The objective of this study is to examine the level of awareness of and interest in the Health Insurance Marketplace in West Virginia. Primary survey data were collected in July/August 2013 from a stratified sampling of West Virginians. A mailed survey was completed by respondents in a cross-sectional study. Key variables included general awareness of the Health Insurance Marketplace and the availability of subsidies, the individual mandate, interest in using the Marketplace, and perceptions of respondents' ability to qualify for financial assistance. A total of 6000 surveys were mailed containing a 9-page questionnaire; 1198 completed surveys were returned. Two months prior to launch, awareness of the Health Insurance Marketplace was low in West Virginia, yet interest in the Marketplace was higher among those most likely to benefit--the uninsured and residents likely to qualify for financial subsidies. West Virginians reported being familiar with the individual mandate. Efforts should be increased among government and nongovernment organizations at the federal, state, and local levels to heighten awareness of the Health Insurance Marketplace in West Virginia and, particularly, the availability of subsidies. Many, once made aware, expressed interest in learning more.