Hundreds of Massachusetts residents started enrolling for subsidized health insurance Tuesday under a new federal system, a long-anticipated process that featured many choices and a few glitches.
Lower-income Massachusetts residents have been able to shop online for subsidized health plans for years, but the nationwide debut of Web-based health insurance marketplaces, a central piece of the federal health care overhaul, will require more than 100,000 residents to sign up for new insurance plans by the end of this year or lose their subsidized coverage.
That’s because the Affordable Care Act, which requires Americans to have health insurance by January, has different rules than Massachusetts for insurance plans and who qualifies for a subsidy.
Unlike other annual enrollment periods, when residents could simply keep their state-subsidized insurance plans if they liked them, residents are required to start from scratch, proving they are eligible for low-cost federal coverage.
“We have had heavy volume,” said Jason Lefferts, spokesman for the Commonwealth Health Connector, the state’s insurance marketplace.
By noon, roughly 1,000 people had dialed the agency’s call center. Nearing day’s end, the Connector had logged 1,300 accounts created, the first step in enrollment, 777 applications started, and 105 applications completed and signed electronically, Lefferts said.
“We’ve had some bugs, some technical stuff, but no system meltdown,” he said.
Among the glitches consumers faced were Web pages that contain answers to frequently asked questions, known as FAQ pages, that did not load properly and were down much of the day.
Also, the website moved very slowly for those who did not use the full Web address, www.mahealthconnector.org to access the site.
The federal health care overhaul is modeled on Massachusetts’ pioneering 2006 law, which mandated that nearly everyone have coverage or pay a penalty.
The Massachusetts law made subsidized coverage available to those making up to three times the federal poverty level, roughly $70,600 for a family of four.
Under the federal law, eligibility has been expanded to include those making up to four times the poverty level, up to $94,200 for a family of four.
That means that 40,000 Massachusetts residents who had not been eligible for reduced-cost insurance under the state’s law are now entitled to such coverage under federal plans, Lefferts said.
Kate Bicego, director of HelpLine, a hotline at the consumer group Health Care for All, said her organization has received a number of calls from residents seeking help with the new system.
“We have not experienced calls from folks that suggest that there is widespread confusion or panic,” she said.
Among the calls was one from a self-employed woman who earned slightly above the limit to qualify for subsidized care in Massachusetts but is now eligible under the federal system.
The woman was so excited, Bicego said, that she went online at 2 a.m. but could not navigate the state’s website, which was not slated to launch until 8 a.m.
Consumers used to shopping for insurance on the state’s website will encounter dozens of new choices under the federal system, Lefferts said. For instance, the state offered three tiers of coverage, known as gold, silver, and bronze, which allowed consumers to select among various options for monthly insurance premiums and copayments at doctors’ offices.
The federal system offers a fourth tier, known as platinum, with yet more choices, Lefferts said.
Another big change involves how consumers obtain their cost savings. Under the Massachusetts system, a consumer’s monthly health insurance premium was reduced, or subsidized, based on the resident’s income.
Under the federal plan, a consumer’s income will be used to calculate a tax credit, and the consumer will have a choice of whether to apply that full amount toward a reduced health insurance premium or to divide it, using part of it for health insurance and the rest for lowering the person’s federal tax bill.