Aetna Inc. will leave the few remaining stateswhere it had been selling Obamacare plans next year, making it the latesthealth insurer to pull out of the health law as Republicans attackthe program as failing and work to dismantle it.

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While the move is likely to attract outsize political attention,the decision affects just Delaware and Nebraska. The Hartford,Connecticut-based insurer already said last year it would pull outof 11 states, and in the last month announced plans to exitIowa and Virginia.

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“At this time have completely exited the exchanges,” Aetna saidin a statement Wednesday. The insurer will also stop sellingnon-Obamacare individual plans in Delaware and Nebraska.

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Aetna had indicated it might pull out earlier this month, whenChief Financial Officer Shawn Guertin said the company would takesteps to limit its financial losses in the program. Aetna has saidit expects to lose more than $200 million on individual healthplans this year in the four states where it’s still sellingAffordable Care Act plans.

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Obamacare’s markets are becoming increasingly vulnerable asmajor health insurers exit, citing financiallosses. Some insurers have stayed in, but raised the premiums theycharge customers by double-digit percentages.

Problems new and old

Some of the instability has been going on for years, as fewerpeople than expected have signed up for plans and many have beensicker than insurers accounted for. Those problems have beenfurther pushed by Republicans, who are considering legislation inCongress to repeal and replace large portions of the health law,and by President Donald Trump, who has threatened to withholdsupport from key portions of the law that keep the marketsfunctioning.

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Aetna’s decision could leave Nebraska with just one insurer,Medica. Medica has pulled back as well, saying it may exit theprogram in Iowa, leaving much of the state without insuranceoptions under Obamacare.

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Greg Bury, a Medica spokesman, said, “We have not made adecision and are reviewing all of our options.”

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In Delaware, the Blue Cross and Blue Shield company Highmarkwould be the lone Obamacare insurer, assuming no other companyenters. Highmark didn’t return a request for comment. The state’sinsurance regulator blamed “the uncertainty and instabilitysurrounding the future of the Affordable Care Act” for Aetna’sexit.

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“I would hope that our elected officials in Washington will comeup with solutions to guarantee that health insurance in Delawareand elsewhere is both available and affordable,” InsuranceCommissioner Trinidad Navarro said in a statement.

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Aetna may not be entirely out of Obamacare. Nevada has said itwas working to convince the insurer to offer individual plans inthe state for next year. T.J. Crawford, an Aetna spokesman, saidthe company had “no comment on a potential Nevada presence at thistime.”

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