The federal website that offers a key provision of president Obama's health law launched this week with a sputter, a crash and a lot more web traffic than anyone expected. But by week's end, with most Floridians still unable to access the online marketplace and sign up for health insurance, organizations were trying to build on momentum even though there was little they could do.
Most of the counselors hired through federal grants to help sign people up for health insurance quickly went to Plan B when the website failed Tuesday morning. Several community health centers around the state, fearing the worst, printed paper applications in advance, even translating them into other languages. Other groups took down consumers' contact information, promising to schedule appointments when the website begins to work better.
There was an odd mix of excitement that the Affordable Care Act was garnering so much attention and frustration that it wasn't accessible.
John Foley, an attorney and certified counselor for Legal Aid Society of Palm Beach County, said he's tried unsuccessfully to log into the system almost non-stop since 5 a.m. Tuesday. A frustrated Foley said his navigators would not try again to enroll anyone until Monday.
"I am too worried to even involve a consumer at this point. I would hate to see a problem in the middle of the process," he said. "I am very worried that people will lose faith in the system. Clearly we are losing most, if not all, of the momentum that was built up leading to open enrollment."
But federal health officials cautioned this was just the first week in a six month enrollment process. Consumers don't need to sign up until Dec. 15 to get coverage on Jan. 1. They have until the end up March to sign up to avoid tax penalties.
"This has never been done before and this is a historic moment ... we think that's a tremendous beginning to this program and we're off to a good start," said Julie Bataille of the Centers for Medicare and Medicaid Services.
Federal health officials played up the high volume traffic, noting 7 million visits to HealthCare.gov in the first two days. Employees were working around the clock to fix issues and by Thursday had increased capacity to the server and cut down wait times by one-third. But it's unclear when the problems will fully be resolved. Most people were still unable to access the site on Friday. Key parts of the website were to go dark between 1 a.m. and 5 a.m. EDT Saturday, Sunday and Monday as programmers work to fix glitches.
Cigna, which offers several insurance plans through the exchange, said it had successfully enrolled a small number of consumers Thursday using the website. Counselors at a Miami Gardens enrollment event that night with Sen. Oscar Braynon were also able to access the website long enough to enroll a few people on the spot.
"There have been a lot of successful moments and every event we attend has been overcrowded with people who want to learn more and get a better understanding of the process," said Jerson Dulis, a counselor with Broward Community & Family Health Centers, Inc.
Turnout has been uneven at events to sign up in-person with a counselor. Counselors sat alone at a Pensacola office Tuesday and also at a Fort Lauderdale library for much of Thursday. But at Borinquen Health Care Center in Miami, more than 400 people wanted to sign up for a plan and asked for more information about their options.
Valerie Carr, a 46-year-old Kendall resident, hasn't had insurance in years. She doesn't qualify for Medicaid because she doesn't have children so she pays about $170 a month for medication for her mental illness, plus regular psychiatrist and therapy appointments. Under the new health law, insurers are required to cover certain essential benefits, including mental health, and they are barred from charging more for having those pre-existing conditions. Carr tried to sign up at a community health center in South Miami this week and counselors said they'd contact her when the website was working again.
Federal health officials declined to say how many signed up for health insurance this week and likely won't release those figures until mid-November. It's also unclear whether the problems are only because of high traffic or a combination of programming errors.
The delays come three months after the Government Accountability Office said a smooth and timely rollout could not be guaranteed because the online system was not fully completed or tested. Experts said the Obama administration may have rushed to meet the Oct. 1 deadline.
"If there's not a general trend of improvement in the next 72 hours of use in this is system ... then it would indicate the problems they're dealing with are more deep seated and not an easy fix," said Jay Dunlap, senior vice president of health care technology company EXL.