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# HCA Healthcare Says Uninsured Patients Cost It About $400 Million, Yet Sees 2026 In Upper Half Of Guidance
- URL: https://www.bullished.co/hca-healthcare-says-uninsured-patients-cost-it-about-400-million-yet-sees-2026-in-upper-c9399799/
- Published: 2026-10-27T11:26:00.000Z
- Updated: 2026-10-28T16:14:25.000Z
- Description: Third-quarter net income fell 3.9% to $1.579 billion as people who lost exchange coverage showed up uninsured, the hospital operator said.
- Author: Matteo Parrino
- Tags: Earnings, HCA, Industry: Healthcare

[HCA Healthcare](https://www.bullished.co/tag/hca/), which runs hospitals and outpatient care facilities in the United States and England, said a surge of uninsured patients [cut third-quarter pretax income by about $400 million](https://www.sec.gov/Archives/edgar/data/0000860730/000119312526432665/hca-ex99%5F1.htm?ref=bullished.co), mostly people who lost coverage on the health insurance exchanges. The company still expects full-year 2026 results in the upper half of its guidance ranges, it said Tuesday in an [8-K filing](https://www.sec.gov/Archives/edgar/data/0000860730/000119312526432665/hca-20261027.htm?ref=bullished.co).

## Revenue up, profit down

[Revenue rose 3.6%](https://finance.yahoo.com/healthcare/articles/hca-healthcare-beats-quarterly-profit-110520058.html?ref=bullished.co) to $19.849 billion from $19.161 billion a year earlier. Net income attributable to HCA fell 3.9% to $1.579 billion, from $1.643 billion.

Diluted earnings per share rose 4.5% to $7.27, helped by a smaller share count (217.212 million shares against 236.181 million). On an adjusted basis, earnings were [$7.22 a share](https://finance.yahoo.com/healthcare/articles/hca-healthcare-beats-quarterly-profit-110520058.html?ref=bullished.co), up 3.7%. Adjusted EBITDA, a measure of operating profit, climbed 1.2% to $3.918 billion, while its margin slipped to 19.7% from 20.2%.

Operating cash flow was $4.461 billion, against $4.416 billion a year earlier. In the quarter HCA bought back 7.230 million shares for $2.970 billion, leaving $4.240 billion on its repurchase authorization.

## Fuller ERs, fewer surgeries

Same-facility admissions rose 2.7% and equivalent admissions, which also count outpatient work, rose 3.0%. Emergency room visits rose 5.1%, while inpatient surgeries fell 1.4% and outpatient surgeries fell 3.7%. Revenue per equivalent admission rose 0.6%.

The company said growth in equivalent admissions accelerated, insured revenue per equivalent admission improved excluding Medicaid supplemental payment programs, and costs improved. CEO Sam Hazen said that despite "challenges brought about by federal policy changes this year," HCA is "positioned to end the year positively."

## Guidance and the dividend

HCA said its full-year operating results should land in the upper half of the ranges it issued July 14\. Those ranges include revenue of $77.0 billion to $79.5 billion, adjusted EBITDA of $15.4 billion to $16.1 billion, and earnings of $28.70 to $30.50 a share.

As of September 30, HCA operated 189 hospitals in 19 states and the United Kingdom. It held $908 million in cash and owed $50.493 billion in total debt.

The board declared a quarterly dividend of $0.78 a share, payable December 29 to holders of record on December 15.

HCA's guidance assumes the expiration of enhanced premium tax credits, which it lists among the policy changes weighing on its payer mix.

Learn

- [Item 2.02: results of operations →](https://www.bullished.co/learn/8-k-items-explained/#item-202-results-of-operations)  
From 8-K Items Explained: What Every Item Code From 1.01 To 9.01 Tells You, With Examples

### Sources

- [8-K Filing — HCA Healthcare, Inc. (HCA)](https://www.sec.gov/Archives/edgar/data/0000860730/000119312526432665/hca-20261027.htm?ref=bullished.co) — SEC EDGAR
- [Exhibit hca-ex99\_1.htm — HCA Healthcare, Inc. 8-K exhibit](https://www.sec.gov/Archives/edgar/data/0000860730/000119312526432665/hca-ex99%5F1.htm?ref=bullished.co) — SEC EDGAR
- [HCA Healthcare beats quarterly profit estimates on demand for medical services](https://finance.yahoo.com/healthcare/articles/hca-healthcare-beats-quarterly-profit-110520058.html?ref=bullished.co) — Reuters

### More on HCA Healthcare

- [HCA Sees Flat 2027 Earnings As Medicaid Payments Drop $550 Million To $650 Million](https://www.bullished.co/hca-sees-flat-2027-earnings-as-medicaid-payments-drop-550-million-to-650-million-5d4caf14/)
- [HCA's Uninsured Patients Hit 10.5% Of Volume As Exchange Losses Cost About $400 Million In A Quarter](https://www.bullished.co/hcas-uninsured-patients-hit-10-5-of-volume-as-exchange-losses-cost-about-400-million-in-a-00297eb8/)

[All HCA Healthcare (HCA) coverage →](https://www.bullished.co/tag/hca/)