The health insurance marketplace opened for business Saturday and performed much better than last year, but many consumers reported long, frustrating delays in trying to buy insurance and gain access to their own accounts at healthcare.gov.
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 remaining uninsured and renewing coverage for those who already had it.
Among those who signed up in Arkansas was Michael Bennett, 37, of Little Rock, who said he works for a moving company that doesn't offer insurance benefits.
With the help of an outreach worker from Future Builders, a Wrightsville nonprofit, at the Laman Library in North Little Rock, Bennett used healthcare.gov to sign up for a plan with a $1,500 deductible offered by Arkansas Blue Cross and Blue Shield, as well as a separate dental plan.
"It was easy, smooth," Bennett said. "It wasn't as crazy and hectic as I thought it was going to be."
Bennett's co-worker, Shannon "Bo" Walters, 25, who also went to the library to sign up, wasn't as successful.
He said he made a mistake while entering his information on the website and wasn't able to correct it. The outreach worker who was helping him said she would try to get the problem fixed and call him, he said.
"I came here to figure out insurance, and now I've spent two hours and got nothing in return," he said.
Some of the problems became evident Saturday just as Sylvia Mathews Burwell, U.S. Department of Health and Human Services secretary, was visiting a community health center in Manassas, Va.
Consumers there were having a hard time logging into their accounts, retrieving old passwords and proving they were who they said they were -- a process known as identity proofing, which also vexed many people last fall.
Some people did complete their applications at the Manassas clinic Saturday, but it often took them 90 minutes.
Many people were unable to finish what they started, so they left the clinic, with plans to return at another time.
Saturday was the first day of the open-enrollment period on insurance exchanges across the country for coverage starting in 2015.
Created under the federal health care overhaul law, the exchanges allow people to shop for coverage and apply for subsidies to help them pay for it.
When the online federal exchange opened last fall, healthcare.gov 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 Saturday.
Burwell tweeted that more than 23,000 people signed up through healthcare.gov in the first eight hours after enrollment began early Saturday.
The website is the enrollment portal for Arkansas and 36 other states with federally operated exchanges. The remaining states operate their own exchanges.
Washington's state-run exchange shut down after the first few hours of open enrollment when state officials discovered it was incorrectly calculating the tax credit subsidies available to help people with low and moderate incomes buy coverage.
The exchange's chief executive said the system will stay down until it can give consumers who want to buy health insurance accurate information.
In Augusta, Maine, 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 Brostek, the executive director of Consumers for Affordable Health Care, a nonprofit group.
Workers at North Little Rock's Laman Library enrolled about a dozen people, including Bennett, during a four-hour event.
David Wright, co-director of the Navigator Project at the University of Arkansas' Partners for Inclusive Communities, said just over half of those who enrolled were eligible for the state's private-option program, which uses federal Medicaid funds to purchase coverage on the exchange for adults with incomes below 138 percent of the poverty level.
Those who qualify for the private option can enroll at any time during the year, although they can change plans only during open enrollment.
Enroll the Ridge, a Jonesboro nonprofit, signed up about 15 people, most of whom were not eligible for the private option, at the group's call center, outreach worker Sharron Bell said.
"I've really been amazed by how smooth things went," she said. "We've not had any problems."
Each enrollment took an hour and a half to two hours, with most of that time spent comparing the premiums and benefits for the different plans, she said.
She said everyone she spoke to was happy with their options.
But in Edgewater, Fla., Mary 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 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," Fischetti said, noting that the deductibles for all three plans were more than $6,000.
After a tax credit subsidy of about $77 a month is applied, Bennett will pay about $208 a month for the health plan he signed up for at the Laman Library. He also will pay $21 a month for the dental plan.
The costs were lower than Bennett thought they would be.
"I think it's pretty good," Bennett said. "I'm happy with it."
With no insurance, he spends about $280 a month on doctor's visits and medication related to back pain and also is paying off more than $2,000 in emergency-room debt at a rate of about $75 a month.
He said he wishes he would have up signed up during the first enrollment period, which ran from October 2013 through March, but said he was busy with work and catching up on bills and doubted he could afford the coverage anyway.
"My girlfriend just kept pushing the issue, and I just never did it," Bennett.
The tax credits are available to many people with incomes of less than 400 percent of the poverty level: for example, $45,960 for an individual or $94,200 for a family of four.
The performance of healthcare.gov is crucial not only to millions of families, but also to President Barack Obama and his political standing.
In Obama's weekly radio and Internet address Saturday, he encouraged people to visit healthcare.gov and sign up in the three-month open-enrollment period, which ends on Feb. 15.
A special section of healthcare.gov offering insurance to employers with 50 or fewer employees also opened 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.
As of early October, more than 220,000 Arkansans had enrolled in coverage through Arkansas' exchange, including more than 182,000 who were on the private option.
Burwell estimated that 9.1 million people nationwide will have marketplace coverage at the end of next year.
Information for this article was contributed by Andy Davis of the Arkansas Democrat-Gazette; by Robert Pear and Abby Goodnough of The New York Times; and by Donna Gordon Blankinship of The Associated Press.
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