Shares of surgical robotics company Intuitive Surgical tumbled in pre-market trading following its second-quarter earnings report, despite results exceeding expectations. The company maintained its full-year procedure growth outlook but warned that changes in U.S. healthcare policy could affect patient timing, sparking a debate about demand for medical technology. The stock was down more than 12%.

The financial report showed second-quarter revenue grew 19% year-over-year to $2.89 billion, surpassing analyst estimates of $2.82 billion. Adjusted earnings per share were $2.80, significantly higher than the expected $2.51. Combined global procedure volume for the da Vinci and Ion platforms increased by 16%, with da Vinci procedures up 15% and Ion procedures surging 36%.

However, slowing growth in the U.S. market has raised concerns. Second-quarter da Vinci procedure volume in the U.S. grew 12%, which was below the company's initial expectations for the year, with the slowdown concentrated in deferrable procedures. CEO Dave Rosa stated on the earnings call that some customers have indicated that changes in patient insurance coverage and premiums may be influencing their decisions on when to seek care and undergo treatment. The company believes the expiration of ACA subsidies had a "modest negative impact" on U.S. da Vinci procedure growth in the quarter.

Analysts at Evercore ISI noted that Intuitive Surgical's U.S. procedure growth rate was the lowest in three years, reigniting market discussion about the impact of ACA policy. Previously, medical device maker Abbott had characterized assumptions about a substantial industry impact from declining ACA enrollment as a "false premise," but Intuitive Surgical's cautious tone has brought this debate back to the forefront.

The company maintained its full-year 2026 outlook for da Vinci procedure growth of 13.5% to 15.5%, expecting growth near the midpoint of that range. This guidance implies a deceleration in growth during the second half of the year. Increasing competition is another underlying worry, with Medtronic seeking to expand the indications for its Hugo surgical system and Stryker launching its Mako robotic system for total knee replacement this week.