Regulators in Georgia and Indiana say the Patient Protection and Affordable Care Act will lead to big increases in individual health insurance rates in their markets.
The U.S. Department of Health and Human Services will be running "federally facilitated exchanges" in both states, in both the individual and Small Business Health Options Program markets.
Ralph Hudgens, the Georgia commissioner, said filings show that only five carriers will be selling coverage through the Georgia exchange.
Aetna Inc. and a newly acquired Aetna unit, Coventry, are two of the companies that have decided not to participate, Hudgens said.
The Georgia department has not released detailed rates for the state's exchange plans, but he said rates for some consumers could double or triple.
Today, carriers in Georgia can refuse to sell coverage to adults with health problems, and they can charge much higher prices for sick or older enrollees.
Because of the PPACA changes, rates for some 25-year-olds could rise as much as 198 percent, and rates could rise 40 percent to 100 percent even for insureds ages 45 to 60, department officials said.
Hudgens said in a statement that he asked HHS Secretary Kathleen Sebelius to let him wait at least 30 days to approve the rates but got no response before the July 31 rate filing deadline.
"Although not surprised, I am disappointed in the unresponsiveness of the Obama administration," Hudgens said.
Indiana expects to have four carriers selling coverage through the state's individual exchange and two selling coverage through the SHOP small-group exchange.
Like Georgia, Indiana now lets carriers use medical underwriting when selling and pricing health coverage.
Logan Harrison, the Indiana chief deputy commissioner, said individual rates in that state will increase an average of 72 percent in 2014, and that small-group rates will rise about 8 percent.
PPACA "requires many Hoosiers to purchase more comprehensive and more expensive health insurance than they may want or need," Harrison said in a statement.