ST. LOUIS (AP) – Missourians hoping to finally find out whether the federal Affordable Care Act lives up to its name were greeted with lengthy delays Tuesday as consumers nationwide flocked to a new online health insurance marketplace.

Those seeking information from the government-backed insurance exchange were advised to “please wait” and thanked for their patience while the website handled heavy traffic. After successfully entering the site by creating a username and password early Tuesday morning, an Associated Press reporter encountered a virtual roadblock when prompted to respond to security questions required before plan information could be accessed. Eight hours later, the wait persisted.

The online insurance exchange in Missouri is being operated by the federal government after state lawmakers and then voters rejected a state-run system. Unlike in many other states, few details about the plans’ premium costs, deductible levels and other specifics were disclosed in advance of Tuesday’s kickoff. And despite high hopes, those details remained unknown for most well into the day.

The delay made for some frantic preparations by the certified application counselors hired by the government to help consumers through the process, as well as the government-approved “navigators” who guide applicants through their choices from among private insurers.

And the less-than-smooth start worried state health advocates who see the exchanges as a chance to potentially provide coverage for as many as half of the estimated 835,000 uninsured people in Missouri as of 2010, per the U.S. Census.

“These exchanges live and die on customer service,” said Thom McAuliffe, a policy analyst with the nonprofit Missouri Foundation for Health. “If too many people show up and see this is a pain, they’re going to say, `Forget about it.”’

Consumers have until the end of March to enroll, or by Dec. 15 if they want coverage starting Jan. 1. The online marketplaces are for those who don’t receive employer-sponsored health coverage or certain residents eligible for workplace plans but looking for better deals.

The online benefits calculator also will provide Missourians a glimpse into the amount of government tax credits they can expect to receive to offset actual out-of-pocket policy costs. But those subsidies won’t be available to adults below the poverty level because the law assumes those people would get coverage under Medicaid expansion. Missouri is among 26 states that have not expanded coverage under the federal insurance program for poor, another key part of the contentious federal law.

“We really have to see the forest for the trees,” McAuliffe added, calling the first-day blips “an annoyance” that he hoped wouldn’t detract too much from the new law’s fundamental benefits.

At the Betty Jean Kerr People’s Health Center in north St. Louis, a community clinic where one-third of the patients are uninsured, the trained health counselors greeted prospective applicants Tuesday morning with balloons, candy and basic plan information. A row of computer terminals were made available in an upstairs classroom for those who wanted to peruse the marketplace, and 10-minute tutorials on the new program were offered every 30 minutes for those who wanted more than a few handouts. The center planned to remain open into the early evening this week in anticipation of client demand for insurance details.

Center president and CEO Dwayne Butler said he wants the outreach on government-backed insurance to extend to broader efforts at preventive care in some of the city’s most distressed neighborhoods

“We are the custodians of our community’s health,” he said. “We’d love to get people to register. But we also want to get our community excited, and elevate the health conversation.”

He said the personal touch was essential to not only help make a complicated government program more easily understandable but also to ease possible concerns about turning over information about income levels, dependents and other personal details.

“You can’t just put a piece of paper in front of them and ask them to fill it out,” Butler said. “You have to make people comfortable.”

Tomika Ewing, an unemployed mother of two, came to the Delmar Boulevard clinic to schedule a doctor’s appointment for her 8-year-old son. She had heard a radio disc jockey discuss the new insurance marketplace earlier Tuesday but was otherwise unaware of the program. She left the health center with a handful of explanatory pamphlets along with renewed hope for affordable health insurance.

“I didn’t know anything about it before today,” she said.

Beneath the state’s largely hands-off approach to the health insurance exchange, an undercurrent of more forceful opposition to President Barack Obama’s signature policy measure remains. Among the most vocal opponents: Republican Lt. Gov. Peter Kinder, who encouraged “active resistance” to the program and urged people last week to register their objections by not signing up for coverage.

In advance of Monday’s roll out, state health care advocates had warned consumers to be patient and expect some possible technical glitches early on a prediction that quickly came true.

Program details can be found online at


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