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The largest health insurance companies in the United States reaped historically large profits in the first quarter of this year, despite all the noise surrounding the Affordable Care Act's individual marketplaces.

Aetna, Anthem, Cigna, Humana and UnitedHealth Group — the big five for-profit insurers — cumulatively collected $4.5 billion in net earnings in the first three months of 2017. That was by far the biggest first-quarter haul for the group since the ACA exchanges went live in 2014. Other major insurers, such as the Blue Cross and Blue Shield company Health Care Service Corp., also are improving their ACA operations.

Expand chart

Aetna lost money because it had to pay Humana a $1 billion break-up fee after their merger failed; otherwise it would have been in the black. Some other things to keep in mind:

  • The ACA exchanges represent a small amount of the insurance market, and most of the for-profit carriers have bailed on those plans.
  • Employer-based coverage is a profit center, but insurers continue to invest more in Medicare Advantage and Medicaid.
  • Congress suspended the ACA's health insurance industry fee for 2017, which is creating a temporary windfall.
  • The first quarter of the year is usually good for health insurers. Deductibles are reset, leaving people on the hook for a lot of their out-of-pocket medical expenses. The fourth quarter usually is the worst, since people often reach their deductibles by the end of the year.

Go deeper

Tina Reed, author of Vitals
2 hours ago - Health

Gottlieb: CDC hampered U.S. response to COVID

Illustration: Shoshana Gordon/Axios

The CDC moved too slowly at several points in the coronavirus pandemic, ultimately hindering the U.S. response, former FDA Commissioner Scott Gottlieb writes in a new book, Uncontrolled Spread.

The big picture: The book argues that American intelligence agencies should have a much bigger role in pandemic preparedness, even if that's sometimes at the expense of public health agencies like the CDC.

911's digital makeover

Illustration: Annelise Capossela/Axios

A next-generation 911 would allow the nation's 6,000 911 centers to accept texts, videos and photos.

The big picture: U.S. emergency communications have remained stubbornly analog, but Congress is about to take another run at dragging 911 into the digital age.

Biden enlists business leaders in campaign for vax mandates

President Joe Biden at a meeting with business leaders Sept. 15, 2021. Photo: Oliver Contretas/Getty Images

President Biden convened a meeting of top business leaders Wednesday to build support for a sweeping vaccine mandate that will affect most of America's workers. The message: Vaccines work, and the stalled uptake is holding back the economy.

Why it matters: As vaccine rates have flattened across the country, business leaders have the power to impact their employees’ decisions. Many corporate leaders had been looking for stronger federal guidance to lean on.