Comment by nradov
3 months ago
Commercial health insurers have relatively low profit margins. This is forced by the ACA minimum medical loss ratio. In theory Congress could increase that ratio slightly but it wouldn't do much to improve affordability for consumers.
That restriction is mysteriously absent from the actual published data showing their revenue growth rate spiking sharply when ACA was passed. There’s lots of sources for that data, but I liked this chart for its simplicity:
https://images.jacobinmag.com/wp-content/uploads/2024/12/111...
It presents nice easy datapoints: Cigna raised its profits by $40B/yr, an increase of 400% of its pre-subsidy profits, in just a decade — and one can safely assume that now that they’re accustomed to the new profit levels, there is no way they’ll voluntarily give them up. Whatever was intended with the medical loss ratio, Congress fucked up by not including a simple dollars-per-subscriber cap on net revenue.