HCA Healthcare shares dropped after the for‑profit operator of medical facilities scaled back its annual guidance due to payer mix shifts on health insurance exchanges.

In premarket trading, the stock fell 9.4% to $354, and it has already fallen 22% over the last three months.

The company lowered its 2026 earnings forecast to $28.70‑$30.50 per share and narrowed its revenue target to $77‑$79.5 billion from the previous $76.5‑$80 billion range. Adjusted EBITDA is now projected at $15.4‑$16.1 billion, versus the prior $15.55‑$16.45 billion range. For the latest quarter, adjusted EBITDA is expected to be about $4.03 billion and revenue roughly $20.23 billion, compared with $3.85 billion and $18.61 billion a year earlier, and below analysts’ estimates.

The decline was attributed to an increase in uninsured patients who lost coverage on exchanges, which has shifted the payer mix and squeezed margins.