Surge of customers snags new health-insurance site

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.

At most, only a handful of people were able to successfully enroll online through the federal website in that time period, according to two industry officials with knowledge of the situation. The officials spoke on condition of anonymity because they were not authorized to speak about the issue publicly. The number of those enrolled is expected to grow as technicians tackle and resolve glitches.

In Obama's home state, dozens of people who came to a Champaign, Ill., public health office to sign up for coverage found computer screens around the room flashing an error message: "System is unavailable."

Kimberly Shockley -- logging in from Houston -- and Mike Weaver, who lives in Southern Illinois, ran into the same glitch as many others: They could not get past the security questions while trying to set up their personal accounts through healthcare.gov.

"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. When she clicked on a drop-down menu of suggested security questions, none appeared. She tried to create her own questions, but that didn't work, either.

Weaver, a self-employed photographer, said he 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, including Missouri's.

In St. Louis, those seeking information from the government-backed insurance exchange were advised to "please wait" and thanked for their patience while the website handled heavy traffic. After successfully entering the site by creating a username and password early Tuesday morning, a reporter encountered a virtual roadblock when prompted to respond to security questions required before plan information could be accessed. Eight hours later, the wait persisted.

The less-than-smooth start worried state health advocates who see the exchanges as a chance to potentially provide coverage for as many as half of the estimated 835,000 uninsured people in Missouri as of 2010, per the U.S. Census.

"These exchanges live and die on customer service," said Thom McAuliffe, a policy analyst with the not-for-profit Missouri Foundation for Health. "If too many people show up and see this is a pain, they're going to say, 'Forget about it."'

The online benefits calculator will provide Missourians a glimpse into the amount of government tax credits they can expect to receive to offset actual out-of-pocket policy costs. But those subsidies won't be available to adults below the poverty level because the law assumes those people would get coverage under Medicaid expansion. Missouri is among 26 states that have not expanded coverage under the federal insurance program for the poor -- another key part of the contentious federal law.

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 state'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 can 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, although some users reported snags. Access Health CT sent out a tweet shortly before noon Tuesday, confirming the marketplace logged 10,000 visitors in the first three hours of operation and 22 enrollments. 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.

The shutdown will have no immediate effect on the insurance marketplaces that are the backbone of the law, because they operate with money that isn't subject to the annual budget wrangling in Washington.

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 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."

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, ranging from mental health treatment to maternity care.

Alan Scher Zagier of the Associated Press in St. Louis contributed to this report.