Tomorrow one of the biggest changes in U.S. healthcare in decades is scheduled to take effect. Millions of Americans who have never had access to health insurance will be able to shop health insurance marketplaces in advance of the coming insurance mandate that is part of the Affordable Care Act (colloquially known as “Obamacare“). However, it seems that most Americans aren’t even aware of the new health insurance marketplaces.

A new survey from healthcare advocacy organization The Commwealth Fund has found that only around 40% of Americans know about the new healthcare marketplaces or the fact that financial assistance for insurance premiums is available to for low and moderate income Americans. Those currently without health coverage were particularly ignorant of the coming programs, with only 32% of Americans who did not have health insurance during the past year aware of the health insurance marketplaces. This is despite the fact that a full 76% of those same Americans surveyed were aware of the Affordable Care Act’s individual health insurance mandate.

Once told about the marketplaces, the survey found that 61% of potentially eligible Americans were likely to use them shop for insurance. Older Americans are more likely to use the markets, and adults with health problems are more likely to use them than healthy adults.

“These survey findings demonstrate that people who need the health insurance coverage the marketplaces will offer want to shop for plans and find out if they are eligible for financial help,” said Sara Collins, lead author of a report on the survey and vice president of the Commonwealth Fund. “However, more work needs to be done to ensure that people who may be eligible are aware of the marketplaces and the subsidies. State and federal efforts to educate people about the marketplaces during the six-month enrollment period beginning in October need to be intensive enough to help close the information gaps this survey highlights.”

Along with the marketplaces, many U.S. states are expanding Medicaid coverage for more Americans. The survey found that Americans are strongly in favor of expanded Medicaid, with 68% of Americans in favor of expanding Medicaid in their state. However a full 85% of American surveyed did not know whether their state would be expanding Medicaid.

“The strong support for expanding Medicaid is consistent with past studies showing that Americans generally like the individual components of the Affordable Care Act when they understand them,” said Dr. David Blumenthal, president of the Commonwealth Fund. “This study also shows that there is a great deal of work to be done to ensure that Americans have a clear, accurate view of the law and what it offers the American people.”

(Image courtesy the U.S. Centers for Medicare & Medicaid Services)