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Health insurance is as big as Big Tech

Data: Company filings and FactSet; Chart: Naema Ahmed/Axios

The 5 largest conglomerates combining health insurance and pharmacy benefits are on track this year to be bigger than the 5 preeminent tech companies.

The big picture: Anthem, Cigna, CVS Health, Humana and UnitedHealth Group cumulatively expect to collect almost $787 billion in 2019, compared with $783 billion of projected revenue for Facebook, Amazon, Apple, Netflix and Google.

Yes, but: The tech companies cumulatively were 5 times more profitable than the health care companies in 2018 and are projected to be 3.5 times more profitable this year.

  • There's more money to be made selling smartphones and online ads than acting as a health care middleman.
  • Health insurers and pharmacy benefit managers pay out a vast majority of their revenues to hospitals, doctors and drug companies.
  • But insurers and PBMs are still turning large overall profits. And a delay in an Affordable Care Act tax is expected to create a big windfall for the insurance industry this year. Companies are working behind the scenes to get that tax delayed again for 2020 or permanently repealed.

It's also worth remembering that health insurance giants today do a lot more than just pay out claims for medical care and prescriptions.

  • UnitedHealth owns surgery centers, doctors' offices, consulting shops and data-analyzing services.
  • CVS, which just bought Aetna, brings in a lot of money through its retail pharmacies and in-store clinics.

Go deeper: The consolidation of health insurance and drug benefits is back

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