More information. New York Times:
With a sweeping overhaul of the nation’s health care system, Congress would be giving the health care industry as many as 32 million additional paying customers in the next few years.
That would mean millions more Americans buying private health insurance and better able to pay for their hospital stays, doctors’ visits, prescription drugs and medical devices.
And some analysts said as the vote neared that the final legislation was shaping up as much kinder to the industry than many initially feared. Hospitals and drug makers, which supported the final legislation, would be clear beneficiaries, analysts say, even if the outlook for insurers was less certain.
Yet the bill would not create the thing that insurers feared most: a government-run public option, a health plan that would compete with the private insurers.
Over all, the legislation would be a positive for much of the industry, said Les Funtleyder, who oversees health care strategy for Miller Tabak & Company, a New York investment firm.
There is no question that insurers would face the most strikingly different business environment, with drastic changes in the way insurance is sold to individuals and small businesses, one of the industry’s most profitable areas. There would also be much heavier regulation.
“It’s a huge business risk,” said Rick Weissenstein, a health care policy analyst at Concept Capital, which follows developments for investors. “There are going to be some insurers that aren’t going to adapt very well.”
But insurers are expected to benefit from the influx of new customers after years of shrinking enrollments. About 16 million of the newly insured are expected to enroll in private plans. The rest would become eligible for Medicaid, the state-administered program for the poor, but some of those would probably sign up for privately run Medicaid plans available in different states.
One place where the rules of the insurance game may shift most significantly is in a new kind of state-supervised marketplace, called exchanges, in which insurers would be required to sell their policies for individuals and small businesses. The exchanges are expected to involve much greater regulatory oversight than insurers now typically face and to alter their business models drastically. Currently, insurers seek to protect profits by trying to enroll only the healthiest individuals, while also charging enough to recoup the expense of covering sick people. But the legislation requires insurers to cover even people with potentially costly pre-existing conditions.
The new law would also place strict limits on how much more an insurer could vary premiums among the people taking out the same policy, largely to factor in age differences.
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