Government programs continued to push down health insurers’ profitability in the third quarter, even as executives promised investors they’ve charted a reliable course to margin improvement. But those promises should be taken with a grain of salt, given the pernicious cost pressures facing Medicare, Medicaid and the Affordable Care Act, experts say.

The average operating margin of the seven major publicly traded payers dropped to just 0.5% in the third quarter, compared to 3% in the same period last year, according to a Healthcare Dive review of financial documents.

Taking out Cigna, which doesn’t provide insurance in government programs and enjoyed comfortable profits in the quarter, the group posted an average operating margin of -1.4%, compared to 2.2% same time last year. That’s des

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