Updates shares, adds analyst comment in paragraph 5 and background in paragraph 6

Jan 27 (Reuters) - HCA Healthcare HCA.N on Tuesday forecast its profit for 2026 above Wall Street estimates after reporting better-than-expected quarterly earnings on robust medical care demand, sending its shares up 6% in premarket trading.

Hospital operators such as HCA are benefiting from higher utilization of the government's Medicare insurance plans, particularly when older adults who are covered undergo surgical procedures.

As subsidies that were present during the COVID-19 pandemic under individual Affordable Care Act (Obamacare) plans expire this year, patients availing themselves of elective procedures, preventive care visits and diagnostic services are expected to increase while their insurance is still affordable.

Raking in patients who are insured under government-backed plans provides reliable reimbursement for medical services, compared to uninsured cases that often result in uncompensated care, which amass costs and bad debt for hospital operators.

Barclays analyst Andrew Mok said the "key moving parts underlying" the 2026 forecast remain unclear, specifically what HCA assumes for the gross Obamacare headwind and change in state-specific Medicaid payment programs.

These programs give additional payments to healthcare providers such as HCA, addressing the shortfall between Medicaid reimbursements and the actual cost of providing care to patients.

HCA's revenue from same-facility per equivalent admission - or the combined volume of inpatient and outpatient admissions - increased 2.9%.

However, same-facility inpatient surgeries were flat, while same-facility outpatient surgeries declined 0.5% in the quarter ended December 31.

HCA reported total revenue of $19.51 billion in the fourth quarter, missing expectations of $19.68 billion.

On an adjusted basis, the company posted a profit of $8.01 per share, beating analysts' estimate of $7.46 per share.

The company expects 2026 profit in the range of $29.10 to $31.50 per share, the midpoint of which is above analysts' average estimate of $29.46 per share, according to data compiled by LSEG.

The company also authorized a share repurchase program for up to $10 billion of its outstanding common stock.

(Reporting by Padmanabhan Ananthan and Christy Santhosh in Bengaluru; Editing by Shilpi Majumdar and Maju Samuel)

((Padmanabhan.Ananthan@thomsonreuters.com))