Although the number of Alabamians with health insurance has increased, hospital officials said they are still treating the same number of uninsured patients as they were before the Affordable Care Act's implementation. "In Alabama, we're getting hit multiple times," said David Spillers, CEO of the Huntsville Hospital System, which manages Decatur Morgan General. "We're not expanding Medicaid, the number of uninsured is going up, and people insuring with high deductibles are going up." Spillers, who serves on the Alabama Hospital Association Board, said these problems are not limited to north Alabama -- it's throughout the state.