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It’s deja vu all over again for US hospital stocks ahead of an expected vote coming Thursday afternoon on Republicans’ latest attempt to pass healthcare reform.

The S&P 500 healthcare facilities index — a gauge that tracks acute-care focused HCA Holdings and behavioural-care geared Universal Health Services — was down more than 0.7 per cent on Thursday, just hours before the US House of Representatives is set to vote on the bill, which is designed to repeal and replace portions of the Affordable Care Act, also known as Obamacare.

Obamacare has been a boon to many hospitals and healthcare providers in reducing the number of uninsured Americans and expanding the Medicaid programme for America’s poor and disabled, which has helped providers cut write-downs on emergency care provided to individuals regardless of their ability to pay.

Hospital stocks have risen and fallen on Republicans’ efforts to deliver on the Obamacare repeal and replace that many have promised. For instance, the facilities index fell 11.2 per cent from when US President Donald Trump — who frequently targetted Obamacare on the campaign trail — was elected in November until the end of 2016.

The day that Republicans abruptly pulled the plug on their first attempt to pass legislation to gut Obamacare in March, the index rallied 3.2 per cent, and it rose an additional 4.6 per cent the following trading day.

Individual companies that also operate healthcare facilities were also tracking lower on Thursday, with Tenet Healthcare down 0.5 per cent, Community Health Systems off 1.66 per cent, LifePoint Health off 1.9 per cent and Acadia Healthcare declining 0.12 per cent.

The outcome of the hastily assembled legislation, however, remains far from certain, meaning that there may be more twists and turns for hospital stocks before the day is over.

Copyright The Financial Times Limited 2018. All rights reserved.

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