HCA Healthcare Faces Potential $1B Loss Due to ACA Subsidy Lapse and Medicaid Payment Decline

HCA Healthcare could lose over $1 billion due to the expiration of ACA subsidies and a decline in Medicaid state supplemental payments. Executives expect a $600-$900 million loss from subsidies and a $250-$450 million loss from Medicaid state payments. However, they plan to offset around $400 million in losses this year through a multi-year resilience plan. Despite this, analysts say the guidance is conservative and expect HCA's full-year 2026 earnings to skew closely to or exceed 2025 figures.