Despite suffering from a past heart attack and diabetes, Kentucky resident Mary Blair was able to receive medical coverage through Medicaid expansion under the Affordable Care Act.

Almost 60 percent of the combined revenue of the top five insurers in the United States comes from the government-sponsored health programs Medicare and Medicaid — and has more than doubled since the passage of Obamacare, a new report says.

The analysis, published in the journal Health Affairs, suggests that policymakers could improve the viability of Obamacare marketplaces, which sell individual health plans, by requiring insurers that benefit from other government coverage programs to sell Obamacare coverage.

Most of the big insurers have pulled back their presence on Obamacare exchanges, citing the difficulty of making money on them.

The report said that in 2010 — the year the Affordable Care Act, known as Obamacare, was signed into law — the big five insurers had revenue of $92.5 billion from operating Medicare and Medicaid plans.

By 2016, that revenue had grown to $213.1 billion at the big five insurers: UnitedHealthcare, Aetna, Anthem, Cigna and Humana. That amounts to 59 percent of their total revenue.