DES MOINES, Iowa (AP) — Iowa’s insurance commissioner has approved a premium increase requested by the state’s dominant health insurance provider. The Des Moines Register reports Insurance Commissioner Susan Voss said Wednesday that the 12 to 13 percent increase requested by Wellmark Blue Cross and Blue Shield was justified due to higher spending on health care services. She said in a statement that overall health care costs will continue to increase rates at levels that may be unsustainable.

The increase will affect 150,000 individual policyholders who buy insurance on their own instead of through an employer. Dozens of policyholders had criticized the proposal online and at a recent public hearing. Wellmark sells about 86 percent of the nonemployer health insurance policies in Iowa. It has been raising premiums for several years.