The six-month period to enroll for health insurance under the Affordable Care Act ended on Monday much as it began in October: with computer problems that prevented consumers from signing up through the HealthCare.gov website.
But unlike the glitch-addled launch of the federally-run website that serves 36 states — including Florida — the closing day included tangible measures of success, with the Sunshine State emerging as a leader in enrollment.
Of the more than 6 million Americans who selected health plans through February, more than 440,000 were Floridians — exceeding every other state relying on the federally-run insurance exchange, according to the Department of Health and Human Services.
An additional 125,000 Floridians were assessed eligible for Medicaid, the state-federal health program for the poor, HHS reported.
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Many of Florida’s sign-ups came from Miami-Dade, which is home to the state’s highest number of uninsured residents.
April Washington, a regional government relations director for HHS, said Miami-Dade led Florida in sign ups and was the nation’s second-most enrolled county as of March 15.
Yet even with those successes, questions about the health law remain. To what extent has the law reduced the number of uninsured Americans, estimated at 45 to 48 million people before October? Did enough young or healthy people enroll to balance out the sicker and older in the risk pool? And how many of those who selected a health plan have paid their first month’s premium?
Those questions might not be answered for months or longer as federal health officials analyze and release enrollment data.
But the demand for health insurance among Miami-Dade residents remained strong through Monday.
At Borinquen Medical Centers, a network of federally qualified health clinics in Miami-Dade, enrollment counselors arrived at 8 a.m. Monday to find consumers waiting.
Strong interest lasted well into the afternoon, despite glitches with the federal exchange website, said Robert Linder, chief executive of Borinquen.
“People were coming in like a stream,” Linder said. “Today was the busiest day we’ve had, by far.”
Many consumers who were locked out of the federal exchange by computer glitches were given time- and date-stamped slips with appointments to return within the next two weeks to complete enrollment, said Linder, who added that Borinquen counselors have signed up about 3,000 people for health plans since October.
Under the law, enrollment ends at 11:59 p.m. Eastern time for the 36 states served by the federal exchange.
The Obama administration said last week it will accept enrollment after the deadline from anyone who began the process earlier.
Fabien Levy, an HHS spokesman, said an overwhelming number of visitors on Monday caused the website to trigger a system that asks consumers to leave their email address and return later to complete their enrollment.
“We are experiencing record volume on HealthCare.gov today,” Levy said, noting that the website had received 1.2 million visits through noon Monday, with more than 125,000 concurrent users at its peak through the afternoon.
Josue Maldonado, a 27-year-old student who lives with his parents in Kendall, avoided that problem by enrolling late Sunday, he said.
“The whole process, from creating a profile to finishing enrollment, took about three hours,” he said.
Maldonado said he waited until the final days to enroll because of the problems with HealthCare.gov and to find the best policy for himself.
He chose a platinum-level plan with dental coverage, which covers 90 percent of his healthcare costs, for a monthly premium of $346.
Maldonado said the plan — his first time buying one — cost more than he had hoped to spend, and that he did not qualify for financial aid to pay his premiums. But his choice, Maldonado said, gave him peace of mind.
“Looking at the other plans,” he said, “it would seem pointless to go with a plan that was going to cost me $100 a month but with a $7,000 deductible.”
Maldonado’s choice appeared to be the exception among Miami-Dade consumers.
According to local enrollment counselors and insurance agents, many consumers — especially those who qualified for federal financial aid — chose plans with the lowest monthly premiums.
Insurance agent Raymond Francois, one of 40 agents who teamed up to sell health plans to South Florida’s Haitian-American communities, said his Miami-Dade customers overwhelmingly chose the lowest-priced silver-level plans offered by Preferred Health Insurance and Coventry Insurance Florida.
And Mercy Cabrera and Odalys Arevalo, co-founders of insurance agency Sunshine Life & Health Advisors, estimated their 60-plus agents have enrolled 20,000 to 30,000 people from Miami-Dade’s Hispanic communities who favored the same lower-cost plans.
But even with six months to consider options, not all eligible consumers were ready to decide on the final day of open enrollment.
Rosa Corea, who works at a plant nursery in Homestead, has been considering her choices since October, when a group of federally-funded counselors known as “navigators” met with her and 48 other workers at Plants In Design to inform them about the health law.
At the time, Corea said she was paying down a $36,000 hospital bill in $50 increments after her husband was injured in a car accident. She was not sure that her family could afford health insurance.
On Monday, she was still unsure whether to get covered or pay a fine of as much as 1 percent of her annual income.
“I’ll probably do it after work,” Corea said, “but I still worry I won't be able to afford it. Health insurance would be another bill I have to take care of.’’
For those who don’t sign up by Monday and aren’t eligible for an extension, enrollment opens in November for coverage starting in January 2015.
This story was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.