The presidential election of Donald Trump combined with the Republicans retaining majorities in Congress leads to greater uncertainty for healthcare stocks. While Trump and the Republicans have been clear on the desire to repeal the Affordable Care Act, there is less clarity on their healthcare policies, except for the focus on reducing regulations. We suspect as plans take shape to repeal the ACA, the likely outcome will be more of a modification than a complete repeal as several groups have benefited from the legislation.
If the ACA were repealed, the outcome will likely mean a lower demand for healthcare combined with less industry fees and profit restrictions. The passage of ACA was largely a compromise with industry stakeholders, mandating increased insurance coverage in return for lower costs. Reversing this mandate is largely a net neutral to the healthcare sector, with the drug, biotech, and insurance industries slightly benefiting, hospitals and drug supply chain firms negatively impacted, and the remaining industries less influenced.
On stock valuations, a repeal of the ACA would create some changes to healthcare fair values, but without clarity on the Republican plans, we have not made any changes to our fair value estimates. The drug industry would likely lose some volume gains as the close to 20 million newly insured patients from the ACA will likely lose some insurance coverage and spend less, but the mandated costs of ACA would likely more than offset the lost revenue. Similarly, for managed care organizations, the increased profitability without ACA restrictions would likely more than offset lost volumes. However, hospitals would face challenges due to the likely reversal of the declines in uncompensated care and higher volumes from the newly insured patients. Also, drug supply chain firms from Pharmacy Benefit Managers to drug distributors would face headwinds due to the lost benefit of drug demands from the newly insured patients.
At the same time, we have mixed thoughts on the near-term impact the election may have on housing. We think that the related uncertainty and market volatility could dampen near-term home sales. At the time of this writing, S&P 500 futures have recovered from session lows; however, we think sustained market weakness would no doubt have a negative impact on housing demand. That said, according to the Fannie Mae Home Purchase Sentiment Index survey conducted before the election, more than half of Americans surveyed believe the United States economy is headed in the wrong direction. We see the election results as a strong mandate for change in Washington, and we submit that the election outcome may spur increased confidence in some Americans, which could act as a tailwind for housing. At this time, we are not materially updating our housing forecast, and we will review the longer-term impact the election may have on housing fundamentals as more policy details emerge from the Trump administration.
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