(Bloomberg) — A Baton Rouge hospital is closing the only emergency room on the city's impoverished north side, a real- world ripple effect of the ideological clash over President Barack Obama's health-care law.

The shutdown on April 1 serves as an early warning for hospitals in states like Louisiana, where Republican Governor Bobby Jindal turned down federal money to expand the Medicaid program for the poor. Charity hospitals will lose billions of federal aid beginning late next year, a cut that was supposed to be offset as more residents were covered by Medicaid.

The combination is a looming "double whammy," said Shawn Gremminger, a lobbyist for America's Essential Hospitals in Washington, which represents those that care for the poor.

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