The exchanges are finally here, but Americans are no closer to being fully on board with the Patient Protection and Affordable Care Act.

A CNN/ORC International survey released Tuesday found that fewer than one in five Americans say their families will be better off because of the health care law.

The survey found that 40 percent of Americans said they will be "worse off" when the provisions of the health care law take effect, while 17 percent said they think they will be "better off." Still, a large percentage (41 percent) thinks the law won't have much of an effect on them at all.

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