(USA TODAY) -- Vermont has 45,000 uninsured residents that it's trying to attract to its new health insurance exchange. Connecticut has 344,000. Washington state is targeting 1 million people without insurance.
The three states, each with its own-sized challenge, will open call centers Tuesday to help as many of these people as they can navigate a new federally mandated way to buy insurance starting Oct. 1.
California and Maryland, which are operating their own exchanges, are among the states already operating call centers. Other states will roll them out during September.
Under the Affordable Care Act, the uninsured will have to buy insurance on so-called exchanges, which are online marketplaces that allow them to compare prices and choose policies. If they don't buy insurance, they will face an annual penalty on their taxes.
Every state must start offering insurance to those who don't have it on Jan. 1, 2014; enrollment begins Oct. 1.
States can build an exchange that's all their own, operate it in partnership with the federal government or simply let the federal government do it for them. The Department of Health and Human Services is required to set up an exchange if a state can't or won't do it, then will handle the consumer help functions, in part through its own call center at 1-800-318-2596.
Fifteen states have approval to do their own exchange, the federal government is running 27 and eight others are different versions of federal and state partnerships. Here's a look at who's running the exchanges. in each state.
The call centers have their work cut out for them explaining the confusing and still-changing details of President Obama's health care law. During September, the first question may well simply be "huh?" or at least "What's an exchange?"
Slightly more than half of 1,500 people polled by the Kaiser Family Foundation in August said they didn't know enough about the law to understand how it will impact their families. And 44% of 1,000 people polled separately by Kaiser in August said they weren't even sure the law is in effect after all of the political fighting and a Supreme Court challenge that was rejected.
Many people "know something's coming, but they don't know how it works," says Karen Pollitz, a senior fellow at the Kaiser Family Foundation.
When 70 new call center employees start in Vermont Tuesday, customer support manager Kelly Barnier says, she expects very basic queries, such as "What is Vermont Health Connect? Who can use Vermont Health Connect?" referring to the state's exchange.
To get phones ringing Tuesday, Vermont is launching what will ultimately be a $2 million TV, radio and print advertising campaign about Vermont Health Connect. Call centers will open at 1-855-899-9600 for those with questions about the new health insurance exchange. The campaign theme focuses on how the health exchange - "a new way to find a health plan" - is "For Vermonters, By Vermonters""
•Washington Health Plan Finder, that state's exchange, has 80 new customer service representatives available starting Tuesday. They were trained for nearly a month and are prepared for questions, as well as the challenge of making people realize insurance is important before they really need it, says spokesman Michael Marchand. "Script scenarios" help prepare the call center reps, but he acknowledges questions and solutions will vary widely based on factors including where people live, how old they are and the hardest situations, which he says are "multitiered family scenarios" such as grandparents in the same household.
•Connecticut has 73 new call center people starting work Tuesday at 1-855-805-HEALTH (4325). Access Health CT, the state's health exchange, has been advertising since June, and new ads will highlight the call center number soon. Call center workers have received "a ton of training," so they can explain the complexity of the law, how to qualify for certain programs and what tax subsidies are available, says chief marketing officer Jason Madrak.
There are plenty of questions remaining across the USA.
Joe Austin, 34, works for a small business near his home in Gulfport, Miss., that doesn't offer insurance. He's an Army veteran, which makes him eligible for some medical benefits, but it can take weeks to get an appointment.
"If I have a cold or stomach bug or immediate injury, then it's to the hospital I go," he said in an e-mail.
He's interested in the new law but has no idea what to do. "Where do I need to go to sign up? What are the rates?" he asks. "I haven't seen anything about Mississippi's at all."
Mississippi is one of the 27 state exchanges run by the federal government.
This story was originally published Sept. 2, 2013.
Jayne O'Donnell , USA TODAY