A combination of regulatory, political, and economic factors are set to create an uncertain environment for U.S. health care insurers, Moody's Investors Service says, leading to a continuation of the negative outlook for the industry.

 "Despite better-than-expected results in 2010, U.S. health insurers will face considerable challenges over the next 12 to 18 months," says SVP Stephen Zaharuk. "These will stem mainly from the health care reform law, increasing health care costs, and the sluggish economy."

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