The increase in premiums was striking because in a poor economy, many people put off going to doctors, to avoid co-payments and higher deductibles. Despite a decrease in the use of medical services, companies have defended higher premiums — and their high profits — reasoning that their costs would rebound once the economy recovered.

Insurers also say that the use and price of medical services have continued to rise in individual and small-group plans, in part because those policies tend to have a higher proportion of people with serious illnesses. If the health care law survives legal challenges and goes into full effect in 2014, increased competition will make it tougher for companies to charge those customers more, the administration says.

Aetna and United Health/Oxford said their requested rate increases in New York largely reflected actual hospital, physician and pharmacy costs. “Our rate requests are simply keeping pace,” said Maria Gordon Shydlo, a spokeswoman for United Health Group/Oxford, which secured rate increases of 18 to 24 percent last year.

Consumer advocates contend that the latest requests exceed any documented rise in costs, with some companies enjoying three years of record profits and paying millions of dollars in dividends and executive compensation.

“We’re at a watershed moment,” said Elisabeth Benjamin, who represents Health Care for All New York, a group of 100 organizations advocating affordable care. “The Cuomo administration has to decide, will the Department of Insurance stand up for the little guy, John Q. Public, or let the insurance companies get away with this nonsense?”

Since last year, the Insurance Department has posted more than 4,000 policyholder objections online. In one typical letter, a small businessman, citing six years of annual increases of more than 15 percent, raged, “There are no words to express how utterly greedy and unconscionable another double-digit increase in health care costs are to the world of small companies and those employed by them.”

Such messages are not lost on Benjamin M. Lawsky, the state’s superintendent of financial services, who oversees the department. “We get it,” he said. “These increases are often hitting people who just can’t afford it.”