latimes.com/health/healthcare/la-fi-obamacare-california-launch-20131002,0,4856547.story

Demand is strong as Obamacare enrollment starts in California

Covered California, the state insurance marketplace, debuts to strong consumer demand, computer glitches and delays.

By Chad Terhune, Melanie Mason and Maeve Reston

8:31 PM PDT, October 1, 2013 - Los Angeles Times

Kicking off a historic healthcare expansion, California's new insurance market stumbled out of the gate with computer glitches, long hold times and an online enrollment delay for small businesses.

Still, many consumers rushed to get coverage Tuesday when enrollment opened nationwide as part of President Obama's Affordable Care Act. It was a rocky start for many government-run insurance exchanges across the country as computers froze and online enrollment was postponed for several hours.

In California, officials nonetheless took heart at the stronger-than-expected response: about 5 million online hits and more than 17,000 calls.

Full coverage: Obamacare rolls out

"It was a huge outpouring of interest, which is good news," said Peter Lee, executive director of Covered California, the new state marketplace. "Today was just the starting point."

The federal law marks the biggest healthcare overhaul since the launch of Medicare half a century ago. Its fate depends a great deal on how well California handles the expansion, given the state's size and strong backing.

The flood of first-day inquiries quickly overwhelmed the state's $313-million enrollment system and its call centers, making it difficult for many to complete applications.

County health officials complained they couldn't access the state's computer system, forcing them to fill out applications by hand. In a disappointment to some business groups, the exchange said Tuesday that it had postponed online enrollment for small employers until November.

But many took the delays in stride. As expected, those with chronic illnesses and huge medical bills showed up first.

"The website was crazy busy. It's like Obamacare just released a new iPhone," said Peter Nowack, a 60-year-old marketing consultant in Oakland who tried unsuccessfully to enroll first thing Tuesday.

Nowack pays $1,200 a month for his health insurance now because of preexisting medical conditions. A similar policy in the exchange could cost him about half that much.

To remedy the immediate service issues, Covered California said it would take down its website overnight for technical work and continue to hire more staff. Exchange officials emphasized that they have time to fix the problems before coverage takes effect Jan. 1; enrollment runs through March 31. The state doesn't plan to disclose enrollment numbers until mid-November.

Some healthcare experts warned that patience could run out if problems persist. The enrollment issues are sure to embolden the law's critics and potentially turn off consumers who are already skeptical about a massive government program.

"This is a setback for those who are trying to promote this program," said Robert Laszewski, a healthcare industry consultant in Virginia. "There is already so much cynicism about Obamacare to start with that these glitches feed into the narrative from opponents that this will be a train wreck."

Holland VanDieren, 63, of Pasadena, tried logging on to the state website at about midnight but got error messages. She pays nearly $300 a month for her high-deductible health plan now.

"There are a lot of bugs to be ironed out," she said. "I'm afraid prices will go up and our healthcare will decline."

One of the major risks is that such obstacles will turn off the young and healthy. Their enrollment is crucial for the exchange, which needs those customers to offset the high costs of older, sicker patients.

Rosa Rodriguez, 45 and uninsured, has struggled for years with rheumatoid arthritis, a bum knee and high blood pressure, which often go untreated. Eager to get insurance, she arrived at a Molina Healthcare clinic in Fontana just as it opened Tuesday.

Rodriguez and her husband lost their previous health coverage when he lost his job two years ago. And the Rialto couple earned too much to qualify for Medi-Cal, the state's Medicaid program. She filled out a form at the clinic and was told she would be contacted later this week by a representative from Molina, one of 12 health insurers selling policies in the exchange.

"I'm definitely going to sign up," she said.

But help wasn't so readily available elsewhere. In downtown Los Angeles near skid row, workers at the Center for Community Health said people with questions about Obamacare would have to come back Thursday. Employees there still need to wrap up state training before they can enroll people in health insurance, said Erik Martinez, the center's project coordinator.

Likewise, many hospitals across the state aren't ready to help with enrollment because of training delays. Covered California says it needs about 16,000 enrollment counselors statewide, but fewer than 1,000 of those workers had been approved as of last count. "We are staffing up and training more people each day," said Ken Wood, a senior advisor at Covered California.

Despite the first-day glitches, officials struck a celebratory tone at events across the state. Lee, the exchange's executive director, started off the day at a state call center with a New Year's Eve-style countdown in the final seconds before 8 a.m., when the marketplace opened.

By the end of the day, Covered California was throwing a festival-style party at Union Station in downtown Los Angeles, sending salsa dancers through the crowd to pull guests to their feet and putting a troupe of Bollywood-style performers on stage to belly dance in midriff-baring pink and blue skirts.

Dr. Marc Eckstein, a professor of emergency medicine at USC's Keck School of Medicine who trains medical students at L.A. County-USC Medical Center, said he doesn't expect the overhaul to change life for most of the patients he sees any time soon. An estimated 70% of the hospital's patients are uninsured, and most probably know little about Obamacare, Eckstein said.

"At the local level," he said, "it's going to take a while to get the word out."

At Long Beach Memorial Medical Center, 49-year-old Tim Medeiros was waiting for his son, who was undergoing a medical procedure. The self-employed mediator hoped someone at the hospital could give him details about the new insurance options. His insurer, Anthem Blue Cross, recently informed him that his monthly premiums would jump to $318 a month.

"Obamacare sounds like it will reduce some of those costs," Medeiros said. "But we'll see how this goes."

chad.terhune@latimes.com

melanie.mason@latimes.com

maeve.reston@latimes.com

Times staff writers Soumya Karlamangla, Paresh Dave and Eryn Brown contributed to this report.

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