The official opening of the online marketplaces created under the ACA was highly anticipated- and not without its glitches, in the best sort of way. After months of foreboding press about how 80% of the uninsured didn’t even know about the healthcare exchanges, let alone whether they would sign up for coverage, websites and call centers were inundated across the country. 4.7 million unique visitors went to healthcare.gov, the portal for individuals and small business owners to find out their options under the new insurance program. For some, this resulted in long wait times or spurious website access. For others, it highlighted institutional gaps that exist for at least 15% of American adults- lack of regular internet access.
My day began with trying to sign my father up for an account on the federal exchange, as he lives in a state that has chosen not to run its own. The first challenge we encountered, on the first page we went to: him sitting in silent confusion for a moment then saying “What’s an email address?” It was then I realized that this might take a while. And here’s the thing- that’s ok. October 1st was just the beginning of a 6 month enrollment period, of the first year, of what will become a program integral to the fabric of our social structure, just like Medicare and Medicaid. These programs (among others) have become interwoven into our concept of what we as a society value and think deserves protection from the unpredictabilities and vicissitudes of both economic downturns and political volatility. The Affordable Care Act is just beginning the social and symbolic work it will do- both over the next year and the next decade.
And Americans understand this- and can be a patient people, which might surprise some of the commentators and pundits who edged toward forecasting failure after technical challenges in the roll outs. But sites were overwhelmed by a pent up demand for affordable health care coverage, a desire by millions across the country to provide financial and emotional security for themselves and their families for the time when (not if) they next find themselves in need of medical care. A narrative emerged from a panoply of community centers and doctor’s offices that people trying to sign up were eager, and while disappointed with some of the wait times, willing to wait. For the savings, and sense of security, some were willing to wait all day. Or perfectly willing to come back next week. Or the week after. Plans don’t kick in until January, and for people who may have been waiting for coverage for years- a few weeks more, after which they will have the same coverage the rest of us can enjoy, feels pretty reasonable. As one official said, this is not a sprint, it’s a marathon. But for the 5700 people enrolled as of today, it’s a marathon they’ve already won.