HELENA (AP) — Before Tuesday's launch, Montana insurers and state officials weren't exactly sure what would happen when a key component of the nation's new health care law kicked in and people could sign up for insurance plans through a new online marketplace.
Would there be a rush to enroll in the insurance exchange? Would people sit back and wait to see what happens? Would there be kinks in the system?
All of the above, as it turns out.
A crush of people jammed the federal government website that featured insurance plans for Montana and 35 other states. Frustrated users encountered delays when they attempted to enroll. Some were booted off the website, while others made it through the initial sign-up steps but were unable to progress further.
Call-center phone lines also were snarled. People turned to insurers offering plans through the new exchange or to federally funded "navigators" trained to help guide them through the basics of the Affordable Care Act.
"The first week has been pretty crazy," said John Doran, director of strategic marketing services for Blue Cross and Blue Shield of Montana. "We've just been encouraging folks who called and emailed to be patient, to do your homework and to better understand the plan that is right for you."
Blue Cross, Montana Health Co-op and PacificSource are the three insurers offering plans under the new health exchange, which is run under the U.S. government's www.healthcare.gov. State lawmakers rejected a proposal for the state to develop its own website.
Some people did make it all the way through the process either by waiting out the delays on the website or logging on in the dead of night when traffic was lower.
Others weren't ready to enroll, but simply wanted to ask questions about everything from subsidy eligibility to the cost of the new insurance.
"One thing that continues to surprise me is that folks believe coverage begins before Jan. 1," said Todd Lovshin, PacificSource's regional director for Montana.
The exchange is meant to help people who don't have insurance find health coverage, and those with insurance to compare plans in an open marketplace. Most uninsured people who aren't enrolled after March will face a tax penalty in 2014 that will rise in subsequent years.
Subsidies are available for people with incomes less than 400 percent of the federal poverty level.
The enrollment period goes through Dec. 15 for coverage that begins in January, and people can wait until March to enroll to avoid the 2014 penalty.
Insurers and individual navigators helped consumers get started by answering questions, outlining plans and opening an account for them on the exchange. Some used internal calculators to estimate for customers what their subsidies might be. But they, too, often were stymied by the overwhelmed federal exchange website and usually could not complete the enrollment process.
The website problems persisted through the first few days of the launch, but what started as a "boil" of queries from frustrated consumers had settled to an "aggressive simmer" toward week's end, said Karen Murphy, senior outreach specialist for the Montana Health Co-op.
"We are catching our breath but we are doing very well," Murphy said. "We knew that things would be frantic."
Insurers and state officials said the overwhelmed system shows just how much interest there is.
"I would rate the opening as surprising in that there were so many people trying to access coverage so quickly on the first day, but not surprising there were technical issues," said state Insurance Commissioner Monica Lindeen.