Yeah absolutely re regulated profit margins (indirectly through MLRs - their actual margins are way below the cap due to expenses) but that only reinforces my point that providers are having more success growing their margins (on a relative basis, anyway).

Great point on bigger pie increasing both shares. I didn't mean to imply it's zero sum.

Oh the irony of MLRs encouraging insurers to provide terrible service (opex recovery boosts profits) and let providers push fees ever upward (bigger pie, bigger premiums, bigger net profit on constrained margin).