In this March 23, 2010 file photo, President Barack Obama signs the health care bill in the East Room of the White House in Washington.

J. Scott Applewhite, Associated Press

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WASHINGTON 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.

The goal is to cover most of the nation's nearly 50 million uninsured, but even Obama says there will be bumps in the road. And discontinued insurance plans could be another bump.

Also, it doesn't seem to square with one of the president's best known promises about his health care overhaul: "If you like your health care plan, you'll be able to keep your health care plan."

But supporters of the overhaul are betting that consumers won't object once they realize the coverage they will get under the new law is superior to current bare-bones insurance. For example, insurers will no longer be able to turn people down because of medical problems.

Other bumps on the road to the new health care law include potentially unaffordable premiums for smokers unless states act to waive them, a new $63-per-head fee that will hit companies already providing coverage to employees and dependents, and a long-term care insurance program that had to be canceled because of the risk it could go belly up.

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Like your health care policy? You may be losing it