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A new study says only a fraction of people know they can sign up in October for the insurance exchanges that are key to President Obama's health care overhaul. - 

A new report by InsuranceQuotes.com finds 90 percent of Americans don’t know they can start signing up for insurance through health exchanges in October. The exchanges are websites that let people compare and buy insurance. The exchanges are also one of the key provisions of the Affordable Care Act, which was passed three years ago. By the end of 2013, people will have to join a plan to avoid penalties. 

“We want to make sure we do what can to inform consumers and give them the education that they need to make the right decisions,” says Laura Adams, with InsuranceQuotes.com, which compares insurance rates for consumers.

Alan Weil, the executive director at the National Academy for State Health Policy, is not surprised people aren’t aware of health exchanges yet, since many  states are just now ramping up publicity efforts. He says the real trick is getting people to use them once they are open. 

“In the long run, if a large number of people eligible for participation in the exchange fail to participate, we have a problem on our hands,” says Weil. 

According to Weil, if healthy people don’t sign up, insurance premiums could jump, undermining one of the Affordable Care Act's goals of making health insurance affordable.