With the only insurer left on the Affordable Care Act exchange in the Knoxville area set to exit the market in 2018, the city could become the first place in the nation where Obamacare fails, according to a

When Humana pulls out of the exchange next year, roughly 40,000 people will be without an option for a subsidized insurance policy unless another carrier steps in.

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"I'm not optimistic that one of our existing insurers would like to expand their coverage area without some changes to the regulatory system, either by Congress or the administration," said Tennessee Insurance Commissioner Julie McPeak.

According to CNN, McPeak said the carriers want more flexibility to limit their exposure to sick, costly enrollees.

Insurance companies have until July 1 to file their 2018 plans in Tennessee, and the report says Blue Cross Blue Shield is reviewing its options.

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