Repealing President Barack Obama’s healthcare overhaul would increase the federal budget deficit by $353 billion over the next decade, the Congressional Budget Office said.

Ending the Patient Protection and Affordable Care Act would increase spending on Medicare while reducing outlays for health- insurance subsidies, Medicaid and coverage for poor children, the agency said in a report Friday. Repealing the law would probably boost the economy as more people sought work to get health insurance, reducing the net cost to $137 billion, the CBO said.

The report is a blow for Republican lawmakers who have sought to repeal and replace the Affordable Care Act ever since its passage in 2010. If the law were undone, about 19 million more people would become uninsured in 2016, rising to 24 million by 2025, the CBO said.

“An end to the ACA’s subsidies for health insurance coverage would generate gross savings,” the CBO said in its report. “The net savings from repealing the law’s coverage provisions would increase more slowly than the net costs of repealing the act’s other provisions.”

Congressional Republicans replaced the former director of the CBO, Douglas Elmendorf, earlier this year with Keith Hall, a former official under President George W. Bush. Elmendorf, who had been appointed to the budget office by Democrats, estimated in July 2012 that repealing Obamacare would cost about $109 billion through 2022, without including broader effects on the economy.