Although a $400,000 loss in Medicaid reimbursements is expected at Neshoba County General Hospital due to the Affordable Care Act, officials hope to generate additional revenue by providing new services such as sleep study, wound care and pain management to help offset the cuts.

"We know it will be $400,000 this fiscal year in reimbursements and we will be absorbing that into our operation because we have been profitable," said Neshoba General CEO Lonnie Graeber.

"As this continues, annually, because it is going to be compounding, there will be steps to address continued cuts in various ways. We are trying to increase revenue by providing new services like pain and wound care to overcome some of the loss."

The cuts this year won't have a major impact on Neshoba General, Graeber said, raising concerns about the future.

"At this point, what we are attempting to do is start new programs that we project will be profitable," he said.

Graeber said Obamacare was designed for additional people to be covered by health insurance and for Medicaid to be provided for those of lower income.

Gov. Phil Bryant has chastised state lawmakers who tried last year pressuring him into expanding the Medicaid system.

Expansion will eventually bankrupt the state when federal startup funding ends, some lawmakers like House Speaker Philip Gunn have said.

"For us to enter into an expansion program would be a fool's errand," Bryant told The Associated Press in a December interview.

He also raised the concern - which has been echoed by other Republican governors - that states could be left with the tab if the federal government isn't able to keep its promises on funding the expansion.

"I mean, here we would be saying to 300,000 Mississippians, 'We're going to provide Medicaid coverage to you,' and then the federal government through Congress or through the Senate, would do away with or alter the Affordable Care Act, and then we have no way to pay that. We have no way to continue the coverage."

Graeber told supervisors earlier this year that the hospital projects an unaudited profit of $6.2 million for fiscal year 2013.

He announced at that time that the Board of Trustees had purchased the adjoining Four Seasons property with plans to construct an outpatient rehabilitation facility.

Graeber said the hospital would take possession of the property in April after Four Seasons relocates to another site.

He told supervisors that FY 2013 was a "tremendous year" for the hospital and nursing home, noting that a good portion of the $6.2 million profit was from the upper payment limit program that defines the maximum reimbursement a state can pay to a class of providers for Medicaid services.

About 644,000 of Mississippi's nearly 3 million residents already are enrolled in Medicaid.

Medicaid expansion would add another 200,000 to 300,000.

Mississippi is among 25 states that have chosen not to expand Medicaid or are still debating it after a U.S. Supreme Court ruling said the federal government couldn't force the state to expand.

Hospitals in the holdout states still have to treat the poor, but they will get less money for doing it.

- The Associated Press contributed to this story.