Wellmark Blue Cross and Blue Shield announced Monday it would pull out of the individual health insurance market in Iowa in 2018, another sign of the uncertainty facing insurers amid the Republican ObamaCare repeal effort.

Wellmark said in a statement that it has lost $90 million in the ObamaCare markets in three years and its customers have "endured double-digit premium increases."

“Finding solutions to stabilize this market is in the best interest of all Iowans, including providers of health care and insurance carriers,” Wellmark Chairman and CEO John Forsyth said in a statement.

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“No one really benefits from rising costs. While there are many potential solutions, the timing and relative impact of those solutions is currently unclear. This makes it difficult to establish plans for 2018.”

Wellmark, which only operates in Iowa and South Dakota, left South Dakota's individual marketplace last year.

According to Wellmark, its withdrawal will affect 21,400 Iowans. They will have coverage with Wellmark until Dec. 31, 2017.

Other insurers must decide in about six weeks whether they will operate in the individual market or raise premiums in 2018. But they are waiting to hear about whether the Trump administration will continue payments to insurers, which help low-income and more costly patients afford health insurance.

An administration official told The Hill on Monday that insurers would continue to receive cost-sharing payments while the House GOP lawsuit over the payments plays out in court.