Earlier this week, CMS's top adviser on the health insurance marketplaces stood before a gathering of health care executives in Chicago and declared that the agency is "going to be ready" for Oct. 1, when the nation's largest experiment in open enrollment begins.

As my colleague Paul Barr reported, Mandy Cohen, M.D., senior adviser to CMS Administrator Marilyn Tavenner, "spoke with confidence about the launch of the health insurance marketplaces."

OK, but are consumers ready? Poll after poll suggests that most Americans are confused and ignorant about the ACA and its rollout. A new tracking poll from the Kaiser Family Foundation found that 44 percent of respondents either think "the law has been repealed (8 percent), overturned by the Supreme Court (5 percent), or unsure whether it remains the law or not (31 percent)."

Some other interesting tidbits from the KFF survey:

  • Respondents mainly trust doctors and nurses (44 percent), federal agencies (34 percent), state agencies (33 percent) and their pharmacist (30 percent) for information about the law. Near the bottom of the list — the news media, at a whopping 8 percent trust factor. However, guess where the vast majority of people — 81 percent — are getting info about the ACA. That's right, the Fourth Estate.
  • There's only been a slight uptick in people hearing information about the exchanges. In June, just 8 percent said they had heard a lot about them. As of August, it inched to 12 percent.

During a webinar yesterday, KFF Senior Fellow Karen Pollitz predicted that enrollment would lag for several months given the amount of confusion surrounding the exchanges.

It will certainly be interesting to watch all of this unfold over the next several months. For hospitals, it seems, one of the biggest worries could be a rise in bad debt. Certain plans sold through the exchanges will carry hefty deductibles, some as high as $5,000. As frequent H&HN Daily columnist Ian Morrison suggests in this interview, there's a concern that people won't be able to make those payments.

What do you think is going to happen? Let us know your thoughts and we'll share them in an upcoming blog.