As presidential hopeful Sen. Bernie Sanders (I-Vt.) grabs headlines with his plan for “Medicare for All” and targets doing away with private health insurance, equity analysts have been working overtime to tell investors what companies have the most to lose.
Health insurers and now hospitals have led the sector-wide plunge even as policy analyst like Veda’s Spencer Perlman argue that Medicare for All has a slim shot at becoming law. With the plan moving 10 percent of GDP to public control from private hands, “it is unprecedented in scale and scope – nothing of this magnitude has ever been attempted, let alone succeeded,” Perlman argues.
That hasn’t stopped the free-fall in insurers, which has peeled off billions of dollars from their market-cap in the worst rout in more than twenty years. “There may be more pain to come but the worst of it may be behind us (let’s hope),” Evercore ISI equity analyst Ross Muken told clients in a note. While managed care may be near the end of its retreat, analysis implies “extremes are plausible.”
While the broader healthcare sector remains under pressure — S&P 500 health care names have lost more than 6 percent over the past three days in their biggest drop since December — managed care’s sell-off appears to have abated for now with S&P 500 insurer names now little changed intraday.
Drugmakers, dental stocks and life science tool makers look the most vulnerable, in Muken’s view. For Citi analyst Andrew Baum the pervasive fear that the skyrocketing price of prescription medicines will be brought under tighter rein in a Medicare for All scenario has created an opportunity for long-term pharmaceutical investors. Baum recommends buying AstraZeneca, Sanofi, Novartis, Bayer as well as Merck & Co.
Some drugmakers are at greater risk than others and underperformance in the sector is likely to persist, Wells Fargo’s David Maris told clients in a note. Deeply indebted companies or those with medicines that are heavily used by Medicare recipients or subject to rebating — like Bausch Health — may be most exposed. Smaller generic companies or those with cash pay products should be better insulated from sector concerns although so far “that has not been the case,” he noted.
Device-makers have also been dragged into the fray although later than other health-care sectors. While the prospect of a single-payer system remains remote, it would be especially damaging to medical technology companies by eroding erode structural incentives for surgical interventions, BofAML analyst Bob Hopkins wrote. These are the companies with sales most at risk, according to BofAML:
>> Likely less than 50 percent of sales paid in cash: Stryker, Intuitive Surgical
>> Companies with roughly half of their sales exposed: Medtronic, Zimmer Biomet, Becton Dickinson, Edwards Lifesciences, Boston Scientific
>> Least exposed: the recent Novartis spinoff Alcon, Abbott Labs and Baxter
“The U.S. is likely to gradually move away from our current fee for service, employment-based system to some sort of hybrid system that resembles certain systems in Europe,but in our view this will take a decade or more,” Hopkins said.
Follow the debate with a “wary eye,” Veda’s Perlman cautioned investors. “Health-care lawmaking is difficult and change occurs infrequently. This is not a bug in the American political system, it is its design.”