The Affordable Care Act’s health insurance marketplace in Iowa is losing two of its providers after this year, leaving many people in the state in limbo.

Recently both Wellmark and Aetna announced they would be leaving the marketplace in Iowa, which means the majority of counties will be down to one option. Wellmark had rejoined the marketplace for 2017, but decided it didn’t want to continue into next year. Meanwhile, Aetna cited the uncertainty of the Affordable Care Act’s future as their reason for withdrawing from the marketplace in the majority of states they cover.

That leaves the Minnesota-based insurance company Medica as the sole provider on the marketplace for all but 15 of Iowa’s 99 counties, including all the counties in the Raccoon Valley Radio listening area. The good news is that Medica is a non-profit company, and they offer several different plans. The Insurance Commissioner’s Office says because of this there is little fear they will attempt to capitalize on their status as the sole provider for most of the state and increase their prices. It’s currently unknown if any other insurance company will step up and enter the marketplace before open enrollment for 2018 starts in November.

The marketplace was created alongside the Affordable Care Act in 2013. Its purpose is to provide competitive and cost-effective options for health insurance to anyone, and without typical restrictions such as preexisting conditions.