Hospitals in poor urban and rural communities that treat large numbers of illegal immigrants are facing a significant financial blow with implementation of President Obama’s health-care law, says The New York Times.

The Affordable Care Act will slash the amount of money the federal government gives so-called safety-net hospitals to cover emergency care for the uninsured, on the premise that the law will steer many more people into getting health insurance.

The nation’s estimated 11 million undocumented aliens are not covered by the law. As hospitals are now legally required to treat all emergency-room patients, regardless of immigration status, facilities in areas with large illegal populations face a loss of federal dollars without a commensurate decline in uninsured patients.

“That’s the 800-pound gorilla in the room, and not just in New York—in Texas, in California, in Florida,” said Wendy Z. Goldstein, chief executive of Lutheran Medical Center in Brooklyn. “I was told in Washington that they understand that this is a problem, but immigration is just too hot to touch.”