Scenes from open enrollment's first day

Ajee Acosta, a 19-year-old student in Brooklyn, was walking down Church Avenue in the bustling Flatbush neighborhood Saturday morning when she spotted a health insurance enrollment shop operated by MetroPlus Health Plan.

Acosta, uninsured since her previous insurance in North Carolina ended, went in and signed up, on the very first day of open enrollment under the Patient Protection and Affordable Care Act. “I want it just in case something happens,” she said.

In communities across the country, insurers, hospitals, and community groups held enrollment events Saturday to encourage sign-ups during Obamacare's second enrollment, which runs through Feb. 15. Advocates are employing new tactics and expanding old ones to reach people who need insurance. Some groups are targeting populations who slipped through the cracks during the last enrollment period, including younger people, Hispanics, and rural residents.

The HealthCare.gov website, where people can sign up and search for coverage in 37 states, appeared to be functioning without glitches midday Saturday, the Associated Press reported.

But the New York Times reported that while new enrollees appeared to be able to quickly and easily sign up across the country Saturday, some people who tried to log into their accounts to re-enroll experienced long and frustrating delays in at least some locations. That occurred at a community health center in Manassas, Va., while HHS Secretary Sylvia Mathews Burwell was visiting. According to the Times, consumers struggled with the so-called identity proofing system of the HealthCare.gov website, though some completed their applications after nearly 90 minutes. Enrollment workers in a number of other states reported mostly satisfactory experiences.

The stakes are high for the success of open enrollment. Many experts say that if it goes smoothly and millions more Americans sign up for coverage, the law will become more firmly entrenched socially and politically in the U.S. and it will be harder to roll back or repeal.

Burwell tweeted that the website opened shortly after 1 a.m. Saturday, with more than 23,000 people submitting applications within the first eight hours. She said 1.2 million unique visitors looked at coverage using the site's window-shopping tool last week.

In Brooklyn, it's hard to miss the MetroPlus storefront where Acosta stopped in. There were balloons, DJs playing music and offering ticket giveaways, and face-painting for kids. A handful of MetroPlus employees were chatting up and pulling in local residents doing weekend errands. Inside, people could get a free blood pressure screening, grab a cookie or cup of coffee, and ask questions about health insurance.

Across the street, another insurer, Affinity Health Plan, also was operating an enrollment shop. Both storefront shops will be open six days a week through the three-month enrollment period.

In Washington, D.C., Susan Lund was among those waiting in line to sign up for coverage when D.C. Health Link, Washington's exchange, kicked off its open enrollment event Saturday morning at Martin Luther King Jr. Library downtown. The 58-year-old freelance copy editor, who currently is uninsured, found out that she's eligible for the District's expanded Medicaid program open to adults with incomes up to 138% of the federal poverty level.

“I don't have a steady income,” Lund said, noting that she makes less than $10,000 annually. “I get jobs when I get them.”

More than a dozen counselors were on hand at the King library event to help individuals sign up for coverage. They faced a steady stream of potential customers during the first two hours of operations.

“We had great success in the first open enrollment period. This time we're really trying to reach harder-to-reach populations,” said Falasha Culpepper, an in-person assister helping to sign people up for coverage. “Everybody wants the young invincibles. But we just want people who are not insured. It's every walk of life in this city.”

Kevin Lambert, a D.C. resident, had been waiting for about 20 minutes to see an application counselor. He has Medicare, but he showed up to see if there are better private insurance coverage options for his wife and 13-year-old daughter. “My family and I are paying out the nose for really wretched healthcare,” Lambert said. He doesn't mind the monthly premium, which is roughly $250, but has been disappointed in the benefits. “There's a huge deductible,” he griped.

As the D.C. event entered its third hour, Culpepper said there hadn't been any significant technical difficulties in signing people up. “We can take you through the whole process,” she said. “We've really been able to find a solution to everything today.”

In Chicago, at a kickoff enrollment event at the Robeson Theater in South Shore Cultural Center, enrollment navigators sat down with a smattering of applicants to get them insured. Toni Martin, who is employed, said she came to the event because she hasn't been able to afford insulin and other medications she needs as a diabetic. “There's a lot of people out there who don't have healthcare and I was one of them,” she said. “This is the land of opportunities, why can't we have healthcare?”

At the Chicago event, navigator Alisha Watson, who works with Heartland Alliance, a not-for-profit social services agency, said Obamacare's subsidized coverage is badly needed in her community. “For so many years, people have gone without medication or have suffered tremendously for not having access to healthcare,” she said.

Joseph German, who lives in Chicago's Washington Heights neighborhood, said he felt “extremely blessed” to be able to sign up for coverage at the event. He worries about the possibility of the law being repealed or struck down by the Supreme Court, and how that would affect low-income communities.

“If people can't have health insurance, they're going to be taking the little amount of money they have to pay for healthcare, and that'll take away from their households and it could affect their neighborhoods,” he said.

Federal and state exchange officials have worked hard to avoid website glitches and outages like those that hobbled initial enrollment last year. Such problems are not out of the question this year, but a full-scale meltdown seems less likely. HealthCare.gov has been revamped to handle last season's peak loads and beyond. The federal website will serve as the online portal for coverage in 37 states, while the remaining states run their own insurance exchanges. Consumers can also apply in person or through call centers.

The pool of potential customers is an estimated 23 million to 27 million people who don't have access to affordable coverage on the job. HHS estimated that 9.0 million to 9.9 million people would sign up and pay for private coverage through the exchanges for 2015, up from a little more than 7 million in 2014.

For most newcomers, the online application has been simplified, cut to 16 computer screens from 76. Navigation is easier. Window shopping is available without first having to create an account. And the website offers an improved Spanish-translation function. Premiums for 2015 are a wild card. Nationally, the average increase is expected to be modest. But prices can vary dramatically from state to state, even within regions of a state. Many returning customers could end up facing premium increases if they don't shop around.

In his Saturday morning radio address, President Barack Obama urged consumers to go to the online marketplaces and shop for a health plan. For those enrolled in 2014, he said “you might be able to save more money, or find a plan that fits your family's needs even better than the one you've got now. If you haven't signed up for insurance yet, this is your chance. Odds are, you'll qualify for tax credits to help you afford it. So spread the word. Tell your friends and family members to get covered.”

Anne Filipic, president of Enroll America, said reaching the uninsured will get harder from year to year as more people get coverage. Part of the challenge during this open enrollment period, she said, is for organizers not just to connect people to health insurance but also make sure those enrolled keep their coverage and make any necessary updates.

"This year, we really have to be able to walk and chew gum at the same time," she said.

--The Associated Press contributed to this article.

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