President Obama signs PPACA. (AP photo/J. Scott Applewhite)

WASHINGTON (AP) — Now is when Americans start figuring out that the new federal health care law goes beyond political talk, and really does affect them and people they know.

With a cranky federal website complicating access to new coverage and some consumers being notified their existing plans are going away, the potential for the Patient Protection and Affordable Care Act (PPACA) to create winners and losers is creating anxiety and confusion.

“I’ve had questions like, ‘Are they going to put me in jail if I don’t buy insurance? Because nobody will sell it to me,’” said Bonnie Burns, a longtime community-level insurance counselor from California.

“We have family members who are violently opposed to ‘Obamacare,’ and they are on Medicaid — they don’t understand that they’re already covered by taxpayer benefits,” Burns said. “And then there is a young man with lupus who would have never been insurable [under the old underwriting rules].He is on his parents’ plan and he’ll be able to buy his own coverage. They are very relieved.”

A poll just out from the nonpartisan Kaiser Family Foundation documents shifts in the country in the month since insurance sign-ups began.

Fifty-five percent now say they have enough information to understand the law’s impact on their family, up 8 percentage points in just one month. Part of the reason is that advertising about how to get coverage is beginning to register.

“The law is getting more and more real for people,” said Drew Altman, the foundation’s president. “A lot of this will turn on whether there’s a perception that there have been more winners than losers. … It’s not whether an expert thinks something is a better insurance policy, it’s whether people perceive it that way.”

The administration is continuing efforts to influence those perceptions. On Wednesday, Obama will meet with volunteers in Dallas who are helping people enroll in health insurance plans. Cabinet officials are also expected to make stops around the country in the coming weeks to encourage people to sign up for insurance even as the website problems persist.

One issue is the cancellation notices going out to millions of people.

At least 3.5 million Americans have been issued cancellations, but the exact number is unclear. Associated Press checks find that data is unavailable in a half the states.

Administration officials say most of these consumers aren’t really getting “canceled” but simply “transitioned” or “migrated” to better plans because their current coverage doesn’t meet minimum standards. They won’t have to go uninsured, and some could save a lot if they qualify for the law’s tax credits.

Speaking in Boston’s historic Faneuil Hall this past week, Obama said the problem is limited to fewer than 5 percent of Americans “who’ve got cut-rate plans that don’t offer real financial protection in the event of a serious illness or an accident.”

But in a nation of more than 300 million, 5 percent is a big number — about 15 million people. Among them are Ian and Sara Hodge of Lancaster, Pa., in their early 60s and paying $1,041 a month for a policy.

After insurer Highmark, Inc., sent the Hodges a cancellation notice, the cheapest rate they say they’ve been able to find is $1,400 for a comparable plan. Ian is worried they may not qualify for tax credits, and doesn’t trust that the federal website is secure enough to enter personal financial information in order to find out.

“We feel like we’re being punished for doing the right thing,” he said.

Their policy may not have met the government’s standards, “but it certainly met our minimum standards,” Hodge added.

The final judgment on PPACA may be in the hands of people who now have employer-provided health insurance. They’re about half the population, and they’ve noted Obama’s assurances that their coverage won’t be disrupted.

PPACA cost control provisions — mainly the “Cadillac plan” excise tax on expensive insurance plans that starts in 2018 — are converging with the long-standing push by employers to tame health costs.

Some companies have raised deductibles and copayments for employees, saying they need to scale back to avoid tangling with the coming tax. Others are giving employees a fixed amount of money to shop in private health insurance markets that resemble those created by the law.

Determining which cutbacks are the result of PPACA and which the result of what employers wanted to do anyway may be difficult.

“What the Affordable Care Act did was give companies a very convenient excuse to say ‘Oh, gosh, we really have to get serious about insurance costs,’” said Paul Keckley, an independent health benefits consultant. “I think there’s a bit of a bob and weave. The ACA was a convenient excuse for doing what (corporate) human resources departments have been calculating to do for years.”

Associated Press writer Michael Rubinkam in Allentown, Pa., contributed to this report.

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