Californians on Tuesday reacted to the widely anticipated rollout of California's online health insurance exchange with a blend of elation and sticker shock.
While the main website sputtered and callers waited in long queues as part of the Day One shakeout blues, officials labeled it a history-making day that many uninsured Californians had waited for years to arrive.
"Welcome to affordable care. Welcome to peace of mind," Peter Lee, executive director of the Covered California exchange, told a crowd gathered at a news conference on San Francisco's Embarcadero. "Gone now are the days you are denied health care."
David Bernard, of Santa Cruz, said he accessed the Covered California site easily and found out the premiums for his family of four will be less.
"The amazing thing for me was how quickly you can look at your possible options and find a better deal," said Bernard, 53, co-owner of a branding development agency.
Still, other Californians greeted Obamacare with cries of outrage, saying their health insurance rates are skyrocketing.
Sherry Houston, a director of a San Jose nonprofit, said the Kaiser insurance policy she's been buying on her own is increasing from about $281 to $579 a month. She received a letter Monday from Kaiser that said her rates were going up partly because of the "new benefit and enrollment rules under health care reform."
"Our premiums have been reasonable in the scheme of things, but now they are unreasonable," said Houston, adding that her family does not qualify for assistance on any level. "It's the middle class that bears the biggest burden for those who cannot, do not or will not pay their own insurance."
In Danville, 61-year-old retiree Chuck DeHont said that an Anthem plan that costs him $375 a month is being discontinued. The replacement plan with similar coverage will cost him about $600 a month, he said.
Across the country, Americans were eager to find out how much they would have to pay under the Affordable Care Act. The partial government shutdown had no immediate effect on the opening of the new insurance marketplaces because they operate with money that isn't subject to the annual budget wrangling in the nation's capital.
On the first day of a six-month open-enrollment period, the Covered California site received 5 million hits by 3 p.m., averaging 5,000 hits per minute and peaking at 16,000 hits per minute.
As of 3 p.m., the two Covered California call centers received 17,000 phone calls -- 13,000 more than anticipated.
At 8:46 a.m., Covered California tweeted that it had enrolled its first person -- even though people have until Dec. 15 to sign up for coverage that begins next year.
Computer users reported slow response times, with some Web pages never loading.
"One should plan on reading a great book while attempting to use the website," suggested user Mark Gaubatz, a Cupertino small-business owner. "Check for a possible website response between chapters."
Robert Booz, a vice president and analyst at Gartner Inc., an information technology research and advisory company, said the technical delays and glitches were "destined to be."
"This is a huge undertaking. It was a very short time frame relatively speaking for a major system implementation," Booz said. "It had all the earmarks of trouble coming."
Meanwhile, key information that was expected to be posted, including the list of doctors and hospitals that each insurance plan provides, was missing on the Covered California site, www.coveredca.com. So was the list of certified enrollment counselors and certified insurance agents tasked with helping users understand the program. The information was expected to be posted online by Wednesday.
"We have some work to do," said Larry Hicks, a Covered California spokesman.
Some of the problems mimicked those around the country, where a combination of high demand and technical glitches overwhelmed online systems.
Illinois residents saw computer screens telling users the system was unavailable. Hawaii's marketplace wasn't allowing people to compare plans and prices, and Colorado officials said the state's website wouldn't be fully functional for the first month.
Covered California's Hicks acknowledged that some individual health plans will see a price hike, most likely because of the increase in number of services being offered and the new guaranteed coverage.
Adults with pre-existing conditions, for example, cannot by denied coverage or charged more. And all new health insurance plans will come with 10 essential benefits that include outpatient and emergency services, hospitalization, maternity and newborn care, mental health care and prescription drugs.
Marian Mulkey, director of health reform at the California HealthCare Foundation, an Oakland-based nonprofit, said that because no one can be denied coverage under the new law, the pool of people eligible for insurance includes a larger number of sicker people.
"Everybody is in a bigger risk pool," Mulkey said. "And it's more expensive on average because the sick as well as the healthy are in the risk pool."
Staff writer Josh Richman and The Associated Press contributed to this report. Contact Tracy Seipel at email@example.com or 408 275-0140.
Colorado: Website won't be fully functional this month
Hawaii: Site didn't allow comparison of plans and prices
Illinois: Computer screens told users that system was unavailable
Minnesota: Site delayed several hours
New Hampshire: Site stopped working
Rhode Island: Site temporarily crashed
Washington: Site used Twitter to thank users for their patience
Source: Associated Press