Anthem, Inc. announced Friday that it will be leaving the Affordable Care Act marketplace in Virginia for 2018. The “Individual market remains volatile” and is “shrinking and deteriorating” the company said in a statement on August 11, citing “continual changes and uncertainty in…cost sharing reduction subsidies” among its primary concerns.

The statement strongly echoes Anthem’s most recent earnings call, in which several executives highlighted this key concern, and CEO Joseph Swedish said decisions on exchanges would be “fast and furious.”

Anthem has now withdrawn or significantly reduced its exchange offerings in six states, most recently announcing its exit from Nevada’s marketplace. It becomes the third state to exit Virginia’s exchange, along with UnitedHealthcare and Aetna. The statement confirmed off-exchange individual plans will still be offered in Washington and Scott counties, as well as the city of Bristol.