FACTBOX: Health sector winners, losers in U.S. reform bill

Thu Oct 15, 2009 5:13pm EDT

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(Reuters) - The U.S. Senate Finance Committee on Tuesday approved its version of legislation to overhaul the nation's $2.5 trillion health care system.

Following are some of the health industry winners and losers based on the Senate committee's bill.

WINNERS ...

DRUGMAKERS

* The pharmaceutical industry kept intact an $80 billion rebate agreement with Finance Committee Chairman Max Baucus and the White House. The industry successfully fended off a challenge that would have called on Pfizer Inc, GlaxoSmithKline Plc, Merck & Co Inc and others to give back $106 billion over 10 years in additional drug rebates under the Medicare insurance program for the elderly and disabled.

HOSPITALS

* Hospitals kept a $155 billion, 10-year deal with Baucus and the White House to accept lower government payments from the Medicare and Medicaid health insurance programs in exchange for what the industry hopes will be an increase in insured customers. Analysts do not expect the deal to change much even as the bill is meshed with other proposals.

* Hospitals, which include companies such as Universal Health Services Inc and Tenet Healthcare Corp, were also exempted from any decisions made by an independent Medicare Commission that would set reimbursement rates and make other changes to the program.

LABORATORY TESTING COMPANIES

* Laboratory companies were happy to see the committee's final bill drop a $750 million annual fee that had been included in Baucus's original proposal. The fee would have hurt companies such as Quest Diagnostics Inc and Laboratory Corporation of America Holdings.

IMAGING COMPANIES

Imaging companies scored a victory with cuts to payments for MRIs and other high-tech scans totaling an estimated $3 billion over 10 years, a figure lower than the $4.3 billion in a House healthcare bill. Makers of imaging equipment include General Electric Co, Siemens AG and Philips Electronics NV.

LOSERS ...

HEALTH INSURERS

* The insurance industry can claim a partial victory because it lobbied to defeat amendments that would have introduced a new government-run health insurance program. But the industry, which includes Aetna Inc, UnitedHealth Group Inc, Cigna Corp and Humana Inc, still faces more than $6 billion a year in fees.

* Private Medicare Advantage health plans for the elderly and disabled offered by some companies will face a competitive bidding process that aims to save the government $123 billion. Such plans can offer more benefits than traditional fee-for-service Medicare coverage but cost more.

DEVICEMAKERS

* Medical devicemakers, such as Boston Scientific Corp, Medtronic Inc and Stryker Corp, still face a $4 billion-a-year fee over 10 years, although some analysts say that could be reduced as the various proposals are melded together. The industry is expected to keep fighting to remove or reduce the fee.

PHARMACY BENEFIT MANAGERS

* Companies like CVS Caremark Corp, Express Scripts Inc and Medco Health Solutions Inc, unsuccessfully fought a provision requiring them to give the Department of Health and Human Services information about rebates they get from drugmakers compared to those through private Medicare drug plans, also known as Part D plans.

(Reporting by Susan Heavey, additional reporting by Bill Berkrot, Lewis Krauskopf in New York; Editing by Leslie Gevirtz and Richard Chang)

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