Obamacare's Value Based Purchasing penalizes Hospitals serving the poor and indigent much harder than others. So just as Obamacare is steering Americans into Medicaid programs, it's also putting more financial pressure on institutions serving the poor.
Here's New York World on the toll Obamacare's taking in New York City,
The pain will also be felt acutely in the city's public hospitals, all but one of which was penalized. Last year, according to the New York City Independent Budget Office, New York City's Health and Hospitals Corporation's facilities anticipated $777 million in Medicare revenue for 2013. Collectively, their penalties could cost the city millions of dollars in federal funds.
Brooklyn's hospitals also fared poorly: 10 out of the 13 institutions there will see reduced Medicare payments.