The announcement means Nevada now joins Wisconsin, Indiana, and Ohio as states where Anthem has withdrawn from the health care exchanges formed under former President Barack Obama’s signature health care law, as Republicans and Democrats in Congress remain at loggerheads over whether and how to tweak the law — and President Donald Trump vows to let it collapse.

In its announcement, Anthem said it had spoken with state leaders and regulators, but the deteriorating market, paired with uncertainty at the federal level, led the company to make a “difficult” decision. The Senate recently failed to make good on the GOP’s years-long campaign promise to repeal the law known as Obamacare, and insurers say Trump has added to instability in the markets with threats to stop paying so-called cost-sharing reduction subsidies.

In a statement, Anthem, one of the largest insurance providers in the country, said only one off-exchange catastrophic medical plan will be made available in Nevada. According to the Nevada Division of Insurance, catastrophic plans are restricted to low-income residents and residents under 30.

Nevada Insurance Commissioner Barbara Richardson said in a statement that she is “disappointed” in Anthem’s decision, but is optimistic that there will be coverage available for consumers on the exchange throughout Nevada. Even before Anthem’s announcement, there were 14 counties in the state at risk of having no insurance coverage available on the exchanges for 2018 enrollment.

“The Division is continuing to work with our state partners on attracting an insurance carrier to serve the 14 bare counties and to support the stability of the market for those insurance carriers who remain,” Richardson said. “We are also working with our state partners on a plan to help consumers shop the Exchange market at open enrollment for the 2018 Plan Year and remain optimistic that there will be coverage for consumers on the Exchange throughout the state.”

A Nevada HealthLink spokesperson told Fortune that the approximately 22,000 Anthem consumers in the state will have coverage for the rest of the year, but will be transitioned to similarly priced plans when their current coverage expires.

“Our commitment to members has always been to provide greater access to affordable, quality healthcare, and we will continue to advocate solutions that will stabilize the market and allow us to return to a more robust presence in the future,” Anthem’s statement said.