Expenses are irrelevant to the law, which looks at money in -> healthcare costs paid externally.

Those expenses are internal and increasing them doesn't change the above at all, those expenses affect profit and that it.

Insurance companies profits come from reducing expenses. Reducing claims doesn't change the profits in any way.

Reducing claims means lower premiums, and that's it.

No, that's not accurate. See https://www.healthcare.gov/health-care-law-protections/rate-...

Unfortunately that link doesn't say anything about profit margins, or revenue/expenses. It only talks strictly about premiums, which is a monthly fee for insurance coverage, and is just one source of revenue for such a company. (at least it did help me learn more about the US healthcare system and some of its regulation, so thanks regardless haha)