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Buzz about Obamacare exposes bugs in the system

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The debut of Obamacare was so successful Tuesday that the program didn't work very well.

That, in a nutshell, was the split verdict reported by state and federal officials, who said tremendous interest in the state-based health exchange markets was so strong that it overloaded the websites designed to help uninsured Americans find coverage.

"If this doesn't show the hunger the American people have to sign up for health care, I don't know what does," Senate Majority Leader Harry Reid, Nevada Democrat, said at a pep rally to tout the opening of the exchanges, which are a centerpiece of the Affordable Care Act.

Top Republicans, though, said the first-day glitches prove Obamacare is not ready and that Democrats should have heeded GOP calls for a delay.

"Today, across the country, Americans are attempting to purchase health insurance on Obamacare exchanges and are being met with crashing websites, missing price information, confusing forms and, in some cases, exchanges that had to delay their start date because they aren't ready yet," said Rep. Darrell E. Issa, California Republican and chairman of the House Oversight and Government Reform Committee. "These 'glitches,' which the president is trying to brush off, reveal how totally unprepared the government is for this launch even with 3½ years to prepare."

The law's supporters — including President Obama in remarks in the Rose Garden — said opening-day verdicts are premature and that heavy interest signals rosier days ahead for the exchanges because many consumers will sign up weeks later and should find a full suite of services.

Federal website HealthCare.gov attracted 2.8 million visitors by midafternoon, officials said. That appeared to be more users than the website could handle, prompting error messages that pleaded for patience because there were "a lot of visitors on our site now."

"That gives you a sense of how important this is to millions of Americans around the country, and that's a good thing," Mr. Obama said.

The online exchanges allow people without employer-based coverage to shop for private health care plans, often with the help of income-based government subsidies. Open enrollment lasts until the end of March, although consumers must sign up by Dec. 15 to have coverage at the start of January, when the individual mandate requiring all Americans to have insurance takes effect.

Three years after the law's passage, the exchanges are considered one of two linchpins of the law — the other is the expansion of Medicaid in states that choose to do so — that could determine whether Mr. Obama's signature vision is a success or failure.

The Centers for Medicare and Medicaid Services declined to release enrollment figures from its federally run exchanges, saying it would release them regularly at points in the future, although several states were able to release detailed data.

D.C. Health Link reported 3,356 accounts on the capital city's exchange. Among them, 398 completed applications and four consumers completed enrollment, including payment.

But some state-run exchanges experienced problems with their security-question functions, while others were overwhelmed. The New York State exchange reported 2 million site visits in its first two hours of operation and asked visitors who were unable to log in to come back later.

Opening the portals

Sixteen states and the District of Columbia have set up their own online portals with unique names such as Cover Oregon, Kynect in Kentucky and the Silver State Health Insurance Exchange in Nevada. The rest of the states are relying entirely or in part on the federal government to run their exchanges for them.

The websites should allow consumers to compare the plans, which range from low-cost "bronze" insurance with minimal coverage to high-cost "platinum" programs.

Jon M. Hager, executive director of Nevada's market, said roughly one-fourth of residents in his state were uninsured for a laundry list of reasons, but that obstacles to affordable coverage would fall away through Obamacare.

He said a Spanish-language version of the Nevada exchange will not be ready until November — officials are building it from the ground up to avoid problems from translating the English version — and warned that there will be "hiccups, errors and other bugs that occur."

Members of his staff checked in on the state's online portal after reporters on a conference call said they could not log on at the hour the site was supposed to go live. The delay lasted 17 minutes.

"I apologize for that," Mr. Hager said.

By midafternoon, the Nevada exchange counted more than 1,000 accounts on the site.

The Department of Health and Human Services said Tuesday that all customers can look up information and start the enrollment process through the federal website — or CuidadoDeSalud.gov for Spanish-speaking consumers — no matter where they live.

A D.C. resident, for example, would be directed to the D.C. Health Link Web page, but a resident across the Potomac River in Virginia would remain on the federal site because the Obama administration is responsible for the commonwealth's exchange.

Soft opening

In the midst of Tuesday's hiccups, advocates for the law said it should be considered a soft opening with increased interest over time. They touted early interest on the federal exchanges as "pent-up demand" and a backhand endorsement of Obamacare, despite the error messages.

"To me that says, 'Whoa, everyone's checking this out,'" said Will Wilson. The 59-year-old Chicago resident said he has AIDS but could not, until Obamacare began, obtain coverage related to any other health issues.

The health care law prevents insurers from rejecting people with pre-existing conditions, a key selling point of the law that also has raised questions about whether younger, healthy people are effectively subsidizing the care of older, sicker patients in the individual market.

Republicans tried to delay key portions of Obamacare last week and into Monday night, but the Senate balked at any negotiations over the president's signature law. The resulting government shutdown did not affect the administration's rollout of the exchanges.

Mila Kofman, executive director of the D.C. Health Benefit Exchange Authority, said the fervor about a mile down the road on Capitol Hill was irrelevant to her team's efforts.

"For us," she said, "it's never been political."

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