The Mysterious Undervaluation of Health Insurers

Dana is a member of The Motley Fool Blog Network -- entries represent the personal opinion of the blogger and are not formally edited.

If you think Apple is undervalued, you don't own a health insurer.

Yesterday, for instance, Wellpoint (NYSE: WLP) delivered a solid beat on earnings, $800 million or $2.64/share, and continued its $0.38/share quarterly dividend. In response the stock barely yawned, rising just two cents a share, yielding a Price/Earnings (P/E) multiple of 10.31.

Wellpoint has become one of the more undervalued big-cap stocks in the market, and within its industry it's not alone. Most players trail the market in terms of their earnings multiples.

What's going on and how can you take advantage?

Why Wellpoint is gaining

The main pain point is politics. Most investors are Republicans, yet Wellpoint and the other insurers are benefiting hugely from the Affordable Care Act of 2010, also known as Obamacare.

The act mandates wellness care, requires a certain percentage of premiums go to care, and prevents past practices like denying coverage for pre-existing conditions. These should be negatives, but as proponents of the law predicted, wellness care does pay for itself.

The truth is in Wellpoint's latest earnings, released this week.  Net income was 19% higher than forecast, and the company said it was because of “lower than projected costs.”

This should not be a surprise. Since the “ObamaCare” law was signed, insurers have been grabbing at high-risk Medicare patients with both hands – Wellpoint itself spent $4.6 billion late last year to buy Amerigroup, which specializes in these types of people. And now it credits that acquisition with fueling its profit growth.

As the processes of handing Medicare patients, who have higher risks than the normal patient, filter down into the general market, the gains are going to only grow. Prevention actually has a bigger pay-off among younger patients. Avoiding obesity, limiting diabetes, and reducing heart attack and stroke have an enormous pay-off, and Wellpoint now has the knowledge to tap into it.

How are the insurers maximizing these profits? By buying groups that combine premium payments with control over clinics and hospitals. This is the model that has let companies like Kaiser and Intermountain Health in Utah under-price standard insurers for years. When you control both income and outgo, you have a financial incentive to keep people well, while if you only control income you don't.

It's really quite simple.

The political discount

It seems that investors like our own Dan Caplinger may not be looking at the full picture. By focusing on the ongoing problems of setting up state-health exchanges, which are subject to political pushback in Republican states, some are ignoring the financial benefits insurers are accruing now, and the additional benefits they're going to accrue as more people get insured.

California, which is rolling out an exchange called Covered California, due to launch enrollment on October 1, is the test case. Conservatives are throwing everything they have against it, harping on every negative they can find, but 13 insurers have had rate plans approvedThe Sacramento Business Journal reports that these rates are as much as 29% lower than current rates with companies offering only insurance competing directly against Kaiser Permanente, which also delivers services.

But here's the real bottom line. If Wellpoint is making a profit serving high-risk Medicare patients, using wellness services to reduce the risk of people going into hospitals, why is it assumed it can't bring the same procedures to the larger insured market and make even more money? And if Medicare is such a bad deal why is it that a company specializing in such patients like Health Net, which even serves Veterans, is trading at a P/E of 32?

The only responses I get from that are political, and when you try to make business political it's an absolute certainty you're going to lose money.

Another Place to Play

United Healthcare (NYSE: UNH) has been especially aggressive in grabbing Medicare accounts, and facilities managers. It bought XLHealth in 2011 and followed it up with two Florida purchases last year. 

In addition to providing insurance and, now, providing care to some patients, UnitedHealth has been a leader in Health IT, combining a number of companies under the brand name Optum. This means it has records and statistics showing what the proper treatment regimen should be, and the power to make doctors follow best practices. This saves money, and improves profitability.

Being further down the road in this way, UnitedHealth sells at a premium to WellPoint, a 13.76 P/E. For the quarter ending in June it earned $1.436 billion on revenues of $30.4 billion, and that revenue number is 11.6% higher than the same quarter a year earlier. Its balance sheet shows $10 billion in cash and just $15 billion in long-term debt, and its operating cash flow has been rising steadily each year, most recently standing at over $7 billion.

Despite this, UnitedHealth still trades at a discount to the general market, albeit a premium over the price currently being paid for WellPoint.

My Foolish bottom line

When the objection to an investment is political, while the numbers look both good and sustainable, ignore the politics and make yourself some money. Wellpoint is one of the best bargains in the market right now, and most of the other insurers, like UnitedHealth, are equally as attractive.

As the Affordable Care Act rolls out over the next year, and both savings and profits become realized, political opposition will go down, and the value of having these accounts will only grow. Barring a radical change toward a single-payer system, or the repeal of the law, the health insurers are a great place to put money to work.

Dana Blankenhorn has no position in any stocks mentioned. The Motley Fool recommends UnitedHealth Group and WellPoint. The Motley Fool owns shares of WellPoint. Try any of our Foolish newsletter services free for 30 days. We Fools may not all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy. Is this post wrong? Click here. Think you can do better? Join us and write your own!

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