Only 11 Percent of Uninsured Know About Obamacare's Next Open Enrollment

This year, the big challenge for officials behind the Affordable Care Act may not be making the website work but getting customers to come shop in the first place.

A new survey of people without health insurance highlights the challenge: It found that 89 percent of the people surveyed were unaware that open enrollment begins in November, or any time soon.

That's a big deal because, unlike last year, the enrollment period for marketplace plans is only three months long. Most people who want to buy policies on new state marketplaces need to pick their plan between Nov. 15 and Feb. 15, or they'll have to wait another year.

Under the Affordable Care Act, most Americans are required to obtain health insurance or pay a fine, and projections from the Congressional Budget Office estimate that millions more will enroll this year. People with incomes low enough to qualify for Medicaid - about $27,000 for a family of three - can sign up for insurance at any time. But the open enrollment period applies to everyone else who doesn't experience a major life change during the year, such as losing a job or getting divorced. Of course, in order to sign up for coverage, eligible people need to know it's available.

According to Mollyann Brodie, who conducted the survey for the Kaiser Family Foundation, a health care research group, the results mirror what surveys showed last fall, before the first open enrollment period. But given all the news coverage of the Affordable Care Act since then, and the experiences of the millions who gained coverage, she was not expecting awareness among those without insurance to stay so low.

'Having just no idea it's coming - that's pretty surprising at this point,' she said. 'You'd think there's just been so much attention and effort put out there.'

The start date wasn't the only thing that the uninsured didn't know. According to the survey, two-thirds of the uninsured said they know 'only a little' or 'nothing at all' about the health insurance marketplaces. More than half said they were not aware that they might qualify for financial assistance to help them afford their premiums - a key motivator to sign up, since several surveys have shown that many uninsured people are worried about the cost of coverage.

Last year, despite myriad technical problems, more than 8 million Americans succeeded in selecting health plans on the new website. About 7.3 million people are currently enrolled in marketplace plans, according to the latest count from the Department of Health and Human Services. It's unclear how well the site will work this time around, but H.H.S. officials have been promising a smoother consumer experience.

Experts who study the uninsured say that the first wave of enrollees was probably the most aware and motivated group of uninsured people in the country. Spreading awareness among the remaining uninsured will be a bigger challenge. Many have been without health insurance for years and have little contact with the health care system. Ms. Brodie said that many people in her survey did not speak English as a first language.

'Those who remain uninsured are likely fundamentally harder to reach than those who enrolled in the first enrollment period,' said Anne Filipic, the president of Enroll America, a group funded by foundations and the health care industry and devoted to spreading the word about the new health insurance options.

Still, Ms. Filipic said she was optimistic that her organization would be able to reach this population in time. It has spent the last year collecting lists of people who will be eligible for coverage options. Enroll America's research suggests that many people who are uninsured will want coverage once they understand how the law works, she said.

'Though they may be harder to reach, they are not necessarily harder to convince,' she said.