One of Maine’s three health care insurers says it will begin to “surgically extract” itself from the individual marketplace if changes aren’t made to the Affordable Care Act. Anthem CEO and President Joseph R. Swedish sent a letter to Republican leaders in Congress this month, telling them it is increasingly difficult for his company to stay in the individual market. “As I have said publicly, without significant regulatory and statutory changes to the individual market, we will be begin to ‘surgically extract’ Anthem from that market beginning in 2018,” Swedish wrote to Rep.