The driving force of health care fear

Insurers are afraid of a deteriorating market for individual coverage, fueled by the repeal of the Affordable Care Act’s individual mandate as well as regulatory changes from the Trump administration.

What to watch: Over the course of the spring, they’ll be deciding whether it makes sense to simply quit offering ACA coverage in some parts of the country. Rural areas will likely be the first to see insurers leave.

Pharma fears Washington after a couple of surprising defeats on Capitol Hill have shown the industry may not be as bulletproof as it seems.

• What to watch: The Trump administration is eager to show progress on drug prices, and its early efforts have largely steered clear of drug companies themselves. But Health and Human Services secretary Alex Azar is open to reining in some of the industry’s patent tricks — a move that could cost drugmakers billions of dollars.

Everyone fears Amazon. Just the possibility that it might enter the pharmacy business has accelerated a trend of health care mega-mergers, as the old guard looks to lock in as much market power as it can.

And the public fears the cost of health care. That’s part of the reason the industry, which profits from those costs, is right to worry about what’s ahead.

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