Burry buys HCA Healthcare: "insanely efficient compounder" at tangible book value

Michael Burry — founder of Scion Asset Management and the investor who shorted the 2008 housing market before the crisis, as chronicled in The Big Short — disclosed a new position in HCA Healthcare (NYSE: HCA) in a June 8 Substack post titled "Trading Post June 8, 2026: Buying a Long-Term Compounder on a Simple Rule." 1 The buy comes as HCA sits -23% year-to-date while the S&P 500 (SPY) is up 23% and the Vanguard Total Market ETF (VTI) is up 24% over the same period. 2

The gap between HCA and the broad market — 46 percentage points in 2026 alone — is the kind of divergence that draws Burry in.

Burry structured the post around a principle he calls his "simple rule": when a high-quality compounder falls to its tangible book value per share, buy it. He laid out the case using Samsung Electronics as a 30-year proof of concept before pivoting to HCA. 1

His words on the rule:

Samsung produced eight such buy signals over 30 years — every one of them at or below tangible book value — and delivered a 470x return from the 1998 Asian Currency Crisis bottom at 24.6% annualized. Burry himself bought Samsung at tangible book value in early 2025, making it the third-largest position at Scion. 1

The chart makes the thesis visual: tangible book value acted as a floor in every cycle, and each touch of that floor was an entry that eventually paid out. Burry's note on Samsung's cyclicality: "Samsung repeatedly trades down to tangible book value because it is cyclical. Has always been. And always will be. Hint hint." — the "hint hint" pointing directly at HCA.

HCA Healthcare is the largest for-profit hospital operator in the United States, running more than 180 hospitals across 20 states and the United Kingdom. Burry described it as "a terrific, insanely efficient compounder" and "one of the best operator-compounders out there." 2 On the M&A dimension specifically, he called it "a true Olympian in M&A and efficient operations," arguing that companies which repeatedly acquire and sustain high return on invested capital (ROIC) over decades are worth close attention — and that HCA has consistently done both.

The "stellar, steady" ROIC is, in Burry's framing, the key driver of long-term stock performance despite periodic regulatory and reimbursement headwinds. 2

The proximate cause of HCA's 2026 selloff is the lapse of enhanced Affordable Care Act (ACA) subsidies. HCA disclosed during its Q1 2026 earnings call that the subsidy lapse cost roughly $150 million in Q1 alone, with the full-year 2026 impact guided at $600 million to $900 million. 2 That is a real hit, and the market has clearly priced it as a structural concern rather than a temporary one.

Burry's counter is direct: "Anything that hurts HCA hurts its competitors more and creates M&A opportunities. It all works out in the end." 2

The logic follows his Samsung framework. A cyclical headwind that pressures every hospital operator in the industry simultaneously creates an asymmetric advantage for the most efficient acquirer. HCA has used prior disruption cycles — reimbursement cuts, policy shifts, regional capacity crunches — to buy distressed assets at depressed prices, then apply its operational model. The Obamacare headwind, in Burry's read, is the same pattern repeating.

He also indicated he may add long-term call options on HCA, suggesting he is not merely buying the stock but structuring for a longer recovery timeline. 2

The Substack post included Scion's top-10 long positions as of March 31, 2025. HCA is not yet in that table — the disclosure is from Q1 2025 and the HCA position was initiated more recently — but the portfolio context matters for calibrating the thesis. 1

The portfolio is striking for what it contains: predominantly Chinese consumer, tech, and internet names, two U.S. special situations (Estee Lauder, Fannie Mae), and Samsung as the sole non-China Asian holding. HCA would be Scion's first conventional U.S. large-cap operator since Burry shifted the fund heavily toward non-U.S. equities. The tangible book value trigger is doing the work that fundamental screens alone could not — it is giving Burry a rules-based entry point into a sector he has historically avoided during AI-bubble obsession, right at the moment the market has priced in maximum pessimism.

Retail sentiment on Stocktwits for HCA was registering "extremely bullish" with "high" message volume following the Burry disclosure on June 9, and HCA opened approximately 1% higher in Tuesday pre-market trading. 2 Whether the tangible book value floor holds in HCA the way it did eight times in Samsung is the question the market will answer over the next 12 to 24 months.