Staffing News- Officials move to tackle Obamacare sign-up problems caused by unexpected high demand

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Obama administration officials were scrambling Wednesday to add computer servers to handle what they say is unexpectedly high demand on the new federal health-insurance marketplace, a centerpiece of the president’s health-care law that opened amid technical difficulties Tuesday.

The federal Web site,, got 4.7 million unique visitors in the first 24 hours it was open, and the help line received 190,000 calls, Joanne Peters, a spokeswoman for the Department of Health and Human Services, said Wednesday. The enormous demand has caused glitches and bottlenecks, though some people were able to successfully enroll Tuesday, she said.

“We expect to see similar volume as yesterday, and while this overwhelming interest is continuing to cause wait times, there will be continuing improvements in the coming hours and days,” Peters said in a statement.

Tuesday’s problems extended to Web sites run by a number of states that built their own marketplaces. The sites are the primary portals for millions of uninsured Americans to buy health plans and apply for government assistance under the Affordable Care Act, the sweeping health-care law widely known as Obamacare.

California, which has been a leader in implementing the law, temporarily shuttered its site at 9 p.m. Tuesday to “help optimize performance for the millions of people expected to log in to use the enrollment function in future,” health officials said in a statement. Maryland, another state that got an early start on building its marketplace, said problems persisted into Wednesday.

“We’ve been trying incessantly to get online all morning and we can’t get on, we can’t log in,” said Linda Cornelius, a worker at Interfaiths Works, a Montgomery County nonprofit group. She is one of more than 300 specially trained consumer guides in Maryland helping people sign up for Obamacare coverage.

But Kentucky, which is also running its own marketplace, offered a more glowing update: More than 1,833 individuals and families managed to sign up for coverage there as of 7 a.m. Wednesday, state health officials said.

Across the country, a number of people tried to sign up for coverage on the first day.

Among them was Andrew Stryker, an enthusiastic Obamacare supporter who managed to sign up Tuesday on California’s state-run marketplace, although the process took three hours because the pages kept freezing.

“Obviously, three hours is a long time to wait, but it will save me over $6,000,” said Stryker, 34, a freelance television producer in Los Angeles. “For that, I would have waited all day.”

For Audrey Campbell, a security guard from Woodbridge, the experience was less satisfying. The 55-year-old took part of the day off Tuesday to sign up for coverage at the Greater Prince William Community Health Center in Virginia, a state that did not build its own marketplace, leaving the task up to the federal government.

A worker told Campbell that the enrollment site was still down and that she would not even be able to see details on available health plans. Campbell put away the documents she had been told to bring. “Now I’ve got to take off work again to come back here,” she said.

Officials running the federal site urged patience. For example, people logging onto the site may run into a “holding page” for a few minutes before they are able to begin their applications. They should not refresh their browsers or leave the page, as they will lose their places in line.

Officials reminded people that they have until Dec. 15 to sign up for coverage that starts Jan. 1, and that people will not be penalized for failing to buy coverage until March 31.

The marketplaces, also called exchanges, are intended for Americans who are uninsured or buy private insurance on their own. They are one of the centerpieces of the Affordable Care Act, the law enacted 31 / 2 years ago that is setting in motion broad changes to the U.S. health-care system.

Once the exchanges are running smoothly, people will be able to enter some personal information and learn quickly if they qualify for Medicaid, the state-federal program for the poor that is expanding under the law, or for government subsidies. They may enroll in plans that take effect next year, when virtually all Americans must carry health insurance or face a fine.

Sixteen states and the District opted to set up their own marketplaces, but the rest defaulted to the federal government, which established a single Web site for residents of all of those states to use.

The problems on the Web sites were not caused by staffing shortages due to the government shutdown, because most of the government employees involved with the law’s implementation were not furloughed. But lingering opposition to the law was central to the Capitol Hill standoff that led to the shutdown, which brought a flurry of new attention to Tuesday’s rollout of the health insurance marketplaces and likely contributed to some of the Web traffic.

For weeks, insurance companies and outside consultants had been warning of problems in the complex computer systems being built by the state and federal governments, who were facing a tight time frame to complete the unprecedented task of linking databases maintained by insurance companies, states and federal agencies, including the Internal Revenue Service.

“I would say it’s not going too well,” said Dan Schuyler, director at Leavitt Partners, a health-care consulting firm founded by former Utah governor Mike Leavitt (R) that is helping a number of states adapt to Obamacare. “I think it’s a combination of high volume and the technology not being ready for prime time.”

Jon Kingsdale, a consultant and former director of Massachusetts’s health exchange that was part of the state’s 2006 universal health-care law, said he was surprised at the level of interest. “There’s just a tremendous amount of curiosity it seems — not understanding, that’s a different thing — but awareness and curiosity about the opening of the exchanges,” he said, crediting some of it to the national coverage of the Obamacare standoff on Capitol Hill.

In South Texas, health-care providers reported an unusual problem with the federal marketplace: Many patients didn’t have e-mail addresses and therefore couldn’t sign up online.

The Brownsville Community Health Center had 50 people show up on Tuesday ready to sign up for health coverage — many even brought pay stubs and income documentation — but not a single one had an e-mail address.

“If you don’t include an e-mail address, they won’t let you through,” said Christela Gomez, the special-projects coordinator and lead certification application counselor at the center. “Quite a few didn’t even know what an e-mail address was,” she added.

In the District, Stephanie Schmalzle, a 26-year-old actress who has been uninsured since March, said she would likely start browsing plans Tuesday night.

“I don’t feel that just because I’m young and healthy that I don’t need health insurance,” Schmalzle said. “Anything can happen to anyone.”

The spotty nature of opening day was evident in surprising ways across the Washington area Tuesday. In the District, where D.C. Health Link had announced just days ago that it was not ready to help customers figure out whether they qualify for subsidies, the exchange’s Web site functioned smoothly in other ways from the moment it opened at 8 a.m.

Maryland, heralded as one of the best-prepared states, was beset by problems throughout the day. Its Web site’s opening was delayed until noon and, after that, was slow — and sometimes inaccessible — through much of the afternoon.

The initial hiccup was a problem in the interface between the exchange’s Web site and local health departments, said Joshua Sharfstein, Maryland’s health chief. Once that was resolved and the site opened, it proved to be a victim of its own popularity, he said.

“We had as many as 1,000 people a minute trying to create accounts,” leading to an electronic bottleneck that had not been expected, he said. “The silver lining is, we are certainly finding a huge amount of interest. ”