Investors in ASX healthcare shares might be wondering how the latest global trade turmoil could impact their portfolios.

In a new broker note, Macquarie Group Ltd (ASX: MQG) has provided investors with a deep dive into the implications of U.S. President Trump's latest round of tariffs – and it is a mixed bag for Aussie healthcare stocks.

According to the broker, while the broader healthcare sector is likely to benefit from investors seeking safety during a market selloff, the impact of tariffs on supply chains and margins is significant enough to separate the winners from the losers.

The Australian healthcare losers

Macquarie believes Ansell Ltd (ASX: ANN) is the most exposed name in its coverage, with a massive 93% of its supply chain facing U.S. reciprocal tariffs of 10% or more.

The broker notes that even assuming a 75% pass-through to customers, its earnings could drop by 17% in FY 2026 and then another 16% in FY 2027. That's a painful hit, particularly for a lower-margin business. It said:

For a low margin business, ANN's earnings face significant downside if the company cannot successfully pass through tariff increase to end customers. However, ANN's products are daily necessities for its industrial and healthcare clients who value supply chain stability over price alone.

The winners

On the other hand, ResMed Inc (ASX: RMD) and Fisher & Paykel Healthcare Corporation Ltd (ASX: FPH) look relatively well positioned.

Macquarie notes that ResMed manufactures ~40% of its products in the U.S., shielding it from some of the trade-related cost pressures. Whereas Fisher & Paykel's products, made in Mexico, are compliant under USMCA and currently avoid the steep 25% tariffs Trump has imposed on other regions.

Commenting on both companies, the broker said:

RMD remains well-placed to take on tariffs with ~40% of manufacturing completed in the US. […] A key challenge for both RMD and FPH will be negotiations with US payors to increase pricing or widening co-payments. We note upside risk for both names if respiratory devices/apparatus are exempt from tariffs under the Nairobi Protocol implemented through the Harmonised Tariff Schedule.

That said, ResMed isn't completely immune. With part of its manufacturing based in Australia and Singapore, both now facing 10% tariffs, and rising input costs from tariffed raw materials, its earnings forecasts have been trimmed by 2% for FY 2026 and FY 2027.

What about CSL and Cochlear?

Biotech giant CSL Ltd (ASX: CSL) escaped the current round of tariffs, thanks to exemptions for pharmaceutical products. However, Macquarie flagged it as a name to watch. It said:

CSL is left unscathed by reciprocal tariffs as pharmaceuticals are exempted. However, potential sector tariffs remain a key risk for CSL in the near term.

As for Cochlear Ltd (ASX: COH), it also sidestepped the tariff net, as hearing devices continue to enjoy duty-free treatment under the current U.S. harmonised tariff schedule. The broker said:

COH's hearing implants continue to be exempt from tariffs under the latest Harmonised Tariff Schedule. We think its market dominance and margins are strong defence against future tariff pressures.

Foolish takeaway

Overall, the broker is feeling a bit mixed about the tariffs. It summarises its views:

There are no clear winners from the latest round of tariffs: Exemptions insulate CSL, COH for now; FPH best positioned and ANN most impacted. We expect the rotation into high-quality, non-cyclical, large-cap healthcare names to benefit CSL, RMD, FPH, as well as domestically focused RHC. We lower estimates for RMD, FPH, ANN while awaiting tariff implementation details and updated guidance in the coming weeks.

Macquarie currently rates CSL, Fisher & Paykel, and ResMed as outperform, and Ansell and Cochlear as neutral.