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Bexar County approves University Health System$4.3 billion operating plan for 2026
Summary
The commissioners unanimously approved University Health System(UHS) FY2026 operating, debt-service and capital budgets after presentations by UHS leadership outlining new community hospitals, jail behavioral-health programs and budget drivers including property tax revenue and medical-education shortfalls.
University Health Systempresented its FY2026 operating, debt-service and capital budget and the Bexar County Commissioners Court voted to approve it, citing investments in community hospitals and programs to expand behavioral health and jail medical care.
UHS leadership told the court the health systemexpects roughly $4,300,000,000 in revenue for 2026. "This is our revenue budget for '26 at 4 point about $4,300,000,000," said Reid Hurley, UHS chief financial officer. Hurley said property taxes (M&O) account for about $564,000,000 or roughly 13.1% of that revenue, and that operating expenses are budgeted at about $4.1 billion, yielding a budgeted bottom line of about $42,000,000 after depreciation and other items.
The presentation by UHS leadership emphasized capital investments: the Palo Alto and Ratama community hospitals and the VIDA building, projects the system says will expand primary, specialty and behavioral-health capacity across Bexar County. Ed Banos, the systemrepresentative who briefed commissioners, said UHS recently acquired a 45-acre CHRISTUS campus and plans to use it for ambulatory services that complement the system's transplant and specialty programs; the campus includes ground-leased medical-office buildings and an unfinished solar array estimated to save about $150,000to $200,000 a year once activated.
Commissioners focused questions on workforce readiness for two new hospitals coming online and on coordination with surrounding counties. Hurley and other UHS management said hospital staff will come largely from existing employees with backfill hiring, and described partnerships with local nursing schools to expand workforce pipelines. UHS also described a jail opioid-assistance program that now serves more than 180 patients in custody and highlighted an accreditation review that praised its coordination with sheriff's staff.
After the presentation and a period of questions, the court moved to approve UHSFY2026 operating, debt-service and capital budgets. The motion carried.
What happens next: UHS will proceed with construction and staffing plans for the community hospitals and the court asked staff to keep commissioners updated on workforce and budget risks, especially potential federal policy changes that could alter exchange-plan subsidies and county uninsured-care burdens.
