Could they be shy some $300M in endowments?
They are saying it is due to 0bamacare, not lack of endowments?
Cleveland Clinic does not really operate off endowment for operating expenses. Rather, endowment is used for new construction. This is true at most nonprofit institutions.
What is happening is that they will be reimbursed at a lesser amount for procedures under Obamacare whether it be Medicare, Medicaid or insurance exchanges or due to government controls on private plans.