A patient is monitored in an examination room inside the Clinical Decision Unit at Kaiser Permanente's Capitol Hill Medical Center in Washington, D.C.

Fewer health insurers plan to participate in Obamacare exchanges next year, according to the Centers for Medicare and Medicaid Services.

By the initial filing deadline, 141 issuers had applied to offer coverage compared to 227 at the same time last year, according to CMS. Last month, the agency published a map that showed as many as 1,200 counties could have just one insurer selling individual plans next year and that 47 could have none.

Health insurance companies started pulling out of marketplaces as they faced uncertainty over whether the Trump administration would continue to reimburse them for billions of dollars in subsidies for low-income customers.