This week, as the Senate considered legislation to repeal the Affordable Care Act, the White House declared “Energy Week” and is touting its efforts to promote fossil fuels. Despite the apparent disconnect, health and energy policy have something important in common: In each area, Trump is pressing policies that would kill tens of thousands of Americans each year. It’s fitting to discuss them together.

During the original debate over ObamaCare, researchers at Harvard Medical School published a staggering finding: Each year, 45,000 people died prematurely in the U.S. due to the lack of health insurance. This study formed part of the moral basis for extending health insurance to millions of Americans. Now, as congressional Republicans work to undo that law, we are rightfully reminded of similar stakes. “There will be deaths,” said Atul Gawande, discussing a literature review he recently published. Gawande and his colleagues found that roughly one life is saved for every 300 to 800 people who get insurance. The Harvard researchers have updated their study, and they estimate that if 22 million Americans lose health insurance, 29,000 additional people will die each year.

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Shocking as these figures are, the body count from Trump’s energy policy could easily rival them. A 2013 study found that air pollution causes 200,000 premature U.S. deaths each year. If air pollution were a proximate cause of death, it would occupy the third position on the Centers for Disease Control and Prevention’s list of leading causes. Instead, it contributes to four of the top five: heart disease, cancer, chronic lower respiratory disease, and stroke (accidents rank fourth).

The estimate of 200,000 deaths is based on one type of air pollution, ground-level ozone and particulate matter from burning fossil fuels, commonly known as smog. It does not include deaths from greenhouse gas pollution, which are growing in number. A recent study found that 30 percent of people worldwide are already subject to lethal heat waves for at least 20 days a year. By 2100 the number will rise to 74 percent. In addition to dangerous heat and sea-level rise, climate change threatens a combination of economic loss, starvation, disease, mass migration, and violence that could prove catastrophic and destabilizing even for developed nations as soon as the second half of this century.

Far from mitigating these harms, the Trump administration and congressional Republicans are working to exacerbate them. They are rolling back air pollution rules, particularly those affecting the two leading culprits: automobiles and power plants. Trump is also trying to boost fossil fuel production and reverse virtually every federal program that supports renewable energy, combats climate change, or merely contributes to our knowledge on those topics.

What is most surprising about killing ourselves with fossil fuels is that we get so little in return. With existing technology, we could phase them out within 20 years, if not sooner. Researchers disagree whether existing technology can get us all the way to 100 percent renewable energy. But virtually all agree we can get very close, which means we can launch the effort now with confidence that we’ll solve the remaining problems along the way. Experts also agree that it won’t cost much. Rather, it would quickly start paying for itself. We would save not only the $875 billion that Americans currently spend on fossil fuels each year, but also several hundred billion more in annual medical costs.

Which returns us to the other Republican obsession—repealing ObamaCare. Far from cutting existing health coverage, we could easily expand it with the money we waste on fossil fuels. And we would need less medical care in the first place.

Unquestionably, we should ensure that all Americans have access to high-quality care. We should also stop poisoning ourselves.

David Arkush is Managing Director of Public Citizen’s Climate Program

The views expressed by this author are their own and are not the views of The Hill.