The American Health Care Act (AHCA) passed the U.S. House of Representatives on May 4, 2017, and is now under debate in the Senate. The bill would eliminate much of the Affordable Care Act. In this report, we present state-by-state estimates of the impact of the AHCA on health care coverage and costs. Nationwide, we find that there would be 23 million more uninsured people under the AHCA by 2022. Federal funding for Medicaid, premium tax credits, and cost sharing reductions would be $130.4 billion lower under the AHCA in 2022, while state Medicaid spending would increase by $1.2 billion.