Despite the technical difficulties and the government shutdown, the Affordable Care Act had its launch in most of the states, with others soon to follow.

Primary beneficiaries of the Affordable Care Act are previously uninsured, who will now enjoy more affordable access to healthcare.

The Affordable Care Act is expected to add 30 million new individuals to insurance rolls. The Congressional Budget Office reports that healthcare spending will rise to 22 percent at 2038 from 16.4 percent at 2011.
With the healthcare spending on the rise, pharmaceutical companies stand to benefit. 

1. Giants: Abbvie ABBV, Lilly LLY, Merck MRK, Pfizer PFE

They mostly produce under patents and are generally reliable. They tend to buy smaller companies during the development and approval cycles – allowing them the constant supply of new patents.

2. Generis: Actavis ACT, Abbot ABT, Perrigo PRGO, Teva TEVA

These companies profit from a products going off of patent. They lose value when a newly patented medicine replaces a generic brand. They may have the most to gain from the Affordable Care Act.

3. Startups: Celldex CLDX, Alynylam ALNY, ISIS ISIS, Array ARRY, Inovio INO

Most startups and small companies are research shops that develop few specialized drugs. These companies can take wild swings in value from FDA approvals or rejections.

4. ETFs: IHE, PJP, XPH

IHE and PJP are primarily comprised of the big names such as Pfizer and Merck while XPH leans more towards the small and medium sized companies.

Pharmaceutical companies are tough to invest in due to high rate of mergers and acquisitions, licensing and patents, and FDA approvals. Since the development process of the new products is not completely clear, many investors see most pharmaceutical companies as a gamble.
All ETFs have YTD return in the double digits. XPH, with its small cap focused strategy, is up more than 40 percent this year.