Nov. 13 (Bloomberg) — The questions kept coming up across Michigan as soon as the Supreme Court said it would take up a case that could reshape Obamacare by ending insurance subsidies in many states.

Dizzy Warren, director of Michigan's biggest health care enrollment group, dealt with it in her presentation to health care advocates last week in Detroit, then again on yesterday's conference call with 57 workers: What do we do now?

Her answer?

"Keep calm and keep enrolling," she said.

Organizers are bracing for more skepticism and confusion as the second year of enrollment begins this weekend under the Patient Protection and Affordable Care Act, which has promised health insurance to tens of millions of Americans without it. In the past two weeks, Republicans won control of Congress and pledged to chip away at the law, the Supreme Court agreed to review the case that challenges who's eligible for insurance subsidies, and the Obama administration lowered the bar for its enrollment goals.

Now comes the toughest challenge: signing up uninsured Americans who are confused, clueless or downright hostile to the programs available for them.

"It seems like the program itself is trending in the wrong direction, not in the right direction," said Les Funtleyder, a health-care portfolio manager at ESquared Asset Management in New York. "Momentum seems to be going against them, not for them."

Instant Insights /

PPACA enrollers learn to cope with latest setbacks

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