One year ago President Obama signed health care reform into law. Local hospitals could be bracing for huge changes as a result.
The provision to cover all Americans does not kick in until 2014. Until that time there's confusion, as all the issues get worked out.
"It was a blessing to get that back. He will be able to continue it on our health insurance," said Maricia Mills, of Knox County.
Mills said she supports some parts of the health care reform, especially the one that allowed her college-aged son to stay on her insurance.
"We've had to amend our health care coverage plans to cover children up to 26 years of age," said Craig Morgan, CEO of Knox County Hospital.
That is one small part of health care form. But local hospitals now are dealing with a much bigger part.
"One of the vehicles they are going to use to pay for this is Medicaid," said Morgan.
"They're going to cut the payments of Medicare and Medicaid to pay for the uninsured," said Milton Brooks, CEO of Pineville Community Hospital.
Hospital officials could have some tough decisions to make in the coming years.
If funding is cut to pay for universal health care, there would be consequences.
"That will make a lot of difference as to what we can do, and if we can continue to provide care," said Brooks.
Until that point, there is not much that can be done, since it's hard to plan for a future that is uncertain.
The Supreme Court will likely get the last say as they are expected to decide the law's constitutionality.
In the meantime, local hospitals will just have to wait and see.
Hospital officials said if the law holds up in court, the effects could be drastic.
That's because Eastern Kentucky has such a high percentage of Medicare and Medicaid patients.