On Friday, the federal government released the Fourth National Climate Assessment, a report on the state of climate change. On Monday, President Trump rejected the report’s findings. The report’s authors, representing 13 federal agencies and hundreds of scientists, “say [the] economic impact could be devastating,” a reporter told the president. “Yeah,” Trump replied. “I don’t believe it.” On Tuesday, White House press secretary Sarah Huckabee Sanders brushed off the report. “It’s not based on facts,” she asserted. “It’s based on modeling.”

Trump and Sanders are repeating an old Republican talking point: that coal jobs and oil sales are real, but climate change is just speculation. But that’s no longer true. We’ve procrastinated about climate change for so long that it’s no longer hypothetical. It’s happening. And it’s hitting Americans in their pocketbooks, especially in Trump country.

The report calculates that by 2090, under present trends, climate change will cost the United States more than $500 billion every year in lost wages, heat fatalities, flooding, coastal property loss, road damage, electrical strain, and other expenses. That’s roughly the annual cost of Medicare or national defense. But this damage isn’t speculative. The report shows it’s well underway.

To start with, we’re cooking ourselves. The Southwest has broken regional heat records in five of the past six years. Southeastern states are leading the country in occupational heat-related deaths, and in 61 percent of Southeastern cities, heat waves have intensified. By 2090, under present trends, outdoor heat in the Southeast will cost workers $47 billion in annual lost wages. Temperatures in Phoenix will reach triple digits 150 days a year. Buckling roads have already cost Texas millions of dollars. The national cost of road repairs due to heat and water damage is creeping into the billions.

In the West, we’re burning. “Human-caused climate change is estimated to have doubled the area of forest burned in the western United States from 1984 to 2015,” says the report. In 2015, wildfires incinerated a record 10 million acres, including 5 million in Alaska and more than a million in Montana. Thousands of homes burned in California, Colorado, and other states. The damage runs into the billions, as does annual federal spending on wildfire control. “By the middle of this century,” the report warns, “the annual area burned in the western United States could increase 2–6 times from the present.”

In the heartland, we’re parching the earth. Climate change has dried out soil across the country. A 2017 drought caused $2.5 billion in damage. A 2015 drought cost twice that. A 2012 drought cost $33 billion, destroying crops across the Plains and the Midwest. Livestock losses from heat stress are approaching $2 billion per year. The report says major portions of the Ogallala Aquifer, a huge area that stretches from South Dakota to Texas—and covers states that produce one-fifth of the country’s corn, cotton, and wheat—“should now be considered a nonrenewable resource.”

In the South and Southeast, we’re flooding. On average, sea levels have risen 3 inches since 1990, more than twice the rate of the previous century. But thanks to subsidence, parts of the Southeast have lost 1 to 3 feet of elevation, relative to sea level, in the past century. In Texas, sea level has risen as much as 17 inches relative to the coast, and nearly $10 billion in property now sits within a 5-foot reach of high tide. In Florida, the portfolio of property at risk is even bigger. The report documents increased flooding from Florida to Virginia. “Annual occurrences of high tide coastal flooding have increased 5- to 10-fold since the 1960s in several low-lying coastal cities in the Southeast,” says the report. In fact, “flooding occurrences increased more than 50% in 2015 compared to 2014.”

It’s not just the sea level that’s changing. It’s the rain. The last three decades are the most torrential on record, and extreme rainfall is becoming more pervasive. “Across the Southeast since 2014, there have been numerous examples of intense rainfall events—many approaching levels that would be expected to occur only once every 500 years,” says the report. Massive downpours caused $2 billion in damage in South Carolina in 2015 and $10 billion in Louisiana a year later. From 2015 to 2017, floods in Texas broke records.

Warmer water is also feeding hurricanes. In 2016, Hurricane Matthew caused $10 billion in damage, mostly in the Carolinas. In 2017, Hurricane Irma caused $50 billion in damage, mostly in Florida. Hurricane Harvey smashed rainfall records, drowning Houston and shutting down much of the energy industry. “The 2017 Atlantic Hurricane season alone is estimated to have caused more than $250 billion in damages,” says the report. “Based on past trends and recent sea surface temperatures, the heaviest rainfall amounts from intense storms such as Harvey are about 5%–7% greater now than what they would have been a century ago.”

These aren’t hypotheticals. They’re facts. Last year, the United States suffered more than $300 billion in damage from weather disasters, breaking the previous record by more than 40 percent. Nearly $1.5 trillion in real estate sits within an eighth of a mile of the coast, and rising tides are beginning to claim it. “There are already indications in places like Atlantic City, New Jersey, and Norfolk, Virginia, that homes subject to recurring flooding may become unsellable,” says the report. “Risk portfolios in the housing finance, municipal bond, and insurance industries may need to be adjusted.”

You’re paying for all of this. You pay for federal flood insurance, which covered losses from the 2017 hurricanes. You pay for federal crop insurance, which shelled out nearly $15 billion to farmers in the 2012 drought. You pay for billions of dollars in federal outlays to control wildfires and coastal erosion. You’ll pay billions more to upgrade electrical grids and elevate ports as the heat grows and the oceans rise.

So when Trump says, “I don’t believe it,” he’s not puncturing a fantasy. He’s telling you not to believe what’s happening right in front of you. He’s turning his back as heat, fires, droughts, and floods destroy lives and livelihoods. When your taxes, electrical bills, and insurance premiums go up, that’s climate change. When you turn on your TV and see homes burning or families wading through streets, that’s climate change. It’s killing people and gutting communities. But it’s not bothering Donald Trump.