Then why do the 7 publicly listed health insurers have shitty shareholder returns?

If their profits are so good, their shares would be worth owning.

Could it be because their profit margins are actually terrible (3% if lucky), and they have to get the price of their product approved by 50 different state government employees, and the federal government constantly changes their customer’s subsidies making revenue and expenses extremely volatile and difficult to forecast?

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eli 3 hours ago | parent | next [-]

If you bought shares of those 7 companies in 2010 when the ACA passed, how much would you have today? More or less than if you bought the S&P 500?

If you're looking for policies to blame for insurance companies having a rough 2025-2026, look to the Republican-led efforts cap Medicare fees and alter eligibility requirements.

	▲	lotsofpulp 3 hours ago \| parent \| next [-]
		You would have about the same or less. Maybe UNH gets you a couple extra percentage points per year, but that's because they have an enormous healthcare provider business instead of just being an insurer. But it's still nowhere near a positive risk adjusted return when comparing to a relatively risk-less investment in SP500. https://dqydj.com/sp-500-return-calculator/ https://dqydj.com/stock-return-calculator/ Since Jan 1, 2010, 18% for UNH, 15% for MOH/CNC, 14% for CI/ELV/HUM/SP500, 8.5% for CVS. Also, these businesses are competing to sell a completely fungible commodity good with tons of non profits like Kaiser Permanente, HCSC, Cambia, Independence Blue Cross, and many others. It makes no sense to expect those businesses to be able to earn any decent profit margin when their competition only needs 0%.
	▲	jpadkins 3 hours ago \| parent \| prev [-]
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Gareth321 3 hours ago | parent | prev [-]

> Then why do the 7 publicly listed health insurers have shitty shareholder returns?

CNC is up 90% YoY. That's far more than any of the largest tech companies. Alphabet is the highest of the tech stocks, and it's up 38% in the same period. When we look at the performance of the seven large U.S. publicly traded health insurers, their returns were extraordinary in the decade following the ACA.