conspiring to kill americans in the united states. if you have any questions about any stories during this news hour go to www.aljazeera.com. "inside story" is next. >> when is a deadline not a deadline? when you punch it full of caveats, exceptions and category carveouts, but march 31st and the enrollment deadline for the affordable care act is coming monday, and right now on "inside story." >> hello, i'm ray suarez.

a lot of ink and sweat has been spilled since october praising the affordable care act, urging the young to sign up. now the initial sign up period is coming to an end, and americans are experiencing firsthand all the benefits and shortcomings of the law. one big russia to buy came at the end of 2013 when people who wanted to be covered at the earliest possible moments had to finish for their coverage. the next russia is coming now for the deadline looming for making a purchase. march 31st was the deadline for the insurance mandate. but so many faced problems buying coverage were navigating online enrollment to understanding the required changes in coverage. the white house announced another extension late tuesday. an honor system will be in place

to recognize good faith efforts by those who tried but not yet managed to complete a purchase. this news was met with scorn from the law's detractors. >> another deadline made meaningless. he has not put enough loopholes in the law already, the administration is resorting to an honor system to enforce it. what the hell is this, a joke? listen, this is part of a long-term pattern of this administration manipulating the laws for its own convenience, it's not hard to understand the questioning of commitment to the law. >> reporter: this comes four years after the signing of the law. there have been many delays and changes. for example, the requirement that employers of at least 50 people offer insurance to its

full-time employees has been delayed twice. first an one-year delay, now it doesn't kick in until 2016. >> you like your plan you'll be keep area plan. no one has taken that away from you. >> that might have been the president's hope, but the law called for existing insurance policies to meet newsstands for coverage. many found they had inadequate policies and would need new ones. the administration changed the rules and for now states can let people renew existing policies until october 2016. the roll out of the healthcar healthcare.gov website was very rocky. glitches made it difficult to sign up for insurance and caused major embarrassment and political headaches for the administration. the republicans particularly in the house dug in to stop the implementation of the law. in this midterm electionier it is still very much an issue. >> democrats passed this law with their own members. democrat president signed it

into law. the dates are the dates. and the law is the law. the president doesn't have the ability to change the law whenever he wants. >> reporter: the obama administration says more than 5 million people have signed up for healthcare coverage as of march 1st. the stated goal was 7. million americans enrolled by the end of march. that's been tempered to projections closer to six million. 60% of the uninsured hold by the kaiser family foundation, the same survey revealed half of those who don't have healthcare coverage say they have no plans to sign up. the gap is closing. but unfavorable views of the law continue to outnumber favorable onces, and a great number of americans want to see congress keep the law in place and work to improve it than the number of those who want to see it repealed flat out or repealed and replaced. >> okay, let's get this out of

the way. what did you come to plug? >> in the weeks leading up to the enrollment deadline, the president has been involved in the marketing push. >> have you heard of the affordable care act. >> yes, that's the thing that doesn't work. why would you get the guy who created the zoon. >> healthcare.gov works great now. >> reporter: the widely we can come di show between two ferns.was part of the appeal to younger americans. the young premium payments help counter the cost of older enrollees. the deadline is still monday march 31st. you can't get the extension unless you start the enrollment process by then. the fine for not being insured is 1% of your annual income or $95 a person, which ever is higher. as is the case with this implicated law there are caveats. in this case 14 hardship

exemptions. >> what happens, and what doesn't happen tuesday, the first day after the healthcare window closes. will the new plan hit its marks when it comes to the size and make up of the risk pool? that's this edition of "inside story." we want to begin our conversation with the fronts lines look with efforts to sign up the uninsured. we're joined by elizabeth clbin who oversees four centers. thank you for being with us on the program. >> yes, thank you. >> are you seeing a big serge and demand for your services in these final days? >> yes, we are. there are 100 people waiting this morning before we opened. >> how do you handle that? are there enough people to talk people through the process? >> well, we're a volunteer-based

program. we have 128 certified application counselors, most of those are volunteers, and our volunteers have been wonderful especially in this final push coming in, coming early, staying late so we can talk to everyone. >> does this last-minute rush and then the announcement that the deadline is softer than we originally anticipated, does that make things tougher for you or easier? are you really clear on whose going to get in under the wire and whose not? >> our goal really is to help people get through the process complete the process by march 31st. but for those who can't, and the ones that can't are really those who struggle with the identity verification issues. it's good that we have this extension so that they can complete the process and get insurance even though we've been struggling with identity verification. >> but at this moment can you say that you're clear on who gets in under the wire and who

doesn't? >> no, that's what we're trying to encourage people to stay, let us process you today, get through the process so you're done by the march 31st deadline. >> texas is one of those states that has been particularly hostile to the affordable care act since it was just a proposal before congress. is it unusual, is it different than other states where the state government has been assisting people like you? >> well, i think the difference is that the outreach and education has had to come from the local level. we haven't had state outreach and education efforts. so on a local level we've had to work very hard to educate people about the benefits of the affordable care act, and encourage them to take advantage of our services and get enrolled. >> so when people come through your door do they have misconceptions, misunderstandings about how the whole system works? >> oh, there are many, many

misconceptions. people think there is, you know, sort of an obamacare insurance. people don't understand why they may not be eligible for help paying for insurance because texas did not expand medicaid. that's created a lot of confusion. there are people who we talked to in our outreach who thought obamacare did not apply in texas. there is has been a lot of confusion and barriers we've had to overcome to get people enrolled in health insurance. >> has there been an effort in texas through private sources and private funding to counter some of those misconceptions about how the law works? do you have billboards and psas and things like that? >> yes, i'm in austin, and our central health, which is a tax-payer hospital district has spent money advertising, television reports trying to get the word out in our country and

in central texas about the affordable care act, and encouraging people to take advantage of it. >> are you expecting a busy day on monday? >> i think every day between now and monday is going to be crazy. >> elizabeth colvin, thanks for joining us. >> thank you. >> elizabeth colvin from insure central texas. we're going to take a short break, and when we come back we'll talk with experts about the implementation of the law, about the looming deadline and what it means for people who have and haven't signed up. this is inside story.

>> welcome back to "inside story," i'm ray suarez. on this edition about the affordable care act with the sign up deadline just days away the obama administration just announced that anyone who begins the sign up process by monday

will get until april 15th to complete it. we've done a number of programs on the aca along the way. we've repeatedly sought insurance company representatives and their trade association to come join our conversations. we offered again today and again they've chosen not to participate. a spokeswoman for ahip, american health insurance plan told "inside story" the new deadline extension has a clear end date so health plans know who is covered as they develop and submit premiums for next year. for the whens, hows for the affordable care act we have katherine carmen, economist for the rand corporation who provided a study on the aca. and managing director for clinic transformation and delivery at the center reform at the brookings institution and in sacramento michael weinberg, senior policy for the ba advisee

bay area council. tavita pate l, for those who are not in the cue on monday, what happens? are you unable to sign up for a while? >> that's right. there is a fixed period if you're not signed up on the website or gone through the beginning of the process. that's your chance. it's not dissimilar to what happens when we go through open enrollment periods on a year to year basis for our employers' insurance. >> how is the traffic? how are you hearing the traffic around the country? we heard from texas. >> right. >> how are things going in other places? >> i checked in with some of the and a half graters in contact within states that have not been very friendly to the aca as well as states who have been proactive, established their own exchanges and traffic is very

high, and there is a lot of not only people waiting before offices open, but the navigators and the people who are helping the people go through the process are overwhelmed with questions. >> michael weinberg, you can understand why the window has to close at some point or else there is a portion of the population that will just leave it go forever. but is there a problem when you design a policy in changing the rules midway? is there a risk on that side as well? >> there is absolutely. i would say that this deadline extension, which isn't really a deadline extension. it's just extra time for people to complete policies, it's not one of the things that is a big deal. one of the things that is a very big deal that the president has done that makes me very nervous is allowing folks to renew their non-aca compliant policies for additional years. that has a much bigger ripple affeceffect. >> how so? >> if you allow the healthy

people, these are the folks most motivated to keep their old health insurance product out of the new risk pools it raises the health insurance rates for people who are in the exchanges and risks making the exchanges unaffordable. >> does that sound to you like a bit of policy improve given the problems with the rejection letters that were coming from insurance companies? >> policy improve is a polite way of putting it, i like that. >> well, i had to come up with a nice way to say it. katherine carmen, tell us what people know and don't know. as you found when you were gathering data for your study, are a lot of americans clear on what the aca is, and how it works? >> so i think a lot of americans are lacking information about two things. first, they're lacking information about the aca and how it works. that means that they don't know things about the penalties or the mandates to have insurance.

but also they're unaware of important aspects of what insurance is in general. for example, about 40% of americans can't really describe what a deductible is. if you can't describe what a deductible is, then it's very hard to choose an insurance policy that's differentiated based on something like a deductible. >> so this goes back to not just understanding the affordable care act, but having very little familiarity with how your own insurance policy works. >> yes, and this lack of information is high not only among people who have insurance, but actually higher among those who did not have insurance in the past. >> and that must have made it only more difficult to make a choice. >> exactly. exactly. only more difficult to make a choice. >> so kavit a patela, should more energy, more money and more time in preparation have been spent in public education rather than in defending the attempt to

put the bill in place in the first place? >> absolutely. i mean, there is a couple of lessons. one, you need to actually dedicate time, attention and resources, and if you look at the affordable care act there were no extra--there was really no room for extra money to say, okay, let's educate the public. the other thing, ray, to remember in 2010 when the president signed the law there was not any clear certainty of how many states would establish their own exchanges and do what california is doing on their own. and then how many would default to this kind of federally facilitated exchange. i don't know if even president obama even realized that over half of the country would really depend on the federal government to do the education, the roll out, so absolutely more money, more resources, but then also being creative of how to get the message out, especially to communities of color, and to the young invincibles, the 27 to

35-year-olds. we really needed to do the targeted messaging around healthcare reform that barack obama did in his campaign to win presidency. >> michael weinberg, is there a back stop now that we're hitting march 31st, people are in are in. people who are out are out. does the country get a chance to catch its breath and sort of get a running start into the next phase of this thing? >> interestingly enough not really. so we're focusing on the open enrollment period. but actually the entire year there is a special enrollment period. you get a special enrollment event if a ton of different things happen, if you lose your job, if you get divorced, get married, there are a lot of different things that trigger a special enrollment event. what a lot of people don't understand is that a lot of people who are uninsured are uninsured for a very short period of time, perhaps because they lose a job or switch to other jobs. and so quite a bit of the enrollment through the exchanges

is actually going to happen outside of the open enrollment period. >> we're going to take a short break. when we come back we'll continue our conversation on the implementation of the affordable care act as the window is beginning to close. it's monday at midnight. stay with us. this is inside story.

>> welcome back to inside story. i'm ray suarez. on this edition of the story we're giving the affordable care act a checkup. the deadline to sign up is march 31st, just days away. there have been twists and turns all along and there is a new one right at the finish line. if you begin the sign up process by the 31st you get another two weeks to complete your application. stay with us from san monica, california, katherine carmen, here with me in washington, d.c. dr. kavita p atel of the

brookings institution a and michael weinberg from the san francisco bay customers. in those states where there has been open hostilities towards the affordable care act versus those states who have worked to get enrolled. >> the data collected prior to the opening of the marketplace, i can't say what happened since that time, but prior to that time most of the differences we saw had to do with individual characteristics like their income, their education levels and gender. >> is it fair to say that people who are hardest to reach with healthcare messages with public service announcements, with the kind of messaging that tries to

urge people the risk. >> the people who lest informed by the policy are similar to the group of people who is least informed about health insurance in general and they have the least amount of information about a wide variety of other topics, yes, they're the hardest to reach with better information. >> and probably also a group that is likely to suffer from high rates of uninsurance and under insurance, and have the least leeway when it comes to getting healthcare at the same time, right? >> yes, in our to choose insurance on the marketplace. >> kavita, isn't that pro pile the challenge from the very beginning. the people you most needed to sign up, the people you needed

to find and educate are the hardest to reach period. >> that's been the experience even with children's health insurance program where there are still stumbling blocks to getting low income children involved. i would say the administration early on knew that was a challenge. those of us still in practice in treating patients we see this still on a day-to-day basis. >> michael weinberg, it's not too much of a stretch to figure that those are some of the people in this country who are least likely to vote. least likely to organize in any way that allows them to exert political pressures in states with very high rates of uninsurance you also had state governments that were not cooperating and probably aren't going to pay a political price. >> i think over time there will be a political price to pay particularly for those states that haven't expanded the

medicaid program. this is something that the business community generally, the actual business community, not the ideological business community, has been pretty frustrated about. one, the hospitals need that money, two, the employers are paying more as a result of the under payment of public program. i think there could be a large political price to. >> i isn't that far down the road? the real effects some of the real effects that are projected for the affordable care act don't really kick in until you've got much higher levels of much lower levels of insurance. >> we've seen new enrollment in medicaid. this is one of the under reported stories. there has been private enrollment. there is a larger number

enrolled in the statement medicaid program, these are people who were not getting compensation at all for the care they're receiving at these facilities. it's a critical issue for the healthcare system and privately held businesses carrying the weight for that. >> katherine carmen i don't want to put you in a position to answer a question that you can't answer, but is this something, are these people who are least likely to be well-informed given time are they more likely to be brought in to a greater level of understanding? is this something that with time for the life of the program you might see greater penetration? >> i think that there are things that we can do to try to improve their understanding of the program. and programs like the navigators and like your guest earlier from insure central texas, i think those kinds of things could really help people. we could try to find ways to make the choices easier for them

so that it would help be more the level that they're prepared for. >> kavita patel what happens after tuesday, and how will we know whether you got the right people in the risk pool, if the numbers are going to work for the insurers. >> yes, we'll definitely, we're all waiting to see the final numbers. remember, we have to make sure that the people who enrolled then pay for the first month's bill. there is this whole debate as what counts as real enroll yeses and what doesn't. that will take time. the real test will be how many of those plans that are argued in the marketplace this year continue to offer plans for the marketplace for the following year because that will give a sense geographically did you do well in the risk pool? did your company feel like this was worth offering the insurance product? and something that i think is very fascinate something that we're going to learn a lot about

people who did not enroll from some of the survey work that is going on like at the rand corporation. i think even more importantly asking people who did enroll why did you do it, and what were the reasons you got to that point. so the months between april, may, and june are going to be these huge crunch times for interesting data as well as how do we turn this around quickly to do something differently when enrollment begins in november. >> thank you all. good to have you on the program. that brings us to the end of this edition of "inside story." thanks for being with us. the program may be over but the conversation continues. we want to hear what you think about the issues of this or any day's show. you can log on to our facebook page or send yours thoughts on twitter. you can reach me directly @ray suarez news. see you for the next "inside story" in washington i'm ray suarez.

>> hello and welcome. i'm phil torres here to talk about innovations that can change lives. we're going to see the intersection of hardware and humanity and doing it in a unique way. a show about science by scientists. let's check out our hard core in other words. coaskosta grammatis. one of day the 3d printer will help save a little boy's nights .