One of the last health insurance companies selling plans through the Obamacare exchanges said Wednesday that it likely would stop selling plans there next year, which would leave 70,000 people without coverage options.

The company, Medica, hinted in a statement that its decision was rooted in uncertainty over whether the federal government would continue to provide Obamacare payments that help insurers reduce out-of-pocket medical costs for consumers, called cost-sharing reduction subsidies.

"Without swift action by the state or Congress to provide stability to Iowa's individual insurance market, Medica will not be able to serve the citizens of Iowa in the manner and breadth that we do today," the company said. "We are examining the potential of limited offerings, but our ability to stay in the Iowa insurance market in any capacity is in question at this point."

The announcement came as a major blow to the state, which already saw withdrawal plans announcements for next year from Aetna and Wellmark Blue Cross Blue Shield. The companies have cited uncertainty as well as massive losses because not enough young, healthy people are purchasing plans to balance out the risk pool. With the withdrawal of those companies, 94 counties, including Des Moines, would be left with one insurer, most of which have plans through Medica.

If Medica pulls out, Gundersen Health Plan would be the only company remaining for now. It is offered in five counties, but if it leaves, no policies would sell insurance in the exchange in Iowa. Shrinking options on the exchanges can result in higher premiums and fewer options, ultimately reducing access to healthcare providers that customers might prefer.

A Gunderson representative told the Des Moines Register that it hasn't decided if it will continue offering plans next year.