As rising health care costs and inadequate insurance coverage leave one in three Americans saddled with medical debt, the nation’s top health insurers have dumped billions into enriching their executives and top shareholders through lucrative stock buybacks.

All in all, the country’s largest health insurers have invested over $120 billion into repurchasing their own shares since the passage of the Affordable Care Act in 2010. These include UnitedHealth Group; Cigna; Elevance Health, the parent company of Anthem Blue Cross Blue Shield; and CVS Health, which acquired Aetna in 2018.

Forty-four percent of buyback expenditures came from UnitedHealth Group, which covers more Americans than any other private health insurer. UnitedHealth has increased its annual share repurchasing program by 217 percent since 2010, dumping a whopping $54 billion into buybacks during that time.