After months of solid performance, the HealthCare.gov website faltered several times on Monday due to problems from heavy usage as record numbers of Americans scrambled to purchase health insurance on the last official day of the Affordable Care Act's inaugural enrollment period.
More than six million Americans have enrolled in marketplace coverage nationwide and the surge of new enrollments - many of which will be accepted beyond the March 31 deadline - will push that figure even higher. The health law requires most Americans to have health insurance in 2014 or face a fine when they file their income taxes in 2015.
In an interview Monday with a television station in Oklahoma City, OK, Health and Human Services Secretary Kathleen Sebelius estimated that “80, 85, some say as high as 90 percent,” of new enrollees have paid their premiums, according to insurance industry sources.
The scramble to enroll caused HealthCare.gov, the federal marketplace used by 36 states to go down for several hours early Monday morning during extended routine maintenance. Technical crews worked to fix the unspecified problem and the site was functional shortly after 8 am.
User load continued to increase, however. By noon, the site had hosted 1.2 million visits and had 109,000 concurrent users, even though it was designed to handle only 100,000.
In addition, the HHS phone center fielded 350,000 calls as of noon Monday. That's three times the amount they handled on December 23 when people were rushin to beat the deadline to purchase coverage that began on January 1, 2014.
Monday's heavy user load also caused people to encounter problems when creating new accounts on HealthCare.gov, said a tweet by HHS spokesperson Joanne Peters.
Throughout the afternoon, site visitors were periodically told to "wait here, so we can make sure there's room for you to have a good experience on our site."
This "queing" function asks users to leave the site until contacted by e-mail when to return after user volume decreases.
People who are unable to complete their health insurance enrollment on Monday can still do so for an undetermined amount of time beyond March 31, if they "self attest" that they, indeed, tried to get coverage before the deadline passed.
Those who utilize this special enrollment period beyond March 31 - and pay their first month's premium by their insurer's deadline - can expect their coverage to begin on May 1, the same effective date as people who complete enrollment by March 31.
Paper applications for coverage must be received by April 7 in order to qualify for extended enrollment. Those consumers will have until April 30 to select a plan that’s effective on May 1.
People with “special circumstances” will also be able to get marketplace coverage after March 31 if they fall into a variety of categories, including those who were affected by “exceptional circumstances,” such as a natural disaster, a medical emergency or marketplace outages and malfunctions that occur near the plan selection deadlines.
Misconduct, misinformation or inaction by insurance representatives and people who provide enrollment assistance could also trigger eligibility for “special enrollment.” So could an error by an insurance company that results in a person not being properly enrolled, incorrect eligibility determinations related to one’s immigration status and incorrect information on a marketplace website that misrepresents key features of a plan, such as premium rates or benefit offerings.
The new regulations also allow for married victims of domestic violence to apply and select a plan through May 31.