New insurance markets open

Surge of first-day customers overwhelms system, reports bugs, buys some policies

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CHICAGO — Americans got their first chance Tuesday to shop for health insurance using the online marketplaces that are at the heart of President Barack Obama's health care overhaul, but government websites designed to sell the policies struggled to handle the traffic, with many frustrated users reporting trouble setting up accounts.

State and federal agencies were working to fix the sites, which represent the biggest expansion in coverage in nearly 50 years. There should be time to make improvements; the open-enrollment period lasts for six months.

Administration officials said they were pleased with the strong consumer interest. At least 2.8 million people had visited the healthcare.gov website as of Tuesday afternoon, said Medicare administrator Marilyn Tavenner, whose office is overseeing the rollout of the Affordable Care Act. The website had seven times the number of simultaneous users ever recorded on the medicare.gov site.

But few of those people had successfully enrolled through the federal website, according to two anonymous industry officials with knowledge of the situation. The number of those enrolled is expected grow as technicians tackle and resolve glitches, and as consumers gather the information to make decisions about their purchases.

Kimberly Shockley — logging in from Houston, Texas — and Mike Weaver, in rural southern Illinois, ran into the same glitch as many others: They could not get past the security questions to set up personal healthcare.gov accounts.

"I'm frustrated, very frustrated," said Shockley, a self-employed CPA. She spent more than an hour trying to get the security questions to work without success.

Weaver, a self-employed photographer, said he also ran into problems with the drop-down menus. And when they started working, he still wasn't able to set up his account.

"The first day of something that you know is going to have a lot of bugs, it's not that frustrating," he said. "If it was the last day to sign up … then I'd be terribly frustrated."

State-operated sites also experienced trouble.

Minnesota got its site running after a delay of several hours. Rhode Island's site recovered after a temporary crash. A spokesman for the New York Department of Health blamed difficulties on the 2 million visits to the website in the first 90 minutes after its launch. Washington's marketplace used Twitter to thank users for their patience.

Exchange officials in Colorado said their website would not be fully functional for the first month, although consumers will be able to get help applying for government subsidies during that time. Hawaii's marketplace wasn't allowing people to compare plans and prices.

Connecticut seemed to be a bright spot. Access Health CT logged 10,000 visitors and 22 enrollments in its first three hours. A family of three was the first to sign up for coverage.

California, home to 15 percent of the nation's uninsured, reported delays online and on the phone because of heavy volume. The first completed health insurance application was taken at 8:04 a.m., just minutes after the exchange opened.

Goal: 7 million

The marketplaces represent a turning point in the nation's approach to health care. The Obama administration hopes to sign up 7 million people during the first year and aims to eventually sign up at least half of the nearly 50 million uninsured Americans through an expansion of Medicaid or government-subsidized plans.

But if people become frustrated with the malfunctions in the computer-based enrollment process and turn away from the program, the prospects for Obama's signature domestic-policy achievement could dim.

"You've got to launch this thing right the first time," said Robert Laszewski, a consultant who worked 20 years in the insurance industry. "If you don't, financially you will never recover."

Neera Tanden, president of the Center for American Progress, which helped work to pass the law, cautioned against rushing to judge on first-day performance.

In Texas, a federally funded network of "navigators" hired to help people enroll was off to a rocky start because participants pulled out — some of them cowed by politics.

At least four regional government councils — covering more than 30 Texas counties — reversed course in the past two weeks and rejected funds to train navigators. Local leaders described their hesitancy as a mix of uncertainty on state rules and a fear of running afoul of Republican leaders.

Many states predicted that an initial surge of interest would test the online system, but they expect most people to sign up closer to Dec. 15, which is the deadline for coverage to start Jan. 1. Customers have until the end of March to sign up in order to avoid tax penalties.

Under the law, health insurance companies can no longer deny coverage to someone with a pre-existing medical condition and cannot impose lifetime caps on coverage. They also must cover a list of essential services, from mental health treatment to maternity care.