Local healthcare providers in Madison County say it may take several years to see exactly how the Affordable Care Act will affect the area, but they are preparing for the changes. Some are already benefiting from the law, but other providers fear they may have to offer some services at a loss in the future. Jill Williams, spokesperson for Pattie A. Clay Regional Medical Center, said the impact of ACA on the hospital will be not entirely beneficial. Williams is referring to reductions in the Medicare and Medicaid Disproportionate Share payments. The ACA aims to reduce these payments by as much as 75 percent, according to the National Association of Urban Hospitals.