Anthem is leaving two more exchange markets in 2018, Wisconsin and Indiana.
Anthem announced earlier this month that it would leave the market in Ohio. The insurer gave as reasons the return of the health insurance tax and the uncertain future for cost-sharing reduction payments.
President Trump has given no guarantee the CSR payments will continue. Insurers cite the continuation of CSRs as their number one concern and have said the payments are necessary for them to remain in the exchange market and to keep premium increases low.
Numerous insurers have left the markets established under the Affordable Care Act, even as other health plans have expanded.
Anthem now sells exchange product plans in about 11 states.