For millions of Americans trying to log in, the online insurance marketplaces created by the new health care law began with a stalled website, an error message or a menu that didn't work.
But the debut of the new insurance marketplaces might have been a victim of the law's own success. The initial sign-up day appeared to draw heavy interest that suggested pent-up demand for just the kind of coverage now being offered.
Tennessee State University student Sam Rutherford, 31, said he signed up for a policy on Tuesday, some 15 years after a sledding accident that resulted in him losing several organs.
"I've been virtually uninsurable since that time," he said.
In 36 states where the federal government is running the marketplaces, a snag involving security questions on users' accounts cropped up repeatedly, preventing many from completing their enrollment.
Brett Graham, a consultant advising states, called the security questions glitch "a real show-stopper."
"If you can't set up an account ... you can't enroll," said Graham, of Leavitt Partners, a consulting firm run by former Health and Human Services Secretary Michael Leavitt, who rolled out the Medicare prescription drug benefit under former President George W. Bush.
In some states, trained health care guides resorted to old-school means of signing people up: paper or telephone.
Katie League, an outreach and enrollment manager at Health Care for the Homeless in Baltimore, used paper applications to register people when the website developed problems. She said she wasn't surprised by the opening delay and took it in stride.
"Today is the start of preseason," League said. "You know, not every quarterback is ready on the first day of preseason."
Officials in President Barack Obama's administration said they are pleased with the strong consumer interest, but on a day of glitches they refused to say how many people actually succeeded in signing up for coverage.
By Tuesday afternoon, at least 2.8 million people had visited the healthcare.gov website, said Medicare administrator Marilyn Tavenner, whose office is overseeing the introduction of the Affordable Care Act. The website had seven times the number of simultaneous users ever recorded on the medicare.gov site.
But at most only a handful of people had been able to successfully enroll online through the federal website in that time period, according to two industry officials with knowledge of the situation. The officials spoke on condition of anonymity because they were not authorized to speak about the issue publicly.
The technical trouble couldn't dampen the relief Hussein Daoud felt for himself, his wife and their six children.
The 51-year-old Detroit man came to apply for insurance at the Dearborn-based nonprofit organization ACCESS. With the help of counselors, he learned that his annual income of $14,500 made him eligible for Medicaid, and he likely won't have to pay for a plan that covers his family.
"This is the first time I asked for anything from the government, and I'm really glad that the government can help my family," said Hussein, who lost his supervisory job at a dollar store when it closed a few years ago. He now sells used cars and can't afford health care coverage.
Minnesota got its site running after a delay of several hours. Rhode Island's site recovered after a temporary crash. A spokesman for the New York Department of Health blamed difficulties on the 2 million visits to the website in the first 90 minutes after its launch. Washington state's marketplace used Twitter to thank users for their patience.
Exchange officials in Colorado said their website would not be fully functional for the first month, although consumers will be able to get help applying for government subsidies during that time. Hawaii's marketplace wasn't allowing people to compare plans and prices.
Connecticut seemed to be a bright spot. Access Health CT sent out a tweet shortly before noon Tuesday, confirming the marketplace logged 10,000 visitors in the first three hours of operation and 22 enrollments.
California, home to 15 percent of the nation's uninsured, reported delays online and on the phone because of heavy volume.
In Portsmouth, N.H., Deborah Lielasus tried to sign up for coverage but got only as far as creating an account before the website stopped working. She said she expected problems.
Lielasus, a 54-year-old self-employed grant writer, currently spends about $8,500 a year in premiums and more than $10,000 for out-of-pocket expenses because she has a health condition and her only option has been a state high-risk insurance pool. She said she expects those costs to decrease significantly.
As excited as she was to sign up, she said, her anticipation was tempered by dismay over the government shutdown that was led by congressional Republicans who want to block the health insurance reforms.
"I'm really happy that this is happening, that this is being launched ... I feel like it's a child caught in the middle of a really bad divorce," Lielasus said.
The shutdown will have no immediate effect on the insurance marketplaces, which are the backbone of the law, because they operate with money that isn't subject to the annual budget wrangling in Washington.
The Obama administration hopes to sign up 7 million people during the first year and aims to eventually sign up at least half of the nearly 50 million uninsured Americans through an expansion of Medicaid or government-subsidized plans.
Many states predicted that an initial surge of interest would test the online system, but they expect most people to sign up closer to Dec. 15, which is the deadline for coverage to start Jan. 1. Customers have until the end of March to sign up in order to avoid tax penalties.
Under the law, health insurance companies can no longer deny coverage to someone with a pre-existing medical condition and cannot impose lifetime caps on coverage. They also must cover a list of essential services, ranging from mental health treatment to maternity care.
Unexpectedly heavy first-day traffic strained the website New York set up for residents to shop for health insurance under the Affordable Care Act, health officials said Tuesday as technicians worked on glitches that prevented some consumers from getting past the home page.
In the first two hours after going live, "the site received an overwhelming and unanticipated response of 2 million website visits, causing users to have trouble logging in," a statement from the Health Department said. By about 2 p.m., the NY State of Health website had recorded 7.5 million hits.
While the department said thousands of New Yorkers had begun shopping for low-cost plans, others were greeted with error messages when clicking on links to register as individuals or families. The links for employers, employees and brokers also experienced periodic problems.
"With considerable time to prepare for the exchanges going live, I was expecting more from the state," said Mike McDougall, president of McDougall Communications in Rochester, who ran into repeated error messages as he tried throughout the day to navigate the site's Small Business Marketplace. "Its inability to anticipate heavy traffic on the first day — or accommodate such a couple hours into the process — is a bit disconcerting."
The Health Department statement said technicians were working on the problems, which were not unique to New York as states' online insurance marketplaces that are at the heart of President Barack Obama's health care overhaul began a six-month open-enrollment period.
At a public outreach event in Buffalo, Lt. Gov. Robert Duffy acknowledged the continuing criticism of Obama's reform, but said New Yorkers were gaining access to plans that are state-certified and cheaper than those offered in the marketplace last year.
"It's not perfect but it's good, it's solid and it will get people into the system," Duffy said of the ACA, "and if government does what it should do then leadership in Washington on both sides of the aisle will come together and work on the Affordable Care Act so that next year and the year after it gets better and better."
Schuyler Banks, 48, of Buffalo was planning to shop for a plan that would cost less than the $800 per month that the adjunct business instructor and his wife now pay through her job in financial services.
"We're going to sit down to see what our options are," Banks said. "I'm not sure how it's going to help me."
Associated Press writers Erik Schelzig in Nashville, Tenn.; Brian Witte in Baltimore; David Kelli Kennedy in Miami; David Lieb in Jefferson City, Mo.; Kristen Wyatt in Denver; Kathy Matheson in Philadelphia; Erika Niedowski in Providence; Holly Ramer in Portsmouth, N.H.; Ricardo Alonso-Zaldivar in Washington; Carolyn Thompson in Buffalo, N.Y; Susan Haigh in Hartford, Conn.; Juliet Williams in Sacramento; Oskar Garcia in Honolulu; Paul J. Weber in Austin; Steve Karnowski in Minneapolis; and David Eggert in Lansing, Mich., and Jeff Karoub in Detroit contributed to this report.
AP Medical Writer Carla K. Johnson can be reached at http://www.twitter.com/CarlaKJohnson .