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The U.S. Senate voted this morning to pass the health-care reform bill, moving us closer to capping off the long process that's weighed on health-care stocks this year. If it's made into law, the $871 billion bill will represent the largest expansion of health-care coverage since the creation of Medicare in 1965.
Of course, we're not quite done; the Senate's bill must be merged with the House version before it can become law. Here's a look back at the health-care-reform debate, and a preview of what to expect in January, once the fight heats up again.
The disappearing, reappearing option
Considering how many times it flip-flopped in and out of the Senate bill, the public option would make a mighty fine politician. In the end, a government-sponsored plan ended up out of the final Senate version, but in the House version.
I expect this will be the biggest sticking point in the negotiations between the two houses. Liberal members of the House will fight to keep it in, but if the combined bill contains a public option, the Senate may not have enough votes to end debate and pass the bill.
Expect health insurers like UnitedHealth Group (NYSE: UNH ) , and WellPoint (NYSE: WLP ) to use their clout to fight against the public option. The companies are worried about competing with a nonprofit entity, which might compress their already thin margins.
I don't have much confidence in the government running anything efficiently, so I'm not convinced investors should be worried about whether the public option ends up in the final bill. Insurers are a resourceful bunch; they'll figure out how to make it work.
Insurance for all (whether you like it or not)
Both the House and the Senate bills contain provisions that require most Americans to carry health insurance or pay a fine. The requirement doesn't exactly follow the tradition of American freedom -- in fact, some Republicans are trying to question its constitutionality -- but I think it's the best part of the bill.
Getting everyone, even the relatively healthy, into the insured pool allows health insurers to spread the costs around. In exchange, health insurers are required to cover everyone, regardless of preexisting conditions. Americans will no longer be tied to their employer for health insurance, because they'll be free to get health insurance on their own if they choose to leave their jobs.
The other advantage to requiring coverage is that it could actually cause health insurance premiums to go down. Currently, insured people indirectly pay for the expenses incurred by the uninsured. Since hospitals can't deny emergency coverage, the money that they can't recover from uninsured patients ultimately gets paid through higher costs for those who do have insurance. According to the president, your bill runs about $1,000 a year. Ouch.
A taxing endeavor
Someone has to pay for this thing, and it's been interesting to see who has the most clout in Washington. Pharmaceutical companies negotiated early. Medical-device companies like Boston Scientific (NYSE: BSX ) and Medtronic (NYSE: MDT ) looked like they were going to get a big hit, but managed to whittle down their tax considerably. And cosmetic treatments like wrinkle removers and breast implants made by Allergan and Johnson & Johnson (NYSE: JNJ ) managed to get their proposed tax removed altogether. Tanning salons (and their customers) apparently don't have that great of a lobby; they've been slapped with a 10% tax, which will raise an estimated $2.7 billion over the next 10 years.
The only question now is whether the companies will end up being able to pass the costs along to consumers. Will investors have to pay for health-care reform with their portfolios or their pocketbooks?
All I want for Christmas is my conference committee
While it's been exciting watching health-care stocks trade at the whim of legislators' latest idea to overhaul the industry -- not unlike AIG (NYSE: AIG ) and Citibank (NYSE: C ) -- I'm looking forward to going back to valuing health-care companies based on fundamentals. Let's just hope the conference committee doesn't drag too far into 2010.