The Affordable Care Act continued its inevitable collapse Wednesday when Anthem Blue Cross and Blue Shield announced it would be pulling out of most of the Wisconsin and Indiana marketplaces.

The bad news for Obamacare followed on the heels of Anthem’s announcement in early June that it would be withdrawing from Ohio’s marketplaces. Roughly 46,000 Hoosiers purchased health care coverage from Anthem on the exchange, while approximately 14,000 Wisconsinites purchased Anthem’s coverage.

“The Wisconsin individual market remains volatile, making planning and pricing for ACA-compliant health plans increasingly difficult due to a shrinking and deteriorating individual market, as well as continual changes and uncertainty in federal operations, rules and guidance, including cost-sharing reduction subsidies and the restoration of taxes on fully insured coverage,” Anthem said in a Wednesday statement.

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Regarding Indiana, Anthem spokesman Tony Felts said, “A stable insurance market is dependent on products that create value for consumers through the broad spreading of risk and a known set of conditions upon which rates can be developed,” the Indy Star reported.

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Jean Morrow, a researcher at The Heritage Foundation, told LifeZette that Anthem’s decision to exit the marketplaces “is really something we’ve expected.”

“And they’ve joined a long line of insurers and other health plans that are exiting the individual market because the Obamacare regulations are not working,” Morrow said, noting that only 218 of the original 395 insurers selling plans are left.

“And that’s a direct response to the over-regulation that was put into place by the Affordable Care Act,” she added. “So between 2013 and 2017, we’ve had a 45 percent decrease in insurers participating in the individual market.”

As Anthem prepares to pull out of most of Wisconsin and Indiana, Americans nationwide anxiously await the result of the Senate’s lengthy deliberation over repealing and replacing Obamacare.

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Anthem’s announcement, in fact, arrived the day before GOP Senate leadership is set to unveil its version of the House’s partial repeal-and-replace legislation.

“The real key here is that just because the ACA is collapsing doesn’t mean that we should all run and embrace whatever Republicans come up with,” said Dr. Ramin Oskoui, a leading cardiologist in the Washington, D.C., area and senior health care adviser to LifeZette.

“This is not a binary choice. The choice that we’re not being offered is one that really uses free-market principles to lower health care, whether it’s for drugs, whether it’s for primary care, whether it’s for more catastrophic or major events,” Oskoui added. “And even under the new [American Health Care Act] bill, as the House has done it, we’ll see what the Senate does. I doubt they’ll do much of anything meaningful.”

The Senate’s most moderate Republicans and its most conservative Republicans have struggled to settle on their own version of the legislation as the ACA continues to collapse around them. While premiums soar, out-of-pocket costs rise, and choices dwindle, many remain doubtful that the House and Senate can ratify a piece of legislation and send it to President Donald Trump’s desk before the summer recess.

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Morrow said it’s expected that more insurers will pull out this year and next.

“So this is very serious,” she said. “At the heart of health care is patients, and patients should have as many choices as possible, and that’s only done through competition,” she added. “So we’d like to see the Senate put out a bill that’s going to help stabilize the markets, help increase competition and lower costs, lower premiums, and lower out-of-pocket costs for the individuals.”

Vice President Mike Pence promised Tuesday during a speech in Washington, D.C., that Trump and Congress “will keep their promise to the American people” and will repeal and replace Obamacare “before the summer is over.”

House Freedom Caucus Chairman Mark Meadows (R-N.C.) said Wednesday on Fox News that he is “optimistic” that “the president will be able to sign something” in the next several weeks, whether or not it turns out to be as full a repeal and a replace as he had promised. Senate Majority Leader Mitch McConnell is expected to roll out the Senate GOP’s bill Thursday morning.

But not all GOP senators are convinced, and many have expressed their concern that they haven’t even seen the legislation yet because it has been crafted “in secret.”

“What I’ve told leadership very clearly is I’m going to need time, and my constituents are going to need time to evaluate exactly how this is going to affect them, so I personally think that holding a vote on this next week would definitely be rushed,” Sen. Ron Johnson (R-Wis.) said Wednesday on CNN.

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“I can’t imagine, quite honestly, that I’d have the information to evaluate and justify a ‘yes’ vote within just a week,” Johnson added.

Morrow argued, however, that Anthem’s widespread withdrawal from Wisconsin and Indiana “should be a red flag for the Senate to call attention back to the fact that there is little or no choice in the ACA exchanges.”

“And when we have 70 percent of U.S. counties with little or no choice, this is unacceptable. And it really just goes to the heart of Obamacare’s flawed policies,” she added. “This is another red flag, another sense of urgency that something definitely needs to get done.”

“We have to wait and see exactly what is going to be in there,” Morrow said of the bill. “Again, whatever is passed just going to be a first step in getting comprehensive health care reform done. But we’re hoping that our proposals will be included in that discussion and in the eventual bill.”