Public Insight Network

Obamacare insurance exchange off to rocky start

George Sauvigné, a 61-year-old real estate agent from Miami Shores, waited almost three years for Tuesday to arrive — the day when government officials would unveil the centerpiece of the healthcare reform law known as the Affordable Care Act: online exchanges offering subsidized health insurance plans in every state.

But Tuesday didn’t go exactly as planned for Sauvigné and countless others. After several unsuccessful attempts to create an account on Florida’s federally-run exchange at, Sauvigné realized he’ll have to wait for the computerized system to be fixed before he can shop for a health plan that will no longer be able to exclude him for having a pre-existing medical condition, potentially saving him hundreds of dollars a month in premiums.

“Medical care has been getting crazier and crazier over the years,’’ he said. “I want lower rates and better options.’’

How long will Sauvigné have to wait?

That’s anybody’s guess, as widespread technical problems rendered the website useless for the many who tried to shop for health plans on the first day.

Though government officials said the website’s problems had been fixed, as of Tuesday night many were still unable to get past the first step: creating an account necessary to shop for health plans and enroll for coverage, which will be subsidized for eligible low- and middle-income families.

Officials with the Center for Medicare and Medicaid Services, the federal agency administering online exchanges in 34 states that elected not to create their own, attributed the technical problems to an overwhelming number of people trying to access it at once.

During a Tuesday press conference to address the government shutdown triggered by a political standoff over the health reform law also known as Obamacare, President Obama said more than one million people had accessed the site before 7 a.m.

About three hours later, CMS Administrator Marilyn Tavenner said the number had gone higher: “More than 2.8 million people have visited since midnight.’’

Tavenner gave no explanation for the website’s technical problems other than citing an overwhelming number of visitors in a short time. And though, during a conference call with reporters, she insisted that the glitches had been fixed, continued to exhibit the same problems several hours later.

Tavenner and other federal officials emphasized that initial glitches are to be expected with an unprecedented rollout of such large technological magnitude, and they noted that a majority of Americans — about 85 percent — do not need to shop for plans on the online exchanges because they already receive some form of health insurance, either through an employer-provided plan or a government program such as Medicare and Medicaid.

Federal officials also noted that the enrollment period runs through March 31, though consumers must sign up by Dec. 15 for coverage to begin Jan. 1. And they pointed consumers to other resources: as a toll-free number with live operators offering assistance in 150 languages, a live chat function on the online exchange and a network of in-person assistors to help people through the process.

But none of those resources could help consumers consider the hundreds of plans available in Florida, verify eligibility for premium subsidies or enroll for coverage on the choked-up, online exchange also called an insurance marketplace.

Some information was made available. Prices for health plans in states with federally-run exchanges were posted to late Tuesday afternoon, giving consumers a glimpse at the many plans and prices offered by insurers. But the posting did not include important plan details such as provider networks, deductibles and copays.

The persistent technical problems that consumers encountered were far from the seamless shopping experience described by President Obama, who likened the exchanges to online retailers, such as

At one point in the day, the overwhelmed website simply shut down.

“We’re working to resolve the issue as soon as possible,” a message on told users. “Please try again later.”

Before the site shut down, users who attempted to create an account were guided through various steps, such as choosing a user name and password. But the process ground to a halt when users reached a page asking “security questions” for the account; the drop-down menu of questions produced none.

Later in the day, the drop-down menu began to function properly, but the site was still unable to register new users, displaying a red box with a message that the system was down. was not the only online exchange facing technical difficulties Tuesday, however. At least 17 states are operating their own online exchanges, and they too reported high traffic in their first few hours of business and problems that kept consumers from signing up.

Maryland’s exchange crashed early Tuesday morning. Minnesota said its site wouldn’t operate until Tuesday afternoon. Vermont said it would not be ready to accept online premium payments until November, and in Washington, D.C., enrollees could not verify their subsidy eligibility.

Despite widespread problems with the state and federal exchanges, though, Tavenner said that some consumers did succeed.

“We can confirm that people have enrolled through the state marketplace and the federally facilitated marketplace,’’ she said.

But Tavenner wouldn’t divulge how many consumers had created accounts or enrolled on the first day.

For Florida, where an estimated 3.8 million people live without health insurance, the exchanges could make an especially big impact. The state ranks near the top of the nation in terms of plan choices, with an average of 102 health plans offered on the federally-run exchange.

Like many consumers who visited the exchange website, Sauvigné of Miami Shores was hoping to find a better deal on health insurance.

He has two pre-existing conditions, takes four prescription drugs daily and currently is insured by Florida Blue , paying what he called “ridiculous prices.” In 2011, he paid $475 a month; in 2012, $536 a month.

Now, the premium is up to $628.

“All of that with a $10,000 deductible,’’ he said. “I call it disaster insurance.’’

Florida Blue is offering dozens of plans in Miami-Dade through the exchange, but Sauvigné could not see any of them on Tuesday because after repeated attempts to create an account on the security question dropdown box did not work. The “live chat” function failed, too. So he gave up — for the day.

“This isn’t upsetting for me now because I know I can’t start receiving coverage right away,’’ Sauvigné said. “If I can’t sign up today, I’ll do it tomorrow, or the next day.’’

Across South Florida, which home to the greatest numbers of uninsured residents in the state, many consumers said they were willing to wait to find an affordable health plan.

Robert Leaver, 51, of Flagami, visiting a local outreach event at a United Way office in Miami, said he was eager to shop on the exchange because his current plan is too expensive, and it does not cover acupuncture and physical therapy treatments recommended for a neurological disorder diagnosed last year.

“I was stuck,” Leaver said of his current insurance. “I couldn’t leave because of my preexisting condition. No one else would take me.”

A substitute teacher and freelance musician, Leaver said he stayed up until midnight — when the plans were scheduled to go on sale — to check out the offerings.

Then he ran into a wall of technical problems on the site. He couldn’t get past the security questions. He tried again at about 6 a.m., and still couldn’t get through.

“I clicked refresh, refresh, refresh,’’ he said. “I got nothing.”

Leaver said he was not discouraged. He expected some problems on the first day of enrollment.

“For a government website, I was actually impressed,” he said. “I’m giving them a chance. I’m not stressed about not being able to enroll today.”

Miami Herald writers Evan S. Benn, Patricia Borns and Kathleen McGrory contributed to this report.

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

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