AP
"The Affordable Care Act is creating significant financial uncertainty to health care organizations," said a survey respondent from the health care and social assistance industry.
"With little warning, the negative impact on revenue has been unprecedented."
ISM's gauge of monthly hiring trends in the American services sector went negative in February for the first time since 2010.
"Commentary from respondents suggests that some of this effect could be due to the implementation of the Affordable Care Act," says Cooper Howes, an economist at Barclays.
"This would be in line with the slowdown in health care and social assistance payroll growth to just 1,000 per month in January and December from an average of just under 30,000 for the 12 prior months. In February, ISM noted that this sector reported the third-largest decline in employment among those reporting, suggesting that this trend could continue."