CHICAGO - Americans got their first chance Tuesday to shop for health insurance using the online marketplaces that are at the heart of President Obama's health care overhaul, but government websites designed to sell the policies struggled to handle the traffic, with many frustrated users reporting trouble setting up accounts. But such glitches were expected, as tens of millions of Americans without health insurance searched the sites for affordable coverage.
State and federal agencies were working to fix the sites, which represent the biggest expansion in coverage in nearly 50 years. There should be time to make improvements. The open-enrollment period lasts for six months.
Administration officials said they were pleased with the strong interest. At least 2.8 million people had visited the healthcare.gov website as of Tuesday afternoon, said Medicare administrator Marilyn Tavenner, whose office is overseeing the rollout of the Affordable Care Act. The website had seven times the number of simultaneous users ever recorded on the medicare.gov site.
In Obama's home state, dozens of people who came to a Champaign, Ill., public health office to sign up for coverage found computer screens around the room flashing an error message: "System is unavailable."
Mike Weaver, who lives in rural southern Illinois, ran into the same glitch as many others: He, like others, could not get past the security questions while trying to set up their personal accounts through healthcare.gov.
Weaver, a self-employed photographer, said he also ran into problems with the drop-down menus. And when they started working, he still wasn't able to set up his account.
"The first day of something that you know is going to have a lot of bugs, it's not that frustrating," he said. "If it was the last day to sign up ... then I'd be terribly frustrated." Weaver is uninsured.
Obama addressed criticism by comparing it to Apple's iOS. "Like every new law, every new product rollout, there are going to be some glitches in the sign-up process along the way that we will fix," he said in a speech at the White House today. "Consider that just a couple of weeks ago, Apple rolled out a new mobile operating system, and within days, they found a glitch, so they fixed it."
"I don't remember anybody suggesting Apple should stop selling iPhones or iPads or threatening to shut down the company if they didn't," Obama continued. "That's not how we do things in America. We don't actively root for failure."
State-operated sites also experienced trouble.
Minnesota got its site running after a delay of several hours. Rhode Island's site recovered after a temporary crash. A spokesman for the New York Department of Health blamed difficulties on the 2 million visits to the website in the first 90 minutes after its launch. Washington state's marketplace used Twitter to thank users for their patience.
Connecticut seemed to be a bright spot, although some users reported some snags. Access Health CT sent out a tweet shortly before noon Tuesday, confirming the marketplace logged 10,000 visitors in the first three hours of operation and 22 enrollments. A family of three was the first to sign up for coverage.
California, home to 15 percent of the nation's uninsured, reported delays online and on the phone because of heavy volume. The first completed health insurance application was taken at 8:04 a.m., just minutes after the exchange opened.
In Portsmouth, N.H., Deborah Lielasus tried to sign up for coverage but got only as far as creating an account before the website stopped working. She said she expected problems.
Lielasus, a 54-year-old self-employed grant writer, currently spends about $8,500 a year in premiums and more than $10,000 for out-of-pocket expenses because she has a health condition and her only option has been a state high-risk insurance pool. She said she expects those costs to decrease significantly.
As excited as she was to sign up, she said, her anticipation was tempered by dismay over the government shutdown that was led by congressional Republicans who want to block the health insurance reforms.
"I'm really happy that this is happening, that this is being launched ... I feel like it's a child caught in the middle of a really bad divorce," Lielasus said.
The shutdown will have no immediate effect on the insurance marketplaces that are the backbone of the law, because they operate with money that isn't subject to the annual budget wrangling in Washington.
The marketplaces represent a turning point in the nation's approach to health care. The Obama administration hopes to sign up seven million people during the first year and aims to eventually sign up at least half of the nearly 50 million uninsured Americans through an expansion of Medicaid or government-subsidized plans.
Michelle Kelly of Chicago said she had no problems signing up for the Medicaid expansion offered by Cook County and available to low-income residents. She did it over the phone in August. But she did get on the countycare.com website yesterday to track where her application is at and heard back within hours. Kelly said she had no glitches on this website, which had been set up months ago. "Not at all," she said.
Medicaid expansion is part of the Affordable Care Act, but some states with Republican governors have balked at providing health care for low-income residents. Applying for Medicaid is a different process than buying health insurance on the health.gov exchange and qualifying for any subsidies or tax credits.
Neera Tanden, president of the Center for American Progress, which helped work for passage of the law, cautioned against rushing to judge on first-day performance. Numerous observers had predicted bugs and setbacks. Trained outreach workers in many states are having trouble getting the certification they need to start helping people to enroll.
Republican ideology and politics have come into play. In Texas, a federally funded network of "navigators" hired to help people enroll was off to a rocky start because of backtracking participants -- including some cowed by the politics of the health law.
At least four regional government councils -- covering more than 30 counties statewide -- reversed course in the past two weeks and turned away funds that would train navigators in their areas. Local leaders described their hesitancy as a mix of uncertainty surrounding state rules and a fear of running afoul of Republican leaders.
Many states predicted that an initial surge of interest would test the online system, but they expect most people to sign up closer to Dec. 15, which is the deadline for coverage to start Jan. 1. Customers have until the end of March to sign up in order to avoid tax penalties. The first year's penalty for those who do not have insurance is $95, or one percent of your income, whichever is higher, but in subsequent years the penalty increases. In 2016, it rises to $695 or 2.5 percent of income, whichever is higher.
Under the law, health insurance companies can no longer deny coverage to someone with a pre-existing medical condition and cannot impose lifetime caps on coverage. They also must cover a list of essential services, ranging from mental health treatment to maternity care. For more information and useful links go to "Obamacare exchanges open: facts, tips and myths".
Associated Press Medical Writer Carla K. Johnson wrote the bulk of this story with other AP writers and PW co-editor Teresa Albano contributing.
Photo: Home page for healthcare.gov, the official online health insurance marketplace.