This is a photo of Access Health CT's call center
Access Health CT's call center Arielle Levin Becker / The CT Mirror

The state’s new insurance marketplace opens for enrollment Tuesday, and officials are marking the occasion with a warning: Be prepared for glitches, or even a system shut-down if problems are bad enough.

Access Health CT, the state’s insurance exchange created by the federal health reform law, is intended to offer customers a way to comparison-shop for health care coverage offered by private insurers.

Exchanges are among the major ways the law commonly known as Obamacare aims to expand health insurance to millions of Americans.

But rather than touting the upcoming changes on the eve of opening, Access Health officials took a more cautious approach. In a press release issued Monday evening, they focused largely on the likelihood of errors occuring once customers begin using the system, in spite of what the statement called “rigorous testing” prior to launching.

“We know there will be defects that we will continue to uncover as we roll out this system to residents,” Access Health CEO Kevin Counihan said in the release.

Peter Van Loon, the exchange’s chief operating officer, pledged that Access Health was committed to customer service and would let people know about any system problems that affect them. But he warned that if “substantial system wide problems” are uncovered, Access Health might temporarily shut down the system to address the problems.

The warning about glitches follows months of efforts by Counihan to lower expectations about the early days of the exchange. The start will likely be rocky, he’s said repeatedly, urging people to view this week as the beginning of a longer process that, like the start of Medicare and the Medicare Part D prescription drug program, will take time to stabilize.

Even so, what happens in the exchange’s early days could help set the tone for the coming months, as outreach workers try to entice those who have gone without insurance to buy into the system. The extent to which their pitches work, particularly among young and healthy state residents, will go a long way toward determining the effectiveness of the health reform law, and the viability of the new marketplace.

No change overnight

The launch of the exchange marks the beginning in earnest of the most significant provisions of Obamacare, ushering in what many people believe will be the largest change in health care coverage in nearly a half century.

That doesn’t mean things will be dramatically different overnight.

Instead, Tuesday is the first day of a six-month shopping period for the exchange’s target customers — people who buy their own coverage, the uninsured, and small employers. Access Health officials expect to have 80,000 to 100,000 customers in the first year, many of whom will qualify for discounted rates subsidized by the federal government.

It’s also the first day for people to sign up for the state’s expanded Medicaid program, which will take effect Jan. 1 and cover an estimated 55,000 to 60,000 additional adults.

For a full list of Obamacare resources from The Mirror, click here.

Tuesday will likely bring lots of interest and inquiries to Access Health, but it isn’t expected to translate to a lot of enrollment.

The coverage people purchase through the exchange won’t take effect until Jan. 1, and Counihan and others have noted that people probably won’t want to pay their premiums three months in advance, which is what signing up this week would require.

Comparison shopping

At the Access Health call center in Hartford, call volume had already picked up Monday, with close to 300 calls by 1 p.m., even though it was too early to enroll. Many people called with questions.

While the premium costs for exchange plans have been available for nearly two months, Tuesday marks the first time shoppers will be able to see which health care providers will be covered by each insurance plan offered through the exchange. Access Health requires that each insurance carrier’s network be substantially equal to those used in its other commercial health plans, but the exchange plan networks are expected to be somewhat narrower than what many customers are accustomed to, with some hospitals and doctors opting against participating in some plans.

Access Health’s application process is available to people seeking private insurance and those who will qualify for Medicaid after Jan. 1, as well as people who aren’t sure which one they’re qualified for (the computer system will sort it out). People can apply online (, through the Access Health call center (855-805-4325), or using a paper application. Close to 300 people from community organizations are receiving training to help people enroll, and the exchange is expected to open storefronts in New Britain and New Haven for people to receive in-person help.

Counihan has urged people to avoid using the paper applications without getting help, saying the process is complex and paper applications are more prone to errors.

Who will sign up?

People buying coverage on their own have until March 31 to enroll in an exchange plan. What happens over the coming months could help answer a number of questions about Obamacare.

For example, will the uninsured sign up?

Some people who have struggled to afford insurance in the past, or who have been unable to buy it because of medical conditions, are eagerly awaiting a chance to shop for subsidized coverage on the exchange. (As of Jan. 1, all insurance companies will be prohibited from denying anyone coverage because of a medical condition.)

But others have expressed skepticism about being able to afford insurance, and even a heavily subsidized premium for someone at the low-end of the income scale can mean paying a large chunk of money, compared to spending nothing now. Will those potential customers, and particularly the young, healthy people whose participation would balance the costs of sicker members, decide that the cost is worth it?

Another question: How will small businesses handle the new requirements on health plans? The health law requires that insurance plans cover at least 60 percent of members’ medical costs. That’s more than the plans offered by about half the small employers in Connecticut, according to a 2011 study by the consulting firm Mercer. Will small businesses, many of which have long struggled with the cost of health insurance, spend more to offer the required level of coverage? Or will many choose to drop their health plans, allowing workers to buy coverage through the exchange?

Arielle Levin Becker covered health care for The Connecticut Mirror. She previously worked for The Hartford Courant, most recently as its health reporter, and has also covered small towns, courts and education in Connecticut and New Jersey. She was a finalist in 2009 for the prestigious Livingston Award for Young Journalists, a recipient of a Knight Science Journalism Fellowship and the third-place winner in 2013 for an in-depth piece on caregivers from the National Association of Health Journalists. She is a 2004 graduate of Yale University.

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