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Obamacare exchanges debut with websites down and state delays

Published: Tuesday, Oct. 1 2013 11:18 a.m. MDT

In this Thursday, July 18, 2013, photo, President Barack Obama stands with families who benefited from the health care law provision that provides consumers with a refund if their insurance company doesn’t spend the majority of premium dollars on medical care, as he speaks about health care reform and the Affordable Care Act in the East Room at the White House in Washington. In his speech, Obama said rebates averaging $100 are coming from insurance companies to 8.5 million Americans. In fact, most of the money is going straight to employers who provide health insurance, not to their workers, who benefit indirectly. (AP Photo/Charles Dharapak, File) (Charles Dharapak, Associated Press) In this Thursday, July 18, 2013, photo, President Barack Obama stands with families who benefited from the health care law provision that provides consumers with a refund if their insurance company doesn’t spend the majority of premium dollars on medical care, as he speaks about health care reform and the Affordable Care Act in the East Room at the White House in Washington. In his speech, Obama said rebates averaging $100 are coming from insurance companies to 8.5 million Americans. In fact, most of the money is going straight to employers who provide health insurance, not to their workers, who benefit indirectly. (AP Photo/Charles Dharapak, File) (Charles Dharapak, Associated Press)

NEW YORK — The Obamacare insurance exchanges got off to a rocky start Tuesday, with many websites meant to provide new access to the uninsured seeing delays or breakdowns. New York's exchange was swamped with 2.5 million visitors in the first half-hour, officials there said.

The U.S.-run marketplace meant to serve 36 states was unresponsive early Tuesday, with messages saying the site was dealing with "a lot of visitors" or simply "down." Federal officials are aware of the delays and working on fixing them as quickly as possible, said an administration official who wasn't authorized to speak about the issues on the record.

Of the 14 states and Washington D.C. that have their own exchanges, only four — Massachusetts, Rhode Island, Colorado and Washington, D.C. — appeared to be up and ready for business between 9:30 and 10:30 a.m. New York time. After New York's website began displaying error messages, state officials began advising people on Twitter to call to sign up, and said wait- times at the state call center were about 10 minutes.

"The not-so-good news is the wheels aren't turning as quickly as they could," said Cesar Perales, New York's secretary of state, at a news conference in New York City. "We are doing something that has never been done before."

The exchanges, created by the 2010 Affordable Care Act, struggled as the United States faced its first partial government shutdown in 17 years, borne of Republican opposition to the law. The shutdown didn't delay the opening of the new markets because they are funded largely through mandatory spending not affected by the budget showdown in Congress.

The federal exchange began posting error messages for at least 24 of 36 states as of 8 a.m. Washington time, Reuters reported. The Obama administration needs some breathing room, said Kathleen Sebelius, the HHS secretary, at a briefing with reporters yesterday. She compared the exchanges to Apple Inc.'s new mobile operating system, which the company upgraded days after its debut to correct a flaw.

"No one is calling on Apple to stop selling devices for a year or to get out of the business," Sebelius said. "It's a reminder that we're likely to have some glitches. We'll fix them and move on."

Would-be enrollees don't have to complete the process until Dec. 15 to guarantee coverage starting in Jan. 1. They may be dissuaded from signing up this month because the first premium payment to their insurer is due within 30 days of enrollment.

Still, the problems offer an embarrassing debut for a system at the heart of the Obamacare's efforts to cover more of the 48 million uninsured Americans. The exchanges are supposed to help consumers access federal subsidies and choose from a menu of private insurance plans that take effect Jan. 1, when the law requires all Americans to obtain insurance.

"We have built a dynamic system and are prepared to make adjustments as needed and improve the consumer experience," Joanne Peters, a spokeswoman for the Health and Human Services Department, said in an email. "This new system will allow millions of Americans to access quality, affordable health care coverage."

The Obama administration had warned of early glitches for weeks and even states that have cooperated with the law's rollout had downplayed today's debut, saying they wanted to avoid having their websites and call centers overwhelmed.

Maryland pushed back the planned 8 a.m. opening of its online marketplace until noon, according to a message on its website that said the exchange was "experiencing connectivity issues."

At the Community Clinic Inc. in Silver Spring, Md., clinic, "navigators" trained to help people enroll handed out fliers with details on the exchange offerings, or mad e appointments for people to come back later.

"It was supposed to be up," said Apoorva Srivastava, one of the navigators, "so there's not all that much we can do."

In Minnesota, which built its own exchange, residents can check prices and determine if they qualify for subsidies on the new MNsure website. They weren't able to sign up until the afternoon at the earliest, after a final check to ensure the state can properly share data with the federal government, said April Todd-Malmlov, MNsure's executive director, on a conference call with reporters.

Consumers won't be able to get in-person help from navigators or other groups designated to assist in the registration process until tomorrow at the earliest, Todd- Malmlov said. The 5,000 individuals preparing for those positions still need to complete training and clear background checks, she said.

"Consumers will have plenty of time to evaluate their options," Todd-Malmlov said. "We are anticipating there will be a lot of interest in the site, but we don't anticipate there will be a lot of applications in the first few weeks."

Republicans, who control the House, had demanded a delay or dismantling of the health law as part of the funding bill. Democrats, who make up the majority of the Senate, refused to concede. The budget fight may actually help by diverting attention away from the rollout, said Sanjay Singh, chief executive officer of hCentive Inc., a Reston, Va.-based software company working on the exchanges.

"Because they haven't had the time to really put the system through its paces, they are happy to see a softer kind of launch, where the traffic will be small the first couple of weeks," Singh said in a telephone interview.

The $1.4 trillion law requires most Americans to obtain health insurance starting next year or pay a fine. To make finding coverage easier, the law set up government-run exchanges in each state where most consumers can buy plans from insurance companies with the help of tax credits.

About two-thirds of uninsured people said they plan to buy medical coverage next year rather than pay a fine, according to a Gallup poll published Monday.

The Obama administration is seeking to get about 7 million people to buy plans through the exchanges in the open enrollment period that starts today and runs through March.

"It's going to be judged on Oct. 2 as a failure by opponents of reform because 7 million people haven't signed up," said Kevin Counihan, the director of Access Health CT, Connecticut's exchange. "The reality is nothing like this begins with great fanfare."

More than 900 businesses, community groups and other organizations have agreed to voluntarily promote the law and help people sign up. Retailers Wal-Mart Stores Inc., CVS Caremark Corp., Walgreen Co. and Rite Aid Corp. plan to promote coverage in their pharmacies.

Wal-Mart, the world's largest retailer, has invited insurance company representatives to about 3,500 stores starting in mid-October to promote their plans, said Dave Tovar, a spokesman for the Bentonville, Ark.-based company.

The government also announced a contract with the Blue Cross Blue Shield Association, the umbrella organization for 37 state and local insurance companies, to sell health plans in 30 states, including three that previously had only one carrier participating in their exchanges.

People eligible for coverage can go to healthcare.gov to find their state's insurance exchange. Monthly prices for the lowest-tier of plans average $249 nationwide. People with incomes less than about four times the poverty level will get discounts on their premiums by way of tax credits. For a family of four, that means those with incomes of less than about $94,000 qualify for the credits.

People with incomes under about 1.4 times the poverty level may be able to enroll in expanded Medicaid programs for the poor in about half the states.

_ With assistance from Meg Tirrell and Shannon Pettypiece in New York and Stephanie Armour, Alex Wayne and Anna Edney in Washington.

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