ST. PAUL — A new state report released Friday shows signs that Minnesota’s shaky individual health insurance may be stabilizing but reveals potential trouble ahead.

The Minnesota Department of Health’s study said insurers who sell coverage directly to consumers or through the state’s health insurance exchange were not losing as much money as in previous years. After years of heavy financial losses that triggered double-digit premium increases, the report suggested “some cause for optimism” ahead.

“We see a more balanced financial picture for carriers continuing to serve the individual market in 2018, with premiums more in line with the health care needs of the enrollees, although some of the improvement may be related to plan design,” the study said.

Just 5 percent of Minnesotans get their coverage on the individual market. But that market has been drastically reshaped by the Affordable Care Act, and Minnesota insurers struggled with how to price those offerings, losing money from 2014 through 2016 and leading to an exodus of two of the state’s largest insurance companies.

The department said insurers were poised for a “turnaround” in 2017, and may post small profits. It follows large premium hikes that have put insurers on better financial footing to cover their claims and new programs from the Legislature to help control costs, like a reinsurance program that takes effect this year.

But the individual market is shrinking, and that could mean bad news for Minnesota residents. Just 166,000 residents bought coverage on the individual market as of the middle of 2017, down from 309,000 people in 2015.

“Shrinking enrollment and the possibility that it is the healthier individuals who are exiting the market is cause for concern about the longer-term stability of Minnesota’s individual health insurance market,” the report said.

Open enrollment for 2018 ends on Sunday.