HCA: former ACA enrollees are going uninsured nearly one for one
HCA Healthcare told investors in July that patients losing Affordable Care Act exchange coverage are becoming uninsured almost one for one, against the company's prior assumption that 80% to 85% would lose coverage and the rest would find other plans. CEO Sam Hazen said the expected migration to other coverage did not happen.
The shift cost HCA roughly $400 million in second-quarter income. ACA volumes fell 15% year over year while uninsured volumes rose 15%, and elective volumes dropped 6% in the first half of 2026 after falling 2% in the same period last year. Community Health Systems and Tenet Healthcare both cited similar ACA pressure in their own second-quarter results.
HCA still beat analyst performance expectations, posting $1.7 billion in net income, helped by admissions growth, emergency room volume, and new Florida Medicaid supplemental payments.