Hospitals nationwide could lose half a billion dollars in federal funding meant to offset the cost of covering the uninsured next year. The loss that will be especially felt in states where lawmakers have decided against expanding Medicaid coverage.

According to rough estimates released Monday by federal health officials, cuts could jump to $4 billion in 2020,

Hospitals around the country that treat a large number of uninsured residents rely on federal funds to offset costs. But the Affordable Care Act assumes more residents will have health insurance and that hospitals will treat a smaller number of uninsured patients.