Profit is not income. That $18B could be spend on salaries, bonuses, company assests, etc, and I'm not an accountant but if it's getting spent on the business it doesn't have to be included in their income reports.
Profit without a qualifier is assumed to mean net income, which is all revenue minus all expenses.
But even supposing that the business earns $18B from Medicare Advantage after all is said and done, it doesn’t pass the smell test because at that level of profit, these businesses should shut everything else down and just do Medicare Advantage.
