Aetna has announced that it will leave all but four of the states where it provides coverage on Affordable Care Act exchanges. Instead of the 15 states the company served in 2016, Aetna will remain only in Virginia, Delaware, Iowa, and Nebraska next year. The company cited financial losses in its announcement. “Providing affordable, high-quality health-care options to consumers is not possible without a balanced risk pool,” Aetna CEO Mark Bertolini said. “Fifty-five percent of our individual on-exchange membership is new in 2016, and in the second quarter we saw individuals in need of high-cost care represent an even larger share of our on-exchange population.” Other insurance providers, including Humana and UnitedHealth, have also reduced their exchange participation in certain markets.