A medically uninsured couple from Woodbridge asks questions to medical assistant Vivian Guillen as the Greater Prince William Community Health Center launched its education and enrollment services for the Virginia Health Insurance Marketplace on Tuesday. (Jahi Chikwendiu/The Washington Post)

Across the country, millions of Americans had their first encounter with Obamacare as the health insurance exchanges opened for enrollment. The interest was high in many places, but there were also numerous technological problems.

Flood of calls, some technical trouble

In Santa Clara County, which includes the city of San Jose and surrounding towns, health advocates were fielding calls all day about Covered California, the state’s new health insurance exchange.

Charis Subil of Santa Clara County’s Community Health Partnership, a consortium of nonprofit health centers and clinics, had 20 messages on the answering machine when she got to the office, and the phone rang incessantly all day.

Churches, synagogues and local community centers were calling to figure out how they could help their members get enrolled. Other callers were among the county’s more than 200,000 uninsured who had been told throughout the year that they’d probably qualify for coverage once the Affordable Care Act took effect.

“A lot of people are calling and asking, ‘Now is it time? What should I do? I remember I was told I would be eligible,’ ’’ Subil said.

Some of those who tried to sign up for coverage on Tuesday via the Covered California Web site were having trouble.

“It’s been tough,’’ Subil said. “We just went on the Web site. It’s a little slow. But what we are reassuring them is that even though today is tough, they have until December 15 to make their policy decision. We’re saying you can use this as a shopping period.’’

Subil said she wasn’t surprised by the flood of calls.

“We know this is going to meet a need,’’ she said.

Janine Zacharia

Lots of questions about Obamacare

At downtown Philadelphia’s Suburban Station, jubilant music and colorful balloons drew passing commuters toward Independence Blue Cross’s quiz game to help promote the opening of the Pennsylvania’s health-care exchange. An energetic emcee called out for volunteer contestants to answer trivia questions about Obamacare.

“You cannot be denied health insurance due to a preexisting condition — true or false?” he asked. (True.)

One contestant, Barbara Antonilly, recently lost the insurance she had through her employer. She said she was “encouraged” by her workplace to cut hours, so she fell under the part-time, rather than full-time, umbrella.

“I used to have Independence Blue Cross, and it was very good,” she said. “But after the pay cut, I could no longer afford the premium.”

Since being uninsured, Antonilly has been using health clinics and paying for services out of pocket.

An observer, Anthony Brandon, was alarmed when one of the trivia questions said everyone must have insurance or face a fine.

“Wait, so we all have to have insurance? Is that true?” he asked the audience members around him. Brandon has coverage through his employer, a luxury hotel, but he feels the law hasn’t been explained well thus far.

“There’s a lot of myths about Obamacare, and it’s so convoluted at this point,” he said. “I don’t know what’s what.”

For one of the multiple choice questions, all three contestants got the official name of the law – the Patient Protection and Affordable Care Act — incorrect.

Meeri Kim

People turned away or unaware

Leslie Rodriguez, an in-person counselor hired by the Puerto Rican Cultural Center in Chicago’s Humboldt Park neighborhood, said people called all day looking to enroll but were turned away because the Web site was down.

“They’re a little upset . . . but we’re just making appointments for them later in the week,” she said. The center, in a low-income community where many lack insurance, has been doing outreach workshops about Medicaid expansion and the exchanges.

“In this community, people are more interested in the expansion of Medicaid than the exchanges, but we have been getting both,” she added.

At the John H. Stroger Jr. Hospital of Cook County emergency waiting room and the affiliated Fantus outpatient clinic serving uninsured people in Chicago, only one of two dozen patients interviewed had heard about the insurance marketplace.

“I don’t have work. How am I going to pay for insurance?” asked George Garcia, 40, an unemployed construction worker. “Obama has a job; he can buy insurance. A lot of people don’t have jobs.”

James Bell, 50, has been unemployed and without insurance since he lost his job as a chef at Loyola University seven years ago. He hadn’t heard about the Affordable Care Act because “I don’t even watch TV; worrying about stuff just messes you up.”

At CommunityHealth Chicago on the west side, Robert Mendez, 30, wants insurance and plans to research the exchange. He just graduated from DePaul University and is a personal trainer but has been unemployed for two years.

“I think everyone should have health care, but I can see why some people would be against a requirement for insurance. I’m on the fence about it,” he said. “I definitely think I need it; I just want to feel comfortable.”

Kari Lydersen

Web site problems snarl access

Carlos Flores, 65, of Woodbridge, Va., heard about the exchanges on TV and made sure to be there the very first day possible to sign up. He’s worried for his wife, Maria Lopez, 59. She was hospitalized twice for depression recently, and her treatment is very expensive.

Katty Aponte-Cardenas, one of four patient-care coordinators at Greater Prince William Community Health Center trained to enroll patients, explained to them in Spanish that the Web site was still down shortly before noon Tuesday (”No funciona,” she said, gesturing toward her computer) and that they would need to fill out paperwork and wait to find out if they qualify. They made an appointment to follow up next week.

Flores came to the United States from Honduras in 1984 and had been working as a painter for a home-improvement company when he had to have heart surgery. Two weeks after he left the hospital, he was laid off, he said, so he no longer has health insurance.

Aponte-Cardenas asked if they had questions.

“Es para Medicaid?” Lopez asked. Aponte-Cardenas explained that when the Web site was functioning, they would be able to find out what they qualify for based on their income level.

Flores said he was grateful for the new opportunity but that it would be wonderful if he could apply Tuesday and have insurance Wednesday, not wait until January.

He wasn’t worried about the Web site being down temporarily. “It’s not a problem for me now,” he added, “but if it doesn’t come up soon, it will be a big problem not only for me, but for a lot of people.”

“I’m grateful that they can help us,” he said.

Susan Svrluga