Enrollment for health insurance coverage through the Affordable Care Act’s new online marketplaces is scheduled to start Oct. 1 in Kansas and across the nation. But it is clear that many, if not most, of the millions of people expected to benefit from the so-called “insurance exchanges,” still know little or nothing about how the marketplaces are supposed to work or the law behind them.

The large majority of Kansas hospitals already have contracts or intend to contract with all three of the state’s KanCare managed care companies, officials say.

People involved with Medicaid services for children say they are hopeful the state’s new KanCare program will someday lead to improved services and health outcomes. But for now, they report dealing with some of the same problems and frustrations others in the program have experienced.

Push is again coming to shove in the struggle over whether the long-term care and support services received by Kansans with developmental disabilities will become part of KanCare or remain outside the control of the private companies hired by the state to manage the Medicaid program.

Advocates pushing Kansas officials to expand Medicaid acknowledge it is unlikely they will achieve their goal this year. But they said they remain hopeful they can convince Gov. Sam Brownback and legislators next year to make more Kansans eligible for the program.