Georgia hospitals were hoping an expansion of the Medicaid program sought by President Barack Obama's administration would ease their costs for treating hundreds of thousands of uninsured patients annually.
The U.S. Supreme Court upheld the requirement that individuals buy health insurance or pay a fine, a central part of the health care overhaul.
But the ruling said states are free to decide whether they want to expand their Medicaid program, the government-run health care program for the poor. Previously, states that did not participate could have lost federal Medicaid funding.
The Atlanta Journal-Constitution reports that not expanding the law would mean hospitals would have to treat as many uninsured patients while absorbing cuts in government-funded health care programs.