Aetna, one of the nation’s largest health insurers, has announced that it will exit all Affordable Care Act exchanges in 2018 after experiencing massive losses in 2016 and 2017.

Aetna announced in August of last year that it would scale back its participation in the Obamacare exchanges in 2017—from operating in 778 counties to 242—citing losses of more than $430 million since January 2014. At that time, the company said it would still operate in four states: Delaware, Iowa, Nebraska, and Virginia.

Earlier this month, the company said it would exit the exchanges in both Iowa and Virginia, saying the insurer has continued to face profitability headwinds from individual commercial products. The company even went so far as to set aside a fund to buffer it from projected losses.

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