<SEC-DOCUMENT>0001214659-24-005341.txt : 20240327
<SEC-HEADER>0001214659-24-005341.hdr.sgml : 20240327
<ACCEPTANCE-DATETIME>20240327171539
ACCESSION NUMBER:		0001214659-24-005341
CONFORMED SUBMISSION TYPE:	PX14A6G
PUBLIC DOCUMENT COUNT:		2
FILED AS OF DATE:		20240327
DATE AS OF CHANGE:		20240327
EFFECTIVENESS DATE:		20240327

SUBJECT COMPANY:	

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			HCA Healthcare, Inc.
		CENTRAL INDEX KEY:			0000860730
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062]
		ORGANIZATION NAME:           	08 Industrial Applications and Services
		IRS NUMBER:				273865930
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		PX14A6G
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-11239
		FILM NUMBER:		24791882

	BUSINESS ADDRESS:	
		STREET 1:		ONE PARK PLZ
		CITY:			NASHVILLE
		STATE:			TN
		ZIP:			37203
		BUSINESS PHONE:		6153449551

	MAIL ADDRESS:	
		STREET 1:		ONE PARK PLAZA
		CITY:			NASHVILLE
		STATE:			TN
		ZIP:			37203

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	HCA Holdings, Inc.
		DATE OF NAME CHANGE:	20101126

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	HCA INC/TN
		DATE OF NAME CHANGE:	20010627

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	HCA THE HEALTHCARE CO
		DATE OF NAME CHANGE:	20010419

FILED BY:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			Reproductive Health Investor Alliance INC.
		CENTRAL INDEX KEY:			0001854466
		ORGANIZATION NAME:           	
		IRS NUMBER:				830828013
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		PX14A6G

	BUSINESS ADDRESS:	
		STREET 1:		47 KEARNY ST. SUITE 600
		CITY:			SAN FRANCISCO
		STATE:			CA
		ZIP:			94108
		BUSINESS PHONE:		(619) 540-5896

	MAIL ADDRESS:	
		STREET 1:		47 KEARNY ST. SUITE 600
		CITY:			SAN FRANCISCO
		STATE:			CA
		ZIP:			94108
</SEC-HEADER>
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<FILENAME>z327242px14a6g.htm
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<P STYLE="margin: 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">United States Securities and Exchange Commission</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">Washington, D.C. 20549</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">NOTICE OF EXEMPT SOLICITATION</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">Pursuant to Rule 14a-103</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Name of the Registrant: HCA Healthcare, Inc.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Name of persons relying on exemption: Rhia Ventures</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Address of persons relying on exemption: 47 Kearny Street, San Francisco,
CA 94108</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">Written materials are submitted pursuant to Rule 14a-6(g) (1) promulgated
under the Securities Exchange Act of 1934. Submission is not required of this filer under the terms of the Rule but is made voluntarily
in the interest of public disclosure and consideration of these important issues.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 3.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; background-color: white">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; background-color: white"><IMG SRC="rhiavent_logo.jpg" ALT=""></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">PROXY MEMORANDUM</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<TD STYLE="width: 0"></TD><TD STYLE="width: 1in">TO:</TD><TD>HCA Healthcare, Inc. Shareholders</TD></TR></TABLE>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0"></TD><TD STYLE="width: 1in">RE:</TD><TD>Proposal No. 5 (&ldquo;Stockholder Proposal Regarding Report on Risk Mitigation Regarding State Restrictions for Emergency Abortions&rdquo;)</TD></TR></TABLE>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0"></TD><TD STYLE="width: 1in">DATE:</TD><TD>March 27, 2024</TD></TR></TABLE>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0"></TD><TD STYLE="width: 1in">CONTACT:</TD><TD>Corporate.engagement&lt;at&gt;rhiaventures.org</TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><I>This is not a solicitation of authority to vote your proxy. Please
DO NOT send us your proxy card; Rhia Ventures is not able to vote your proxies, nor does this communication contemplate such an event.
Rhia Ventures urges shareholders to vote for Proposal No. 5 following the instructions provided on management's proxy mailing. </I></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">Rhia Ventures urges shareholders to <B>vote YES</B>
on Proposal No. 5 on the 2024 proxy ballot of HCA Healthcare, Inc. (&ldquo;HCA&rdquo; or the &ldquo;Company&rdquo;). The Resolved clause
states:</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 28pt">RESOLVED: Shareholders request that HCA&rsquo;s Board of Directors
issue a public report detailing any known and potential risks to the Company posed by state laws severely restricting abortions in the
case of medical emergencies. The report should detail any strategies beyond litigation and legal compliance that the company may deploy
to minimize or mitigate these risks. The report should be published prior to December 31, 2024, omitting confidential information and
completed at reasonable expense.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">The full text of the proposal is appended below.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">This communication has been prepared and submitted
by Rhia Ventures on behalf of the proponent of this proposal, United Church Foundation (&ldquo;UCF&rdquo;). Established in 1909, <FONT STYLE="font-weight: normal">UCF
helps churches and faith-based organizations grow their ministry through values-aligned investing.</FONT> Rhia Ventures is a nonprofit
organization developing a vibrant sexual, reproductive, and maternal health care market that contributes to equitable outcomes for all
women and other birthing people in the US. Rhia uses complementary strategies to transform this market, including direct investment, technical
assistance, field building, and corporate engagement.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"></FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center"><B><U>Why a YES Vote is Warranted for Proposal
No. 5</U></B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B>&nbsp;</B></P>

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<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in">1.</TD><TD>With numerous hospital facilities in states that have adopted stringent abortion laws, HCA Healthcare is broadly exposed to risk stemming
from the varied legal landscape restricting abortion access in the case of medical emergencies.<BR>
<BR>
</TD></TR></TABLE>

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<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in">2.</TD><TD>HCA has not evidenced, either in its public disclosures or in private dialogue with the proponent of this proposal, the existence
of risk mitigation oversight or measures specific to emergency abortions.</TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in">3.</TD><TD>Further disclosure will enhance shareholder value. Disclosing the Company&rsquo;s risk management specific to emergency abortion situations
is needed to provide assurance to investors that HCA has fully assessed the legal, reputational, market, or financial risks attendant
to emergency abortions, and is taking measure to mitigate these risks for the Company, its medical personnel, and patients.</TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">A vote FOR this proposal is a vote in favor of clear and transparent
policies.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B><U>State Laws Restricting Abortion Pose Broad Risks for HCA Healthcare
</U></B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">In June 2022, the Supreme Court overturned the
long-standing precedent established in <I>Roe v. Wade </I>affirming a constitutional right to abortion, dramatically altering the legal
landscape regarding abortion access in the United States. In the nearly two years since the <I>Dobbs v. Jackson Women&rsquo;s Health Organization
</I>ruling, 14 states have enacted near-total abortion bans (43 states altogether prohibit some abortions after a certain point in pregnancy).<SUP>1</SUP>
While all 14 states with bans beginning at conception contain exceptions to save the life of the mother, the vaguely worded statutes and
fear of legal repercussions have resulted in numerous documented instances of delays and denial of abortion services to patients whose
health and lives were in jeopardy from pregnancies that had become unviable.<BR>
<BR>
</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">According to the American College of Obstetricians
and Gynecologists (&ldquo;ACOG&rdquo;), &ldquo;The vast majority of state laws banning abortion have exceptions for &lsquo;medical emergencies&rsquo;
that are inherently vague, with language referencing &lsquo;serious risk of substantial and irreversible impairment of a major bodily
function;&rsquo; &lsquo;serious, permanent impairment of a life-sustaining organ;&rsquo; or &lsquo;a life-threatening physical condition
aggravated by, caused by or arising from a pregnancy.&rsquo;&rdquo;<SUP>2</SUP> The laws do not discuss expectations regarding the most
common obstetric complications that can lead to late-stage pregnancy loss, such as previable premature rupture of membranes, excessive
bleeding, gestational hypertension, preeclampsia, or placental abruption.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">As a result, numerous occurrences of delays and
refusals in providing care have been documented. Between September 2022 and March 2023, researchers at the Texas Policy Evaluation Project
and the University of California San Francisco collected 50 detailed cases of care that &ldquo;deviated from the usual standard due to
new laws restricting abortion&rdquo; in states with severe abortion bans. According to their report on these findings, &ldquo;[t]he post-Dobbs
laws and their interpretations altered the standard of care across these scenarios in ways that contributed to delays, worsened health
outcomes, and increased the cost and logistic complexity of care. In several cases, patients experienced preventable complications&hellip;
making it impossible for them to provide treatment sooner.&rdquo; Many health care providers have consequently faced personal and professional
strains, prompting considerations of relocation and highlighting heightened resource utilization and costs:</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.25in">Health care providers described feeling moral distress when
they were unable to provide evidence-based care that put their patients&rsquo; health at risk, as well as frustration about the additional
work involved in trying to find options for care in other states. In some cases, the dissatisfaction was so extreme that clinicians considered
moving to a state with fewer restrictions on care. In addition, health care providers highlighted how these restrictions on care increased
resource utilization, both by increasing the cost of services, particularly for treating complications, as well as by diverting clinician
time away from other patients. <SUP>3</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">Physicians in states with severely restricted
access to abortion face an enormous dilemma of having to, balance the need to care for patients proactively with the possibility of facing
criminal and civil prosecution and loss of licensure if they do take action to terminate a pregnancy.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">_____________________________</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>1</SUP> &ldquo;State Bans on Abortion Throughout Pregnancy,&rdquo;
Guttmacher Institute at https://tinyurl.com/39jchkhz.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>2</SUP> &ldquo;Questions to Help Hospital Systems Support and
Empower Physicians in the Post-Roe Legal Landscape,&rdquo; ACOG at https://tinyurl.com/yc4tr5xs.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>3</SUP> &ldquo;Care Post-Roe: Documenting cases of poor-quality
care since the Dobbs decision,&rdquo; ANSIRH at https://tinyurl.com/25rssrpb.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">The case of <I>Zurawski v. State of Texas </I>exemplifies
how the consequences of vaguely worded state laws could be exacerbated by arguably insufficient medical oversight. The plaintiffs to the
suit are five formerly pregnant women and two doctors. The five pregnant women all experienced life-threatening medical emergencies and
were denied care in Texas hospitals. Four of the women had to leave the state to receive necessary and potentially lifesaving abortions.
The only plaintiff who received her abortion in Texas had to wait until she was septic to receive care and subsequently spent three days
in ICU.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">In <I>Zurawski</I>, the plaintiff doctors expressed
that &ldquo;widespread fear and confusion regarding the scope of Texas&rsquo;s abortion bans has chilled the provision of necessary obstetric
care, including abortion care.&quot; The doctors expressed that they and their colleagues &ldquo;fear that prosecutors and politicians
will target them personally and threaten the state funding of the hospitals where they work if they provide abortion care to pregnant
people with emergent medical conditions.&rdquo;<SUP>4</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">Beyond the <I>Zurawski</I> case, recent research
sheds light on the broader challenges faced by doctors operating under abortion bans. A new study published in the Journal of the American
Medical Association&rsquo;s Network Open surveyed 54 obstetrician&ndash;gynecologists (&ldquo;OB-GYN&rdquo;) practicing under abortion
bans in 13 states. The study found that these doctors &ldquo;described a range of perceived impacts, including distress at having to delay
essential patient care, fears of legal ramifications, mental health effects, and planned or actual attrition.&rdquo; The authors characterize
these outcomes from state abortion bans as an &ldquo;occupational health crisis,&rdquo; and provide that &ldquo;[s]upporting the OB-GYN
workforce in the current policy environment is essential for preserving timely and accessible reproductive health care in the US.&rdquo;<SUP>5</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">In response to the legal constraints imposed by
abortion bans, doctors have also reported steering clear of conventional abortion methods and have instead opted for risky and dangerous
procedures that may not be construed as an abortion under the law, in an attempt to mitigate the risk of facing legal action.<SUP>6</SUP>
Reporting suggests that this widespread fear around abortion bans even extends to hospital administrators.<SUP>7</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">_____________________________</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>4</SUP> https://reproductiverights.org/wp-content/uploads/2023/03/Zurawski-v-State-of-Texas-Complaint.pdf.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>5</SUP> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10794934/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>6</SUP> https://www.nejm.org/doi/full/10.1056/NEJMp2207423</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt"><SUP>7</SUP></FONT> J<FONT STYLE="font-size: 10pt">.
David Goodman, &ldquo;Abortion Ruling Keeps Texas Doctors Afraid of Prosecution,&rdquo; NYTimes (12/3/2024), https://www.nytimes.com/2023/12/13/us/texas-abortion-doctor-prosecution.html</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">As mentioned in the Proposal text, abortion restrictions
expose HCA to risks related to physician recruitment and retention &ndash; an issue that could severely impact the Company&rsquo;s ability
to continue to provide medical services. Physicians are showing &ldquo;reluctance to practice in places where making the best decisions
for a patient could result in huge fines or even a prison sentence.&rdquo;<SUP>8</SUP> As an example of this risk, after Idaho&rsquo;s
abortion ban took effect more than 50 obstetricians (of only 227) left the state and two hospitals in Idaho closed their obstetrics programs.<SUP>9</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">HCA Healthcare is exposed to legal liability as
well as the reputational liability and employee dissatisfaction that could result from allegations of health care refusal. About 70% of
HCA&rsquo;s 182 U.S.-based hospitals are in states that have adopted laws severely restricting access to abortion. Facilities in Florida
and Texas comprise 50% of the company&rsquo;s hospitals and earn 50% of consolidated revenues. As the Company&rsquo;s latest 10-K states,
&ldquo;[t]his geographic concentration makes us particularly sensitive to regulatory, economic, public health, environmental and competitive
conditions in those states.&rdquo; In 2023, over 9.3 million patients were treated in HCA emergency rooms.<SUP>10</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B><U>What Clearer Guidance Could Look Like</U></B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">The American College of Obstetricians and Gynecologists
(&ldquo;ACOG&rdquo;), the premier professional membership organization for obstetrician&ndash;gynecologists with more than 60,000 members,
has published at least two resources for hospital systems to navigate the post-<I>Roe </I>legal landscape, including the article, &ldquo;Questions
to Help Hospital Systems Support and Empower Physicians in the Post-Roe Legal Landscape.&rdquo; Recognizing the &ldquo;inequitable and
volatile status of legal access to abortion care in the United States,&rdquo; the article begins by noting that &ldquo;it is critical
that hospital systems be able to <B>clarify to their physicians and allied health care professionals the extent and limitations of reproductive
health care that the system will support.&rdquo;<SUP>11</SUP></B> [emphasis added]</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">To achieve this overarching goal, ACOG recommends:</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">_____________________________</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>8</SUP> https://tinyurl.com/4hzbemf2</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>9</SUP> https://apnews.com/article/idaho-abortion-ban-doctors-leaving-f34e901599f5eabed56ae96599c0e5c2</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>10</SUP> HCA Healthcare 2024 10-K at https://bit.ly/3IrTygS.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt"><SUP>11</SUP></FONT> h<FONT STYLE="font-size: 10pt">ttps://tinyurl.com/yc4tr5xs</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in">Hospitals in states with abortion bans, including burdensome
restrictions and gestational bans, must maintain clear <B>policies that empower clinicians</B> to practice with autonomy within the hospital&rsquo;s
set parameters and consistent with best practices and the standard of care. In all cases, <B>hospitals should provide guidance that permits
treatment to the full extent of applicable state law</B> and <B>support and defend their clinicians</B> when they provide care to patients.
Hospitals should also establish processes that health care professionals can follow to <B>connect patients with care</B> that they are
not allowed to provide, including care in other states. As patients in need of care continue to travel beyond state lines for care, hospitals
in unrestricted states should <B>take action to address the capacity issues</B> created by increased volume of patients.<SUP>12</SUP>
[emphases added]</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">Questions to develop unified strategies along
with clinicians to navigate the evolving and heavily regulated legal environment surrounding abortion include:</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-family: Symbol">&middot;</FONT></TD><TD><FONT STYLE="font-family: Times New Roman, Times, Serif">What is our institution doing to help protect clinicians and their pregnant
patients who present for care? Does our institution have policies and processes to protect health care professionals from the consequences
of abortion bans when they provide evidence-based medical care to intervene in emergent situations? What does liability coverage look
like in these situations?</FONT></TD></TR></TABLE>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-family: Symbol">&middot;</FONT></TD><TD><FONT STYLE="font-family: Times New Roman, Times, Serif">How can our institution implement processes for protecting the privacy of
people who travel from states in which abortion care is banned?</FONT></TD></TR></TABLE>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-family: Symbol">&middot;</FONT></TD><TD><FONT STYLE="font-family: Times New Roman, Times, Serif">What steps can our institution take to support clinicians when they are unsure
what care they can provide to a patient under a state&rsquo;s laws?</FONT></TD></TR></TABLE>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-family: Symbol">&middot;</FONT></TD><TD><FONT STYLE="font-family: Times New Roman, Times, Serif">Does our institution have resources available to clinicians in real time?
Do we provide guidance in a timely fashion and in a way that maximizes care consistent with the law in our state?</FONT></TD></TR></TABLE>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-family: Symbol">&middot;</FONT></TD><TD><FONT STYLE="font-family: Times New Roman, Times, Serif">For institutions in restrictive states: How can our hospital establish seamless
transfer and referral of patients we are unable to care for at our institution due to state laws or personnel availability?</FONT></TD></TR></TABLE>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-family: Symbol">&middot;</FONT></TD><TD><FONT STYLE="font-family: Times New Roman, Times, Serif">For institutions in protective states: What is our hospital doing to meet
capacity demands for people who need to access abortion care at our institution?</FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">These questions will yield different answers for
different facilities due to numerous variables, among them, how individual statutes define exceptions to state bans, and the extent to
which those statutes prohibit medical personnel from referring patients to care providers that offer abortion services. Nonetheless, with
9.3 million emergency room visits per year, HCA cannot afford <U>not</U> to undertake an internal audit of this nature, as the subject
proposal requests.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">In neither its public disclosures nor in private
dialogue with the proponent of this proposal has HCA Healthcare evidenced the existence of training, written policies, or guidance aimed
at educating medical personnel on relevant laws and their interpretation, how they can (or cannot) connect patients to out-of-state care,
physician liability, and protocol for medical personnel to obtain legal counsel during a real time crisis or evaluate capacity demands.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">_____________________________</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>12</SUP> Ibid.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">In December 2022, in response to a shareholder
proposal, HCA posted a statement on its website that stated: &ldquo;In medical emergency circumstances, a licensed and appropriately credentialed
physician at an HCA Healthcare hospital may perform an emergency abortion that such physician (exercising his or her independent medical
judgment) determines and documents as meeting an applicable federal requirement or state law exception.&rdquo;<SUP>13</SUP> While this
is a start, the statement is not a substitute for a more expansive guideline addressing the questions and concerns identified above &ndash;
particularly because the question of whether the federal requirement or state law exceptions prevails is currently unsettled, as addressed
directly below.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B>&nbsp;</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B><U>Complicating Issue: Conflict Between Federal and State Law </U></B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">The Emergency Medical Treatment and Labor Act
(&ldquo;EMTALA&rdquo;) requires any hospital which participates in Medicare to screen any person who comes to the hospital, regardless
of that person&rsquo;s ability to pay for medical services. If the screening process shows that the person has a medical condition, the
hospital then has an obligation to provide stabilizing treatment. EMTALA was described by the President of the American College of Emergency
Physicians as, &ldquo;a bedrock law and the foundation of the emergency care safety net in this country.&rdquo;<SUP>14</SUP> All of HCA&rsquo;s
hospitals in the US are subject to EMTALA.<SUP>15</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">The types of care necessary for stabilization
are not specifically outlined in EMTALA, including whether abortion care is required under the statute if a pregnant person&rsquo;s health
is in danger.<SUP>16</SUP> In response to <I>Dobbs</I>, President Biden directed the Department of Health and Human Services (&ldquo;HHS&rdquo;)
to issue a guidance<SUP>17</SUP> (the &ldquo;HHS Guidance&rdquo;) clarifying that EMTALA preempts conflicting state abortion bans. Specifically,
the HHS Guidance explained that if abortion has been determined to be the stabilizing treatment necessary to resolve the emergency medical
condition identified, then the physician must provide it, &ldquo;[a]nd when a state law prohibits abortion and does not include an exception
for the life and health of the pregnant person &mdash; or draws the exception more narrowly than EMTALA&rsquo;s emergency medical condition
definition &mdash; that state law is preempted.&rdquo;<SUP>18</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">_____________________________</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt"><SUP>13</SUP></FONT> &ldquo;<FONT STYLE="font-size: 10pt">Disclosure
Statements as of 12/20/2022&rdquo; at https://hcahealthcare.com/legal/index.dot#responsible-disclosure. </FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>14</SUP> https://tinyurl.com/3fx9vebk</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>15</SUP> HCA Form 10-K (2024) at 24.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>16</SUP> It states: &ldquo;A medical condition manifesting itself
by acute symptoms of sufficient severity (including severe pain, psychiatric disturbances and/or symptoms of substance abuse) such that
the absence of immediate medical attention could reasonably be expected to result in: Placing the health of the individual (or, with respect
to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy.&rdquo;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>17</SUP> https://www.cms.gov/files/document/qso-22-22-hospitals.pdf</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>18</SUP> https://www.hhs.gov/sites/default/files/emergency-medical-care-letter-to-health-care-providers.pdf</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">Two lawsuits are challenging the HHS Guidance
(<I>Texas v. Becerra</I> and <I>Idaho v. United States</I>). The latter is currently before the US Supreme Court. According to the law
firm Foley Hoag, the Court is likely to weigh in on the central question at issue &ndash; whether EMTALA preempts a state abortion law
that does not allow an exception in cases where a physician determines that abortion is necessary as a stabilizing treatment under EMTALA.<SUP>19</SUP>
One thing is clear: <B>however the Court rules - it will still be necessary for hospitals to guide, train, and defend medical personnel,
and to inform patients in crisis about their options to the extent permitted by law.</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in"><B>&nbsp;</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B><U>Complicating Factor: Catholic Ethical and Religious Directives
(ERDs)</U></B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">As the legal landscape surrounding EMTALA and
abortion laws remains uncertain, the implications for certain faith-based hospitals, which must navigate conflicting mandates, become
increasingly complex. HCA Florida Healthcare in Miami (formerly Mercy Hospital) adheres to the Ethical and Religious Directives (&ldquo;ERDs&rdquo;)
for Catholic Health Care Services, which prohibit abortion care. HCA Florida Healthcare&rsquo;s website features a page that describes
high-risk pregnancies as one of the hospital&rsquo;s specialties.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">The HHS Guidance regarding EMTALA conflicts with
the ERDs. While we will not attempt to describe the nuances of how the Catholic church defines abortion or its moral permissibility, it
is understood that under the ERDs, the church allows abortion under the concept of &ldquo;double effect,&rdquo; wherein termination of
a pregnancy may be permissible for procedures which &ldquo;do not directly intend the termination of a pregnancy and do not have ending
a pregnancy as their sole, immediate effect.&rdquo;<SUP>20</SUP> <B>This complexity further supports the necessity of clear guidance from
HCA.</B> It would be impossible for an HCA Healthcare facility to follow both EMTALA and the ERDs regarding emergency abortions. The Company
should clarify which standards it requires HCA Florida Healthcare to follow.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; color: #FB0017">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B><U>Response to the Statement of the Board of Directors in Opposition
to the Stockholder Proposal</U></B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 4.5pt"></TD><TD STYLE="width: 13.5pt"><B>1.</B></TD><TD><B>HCA&rsquo;s opposition statement wrongly characterizes this proposal as focusing mainly on risk mitigation, asserting that its
risk mitigation processes, and oversight mechanisms sufficiently address the concerns raised in the proposal.</B></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">If the Company has been implementing risk measures
specific to emergency abortions, a logical place to reference or discuss them would be in the opposition statement to this proposal. But
the opposition statement is entirely silent on the matter, and there is no evidence of any specific measures to mitigate risk around emergency
abortions in any of HCA Healthcare&rsquo;s disclosures. HCA has also declined to share any such policies in private dialogue with the
proponent of this proposal. Investors are left without sufficient information to determine if HCA is properly managing the immense and
complex risks related to emergency abortion care.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B>&nbsp;</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B>_____________________________</B></P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B>&nbsp;</B></P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>19</SUP> &ldquo;EMTALA Abortion Question Set up for Supreme Court
Review,&rdquo; at https://tinyurl.com/45j8tnv4</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>20</SUP> https://tinyurl.com/54m9yn98.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0"></TD><TD STYLE="width: 22.5pt"><B>2.</B></TD><TD><B>HCA claims the scope of the request is too broad, necessitating analysis of the current laws in all 20 states in which it operates,
as well as consideration of &ldquo;all proposed bills and regulations, speculation about the result or outcomes of relevant pending state-level
litigation, and any current or proposed administrative policies of state governmental bodies.&rdquo;</B></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">HCA fundamentally misstates the request and scope
of the proposal. The Proposal calls for an analysis of known and potential risks to the Company about state laws severely restricting
abortions in the case of medical emergencies, and strategies it may deploy to mitigate those risks. This does not necessarily require
an analysis of individual state laws. HCA could satisfy the request of the proposal by, among other approaches, conducting a legal landscape
analysis, developing a risk assessment framework, selecting&nbsp;a representative sample of state laws for case studies, seek input from
legal experts&nbsp;specializing in healthcare law and reproductive rights, and/or engage with stakeholders&nbsp;to gather diverse perspectives
on the potential risks and implications of state abortion laws for the company. Nevertheless, discretion on how to satisfy the proposal's
request is ultimately left to management. To the extent the Board determined that such a report requires a state-by-state analysis, such
a report is consistent with many other state-specific actions and reporting done by the Company.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 22.5pt">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 22.5pt">HCA&rsquo;s political participation is extensive.
It includes lobbying activity and annual donations of millions of dollars from the corporate treasury and employee PAC to hundreds of
state and federal politicians and their associated PACs, and membership in trade associations.<SUP>21</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 22.5pt">Given HCA&rsquo;s substantial participation in
the political process, it would be reasonably expected that the Company&rsquo;s government relations team already engages in monitoring
political activity with a high level of sophistication, including judicial developments and legislation at the state and federal level.
It would also be expected that HCA is actively monitoring, analyzing, and forecasting developments regarding the topic at hand. Indeed,
HCA&rsquo;s latest Annual Report identifies &ldquo;severe penalties&rdquo; and legal liability related to EMTALA violations as a risk
to the Company, noting specifically that &ldquo;[h]ospitals may face conflicting interpretations of EMTALA&rsquo;s requirements with respect
to state laws that limit access to abortion or other reproductive health services.&rdquo;<SUP>22</SUP> The disturbing alternative is that
the opposition statement is an indirect admission that the Company is not closely following proposed changes in laws that could lead to
its inadvertent complicity in preventable harm to patients, including death.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">If indeed this monitoring is taking place, given
the Company&rsquo;s commitment and infrastructure to political participation, reporting on its findings should not be overly burdensome.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">_____________________________</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>21</SUP> HCA Healthcare Political Participation Overview, January
1, 2023 - June 30, 2023</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>22</SUP> HCA Form 10-K (2024) at 24.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">Lastly, we reject the Company&rsquo;s contention
that the request report would quickly become dated as a reason for not doing the report. Of course, just like financial statements, the
report will not remain applicable in perpetuity. Transparency into the Company&rsquo;s risk oversight is necessary <B>now</B> to ensure
that those risks are being properly handled and will not escalate to become even more dangerous and costly. A report of this type could
also be updated at the Company&rsquo;s discretion.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B>Vote &ldquo;Yes&rdquo; on this Shareholder Proposal No. 5.</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><I>For questions, please contact Corporate.Engagement@rhiaventures.org.</I></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">THE FOREGOING INFORMATION MAY BE DISSEMINATED TO SHAREHOLDERS VIA TELEPHONE,
U.S. MAIL, E-MAIL, CERTAIN WEBSITES AND CERTAIN SOCIAL MEDIA VENUES, AND SHOULD NOT BE CONSTRUED AS INVESTMENT ADVICE OR AS A SOLICITATION
OF AUTHORITY TO VOTE YOUR PROXY. PROXY CARDS WILL NOT BE ACCEPTED. PLEASE DO NOT SEND YOUR PROXY TO RHIA VENTURES. TO VOTE YOUR PROXY,
PLEASE FOLLOW THE INSTRUCTIONS ON YOUR PROXY CARD.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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    <!-- Field: /Page -->

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><U>Text of Proposal</U></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">Report on Risk Mitigation Regarding State Restrictions
for Emergency Abortions</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">According to its 2022 Factsheet: &ldquo;HCA Healthcare
is one of the nation&rsquo;s leading providers of healthcare services with 182 hospitals and 2,300+ sites of care, including surgery centers,
freestanding ERs, urgent care centers, home health, and physician clinics located in 20 states.&rdquo; However, about 70% of HCA Healthcare&rsquo;s
US-based hospitals operate in states that have adopted laws severely restricting access to abortion absent exigent circumstances that
often differ from federal statutory emergency abortion exceptions; the Florida and Texas facilities represent 50% of the company&rsquo;s
hospitals and 50% of consolidated revenues. According to HCA&rsquo;s 2023 10-K: &ldquo;This geographic concentration makes us particularly
sensitive to regulatory, economic, public health, environmental and competitive conditions in those states.&rdquo;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">For example, it has been widely reported that
in states that have passed severe restrictions on abortion, doctors have been struggling with the legality of providing terminations for
ectopic pregnancies, incomplete miscarriages, or other circumstances where miscarriage is inevitable, or the health or life of the pregnant
woman is in danger. This uncertainty is not only dangerous for patients, but also puts physicians and the hospital at legal risk. The
Department of Health and Human Services has already begun investigating and found that at least two hospitals violated federal law when
they denied a patient abortion care. The potential for improperly denying abortion care poses legal, financial, and reputational risks
to HCA.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">Further, abortion bans are creating impediments
to physician recruitment and retention. Physicians are showing &ldquo;reluctance to practice in places where making the best decisions
for a patient could result in huge fines or even a prison sentence.&rdquo;<SUP>1</SUP> This trend has already begun, with fewer medical
school graduates applying to residencies in abortion ban states.<SUP>2</SUP> If this worrying trend continues, it will pose risks to HCA
beyond limited capacity for abortion services - there will be fewer physicians and fewer services being provided for all obstetric and
gynecological patients at HCA.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">The patchwork of state and federal laws regarding
abortion (specifically the varying definitions for what constitutes a medical emergency warranting an exception) poses risks for HCA because,
as a healthcare provider, it must necessarily make determinations for when it can legally provide an abortion.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">RESOLVED: Shareholders request that HCA&rsquo;s
Board of Directors issue a public report detailing any known and potential risks to the Company posed by state laws severely restricting
abortions in the case of medical emergencies. The report should detail any strategies beyond litigation and legal compliance that the
company may deploy to minimize or mitigate these risks. The report should be published prior to December 31, 2024, omitting confidential
information and completed at reasonable expense.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">SUPPORTING STATEMENT: Shareholders recommend that
the report evaluate: how the Company makes determinations regarding arguably conflicting state and federal laws; how the Company educates
its medical professionals on the evolving legal landscape; and how it recruits and retains medical professionals in restrictive states.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">_____________________________</P>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>1 </SUP>https://www.npr.org/sections/health-shots/2023/05/23/1177542605/abortion-bans-drive-off-doctors-and-put-other-
health-care-at-risk<BR>
<SUP>2</SUP> https://www.aamc.org/advocacy-policy/aamc-research-and-action-institute/training-location-preferences</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: right">12</P>

<P STYLE="margin: 0"></P>

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end
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
