Blank boxes where security questions are supposed to appear. Pleas to "be patient." Error messages galore. Notices that "the system is busy right now." Web pages timing out before they load. Garbled lines of text riddled with stray question marks.
Technology experts and government officials were stumped about the reasons for the computer glitches plaguing the Obama administration's launch of new health insurance exchanges. They variously blamed an unexpected deluge of customers and outright errors that information technology (IT) teams labored throughout the day to fix.
Officials scrambled just to keep up with what was working and what was not. In a late-afternoon call with reporters, Marilyn Tavenner, administrator for the Centers for Medicare & Medicaid Services (CMS), said that the federal website running the 36 exchanges operated by CMS had "added capacity" to address the problems with the security questions. Told that users were still blocked by security-question snafus, she said: "We are making improvements as we speak."
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In one of the biggest mysteries, the website for New York State of Health received 10 million visits by Tuesday afternoon, a deluge a spokesman called "overwhelming and unanticipated." Outside IT experts speculated that New York's astronomical numbers might reflect repeated "refreshing" by users. But it was not clear why that would occur in New York alone. Arkansas had about 16,000 visitors in the same period, and Connecticut's exchange logged 34,500 visitors by mid-afternoon.
Some exchanges were hobbled even by much lighter traffic than New York's. Kentucky's Kynect exchange was "swamped" with 60,000 visitors, Gov. Steve Beshar said, with the "crush of hits" revealing a glitch that kept the exchange from filing applications for several hours.
The federal government's healthcare.gov portal logged over 2.8 million visitors by Tuesday afternoon, Tavenner said, or "seven times more users than have ever been on the Medicare.gov at one time." Many visitors were greeted with: "The system is down at the moment. We're working to resolve the issue as soon as possible. Please try again later."
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It was not clear that volume alone explained the problems. Maryland delayed its exchange opening due to "connectivity" issues. Minnesota did not try to launch until the afternoon to make sure it could access federal databases. Colorado temporarily threw in the towel soon after its exchange opened, suspending customers' ability to create accounts for a few hours. Hawaii enrollment was so stymied it could be the end of the week before customers can assess plans and sign up for coverage.
ACHILLES HEEL
IT had for months been viewed as the exchanges' most likely Achilles heel, and on opening day experts were divided as to the cause of the snags. The best guess of outside IT experts was that traffic volume more than software bugs was at fault.
One insurer offering policies on the New York exchange said its technical experts "read the error messages as the system is just buckling under high demand," adding, "it doesn't look like it's a bug. Once they've spun up more servers, the site should stabilize."
"There been a huge amount of Internet volume of people trying to access the websites and that is either slowing down or overwhelming the system," said Caroline Pearson, who runs the health reform practice at consulting firm Avalere Health. She said at least some of the traffic could have represented the curious onlookers and stakeholders in Obamacare, rather than uninsured consumers.
Molina HealthCare, which plans to sell on nine state exchanges, was stymied by some sites. California worked; New Mexico didn't. "That's another important state for us," said Chief Executive J. Mario Molina. "But we weren't able to get in, so I don't know if it's a technical problem or if they were just inundated and the volumes were high."
On the other hand, CMS's Tavenner said that the security-question snag was "one of the glitches we corrected today," implying that it was a pure software-coding problem. After she spoke, however, dozens of Reuters reporters continued to report encountering that and other problems.
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Some of the 15 states running their own exchanges were hardly better off than the federal website that powers the other 36, even if their technology was considered more advanced.
Richard Onizuka, chief executive of the Washington Health Benefit Exchange, said that about an hour after its 7:30 a.m. local time launch "some users were experiencing slow loading times or difficulty completing their application," and the site was placed "in maintenance mode" - shut down for several hours.
Unlike in other states, Washington's malfunction is "not a capacity issue," said spokeswoman Bethany Frey, but did not elaborate.
'BE PATIENT'
The security questions that are central to insuring that people are who they say they are - a potential glitch in the marketplaces that critics have warned about for months - were particularly problematic.
On the Texas exchange, answers to the security questions were initially met with the warning that two answers cannot be the same - even if they weren't - or that they were in the wrong format. After a few more tries the questions did not show up at all. Virtually all the federally run exchanges, from Maine to the Carolinas and from Iowa to Arizona, had the same IT flaw.
Would-be users were repeatedly asked to "be patient," even when they tried to access chat boxes and other devices meant as workarounds to IT problems. In Michigan, opening a chat box to ask a question yielded repeated messages saying, "Please be patient while we're helping other people." After an hour the empty box closed with the statement, "your chat session is over, thanks for contacting us and we hope we've answered your questions. Have a great day."
Even commercial sites stumbled. Ehealth, which received federal permission to sell Obamacare policies, was able to sell coverage to people in Connecticut, California, Maryland, Texas and Florida but not New York, New Jersey or Rhode Island.
Chief Executive Gary Lauer said it would be weeks before eHealth's website could determine customers' eligibility for federal subsidies: the company had received the data it needs to do that from federal officials only in the last few days, too late to have integrated it into existing IT. "We have to work though what's called a pipe in the federal exchange and we are integrating all of that right now," Lauer said.
Access to federal data sites was also an issue for HealthAviator.com, another private website that will sell subsidy-eligible plans. "Based on the issues the federal marketplace is having today, we, too, do not have accessibility to enroll individuals," said chief executive John Adair. He said he believed the situation could continue until late October and called the government's IT performance "disappointing at best."
When some users logged back into exchanges after getting stuck on an earlier attempt, the application did not resume where they last completed an entry but took them back to step one. Bob Hanson, spokesman for the Kansas Insurance Department, said that state officials have been warning people for weeks not to try to sign up on Tuesday: "We're advising people to wait a week or two."
