TRAIN WRECK UPDATE: Anthem Threat Highlights Obamacare’s Big Test.

Anthem Inc. is threatening to leave the Obamacare exchanges.

“If we do not see clear evidence of an improving environment and a path towards sustainability in the marketplace, we will likely modify our strategy in 2018,” Anthem Chief Executive Officer Joseph Swedish said on a call Wednesday discussing his company’s third-quarter results. “Clearly, 2017 is a critical year as we continue to assess the long-term viability of our exchange footprint.”

But in fact, this is huge news, because Anthem runs the Blue Cross/Blue Shield organizations in 14 states. And though Anthem doesn’t appear to be the sole company offering exchange coverage in any of those states, the Blues are generally the backbone of the exchanges. Where others have quailed, the Blues have by and large stuck with Obamacare. If they pull out, then it’s likely that we’ll see more counties, and possibly entire states, with no Obamacare policies on offer.

Anthem doesn’t run all the Blue Cross organizations. But it’s still a bellwether for what may be happening in other markets. Whether the Blues pull back — and how far — will tell us a lot about how Obamacare is going to go.

One of my friends on Facebook was lamenting yesterday that her family’s health insurance premiums just increased by 60% even as the deductibles climbed high. This is happening all over the country, despite the lies that premiums would go down, and people could keep their doctors. If Trump wins, it’ll be a big reason.