The Affordable Care Act (ACA), aka Obamacare, was developed to help the approximately 50 million uninsured Americans get health coverage. But it turns out many of those who were supposed to benefit the most from the law still don’t understand it or like it—even after months of campaigning by the president and administration officials, according to a new survey.

The study, published in the Proceedings of the National Academy of Sciences (PNAS), which involved more than 3,400 individuals, produced many other discouraging facts for the embattled health reform measure.

• About a third of respondents were unaware that they had to get health insurance this month or be penalized.

• Nearly half were clueless about the health exchanges set up for people to purchase insurance through Healthcare.gov.

• More than half didn’t know about the subsidies available to help low-income individuals afford coverage.

Meanwhile, those who don’t stand to benefit much from Obamacare, the insured and the well-off, had a better understanding of the law than those who would benefit most from the ACA.

One of the administration’s big missteps was to take for granted how much uninsured Americans understood about health insurance. Those surveyed by PNAS who would qualify for ACA subsidies were on average able to answer correctly only four of 11 questions about the law.

Olga Khazan at The Atlantic noted that another survey, conducted by the Kaiser Family Foundation, revealed that “a third of Americans have only basic or below-basic health literacy.”

“Clearly some of those most likely to be affected by the ACA were ill-prepared to navigate the new health insurance environment,” the PNAS researchers wrote.

-Noel Brinkerhoff

To Learn More:

Uninsured People Don't Like or Understand Obamacare (by Olga Khazan, The Atlantic)

Most Americans Don’t Understand Affordable Care Act (by Noel Brinkerhoff, AllGov)