Racing to Inform Millions Unaware of New Health Coverage EAST LANSING, Mich. - President Obama and the Democrats passed the 2010 health care law to make medical insurance available to more than 30 million people who do not have it. But with recent studies showing that as many as three-fourths of those people are unaware of their new options, health care providers are joining community organizers and insurance companies in an ambitious effort to spread the word in the six months remaining before the health plans become available. Here in Michigan, a small army of doctors and nurses, hospital employees, insurance agents and advocates for low-income people is mobilizing for the next phase of this revolution in domestic social policy: finding people who are eligible for health insurance and getting them enrolled. It will not be an easy task. The simmering political debate over Mr. Obama's health care law - which includes an expansion of Medicaid, the government program for low-income people, and the creation of "exchanges" to market subsidized private insurance - makes the work of these foot soldiers more difficult, but also more important. Michigan is, in many ways, a microcosm of what is going on around the country as people race toward the start of "open enrollment" on Oct. 1. "Confusion, total confusion," said Jan M. Hudson, a consumer advocate, describing state efforts to help more than a million Michigan residents get insurance under the law. Ms. Hudson, a founder of Michigan Consumers for Healthcare, a coalition of consumer groups, led a recent conference of more than 200 experts and advocates who banded together here on the campus of Michigan State University to try to identify and enroll everyone in the state who might be eligible for coverage. Amy L. Allen, the director of health care reform at the Michigan Department of Community Health, said that delays and resistance by the State Legislature meant that more of the work must be done by community groups and the private sector. The Republican-controlled Legislature declined to set up a state insurance exchange, and Gov. Rick Snyder, a Republican, has met opposition within his own party to his proposal to expand Medicaid. Nevertheless, in Michigan, as in many states, advocates for poor people, blacks, Hispanics and people with disabilities are joining health care providers and insurers in a campaign to find the uninsured wherever they live, work, play or pray. "Getting all these people enrolled will not necessarily be an easy task, but it's a great opportunity," said Anita M. Fete, who was one of the speakers at the conference and is the director of state assistance at Enroll America, a national nonprofit group set up to maximize enrollment. The Census Bureau estimates that 1.2 million people in Michigan are uninsured. Most will qualify for subsidized private insurance, or for Medicaid if the state chooses to expand the program. Nationally, the Congressional Budget Office predicts that 14 million uninsured people will get coverage next year. But that goal is ambitious. Studies for Enroll America and the Kaiser Family Foundation indicate that three-fourths of uninsured adults are unaware that they will have new insurance options. Among the people expected to sign up for coverage in the new online markets known as insurance exchanges, one in four speak a language other than English at home, and three out of four have a high school diploma or less. Citing those statistics, Christine P. Barber, a senior policy analyst at Community Catalyst, a consumer organization, said: "There is no time for turf battles. We need to come together to make this work. In California, the health insurance exchange faces an even more daunting task. It is trying to reach five million people who speak 13 different languages and are spread across 163,000 square miles. Nearly half of those in the state who are eligible for insurance subsidies are Hispanic. The fact that so many people are unaware of their new options has the potential to undermine the entire purpose of the health care law. Congress provided hundreds of billions of dollars for expanded coverage, but it did not fully account for the difficulty or expense of getting people to sign up. Also, Democrats did not anticipate the effects of continued Republican hostility to the law. "Opponents" attacks seem to have taken a toll on the public's expectations, and Americans are now more likely to think the law will make things worse rather than better for their own families," the Kaiser Family Foundation said last month in a summary of its latest poll. "Americans" awareness of key elements of the law has declined somewhat since passage, when media attention was at its height."