Welcome to Health Reform Watch, Sarah Kliff’s regular look at how the Affordable Care Act is changing the American health-care system — and being changed by it. You can reach Sarah with questions, comments and suggestions here. Check back every Monday, Wednesday and Friday afternoon for the latest edition, and read previous columns here.
If you've been trying to buy health insurance coverage on the Obamacare marketplace, you're probably quite familiar with the screen above. It asks potential shoppers to hang on a moment because there are "a lot of visitors on the site."
This screen has been a big part of the Affordable Care Act's launch so far: There are lots of people who, in Obamacare's first 36 hours, have had trouble signing into the new marketplaces. And even if they've gotten in, they've found it difficult to move past the first few screens of the application, where drop-down menus for security questions wouldn't load.
The wait times aren't ideal. Some people who wanted to sign up for Obamacare on launch day couldn't. But though I spent most of Tuesday on the phone with people who were struggling to use the Web site, I don't tend to think these initial glitches will have a significant impact on the law's success.
Everyone I spoke with, even those who couldn't sign up, took nearly the same attitude: I guess I'll come back and try again later.
"I went on at 9 a.m. [Tuesday] morning, and it said it was too busy, to check back later," Steve Martin, a self-employed consultant in Herndon, Va., told me on Tuesday. "I'll try again tomorrow. I'm just super curious, since we're part of the federal exchange, what the rates will be. I have no real sense of that."
"I'll probably check back in a couple of days," Dylan Cole, a 28-year-old stand-up comedian in Idaho, said later in the day. "I'm a geek, so I'm used to trying to buy the new thing on the first day. I guess I'm going to have to wait on this one."
I asked Cole whether the first day's tech glitches would deter him from signing up for the program. "Absolutely not," he said. "It's something I've been looking forward to. It doesn't work the way I want it to today, but that's how brand-new services work online. Unless they're so unpopular that no one wants to use them. They're easy as pie."
The White House says that most of the delays have been a product of overwhelming traffic. The main Web site for the federal marketplace, HealthCare.Gov, has tallied more than 4.7 million visits in the first 24 hours of open enrollment.
Some of the Web developers I've spoken with who have walked me through some of the back-end error messages on the site generally agree that system overload is the big problem for those trying to sign up right now.
"My opinion is that its probably 99 percent capacity right now and not glitches," Dan Katz, vice president for technology at contracting firm Inadev, and a former lead web developer at CareFirst BlueCross BlueShield. "Typically when you're doing capacity you're basing models on previous usage data. For the health insurance exchange, that doesn't exist."
In one example, many applicants have had trouble getting the security questions to load after filling in a username and a password. The drop-down menu to pick a security question shows up as a blank box. On the back end, apparently, the Web site is sending out a request for more information -- but not getting a response back.
"It probably means those systems are not able to handle all the traffic they get, so they crash," says Niek Dekker, one of the Web developers I spoke with. "It's not so much a programming error but a problem with the size of the system."
The federal government says it's fixing this problem, adding more capacity for HealthCare.Gov by the hour. Outside experts estimate that increasing capacity for a project like this should take hours or days, but not necessarily weeks. If we get into mid-October and this slowdown is still a problem, that could spell trouble for the Affordable Care Act.
Other glitches will likely start showing up, too. Some health plan officials told me Wednesday that the federal marketplace is still having trouble calculating the premium tax credits that low- and middle income Americans could receive. Though, right now, a lot of people aren't even getting that far in the process to notice the issue.
Jon Tucci was far and away the most frustrated person who I spoke with Tuesday about the online glitches with the marketplace. He's a 60-year-old supporter President Obama who tried twice to sign up on launch day, once at midnight and again at 6 a.m., before going to work. He couldn't get through.
"I'm pretty fluent on the Internet," said Tucci, who is self-employed in the oil and gas industry. "I've applied for a lot of things, and there are always glitches. But this was totally disappointing. I'm just really frustrated."
I asked Tucci what he would do next. Would he apply for coverage later, when the site might work better? Or just give up on the whole project?
"I might try later, when I get home from work," he told me. "I may call them again and see what's going on there."
KLIFF NOTES: Top health policy reads from around the Web.
Some insurance companies have not had any people enroll on the marketplaces. "Louisiana’s leading health insurance company reports that not one person has yet successfully enrolled in a new health care plan offered through the Affordable Care Act. Since the marketplaces opened to much fanfare Tuesday (Oct. 1), many of the state’s potential customers have been stalled on the website, unable to move past the portion of HealthCare.gov that instructs them how to set up their profile. Rebecca Catalanello in the New Orleans Times Picayune.
New York's marketplace had especially heavy opening day traffic. "By late afternoon in the East, state exchanges reported much heavier traffic than expected to their Web sites. New York said that 10 million attempts had been made to reach its site, although with many people making multiple tries, it was not clear how many individuals that represented. And officials said the figure was so far beyond anything they had considered plausible that they were investigating the cause." Abby Goodnough, Robert Pear and Richard Perez-Pena in the New York Times.