrition benefits are not part of Medicaid, but is funded solely by the federal government.

“These cuts, essentially speaking, save some money from the federal government’s perspective,” said Leighton Ku, director of the Center for Health Policy Research and professor of health policy and management at the Milken Institute School of Public Health.

“On the other hand, it’s states and businesses that ultimately pay the price.”

Outlined in the House budget resolution, the proposed cuts would slash funding for the committees overseeing Medicaid and SNAP by more than $1 trillion over the next decade, making both programs likely targets.

While low-income individuals and families are the primary recipients of Medicaid risk losing health care coverage, state governments and healthcare providers would face significant financial losses.

Health care providers would absorb the bulk of the job losses, which could impact services and hours and, in some cases — particularly in rural areas — hospitals could face closure.

“The reality is that this will not be harmless,” Ku said.

Medicaid enrollment is renewed annually but was suspended during the COVID-19 public health emergency, which ended two years ago, triggering what was called an “unwind.” Initially, state officials estimated about 325,000 Coloradans would lose their Medicaid coverage, but nearly 500,000 did.

Officials have said the big reduction is expected, as Colorado was among the states whose Medicaid rolls grew the most during the pandemic. They also pointed to the state’s low unemployment rate, which they said meant not as many Coloradans need Medicaid.

Simon Smith, president and CEO of Clinica Family Health & Wellness in Lafayette, said the unwind has already meant the elimination of more than 100 jobs.

Further cuts, Smith has said, would lead to “an existential crisis.”

“Reductions in Medicaid will lead safety net health care providers across our state to reduce programs and close our doors,” Smith has said. “All this will ultimately lead to more expensive care and worse health in our community.”

In Colorado, roughly 1.1 million people — including nearly 432,000 children — depend on Medicaid.

The U.S. House budget plan aims to cut $880 billion over 10 years from programs overseen by the Energy and Commerce Committee. While “Medicaid” isn’t named in the resolution, many said Republicans would likely need to reduce Medicaid to meet their target, particularly because President Donald Trump has ruled out cuts to Medicare and other “entitlement” programs.

The GOP is weighing policy options, such as work requirements and Medicaid provider fees that would cut federal funding for the program without disrupting enrollee benefits, while Democrats have taken the policy position of defending Medicaid.

Critics argue the ACA’s expansion has meant runaway Medicaid spending for able-bodied adults created a “perverse incentive” that diverts funds from people who need the coverage.

Medicaid is the nation’s health care safety net for the poor and disabled, jointly administered by the federal government and states. Federal funding accounts for about two-thirds of state Medicaid programs. Jointly funded by federal and state governments, Medicaid covers one in five Americans, costing the federal government $618 billion last year, according to the nonpartisan Congressional Budget Office.

Medicaid is the third largest line item after the Medicare program for older Americans and the Social Security retirement program.