As millions of Americans struggle with mounting medical debt, delayed care, and shrinking access to providers, the seven largest publicly traded U.S. health insurance companies reported a combined $71.3 billion in profits for 2024—setting a new record and fueling growing bipartisan scrutiny of the industry’s practices. The profits, up by more than half a billion dollars from 2023, were released ahead of former Cigna executive Wendell Potter’s testimony before the Senate Health, Education, Labor, and Pensions (HELP) Committee.
Potter, now president of the nonprofit Center for Health and Democracy, compiled the financial data and published it in his Health Care un-covered newsletter. Alongside a breakdown of revenues and profits for UnitedHealth, CVS/Aetna, Cigna, Elevance, Humana, Centene, and Molina, Potter also released CEO compensation figures showing the companies’ top executives collectively earned $146.1 million in 2024. “That’s enough to cover annual premiums for thousands of American families,” he wrote.
While Americans skipped medications and rationed insulin, “shareholders are not the only ones benefiting from the care-restricting barriers insurers have erected to boost profits,” Potter said. “The CEOs of those seven companies took home a combined $146.1 million in 2024 compensation.”
The scale of the industry’s gains, he argued, reveals a deeper crisis in the healthcare system: “So, what’s driving the revenue surge? Gouging. Insurers continued to jack up premiums for their commercial customers and overcharge the government.”
That gouging, according to Potter, is happening on multiple fronts. In addition to raising premiums for private plans, insurers have profited from upcoding and overbilling in Medicare Advantage—despite ongoing federal audits and investigations. “Despite watchdog warnings, Uncle Sam continues to pour money into private Medicare Advantage plans even as audits and investigations uncover widespread fraud and upcoding,” he wrote. “And Medicaid managed care is a gold mine, too.”
These firms have increasingly consolidated control of the healthcare ecosystem, with ownership extending beyond insurance into pharmacies, pharmacy benefit managers (PBMs), and provider networks. “It’s not just health insurance anymore—it’s a monopolized empire,” Potter wrote.
This expansion and vertical integration have occurred as Americans report greater financial strain from healthcare expenses. According to a poll released by the Associated Press-NORC Center for Public Affairs Research, 17 percent of U.S. adults have used “buy now, pay later” services to afford medical or dental care. Forty-two percent of adults cited healthcare costs as a major stressor, while another 36% called it a minor stressor. The poll also identified groceries, housing, and wages as major sources of anxiety.
The cost burden for patients extends beyond premiums. Increasing out-of-pocket expenses, aggressive prior authorization hurdles, and narrower provider networks are contributing to a growing gap between what Americans pay and the care they receive. “We all paid more for health insurance and got less for the hard-earned money we had to shovel out for our ‘coverage,’” Potter wrote.
Amid this public frustration, congressional interest in insurance industry profiteering appears to be growing. “The curiosity from senators on both sides of the aisle signaled, to me, that lawmakers are as interested as I’ve ever seen in the industry’s rampant profiteering,” Potter said of his July 2025 testimony before the Senate HELP Committee.
At the same time, Republican-led budget legislation threatens to further reduce access to care. The recently signed budget reconciliation package includes cuts to Medicaid and the Affordable Care Act (ACA), which are projected to strip coverage from millions. “Cuts to the ACA will raise premiums for almost 23M Americans by hundreds of dollars each year,” Congressman Ro Khanna (D-Calif.) warned. “Working and middle-class families can’t afford that. We need to pass Medicare for All and make sure health insurance stays affordable for all Americans.”
Though more than 100 Democratic House members and a dozen senators support the Medicare for All Act—spearheaded by Rep. Pramila Jayapal (D-Wash.) and Sen. Bernie Sanders (I-Vt.)—the proposal remains stalled due to opposition not only from Republicans, who hold majorities in both chambers, but also from some centrist Democrats with ties to corporate donors.
Even with the soaring 2024 profits, the beginning of 2025 has not been without turbulence for the industry. Several of the major insurers have reported paying out more in medical claims than expected, causing a temporary dip in profits. But Potter was quick to downplay the impact: “No need for you to shed any tears for them, though, because we’re still talking billions and billions in profits.”
If anything, he warned, the short-term drop will likely prompt companies to implement even tighter cost controls and access restrictions to maintain Wall Street’s expectations. “Expect even more financial pain (and difficulty getting the care you need) as these companies do all they can to get their profit margins back to where Wall Street wants them.”
As the U.S. healthcare system continues to operate at the intersection of private profit and public need, the disparity between insurer wealth and patient suffering remains stark. In Potter’s view, the problem is no longer hidden in fine print or complex billing codes—it’s in the headlines, investor calls, and earnings reports. “If you’re wondering why your premiums, deductibles and costs at the pharmacy counter keep going up—just look at those 2024 numbers.”
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