Shares fell 9.4% to $354 in premarket trading after the hospital operator widened its expected health insurance exchange headwind and reported a payer mix shift from more uninsured patients.
HCA Healthcare issued preliminary second-quarter 2026 results and lowered its full-year earnings guidance after a payer mix shift tied to patients losing health insurance exchange coverage weighed on profitability. The company said second-quarter revenue is expected to be about $20.230 billion, up from $18.605 billion a year earlier, while net income attributable to HCA Healthcare, Inc. is expected at about $1.699 billion, or $7.62 per diluted share, versus $1.653 billion, or $6.83 per diluted share, in the second quarter of 2025. The payer mix shift reduced income before taxes by about $400 million in the quarter, partly offset by about $400 million of incremental net benefit from Medicaid Supplemental Payment Programs, primarily in Florida. HCA revised its 2026 guidance lower, and its shares fell 9.4% to $354 in premarket trading after the announcement, extending a decline that had already reached 22% over the prior three months as of Monday's close.