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What's next ... carrier pigeons? Health care helpers turn to paper, phones

Volunteers in several states trying to help people without insurance sign up for Obamacare say they struggled with the new technology.
Volunteers in several states trying to help people without insurance sign up for Obamacare say they struggled with the new technology.Baiata, John (206004872) / NBC News

Volunteers and staffers trying to help people sign up for health insurance on the new federal websites say they’ve turned to 20th-century technology after being frustrated by bottlenecks. They’re signing people up using telephones and paper applications.

Federal IT experts took down the new health insurance market at Monday night and struggled well into Tuesday to get it up and running.

Users were able to create accounts and even got e-mails confirming they had signed in. but were then sent to an online “waiting room”. “We have a lot of visitors on the site right now. Please stay on this page,” it advised.

Dizzy Warren, Community Outreach Manager for Michigan Consumers for Healthcare, says her team is trying to keep people calm. Michigan is one of 36 states that is letting the federal government run its health insurance exchange, so people there have been hitting the online traffic jams.

“At this time we cannot honestly confirm how many people have been enrolled through the state,” Warren told reporters in a telephone briefing Tuesday.

“Some navigators have been able to help people over the telephone,” she added. “We have actually been encouraging them to make appointments with these individuals for some time next week.”

But Warren confirms what the federal government has been saying – a big part of the problem has been that so many people are trying to enroll. “All of our phones are ringing off the hook, even well beyond regular business hours,” she said.

The federal Centers for Medicare and Medicaid Services, which is running the websites, says more people should be able to get through now, after some work to increase both capacity and efficiency of the network. “An extraordinary number of people are coming to check out Traffic on the website and at the call center continues to be high, suggesting a strong interest by consumers in learning about their health coverage options,” CMS said in a statement.

“Our top issue is that too many people are coming to check out plans and find out more about the health care law.”

Jill Hanken, a health attorney at the Virginia Poverty Law Center, said volunteers there are also advising people to come back next week or to call. Virginia is another one of the states relying on the federal site.

“We have been taking this opportunity to take a deep breath,” she said. “Our navigators are taking appointments so people can come in next week.”

But even some states running their own exchanges are straining. Maryland navigators said they turned to paper forms to help the most impatient people enroll in health insurance.

More than 174,000 people had visited Maryland’s website as of Sunday, the state said, but only 326 people had actually signed up for health insurance. “We are working around the clock to make the site better. Marylanders can use the system now, and they should also know that we expect the user experience to improve substantially in the days and weeks ahead,” officials there said in a statement.

Kentucky has been having fewer problems. Kentucky opted to run its own exchange. Governor Steve Beshear, a Democrat, used an executive order to push the plan through.

“I just did it,” Beshear said in an interview this week. “I issued an executive order. It’s just too important for our state.”

Barbara Gordon of Kentuckiana Regional Planning & Development Agency, one of the non-profit groups helping people enroll, said the state’s exchange had some problems the first day, but not since. “Statewide, the numbers indicated this morning that over 7,000 Kentuckians have enrolled in health insurance at the exchange,” she said. Kentucky has about 640,000 people without health insurance.

Some states report better progress. New York says 40,000 people have signed up on its state-run site, California says more than 16,000 have signed up and Washington state signed up 9,400 -- most of whom will go onto the state's expanded Medicaid program.

Despite the delays, groups like Hanken’s are still trying to reach out and encourage Virginia’s 1 million uninsured people to sign up for health insurance. “We don’t want to lose anybody, so we’ll make sure the public is aware when we get up to full speed,” Hanken said.

Ron Pollack of the non-profit group Families USA, which has been pushing to help publicize the health insurance exchanges, says he thinks people will keep trying. Anyone who signs up by Dec. 15 can buy a health insurance policy that starts coverage on Jan. 1 and people have until March 31 to get coverage in the 2014 open enrollment period.

“Given how significant health coverage is, especially for people who don’t have it today … I can’t imagine that people are going to give up, given what the stakes are,” Pollack said.

Mark Nelson, an Arizona insurance broker who has been trying to sign up on the federal exchange since it first opened a week ago, says he was finally able to set up an account Tuesday.

“However, the site is extremely unstable and temperamental. It erred out on the final page,” Nelson said via email. “I think I did get the info in so will see what I get back. I believe this is far too complicated and overly secured to simply get a rate.”