"THE ONLY HEALTHCARE I WILL SUPPORT OR APPROVE IS SENDING THE MONEY DIRECTLY BACK TO THE PEOPLE, WITH NOTHING GOING TO THE BIG, FAT, RICH INSURANCE COMPANIES, WHO HAVE MADE $TRILLIONS, AND RIPPED OFF AMERICA LONG ENOUGH"
- Donald Trump on his Truth Social platform, November 2025 (original in all caps)
Now for some numbers. Based on statements submitted by 1,225 health insurers, the National Association of Insurance Commissioners (NAIC) reported the health insurance industry experienced a significant decline in both net income and profit margin in 2024. The net income dropped to $9 billion, a sharp decrease from $25 billion in 2023 and the profit margin fell to 0.8%, down from 2.2%. Low profit margins in the health insurance industry are not a new development; margins averaged just 2.2% over 2015-2024. Take a look:
For comparison, average net profit margin for top 500 companies (using the S&P 500 as a proxy) was around 12% in 2024, with a five-year average of 11.5%.
According to NAIC, the main issues affecting health insurer financial results are rising healthcare costs and increased utilization. Another financial pressure facing insurers is the popularity of expensive prescription drugs for obesity and diabetes, along with new rules mandating 60% coverage of catastrophic-phase costs for name-brand drugs, up from 15% in 2023 and 20% in 2024.
On a side note, Obamacare subsidies are primarily in the form of premium tax credits that go to the consumers of healthcare, aka “the people”. They do not go to insurance companies.
Let’s hope our President does more homework on how the healthcare system actually works in America before he proposes his own fix to the system.
Reference:
U.S. Health Insurance Industry / 2024 Annual Results, National Association of Insurance Commissioners https://content.naic.org/sites/default/files/2024-annual-health-industry-commentary.pdf