Anthem Inc. said it may join other major U.S. health insurers in largely pulling out of Obamacare’s markets in 2018 if its financial results under the program don’t improve next year.

Anthem retreating from the Affordable Care Act would mean that almost all of the major American for-profit health insurers have substantially pulled back from the law. The other big insurers -- UnitedHealth Group Inc., Aetna Inc. and Humana Inc. -- have already scaled back, after posting massive losses.

The retreats threaten to further destabilize coverage in the markets for individual coverage, known as exchanges, that provide insurance to millions of Americans.

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