Managed Care: Read Across From HCA‘s ACA Exchange Commentary

Research evidence excerpt

Managed Care: Read Across From HCA‘s ACA Exchange Commentary

J P M O R G A N North America Equity Research

14 July 2026

Managed Care

Read Across From HCA’s ACA Exchange Commentary

We want to briefly touch on HCA’s preliminary 2Q26 results (covered by JPM Managed Care and Facilities

ACanalyst Ben Rossi, see his takeaway here) and the implications for MCOs with John Stansel, CFA

exposure to the ACA Exchanges. In the release, HCA noted an adverse payor mix (1-212) 622-0083

shift, with an increase in uninsured volume, primarily due to patients who lost john.stansel@jpmorgan.com

coverage on the ACA Exchanges, driving a ~$400M unfavorable EBITDA impact Lisa C. Gill

in 2Q. We read this as supporting the more constructive stance implied by (1-212) 622-6466

valuations for MCOs (namely CNC, +37% since 4/28 vs. XLV +12%) with lisa.c.gill@jpmorgan.com

exposure to the ACA Exchanges. A major point entering 2026 was the concern that Benjamin Rossi

the enrollment attrition in the ACA Exchanges would be driven by lower-utilizers (1-212) 622-9603

benjamin.rossi@jpmorgan.com

(creating adverse shifts in acuity for payors). There are moving parts, and the

Cole Harrischange is relative to HCA's expectations for payor mix; however, higher-than-

(1-212) 622-9068

expected volumes attached to the enrollment exiting the ACA Exchanges (a cole.harris@jpmorgan.com

concerning sign from a public health perspective), suggests a more muted shift in J.P. Morgan Securities LLC

acuity and aligns with our intra-quarter channel check. Within our coverage, CNC

has the largest exposure to the ACA Exchanges (see our takeaways on CNC's

guidance and key debates exiting 1Q earnings here), followed by MOH, ELV, and

UNH.

Wakely assumes the ACA Exchanges will contract by -17% to -26% in 2026, which