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HCA Reaffirms 2026 Outlook After Soft Q1 Volumes

The hospital giant flagged a $600 million to $900 million earnings drag this year from changes in Affordable Care Act exchange coverage.

Overview

  • HCA Healthcare, which reported first-quarter results Friday, posted $19.1 billion in revenue and $1.62 billion in net income.
  • The shares fell about 9% after the release as investors reacted to lighter patient traffic and shifts in insurance coverage.
  • The company kept its 2026 forecast for $76.5 billion to $80 billion in revenue, $6.5 billion to $7.0 billion in profit, and $15.6 billion to $16.5 billion in adjusted EBITDA.
  • A mild respiratory season and a January storm reduced traffic, with respiratory admissions down 42% and related ER visits down 32% from a year ago.
  • Management expects a $600 million to $900 million hit to 2026 EBITDA from ACA exchange changes and recorded about $150 million of that in Q1, while state Medicaid supplemental programs added roughly $200 million that helped offset the shortfall.