HCA says ACA coverage losses have cost about $950 million in pretax earnings

HCA said it has lost about $950 million in pretax earnings this year as more people who dropped Affordable Care Act exchange coverage went uninsured, increasing uncompensated care and reducing demand for elective procedures. The company had expected some former exchange customers to move into other coverage, but hospital operators said people instead became uninsured at almost a 1-to-1 rate.

In the third quarter, admissions among HCA patients with ACA coverage declined 19% year over year, and elective volumes in its outpatient ambulatory unit fell 5.4%. HCA said overall inpatient and outpatient admissions grew 3%, helped by more commercially insured patients. Revenue was $19.9 billion, up 3.6%, while net income fell about 4% to $1.6 billion. HCA kept its forecast of $1 billion to $1.2 billion in losses from ACA headwinds this year and expects to land in the upper end of its earnings guidance range.