Essentially, non-profit/charity hospitals either have to go for-profit or comply with assessments of community needs.
Yeah... I'm relatively certain (if not 100%) that they could just stay non-profit and just... pay taxes on taxable income. Might technically be a not-for-profit or something (iirc, there's a difference, though I don't recall what), but... yeah. Could also just go for-profit and do charity anyway. Businesses can do that. Tend to already, up the maximum (if feasible) extent it counts as a tax deduction
And to clarify, taxable income for businesses (non-profit or otherwise) is almost always revenue
minus deductions, which tends to include most or all of operating expenses (at the least). So, it generally
is profit (revenue minus expenses, simple as that) that gets taxed, minus other potential deductions. For the change to effect the hospitals at all, they couldn't be running a deficit or
just covering expenses, which... would mean they'd be fine if they paid taxes on the profit. Less expansion capability, perhaps, but I'd say that's alright, m'self.
As for some of the "non-profit" hospitals no longer being able to call themselves that, well... the ones the change would seem to be effecting frankly seem to
already be for-profit, just taking advantage of an administrative trick to avoid taxation. Could do without that, m'self.
General point being that while we
might see a reduction in medical organizations legally qualifying as non-profit, if we see a reduction in medical charity because of it then it's pretty likely the ones we lose weren't in it for the charity to begin with. Might be able to do more good getting taxes from those ones.
The mention of a "fine" took me some digging to find what they were actually talking about, but it seems to be general IRS fines for not complying to 501(c) standards (which could also result in shutting them down) and an additional $50,000 fine for failing to comply with standards regarding the community needs assessments.
Though I have to admit, this one amuses me a bit. Blaming the ACA for the organizations being hit by the IRS for evidently lying on their taxes (some of them
before the ACA came into effect) is kinda' hilarious