Big health insurance companies have been on a spending spree buying back shares of their own stock, a gimmick — illegal until a few years ago — that has made a few insurance company CEOs incredibly rich at a time when one hundred million Americans are saddled with medical debt.

Share repurchases benefit top executives and other shareholders at the expense of the insurers’ customers — especially health plan enrollees with such high out-of-pocket requirements they’re getting buried under a mountain of medical debt. As Forbes reported last July, those out-of-pocket requirements have reached such heights that millions of Americans are now “functionally uninsured.”

Now that the seven investor-owned health insurers have disclosed how much money their top executives made last year (as the SEC requires publicly traded companies to do), we can see just how important that gimmick has become to the people who are ultimately responsible for whether we get the care our doctors say we need, how much we have to send them every month in premiums, and how much we have to shell out in copays and deductibles before they’ll start paying our medical bills.