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Health insurers like Aetna would reap big gains from the Republican tax overhaul. Photo: Bill Sikes / AP

Large health insurance companies would be among the biggest winners under Republicans' tax overhaul bill. Nearly all of their business is based in the U.S. and they consequently pay close to the full 35% corporate tax rate.

The bottom line: Cutting the corporate tax rate to 20% would instantly boost insurers' profits. Some of that benefit could result in lower premiums for anyone who has health coverage, but insurers would also find ways to keep as much of that money as possible.

The details: Cowen's health care equity research team modeled how tax reform would affect earnings per share for the biggest for-profit insurers. Cowen assumed the tax cuts would go into effect for 2018, though the House and Senate are deciding whether to push it to 2019.

Here's how much earnings per share projections for insurance companies would rise next year if Republicans agreed to a 20% corporate tax rate starting in 2018, per Cowen:

  • Molina Healthcare: 62.1%
  • Humana: 34.4%
  • WellCare Health Plans: 32.5%
  • Centene: 31.6%
  • Aetna: 30.4%
  • Anthem: 25.2%
  • UnitedHealth Group: 24.3%
  • Cigna: 21.6%

State Medicaid programs and employers likely would demand some of that money be passed back to them in the form of lower Medicaid rates and cheaper premiums.

The big question: Medical loss ratios, or MLR. These ratios require health insurers to spend so much of their premium dollars (minus taxes) on medical care or activities that try to improve health quality. For most types of health insurance, companies have to spend at least 85% of premiums on patient care, and the remainder can go toward administrative expenses, salaries and profits.

Insurers have to issue rebates back to consumers if they don't meet their MLR. And a tax windfall would inherently lower the ratios to the point where insurers may have to issue rebates. But it's possible companies could "increase spending on quality initiatives in order to avoid triggering the minimum MLR or lower price points to customers," Cowen analysts said in a report.

Go deeper

3 mins ago - World

Abbas announces first Palestinian elections in 15 years

Abbas is 85 and in the 15th year of a 4-year term. Abbas Momani/AFP via Getty

Palestinian President Mahmoud Abbas published a decree on Friday announcing the dates for parliamentary and presidential elections in the Palestinian Authority.

Why it matters: This is the first time in 15 years that such a decree has been published. The last presidential elections took place in 2005, with Abbas winning, and the last parliamentary elections took place in 2006, with Hamas winning.

Updated 9 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Health: Coronavirus deaths reach 4,000 per day as hospitals remain in crisis mode — America has tuned out the coronavirus at the peak of its destruction — 1 in 3 people in L.A. County believed to have been infected with coronavirus.
  2. Politics: Biden taps ex-FDA chief to lead Operation Warp Speed amid rollout of COVID plan— Widow of GOP congressman-elect who died of COVID-19 will run to fill his seat — Joe Biden will seek nearly $2 trillion in COVID relief spending.
  3. Vaccine: Battling Black mistrust of the vaccines"Pharmacy deserts" could become vaccine deserts — Instacart to give $25 to shoppers who get vaccine.
  4. Economy: Unemployment filings explode againFed chair: No interest rate hike coming any time soon —  Inflation rose more than expected in December.
  5. World: WHO team arrives in China to investigate pandemic origins.
Dan Primack, author of Pro Rata
1 hour ago - Economy & Business

Trump blocks banks from limiting loans to gun and oil companies

Illustration: Sarah Grillo/Axios

Big banks are no longer allowed to reject business loan applicants because of the industry in which they operate, according to a new rule finalized on Thursday by the Trump administration.

Why it matters: Wall Street has curtailed its exposure to industries like guns, oil and private prisons, driven by both public and shareholder pressures. This new rule could reverse that trend.

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