The Obama administration and its allies are set to start their education efforts for the Affordable Care Act and it is clear that they have a lot of work to do. Among the people who will be most affected by the law, the currently uninsured, 43 percent aren’t aware of the individual mandate. From Gallup:

8gswwsiq7uknhqscaakzfq.png

If health care reform used an automatic enrollment system, like most single payer systems do, this wouldn’t really be a problem. People would be signed up even if they didn’t know the details of the program. Instead, Democrats went with a Rube Goldberg system that not only requires individuals to actively figure out if they qualify but then actively choose a plan.

What should be most worrying for the administration is who makes up this 43 percent. To keep premiums on the new exchanges from spiking, they need the very healthy individual to sign up, but people without health concerns are probably the ones who’ve paid the least attention to news about the law.

If signup doesn’t go well in the first year it could seriously hurt the law for years to come. The more the exchanges end up as a dumping ground only for the sick in year one, the less appealing it will be for other people going forward.