Consumers could see higher premiums since the state’s three largest health insurance companies will continue to dominate the health insurance market in the California. Blue Cross, Blue Shield, and Kaiser are in the health exchange. United Healthcare, Aetna, and CIGNA say they will not participate in the exchange, and the law prevents them from reconsidering joining for the next two years. “When smaller companies step aside, the Big Three insurers gain even more power over prices in the health insurance market,” said Jamie Court, president of Consumer Watchdog. In some states with rate regulation in place, health insurance companies have proposed higher rates than necessary and lowered them when confronted by regulators and competitors with lower prices, he noted.