Health care talk wobbles market

NEW YORK — U.S. stocks declined for the third time in four days on Tuesday as health care companies took center stage.

Drugmakers fell after President Donald Trump said he wants to bring prescription prices down. Insurers rose and hospital companies dropped after Republicans in Congress introduced a bill intended to replace the 2010 Affordable Care Act.

The Standard & Poor’s 500 index fell 6.92 points, or 0.3 percent, to 2,368.39. The Dow Jones industrial average dropped 29.58 points, or 0.1 percent, to 20,924.76. The Nasdaq composite fell 15.25 points, or 0.3 percent, to 5,833.93. Two stocks fell for every one that rose on the New York Stock Exchange.

Shares of pharmaceutical and biotechnology companies fell after Trump said in a morning tweet that he intends to bring down drug prices. The health care proposal was good for shares of big health insurers, but hurt companies that do a lot of business with Medicaid.

It’s not clear if the bill will pass the Senate, as several Republicans have already questioned it. Stocks turned lower at the end of the day as that criticism increased, leaving the fate of the current bill, a key part of Trump’s agenda, uncertain.

“We’re going to still be having this conversation six months from now,” said Les Funtleyder, health care portfolio manager for E Squared Asset Management.

Since the middle of 2015 drug companies have repeatedly tumbled as investors worried that the government would take action to reduce prices or at least curb price increases. While Trump has talked about dealing with the issue before, he has never discussed details. Funtleyder said the task might be harder than it sounds.

“There’s no government mechanism at the moment to control costs directly,” he said.

Companies that make high-price drugs took some of the largest losses. Biotechnology company Alexion Pharmaceuticals shed $4.15, or 3.1 percent, to $129.18. Alexion makes Soliris, a high-priced drug that treats two rare genetic disorders. Mallinckrodt, which has faced criticism over repeated increases in the price of its HP Acthar gel, gave up $1.55, or 3 percent, to $49.71.

Prescription drug distributor Express Scripts and biotech company Gilead Sciences each fell as they bickered over the price of Gilead’s hepatitis C drugs, some of which are listed at $1,000 a pill. Express Scripts shares fell $2.66, or 3.8 percent, to $67.39 and Gilead slid $1.10, or 1.6 percent, to $69.02.

The Republican health care legislation would provide tax credits for people buying their own insurance and would scale back the government’s role in helping people afford coverage. It would likely leave more Americans uninsured and would also overhaul Medicaid, a joint federal-state health program for low-income Americans.

Hospital operators tumbled. Community Health Systems fell 9.3 percent and Tenet Healthcare sank 7.1 percent. Insurers that do a lot of business with Medicaid, such as Molina Healthcare, also fell. But the largest national health insurers did better than the rest of the market. Humana added $5.21, or 2.4 percent, to $217.95, the largest gain among S&P 500 stocks.

Benchmark U.S. crude fell 6 cents to $53.14 a barrel in New York. Brent crude, used to price international oils, lost 9 cents to $55.92 a barrel in London.

Bond prices fell. The yield on the 10-year Treasury note rose to 2.52 percent from 2.50 percent.