Executives on a Tuesday call with investors said HCA could lose between $600 million to $900 million due to the subsidy lapse and between $250 million to $450 million from declines in some of its Medicaid state supplemental payment programs. HCA expects about a 15% to 20% decline in exchange volumes this year, Marks said. Of those, HCA expects approximately the same number will move to employer health insurance. HCA also said it’s anticipating headwinds from a decline in Medicaid state supplemental payments this year. The hospital operator also expects revenue growth in 2026 and consistent margins compared to 2025.