Millions flood healthcare insurance sites as feds grapple with glitches

Web traffic was 7 times greater than Medicare site ever saw

The U.S. government's Health Insurance Exchange (HIX) website and its state-run counterparts launched today and were immediately flooded with potential enrollees, causing widespread glitches throughout the country.

As of about 4 p.m. ET, more than 2.8 million people had visited the U.S. Health and Human Service's healthcare website since the HIXes went live at 8 a.m., according to Marilyn Tavenner, administrator for the U.S. Centers for Medicare & Medicaid Services (CMS).

CMS oversees the administration of the HIXes, a cornerstone of the Affordable Care Act (ACA), also known as Obamacare. The ACA requires all states to roll out HIXes or opt for a federally-operated version of one, where consumers can compare in one place plans based on price, deductibles and benefits.

Citizens who apply for healthcare insurance on the open exchange by Dec. 15, will be able to receive coverage beginning Jan. 1, 2014. Those who wait until after Dec. 15 to apply will receive coverage at a later date.

"In less than 15 hours today, our site traffic has tripled from what we saw when we re-launched in June. What's more, there were seven times more users on the [HIX] marketplace website today than have ever been on the website at any one given time," Tavenner said, referring to HHS's site.

The HHS, under which CMS operates, also posted a warning on its website about being flooded with a high volume of requests.

CMS refused to disclose how many people have been able to enroll in health insurance plans, saying only that "people have been able to successfully complete the application and enrollment process."

Officials admitted to having technical issues with their website that stopped some from enroll ing. The officials said they're continuing to work on those problems to smooth out the wrinkles.

"We're very pleased with progress states are making," Gary Cohen, deputy administrator and director for the Center for Consumer Information and Insurance Oversight, said during a news conference at 4 p.m.

"We are making improvements as we speak. What we're hearing from other issuers is that problems are being resolved," Tavenner said. "This is day one of a six-month process. You have until Dec. 15 to enroll for coverage for Jan. 1."

The Congressional Budget Office estimates that 12 million consumers will buy health insurance in the HIX market by 2014, with that figure rising to nearly 28 million people by 2019.

The overwhelming majority of those using the HIXs will be low-income people, contractors who don't have an employer-sponsored plan or those already insured through employer plans, but whose family members aren't covered.

"About 17 million of those newly insured (those below 133% of the Federal Poverty Level) will receive coverage through an expanded Medicaid program," PricewaterhouseCoopers International (PwC) said in a report released in June.

"There are potentially 14 million new people walking through the electronic front door in light of ACA," said Garland Kemper, health and human services program director at services provider Unisys. "There are [state-based computer] systems that in some cases are 25 years old. They're legacy apps that, to modify the rules to reflect the new federal ones, will be very difficult. It varies state to state.

"This is going to be a huge impact to state government," she added.

One of the most cited problems by those attempting to sign up for healthcare insurance online was an issue associated with creating a password, which protects the enrollee's identity. Several members of national news organizations stated that people states including Maryland, Virginia, Hawaii, Michigan and Florida had trouble logging into the HIX website in order to enroll.

One of the problems is that some public HIXes, such as Massachusetts' Health Connector, have been online for years,. Other states found themselves behind the curve and faced tough deadlines to enact their exchanges. Massachusettts' Health Connector uses a model where the state evaluates and selects insurers in a competitive bidding process, and then offers those insurers to the public.

However, 36 states opted out of creating their own HIXes and instead opted to allow residents to visit the federally-created HIX, which offers a central database of insurers from which they can choose based on their state and economic status.

About 85% of Americans are already covered by some form of insurance, ether privately or as part of their benefits from an employer. The other 15% of Americans who are self-employed or unemployed are the target of the HIX system.

The site also offers an around-the-clock chat line to assist enrollees with the process. Some users found that service down, as well. Additionally, a Medicaid calculator tool that allows enrollees to calculate their tax credits after enrolling also experienced issues with accuracy.

Tavenner said part of the problem with the calculator has been that it double-checks all the results, which can result in slowdowns, but "we're seeing more accuracy," she added.

Lucas Mearian covers storage, disaster recovery and business continuity, financial services infrastructure and health care IT for Computerworld. Follow Lucas on Twitter at  @lucasmearian or subscribe to Lucas's RSS feed . His e-mail address is

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