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It doesn't cut the bottom line if they no longer have to pay the obligation pursuant to the terms of the contract, and instead merely contract as a claims processor.
If it's a publicly traded company, then they are obligated to pursue shareholder value above all else. If total revenue go down, shareholder value go down. They would see some pretty marginal gains because they'd still be able to lay off most employees, but they'd practically be cutting off both of their arms.
They make their money by absolutely draining every working class American for every dollar they can afford. Most claims are handled automatically by computer, we do not need them to do that for us. The 5% of claims or so that are not automatically handled are given over to review by a pretty small group of people, we would not need 3 insurance companies to do that work nationwide.
What you're proposing is a form of universal healthcare where Americans continue to spend more than every other developed nation for similar outcomes as to what we already have.
Yes, our system is fucked up in 2 ways: (1) middlemen deny care b/c the care affects the bottom line, and (2) our care is expensive.
I'm thinking we solve problem 1 now by de-linking the care provided with the profit motive to deny care. But, if we do that unilaterally, we'll run into a wall of cash that opposes that change. We might still spend more as a society, but at least people won't be dying in the streets. The future people can work on getting the price down tomorrow. But, today? Give universal health-insurance by any means.
Kicking the can got us the ACA, it's been almost entirely gutted in under 15 years.
If we leave them in place, on the presumption that there's profit motive for them to remain, then we leave them with enough cash to claw back everything they lost, and they'd keep their cushy government contracts.
Again, there is no universe in which that wall of cash doesn't oppose this anyway. Don't negotiate with terrorists.