Some hospitals, such as for example Park Nicollet Health Services near Minneapolis, are cutting back services and personnel already. Even for many individuals who do have insurance coverage under Medicaid or Medicare, some experts say, severe state and federal budget constraints mean hospitals will most likely obtain squeezed by significant authorities payment cuts, whether or not the overhaul legislation moves forwards . Moreover, hospitals likely have missed their possibility to negotiate a cope with lawmakers providing more certainty on government payments. Federally-run Medicare and state-administered Medicaid take into account 40 percent to 45 percent of hospital revenue, Mr. Ransom said . Analysts and business executives say the sector has room for general consolidation still, as companies turn to gain marketplace leverage and share in local markets.