Stock price ! profitability, but you're still correct. UnitedHealth's operations have churned out cash each of the last four years [1], as have Cigna [2] and Elevance [3]. Underwriting gains across the industry have been strong for years [4]. The only story I can think of where American health insurers lost money was Aetna with its underpriced ACA plans [5].

That said, whimsicalism is also partly right in that insurers aren't the cause of the unaffordability of American healthcare. They by and large pay out most of their premiums. (With some variance.)

[1] https://finance.yahoo.com/quote/UNH/cash-flow/

[2] https://finance.yahoo.com/quote/CI/cash-flow/

[3] https://finance.yahoo.com/quote/ELV/cash-flow/

[4] https://content.naic.org/sites/default/files/2021-Annual-Hea...

[5] https://spia.princeton.edu/news/why-private-health-insurers-...