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

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viewkind4uc1pardhighlight1f0fs24 (Reuters) - The U.S. House of Representatives on Thursday unveiled its final proposal to overhaul the nation's $2.5 trillion health care system. The legislation combines three previous committee bills but could still face changes before lawmakers vote on it.\par

Following are some of the health industry winners and losers based on the House bill.\par

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LOSERS...\par

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HEALTH INSURERS\par

Already braced for competition from a government-run insurance plan, health insurers such as UnitedHealth Group Inc, Cigna Corp and others would take a further hit under the latest version of the House bill.\par

The measure takes direct aim on profit margins. It would force insurers to immediately start giving customer rebates if less than 85 percent of an enrollee's premiums were spent on actual care.\par

The public plan itself could also undercut insurers by paying doctors, hospitals and others rates as low as those by the Medicare plan for the elderly and disabled. Rate hikes by private insurers would also be scrutinized.\par

The bill also would eliminate the exemption health insurers had from antitrust laws, explicitly barring them from price fixing, bid-rigging or dividing up markets.\par

And while individuals would have to buy a plan or pay a fee as high as 2.5 percent of their adjusted income -- a move backed by insurers -- more smaller businesses would be exempt from the requirement to offer coverage.\par

Government reimbursement for private Medicare Advantage health plans would also see cuts.\par

Lawmakers did not include a tax on more extensive, so-called "Cadillac" health care plans or impose any other fees on the industry, as one Senate version did.\par

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DRUGMAKERS\par

Drugmakers would take a larger hit under the House bill than with another Senate version, which included an agreement with the industry to provide $80 billion worth of savings over 10 years.\par

The House version would require drug companies to pay rebates to the government for drugs used by elderly and disabled Medicare patients who also are on Medicaid, the health program for the poor. It also would require the health secretary to negotiate drug prices under Medicare.\par

Drugmakers, which include Pfizer Inc, GlaxoSmithKline Plc, Merck & Co Inc and others, have opposed both ideas.\par

The House bill would gradually eliminate the Medicare "doughnut hole," when prescription drug costs are not covered, by 2019. The drug industry had agreed to provide a 50 percent discount for drugs in the doughnut hole over the next decade.\par

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WINNERS ...\par

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DEVICEMAKERS\par

Lobbyists representing medical devicemakers such as Boston Scientific Corp <BSX.N