I believe this is true. Before the ACA hospitals absorbed millions of dollars in unreimbursed care for uninsured patients. Under the ACA, they got paid, even if the amounts weren't large. Gutting Medical Assistance will be putting many of them out of business.  People without regular health care because of affordability, enter the system with much poorer health and more complex conditions. This is one reason the insurance companies are pulling out of Obama care;  so many people entered the system and had many needs. Surprise, surprise.  The Republicans answer to this is to get rid of covered preventive care, without copays.  A lousy plan any way you look at it.