HCA Projects Flat 2027 Earnings on Medicaid Supplemental Payment Drop
HCA Healthcare CEO Sam Hazen told investors on the system's Oct. 27 third-quarter earnings call that 2027 earnings will likely be flat versus 2026, citing declining Medicaid supplemental payments and continued exchange coverage losses. The hospital system expects $550 million to $650 million less in Medicaid supplemental payment net benefits in 2027, after several states' grandfathered approvals boosted 2026 payments by $600 million to $800 million. HCA also flagged Medicaid work requirements under HR 1 as a drag on roughly 15% to 20% of its Medicaid volumes, calling the expected impact "modest" but declining to quantify it. Full 2027 guidance will come in January; uninsured patients already rose to 10.5% of equivalent admissions in Q3, up from 8.5% a year earlier, as exchange coverage losses converted "almost one for one" into uninsured volume.