As millions clogged the government's new website for purchasing low-cost health insurance Tuesday - with many unable to get through - Alfred Chavis filled out an application the old-fashioned way:
On paper.
Chavis, 55, who works part time at a McDonald's restaurant and is taking classes at Community College of Philadelphia, applied for coverage at the Rising Sun Health Center in Olney. He was happy to learn he might pay as little as $290 a year for a midlevel "silver" insurance plan, after receiving a government subsidy that could amount to thousands of dollars.
"I just hope everything goes through," said the Germantown resident, who said he earns $14,500 a year. "I can't be a productive part of society if I'm not healthy."
Many others across the region and beyond were less successful in their attempts to sign up, encountering glitches at the website healthcare.gov. Staff at some area clinics and health centers handed out information and made appointments for people to come back and apply later in the week, whereas other providers said they had decided not to publicize the new program just yet - predicting, correctly, that there would be kinks in the system.
In a late-afternoon conference call with the media, officials from the federal Centers for Medicare and Medicaid Services declined to answer questions about how many people had successfully signed up or when that information would be made public - saying they wanted to make sure first that it was accurate. They said more than 2.8 million people had visited the website Tuesday.
"This is day one of a six-month process," said CMS administrator Marilyn Tavenner, referring to the March 31 deadline by which the uninsured must sign up to avoid incurring a penalty. "We're in a marathon. It is not a sprint, and we need your help."
The first day of the insurance sign-up came amid continued wrangling over the shutdown in Washington, where congressional Republicans have repeatedly sought to delay or repeal the health-insurance overhaul, commonly dubbed Obamacare by foes and supporters alike.
The shutdown did not appear to have any immediate effect on people who tried to sign up, local health providers said. The website, on the other hand, stymied many - particularly at a point in the sign-up process when users were asked to choose a security question.
"I've tried all morning and I have yet to get on," said Emily Nichols, director of operations at the Family Practice and Counseling Network, which runs health centers in Philadelphia and York.
At CAMcare, a bustling health center in downtown Camden, Morris Richardson, 49, was grateful simply to get information.
"My teeth are killing me," said Richardson, a Sewell resident who lost his insurance about a year ago when his wife could no longer afford her premium. "It's definitely cavities."
Suffering from multiple disabling injuries besides his dental problems - he is blind in his right eye, has a bullet lodged in his left arm, and arthritis in both hands - Richardson said he looked forward to purchasing a plan through the new health-insurance exchange.
Sharon Buttress, CAMcare's medical director, predicted that her group, which operates six locations in Camden, would enroll 7,000 people in a plan, many with diabetes and other complex issues.
"The good news is we will be able to start managing these people, and in the long term, we'll get a healthier population," said Buttress, who estimated that 30 percent of CAMcare's patients lacked health insurance.
At the new Spectrum Health Center in West Philadelphia, the walls were papered with black and yellow signs touting the new health-care law, formally called the Affordable Care Act.
Roderick Schichtel, 46, an artist, house painter, and handyman who has not had health insurance for more than 20 years, decided to visit the center at the suggestion of a friend.
After briefly talking with a navigator - a counselor who has undergone extensive training on the law - Schichtel discovered that he makes too little to qualify to buy health insurance in the marketplace. Nor can he get Medicaid because Pennsylvania has not yet accepted money from the federal government to expand its Medicaid program. But that did not anger Schichtel.
"It doesn't bother me," he said. "It just is what it is."
Altonya Sheppard, 37, who works part time at a West Philadelphia health clinic, was not too happy when she plugged her income and other personal information into a cost estimator on the government website. She learned she would have to pay $100 a month for a plan.
"I was hoping it would be affordable, but $100 a month is not for me," said Sheppard, who is uninsured.
That included a $1,400 tax credit. But she said rent, utilities, and food absorbed almost all of her income.
She takes eight to 10 medications to control her asthma, allergies, arthritis, and high blood pressure. A few years ago, Sheppard had a mild heart attack and sees a specialist at an additional cost.
At the Rising Sun Health Center, which is operated by the nonprofit Public Health Management Corporation, officials said Chavis was among more than 50 people who filled out paper applications.
Amanda Kimmel, social services manager at PHMC, predicted Chavis would get a response to his application within a week.
In an air-conditioned trailer in the parking lot outside the center, white-shirted employees from Independence Blue Cross also were drumming up support. Next to the trailer, passersby were invited to answer questions about the health-insurance law in a mock game show.
St. Mary Medical Center welcomed information-seekers at a community outreach center on Knights Road in Bensalem. The hospital also will be staffing similar centers in Levittown, Morrisville, and Bristol Borough.
Spokeswoman Lori Palmer said that by midafternoon, three people had come by to apply for insurance - two of whom had a prior appointment. Staff members gave them information and took their phone numbers to let them know when the website was more accessible.
"We're ready," Palmer said. "We need the system to cooperate."
People have until Dec. 15 to sign up if they want the coverage to start Jan. 1, the earliest date possible. They can sign up as late as March 31 without incurring a penalty.
IMPORTANT DATES
Tuesday: Health insurance exchanges opened.
Dec. 15: Deadline to sign up for insurance that takes effect Jan. 1, 2014.
Jan. 1: The first date exchange insurance takes effect.
March 15: Deadline for insurance that takes effect April 1, 2014.
March 31: End of open enrollment.
tavril@phillynews.com
215-854-2430
This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente.
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