A Christmas Gift for the Insurers?

I’m a little late on this, but had to share the latest evidence that investors in private health insurance companies feel they prevailed in their lobbying efforts over the Democratic health care bill. Here’s what happened after the Senate voted to break the Republican filibuster on Monday, according to the AP:

Shares of Aetna rose $1.81, or 5.6 percent, to $34.32; Cigna gained $2.15, or 6 percent, to $37.95; Humana added $1.71, or 3.9 percent, to $45.24; UnitedHealth traded up $1.35, or 4.3 percent, to $32.89; Wellpoint Inc. jumped $2.19, or 3.8 percent, to $60.51. All hit 52-week highs, except for Humana, which was a little more than a dime short of its 12-month high.

Some have been citing this news as proof that the Senate health reform bill is a giveaway to the insurance industry, but passing judgement on the health care bill solely by looking at health insurance stock prices is not fair. Yes, the industry stands to gain some 30 million new customers thanks to new federal requirements that Americans buy coverage. Yes, much of this coverage would be purchased with the help of federal dollars in the form of subsidies for Americans earning up to 400 % of the federal poverty line. But to say that the Democratic Senate health reform bill is nothing more than a boon to private insurers is a gross over-simplification.

First of all, the stock market is volatile and this is a piece of legislation that would be implemented over decades, so looking at a one-day or one-week bump in stock prices as evidence of anything is pretty dicey. But more importantly, the Senate bill would fundamentally transform the way the health insurance industry works. The coverage business, for example, now operates on the principle of underwriting – figuring out how much individual customers might incur in health costs and setting premiums rates accordingly. This whole practice of basing prices on health status would end under reform. Now throw in the end to pre-existing condition exclusions and rescissions. Now consider that insurers will be required to sell coverage to everyone. The health insurance industry will be turned on its head. Investors in health insurance companies believe the transformation will mean more business. Senate bill supporters know this but they also believe that the insurance industry transformation will benefit consumers. These two effects are not mutually exclusive.

Here’s what Nate Silver wrote in reaction to the stock bump, explaining that the most significant impact of the Senate bill on the insurance industry is more customers, not higher profit margins:

The bottom line is that, by the stock market’s estimation, the private health care industry appears as though it will benefit if the Senate enacts its plan. But the benefit — about $16 billion in discounted cashflows — is small as compared to the total magnitude of the program, and likely reflects an increase in the size of their customer base rather than any anticipation of higher profit margins.

See TIME’s People Who Mattered in 2009 here

See TIME’s Person of the Year 2009 here

Related Topics: aetna, cigna, health reform, humana, insurance industry, nate silver, Senate, Uncategorized
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  • queencersei

    “The health insurance industry will be turned on its head”
    Just like the credit card compaines I am sure. Fear not, the health insurance company will find a way to turn a nice profit year after year. Count on it.

  • deconstructiva

    Kate, you’re right to be skeptical. Market traders seem to react to anything. “Buy on rumor, sell on news” may be more true in the short term than we admit. Remember Jim Cramer’s famous meltdown over Ben Bernanke in Aug. ’07? (It’s on youtube, enjoy it. I still feel for Erin Burnett taking the heat.) The market tanked that day because of him. ‘nuff said. Can you get Barbara Kiviat or other biz colleagues / friends to blog more about this short term spike?

  • rustyreturns

    “…and likely reflects an increase in the size of their customer base rather than any anticipation of higher profit margins.”

    .
    But, what is not disclosed is that the profits for health insurance companies is less than 2%. The more people that they insure, the more overall profits they make.
    .
    However, just because they will make more profits overall, does not equate to any consumer savings on health care costs or the cost of insurance. Health care will undoubtbly continue to rise.
    .
    Real reform was bypassed for big deals, payouts and bribes. None of the measures that may have reduced price and enhanced competition were passed.
    .
    So yet again, the American consumer and tax payer will foot the bill. Pay for those who do not have insurance so they can be subsidized. Pay for a bigger government entitlement program, which is already broke.
    .
    “Change we can believe in Ladies and Gentlemen”!

  • http://phd9.blogspot.com Paul Dirks

    However, just because they will make more profits overall, does not equate to any consumer savings on health care costs or the cost of insurance.

    Except insofar as a larger pool of healthy people buying insurance will indeed help bring down per-patient costs. Need I remind you that a significant fraction of health care cost comes in the form of delinquencies and defaults.

  • shakrai

    I doubt the individual mandate will survive a court review. Nothing in the US Constitution grants the Congress the power to require that all Americans do business with a particular private industry.

    I’m really surprised that nobody in the mainstream media has examined this particular provision in more detail. I suppose it’s been buried by all of the focus on the “public option” and “path to 60″. Never before in the history of our Republic has the Federal Government imposed such a sweeping mandate on the people. Just by virtue of being an adult American you MUST do this.

    The comparison to auto insurance rather misses the point too. Owning an automobile is a choice. In most American cities (even the smaller ones) you can get by without one. The individual mandate will apply to every American that draws breath. Personally I regard that as a dangerous precedent to set and hope that the courts shoot it down as the unconstitutional power grab that it is.

  • Ivy_B

    Of course by clicking through, one learns that health care stocks were not the only ones that went up, but that doesn’t make as good a story I guess. Or, doesn’t fit into the CW line.

    **
    DuPont shares rose 1.6%, while Hewlett-Packard Co. shares climbed 1%.

    The Nasdaq Composite climbed 0.6%.

    The Standard & Poor’s 500 index rose 0.5%. Its technology and health-care sectors led the gains, fronted by a 7% jump in Jabil Circuit shares.

    The electronics-components maker said late Monday it swung to a fiscal first-quarter profit and forecast second-quarter results above Wall Street’s expectations.

    Tuesday’s action follows strong stock gains on Monday, helped by mergers activity.
    **
    http://www.marketwatch.com/story/us-stocks-gain-led-by-rally-in-tech-2009-12-22?reflink=MW_news_stmp

  • http://phd9.blogspot.com Paul Dirks

    As long as the penalty is framed as an excise tax, it will get through just fine. There’s no shortage of taxes that are designed specifically to reward and punish specific behaviors. This is merely being added to a long list.

  • jrm03063

    Let’s not forget – stock price is a function of two things: the perceived value AND RISK. If one wants to attribute this small day over day change to the actions in Congress, it probably makes more sense to understand it as a measure of increased certainty about the environment that insurance companies will be operating in. Until now, there was some more or less immediate threat that the government was going to enter their market in a big way. That seems off the table for now, so there isn’t as big a down-side risk in that industry as there may have been.

    Other changes in this legislation – forcing companies to accept people with pre-existing conditions, changing overall limits and so forth – just change some of the terms going in to the actuarial process.

    So I think you can be a fan of the legislation, expect it to help a lot of people, and expect it to put some downward pressure on insurance prices – even while you see a positive blip in insurance company stock prices.

  • shakrai

    5.1, an excise tax on what? Excise taxes apply to ITEMS. Gasoline, tobacco, etc. They don’t apply to the act of doing nothing.
    .
    Congrats on ignoring the rest of my points too.

  • http://phd9.blogspot.com Paul Dirks

    Congrats on ignoring the rest of my points too

    I could have merely typed “You’re wrong” and called it a day:

    http://lawprofessors.typepad.com/conlaw/2009/09/is-an-individual-health-insurance-mandate-constitutional.html

  • shakrai

    So what does that prove besides the authors of your quoted article think it’s Constitutional? I can link to five different papers that say the exact opposite. Many of them go into more detail than yours. The paper you linked is silent on the free exercise and freedom of association clauses of the 1st amendment. SCOTUS has previously ruled that the freedom to associate also includes the freedom NOT to associate.
    .
    There’s also the 5th amendment (you be denied property or liberty without due process of law) and the 4th amendment (if you have the right to be secure in your papers then what gives the Feds the right to know whether or not you have health insurance?) to consider.
    .
    Lastly and not that it really matters since all politicians lie, but I do seem to recall Candidate Obama promising not to raise your taxes if you make <$250,000 and that he didn't support the notion of an individual mandate. In fact he used the individual mandate AGAINST his key two opponents. Why is nobody calling him out on this?

  • http://phd9.blogspot.com Paul Dirks

    Why is nobody calling him out on this?
    Because you apparently paying attention to the various places where he is being called out on it.

    http://www.google.co.vi/search?hl=en&source=hp&q=obama+reversal+individual+mandate&aq=f&oq=

    It is well known that he’s either gone back on his word, or more charitably – changed his mind.

    As to the Constitutional question, you are free to believe whatever you want but in the end, it will be up to the courts. You can’t honestly believe that this hasn’t been thought through.

  • shakrai

    Yes I can. Congress passes legislation all the time that gets struck down by the courts. Why do you think we have the notion of judicial review?
    .
    Let me add another point: I doubt it will survive a political review either. It’s only a matter of time before all of the “tough choices” in this legislation get repealed by a future Congress in order to curry political favor with the folks back home. Then we’ll be stuck with the worst of both worlds — all spending and no saving.
    .
    David Brooks said as much in his excellent op-ed the other day. I don’t think you can dismiss him as a far right-wing Rush Limbaugh style ideologue.

  • http://phd9.blogspot.com Paul Dirks

    This is fascinating reading. You may be quite right about political ramifications. But the constitutionality of the excise tax seems quite secure:

    http://supreme.justia.com/us/345/22/case.html

  • deconstructiva

    …powers grated to congress + tax…
    article 1 / sect. 8′s taxing, commerce, and necessary and proper clauses

  • shepherdwong

    Ha! We need to look at the stock market to judge whether dropping the promised public plan to compete against industry is a “gift” for the insurers?!
    .
    Gosh, maybe we should ask Mrs. Lieberman or Bayh.

  • shakrai

    *shrug*, what you just linked to was a case that applied an excise tax to people in the business of accepting wagers. I.e.: something they made a CHOICE to do. Being an American citizen and drawing breath is not a choice.
    .
    I’d also like to know how it meets muster under the Freedom of Association clause. It would be one thing if we could pass a single payer system and fund it with income taxes. But a mandate that I do business with a private entity? Doesn’t that seem to run afoul of the very notion of freedom of association?
    .
    What if I have a moral objection to the way private insurance companies do business? What about a religious one? If I have a religious one, who determines whether or not it’s valid? Will I need to justify my religious beliefs to a judge or bureaucrat or will they just accept my word? If I need to justify them doesn’t that put the Government into the business of regulating religion?
    .
    So many unanswered questions.

  • freeinpa

    The religious aspect may be interesting. Will the Amish be forced (and then Excised taxed) for not buying insurance. They self insure and pay cash fo rall of their medical expenses. I believe the self-employed Amish are also omitted from paying Social Security taxes. There could be a rash of conversions.

    “Excise taxes are taxes paid when purchases are made on a specific good, such as gasoline. Excise taxes are often included in the price of the product. There are also excise taxes on activities, such as on wagering or on highway usage by trucks”

    Congress and the WH may try to twist the definition of an excise tax but the IRS seems pretty clear. It is a tax on a service or good that is acquired or done voluntarily. I have no don’t that lawyers have looked at this. In any law suit however, there are 2 sides who feel equally correct on the law.

  • http://forgottenlord.livejournal.com forgottenlord

    Re: Amish:
    .
    A case could be made that the Amish are effectively running a communal insurance company without actually registering it with any government. After all, if you remove the business element (profit margin, etc), insurance companies are basically we, as a society, pool our money to pay for the health care/auto damages/housing damages/etc of those that need it with the company managing the funds (rather than the community).

  • theotherjimmyolson

    Everything the author of this piece wrote may be true, but the bottom line is the price for all health insurers still went up.

  • formerlyjames

    Thanks everybody up at # 5 for the interesting exchange. I have this thought. How exactly will the courts decide this? In the same order as the disgraceful political decision of the 2000 supreme court to install gwb as president? The fact is that the courts, one of our supposed checks, as in checks and balances, are politicized beyond belief. The holy judges are as corrupt as every whore politician as there is.

  • Paul-no not that one

    I agree with formerlyjames, thanks for the #5 thread.

    I have been asking about the Constitutionality of the non-public option HCR for a while now.

    That thread helped me more than most posts by our hosts. (Rhyme time!)

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    History of Ukraine contains all roads which pass through its state is the state of the Black and Caspian Sea states of Europe and the Russian Federation and Belarus and the Baltic States. In this environment, Ukraine was and will be, but you should know about the many communities of national minorities in Ukraine, which should assist the indigenous population to win the victory over Russian chauvinism and cynicism.
    Many professors from the science of physics know what the torsion fields, which affect the human brain, and at different frequencies program commands to perform the person will be in it in the brain. This experiment was prepared and holding extensive amount in Ukraine during the Orange Revolution, the square of the capital and major cities of Ukraine. During the Orange Revolution, where I took part in rallies, I was surprised by the behavior of a video camera operator, who runs a video camera on the faces of people actively speakers for Yushchenko and Ukraine’s future. Why people who participated in the election of President Yushchenko and the future of Ukraine, located in a large garden and joy (remember the first speech by President of Czechia) after the election. I am a former journalist was surprised not competent operator, because the video camera does not include dae signal on a video shoot. To me, at my invitation arriving Jaroslav Ksonzhek, Consul of Poland, where our conversation and confirmed abuse of the Moscow government. It turns out that Moscow is continuing research to control and possess the human brain. It turns out that Putin is in this regard will have the state not only Europe and America but to solve their business programs. Carrying gas pipe through the Baltic States. I want to thank the many Jew for their help when I conducted an investigation, rabbi warned their communities do not come to the square, then be bad for health and psychological disorder. In order to save not only the state president, people, foreign embassies are located in Ukraine, I send the mail letters and telegrams to the President, but in the presidential administration or the children sit or bureaucrats. I understand that Ukraine is very far from your country and therefore should be realistic and simple plan for withdrawal from such situations. You may be surprised by my feeling high torsion fields “But I believe in God and constantly attend Protestant church Evangelicals, Bible study, psychology, folklore, cultural studies, analytics, folk music and songs. Second great experience to travel by military enterprises of when I worked in a factory where assembly consisted of turbines in Krivoy Rog. So I like the saying: The wisdom of man checks only way direction and goals. To convey to the President of Ukraine is a question I have for the first time in its life wrote a letter to the USА Embassy Vil’yamu Taylor, knowing that letters to foreign embassies can check (I wrote the text of the letter to enter a deadlock that people check messages on Post Office in Kiev ) counting on professional psychologists embassy. Maybe my innocence and romanticism great kindness not give me a quiet life, so I thought that everything will be like in the movies. For example, Come from Kiev or the USА embassy good man, and on home phone inviting meeting in Dnipropetrovsk administration and great pity it is all fairy tale, which shows in the film. How can I feel a major role analysis on various issues when I sent a fax wife Ekaterina Yushchenko president and then president’s wife appealed to the USА Ambassador (because her aides have not read Catherine fax). So no one sees me as an expert, thinking that I am working with the USА Embassy, President of Ukraine in 2006, invited himself to the USА Ambassador and the Ambassador of Poland. Unfortunately there is not securing for copyrights. Very please note the danger, that Russia may give your country, and protect my copyright on intellectual property, to realize their potential to the benefit of our good relations. Now, please imagine if Russia can use the torsion field during military operations as well as in public (panic, revolution, rebellion and what you want) to be a civil war and chaos in the elections and other companies. If Russia will send a torsion field in the brain of miners from the city of Donetsk, what then will be in Kiev?. Why do I appeal to you Your Majesty, for help! Because you are a patriot of the United States Americas and the state can imagine that a person before the rally (The action darling) can drink tea or coffee active liquid, the influence of torsion fields resulting in a mutation of the body!. This is a question that I have studied, we save lives and you and the President of the United States Americas and many people! And the main thing that Ms. Catherine Chumachenko was born in the United States and was the square with the children. With great respect to you and hope for your tolerance and kindness, Your Majesty. And for me there will be enormous gladness when any man will arrive to me in guests that could make sure in veracity of my moral principles.

    Valeriy Kharchenko, son of Mary Chumachenko father Vladimir Kharchenko. Kirovograd region, Dolinsky district, village Vasylivka.

    city DNIPROPETROVSK 49029
    Street. Заміська 39-1
    phone mobile 380985052947
    home 38056 7166470

    UKRAINE xarchenko2009@meta.ua

    Р.R.

    In the Regional State Administration in the archives of Х26148 is evidence and the failure of the President of Career and many officials where the main role played Kyslynskyi (Moskal know) and sent by fax to the fund Ekaterina Yushchenko 2006, no one know who saved the life of the President and the citizens of Ukraine.

    Therefore for us and to the nemae securing for intellectual property, but I Gorbulinu in did in kar’eru. In Evropi above all things bachut’ man so as I was seen by the consul of Pol’shi Yaroslav Ksenzhik. To god that I did not write script clip where passage-way on elections of dae 90 percents of beautiful result! To Ukraine! I can not arrive in KYIV and be as a cadger near a baba Paraski! On the large failing such for us are skilled questions!
    Р.Р.
    Only the huge sponsor for dictators and a victory to a bad mode of authority, is our indifference, a negligence, egoism and a sluggishness in decisions of questions! What sense of living by the example to uphold moral principles of trust and increase of intellectual level of our society is in.

    Valery Harchenko, the culturologist of Ukraine.

  • iggydwonderllama

    I’d also like shakrai and Paul for #5. I have wondered about the constitutionality of the mandate since the primaries, although shakrai brings up more and better points than I had ever considered.
    .
    And I agree with formerlyjames that the politics of the courts will decide this, rather than the actual words in the constitution. But I don’t have a good reading on the Supreme Court on this one. Will the conservatives vote against it because the Democrats passed it? Will the liberals vote against it because it conflicts with individual liberties? I could really see either side going either way, or splitting. Do you have guesses?

  • shakrai

    10.1,
    .
    I would never try and guess what “the nine” will do. As a random example, consider Kelo v. City of New London. That was the case that said it’s acceptable for states to use eminent domain to seize your property for PRIVATE development, i.e: someone wants to build a Wal-Mart where your house is.
    .
    At first glance you’d think it was the Conservative wing of the court that decided that case, right? You’d be wrong. The Conservatives all dissented. It was the Liberal justices that found it acceptable to seize your property for commercial development.
    .
    The one that I’m currently following is McDonald v. Chicago. That’s the NRA’s attempt to apply the 2nd amendment against the states and invalidate gun control regimes like Chicago or New York City’s. They are making a 14th amendment argument — the 14th amendment says that no state can infringe on the “privileges or immunities” of it’s citizens. It’s the same amendment that’s been used to apply the 1st, 4th and 5th amendments against the states, as well as the amendment that justifies the Federal Government’s role in protecting the Civil Rights of minorities/other protected classes.
    .
    If the court is at all consistent they will have to rule that the 2nd amendment applies against the states. If it doesn’t then how do you justify the fact that other amendments have been held to apply against the states? It will be interesting to see where the liberal members of the court rule on this one. Weakening the 14th amendment is not in their best interest. It’s arguable that if the 14th amendment hadn’t been neutered in the Slaugherhouse cases that Jim Crow never would have been allowed to happen.
    .
    So will they rule in an intellectually consistent manner or will they cave to political interests and rule against it just because it involves the 2nd amendment? Nobody knows. Follow SCOTUS long enough and you’ll learn that it’s a waste of time trying to predict what they’ll do. It really is a fascinating institution, isn’t it?

  • iggydwonderllama

    Yes, that does sound like a very interesting case to watch. Can you recommend a good source of news on it?

  • freeinpa

    forgottenlord:

    re:Amish

    Remarkable as to how efficiently it works through volunteer commitments and no government regulation or intervention.

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