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Anthem, one of the nation’s largest insurers and a major player in the individual insurance market created by the federal health care law, announced Tuesday that it would stop offering policies in the Ohio marketplace next year. Although its departure would leave a small number of people — roughly 10,500 who live in about a fifth of the state’s counties — without an insurance carrier, the move was seized on by Republicans as more evidence that the markets are “collapsing” under the Affordable Care Act. President Trump, meeting with congressional leaders on Tuesday, said it was more proof that insurers are “fleeing and leaving” the marketplaces and added that it was essential for Congress to pass a bill repealing the health law this summer. (Abelson, 6/6)

In 18 counties, including Muskingum and Coshocton, Anthem's pullout will leave no options for Ohioans who get insurance through the exchange. The 18 counties, which currently have 10,500 Anthem exchange customers, are concentrated in Appalachia and include some of the poorest in the state. (Balmert and Thompson, 6/6)

Ohio had one of the country's most competitive insurance marketplaces. In 2016, there were 17 insurers selling on the exchange in Ohio, with four offering plans state-wide. In 2017, there were still 11 insurers participating in the exchange, but 20 counties had only one insurer, according to the Ohio Department of Insurance. (Johnson, 6/6)

Anthem said the market remains volatile and it cited the uncertainty surrounding key issues, including federal “cost-sharing” payments that help reduce costs for low-income ACA enrollees. Anthem’s decision was immediately seized on by both sides of the debate over the Republican health bill. Republicans, who have pointed to insurers’ withdrawals and rate increases as signs of trouble with the ACA, said the move was evidence of the need for new legislation. President Donald Trump mentioned the Anthem withdrawal at a White House meeting with congressional Republican leaders on Tuesday. (Wilde Mathews, 6/6)

For months, Anthem has been hinting that it may pull out of some Affordable Care Act exchanges, but Ohio marks its first retreat. The Indianapolis-based insurer sells policies on exchanges in 13 other states. Anthem covers about 1.1 million exchange members. (Livingston, 6/6)

Withdrawal from other states could follow. Anthem's Ohio decision was announced Tuesday because it followed the Monday state deadline for all insurers to make their intentions clear with rate filings. "Regarding other states, we remain in active dialogue with state leaders and regulators in hopes that we can find a sustainable path moving forward before we are required to make a decision," company spokesman Jeff Blunt said in an email. "As the individual marketplace continues to evolve, Anthem will continue to advocate solutions to ensure long-term stability in the market." (Koff, 6/6)

“I think this will lead to increased uncompensated care,” said Steve Wagner, executive director of the Universal Health Care Action Network of Ohio, a nonprofit that promotes accessible and affordable health care. “Certainly, people will go without care, or defer it until it’s so critical they end up in the emergency department.” (Huson, 6/6)

Sen. Rob Portman (R-Ohio) issued a statement shortly after the announcement, saying “this is one more reason why the status quo on health care is unsustainable. The Affordable Care Act has failed to meet the promises that were made to Ohio families.” Rep. Patrick Tiberi (R-Ohio), who represents a county now at risk of having no ObamaCare insurers, said the healthcare law is "collapsing under its own weight." (Roubein, 6/6)

After Senate Republicans wrapped up their health-care meeting with Vice President Pence, Sen. John Barrasso (R-Wyo.), one of the body’s few physicians, told reporters that the party got a new sense of urgency after Anthem, an insurer in Ohio’s Affordable Care Act exchange, announced that it was pulling out. Thousands of Ohioans, most in rural areas, could be left uninsured. “We need to stabilize the markets right now,”  Barrasso said. “While we were in there, another company pulled out, which shows the continued collapse of the Obamacare market. I mean, it happened during the policy meeting.” (Weigel, 6/6)