There are multiple levels of irony in this New York Times report on the impact of ObamaCare on poor patients in the nation’s hospitals. Congress demanded the power to revamp the health-insurance industry and expand Medicaid in order to help the poor get better medical care for less money. In reality, the opposite appears to be happening, as hospitals attempt to force the poor into ObamaCare:

Hospital systems around the country have started scaling back financial assistance for lower- and middle-income people without health insurance, hoping to push them into signing up for coverage through the new online marketplaces created under the Affordable Care Act. The trend is troubling to advocates for the uninsured, who say raising fees will inevitably cause some to skip care rather than buy insurance that they consider unaffordable. Though the number of hospitals tightening access to free or discounted care appears limited so far, many say they are considering doing so, and experts predict that stricter policies will become increasingly common.

Why did this unintended consequence occur? In part, because ObamaCare penalizes hospitals for extending charitable assistance:

Driving the new policies is the cost of charity care, which is partly covered by government but remains a burden for many hospitals. The new law also reduces federal aid to hospitals that treat large numbers of poor and uninsured people, creating an additional pressure on some to restrict charity care.

Got that? The law that supposedly answered the fierce urgency of now in assisting the poor penalizes providers for, er, assisting the poor. They want to force low-income patients to either enroll in an ObamaCare plan, or to accept Medicaid coverage — even though fewer and fewer providers will see patients with either coverage.

This sets up a damned-if-they-do conundrum for hospitals, which have been the front line of caring for the poor:

“Do we allow our charity care programs to kick in if people are unwilling to sign up?” said Nancy M. Schlichting, chief executive of the Henry Ford Health System in Detroit. “Our inclination is to say we will not, because it just seems that that defeats the purpose of what the Affordable Care Act has put in place.” But advocates for the uninsured point out that many Americans avoided obtaining coverage in the inaugural enrollment period of the Affordable Care Act this year because they found the plans too expensive, even with subsidies. Many uninsured people also remain unaware of the new insurance options, And immigrants who are in the country illegally are not even eligible to apply.

Most hospitals are not reducing charitable service to those who fall under the federal poverty level, the NYT’s Abby Goodnough reports. It’s a different story, though, for those who earn between 200-400% of the federal poverty level, where Medicaid eligibility ends and the mandate requires everyone to buy coverage and accept subsidies. Thanks to the new federal restrictions on charity, hospitals have to focus their efforts on the neediest patients — and everyone else gets stuck with the bill.

These are the kinds of things that one might have foreseen had Congress not been in such a rush to pass a bill without carefully reading through its language. On that point, CNS News and the Daily Surge note a moment of supreme irony last week in the debate over how to fix the VA: