Consumers attempting to log on to new insurance exchanges created under the Affordable Care Act were met with an error message early Tuesday due to an overload of Internet traffic.
The message read: "We have a lot of visitors on our site right now and we’re working to make your experience here better. Please wait here until we send you to the log-in page. Thank you for your patience!"
The delay was as long as four minutes at 7:10 a.m.
An Illinois landing page, GetcoveredIllinois.gov, which directs consumers to either the federal exchange website or a separate state portal for enrolling in an expanded Medicaid program, was operating without issues.
Even with the early hiccups on the federal enrollment site, President Barack Obama’s health care law launched Tuesday despite a government shutdown brought on by an argument about its future.
The federal website for enrolling in health coverage — healthcare.gov — went live at 7 a.m Central time today, allowing consumers to begin signing up for plans.
Officials in most states that are running their own online insurance marketplaces are open for business today, as well as call centers set up to handle consumer questions through the government's (800) 318-2596 hotline.
"The Affordable Care Act is moving forward. That funding is already in place. You can't shut it down," Obama resolutely informed his Republican opponents in a televised statement at the White House on Monday.
The launch marks a milestone for Obama's signature domestic policy achievement, which aims to provide subsidized healthcare to millions of the uninsured, the most ambitious U.S. social program since Medicare was introduced in the 1960s.
The marketplaces, or exchanges, require health plans to provide a broad range of essential benefits that were not necessarily part of individual policies in the past, including mental health services, birth control and preventive care. The coverage is linked to other insurance market reforms and new consumer safeguards including a ban on discrimination based on gender and health history.
It also mandates that Americans obtain insurance or pay a fine.
"Nothing like this has ever existed before," said U.S. Health and Human Services Secretary Kathleen Sebelius.
Republicans have fought for months to delay or stop Obamacare, most recently triggering a shutdown of the federal government on Monday night by insisting that a routine funding measure include a delay in Obamacare, which the Democratic-controlled Senate rejected.
Officials running the new exchanges braced for technical glitches that could hamper the enrollment effort.
But the president said that whatever the outcome of talks in Congress, the healthcare reform launch would proceed.
As many as 7 million Americans are expected to sign up for insurance in 2014 through the exchanges, which open for enrollment into new insurance plans on Tuesday and will accept applications through March 31. An additional 8 million people are expected to receive health benefits through an expansion of the government's Medicaid program for the poor.
Republicans have blamed Obamacare's requirements for pushing up the cost of health insurance for business and individuals, a claim the Democrats deny.
"What I want is to keep the government running and at the same time to deal with the harms, the millions of Americans who are ... at risk of losing their healthcare, are facing skyrocketing insurance premiums," Texas Senator Ted Cruz, who has been leading the charge among Republicans in Congress to defund the law, said in an interview with CNN.
The Patient Protection and Affordable Care Act has been the object of intensive Republican attack since it was signed into law in 2010. Its foes tried and failed to use the U.S. Supreme Court and a presidential election to get it overturned in 2012.
Illinois in 'good shape'
In Illinois, officials said more than 1.6 million people in the state will wake up Tuesday to begin the process of determining whether they're eligible for government subsidies.
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Starting at 7 a.m., consumers can get their first look at the 162 plans offered by six insurers through the Illinois exchange. Deputy Gov. Cristal Thomas said a call center staffed with operators who will walk consumers through the law and answer enrollment questions should open at 8 a.m.
"We are in good shape," Thomas said. "We're pretty confident the website is going to be fine."
To be covered by Jan. 1, people need to sign up and pay for their first month of coverage through the exchanges by Dec. 15. Open enrollment continues through March 31. Those who do not have health insurance in 2014 must pay a tax penalty, starting at $95 per individual or 1 percent of household income, whichever is greater.
The state over the weekend also released more information about the number of plans offered by each of the six insurers participating in the Illinois exchange. In Cook County, consumers will be able to choose among plans offered by five carriers — Blue Cross Blue Shield of Illinois, Land of Lincoln Health, Humana Inc., Aetna Inc. and Coventry Health.
Only two carriers — Blue Cross and Land of Lincoln, the startup insurer launched with the help of a $160 million federal loan — will offer both individual and small-group plans on the exchanges statewide.
Humana and Coventry will offer the most individual plans in the state, with each providing more than 30 separate options.
Blue Cross, Illinois' dominant insurer by market share, will offer 16 individual plans and 19 for small business, while Land of Lincoln will offer 19 individual plans and 16 small-group plans.
While not all insurers have released rate and cost information about those plans, Land of Lincoln late Monday issued some details on the 2014 plans it will offer, providing an early window into some of what consumers can expect to see when they start comparing plans.
Without taking into account federal subsidies, the nonprofit insurer's monthly premiums range from $107 for a nonsmoker under age 21 who lives in Moline to $1,113 for a 64-year-old smoker in Lake County. Deductibles range from $500 to $6,250.
The health care law established four broad categories of coverage — platinum, gold, silver and bronze — for which premiums vary based on the amount of out-of-pocket health care expenses consumers are required to pay. Bronze plans have the lowest monthly premiums, but they cover only 60 percent of projected medical costs. Platinum plans have higher premiums but cover 90 percent of medical costs.
For a 30-year-old in Chicago making more than $46,000 a year, Land of Lincoln's bronze plans have monthly premiums ranging from $195 to $236. Annual deductibles in those plans are $4,000 to $6,250. If the same person made just under $16,000 annually, monthly premiums drop to $66 to $107 with federal subsidies.
"We're encouraging people to really get out there and shop," said Dan Yunker, Land of Lincoln's chief executive. "It's not just that monthly premium that's important here; the total cost (of) the health plan is what's going to be important."
Yunker also urged consumers to ensure that their preferred doctors, hospitals and other health care providers are in the plan's network. Each of the 35 plans Land of Lincoln is offering in Illinois has the same network of providers.
Other insurers, however, plan to offer so-called narrow network plans, which often have lower rates at the expense of restricting the number of hospitals and doctors available to patients
State and federal officials urged consumers to seek assistance through a group of paid counselors called navigators who will help people compare and sign up for insurance plans.
While Illinois officials say they've trained more than 700 navigators, just more than 100 will have full federal certification by Tuesday, Thomas said. In response, the state made a last-minute push to ensure that licensed insurance brokers have updated their contact information in state and federal databases where the state websites can direct consumers.
"We do see (brokers) as an important resource," Thomas said. "We'd like to have more (certified navigators), but we know our partners are working on that, and we'll continue to work on it in the coming days and weeks."
Slow start
In the early planning, the administration aimed to create new healthcare markets that would make shopping for insurance as simple as buying an airline ticket online. But repeated delays and technical difficulties mean the new sites in many states won't have all of their functions ready in the first weeks, at the earliest.
Minnesota officials said on Monday that they were not yet sure what time their state's exchange would launch, and that the timing would only be determined after further testing on Tuesday morning to see if the system connected properly with federal government's network for determining subsidies.
The U.S. Department of Health and Human Services, which will operate federal marketplaces in 36 states that are not running their own, has also said that technical glitches are likely.
"We will fix them and move on. Is it a sign that the law is flawed and failed? I don't think so. I think it's a sign that we're building a piece of complicated technology," Sebelius said.
Senior administration officials and organizers working to help reach the uninsured with news of Obamacare benefits believe enrollment will get off to a quiet start on Tuesday and build slowly through the six-month enrollment period.
The first enrollees are likely to be people with pre-existing health conditions and older people who have had a hard time obtaining coverage up to now. But Obamacare's success will depend on young healthy adults, whose lower risk profile is needed to compensate for higher cost beneficiaries.
However, the law remains unpopular with 46 percent of the public. Anti-Obamacare forces have spent hundreds of millions of dollars in television advertising, outspending Obamacare supporters by more than four-to-one. Meanwhile, millions of potential beneficiaries don't know the law exists.
Officials said Tuesday would also see a ramp-up in the administration's multimillion-dollar media campaign to reach prospective beneficiaries through television, Twitter, Facebook and social organizations including churches.
In particular, they are targeting young and healthy Americans whose participation will help offset the cost of covering sicker beneficiaries. The advertising campaign is targeting black and Hispanic men between the ages of 18 and 35 in large cities in Florida, Texas, Illinois and California.
"People are just starting to tune in," Sebelius said. "As we ramp up our communications and connect it with real facts, for the first time, a lot of Americans will be learning what the law means for them."
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