Millions of low-income residents who might qualify for new insurance coverage options in 2014 under the Affordable Care Act (ACA) are unaware of the upcoming benefits. In a focus group conducted by Enroll America, a not-for-profit organization, none of the 31 participants were aware of subsidies for individuals with incomes below 400 percent of the federal poverty level or Medicaid for the lowest-income U.S. residents. However, most of the participants were aware of the requirement to purchase coverage under the ACA.

A survey by the Democratic polling firm Lake Research Partners found that 78 percent of uninsured residents that are likely to qualify for insurance subsidies are unfamiliar with the new coverage options. 83 percent of people surveyed who are likely to qualify for Medicaid in 2014 were unaware of the option. According to estimates from the Congressional Budget Office, six million individuals who are expected to be eligible for Medicaid after the program expands in 2014 will not enroll.

Experts say that one reason individuals do not realize they might be eligible for insurance subsidies is that the subsidies are not available for another year. However, residents must start signing up for state health insurance exchanges on Oct. 1, 2013. Low enrollment could lead to higher insurance premiums, while hospitals fear that low enrollment could force them to continue paying for a large share of patients’ unpaid medical costs.