FACTBOX: Health company winners, losers in U.S. House bill

WASHINGTON (Reuters) - The U.S. House of Representatives voted 220-215 on Saturday to pass legislation overhauling the nation’s $2.5 trillion health care system.

The Senate must also vote on its version of a bill, which is not expected until December at the earliest, and both chambers would then meet to work out a final measure.

Following are some of the winners and losers in the U.S. healthcare industry based on language in the House bill.



Health insurers such as UnitedHealth Group Inc, Cigna Corp and others could see greater competition, more scrutiny and fewer protections under the bill.

The sector has said it would take a big hit from a government-run insurance plan that Democrats say would force insurers to streamline. Cooperative exchanges and the sale of insurance plans across state lines also aim to give consumers more information and choices that could redefine the market.

Profit margins could also shrink with the bill, forcing insurers to give customer rebates if less than 85 percent of an enrollee’s premiums are spent on actual care.

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

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

And while individuals would have to buy a plan or pay a fee -- a move backed by insurers -- more smaller businesses would be exempt from the requirement to offer coverage.

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


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.

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.

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

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.



Lobbyists representing medical devicemakers such as Boston Scientific Corp, Medtronic Inc and Stryker Corp successfully whittled down an expected $4 billion annual fee to $2 billion. The industry had wanted the fee removed altogether.


Brand-name makers of biotechnology drugs would see their medicines protected from cheaper copycats for at least 12 years. This is a win for the brand-name companies, such as Amgen Inc and Roche Holding AG’s Genentech unit, and a defeat for generic drugmakers that want a shorter period.

(For full coverage of U.S. healthcare reform, click on [nN20512341])

Editing by Doina Chiacu