WASHINGTON — A critique of two proposed hospital projects in Montgomery County, Md., echoes warnings that the enactment of health care reform will make it more challenging for nonprofit health providers to finance projects through the municipal bond market. 

Increasing health care costs to nonprofit hospitals stemming in part from the Patient Protection and Affordable Care Act of 2010 “will make hospital bond offerings increasingly less attractive over the coming decade, driving up the cost of capital” and making some projects “unfeasible,” according to a Maryland report on two hospital certificate of need applications.

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