High volume spurs health exchange system crash

WASHINGTON (USA TODAY) - A high number of visitors to the new federal healthinsurance exchange site Wednesday caused the system to crash or causeprospective insurance customers to endure long waits.

TheDepartment of Health and Human Services has tried to limit the problemsby changing how site visitors enter the site and reach details on how toshop for and buy insurance.

Visitors to HealthCare.gov wereconfronted with a combination of greetings Wednesday. They were eitherasked to wait, which took up to 20 minutes around midday Eastern time,and then guided to other pages, where the process moved more quickly.

By2 p.m., however, the message was far less encouraging: "The system isdown at the moment. We're working to resolve the issue as soon aspossible. Please try again later."

Then, after typing in personalinformation and creating a user identification and password, anothermessage: "Important: Your account couldnt be created at this time. Thesystem is unavailable."

HHS wanted to limit the initial volume ofvisitors to the site to limit the problems, said Ed Mullen, an Internetconsultant who helped design the page. It is modeled on what companiesthat are making big launches try to do to limit volume. For example,when Google launched Gmail, it was an invitation-only process.

Despitethe myriad problems both Tuesday, the first day the exchanges wereopen, and on Wednesday, HHS officials said they consider the opening asuccess.

"Volume at HealthCare.gov continues to be high, with 4.7million unique visits in the first 24 hours, our call center receivingmore than 190,000 calls and more than 104,000 Web chats requested," HHSspokeswoman Erin Shields Britt said. "We expect to see similar volume asyesterday, and while this overwhelming interest is continuing to causewait times, there will be continuing improvements in the coming hoursand days."

State exchanges sites also reported problems. Hawaii'sexchange still lacked plan prices Wednesday afternoon, and Marylandposted a note stating, "You may experience wait times during the initialsteps of account creation of up to approximately two minutes." Thatproved to be overly optimistic.

HHS officials emphasized thatpeople have until Dec. 15 to buy insurance if they are to startreceiving coverage in January. So while the sites may be slow andplagued with bugs, there is still time to fix the problems.

Mullen,who helped with the overall design of the site, said it has been odd tosit on the sidelines and watch the launch of the exchanges.

"It'ssort of surreal, it's like what everyone in America is talking aboutright now," he said. "I helped define, in broad strokes, how it wouldwork."

He looked at the big pieces of the program: Medicaid, newplans and financial assistance, and then helped design "what this wholebig thing feels like." That involved making sure it was a smoothexperience - eventually - and that people would understand whateverything meant and wouldn't get lost as they made their ways through.

"I know they were expecting a lot of traffic," he said. "It is a big, complex system."

Eventually, he will use the site to buy his own insurance, he said.

HHShopes at least 7 million will buy insurance in 2014, although it ishard to know from the initial statistics how many of the site visitorsactually bought or plan to buy insurance through the exchange. Much ofthe interest came from people curious about the site but who alreadyhave insurance.

People who don't have insurance or who areself-insured may buy insurance from private companies through thegovernment website. The site allows customers to compare rates, benefitsand out-of-pocket costs across a variety of plans. If a person lives ina state that has its own exchange, the federal website will send thatperson to that site.

Anyone who makes less than 400% of thefederal poverty level, or about $94,200 for a family of four, may beeligible for a tax subsidy that will be directly applied to thecustomer's insurance premium.

Because of the Affordable Care Act,people with pre-existing medical conditions may no longer be turned awayor charged more than other consumers by insurers. Anyone who receivesinsurance through an employer, Medicare or Veterans Affairs will not beaffected by the exchanges and will not need to apply for insurance.

People who sign up for the exchanges by Dec. 15 will begin receiving coverage Jan. 1.

Follow @kellyskennedy on Twitter.


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