BISMARCK, N.D. (AP) — Sanford Health Plan will offer individual health insurance coverage on the federal marketplace in North Dakota next year, but only in certain areas.

North Dakota Insurance Commissioner Jon Godfread on Thursday announced that the Sanford Health individual plans will be available on the federal Affordable Care Act exchange for people in the counties of Burleigh, Cass, Morton, Oliver and Traill.

The insurer chose an option that enables it to still offer individual policies on the exchange to residents in the state's two largest urban areas — Fargo and Bismarck — while mitigating the impact to Sanford from the loss of federal payments, Sanford Health Plan President Kirk Zimmer said.

President Donald Trump decided to halt cost-sharing reduction payments under the Obama health care law. Those payments to insurers help low-income customers with out-of-pocket costs such as co-payments and deductibles.

Godfread estimated earlier that the decision could potentially raise health insurance costs as much as an additional 10 percent for up to 42,000 North Dakotans. He announced Oct. 17 that he would deny any additional rate increases, meaning insurers who stayed in the marketplace would have to absorb the loss of the payments.

Blue Cross Blue Shield of North Dakota decided to do just that. Medica is withdrawing its individual health plans from the federal marketplace in North Dakota next year. The status of Sanford Health Plan wasn't known until Godfread's announcement Thursday.

"We are fortunate in North Dakota to still have meaningful competition in our health insurance market, something that does not exist in a number of states across the country," he said.

However, Godfread also said "North Dakotans have been forced to face a marketplace with fewer options," and he called for health care reform "sooner rather than later."

Blue Cross Blue Shield, Sanford Health Plan and Medica all will continue to offer health insurance statewide outside of the federal exchange in 2018.

Godfread has said that 2018 health insurance rates previously approved by his department will increase anywhere from roughly 8-22 percent for the 42,000 North Dakotans enrolled in Affordable Care Act-compliant individual plans.

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