The more uninsured residents Mississippi's health insurance exchange signs up under the Affordable Care Act the bigger the hit the state's hospitals will take on federal reimbursements for treating the uninsured. The consequence is one of many Mississippi Gov. Phil Bryant and legislative leaders must weigh in refusing state participation in expanding Medicaid. The state stands to lose hundreds of millions of dollars in coming years in federal Disproportionate Share Hospital, or DSH, reimbursements for uncompensated hospital care, the Mississippi Hospital Association says. The money would be offset by the new federal dollars flowing in to add an estimated 300,000 of the state's working poor to Medicaid rolls.