Wendy Jackson, with Independence Blue Cross, provided information on health care reform at Suburban Station in Philadelphia, on Tuesday.
The insurance exchanges at the core of President Obama’s health care law began operation Tuesday, with federal, state and insurance industry officials watching closely, unsure of what to expect from the rollout.
Monday morning, healthcare.gov, the federally run exchange, posted an error message saying high volume had slowed the system. “Please wait here until we send you to the login page. Thanks for your patience!” the message read. A state-run exchange in Maryland also posted a message saying it was “experiencing connectivity issues” and asking visitors to return at noon.
Most predictions have been for a trickle of new customers at first, with polls showing that many Americans remain uncertain about the purpose of the exchanges and unconvinced that the law will help them. The exchanges are online markets where people can shop for health plans and see if they qualify for federal subsidies.
Despite months of feverish preparation, few officials are sure the exchanges have overcome a range of problems that have plagued the system in many states, including with Spanish-language versions, subsidy calculators and programs to enroll small businesses.
Nor can officials do more than guess how many of the tens of millions of people who are supposed to buy private coverage through the exchanges will do so in time to meet the law’s Jan. 1 deadline for obtaining insurance.
The stakes are immense for Mr. Obama, whose signature achievement is the 2010 law that is supposed to push the United States closer to universal health care. Defending the law in the 2012 campaign, he defeated a Republican opponent, Mitt Romney, who vowed to repeal it.
A trouble-plagued launching, accompanied by the complaints of frustrated consumers, could undermine political support for the law, while tepid participation by the uninsured could weaken its financial underpinnings, which depend on the largest possible number of people paying into the system. The logistics of the new online system are daunting, relying on links to government records to verify citizenship and eligibility for subsidies, and to thousands of different coverage combinations offered by insurers.
The Republican majority in the House, which has voted more than 40 times to overturn the law, has refused to approve financing to continue government operations unless that bill also strips money from the law, the Affordable Care Act, often referred to as Obamacare. With Mr. Obama refusing to accede to Republican demands, Congress failed to act to keep the government financed Monday, producing a partial government shutdown on Tuesday.
Obama administration officials said the opening of the new exchanges would not be affected by a shutdown. But the exchanges went into operation on Tuesday morning with limited fanfare, even among their supporters. The insurance marketplaces, accessible through the Internet and, depending on the state, a patchwork of telephone hot lines and in-person locations, are intended to give uninsured people a choice of coverage plans, often at lower prices than they have been able to find on the open market. To meet a Jan. 1 deadline, those people must buy a plan by Dec. 15. State officials have said they do not expect to see large numbers of consumers buying until November.
In 34 states, the federal government is entirely or partially running the exchanges, because the states declined to do so. That federally operated system also had its share of glitches in the run-up to Oct. 1.
