DES MOINES, Iowa (AP) — Iowa’s last health care insurer to sell policies to individuals statewide through the federal Affordable Care Act is seeking a 43.5 percent increase in premium rates for next year.

Minnesota-based Medica says the increase is necessary to remain in Iowa.

Company Vice President Geoff Bartsh said Monday that a number of risks remain with its decision to be the lone statewide provider. Medica will re-evaluate the decision in September before contracts to provide coverage in Iowa are signed.

The company insures about 12,500 Iowans through the Affordable Care Act exchange, which offers subsidies for those meeting income guidelines and about 1,400 who buy their own insurance off the exchange.

Iowa is seeking a waiver that would allow it to repurpose federal subsidies to attract younger, healthier individuals into the market.