With the Affordable Care Act’s next milestone a little more than a week away — the health insurance exchanges are scheduled to open Oct. 1 — many Americans still are unclear of the law’s effects.

“They don’t have a clue,” said Tommy Eden, a partner working out of the Constangy, Brooks & Smith, LLP offices in Opelika and a board member for the East Alabama chapter of the Society for Human Resource Management.

According to a recent NBC News/Wall Street Journal poll, 34 percent of Americans said they don’t understand the Affordable Care Act very well, and 35 percent said they understood it only “some.” That’s compared to 30 percent who said they understood the law “very well” or “pretty well.”

“It’s very complex,” said Terry Andrus, president of East Alabama Medical Center. “I think that’s why there is a lot of skepticism and concern … because it’s a little confusing.”

On Oct. 1, health care exchanges are set to open. The exchanges will serve as marketplaces where uninsured individuals and small businesses with fewer than 50 employees can comparison shop for insurance plans. Alabama, like most sates, has opted to participate in the federal exchange.

Uninsured individuals can begin open enrollment for health insurance coverage through the health care marketplace next month for coverage effective as early as Jan. 1. Open enrollment ends March 31, 2014.

According to the federal government’s health care website, people eligible to use the exchange will fill out an application to see what plans are available in their area, and if they qualify for subsidies or free or low cost coverage through Medicaid or the Children’s Health Insurance Coverage. Downloadable and paper applications will be available Oct. 1, and individuals can apply for coverage online, in person, or by mail.

Access to the exchanges and applications is not yet available.

“They really don’t know what plans there are available until right around Oct. 1,” said Rosemary Blackmon, a spokesperson for the Alabama Hospital Association.

What is known is Alabama’s exchange will include a bronze, silver and gold plan from Blue Cross Blue Shield, Humana and United insurance providers. Andrus said the bronze plans are geared to pay roughly 60 percent of a person’s health care bill, the silver will pay 75 percent and the gold will pay 90 percent.

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