Business & Finance · HCA Healthcare · Health Costs
HCA Took a $400 Million Hit as More Patients Showed Up Uninsured. Check Your Coverage Before It Lapses
Revenue rose 3.6%. Profit still slipped. The reason was a wave of patients who had lost coverage on the health-insurance exchanges.
By Sean Anees Saifi · Capital Wealth · Published Wednesday, October 28, 2026 · Source: The Wall Street Journal, Wednesday, October 28, 2026, whose market figures are the Tuesday, October 27 close (Business & Finance)
Key Points
HCA Healthcare (HCA) posted third-quarter net income of $1.58 billion, down from $1.64 billion a year earlier, Adriano Marchese reports.
The company took a $400 million hit to pretax income because more patients came in without insurance. Most had lost coverage on the health-insurance exchanges.
Per-share earnings still rose, to $7.27 from $6.96. Adjusted earnings came to $7.22 a share. Revenue grew 3.6% to $19.85 billion.
HCA still expects full-year results at the high end of its guidance.
Shares fell $15.30 to $449.96 on Tuesday. HCA is held at weight in 4 books; nothing added.
$400 million
pretax hit from uninsured patients, third quarter
$1.58 billion
net income, down from $1.64 billion a year earlier
3.6%
revenue growth, to $19.85 billion
$449.96
HCA close on Tuesday, down $15.30
A hospital gets paid less when no insurer stands behind the patient. HCA put the cost at $400 million in one quarter.
In one line: HCA's $400 million hit from uninsured patients is a hospital's problem first and a warning to anyone whose own coverage could lapse.
An emergency room treats you first and bills you later. Last quarter, HCA Healthcare (HCA) saw more patients arrive with no insurer behind them. The hospital operator took a $400 million hit to pretax income from patients who came in without insurance. Most had lost coverage on the health-insurance exchanges.
The rest of the report was fine. Revenue rose 3.6% to $19.85 billion. Net income came in at $1.58 billion, down from $1.64 billion a year ago. Per-share earnings still rose, to $7.27 from $6.96. Adjusted earnings were $7.22 a share. HCA says it still expects full-year results at the high end of its guidance, Adriano Marchese reports in the Journal.
The market didn't love it. HCA shares fell $15.30 to $449.96 on Tuesday. The desk holds HCA at weight in 4 books. Nothing added.
Why the uninsured number matters to you
Read past the stock for a second. A $400 million swing in one quarter means a lot of people lost coverage and still needed care. The paper says most had been on exchange plans, the ones people buy on their own when a job doesn't provide insurance. That's a big group of early retirees. It's also the self-employed and anyone between jobs. When coverage lapses, the hospital's unpaid-bill line grows. So does the patient's.
Our read
This is health costs. A hospital's lost quarter is a household's lost year, one patient at a time. The people in HCA's numbers didn't plan to be uninsured. The paper doesn't say why they lost coverage, and the reason doesn't change the bill much. The gap is what costs. If you're under 65 and buying your own plan, the cost of a gap is the whole hospital bill. Open enrollment for next year's exchange plans begins in early November in most states. That window is the moment to confirm the plan, the price and the renewal. A plan that gets dropped in January is a plan you don't have in March.
The one thing in your plan this touches is the health-coverage line for anyone in the family who isn't on an employer plan or Medicare. The check this week is to confirm that plan is in force for next year and that the premium is in the budget. Make sure nobody is counting on a renewal that won't happen. Nobody buys the umbrella in the downpour. Buy it this week.
What It Means For Your Portfolio
Hold. Confirm next year's health plan before it lapses
HCA (HCA) is held at weight in 4 books; nothing added. The household point is that a coverage gap is the most expensive line in any plan.
General planning principles, not advice for anyone in particular. If you buy your own coverage, check three things during open enrollment. The plan is renewing. The premium fits next year's budget. Your doctors are still in the network. Set a reminder for the deadline.
Early retirees under 65 should treat the bridge-to-Medicare plan as a fixed cost, like the mortgage. A lapse there can cost more than a bad year in the market.
