When Peter Beilenson and his bare-bones staff spread the word about President Obama's health care law, a series of discouraging themes emerge.
Some people don't know what is in the legislation or that it still exists, while others don't know about government subsidies on upcoming state-based insurance markets, or "exchanges," that could defray the costs of their premiums.
"There's just a tremendous lack of information," said Mr. Beilenson, a physician and president and CEO of Evergreen Health Cooperative, a nonprofit that will offer plans on Maryland's health care exchange alongside larger, private insurers such as CareFirst.
Even in Maryland, one of the bluest of Democrat-led states, officials who embraced the Affordable Care Act from its infancy face myriad hurdles with just 36 days to go until the state exchanges begin to enroll Americans without employer-based insurance on Oct. 1.
The implementation of exchanges is a key pillar of the law, but in Maryland there is no handout that compares the plans that will be offered, certain in-person assisters might not be trained in time for the start of open enrollment and young, healthier residents need to learn more about the law so they are persuaded to enroll to offset the costs for sicker patients.
A group of health care providers and government officials aired these concerns Monday at a roundtable discussion hosted by Sen. Benjamin L. Cardin, Maryland Democrat.
"You're out there on the front lines," Mr. Cardin said during the brainstorming session. "What can we do to make your job easier?"
Maryland is among 16 states that embraced the 2010 law early on and decided to set up an exchange on its own instead of partnering with the federal government or letting Washington operate it.
Nonetheless, "it's been hard to get a clear message out," Mr. Cardin said in an interview.
Mr. Obama's reforms will overhaul an industry — health care — that is hard to understand anyway, and political opposition on Capitol Hill has muddied proponents' attempts to explain the law to the American people, he said.
"The question," he told the health care providers and officials at the gathering, "is how do you organize this grass-roots campaign?"
Mr. Cardin and his Democratic allies are at loggerheads with a "grass-roots tsunami" of opposition to the health care law, as outspoken Sen. Ted Cruz, Texas Republican, termed it recently.
Mr. Cruz and fellow conservatives want Congress to defund Mr. Obama's signature domestic achievement when it reconvenes next month and attempts to pass a continuing resolution to fund the federal government past the end of the fiscal year on Sept. 30.
Critics say this is their last chance to dismantle the health care law before government subsidies take hold among Americans who use the state-based exchanges.
But the Republican leadership argues that the risk of a government shutdown could tarnish the party's reputation as it tries to grab a larger portion of the electorate in the 2014 midterm elections and beyond.
Tea party activists plan to rally outside the office of House Speaker John A. Boehner, Ohio Republican, on Tuesday to warn him that if he doesn't use this year's spending fight to defund the health care law, it will hence be known to them as "BoehnerCare."
Despite intraparty divisions on strategy, congressional Republicans have been steadfast in their opposition to the law.
Conversely, Mr. Cardin pitched the environment around health care reform as a good news/bad news situation.
The new law is letting young people stay on their parents' health plans until age 26, consumers with pre-existing medical conditions no longer can be denied coverage and the reforms could positively change the economics of health care in years to come, he said.
Mr. Cardin and his allies have said they are determined to make the law work no matter what stands in their way.
"There is no Plan B, by the way," John Sackett, president of Shady Grove Adventist Hospital in Rockville said Monday. "I really think this is our best shot. We need to make it work."
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