The first six-month window for Americans to gain health insurance under the Affordable Care Act closed on Monday.
Union halls, shopping-mall kiosks and insurance company lobbies across the country were jammed with people racing to get insurance on the final day before the law required most Americans to choose health insurance or risk a financial penalty.
"It's like going into the mall on Christmas Eve," said Brian Lobley, senior vice president of Independence Blue Cross, which set up a "Countdown to Coverage" with extra desks and phone lines in the usually empty lobby of its headquarters four blocks from City Hall in Philadelphia's Center City. Employees whose jobs have nothing to do with sales were pressed into service, and customers were triaged as they walked in, with priority given to people who had not even begun to shop for insurance before Monday.
In Los Angeles, the local affiliate of the Service Employees International Union began an enroll-athon at 5 a.m. and by the end of the day had attracted more than 700 people to a lively scene with food trucks, music and more than 50 staffers and volunteers.
By the time President Barack Obama appeared Monday evening on "CBS Evening News," he sounded relieved. "We admittedly had just a terrible start because the website wasn't working," Obama said, referring to the site's rocky beginnings. "But given how gloomy I think everybody's assessment was back in the middle of November, I'd say that we're on our way to making sure that no American ever has to go without health care."
NO SIGN-UP NUMBERS
Late in the day, federal officials could not say how many people had signed up. But health officials said that, by 4 p.m., 840,000 people had phoned in to a network of call centers across the country - about 300,000 more than the total for any other day since the federal insurance marketplace and 14 similar state ones opened Oct. 1.
The outpouring of last-minute interest reinforced arguments by the Obama administration and its allies, made since the law was enacted four years ago, that it would become popular once Americans had a chance to get the new health plans that it spawned - and in most cases, with federal subsidies to help pay for them.
Still, as the deadline arrived, fresh evidence emerged that the law, which has set in motion the broadest changes to the U.S. health care system in nearly half a century, remains mired in a wide partisan divide. A new Washington Post poll indicates that three in four Democrats support the law - a rise of 11 percentage points since January - compared with one in five Republicans.
The last day of sign-ups contained an echo of the computer troubles that dominated the early months of the open-enrollment period last fall. During two periods of the day that lasted a total of several hours, HealthCare.gov was inaccessible to new customers - and early on, to anyone at all.
Instead of opening at 5 a.m. as scheduled after a routine maintenance period, the website remained closed until after 8 a.m. because of a software problem. Then, starting shortly after noon Monday, visitors to the website were greeted with a screen saying, "We need you to wait here, so we can make sure there's room for you to have a good experience on our site." The screen invited users to leave email addresses so they could be contacted when the volume lessened, although it was unclear whether that would be later Monday or after the official deadline.
Federal health officials equivocated about the reason for the second problem, saying it was caused primarily by the large numbers of customers coming to the site - but not ruling out that a second software problem was at fault. During this time, consumers were unable to start new applications, although those who already were further along in the steps towards enrollment were able to continue, according to Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services, the agency overseeing the new insurance exchange.
STOP AND GO
By about 1:30 p.m., the site had begun to reopen, although access to it remained intermittent throughout the afternoon and into the evening as federal health officials instituted a "virtual waiting room" for people who could not get on the site.
By late afternoon, Jeanne Devoe, a retiree who lives outside Asheville, N.C., had been trying for more than an hour to get onto HealthCare.gov to help her 27-year-old son get a health plan. He had begun the application process before but could not remember his password. Devoe arranged for the website to send a link to reset the password, but every time she tried to log back in, she said, she encountered a screen telling her that the site "has a lot of visitors right now!" She phoned a call center and got a recording saying that someone would call back in five to seven business days.
"We've gotten lots of phone calls and lots of interest," said Christopher Cook, owner of Alliance Insurance, an independent insurance agency with three offices around the Winston-Salem, N.C., metro region. He said Monday night that Alliance's offices talked to 48 people who wanted to sign up, but because of the website troubles they were able to complete only two enrollments online.
Such frenzy materialized Monday even though Obama administration officials had been mindful of the potential for a last-minute surge. They had acknowledged publicly that they were uncertain whether HealthCare.gov could withstand a late rush.
As a result, administration officials decided last week to try to take pressure off the official deadline, saying that anyone who had tried to choose a health plan in the new insurance marketplaces by the last day of March could ask for an extension. People can claim the extra time through an as-yet-unspecified date in April. The government will rely on an honor system in which people will simply have to click on a blue screen, scheduled to appear on HealthCare.gov after Monday, saying that they had previously attempted to enroll.
"I try to tell people: 'Don't worry. Just because you can't get in right now, it doesn't mean you won't be able to,' " said Karla Borders, a manager for enrollment assisters at a senior center in southeastern Wyoming, who spent Monday fielding calls from anxious people who had not yet gotten insurance.