It's hard to believe that Oct. 1 is a mere 41 days away. Ever since passage of the Affordable Care Act, that date has been marked on everyone's calendar. The countdown seemed to take forever, but now it is almost here. Depending on your world view, it will either be the day the world comes to an end or a day of unparalleled euphoria.

As each day passes (for some reason, I hear Macdonald Carey in my head, "Like sands through an hourglass, these are days of our lives"), there's an ever-increasing number of emails in my inbox promoting a report or press conference or webinar on the launch of the health insurance marketplaces. Just yesterday, I dialed into a call sponsored by Families USA, "Strategies for enrolling communities of color in Obamacare." While that was going on, the Center for Rural Affairs emailed over a report that "examines rural benefits of health insurance marketplaces, cost-sharing and other incentives."

The focus of so many of these events is on helping people understand what the marketplaces are and how they can enroll. During the Families USA call, Dizzy Warren, community outreach manager for Michigan Consumers for Health Care, talked about education and outreach programs that a coalition of community organizations and social agencies put together to help people understand the ACA and the insurance marketplaces. Importantly, she said, they've partnered with local agencies that already have standing — and are trusted by people — in various communities. While the coalition has linked with Enroll America, a major national effort to increase enrollment, Warren said that it is more helpful to let local agencies make the initial contact with consumers and then direct them to a larger organization if necessary. "Enroll America isn't known in these communities," she said. "That's important, especially when you are asking people for personal information."

I wonder, though, if these efforts are too little, too late. Poll after poll finds that consumers still feel in the dark. In a recent survey by the Field Research Corp., three-quarters of California voters younger than 65 said that they've heard little or nothing about the state's exchange. Worse yet, "just 18 percent of voters who are currently uninsured say they've heard a lot or some about it. Similarly, only 18 percent of voters younger than 30 report this level of awareness, as do 16 percent of African-Americans and 20 percent of non-English speakers," according to Field researchers. These are key demographic groups that are supposed to benefit greatly from the law.

The findings mirror data from a March Kaiser Family Foundation poll, in which 77 percent of respondents said that they knew nothing or only a little about their state's plan to run an insurance exchange.

Time will tell if the late efforts to educate people about the exchan … sorry, marketplaces … are successful. Time will also tell what it all means for hospitals. In an upcoming cover story, Senior Writer Paul Barr examines the impact the marketplaces will have on hospitals and health systems. Look for it on the cover of next month's magazine.