Live Blog: Exchanges Launch, Government Shuts Down

It’s Oct. 1, which means that the online insurance marketplaces created by the Affordable Care Act are launching. But it also means that the start of the new federal fiscal year was marked by a government shutdown.

KHN helps you make sense of the day’s developments on this live blog and with our coverage of the important stories of the day.

5:10 p.m. — FINAL UPDATE:  In a late afternoon press call, Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner offered some thoughts on the launch of the health law’s online insurance marketplaces.

The federal website, www.healthcare.gov, saw seven times more traffic Tuesday than Medicare.gov ever had, she said, adding, “This is certainly a historic day.” And, when asked why several state exchanges did not launch, Tavenner replied, “We are pleased with the progress states are making. They have experienced extraordinary volume to their sites and call centers.”

“This is day one of a six month process,” she said. “We are pleased with the remarkable interest we have seen.”

That’s the end of today’s live blog. Thanks for hanging out with KHN today.

3:56 p.m.: These updated figures were just passed on by KHN’s Phil Galewitz: HHS spokeswoman Joanne Peters said, “Since midnight 2.8 million people visited healthcare.gov.  Additionally, 81,000 have called 1-800-318-2596, and 60,000 have requested live chats.”

3:47 p.m.: In the Golden State, KQED’s Lisa Aliferis reports that Covered California, the state’s health insurance exchange, reported at 8:46 a.m. that one person was officially “on board.” Later, at a press event, Peter Lee, the marketplace’s executive director, explained that some people may be experiencing delays because the site is getting 10,000 hits every second. Officials don’t expect a wave of applications immediately because the process of comparison shopping and filling out the application is time consuming.

“Washington is talking about shut down. California is talking start up,” Lee said, according to KHN’s Sarah Varney, also reporting from California.

3:44 p.m.: In an interview on MSNBC’s Andrea Mitchell Reports, Health and Human Services Secretary Kathleen Sebelius characterized the technical problems that have been experienced on the federal online marketplaces so far as a great problem to have because they’re “based on the fact that the volume has been so high.” She also noted that the health law is not being stopped because of the federal government shutdown.

3:00 p.m.: KHN is also tracking media coverage of President Barack Obama’s Rose Garden remarks in which he said federal officials will overcome the day’s technical glitches. Check out the news summaries.

2:58 p.m.: WNPR’s Jeff Cohen reports that Connecticut’s exchange, Access Health CT, so far today has been “glitchy at best, and offline at worst.” The site went live shortly after 9 a.m. ET, and by 9:30, someone had already enrolled. “But throughout the morning, it was nearly impossible to get the Web page to load.”

KHN’s Phil Galewitz reports the latest from Hawaii, which has 100,000 uninsured, or about 10 percent of its population. The state did not launch its online enrollment today, and it could take until Friday for people to be able to shop and purchase plans. On the marketplace website visitors can fill out a short form, and the Hawaii Health Connector “will contact you in the coming weeks … to inform you of your eligibility and plan options.” The Honolulu Star-Advertiser reports sources have told them exchange officials hoped to have the software problems resolved by Friday.

2:44 p.m.: At Bloomberg News, Alex Nussbaum offers a look at the big picture, reporting on the range of delays and difficulties websites have experienced so far. “The U.S.-run marketplace meant to serve 36 states was unresponsive early today, with messages saying the site was dealing with ‘a lot of visitors’ or simply ‘down,’” he reported. Meanwhile, “Of the 14 states and Washington D.C. that have their own exchanges, only four — Massachusetts, Rhode Island, Colorado and Washington, D.C. — appeared to be up and ready for business between 9:30 and 10:30 a.m.,” he wrote.

Here’s some state-specific news:

KHN’s Ankita Rao reports on the rollout in Maryland: “A morning website snafu was ‘both expected and unexpected’ for Maryland Health Connection workers on Oct. 1, said Mary Anderson, a public information officer at the Montgomery County Department of Health and Human Services. After months of planning, outreach and training outreach staff, she said the online Maryland exchange attracted a moderate number of visitors and was up and running Tuesday afternoon. Anderson said she advised people looking for health care plans to look carefully at their options and wait until some of the initial glitches in the system were smoothed out before enrolling. Meanwhile, she attended an exchange launch event at Rockville Town Center and said the state had started processing paper applications immediately. ‘Our team is pleased with how things are going; they’re pleased with our readiness,’ Anderson said. ‘But they’re not breathing freely yet because they know this is just the beginning.’”

According to The Seattle Times, a KHN partner, Washington’s site has been effectively down from the start. State officials say they’re making repairs and that it’s not a capacity problem. More details available in the Seattle Times’ Healthcare Checkup blog.

The Las Vegas Sun reports that the state’s Silver State Health Exchange website, despite launching 17 minutes later than it was scheduled to, was up and running and its call center opened on time.

And Health News Florida reports that Florida’s online marketplace opened Tuesday for browsing at healthcare.gov, with only 34 licensed “navigators” ready to offer advice to the millions who may need it.

2:20 p.m.: It’s a busy day, and a little humor seems to be in order. And for some people, a segment from last night’s Daily Show called “Jon Stewart’s Rockin’ Shutdown Eve” might help. Stewart attempted to explain the battle lines and rules of engagement in the congressional fight over the health law – which he dubbed “The End of America as We Know It for Reasons No One is Able to Clearly Explain” – and the government shutdown. He even sites sources ranging from the Constitution and Schoolhouse Rock to the NFL.

If you don’t want to watch The Daily Show excerpt, Schoolhouse Rock is also highly recommended.

2:00 p.m.: This afternoon, after President Barack Obama met in the Oval Office with a group of people who are benefiting from the health law, he headed outside to the Rose Garden, where he again urged Republicans to reopen the government and abandon their efforts to stop implementation of the Affordable Care Act.

“This shutdown is not about deficits. It’s not about budgets. This shutdown is about rolling back our efforts to provide health insurance to folks who don’t have it,” Obama said.  “This more than anything else seems to be what the Republican Party stands for these days. I know it’s strange that one party would make keeping people uninsured the centerpiece of their agenda.”

Obama also said that more than a million Americans had visited www.healthcare.gov this morning. “There were five times more users this morning than have ever been on Medicare.gov at one time.  That gives you a sense of how important this is to millions of Americans around the country,” he said. But he also acknowledged that there had been problems. He said the traffic had caused the site to be temporarily unavailable but noted that fixes would be made today to handle the demand.

“We’ll be speeding this up in the next few hours to handle all  this demand that exceeds anything we expected,” he said.

1:50 p.m.: An update from Eric Whitney, reporting for Colorado Public Radio, on how things are going for Connect for Health Colorado, the state’s online insurance marketplace: It’s open, he says, “but not 100% functional on this, its first day.” He reports that people using the website have been able “to shop for plans, get prices and find out whether they qualify for new tax subsidies to help them afford coverage. But they’re not able to create accounts and actually buy health policies today.” Wait times for callers using the toll-free phone number that supports the portal are reportedly running at least 10 minutes today.

1:25 p.m.: KHN’s Phil Galewitz reports that, as of 1 p.m. ET, three state exchanges were not up and running. Minnesota’s online marketplace, MNSure, was scheduled to go live Tuesday afternoon after “several last-minute test and security checks,” according to Minn Post. Officials in Hawaii are ready to flip the switch for the Hawaii Health Connector at 8 a.m. local time, which is 2 p.m. ET.

At last check, Washington Health Plan Finder was still experiencing difficulties.

1:12 p.m.: Celebrities who tweeted their support for the Affordable Care Act today include singer John Legend, actress Mia Farrow, celebrity chef Tom Colicchio, talk show host Conan O’Brien and sports star Magic Johnson, according to National Journal. Katie Perry tweeted “YO what a day!” Even the boy band ‘N Sync joined the Twitter chorus, offereing encouragement: “Love, hate, or just confused by it -learn all you can about the Affordable Care Act…”

Meanwhile, Jimmy Kimmel decided to seek the opinions not of celebrities, but of passers-by on Hollywood Blvd. about Obamacare vs. The Affordable Care Act.

1:03 p.m.: Here are two dispatches from NPR member station reporters in Texas, offering vignettes from an application counselor as well as uninsured patients who were signing up for coverage.

Stephanie Pollock (Photo by Carrie Feibel/KUHF)

Reporter Carrie Feibel of KUHF interviewed Stephanie Pollock, a certified application counselor working at Gateway to Care, a nonprofit health network that serves the uninsured in Houston. Pollock was working the phone bank on Monday when she took a call from a woman who said  her husband has a heart condition and she is diabetic and insulin-dependent. The woman told Pollock that they cope with not being insured by alternating who gets to take medicine each day.

Fiebel recounts the conversation with Pollock: “‘One day I take my insulin, and then the next day he takes his heart meds. Because we can’t afford a whole month’s.’ And she started crying and saying, ‘Do you know you’re saving our lives? We’re gonna live, we’re gonna live!’ And I almost started crying because I thought this is the face of America that we’re talking about, that we’re changing lives.”

In Dallas, KERA’s Lauren Silverman went to Parkland Hospital, the city’s large public hospital where many of the city’s uninsured are treated.  Silverman met with three people signing up for Obamacare on Tuesday morning, one in Spanish and two in English.  They all had to complete paper applications because the website was down, so they had no access to details about the health insurance plans — including what the plans would cost them.

12:55 p.m.: As tensions run high in on Capitol Hill over effort to derail the health law, even if it means keeping the federal government shuttered, The Onion raises an important question: Is this a showdown or a hoedown?

12:25 p.m.: Just hours into a process that will last six months, some state exchanges are reporting traffic to their websites while others are noting difficulties. Here’s a sampling of what we’re hearing:

Kentucky: Kynect, the state’s online marketplace, had more than 1,000 applications for coverage by 9:30 a.m. ET. The site went live at midnight, and more than 24,000 people have browsed the site so far today.

New York: New York’s marketplace, the New York State of Health, reports 2 million visits in the first 2 hours of the site launch. Because of this volume, some visitors are seeing a message letting them know the site is currently having log in issues and encouraging users who are unable to log in to come back to the site later.

Connecticut: Access CT reports that it has logged 10,000 visitors in the last 3 hours, with 22 enrollments so far.

Maryland: Maryland’s online portal, the Maryland Health Connection, has experienced connectivity issues since it went live at 8 a.m. ET but expects to be operating by midday, according to The Baltimore Sun.

Washington: The state’s Washington Health Plan Finder exchange website experienced difficulties and “went down for maintenance” as it launched, according to The Associated Press. Shortly after the site’s launch at 7:30 a.m. PT, officials released the following statement: “We became aware that some users were experiencing slow loading times or difficulty completing their application. While this is not affecting all users, we want to investigate the root cause for why this is happening and will be placing the site in maintenance mode in order to identify and correct these issues. We expect to have an update at 9:30 a.m. [PT]”

11:58 a.m.:  HHS spokeswoman Joanne Peters reports that healthcare.gov had over 1 million visits in the last day. She says this is five times more users than have ever visited Medicare.gov at once. It might be part of why the twittersphere is full of talk of long waits and other frustrations.

KHN’s Phil Galewitz decided instead to take a different route: to call the consumer hotline to search for prices for individual coverage in Florida. Here’s what he reports happened: When he pressed zero to ask for a hotline representative, he was informed the wait would be at least 20 minutes. Luckily, he says, it was only 10 minutes. But it wasn’t entirely smooth sailing from there. “I gave the representative my name and address and then was disconnected,” he says. He then called back and waited a full 20 minutes before reaching a hotline rep. This time she took his name, address and phone number, but she then told him if he wanted any information on the health plans, including premiums and benefits, he had to go to www.healthcare.gov.  She apologized again and again for they delays and stressed he had until Dec. 15 to sign up for coverage to get enrolled this year and how open enrollment runs through March. When he asked the representative where she was, she refused to answer only saying “Southeast.”  She said she was not allowed to say where she was.

11:22 a.m.: In addition to being launch day for the health law’s online marketplaces, it’s also day one of the federal government shutdown – the first one in 17 years. President Barack Obama is scheduled to meet at noon today in the Oval Office with a group of people who will benefit from the health law. Afterwards, at approximately 12:25 p.m., he will speak in the Rose Garden.

11:12 a.m.: In Connecticut, it’s official. Someone got health coverage from Obamacare. By 10:50 a.m. today the state’s health exchange, Access Health CT, reported that they have completed their first enrollment: a family of three. They are believed to be the first state to announce this milestone. Here’s their tweet:

But the Connecticut marketplace has its own growing pains. Here’s a message from its website:

WARNING: The information shown is not a legal contract. Access Health CT (AHCT) acknowledges that there are some inaccuracies on the shopping screens. For example, cost sharing for out of network benefits should apply only after the deductible is met; the skilled nursing benefit should show a 90 day visit limit; and the standard silver plan’s specialty drug tier should show a 40% co-insurance after the prescription deductible is met. The insurance carriers have provided the exchange with complete and accurate information about each plan. You can view this information by clicking on the “Detailed Plan Documents” (PDF) link, found above the Apply button for each plan. We strongly advise you to review this information before selecting a plan. The inaccuracies are created by the AHCT system. Until these inaccuracies on the plan summary and plan comparison screens are corrected, an AHCT representative will contact you to review and confirm benefits, rates and the health plan selected before your enrollment is finalized.

11:05 a.m.: Eric Whitney reports from Colorado that the state’s online site – Connect for Health Colorado — is open and allowing people to browse plans and prices. However, its subsidy determination is not working. Consumers receive the following message when they enter their information to check on eligibility for subsidies: “”Thank you for your patience while we work to fix a technical issue. Please contact us at 1-855-PLANS-4-YOU (1-855 752-6749) if you need assistance.”

10:47 a.m.:  KHN’s Jay Hancock and Ankita Rao report on the marketplaces launching this morning, but many consumers are being greeted by delays, hiccups and crashes.