I think some of it is framed as "well the insurance company doesn't have to give you anything, so it's not murder to deny coverage when they don't really owe you anything anyway."

But that just indicates the person saying it doesn't understand that our healthcare system is so fucked up because of the insurance industry. The price, the administrative bloat, the declining quality, all in some way directly traceable back to these piece-of-shit insurance companies and their fucking lobbyists.