Health

Max Nisen is a Bloomberg Gadfly columnist covering biotech, pharma and health care. He previously wrote about management and corporate strategy for Quartz and Business Insider.

The only group more excited by the clumsy death of Republican efforts to repeal and replace Obamacare than the millions set to keep their health insurance are the hospitals that treat them. 

Hospital investors are thrilled for good reason; the GOP plan would have increased the ranks of uninsured Americans, gouged Medicaid and dropped regulations forcing insurance to cover hospitalization. That would have hurt sales and profits.

Shares of a Bloomberg Intelligence index of North American hospitals jumped 5.4 percent on Friday as the GOP bill died and gained another 4 percent Monday. But the relief rally may be short-lived. 

Bouncing Back
Hospital stocks rallied after the failure of Republican efforts to replace the Affordable Care Act
Source: Bloomberg

The GOP plan to replace the Affordable Care Act failed for a number of reasons. It was a rush job almost universally derided as bad policy. But fundamentally, it failed because of the unbridgeable GOP divide between conservative hardliners who wanted a more thorough ACA repeal and moderates for whom this bill was too harsh. That divide remains. 

Where it Hurts
The Congressional Budget Office projected that more than 20 million would lose health insurance under the GOP's proposed ACA replacement

But President Donald Trump is still in the health policy driver's seat, albeit in a smaller truck, and he's mapping out an uncertain future. He has warned the ACA is doomed to collapse, and there are several ways he could sabotage the law, from loosely enforcing its individual insurance mandate to fighting subsidies that help insurers.

The ACA might not collapse through neglect alone, but a Trump administration actively undermining it could make things messy. That seems a more likely outcome than any dream that Trump and lawmakers will forge a bipartisan consensus on fixing the ACA's shortcomings. 

Swinging
Hospitals have faced dramatically elevated volatility since Donald Trump's election, and that may not be going anywhere
Source: Bloomberg

That could create a feedback loop of uncertainty between insurers who don't know whether they will please or infuriate the administration by staying in the ACA's exchanges and hospitals who don't know if the population they serve will be insured.

Tenet Healthcare Corp. and Community Health Systems Inc. -- two struggling hospital groups which each have have debt that exceeds their market cap by more than $13 billion -- have seen their stocks jump by 19 and 18 percent, respectively, over a six-day period, while their bonds rallied. Considering the uncertainty that remains, that looks like over-exuberance.

Add in the broader market retrenchment -- as investors realize the bullish Trump Trade was basically overwrought fan fiction -- and it's hard to see health care's relief rally lasting much longer.

This column does not necessarily reflect the opinion of Bloomberg LP and its owners.

To contact the author of this story:
Max Nisen in New York at mnisen@bloomberg.net

To contact the editor responsible for this story:
Mark Gongloff at mgongloff1@bloomberg.net