A report from George Washington University shows the county-by-county impact of the decision by Gov. Pat McCrory and fellow Republican legislators against expanding Medicaid in North Carolina – and the news is not good.

“North Carolina has a higher-than-average uninsurance level compared to other states in the country,” said Leighton Ku of the Public Health School at George Washington University in Washington, D.C. “And part of the reason is because North Carolina has particularly low eligibility for Medicaid, really, in the bottom quarter of the country – lower, even, than in your neighboring states.”

Ku is the lead author of the recent Medicaid study, in conjunction with North Carolina organizations the Cone Health Foundation and the Kate B. Reynolds Charitable Trust.

“Because North Carolina did not expand Medicaid at the beginning of this year, 2014, when it first became possible, and when more than half the states in the country did so, North Carolina’s already lost thousands of jobs, and lost billions of dollars,” said Ku.

According to the report, North Carolina lost $2.7 billion, and stands to lose $3.3 billion more next year.

Ku said that if the Republican-led state legislature has a change of heart and begins expanding Medicaid, starting in 2016, it would bring in more than $20 billion in federal matching funds through 2020.

He said that would create more than 43,000 jobs statewide, and increase business activity by around $21 billion.

And more than half a million North Carolinians would get health insurance coverage.

The research also breaks down the impact of McCrory’s decision in each of North Carolina’s 100 counties, and shows the possible benefits of reversing that decision.

“We found that more than 5,000 people would get health insurance coverage if Medicaid was expanded,” said Ku. “We estimated that there would be around 726 new jobs by 2020 for people, so that would increase the employment rate and decrease unemployment.

“And business activity in the county would surge by about $400 million over the next five years.”

You can find a link to the full report here.