South Carolina became the fifth state to have only one company offering health insurance through its Affordable Care Act exchange.

The South Carolina Department of Insurance announced on Tuesday that Blue Cross Blue Shield of South Carolina will be the sole provider for South Carolinians looking to get covered through the ACA, better known as Obamacare, according to The Post and Courier.

Aetna and United Healthcare both announced earlier in 2016 that they would pull out of the state's exchanges, and BCBS of SC said it would no longer offer coverage through its BlueChoice subsidiary, according to The Post and Courier's Lauren Sausser.

Sausser also noted that Obamacare premiums will increase by an average of 27% in the state.

South Carolina becomes the fifth state to officially be left with a single insurer in the Obamacare exchanges, with Alabama, Alaska, Oklahoma, and Wyoming. Based on current projections, North Carolina and Kansas could also be left in the same boat.

Insurance firms have struggled with a group of enrollees that have been sicker and older than expected, leading to large losses for the firms. This has been especially acute in states that did not expand their Medicaid offerings, such as South Carolina.

This has caused insurers like Aetna and United Healthcare to ditch some of the more rural coverage areas, leaving residents of those areas high and dry. Even states with more competition are facing strains, such as Tennessee and Minnesota.

On the positive side, most of the premium increases, while intense, appear to be a normalization after insurers underpriced plans in the first few years of the law.

Jonathan Gold, a spokesperson for the Department of Health and Human Services, said in a statement that the changes are not representative of the experience of all of South Carolinians. From Gold's statement:

"HHS projected that the majority of South Carolina Marketplace consumers would still be able to purchase coverage for less than $75 per month even if all Marketplace premium rates were to increase by double digits. Meanwhile, for the 50 percent of people in South Carolina with employer coverage, premiums have grown at some of the slowest rates on record since the Affordable Care Act was enacted.

"All South Carolina consumers, no matter where they get their coverage, are benefiting from ACA protections like no more exclusions for preexisting conditions, no annual limits on coverage, and no cost sharing for preventive services."

The 2017 open enrollment period for Obamacare begins November 1. The Obama administration and health officials are expected to make a strong push to get younger people to sign up for ACA plans to alleviate some of the stress on the system.