It’s hard to get a handle on the ugly, smoggy implications of this nation’s dependence on fossil fuel-burning cars. Deaths from pollution and climate change tend to pile up slowly, in asthma attacks, flood fatalities, and respiratory illnesses. But you, me, the kids, the politicians—everyone is suffering the effects of passenger car-related pollution.

According to a new report from the American Lung Association of California, cars are responsible for $37 billion in health and climate costs each year.

That's just for California, Connecticut, Maine, Maryland, Massachusetts, New Jersey, New York, Oregon, Rhode Island, and Vermont—the 10 states that have zero emission vehicle sales programs. The price tag includes the economic costs of 220,000 days of missed work, 109,000 asthma-related attacks, and 2,580 premature deaths per annum.

Even if you don't have asthma, you're getting hit: The report estimates that every tank of gasoline you combust adds $18.42 to public health and climate bills—bills your taxes pay off.

Fortunately, the policy/lung specialists can imagine a rosier future, if those states get even more into electricity. The report estimates that if, by 2050, EVs account for 100 percent of new sales and about 65 percent of cars on the road, health- and climate-related costs will drop by $21 billion, to $15.7 billion. If the states get real aggressive and move away from the current coal-tinged grid toward 100 percent renewable energy, those benefits could climb by 40 percent.

"I think people haven’t been used to factoring health and climate into the daily choices they’re making," says Bonnie Holmes-Gen, the American Lung Association of California’s senior director of air quality and climate change. "We’ve quantified the hidden costs."

The Future: Electric Boogaloo

The lung folks timed the release of the report to influence the EPA, the National Highway Traffic Safety Administration, and the California Air Resources Board, which are working on a midterm review of the country's corporate average fuel economy (CAFE) and greenhouse gas emissions standards.

By April 2018, these agencies will decide whether to tighten or loosen these standards, which have an enormous impact on the sorts of cars automakers decide to produce.

A technical report released this summer found that automakers won’t hit their fuel economy target of 54.5 mpg by 2025 unless regulations get more hardcore, so that’s what industry busybodies expect to happen. Stricter standards would be great news for the electric vehicle sector, which would hardly exist if it weren't for the rules already in place.

Now, there are lots of reasons to buy an EV. On top of keeping the air clean, they're fun—silent, zippy, and, thanks to Tesla, cool. But sales have stalled.

It’s not that people hate the idea of electric cars. A recent survey by the Union of Concerned Scientists and Consumers Union found more than half of California drivers are likely to consider an electric car during their next big vehicle purchase. 55 percent of Northeast drivers are interested, and 43 percent would be able to depend on an electric car for their driving needs—even given the vehicles' current range and infrastructure shortcomings.

But even with substantial, California-sized subsidies, new and up-to-date EVs are still out of reach for those who buy on the secondary market. Finding a charging station can be a bear, though the network is expanding. Batteries are yet to match Americans’ spiritual connection to the road trip, though you can now get 240 miles of charge in the $30,000 Chevy Bolt EV.

While the tech gets better and better, the American Lung Association report argues, governments seriously interested in stalling climate change and healthcare costs will have to do more than put a finger on the scale—they'll have to climb onto the dang thing. That's why the group's policymakers suggest officials stay the course with EV perks like HOV lane access, support the construction of more robust, electric-friendly infrastructure, and extend electric vehicle tax credits. Because if the health and climate stuff doesn’t get you, maybe a glance at your checking account will.