Insurers used to make their money that way. But now that US health care insurers are required to use at least 80% of premiums to pay health care costs, they've lost the incentive to keep prices low. Increasing their profit now requires paying out more in claims.

Not really true. United's long play is with medicare advantage. They plan to add an insane 450k new members by 2024.

https://www.forbes.com/sites/brucejapsen/2023/11/28/unitedhe...

https://www.healthcarefinancenews.com/news/unitedhealths-med...

This is a great example why United was the sole insurer who was able to absorb the Medicare cuts while everyone else is shedding their MA exposure.

Nope, that's not how it works anymore. First, insurers (payers) no longer even provide much insurance. The majority of their business is now managing networks and processing claims on behalf of self-insured employers.

Second, payer profit margins are now capped by the 80% minimum medical loss ratio introduced by the Affordable Care Act (Obamacare). Payers actually make less profit when they deny care. When coverage for certain services is denied it's usually because your employer designed your plan with strict limits.

MA plans complicate this. There's a reason why everyone but United is getting out of the MA space, because united is growing despite medicare cutting payments.