(Bloomberg) -- It’s chaos in Washington health-care policy:Obamacare will get ripped out by the roots --or Republicans’ repeal plans will go up in flames -- in adramatic end-of-week Senate voting barrage.

You wouldn’t know it from looking at the stock market.

Health-care companies in the Standard & Poor’s 500 Indexhave rallied 16 percent this year, beating the overall market’s 11percent gain. Insurers, the companies tied most closely to theAffordable Care Act, are up even more at 23 percent.

Wall Street’s apparent indifference to the possibility thatRepublicans will succeed in repealing the ACA shows how thefor-profit health industry has largely separated itself from thelaw’s fate.

While Obamacare brought insurance to 20 million people,drugmakers say it hasn’t boosted their profits. Publicly tradedinsurers have largely quit the health law’smarkets after losing money. And hospitals have bigger problems,tied to structural shifts in how people are getting care.

“It’s really steady as she goes,’’ said Les Funtleyder, a healthinvestor at E Squared Capital Management. “Most of the stocks arebasically calling the Congress’s bluff, in that really nothingmaterial is going to happen.’’

So far, betting Obamacare would stay the law of the land hasbeen the right move.

Ever since President Donald Trump beat Hillary Clinton with avow to waste no time repealing the program, the timeline forundoing it has been pushed back repeatedly.

This week, senators voted to begin debate on ending the healthlaw, after the House of Representatives narrowly passed a repealbill. But two initial Senate votes -- one for a repeal, the otherfor a replacement -- both failed.

Republicans appear to be scaling back their ambitions. Onepossible path forward is a “skinny repeal,” ending just a handfulof the law’s most controversial features. GOP senators would likelypush to halt requirements for all people to have health insuranceand for companies to provide health coverage for full-timeworkers.

A repeal of the tax on medical devices might also be included.But the insurance subsidies and Medicaid expansion wouldremain.

Meanwhile, second-quarter results from health insurersAnthem Inc. and Centene Corp., both big players in Obamacare,exceeded Wall Street’s expectations this week. Anthem said it’llquit Obamacare markets if it can’t make them work, while Centene isconfidently planning to expand in parts of nine states.

A specialist in administering Medicaid plans for the poor,Centene plunged after Trump’s election in November. This year, it’ssoared almost 50 percent, putting it among the best performinghealth stocks in the S&P 500.

Other big, publicly traded health insurers -- Aetna Inc., HumanaInc. and UnitedHealth Group Inc. -- have largely quitObamacare.

Molina Healthcare Inc. ousted its top executives earlier thisyear after poor ACA results, and its stock has surged since onhopes for a turnaround or sale of the company. Molina is scheduledto report quarterly results next week.

Big drug and biotechnology companies, up about 13 percent thisyear as a group, say they’re not much exposed to Obamacare.

Trump’s early rhetoric that he’d force drug companies to lowerprices has faded. Instead of relying on government interference inprice setting, the administration has backed plans by the the Foodand Drug Administration commissioner to boost competition.

Coverage impact

Eli Lilly & Co. Chief Executive Officer Dave Ricks said hiscompany is far more focused on policies that affect employerinsurance plans than on the ACA.

“Medicaid and the individual insurance market, which is nowmostly exchanges, really isn’t a big contributor for us at all,’’he said in an interview. “So we watch that but we don’t necessarilyhave a dog in the fight in terms of a big business impact. Butconversely, the commercial market, that’s a very important segmentfor us.”

Virtually alone among major medical trade groups, device makershave backed repeal because it would end an Obamacare tax that’sprojected to cost them about $20 billion over the next decade.

Much of their business comes from customers old enough toqualify for Medicare, meaning they’d be immune to reimbursementlosses if Obamacare were overturned.

If any of the Republican repeal plans passes, somewhere between15 million and 32 million more people would be without healthinsurance coverage in a decade, compared to current law, accordingto estimates from the nonpartisan Congressional Budget Office.

The coverage losses, stemming from cuts to the Medicaid programfor the poor and reductions to Obamacare’s subsidies, could pose achallenge to hospital companies, in particular.

Hospital operators have already faced headwinds from climbingdeductibles and a push to move more care to clinics and surgerycenters, where reimbursements are lower.

Certainty elusive

“Hospitals are again at risk for future Medicaid cuts,’’ SherylSkolnick, an analyst at Mizuho Securities, said in a note toinvestors on Tuesday. “The only way, in our view, for investors andcompanies to get certainty here, is for the thing to pass and besigned.’’

And yet, after declining last year, hospital stocks arerebounding. The Standard & Poor’s Supercomposite Health CareFacilities Index is up 14 percent this year, even after a pullbacktied to disappointing earnings at HCA Healthcare Inc.

The optimism isn’t too far-fetched, E Squared’s Funtleydersaid.

“Something draconian and cataclysmic seems like it’s off thetable,” he said. “The outcome seems like it’s going to be statusquo.

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