As the U.S. government began its partial shutdown on Tuesday morning, the online health insurance marketplaces established under the Affordable Care Act or Obamacare opened for business. Republican opposition to Obamacare is what led to the gridlock in Washington, yet the nationwide exchanges proved so popular on their first day that their websites struggled and, in some cases, crashed under the weight of so much traffic.
President Obama has compared online the marketplaces to shopping sites such as Kayak and Amazon which allow users to compare the health coverage options offered by private insurance companies; they also explain the tax subsidies that have been introduced to help pay for coverage.
According to the administration up to seven million previously uninsured Americans are eligible to enroll on insurance plans in the coming months. Users experienced long waiting times and crashes as they tried to access the exchanges, which between them had more than 10 million unique visitors in their first 24 hours, according to Reuters.
Washington DC and 16 other states are operating their own exchanges, while those in the remaining 34 states will be overseen by the national government. The federal healthcare.gov website received some 2.8 visitors on Tuesday, while the New York state marketplace alone reported 7.5m visits to its website by mid-afternoon.
The health insurance plans being offered will not actually kick in until 1 January 2014. Jay Angoff, former head of insurance implementation at the Department of Health and Human Services, told USA Today he was unconcerned by the website glitches. “We’re at three months before coverage starts, and I’m not worried that people won’t be able to get in,” Angoff said. “They have 60 days to see what works and what doesn’t.”
Speaking at the White House on Tuesday, President Obama said, “Tens of thousands of Americans die each year just because they don’t have health insurance. Millions more live with the fear that they’ll go broke if they get sick. And today, we begin to free millions of our fellow Americans from that fear.”
President Obama signed the Patient Protection and Affordable Care Act in 2010, and the law was ratified by the Supreme Court in 2012. When it takes effect in January, the legislation will prevent insurers refusing coverage to those with pre-existing health conditions. It also allows children to remain covered by their parents’ insurance until age 26, and introduces discounts on prescription drugs for the elderly, among other provisions.
Employers with 50 or more full-time employees will also be required to provide insurance for their staff, though the so-called employer mandate has been delayed a further year, until 2015. The most controversial aspect of the law, known as the individual mandate, requires people without health insurance to purchase an individual plan or face a fine.
Low-income individuals and families whose incomes are between 100% and 400% of the federal poverty level will receive federal subsidies on a sliding scale if they purchase insurance via an exchange.Those from 133% to 150% of the poverty level will be subsidized such that their premium costs will be 3% to 4% of income.In 2013, the subsidy would apply for incomes up to $45,960 for an individual or $94,200 for a family of four.