HCA Stock Plummets After Slashing 2026 Guidance – Marks Fifth Straight Day Of Losses

• HCA lowered its forecasts for net income, adjusted EBITDA, and earnings per share while making only a modest adjustment to its revenue outlook.
• Cantor Fitzgerald said the weaker payer mix likely triggered the stock's sharp decline but maintained its 'Overweight' rating and $525 price target.
• Other healthcare stocks, including Johnson & Johnson, Eli Lilly, Merck, AbbVie, and UnitedHealth Group, also traded lower following HCA's update.

HCA Healthcare (HCA) shares fell on Monday morning after the hospital operator cut its 2026 earnings outlook, blaming a worse-than-expected payer mix shift tied to losses in health insurance coverage. 

The company also raised the size of the headwind from health insurance exchanges, a sign that coverage changes are pressuring reimbursement more than it had previously modeled.

HCA stock fell nearly 7% in morning trade to under $365, recovering from earlier lows seen in August last year and extending its losing streak. On Stocktwits, retail sentiment around the stock remained in ‘neutral’ territory with chatter at ‘normal’ levels. 

Some retailers on the platform expressed interest in buying the stock amid the downturn.

Guidance Cut, But Revenue Range Mostly Intact

HCA lowered several key 2026 profit targets while leaving its revenue outlook only slightly narrower. The company now sees revenue of $77 billion to $79.5 billion, down from a prior range of $76.5 billion to $80 billion, while net income attributable to HCA is now expected to come in between $6.3 billion and $6.7 billion, versus an earlier range of $6.495 billion to $7.035 billion.

"Our colleagues continue to manage well through the positive and negative factors that have impacted our business in the first half of the year,” said Sam Hazen, Chief Executive Officer of HCA Healthcare. "As we look to the balance of the year, we have adjusted our guidance to reflect these factors." 

Adjusted earnings before interest, tax, depreciation, and amortization (EBITDA) guidance was also trimmed to $15.4 billion to $16.1 billion from $15.55 billion to $16.45 billion. Earnings per diluted share were cut to a range of $28.70 to $30.50, compared with the prior forecast of $29.10 to $31.50. 

Health Insurance Exchange Headwinds Grow

The company kept its 2026 capital spending plan unchanged at $5 billion to $5.5 billion, excluding acquisitions, suggesting it is not pulling back on longer-term investment even as profit expectations soften.

HCA said the cuts were driven by the expectation of a larger unfavorable impact from health insurance exchanges. It stated that the drag on income before taxes would widen to between $1 billion and $1.2 billion from an earlier estimate of $600 million to $900 million. That points to a less favorable payer mix, meaning a larger share of patients are arriving with coverage that reimburses less richly than the company had anticipated.

Analysts Point To Payer Mix Concerns

In a note to investors cited by TheFly, Cantor Fitzgerald said the guidance, due to worsening payor mix, is the likely trigger for the sharp stock sell-off. It added that the downturn is weighing on healthcare peers as results fell short of expectations. The firm has an ‘Overweight’ rating on HCA’s stock and a $525 price target.

Shares of Johnson and Johnson (JNJ), expected to report earnings later this week, fell by nearly 2%. Shares of Eli Lilly (LLY) and Merck (MRK) dropped nearly 3% each, while AbbVie (ABBV) and UnitedHealth Group (UNH) moved over 1% lower. 

Earlier in the day, KeyBanc also lowered its price target on HCA Healthcare to $475 from $510 and kept an ‘Overweight’ rating on the shares, citing “uncertainty” around hospitals' core earnings trajectory.

Read also: IBM Stock Tanks To 2-Month Lows In Pre-Market – CEO Says Company ‘Faltered’ In Q2 As ‘Large Deals Failed To Close’ On Expected Timelines

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