Many people who buy their own health insurance could get surprises in the mail this fall: cancellation notices because their current policies aren't up to the basic standards of President Barack Obama's health care law.

They, and some small businesses, will have to find replacement plans — and that has some state insurance officials worried about consumer confusion.

Rollout of the Affordable Care Act is going full speed ahead, despite repeal efforts by congressional Republicans. New insurance markets called exchanges are to open in every state this fall. Middle-class consumers who don't get coverage on the job will be able to pick private health plans, while low-income people will be steered to an expanded version of Medicaid in states that accept it.