Major hospital operator Tenet Healthcare is moving aggressively into states with large numbers of people without health insurance.
There's more potential upside down the road "the bigger you are in California, Texas and Florida," Tenet CEO Trevor Fetter told CNBC on Wednesday, the second day of enrollment for Obamacare. For example, he said, "we are doubling the size of our company in the state of Texas.
"The more you're exposed to states with large numbers of uninsured people, the better it is for a hospital in the future," he said.
Operating in 14 states, Dallas-based Tenet completed its $1.8 billion acquisition of competitor Vanguard Health Systems on Tuesday, as millions of uninsured began buying coverage on state and federally operated exchanges under a mandate of President Barack Obama's Affordable Care Act.
"The very interesting thing to watch is going to be these health-care exchanges, because this is a consumer-oriented solution to an uninsured problem," Fetter said in a "Squawk Box" interview. "They don't cover everything. People will have 'skin in the game.' "
The trend of putting more of the health-care burden on patients has been going on for several years and has been "depressing utilization in hospitals," he said, adding that "employers have shifted to higher-deductible plans" that also force people to pay more out of pocket.
Health-care costs are expected to rise about 4 percent this year, according to a report from the Department of Health and Human Services. But the agency projected a spending increase of 6.1 percent in 2014, partly because of the implementation of Obamacare.
(Read more: 'Many, many problems' with Obamacare: Insurer's CEO)
The HHS report also estimated that 11 million uninsured Americans will get health coverage next year—down from the 22 million projected a year ago.
"There will still be plenty of uninsured people in the United States," Fetter said. "We'll still have a problem in our emergency rooms with plenty of patients who come in and are not able to pay."
Since 2000, hospitals have provided more than $367 billion in uncompensated care, according to the American Hospital Association.