The effects of that competitive pressure have been compounded by the weak economy, which has put a lid on price increases. Price increases in this year's soft economy have been around 7 to 8 percent, which is in line with costs, analysts say. (That figure is expected to go up next year as medical costs rise.) "The economy being what it is, employers are more concerned," Matthew Coffina, an analyst with Morningstar, Inc., says in an interview. "If you're (an insurer) expecting to get a 7 percent increase, you're going to ask for 7 percent, and you're going to work very hard to get it."

Insurance companies are being hammered by the weak job market too. UnitedHealth lost 275,000 commercial insurance customers in the third quarter because of layoffs. WellPoint expects to lose about 1.4 million members this year.

Yes, there are a few outliers. Cigna Corp. reported Thursday that third-quarter earnings jumped 92 percent, to $329 million, as the company had stronger sales of annuities, a business that it's winding down. Health care revenue was up 9 percent, to $204 million.

But by and large, industry profits simply aren't as big as the politicians say they are.

In July, President Obama implied insurers didn't want competition from a proposed government health plan because it would encroach on their "record profits."

"There have been reports just over the last couple of days of insurance companies making record profits right now," Obama said last summer. "At a time when everybody's getting hammered, they're making record profits, and premiums are going up."

But Obama's statement wasn't true.

"The president was likely overstating the case for political value," Miller Tabak analyst Les Funtleyder says in an interview. "It doesn't change the fact there are a lot of dollars here but it's a rhetorical issue."

Industry experts are quick to point out that while Rockefeller's claim of a 400 percent increase in profit is technically accurate, that's a measure of 10 large insurers from 2001 to 2007, according to PolitiFact.com. The past two years have been particularly challenging for insurance companies as medical costs soared.

Looking ahead, health care reform is likely to narrow those margins even more, Thomas Carroll, an analyst with Stifel Nicolaus, says in an interview. "The managed-care market is not any less competitive than it has been." Though he expects margins will eventually rise to the 6 to 7 percent range, he says federal reform could bring them down two percentage points. Increased competition from the government and cuts to supplemental Medicare plans offered by private insurers are going to pinch profits, he says.

Asked if he's making record profit, John Molina, chief financial officer of Long Beach, California-based Molina Healthcare Inc., laughs. His company administers Medicaid insurance, a business with profit margins around 2 percent. Molina Healthcare's third-quarter earnings dropped by almost half, to $8.6 million, as swine flu and other costs rose.

"The data is clear that health plan profits are not what is driving rising health care costs," Robert Zirkelbach, a spokesman for America's Health Insurance Plans, says in an interview. "Yet you hear all these claims that won't go away."