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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

Top general: Calls to China were "perfectly within the duties" of job

Gen. Mark Milley. Photo: Andrew Harrer/Bloomberg via Getty Images

Joint Chiefs Chairman Mark Milley told the Associated Press on Friday that calls with his Chinese counterpart during the final months of Donald Trump's presidency were "perfectly within the duties and responsibilities" of his job.

Why it matters: In his first public comments on the calls that have prompted critics to question whether the general went too far, Milley maintained that such conversations are "routine," per AP.

The consumer's massive "war chest"

Illustration: Megan Robinson/Axios

Economists expect the pace of economic growth to cool off now that government transfer payments like stimulus checks and emergency unemployment benefits are in the rearview mirror. But evidence suggests that the U.S. consumer is sitting on a lot of financial firepower that could be a key driver of growth in the quarters to come.

Why it matters: U.S. consumer spending is massive, representing about 70% of GDP.

The Fed takes on its own rules amid stock trading controversy

Photo: Al Drago/Bloomberg via Getty Images

New disclosures that showed Fed officials were active in financial markets set off a firestorm of criticism. Now the Fed may overhaul the long-standing rules that allow those transactions.

Why it matters: What officials actively traded was sensitive to the Fed decisions they helped shape, including the unprecedented support that underpinned a massive financial market boom.