Some New Frustrations as Health Exchange Opens

WASHINGTON - The health insurance marketplace opened for business on Saturday, and, in contrast to the technological frustrations of opening day last fall, consumers found that they could actually use it to compare health plans and buy insurance online.

Thousands of people turned up for hundreds of enrollment events around the country at public libraries, churches, shopping malls, community colleges, clinics, hospitals and other sites. Insurance counselors and federal, state and local officials said they were trying to juggle two tasks - enrolling more of the uninsured and renewing coverage for those who already had it.

When the online federal exchange opened last fall, the HealthCare.gov website collapsed under the pressure of millions of would-be users, and was barely functional for a couple of months. The problems required emergency repairs and an overhaul of the site, and the White House replaced many of the people who were responsible for the fiasco.

The fixes appeared to be making the process much easier on Saturday. In Augusta, Me., Emily Brostek, an enrollment counselor, said she had helped a friend sign up for a new plan through HealthCare.gov with no problems.

'We were in and out in 30 minutes,' said Ms. Brostek, the executive director of Consumers for Affordable Health Care, a nonprofit group.

There were no spinning wheels or frozen screens, Ms. Brostek said, recalling the nightmares that tormented consumers last fall. The difference, she said, is 'like night and day.' Ms. Brostek said her friend had done some homework in advance, using the exchange's browsing tool earlier in the week to figure out which plan he wanted to switch to. And since the website had retained his personal information from last year, he could move quickly through the application.

But in Edgewater, Fla., Mary D. Fischetti, 63, had a different experience. In an interview, she said she had returned to HealthCare.gov after learning on Friday that her current plan would no longer be offered in her region. Her insurance now costs $67 a month, after a federal subsidy is taken into account, she said; the insurer had suggested a comparable plan that would be $192 a month, after the subsidy.

'I don't want to be stuck paying that much,' said Ms. Fischetti, a retired office manager. 'So I'm going to have to start all over again.'

With the browsing feature of the federal website, she found three so-called bronze-level plans that would cost less than $100 a month after the subsidy.

'I'm kind of discouraged by the entire situation,' Ms. Fischetti said, noting that the deductibles for all three plans were more than $6,000.

The website's performance is crucial not only to millions of families, but also to President Obama and his political standing.

In Mr. Obama's weekly radio and Internet address on Saturday, he encouraged people to visit HealthCare.gov and sign up in the three-month open enrollment period, which ends on Feb. 15.

In St. Louis, Irene M. Allen, 39, a professional singer, visited her insurance agent on Saturday to choose a different health plan. But she could not get into her marketplace account because she could not remember her username or password, or the answers to her security questions.

'The website is very secure,' Ms. Allen said. 'I can't use it, but nobody else can, either. I like my health plan, but it's no longer being offered. I wouldn't change it if I didn't have to.'

The Obama administration, anticipating such problems, offered troubleshooting tips to help consumers who could not log in.

Thomas M. Harte, an insurance broker in Hampstead, N.H., said he jumped on HealthCare.gov early Saturday.

'I was pleased to discover that the website does not have a waiting room on the first day of open enrollment,' Mr. Harte said. But, he said, 'some plans for New Hampshire residents have links to benefit summaries, while others do not have access to this important document that assists with making a decision on a family's health care needs.'

Emily Black Bremer, the president of the Missouri Association of Health Underwriters, used the federal website to help clients on Saturday and said it seemed to be working. 'The application for those newly applying does not feel that much different from 2014, despite the hype over the new streamlined design,' Ms. Bremer said.

To those who already have coverage, Ms. Bremer offered a bit of advice: 'Rates are increasing, plans are being added and discontinued, and benefits within plans are changing. Consumers who do not take an active role in evaluating their benefits and subsidies may find themselves unpleasantly surprised in 2015, or at the very least paying more than they have to.'

As the website went live, the Obama administration told insurers to be alert to hacking and other attempts to compromise the security of their computer systems.

The Government Accountability Office, an investigative arm of Congress, identified security weaknesses in the website this year, but administration officials said the risks were minimal. Sylvia Mathews Burwell, the secretary of health and human services, said that 'we've enhanced our cybersecurity team' and adopted stringent protocols to protect personal information.

A special section of HealthCare.gov offering insurance to employers with 50 or fewer employees also opened on Saturday.

Open enrollment started as the Obama administration was facing the prospect of new attacks on the health care law from a Republican-controlled Senate, as well as Republicans in the House. In addition, the administration is mapping its strategy for another showdown in the Supreme Court. If critics of the law prevail in court, several million people could lose subsidies that make health insurance more affordable.

The administration says that as of last month, 7.1 million people were enrolled in private health plans purchased through federal and state exchanges. Ms. Burwell estimated that a total of 9.1 million people will have marketplace coverage at the end of next year.

People who take no action this fall will have their coverage automatically renewed in the same or similar health plans. Consumers must select a plan by Dec. 15 to have coverage by Jan. 1. But they have until Feb. 15 to sign up for coverage beginning in March. Lower-income people can enroll in Medicaid at any time.

Thirty-seven states are using the federal exchange. They include Florida, Georgia and Texas, which together account for about one-fourth of the nation's uninsured. Other states run their own insurance exchanges.