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Updated at 6:40 p.m. with more details

To shore up its bottom line, UnitedHealth Group Inc. plans to stop selling next year individual medical insurance plans in Missouri, including those offered through the federal government’s health insurance exchange.

There was no information on whether UnitedHealth, the nation’s largest health insurer, would take similar action in Illinois.

The news comes after the UnitedHealth CEO told investors Tuesday morning that the insurer would only offer exchange health plans in a handful of states after expanding to 34 this year. Specifics on the exact footprint was not provided during a conference call with investors.

The insurer cited losses as a reason for exiting the individual exchange business. The online exchanges are a key component of the Affordable Care Act that allows consumers to buy and compare individual health plans online.

UnitedHealth sent a letter, dated April 15, to inform the director of Missouri’s Department of Insurance, Financial Institutions and Professional Registration of the decision to exit the exchange business altogether.

“I am providing you with this formal notice of our intention to effectuate an individual market exit effective 1/1/2017 … as well as our decision not to participate on the Individual Exchange for 2017,” the letter states.

Current enrollees in UnitedHealth’s individual insurance plans in Missouri will be notified of the change at least 180 days prior to Jan. 1, according to the letter.

Health insurance broker Emily Bremer, of Clayton-based Bremer Conley, said UnitedHealth offered plans with a network that allowed patients to see a broad number of doctors at different area health systems. It’s more common to see very limited networks with individual plans, she said.

The letter says the exit will not affect other UnitedHealth products, such as small and large group insurance plans, sold in the state.

Meanwhile, a UnitedHealthcare spokeswoman declined to say whether the company would exit the Illinois exchange.

The Illinois Department of Insurance had no comment, said spokeswoman Allie Bovis.

Losing money

UnitedHealth Group Inc. said Tuesday that it expects to lose $650 million this year on its exchange business, up from its previous projection of $525 million. The insurer lost $475 million in 2015.

CEO Stephen Hemsley told analysts during a Tuesday morning conference call that his company will not carry into 2017 financial exposure from the exchanges, which represent a small slice of its overall business.

UnitedHealth covered 795,000 people through the exchanges as of the end of March, or roughly 6 percent of the 12.7 million total people who signed up for 2016 coverage through the ACA’s public exchanges. Some states operate their own exchanges, while others rely on the federal government to run the online exchanges.

It’s unclear how many individuals UnitedHealth covers in Missouri. Insurers also offering individual plans in Missouri include Coventry, Cigna, Anthem Blue Cross Blue Shield and Humana.

However, a study this week by Kaiser Family Foundation for Health found that 83 percent of Missouri counties would still have a choice of at least two insurers selling exchange plans.

The study also found that consumers in two counties — Buchanan and Clinton in northwest Missouri — would be left with only one insurer to choose from after UnitedHealth leaves the market.

Industry watchers say they expect other companies to also adjust their exchange participation as they put together their coverage plans for 2017. But they don’t see UnitedHealth’s move as the start of a mass exodus.

“I think insurers will have to become more selective in terms of which exchanges and how they participate, but by far and away I think the United move will be the biggest one this year,” said Mizuho Securities Managing Director Sheryl Skolnick.

UnitedHealth had been cautious about participating in the state and federal exchanges. It begin offering plans in Missouri and other states in 2015, the year following the introduction of the exchanges.

Health and Human Services spokesman Ben Wakana said the government expected insurers to enter and leave exchanges in their early years, and they have confidence that the new marketplace “will continue to thrive for years ahead.”

Health insurers have faced several challenges in building their exchange business. Their initial wave of customers generated higher-than-normal claims in part because some of the uninsured had not used the health care system for years and were waiting for coverage to help pay for needed care.

Insurers also have struggled in many markets to add younger consumers who don’t use as much health care and could balance those more expensive patients. Insurers say they also have been hurt by expensive patients who sign up outside regular enrollment windows.

The Associated Press and the Chicago Tribune contributed to this report.

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