HCA Healthcare Cuts Annual Profit Forecast as Obamacare Coverage Losses Increase Uninsured Patient Load

On July 14, 2026, HCA Healthcare lowered its annual profit forecast to $28.7 to $30.5 per share, citing a rise in uninsured patients as Obamacare enrollment fell 13% following the expiration of pandemic-era subsidies. The patient shift caused a $400 million second-quarter hit, leading to declining elective surgeries and rising uncompensated care costs. Consequently, HCA shares fell up to 10% in early trading, dragging down peers like Tenet and Universal Health Services.

HCA Healthcare profit forecast cut

• ▪HCA Healthcare narrowed its annual revenue forecast to a range of $77 billion to $79.5 billion, compared with its previous expectation of $76.5 billion to $80 billion
• ▪HCA Healthcare reported preliminary second-quarter revenue of $20.23 billion, which was above analysts' average estimate of $19.43 billion
• ▪HCA Healthcare cut its annual profit forecast on July 14, 2026, expecting annual profit per share between $28.7 and $30.5, down from its previous range of $29.1 to $31.5

Obamacare enrollment decline

• ▪Americans are dropping off Affordable Care Act plans in 2026 due to the expiration of extra subsidies created during the COVID-19 pandemic
• ▪Enrollment in "Obamacare" plans established under the Affordable Care Act fell 13% in 2026

Uninsured patient load increase

• ▪HCA Healthcare estimated that the shift in patient coverage had an unfavorable financial impact of approximately $400 million in the second quarter, including a $75 million increase tied to its first-quarter estimate
• ▪HCA Healthcare experienced an increase in uninsured patients, primarily driven by individuals who lost coverage under Affordable Care Act plans

Surgery volume declines

• ▪Hospitals are facing declining elective surgeries and diagnostic volumes alongside rising costs from providing uncompensated care to uninsured patients
• ▪HCA Healthcare's same-facility inpatient surgeries declined 2.3% and outpatient surgeries declined 3.4% in the second quarter

Hospital stock price drops

• ▪Shares of HCA Healthcare fell nearly 10% in premarket trading on July 14, 2026
• ▪Shares of HCA Healthcare fell 6% in morning trading on July 14, 2026, while Tenet Healthcare slid more than 2% and Universal Health Services fell 5%

Future Medicaid payment cuts

• ▪Investor fears regarding HCA Healthcare and the hospital industry's near-term profit growth trajectory are rising due to potential regulatory moves and stalling momentum
• ▪The hospital industry faces a potentially steeper financial impact in 2027-2028 when Medicaid spending and supplemental payment cuts start