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Frustration, uncertainty keep people off health insurance sites

About 17 percent of people who don’t have health insurance actually tried to buy some on the new marketplaces in October, a new survey published Monday indicates. And just 20 percent of those who did try managed to buy a policy, the Commonwealth Fund survey finds.And health officials have made clear the frustrations will not be completely over for anyone, even by the end of the month. The troubl
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About 17 percent of people who don’t have health insurance actually tried to buy some on the new marketplaces in October, a new survey published Monday indicates. And just 20 percent of those who did try managed to buy a policy, the Commonwealth Fund survey finds.

And health officials have made clear the frustrations will not be completely over for anyone, even by the end of the month. The troubled website crashed again Monday, its third complete outage in just over a week. But this time, technicians were able to get it up and running again after 90 minutes.

"We expect these occasional outages are likely to continue as a natural part of the process," Andrew Slavitt, a vice president at contractor QSSI, told reporters in a telephone briefing. "These outages are not unusual."

Teams working to repair the site made "more than a dozen important fixes" to the site over the weekend, said Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, which runs the exchanges.

Teams upgraded hardware and added switches to external provider Verizon Terremark's part of the complicated website package to avoid any more outages like the two that happened last week, Bataille told reporters.

But Bataille appeared to try to dial back expectations of just how well the site will be running by the end of November. "We do expect that the site will be much improved for the vast majority of users," she said. Pages should load more quickly and buttons should work better by then, she said.

"This is an incremental, continuous process,' she added. Although officials had said earlier that the site would improve day by day, Bataille said users could be expected to notice improvements on a weekly basis rather than on a daily basis. The site will be down for intensive maintenance every night from about 1 a.m. to 5 a.m. ET.

The Commonwealth survey — by a group that is an unabashed cheerleader for health care reform — shows just how big a hill the Obama administration is going to have to climb to sign up anywhere near the 7 million people that most experts hoped would buy health insurance on the exchange the first year.

The findings were released just as Republicans on the House Oversight Committee fired their latest salvo in what’s been a steady barrage of leaks and disclosures aimed at embarrassing the administration. This time, the leak takes the form of notes from "War Room" meetings at the Center for Consumer Information and Insurance (CCIIO), the agency at CMS that put together the exchanges.

The notes confirm what navigators trained to help people sign up for insurance have told NBC News and other outlets: that they, too have been frustrated and had to resort to filling out paper applications to keep people engaged in the process.

The health insurance exchanges, the centerpiece of the 2010 Affordable Care Act, fizzled on the very first day they opened. Technical problems ranging from software glitches to complete hardware failures have kept all but a few people from getting through the complex sign-up process. For the first week or so, almost no one was able to sign up.

The White House hasn’t released recent figures on how many people have tried to get insurance, but at last count said 700,000 people had at least started the process. The Commonwealth survey offers a peek at just how many — or how few — did try.

Commonwealth hired Social Science Research Solutions to call more than 4,000 people from Oct. 9 to Oct. 27. Out of those 4,000, they found 682 who didn’t have health insurance, or who had gone onto the marketplace to buy some. A total of 17 percent of people eligible to shop on the exchanges had tried.

“We can say with confidence that 17 percent of people who were eligible actually went to the marketplaces in October,” said Sara Collins, who led the research. “Of those, 21 percent said they enrolled in a policy.”

The numbers get too small to say with much accuracy what this means about how many people actually have managed to sign up. The White House says it will release those numbers in mid-November and then monthly after that.

The survey gives a little insight into what people are thinking. Nearly half, 48 percent, said they weren’t sure they could afford the insurance, while 46 percent said they were still deciding on a plan. And 37 percent said they were having technical difficulties.

“Seventy percent of people who visited the marketplaces rated the experience as fair or poor,” Collins said in a telephone interview. “It is disappointing that people did have problems enrolling in health plans.”

And the results, which have a margin of error of about 4 percent, also show that people are still confused. Although the rollout of this major stage of Obamacare has made headlines and dominated news coverage, 46 percent of those surveyed weren’t aware that the federal government was helping people pay their premiums.

Collins says the findings also suggest that people will keep trying. “People appeared determined to go back,” she said.

The Affordable Care Act gives people until March 31 to sign up for health insurance if they don’t already have coverage. More than half of Americans have coverage through an employer; many others have Medicare or Medicaid. About 16 percent — more than 40 million people — don’t have any insurance at all and these are the people that the exchanges aim to help.

The federal government has paid out grants to groups to train “navigators” to help people through the signup process.

But the navigators fared no better than ordinary folks in getting the online site to work. Republicans on the House Oversight Committee said notes from a meeting show the depth of frustration.

"Navigators are seeing people very frustrated and walking away," one document from an October 15th meeting reads. "They are turning to paper applications to protect their reputations as people in the communities who can help, even though paper applications will not have a quicker result necessarily."

White House spokesman Jay Carney acknowledged this Monday. "The whole point was to alleviate the frustration that so many Americans were having online and to take that frustration away from them and allow a live person at a call-in center to handle their questions and their sign-ups and their enrollment for them," he said.

The administration, Collins and other supporters of health reform say that people eventually will sign up. Jeff Zients, the management expert who’s heading up the rapid repair response for the website, says it’s on track to be working smoothly for most people by the end of November.

And states that have successfully set up their own exchanges — California, New York and Kentucky among them — say their sites are working well. Kentucky officials say 32,485 people signed up health insurance on its exchange the first month. More than 40 percent are under 35 — the so-called “young invincibles” needed for policies to work well without having to charge high premiums.

About three-fourths of those who signed up qualified for federal subsidies to help them pay the premiums, Kentucky officials said. About 650,000 people in Kentucky don’t have health insurance now, officials said.

As of Oct. 24, New York officials said 37,000 people had signed up on that state’s exchange.

Other states, such as California and Connecticut, said they won’t release enrollment figures until later in the month.