New poll results show the depth of the Obama administration's challenge on the eve of the rollout of the federal health law's core provisions, as many Americans say they don't understand the law and don't think it will help them.
A Wall Street Journal/NBC News poll found that even those lacking health insurance, who are supposed to be the law's biggest beneficiaries, generally believe it wouldn't do them much good.
Overall, nearly 70% of poll respondents said they didn't understand the health-care overhaul passed by Democrats in March 2010 or only understood a part of it. Only 31% said they thought the overhaul was a good idea, with 44% saying it was a bad idea and 25% saying they didn't have an opinion or weren't sure.
An advocate of the new health-care law explains benefits in Hialeah, Fla.
Uncertainty over the law has created a window for political groups on both sides to try to shape opinion in advance of midterm elections next year. Conservative organizations such as Americans for Prosperity have begun television advertisements criticizing the law, while Organizing for Action, the spinoff of President Barack Obama's re-election effort, is running ads in its favor.
"I think that the coming six months or so is going to say a lot about whether this law comes forward or collapses under its own weight. The administration has a pretty heavy lift," said Levi Russell, a spokesman for Americans for Prosperity. "I think clearly people are skeptical, and rightly so, and that's a good thing," he said.
"There have been very relentless efforts under way by opponents of the health law designed to undermine successful education efforts," said Tara McGuinness, a senior White House official.
"From staff in community health centers, to public service announcements and outreach efforts, the six months from October to March will be key to raising awareness about the new market places and the benefits of the law for Americans," Ms. McGuinness said.
New health-insurance exchanges where people can shop for individual insurance plans and apply for subsidies toward the cost of premiums will open for enrollment on Oct. 1. Plans sold through the exchanges will take effect Jan. 1, the same date on which most Americans will have to have coverage or pay a penalty.
Those exchanges are aimed at the portion of the population—about 46 million Americans—who don't currently have access to coverage through an employer or government program such as Medicare or Medicaid.
But the financing of the exchanges may not work well if they fail to sign up enough people, in particular healthy young people, who generally don't need a lot of health-care services. That is why spreading the word about the law is critical to its success.
Among the uninsured, 76% of respondents said they didn't understand the law and how it would affect them. Only 32% of the uninsured thought they were "fairly" or "very" likely to use the exchanges. That proportion was even lower among people who are currently getting insurance on the individual market. Of those, 23% believed they would use the exchanges.
People who don't already have access to insurance through an employer or government program were as skeptical of the law as the people less directly affected by it.
Some 34% of respondents who don't currently have insurance said they thought the law would have a negative effect on their family, and 52% said it wouldn't change things for them. Among people already buying coverage in the individual health insurance market, 34% thought they would be worse off as a result of the law and 43% said they didn't think there would be much of an impact either way.
Overall, 53% of those polled said they didn't believe the law would affect them or their family, alongside 30% who said it would have negative effects and 12% who thought it would be positive.
The Obama administration has limited funding to promote the law, especially in parts of the country where there is the most hostility to it, and are relying on a coalition of supporters, celebrities and private companies such as pharmacies and insurers to encourage participation.
The survey of 1,000 adults was carried out Sept. 5-8 and has a margin of error of plus or minus 3.1 percentage points.
The law has a more limited impact on benefits already offered voluntarily by companies to their workers. But some big employers have announced changes to their plans, including United Parcel Service Inc., which told workers last month it would no longer cover workers' spouses who had an offer of coverage from another company, in part because of higher costs UPS said it expected to incur as a result of the health-care law.
Many companies have also tweaked their policies to accommodate some new requirements in the law, such as allowing parents to keep children on their plans until their 26th birthdays, and covering preventive services including contraception without out-of-pocket costs.
Write to Louise Radnofsky at louise.radnofsky@wsj.com
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