A version of health care overhaul was approved by the Senate Finance Committee on Tuesday. While the legislation still has hurdles to overcome and could look very different in the future, it’s worth considering which exchange traded funds (ETFs) could be affected by health care reform.

The U.S. Senate Finance Committee approved its version of legislation to overhaul the nation’s $2.5 trillion health care system.

Matt Phillips for The Wall Street Journal reports that following the official vote moving the bill out of the committee, health shares moved even lower. Unfortunately, the S&P Health Care Sector index is the worst-performing segment of the S&P 500, knocking the financial sector off from the top position. (Read why health care ETFs still have appeal).

Health insurers took the biggest decline after the vote, which pharmaceuticals close behind. The Standard & Poor’s pharmaceutical index is down 1.5%, outpacing the declines in the health care index and the S&P 500.

Leslie Gevirtz for Reuters says there are both winners and losers in the current bill.

Winners:

• Drugmakers/Pharmaceuticals. The pharmaceutical sector managed to keep an $80 billion rebate agreement while also successfully heading off a fight that would have required some of its largest players to give back another $106 billion in additional rebates over 10 years. Pharmaceuticals can be played with the PowerShares Dynamic Pharmaceuticals (NYSEArca: PJP), which is up 9.7% year-to-date.

• Hospitals. Hospitals kept intact a $155 billion, 10-year deal to accept lower payments from Medicare and Medicaid. Some hospitals can be found in the iShares Dow Jones U.S. Healthcare Providers (NYSEArca: IHF), which is up 18.9% year-to-date.

Losers:

• Health Insurers: While the industry successfully fought amendments for a government-run program, it still faces more than $6 billion in yearly fees. Vanguard Health Care (NYSEArca: VHT) is up 12.3% year-t0-date.

• Device makers: Device makers are facing a $4 billion yearly fee, although analysts feel that this feel could be reduced. iShares Dow Jones Medical Devices (NYSEArca: IHI) is up 29.9% year-to-date.

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Tags: Health Care, IHF, IHI, Pharmaceuticals, PJP, Sector ETFs, VHT