So says the Kaiser Family Foundation in a poll conducted in mid-September, a few weeks before the Affordable Care Act's new marketplaces open for enrollment.
Twelve percent of the uninsured knew that the marketplaces would open on Oct. 1, just three days from now. An additional 14 percent guessed that it would start sometime in 2013 or 2014. The majority, though -- and this held true for the general population as well -- just didn't know when the programs kick in, or declined to guess.
There are two ways to think about these poll numbers. One is that they're a disaster: The White House has had more than three years now to talk about the Affordable Care Act, hype its benefits and get the word out about a sweeping new legislative accomplishment. If people are this uninformed right now, how are they ever going to hit projections of 7 million people enrolling in the first year?
That's the pessimistic take. But there's also a more optimistic case I hear when I talk to people running these marketplaces -- who, it's fair to say, have a vested stake in staying optimistic about these things. They contend that knowing that the exchanges launch on Oct. 1 is essentially meaningless for the people they're trying to reach. Those people could sign up on Oct. 1 or Dec. 1 and still access exactly same benefits under the health-care law, since coverage purchased on the marketplaces doesn't start until January.
Many of the marketplace directors I talk to -- alongside the White House -- say they're holding their advertising fire until after next Tuesday. At that point, they will have an actual product to sell consumers. Right now though, they can talk a whole lot about the law, but can't give people the tools they need to buy coverage.
We don't know which one of these takes will prove right, whether the low awareness portends badly for the Affordable Care Act or whether it will start to dissipate in coming weeks and months. For now, it's probably too early to draw any conclusions about what either means for the health law's success.