We are now just five weeks away from the opening of state-run exchanges under the Patient Protection and Affordable Care Act, also known as Obamacare, and while we've seen measurable improvements in educating the public regarding this transformative health care bill, there's still a lot left to be done.

According to the Congressional Budget Office, through the end of March the U.S. government had contracted out nearly $400 million in funds to get its cloud-based data center up and running by October 1. The level of complexity needed to connect multiple levels of the government with consumers in order for the state-run exchanges to work properly is difficult to describe -- but just as important is the ability to educate the public about Obamacare.

We're seeing modest improvements
Admittedly, the government believes we have the memory span of a goldfish and has been planning all along to really begin its educational push in the final three weeks leading up to the opening of the state-run exchanges. But, I have to wonder if waiting until the last minute is going to wind up being a big mistake.

In a Kaiser Health Tracking Poll at the end of March, 48% of respondents reported hearing "nothing at all" as to whether an insurance exchange was being set up in their state while another 42% of respondents were unaware that the PPACA was the law of the land. A Gallup poll conducted last week that looked at multiple factors surrounding the PPACA -- including how familiar people were with the bill as well as overall approval -- showed some modest improvement in the bill's educational aspects but also showed many of areas left to be addressed. 




Not too familiar

Not at all

No opinion

How familiar are you with the health care law?






Source: Gallup.

According to Gallup, only 30% of Americans are now considered unfamiliar with the law, which would be a big reduction from the more than 4-in-10 people polled five months ago that were in the dark. The concern that insurers like WellPoint (NYSE:ANTM), Molina Healthcare (NYSE:MOH), and Centene (NYSE:CNC) should have is that while people are slowly becoming more familiar with the law, those who would benefit the most from it are primarily among the 30% who are still largely unfamiliar with Obamacare. These three insurers should be big beneficiaries of the upcoming Medicaid expansion, but could run into trouble if educational awareness of the bill isn't there when Oct. 1 rolls around.

A worrisome generational gap
Poll question: How familiar are you with the health care law?


18 to 34

35 to 54


Very familiar




Somewhat familiar




Not too familiar/Not familiar at all




Source: Gallup.

First of all, it shouldn't be too much of a shock that older Americans are more familiar with Obamacare since they're considerably more likely to go to the doctor or a hospital than someone who's 18-to-34 years old. Yet, on the other hand, the real target for the aforementioned insurers in this expansion is the younger crowd, of which 36% still claim to be "not too familiar" or "not familiar at all" with Obamacare.

Some states have come up with innovative ways to potentially reach these younger individuals, including Oregon's plans to use musicians and advertising on branded coffee cups to reach people, and California's attempts to teach children in school about the bill who would, in turn, take that information home and explain it to their parents, family members, and friends.

But, I seriously have to wonder if the government isn't cutting this just a bit close. The vast majority of people who disapprove of Obamacare are those who place themselves among the "most familiar" with the bill that meaning those who should benefit the most -- and, according to Gallup, feel the most positive about this bill -- won't understand exactly how they're going to benefit, possibly negating the benefit of a transparent health insurance marketplace.

Unless something is done relatively soon to curb this generational education gap in the PPACA, insurers may wind up disappointed come Oct. 1, and the success of the PPACA early on will definitely be thrown under an even more powerful microscope.


Fool contributor Sean Williams has no material interest in any companies mentioned in this article. You can follow him on CAPS under the screen name TMFUltraLong, track every pick he makes under the screen name TrackUltraLong, and check him out on Twitter, where he goes by the handle @TMFUltraLong.

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