The health care industry is bracing for the next presidential election and the potential for big changes in how medical services are provided and funded.

Locally, Centene Corp. of Clayton expanded its business by purchasing Celtic Group Inc. for $80 million. Centene has grown rapidly in recent years by contracting with states to administer Medi-

caid contracts and other health benefits to poor and disabled residents. Celtic's focus is different. Based in Chicago, Celtic provides health insurance to individuals not provided coverage through their jobs.

Centene said the purchase will position the company for possible expansions in health benefits provided by states, plans likely to look more like private insurance than Medi-caid coverage.

For Express Scripts Inc., of north St. Louis County, the presidential election has stifled existing bills from being passed into law. Express Scripts has been pushing for several bills, including one that would make it easier for generic versions of some of the most expensive medications to come to market.

Though few health care industry watchers expect a revolution, many think the public's interest in health care reform, coupled with the vigor of a new presidency, could lead to some change. The question is who will win and who will lose, both in the election and in the industry.

mjfeldstein@post-dispatch.com

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