New York’s public hospitals, which shoulder most of the burden of care for the city’s poorest patients, are facing a financial blow that could dramatically weaken New York’s already stretched health care system, according to a new report.

Titled “Restructuring NYC Health + Hospitals,” the study shows how the city’s public and private medical facilities share the costs and revenues of medical care.

For the city’s Health + Hospital system especially, it’s not a pretty picture.

H+H is already facing a $1.6 billion deficit in 2019, projected to rise to $1.8 billion in 2020 —and that’s before a potentially devastating funding cut, an unintended consequence of the Affordable Care Act.

NYC hospitals fume: State withholding millions

That defect in the ACA was just worked around under President Obama. But then came last November’s election and the assault on “Obamacare.”

This week, that little-known flaw in the ACA will be allowed to take its toll, when a makeshift Medicaid fix — supplemental payouts to so-called Disproportionate Share Hospitals, or DSH payments — will suffer deep cuts.

Gov. Cuomo called the change a “missile” headed straight at both the state and city hospital systems, which currently receive $3.7 billion a year in DSH funds.

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