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Even state budgets could take a hit.
The sweeping health care laws cover a third of Americans.
Some analysts see a 'fundamental shift' in the system.
The president is courting conservative states to expand Medicaid.
Under the deal reached this week, there will be monthly premiums of at least $1.
Program to move from fee-based to a quality-based payment system.
The report comes a few weeks after a temporary bump in rates ended.
Hospitals could save billions on charity care. But federal cuts are coming.
But it's not clear how much is left to change.
It may be less expensive for states to expand Medicaid than previously estimated.