Researchers at the Milken Institute School of Public Health say that if the House Republicans’ health care bill becomes law, almost every state in the nation will see an economic downturn.

Nearly one million jobs will be lost by 2026, with states that expanded Medicaid coverage under the Affordable Care Act, known as Obamacare, hardest hit, according to the report released Friday by public health school researchers and The Commonwealth Fund, a private health care foundation.

Researchers found that an estimated 924,000 jobs will disappear nationwide in less than a decade if the American Health Care Act, the House bill to repeal and replace Obamacare, is signed into law. Seven states: Arkansas, Illinois, Indiana, Michigan, New Hampshire, New Mexico and Washington will be able to reverse any expansions because of laws already in place, the report found

Researchers also found that gross state products, a measurement for a region’s economy, could fall by $93 million in less than 10 years.

The Congressional Budget Office already forecasted that 23 million Americans would loose health insurance by 2026 under the AHCA, but the study found the bill would have a gradual, but ultimately drastic impact on the job market.

“The AHCA would initially cause a brief spurt of economic growth from tax cuts, which primarily help those with high incomes,” Leighton Ku, director of the Center for Health Policy Research at the public health school, said in a release. “However, cuts in funding for Medicaid and health subsidies then begin to deepen, triggering sharp job losses and broad disruption of state economies in the following years.”

As early as 2018, 17 states would be affected by low health-sector employment and hospitals, clinics and pharmacies will have to to lay off workers potentially forcing some to close, researchers said.

Sara Collins, vice president for Health Care Coverage and Access at The Commonwealth Fund said the drawbacks of AHCA outweigh the benefits.

“The Affordable Care Act enabled the U.S. to make substantial gains in health insurance coverage and led to nationwide improvements in health care access and affordability for millions of people,” Collins said. “The deep coverage losses projected under the American Health Care Act would be damaging both to the health of Americans and the state economies in which they work.”