Anthem announced Tuesday that it will leave the Obamacare exchange in Ohio next year and reduce its overall participation in the individual marketplace. The move would leave participants in 20 counties without any insurer.

The company cited uncertainty over the future of the law, referring to whether the Trump administration would continue making cost-sharing reduction payments, which allow insurers to offer lower out-of-pocket costs to customers. The company also cited an “increasing lack of overall predictability” as contributing to its decision, likely referring to whether Republicans would succeed in repealing Obamacare and whether it could count on the federal government to enforce the individual mandate that obligates Americans to purchase insurance or pay a fine.