States establishing their own health insurance exchanges under the Affordable Care Act are turning their attention to the challenge of spreading the word, particularly to young people -- whose participation is needed for the concept to work -- and those who opposed the law. Washington state data illustrate the challenge: Officials there want to enroll 410,000 people in the exchange's first two years, but just 1 in 6 residents have heard of the marketplace. Education about insurance is key to reaching the uninsured, while innovation is needed for connecting with young adults.

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