You’ll hear a lot of ideas for spending taxpayer money during election seasons. As the battle over clean-air regulations continues, automakers and campaign donors get involved. Naturally, electric vehicles enter this discussion at various points. Is it worth taxpayer money to subsidize EV purchases? According to a study by the American Lung Association, we are deciding whether to pay for EVs now or lose lives and pay billions more in health costs later.

The equation is remarkably simple. Currently, the 10 states participating in California’s zero-emissions vehicle (ZEV) program spend $37 billion on annual health and climate costs. If those 10 states met their lofty ZEV goals by 2050, the costs would shrink to $16 billion.

Savings in climate costs ($1 billion) hardly project to drop. However, costs associated with premature death, hospitalization, and lost productivity would fall $21 billion in the coming decades. States like California ($13.5 billion) and New York ($7.1 billion) would save the most by seeing through clean-air measures.

Gasoline vehicles’ impact on public health is staggering.

Gasoline’s toll in human terms

The American Lung Association data puts the impact in very human terms. If states followed the ZEV guidelines, the 10 states could boast the following by 2050:

• 6,370 fewer asthma attacks;
• 194,908 fewer work-loss days;
• 2,246 fewer premature deaths;
• 1,625 fewer ER/hospitalizations; and
• 1,629 fewer heart attacks.

Many countries around the world have confronted serious smog problems in recent years. In late 2015, Chinese officials declared a “red alert” for air quality when smog got so bad in the largest cities. The government said residents should stay indoors rather than breathe polluted air.

Closer to home, pollution levels in Mexico City forced officials to declare bans on driving certain days of the month beginning in March 2016. Statistics released later that summer showed as many as 20,000 people died every year in Mexico due to air pollution.

While state and federal officials in the U.S. may not like to frame transportation issues in such stark terms, budget decisions in the coming decade have life-or-death implications.

Getting more EVs on the road

Considering the data presented pertains to only 10 U.S. states, the number of premature deaths and illnesses we could prevent may be five times greater than the figures presented by the American Lung Association. Reaching the goals set by California’s Air Resources board (CARB) requires a major ramp-up in low- and zero-emissions vehicles in the coming years. Without adjustments to the current mandate, 3.3 million electric cars would need to join the passenger fleet by 2025.

While California will struggle to meet its goals of 1.5 million ZEVs in the next decade, East Coast states lag well behind the pace. To get closer, the American Lung Association suggests (as do most EV researchers) better outreach from public officials, better charging infrastructure, and more purchase incentives. The loss of the EV incentive in Georgia in 2015 led to a swift decline in plug-in sales almost immediately.

Will it be worth it to Georgia politicians who hoped to cut costs and score political points? All the available data says no. The federal government faces the same challenge in the coming years when the federal tax credit ends for automakers like GM and Tesla, effectively raising the price for plug-ins just as their growth accelerates.

In this case, the government has every right to “pick winners and losers.” It is both the right thing to do for public health and the fiscally responsible thing to do with taxpayer money. There are many issues on the ballot every election. Remember what’s behind the debate about electric vehicle incentives.

Connect with Eric on Twitter @EricSchaalNY