Sure, the ACA touches a lot of stakeholders and has a jillion moving parts. That's inevitable when you're trying to improve things, much less fix some of the terrible problems our health system has. Under such circumstances, it's hardly surprising that observers from key industries in the healthcare world aren't willing to predict who the winners and losers will be under health reform.
That being said, there is one group of pundits that everyone listens to -- they have no choice -- and who aren't known for sentiment. And that's Wall Street. So when Wall Street treats a bloc of industry stocks kindly, it's impossible to ignore.
And that's why I'm willing to step out and say that despite a whole lotta complaining by health insurance industry leaders, it's the health insurance business that's going to gain the most from the ACA.
While Wall Street might punish mildly those health insurance companies that don't make their numbers, on the whole stocks of the big players in healthcare insurance (such as Humana, Wellpoint and UnitedHealthcare) haven't taken any plunges. Whether the reason is high premium rates, a shift to narrower networks or some other factor, the money-watchers on Wall Street seem to believe insurers are going to be just fine. In fact, many major health plans are near their 52-week highs.
But wait, you say: Aren't health care providers going to profit from seeing more patients with insurance? Wouldn't that make them winners too? Well, not really. The truth is, hospitals and doctors will be lucky to make a percentage point or two extra in their revenues, I'd argue.
It seems logical to argue that doctors are going to see less bad debt now that more people are insured under the ACA, but I'd submit that physicians will benefit little from ACA policies, which come with staggering deductibles which are as much as $10,000 per family. For doctors hoping to collect, say, a $500 bill, their patients' insurance is worthless to them, as such patients are no more likely than they were before to be able to pay off these charges out-of-pocket.
No, it seems that health insurers are the best positioned to move the healthcare industry in the direction they wish -- and that direction is "give us your money and we will cover you if we feel like it." Health plans even have access to a $5.5 billion fund to cover their losses for this year. Folks, if I were a bettin' woman, I'd say that Wall Street will continue to love them some health insurance plans. Like it or not, that's where the ACA has taken us.