Light did not mean to imply quantity of paperwork you have to do, rather are you allowed to do the things you want to do as a company.
More compliance or reporting requirements usually tend to favor the larger existing players who can afford to do it and that is also used to make the life difficult and reject more claims for the end user.
It is kind of thing that keeps you and me busy, major investors don't care about it all, the cost of the compliance or the lack is not more than a rounding number in the balance, the fines or penalties are puny and laughable.
The enormous profits year on year for decades now, the amount of consolidation allowed in the industry show that the industry is able to do mostly what they want pretty much, that is what I meant by light regulation.
I'm not sure we're looking at the same industry. Overall, insurance company profit margins are in the single digits, usually low single digits - and in many segments, they're frequently not profitable at all. To take one example, 2024 was the first profitable year for homeowners insurance companies since 2019, and even then, the segment's entire profit margin was 0.3% (not 3% - 0.3%).
https://riskandinsurance.com/us-pc-insurance-industry-posts-...
It's an accounting 101 thing to use all tricks in the book to reduce the reported profit, to avoid paying taxes on that profit.
The total profit of ALL US health insurance companies added together was $9bln in 2024: https://content.naic.org/sites/default/files/2024-annual-hea.... This is a profit margin of 0.8% down from 2.2% in the previous year.
Meta alone made $62bln in 2024: https://investor.atmeta.com/investor-news/press-release-deta...
So it's weird to see folks on a tech site talking about how enormous all the profits are in health insurance, and citations with numbers would be helpful to the discussion.
I worked in insurance-related tech for some time, and the providers (hospitals, large physician groups) and employers who actually pay for insurance have signficant market power in most regions, limiting what insurers can charge.