WASHINGTON — Several state- and federal government-run health insurance marketplaces opened Tuesday with glitches, delays and even crashes, marring the launch of the centerpiece of President Obama's health care law.
Some of the delays were due to high volume. President Obama said in a White House conference that more 1 million people tried to use the sites before they officially opened at 8 a.m. ET.
The exchanges are the critical part of the Affordable Care Act's requirement that uninsured Americans buy health insurance. They opened Tuesday for business and the open-enrollment period for insurance customers will last until March 31.
"Like every new law, every new product signup, there are going to be some glitches that we will fix," Obama said.
Those glitches frustrated potential insurance customers around the country, such as John Sanders, of Kaukauna, Wis. He said he signed up on the exchange website three weeks ago but hit snags Tuesday.
Sanders called the system's launch "reckless at best. I will not accept the 'heavy traffic' argument. What else would be expected on the national launch date?"
He and others faced many of the same problems online shoppers often do on the busy Monday after Thanksgiving known as Cyber Monday or like the launch of a new retail site.
State and federal governments had no idea what to expect in terms of traffic, said retail technology expert Peggy Pulliam. She sayid retailers will stress or "load test" their sites simulating a surge of traffic ahead of big shopping days.
"If any simulation they ran for the stress test didn't reflect actual user behavior on that site today, they may have not found the vulnerabilities." said Pulliam, vice president of services for retail technology company Micros. "It's harder to load test a brand new system because you don't know how people are going to browse and shop the site."
Federal site an early bottleneck
Many problems centered on the federal government's HealthCare.gov site, the portal through which many Americans will go to sites geared to their states. The site is handling exchanges for 34 states that defaulted to the federal government for at least the first year.
Consumers around the country frequently got messages telling them to come back later or endured long delays in connecting to the sites.
Bruce Brian, a self-employed real state broker from Greenwood, Ind., said he tried logging into HealthCare.gov and got a computer message: "Your account couldn't be created at this time. The system is unavailable."
"You would just think that with all this time they've had to get it set up and ready to go, they would have been a better premiere," Brian said.
Other potential customers, such as Nicole Argall of Appleton, Wis., were more relaxed. She called the initial difficulties minor given the benefits of having the new coverage.
"I had some trouble with the security question portion, but I'll try again later or tomorrow," Argall said Tuesday. "My husband and I are both self-employed and we've had issues with pre-existing conditions and being rejected in the past. I think a lot of people with employee-sponsored insurance don't understand that there are lots of people like us that make a good living, but are self-employed."
Much of the glitches could be caused by the interest in the site, according to Joel Ario, formerly the director of the Office of Health Insurance Exchanges at the Department of Health and Human Services and now a managing director at Manatt Health Solutions.
Ario compared the politics surrounding Tuesday's launch to a football game between the left and the right.
"This day has gotten a lot more attention than anyone anticipated," he said. "I'm not eligible for the exchange, but I've been on the site. There are going to be reporters. I've seen a lot of people come across my screen saying, 'Check out this state.'"
In the social media universe, there are thousands of people who don't need insurance posting about the glitches they encountered when they visited the federal site. And, for those who do actually need insurance, Ario said it takes a few hits to actually purchase it.
"It's a surprisingly high number to me," Ario said of the millions of hits reported so far. "I think it all goes to that notion that this is supposed to be a six-month gradual process."
In fact, he said the number of people who actually buy insurance Tuesday could say a lot more than the number of people who check the site out of curiosity.
"Even when people are frustrated they remain enthusiastic and interested."
As he vowed he would be, the Rev. Donald Morton, pastor of Perfected Life Church in Wilmington, Del., was first in line Tuesday morning at Brandywine Women's Health Association to enroll in Obamacare.
Morton, though, and thousands of others nationwide, may need the patience of Job for a while – especially on this first day of open enrollment.
For hours, eager enrollees and their guides got hung up somewhere in the "create an account" process or saw a message that said: "Please wait. 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 login page. Thanks for your patience!"
Morton said he and others have been waiting a long time for health care. A little longer wouldn't hurt.
"I'm one of the most vulnerable," Morton said, "a black male with a pre-existing condition."
Lisa Oglesby, who directs Brandywine's team of certified marketplace guides, said it probably was a good sign that the system was overwhelmed. It shows the pent-up demand for such coverage, she said.
Those who don't get through Tuesday can rest easy. There are six more months to get through. If you want coverage to start Jan. 1, be sure to enroll by Dec. 15. Otherwise enrollment for 2014 remains open through March.
Minnesota residents were told they had to wait until sometime in the afternoon to use Minnesota's new online marketplace for health insurance, the head of the state-run exchange said Monday.
April Todd-Malmlov, executive director of MNsure, said officials want to make sure the system connects properly with federal computer systems and it's secure before it goes live for consumers. MNsure officials had been saying for months they expected consumers could start signing up at the start of the business day Tuesday.
In Dearborn, Mich., long lines formed early in the day at the Access, a non-profit social service agency that is helping people navigate the new law, after the signup website stopped functioning.
Rick Murdock, of the Michigan Association of Health Plans which represents Michigan insurers, said technical glitches aren't unexpected. "That will take care of itself," he said of the website delays. He said he doesn't expect a high number of enrollees the first few days of the six-month enrollment period because consumers will, and should, take their time to comparison shop and weigh their choices.
Just after the Detroit-based Thea Bowman Community Health Center opened at 8 a.m., a patient in for a regular check-up at 9:30 asked about his options on the marketplace, triggering a call from his doctor to Jamie Jackson.
Jackson is one of four community health guides for Advantage Health Centers, which operates several clinics that provide free and low-cost care to the homeless and poor.
Jackson said she wasn't surprised at the call and she was able to discuss options for the patient. Despite plenty of news about federal health reform and the stalemate in Congress, consumers are still working out the details for themselves, she said.
"I don't necessarily think that people will be clamoring to sign up today," Jackson said, "but I do think that the questions will start today."
Around the country
Early reviews from various states were mixed. For example:
• Connecticut. Jason Madrak, the spokesman for the state's exchange, said there were initial bugs but the exchange had 11,000 visitors and its first customer at 9:30 a.m. and 24 by noon.
"We're off to the races," Madrak said.
• Maryland. The state's marketplace announced a four-hour delay and apologized for the inconvenience. "Thank you for visiting Maryland Health Connection. We are experiencing connectivity issues. Please visit the site again at 12 Noon."
• New York. Traffic apparently overwhelmed its website. Reports on Twitter cited 2 million visitors in the first 90 minutes that nystateofhealth.ny.gov was open for business. A spokesman at the Department of Health at 8:30 a.m. said the site was working fine, but already there were delays, locked screens and error messages. By mid-morning, the site was much slower. While the home page came up on Internet Explorer, Firefox and Chrome web browsers, server error messages were common when clicking on the individual and small business links.
• Mississippi. At 9 a.m., healthcare.gov would not show Mississippi's exchange. Instead, it displayed a message saying visitors would be directed to the login site as soon as traffic allowed. After several minutes, a message appeared saying the system was down. Several attempts to log in yielded the same result.
• Arkansas. The online exchange in Arkansas was moving at a crawl due to heavy trafficl.Mountain Home, Ark., insurance agent Joey Crump said a number of people have approached him seeking help today with insurance needs but he has not been able to get on. "It' been frustrating," Crump said.
• Iowa. Problems there problems went beyond the exchange. Visiting Nurse Services and Planned Parenthood of the Heartland both received federal grants to hire "navigators," who are to help consumers figure out their options on the new online system. Both agencies say they're working to hire and train navigators, and should have them available within a few weeks.
Reporters trying to ask questions about the website were equally out of luck Tuesday. The Chicago-based Department of Health and Human Services staff bounced back e-mails stating they were furloughed and unable to answer press inquiries due to the federal government shutdown.
Secretary of Health and Human Services Kathleen Sebelius said 52% of her staff is working despite the federal shutdown that started at midnight Tuesday.
Contributing: Brian Eason, The Clarion Ledger; Matthew Daneman, Rochester Democrat & Chronicle; Kevin Pieper, The Baxter (Ark.) Bulletin; Jens Manuel Krogstad, Des Moines Register; Nick Penzenstadler. The Post-Crescent (Appleton, Wisc.); Jess Rollins, Springfield (Mo.) News-Leader.