Thursday's high court decision may lead to health care coverage to millions of uninsured Americans, but many folks are wondering how the dollars and cents add up.

In a down economy, times are hard for local hospitals.

Wellmont Health System president and CEO Denny DeNarvaez explained to News 5, the health care industry has recently weathered a bombardment of funding cuts, but she said the Supreme Court's decision to uphold the Affordable Care Act has a silver lining that's looking more like green.

"It does give us some relief with the hope that we're going to have more folks insured and therefore a revenue source to offset many of the cuts," DeNarvaez said.

But cuts aren't the only problem our region's hospitals are facing. Uncompensated care is on the rise, something Mountain States Health Alliance CEO Dennis Vonderfecht knows all too well.

"This year, we're over $100 million in charity care. Actually, our charity care is up 40 percent this year over last year," Vonderfecht explained.

We found out, with more people on some kind of insurance there will be a greater focus on preventative care, which could spark a chain reaction Vonderfecht said might lower everyone's health care bill.

"When someone is starting to get sick, we can deal with it at a less expensive level instead of waiting for someone to get really sick and have to come to the emergency department and have to be admitted to the hospital and all these high cost settings," said Vonderfecht.

But a cost could come elsewhere.

Small business owner Dan Mahoney isn't yet sure what will be required as far as providing health insurance for his employees, but the questions rattle his nerves.

"We're going to be in the position to determine what's the best thing and what's the most economical thing that we can do. We don't want to put the cost back on the public. We don't want to the cost back on the employees. So, we're going to have to decide which way, “said Mahoney.

News 5 found out hospitals are questioning how many people will simply opt of buying insurance by paying the penalty tax rather than buying insurance.

We looked it up and discovered they would pay $695 per uninsured adult or 2.5 percent of their family income up to $12,500 a year.