With two weeks before public health insurance exchange enrollment starts, four hospital industry executives and one of their regulators joined together for an educational webinar on what hospitals should be doing to help get patients enrolled.

Their primary message: Hospitals by now should be actively getting ready to assist patients with enrollment and educate the public and their own employees on the mechanics of the law. And it's not too late to get started, with a CMS Web page a good place to begin.

Three association executives were on the panel, all urging hospitals to get or remain active in preparing to help patients get enrolled, and all holding the title of president and CEO of their respective groups: Richard Umbdenstock, of the American Hospital Association, Chip Kahn, of the Federation of American Hospitals and Sister Carol Keehan, of the Catholic Health Association of the United States.

Umbdenstock made it clear that he would prefer that no hospitals be on the sidelines regarding becoming certified applications counselors, one form of in-person enrollment assisters. "We really want to see every hospital have this certification and capability," Umbdenstock said.

Joining them on the panel were Mandy Cohen, M.D., senior adviser to the administrator of the CMS, and Cynthia Taueg, vice president, ambulatory and community health services, at St. John Providence Health System in Michigan.

Cohen echoed her talk given at a community health center conference a few weeks ago by emphasizing that the exchanges will be operational when planned, and noting that enrollment then will continue for some time, which will provide some leeway for everyone. "On Oct. 1, we will be open for business," Cohen said. "We have six months to do this work."

Cohen also subtly hinted that states that did not expand Medicaid might face political repercussions that could inspire their leaders to change their minds. She said there wouldn't be anything the federal government could do for those people in states without a Medicaid expansion in place who don't qualify for Medicaid or subsidized coverage through a marketplace.

Cohen said they will explain to those left uncovered what happened with their state's lack of participation and what the consequences are. "We're just going to share the information that they're unfortunately not eligible," she said, adding that it is never too late for states to get on board. "There is no deadline for a state to tell us at CMS that they're going to expand."

Indeed, Pennsylvania's governor decided to throw in the towel on that fight. Other states may follow.