The healthcare sector, the second-largest sector by exposure in the S&P 500, is in the midst of a dismal run. After ranking as the best-performing sector in the U.S. last year, healthcare is the worst-performing group in the S&P 500 in 2019.
Just look at the Health Care Select Sector SPDR (NYSEARCA:XLV), the largest of healthcare ETFs by assets. XLV is down 0.84% year-to-date while the S&P 500 is higher by nearly 16%. XLV’s year-to-date loss does not paint a complete picture of healthcare stocks’ weakness. Investors’ distaste for the sector has recently been increasing as highlighted by an April loss of more than 7% for XLV.
While the long-term outlook for the healthcare sector remains solid, healthcare ETFs and stocks face myriad headwinds, including some that are politically-charged. As has been widely noted, the idea of Medicare For All has significant traction among several Democrats running for that party’s 2020 presidential nomination and that is plaguing insurance providers and some more focused healthcare ETFs.
More recently, politicians from both parties continued assailing high pharmaceuticals prices, sending the S&P Pharmaceuticals Select Industry Index lower by more than 6% for the week ending April 18.
In other words, healthcare ETFs face a lot of near-term headwinds, meaning it could be time to consider dumping these funds.
SPDR S&P Pharmaceuticals ETF (XPH)
Expense ratio: 0.35% per year, or $35 on a $10,000 investment.
The SPDR S&P Pharmaceuticals ETF (NYSEARCA:XPH) tracks the aforementioned S&P Pharmaceuticals Select Industry Index and even with the recent consternation over high drug prices, this healthcare ETF is maintaining a year-to-date gain of over 6%. That makes XPH one of the better-performing healthcare ETFs this year.
The White House claims that it has affected favorable changes when it comes to drug prices, but with a presidential election year looming, the rhetoric on this issue is likely to increase, not abate, and that presents a potential headwind for a slew of healthcare ETFs, including XPH.
“Even if politicians truly wanted to lower drug prices, one complexity is that Medicare, which many candidates want to expand broadly, has no authority to negotiate thanks to a possibly ill-advised policy proposed by the Bush administration that has been in effect since 2006,” according to CNBC.
XPH and several other healthcare ETFs are front-and-center in the drug price debate. XPH’s deteriorating technical health is another cause for concern with this healthcare ETF as the fund currently resides more than 10% below its 200-day moving average, a percentage that has recently been growing.
Invesco S&P SmallCap Health Care ETF (PSCH)
Expense ratio: 0.29%
The combination of small-cap stocks and the healthcare sector can be rewarding for investors when both of those elements are moving higher in unison. Small caps are doing their jobs this year, but healthcare is not, and that drag has recently been weighing on the Invesco S&P SmallCap Health Care ETF(NASDAQ:PSCH).
PSCH, the small-cap counterpart to the aforementioned XLV, is a diversified healthcare ETF and its 69 holdings “are healthcare companies principally engaged in the business of providing healthcare-related products, facilities and services, including biotechnology, pharmaceuticals, medical technology and supplies,” according to Invesco.
In more sanguine environments for the healthcare sector, PSCH’s diverse roster would be an advantage. For the time being, the opposite is true. PSCH’s nearly 13% weight to pharmaceuticals stocks is a problem in its own right thanks to the drug price debate, but the real drag on this healthcare ETF is the 22.69% weight to the healthcare providers industry, meaning this healthcare ETF features significant exposure to the Medicare For All debate.
First Trust Health Care AlphaDEX Fund (FXH)
Expense ratio: 0.63%
Alternatively-weighted, or smart beta, funds have caught on with advisors and investors in recent years, but when it comes to the sector funds in this group, there are often two-fold reminders. When things are going well for that sector, smart beta sector funds can outperform their cap-weighted rivals. When that sector falls out of favor, there is little or no downside protection in alternatively-weighted sector funds.
Meet the First Trust Health Care AlphaDEX Fund (NYSEARCA:FXH), a healthcare ETF that has recently been taken to task in significant fashion. This healthcare ETF uses a mix of growth and value traits to build its portfolio, a methodology that can lead to upside when the sector is performing well, but in the current environment, FXH is being hit on multiple fronts.
A combined weight of 39.60% to biotechnology and pharmaceuticals stocks exposes FXH to the drug price debate. Second, this healthcare ETF has devotes 17.48% of its weight to healthcare providers, meaning Medicare For All is dinging this fund’s performance as well. Put all that together and FXH is experiencing epic April showers with a month-to-date loss of 8.57%.
Todd Shriber does not own any of the aforementioned securities.
