Despite the confusion, the insurance industry has held off public criticism. Alarmed that only a trickle of customers got through initially, insurers now say enrollments are starting to come in and they expect things to improve.
The last major federal health care launch the Medicare prescription program in 2006 also had big startup problems. Government leaders who oversaw it say things could look very different in a couple of months for Obama's law if the administration manages to get a grip on the situation.
"There wasn't enough time for testing, so the dress rehearsal became opening night," said former Utah Gov. Michael Leavitt, who as President George W. Bush's top health official, was responsible for the Medicare drug-plan debut.
"The moment of truth is going to come in the middle of November, when people want to see the real deal," said Leavitt, who heads a consulting firm that advises states on the health-care overhaul. "If they don't have this running smoothly by then, it's going to be a bigger problem than we're seeing today."
The insurance industry is calling for patience. "This is a marathon and not a sprint," said Karen Ignagni, head of the trade group America's Health Insurance Plans.
The Affordable Care Act was designed to provide insurance for people who don't have access to coverage on the job. Middle-class uninsured people can buy a government-subsidized private plan, while the poor and will be steered to Medicaid in states that agree to expand the safety net program. The online insurance markets were envisioned as the 21st century portal to an overhauled system.
But when the health care markets went live last week, millions of curious Americans overwhelmed federal and state insurance websites. The level of interest could be read as a good sign, since polls just prior to the launch found most uninsured people unaware it was coming. Yet for many, the consumer experience was like a Saturday morning spent twiddling thumbs at the local motor vehicle department.
Some prospective customers got a screen that told them to wait and nothing happened, for hours. Others started to sign up and got trapped by a recurring glitch when they tried to set up security questions to protect their personal accounts. Some who got through all the way to the end found their sessions had timed out, and they had to start over.