The health-insurance marketplaces at the center of President Barack Obama's health law saw a surge of consumer interest Tuesday that surprised even many of the law's backers. But the debut proved patchy, with few applicants actually able to buy coverage on clogged websites that were bedeviled with technological problems.
Federal officials said more than 2.8 million visitors between midnight and late afternoon contributed to long wait times for access to healthcare.gov, the website they are running for 36 states.
Officials in New York state, which is running its own insurance site, said an unanticipated surge of visitors in the first hours left the marketplace only partially functional. California said its website fielded five million page views by 3 p.m. local time.
The swell of online traffic underscored potential demand for health coverage that has been inaccessible to many of the nearly 50 million uninsured consumers, who either couldn't afford coverage or were excluded from plans because of existing medical conditions—one of the major issues the legislation sought to address.
"That gives you a sense of how important this is to millions of Americans around the country," President Obama said Tuesday. "And we're going to be speeding things up in the next few hours to handle all of this demand that exceeds anything that we had expected."
But the volume of visitors to the online marketplaces, called exchanges, added to stubborn technological hurdles that officials have grappled with for weeks.
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Associated Press
Anne Lyon, left, talks with Brandi Hawkins about different types of health insurance at the University of Arkansas in Little Rock, Ark., on Tuesday.
Many consumers found they were unable to enroll for insurance, due to the long delays on the websites and glitches in the calculations for federal subsidies meant to help buy coverage, according to insurers such as Cigna Corp. and Blue Cross & Blue Shield of Florida, insurance brokers and government-financed nonprofit workers who are helping with the enrollment.
"Sometimes being first, you're the guinea pig out there," said Bruce Allen, marketing director of Blue Cross & Blue Shield of North Carolina, which wasn't able to enroll any subsidy-eligible customers Tuesday due to technical glitches.
A spokeswoman for the Department of Health and Human Services said that some applications made through both the state-based and federally facilitated exchanges had been completed Tuesday. But officials wouldn't say how many people signed up successfully.
The launch marks a milestone in the rollout of the Affordable Care Act, which was signed into law in March 2010. But administration officials and health companies that depend on the law's coverage for new customers say it is the beginning of long journey: The ranks of newly insured are expected to swell to more than 20 million by 2016.
A clear picture of the scope of the initial wave of enrollees could take months to emerge. States that launched their own exchanges were at varying levels of preparedness. In some states where political leaders oppose the law, outreach efforts funded by Washington and carried out by local nonprofit groups have been quashed. And while Americans will face new tax penalties next year if they continue to go without coverage, it is an open question among health policy experts how many people ultimately will buy policies.
In Kentucky, more than 2,900 residents had either signed up for coverage from health-insurance plans or enrolled in the state's Medicaid program using its new marketplace Tuesday, said Gwenda Bond, a spokeswoman. In Connecticut, a state-run exchange enrolled just 83 people receiving health-law subsidies in health plans, but more in Medicaid.
Critics of the law were quick to seize on the glitches as a sign that its implementation is being rushed, and to argue that a delay, which some congressional Republicans have demanded as a condition of ending the government shutdown, is needed.
"This law was never ready for prime time and never will be," said Rep. Renee Ellmers, a North Carolina Republican.
Officials in Maryland delayed fully launching their state marketplace, citing technical problems, while other states, including Minnesota, got off to late starts Tuesday afternoon.
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Officials in Washington state took their website offline for five hours Tuesday in an attempt to make changes to speed response times. Exchange officials in Colorado, Oregon and Washington, D.C., earlier acknowledged some features of their marketplaces wouldn't be ready Tuesday.
The steady stream of consumers seeking new policies suggested an unexpected level of demand for benefits, despite efforts by administration officials to play down consumer interest in the Oct. 1 deadline and a recent Kaiser Family Foundation poll showing only 15% of respondents were aware that the date marked the opening of the marketplaces.
In Philadelphia, Carmen Santiago, a 49-year-old with diabetes, shopped for coverage—something she had gone without because of high costs. At her household income level, about $30,000, Ms. Santiago and her family likely qualify for federal subsidies that would put an array of health plans within reach.
Like thousands of would-be customers around the country, Ms. Santiago learned she will have to wait to find specific details or buy coverage. After technical problems with the marketplace blocked her from signing up, an enrollment helper at a local health center told her she will have to wait a week for a response to her paper application.
But she didn't seem bothered by the delay: "I've tried to buy insurance [before] but when they find out I have diabetes the rates go up." She said she struggles to pay for medicine now.
Six people had lined up at a Miami health clinic's new office dedicated to health-law enrollment by 8:30 Tuesday morning. Throughout the day, a dozen seats in the waiting area filled and, at times, the crowd swelled to standing-room-only status.
Among them was Sandy Calderon, a 24-year-old house painter who said she never has had health insurance.
"It's hard to live through your day hoping you don't get sick," said Ms. Calderon, who learned she might be able to buy a minimal plan for as little as $40 a month. Once she is covered, she said, "I think I'm going to feel very, very secure."
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