Health Care Signups Reach Frenzy in Final Day to Enroll

WASHINGTON - A frenzied last-minute scramble to sign up for health insurance overloaded phone lines and temporarily overwhelmed the website of the federal marketplace on Monday, as hundreds of thousands of people around the country raced to beat the deadline to obtain coverage under the Affordable Care Act.

Administration officials, stepping up the push for enrollment in the final hours, said they were confident that they would reach their original goal of having seven million people sign up for private health plans through federal and state exchanges. But the end of the open enrollment period, which began six months ago with the disastrous debut of the federal website, starts a new phase likely to be defined by the economics of health insurance as well as by politics.

Though HealthCare.gov, the federal website, performed markedly better on Monday than on the day it opened, many consumers still struggled to enroll. The site unexpectedly stopped taking applications for several hours early Monday because of a software problem discovered during scheduled maintenance overnight, said Aaron Albright, a spokesman at the Centers for Medicare and Medicaid Services, the agency running the site. For at least an hour at midday, the site again thwarted people trying to create accounts so they could buy insurance online.

'We are experiencing record volume on HealthCare.gov, with three million visits as of 8 p.m. and approximately 125,000 concurrent users at the peak' on Monday, Mr. Albright said. 'As of 8 p.m., we had received one million calls to the call center.'

At the White House, officials embarked on a kind of victory lap. Jay Carney, the press secretary, said that the number of people signing up for health care would be 'significantly above six million,' and he reminded journalists of the predictions of doom when HealthCare.gov crashed last fall.

Mr. Carney said he did not have 'any concrete numbers' to show how many people had paid premiums, as required to activate coverage.

In a television interview with KWTV in Oklahoma, Kathleen Sebelius, the secretary of health and human services, said reports from insurers indicated that 'somewhere between 80, 85, some say as high as 90 percent, have paid so far.'

Officials in Washington said they were delighted to see pictures of long lines of people snaking around clinics and social service offices, trying to obtain insurance. The demand, they said, vindicated President Obama's approach to health policy - and the bill passed four years ago without support from a single Republican.

Consumers were urged to sign up by a steady stream of government emails and television commercials featuring basketball stars like Magic Johnson and LeBron James, and entertainers like the rapper Lil' Kim.

People who called the federal insurance exchange on Monday heard a recorded message that said, 'We are currently experiencing very long wait times due to a surge in demand for marketplace coverage as the end of open enrollment approaches.' The message said the government was holding a place in line for people who left their phone numbers, so they could finish their applications for insurance after the deadline.

Likewise, visitors to HealthCare.gov were often shunted into a 'virtual waiting room,' like the one where consumers spent countless hours in October.

The Obama administration is offering an unspecified amount of extra time to people who tried but, for one reason or another, failed to complete their applications by the deadline at 11:59 p.m. Monday.

At least eight states running their own exchanges have also given consumers additional time to sign up. In Oregon, for example, where the state-run website has been plagued with problems, residents have 30 more days to enroll.

Sakile Mitchell, a 19-year-old student who works as a cook in a restaurant in Portland, Ore., obtained insurance for the first time by signing up at a community health center.

'I went in and said that I want to make sure that if I break my arm, it's covered,' Ms. Mitchell said. 'And that's the case. If I need to go to the doctor, I can do so. I really never thought I would be at this point but I am. I am someone with health insurance.'

Another Portland resident, Cathy Cleveland, 64, was not so lucky. 'I applied in early November,' she said. 'I finally got all my paperwork on Feb. 20, and they told me I didn't qualify for a tax credit. I was blown away.'

Though the open enrollment period was coming to an end, the same could not be said for the political fight over the law. White House officials and their allies said they were planning a big effort to make sure newly insured Americans turn out and vote in this year's midterm elections and they cited the health care law in fund-raising appeals to supporters.

'The narrative around Obamacare is changing,' said Jon Carson, the executive director of Organizing for Action, a grass-roots group that grew out of Mr. Obama's 2012 campaign organization. 'Now that six million Americans have signed up for coverage, you can feel the wind being taken out of our opponents' sails.'

Republican critics of the law showed no signs of relenting and bemoaned what they called a deadline day disaster. 'Millions of Americans are facing higher premiums, canceled plans and the loss of doctors and hospitals they liked,' said the Senate minority leader, Mitch McConnell of Kentucky.

The last-minute surge created a wide range of emotions among consumers, from happiness and satisfaction at having insurance for the first time to frustration at being unable to get answers or assistance, or affordable coverage.

In Miami, Judy McKinley, 58, sought help at an enrollment event and was pleased to line up coverage.

Ms. McKinley said she had worked for her husband's financial services company until he died in 2012. 'I have no job, no insurance and no income, and I need a mammogram,' she said. 'The relief that I'm walking away with is worth the headache that I have.'

But for Crisdelin Calduch, who reviewed her options with the help of a counselor at Miami Dade College, the premium - $160 a month - was too high.

Ms. Calduch, 26, who has a part-time job as an assistant manager at a Dollar Tree store in Cutler Bay, south of Miami, said she was struggling to pay off a $60,000 college loan, had car payments of $340 a month and gave $200 a month to her parents as rent.

'I'm not paying $160 for health insurance,' she said. 'That's my school money.'

At an enrollment assistance center in Dallas, several people left after being told they would have to wait three hours or more.

Zakaria Elyossri, 46, said he tried to enroll online at home, but did not understand how to navigate the website. Mr. Elyossri said he was eager to sign up for a health plan because he had a history of heart problems and diabetes.

He left after 90 minutes, saying, 'We need more people in there to help us. This is insurance, it's complicated.'

Andrew Lopez, 25, also left the Dallas center without receiving help.

'I tried to enroll online and over the phone, and it's just too hard,' Mr. Lopez said. 'The website keeps messing up. Whenever I try to call the toll-free number, the message says they're not able to answer any more calls, and it just hangs up.'

Nataliya Pollack, 54, signed up for a subsidized health plan on Monday at a food pantry in the basement of a church on the Upper West Side of Manhattan - after spending 90 minutes with a counselor.

'I grew up in the Soviet Union,' Ms. Pollack said. 'We have universal health care. It was maybe not the best, but it was free.'

Driven by a need for insurance and by the threat of financial penalties if they go without it, millions of Americans were shopping in the health care bazaar.

In the last week, the administration counted more than 8.7 million visits to HealthCare.gov, including more than two million over the weekend. The telephone call center took more than 2.5 phone calls in the last week, compared with 2.4 million in all of February.