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New U.S. health care law exchanges see much interest, some glitches

The Washington Post

Millions of Americans flooded government websites Tuesday to get a long-awaited look at insurance options available under the Affordable Care Act, but the high traffic contributed to widespread computer problems on what President Barack Obama hailed as a historic day.

HealthCare.gov, the federal Internet marketplace serving more than 30 states, was jammed for most of the day, with people encountering error messages that froze their applications.

In states operating their own marketplaces, the experience was spotty. Maryland’s site, Maryland Health Connection, was down for the morning and sluggish into the evening. Lesser problems were reported in Colorado, Washington, Hawaii and elsewhere.

Obama and federal health officials described enormous interest, with 2.8 million people visiting the federal marketplace since early Tuesday, another 81,000 dialing the help center, and some people actually enrolling in coverage, though they declined to say how many.

“This is life or death stuff,” Obama said during remarks in the Rose Garden. “Tens of thousands of Americans die each year just because they don’t have health insurance. Millions more live with the fear that they’ll go broke if they get sick. And today, we begin to free millions of our fellow Americans from that fear.”

The problems on the websites were not caused by staffing shortages due to the government shutdown, because most of the government employees involved with the health care law’s implementation were not furloughed. But lingering opposition to the law was central to the Washington standoff that led to the federal government shutdown, which brought a flurry of new attention to Tuesday’s rollout of the health insurance marketplaces and likely contributed to some of the Web traffic.

Some states released their own enrollment figures. In Kentucky, more than 1,000 people had completed insurance applications by 5 p.m. Tuesday. Connecticut had processed 167 applications by 4 p.m., and 175 people in the District of Columbia took all the steps toward enrolling aside from cutting a check — and four did.

In California, an enthusiastic supporter of the health care law managed to sign up on the state’s marketplace, though the process took three hours because the pages kept freezing.

“Obviously, three hours is a long time to wait, but it will save me over $6,000,” said Andrew Stryker, 34, a freelance television producer in Los Angeles. “For that, I would have waited all day.”

For Audrey Campbell, a security guard from Woodbridge, Virginia, the experience was less satisfying. The 55-year-old took part of the day off to sign up for coverage at the Greater Prince William Community Health Center in the state, which did not build its own marketplace, leaving the task up to the federal government.

A worker told Campbell the enrollment site was still down and that she would not even be able to see details on available health plans. She put away the documents she had been told to bring. “Now I’ve got to take off work again to come back here,” she said.

The marketplaces, also called exchanges, are intended for Americans who are uninsured or buy private insurance on their own. They are one of the centerpieces of the Affordable Care Act, the law enacted 3½ years ago that is setting in motion broad changes to the U.S. health care system.

Once the exchanges are running smoothly, people will be able to enter some personal information and learn quickly if they qualify for Medicaid, the state-federal program for the poor that is expanding under the law, or for government subsidies. They may enroll in plans that take effect next year, when virtually all Americans must carry health insurance or face a fine.

Sixteen states and the District of Columbia opted to set up their own marketplaces, but the rest defaulted to the federal government, which established a single website for residents of all of those states to use.

For weeks, insurance companies and outside consultants had been warning of problems in the complex computer systems being built by the state and federal governments, who were facing a tight time frame to complete the unprecedented task of linking databases maintained by insurance companies, states and federal agencies, including the Internal Revenue Service.

“I would say it’s not going too well,” said Dan Schuyler, director at Leavitt Partners, a health care consulting firm founded by former Utah Gov. Mike Leavitt that is helping a number of states adapt to the health care law. “I think it’s a combination of high volume and the technology not being ready for prime time.”

Jon Kingsdale, a consultant and former director of Massachusetts’ health exchange, said he was surprised at the level of interest. “There’s just a tremendous amount of curiosity it seems — not understanding, that’s a different thing — but awareness and curiosity about the opening of the exchanges,” he said, crediting some of it to the national coverage of the health care debate on Capitol Hill.

In the District of Columbia, Stephanie Schmalzle, a 26-year-old actress who has been uninsured since March, said she would likely start browsing plans Tuesday night. “I don’t feel that just because I’m young and healthy that I don’t need health insurance,” Schmalzle said. “Anything can happen to anyone.”

Federal health officials downplayed the impact of Tuesday’s technical problems, saying they had expected some bugs all along and that many people would be simply window-shopping initially. People will have until March 31 to sign up before running afoul of the insurance mandate. They blamed the problems on higher-than-expected traffic to the site.

The spotty nature of opening day was evident across the Washington area. In the District of Columbia, where the DC Health Link exchange had announced just days ago that it was not yet ready to help customers figure out whether they qualify for subsidies, its website functioned smoothly in other ways from the moment it opened at 8 a.m.

Maryland, heralded as one of the best-prepared states, was beset by problems throughout the day. Its website’s opening was delayed until noon and, after that, was slow — and sometimes inaccessible — through much of the afternoon.

The initial hiccup was a problem in the interface between the exchange’s website and local health departments, said Joshua Sharfstein, Maryland’s health chief. Once that was resolved and the site opened, it proved to be a victim of its own popularity, he said.

“We had as many as 1,000 people a minute trying to create accounts,” leading to an electronic bottleneck that had not been expected, Sharfstein said. “The silver lining is, we are certainly finding a huge amount of interest.”