Repeal of the Affordable Care Act could cost more than 2.5 million jobs, and many would come from the nation’s hospitals and health systems, new reports and industry lobbies say. The ACA’s subsidized private individual coverage and expanded Medicaid benefits have turned patients who couldn’t afford care into paying customers, allowing hospitals to hire more nurses, medical technicians, doctors and other caregivers to treat millions of newly insured Americans. “Given that our hospitals already operate with no margin on average, it's hard to see how they could avoid layoffs if repeal increases uncompensated care,” says Beth Feldpush, senior vice president of policy and advocacy at America’s Essential Hospitals, which represents public health systems across the country. A hospital is often the largest employer in a community, and healthcare facilities have been an economic engine that have helped reduce unemployment under President Obama . Friday’s jobs report again showed major growth in health industry jobs, "with most of the increase occurring in ambulatory healthcare services and hospitals."