Remember that landmark Supreme Court case last year that ruled the Patient Protection and Affordable Care was constitutional, changing the country’s health care system forever as we know it?

Well, a big chunk of Americans don’t.

Four in 10 Americans (42 percent) are unaware PPACA is still law and is being implemented, according to a poll by the Kaiser Family Foundation.

Of that percentage, 12 percent believe the law has been repealed by Congress, 7 percent believe it’s been overturned by the Supreme Court and 23 percent say they don’t know enough to say what the status is.

Kaiser’s latest tracking poll is a stark reminder that Americans remain confused, or completely unaware, about the implications of President Obama’s health care law. The news likely isn’t good for the administration, which has set to work on a heavy marketing campaign to raise awareness of reform just months before open enrollment in new exchanges begin.

Though confusion surrounding the law isn’t new, it’s a percentage most had hoped would have chipped away by now, as the main pieces of reform are set to begin in 2014.

Open enrollment begins Oct. 1, and the exchanges are set to open in January 2014. Just how enrollment plays out will be a major part of how reform’s success is measured.

Worse yet, according to Kaiser’s poll, the share of the public that says they lack enough information to understand how the PPACA will affect their family is higher among the two groups the law is likely to benefit most—the uninsured (58 percent) and low-income households (56 percent).

The bleak poll results come shortly after top Democratic senator Max Baucus made headlines when he predicted a “train wreck” coming for PPACA. In a budget hearing in April, Baucus expressed his concern that the exchanges for consumers and small businesses wouldn’t open on time in every state.

Health and Human Services Secretary Kathleen Sebelius has since insisted the exchanges would open on time.

Overall, the Kaiser poll found, more Americans have a negative perception of the law. In the latest tracking poll, 40 percent said they have an unfavorable view of the law, compared with 35 percent who have a favorable view—roughly in line with past results.

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