The many tradeoffs that health insurers had to make from both a regulatory and plan-design standpoint in order to adapt under the Affordable Care Act appear to be paying off as the landmark legislation approaches its five-year mark.

A recent CNNMoney report suggested that the nation’s top health insurance carriers, as well as large hospital chains and pharmaceutical companies, have thrived on President Barack Obama’s watch, despite steady talk that he’s bad for Corporate America.

“There is greater demand for health care and that has improved profits for insurers and hospitals,” Phil Orlando, chief equity strategist at Federated Investors, was quoted as saying.

Also see: States with the highest cost of health insurance

For example, UnitedHealth’s recently reported earnings not only beat forecasts, but its stock also edged up 3% to a new all-time high. And while ACA fees muted the carrier’s earnings last year, UnitedHealth still decided to deepen its HIX commitment for 2015, along with its competitors, who also are sharing the spoils in an expanded marketplace.

Aetna, Cigna, Humana and Anthem have all surpassed the S&P 500 since the March 2010 passage of health care reform, while several hospital chains, including HCA, Universal Health Services and Community Health Systems, reported a banner year in 2014, according to CNNMoney.

In addition, the Health Care Select Sector SPDR exchange-traded fund outperformed the stock market last year and is running ahead of the S&P 500 in 2015 so far. The fund includes most of the leading health insurers, as well as pharmaceutical companies such as Pfizer, Merck and Bristol-Myers Squibb.

Also see: States with the lowest cost of health insurance

CNNMoney also pointed out that many health care returns on investment are “significantly higher” than long-term U.S. Treasury bonds, noting that at 3.4% Pfizer’s yield is nearly double a 10-Year Treasury.

When weighing these results, it’s important to consider all lines of business and that the ACA impact will vary from one plan to another, according to Clare Krusing, a spokeswoman for America’s Health Insurance Plans. Another factor she cites that could have a tremendous impact on the ability of health plans to move forward is the upcoming U.S. Supreme Court decision on HIX subsidies.

Also see: Supreme Court agrees to hear case challenging ACA subsidies

“Consumers and health plans are still in the early stages of transitioning to an entirely different marketplace,” she says. “We’re entering uncharted waters, even more so over the next several months. In light of all of these changes and uncertainty, our focus is on ensuring an affordable and stable market for consumers.”

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