The end of preexisting conditions in health insurance is among the most popular provisions of the Affordable Care Act; on its own, 71 percent of voters support it. That makes for a pretty compelling Democratic talking point: the Affordable Care Act will stop insurance companies from denying you coverage.

Turns out, that message has not resonated — especially among those who have a preexisting condition. Fewer than half of those who have a preexisting condition, or live with someone who has, think the law will help them, according to a Kaiser Family Foundation poll out this morning. Twenty-seven percent say they’ll be left worse off by the law. Weirdly, the forecasts for health reform are more negative among households with a preexisting condition than those without:

These results look pretty similar to last month’s poll, which found that only a third of the uninsured thought the Affordable Care Act would help them.

The explanation for the two poll results is probably pretty similar: The major parts of the health-reform law — the end to preexisting conditions and health insurance subsidies — don’t start until 2014. Health reform did have a few popular insurance reforms come online early, like the extension of dependent coverage up to age 26 and the end to preexisting conditions for kids. Those, collectively known as the Patients Bill of Rights, actually hit their one-year anniversary today. But even though those reforms are very popular, they haven’t had a wide reach. The health-reform law has yet to impact the vast majority of Americans.