Glad the NY Times has spotted it. That Missouri federally facilitated health insurance exchange is a tricky one. You can rarely spot it. But you can read about it here: http://www.nytimes.com/2013/08/03/us/missouri-citizens-face-obstacles-to-coverage.html?
Based, anecdotally, on the number of questions I receive via email as well as the number of speaking engagement requests I receive, I imagine that most of Missouri's citizens are not only woefully underinformed about the ACA but also woefully underinformed about the choices the state has made that will shape the Missouri ACA experience.
In June, I suggested in remarks at a conference of health law professors, that we were in the midst of the largest health insurance counseling challenge of our lifetimes. Missouri's stealth exchange may make ours particularly acute.
Missouri State of Mind 