Iowa’s lone ObamaCare insurer has requested a 57 percent rate increase for 2018, citing uncertainty over how the Trump administration will handle the healthcare law. 

In a revised rate request, Medica on Wednesday asked for an increase 13 percentage points higher than its original request filed in June. 

Medica and other insurers have worried about whether the Trump administration will continue funding key ObamaCare payments known as cost-sharing reductions. 

{mosads}These subsidies reimburse insurers for giving discounted deductibles and copays to low-income patients. The Trump administration has been making the payments on a month-to-month basis and could cancel them at any time. Insurers, who have asked for long-term certainty, have threatened to raise premiums or leave the ObamaCare market altogether if the payments don’t continue. 

“We remain hopeful the federal government will fund the cost-sharing reductions, but we are working with the Iowa Insurance Division to help consumers understand the implications of lack of this funding,” Geoff Bartsh, Medica vice president of individual and family business, said in a statement. “We regret the disruption this creates for consumers.”

An analysis released by the nonpartisan Congressional Budget Office this week said insurance companies would raise premium prices about 20 percent for ObamaCare’s mid-level silver plans if the payments are ended. 

Premiums for silver plans would be 25 percent higher by 2020, according to the CBO. The analysis also found that halting payments would increase the federal deficit by $194 billion through 2026.

While ending the payments would increase premiums, many people would be cushioned from the impact because federal tax credits rise automatically when premiums do.