Premier Health Plan, a health insurer serving Ohio, has announced it is exiting the Obamacare exchanges by the end of this year.

"Amid significant uncertainty surrounding the future direction of U.S. health care policy, Premier Health Plan will join several other health insurers in exiting the federal health insurance exchange in Ohio by discontinuing its Premier HealthOne On-Exchange plan at the end of 2017," the company said.

According to the Kaiser Family Foundation, Ohio had 10 insurers operating at the beginning of 2017. Premier Health Plan is the second health insurer to exit, after Anthem announced earlier this month they were leaving the exchanges.

"The uncertainty in Washington, D.C., around the future of the Affordable Care Act—through which the federal exchange was created—and the associated volatility in the marketplace have led us to conclude that we cannot effectively plan and price affordable health insurance to sell on the exchange," Renee George, president of Premier Health Plan, said in a statement.

"As a Dayton-based, physician-led health plan that believes strongly in value-based care, we're disappointed that we must discontinue our participation in the exchange in 2018," George said. "However, we will continue to offer a range of other insurance plans, including to individuals off of the exchange."

The recent health insurer exits in Ohio could leave some counties with no options at all on the exchanges.

Recent data from the Centers for Medicare and Medicaid Services show there will be 49 counties with no insurer operating next year. Many of those counties will be in Ohio.

Even if an individual lives in an area where there is no insurer offering health coverage, individuals will still be forced to purchase coverage because of Obamacare's individual mandate.

"We continue to see a decline in issuer participation in the Health Insurance Exchanges leaving consumers with fewer and fewer insurance options," said CMS Administrator Seema Verma. "I am deeply concerned about the crisis situation facing the individual market in many states across the nation."