Commissioners Approve University Health's $4.3 billion FY2026 Budget After Presentation

University Health officials presented the health system's FY2026 operating, debt service and capital budgets at the Bexar County Commissioners Court on Dec. 9, and the court approved the budgets after brief questioning.

Reid Hurley, University Health's chief financial officer, told the court the revenue budget for 2026 is about $4.3 billion and operating expenses are roughly $4.1 billion, leaving an operating gain of roughly $160 million and a budgeted bottom line near $42 million. "This is our revenue budget for '26 at 4 point about $4,300,000,000," Hurley said. He also told the court that property tax (M&O) revenue represents about 13.1% of the total and that the system provides approximately $361 million annually in care for uninsured patients, of which $331 million is tied to services for Bexar County residents.

Ed Banos, the system's chief executive (introduced to the court earlier by UHS staff), walked the court through capital projects including the Palo Alto and Ratama community hospitals and the recently acquired CHRISTUS Santa Rosa campus. Banos said the community hospitals are on track and emphasized behavioral-health expansion and jail-based clinical programs. "We currently... have a significant number of capital projects as we have shared with the court in the past," he said, describing the goal of increasing access to primary and mental health services across Bexar County.

Commissioners asked about workforce capacity for two new community hospitals opening in 2027 and 2028 and the handling of services shifted to the CHRISTUS campus. Hurley said the system expects to staff most new facilities from existing employees and to backfill where needed; he added that UHS has more than 3,500 nurses with turnover near 10%, below the national average. After discussion the court approved the budget by unanimous voice vote.