Cause For Hope And Frustration In the Shadow Of ACA Deadline

As the Affordable Care Act's midnight deadline draws near, there has been a surge in last-minute signups. The heavy traffic has caused both glitches in the website and optimism from some forecasters.

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Demand for health insurance is reaching a fever pitch. The deadline is midnight tonight to enroll in coverage for this year through the Affordable Care Act. And people are flocking to healthcare.gov. By early this afternoon, the website had had already logged a record 1.6 million visitors. There are lingering technical glitches but one forecaster says the government is still poised to reach its original goal of signing up seven million people. Here's NPR's Scott Horsley.

SCOTT HORSLEY, BYLINE: Health insurance isn't the kind of product people usually stand in line for, like concert tickets or the latest iPhone. But that's just what people have been doing on this final day of the government's open enrollment period.

SEAN WHERLEY: There were 50 people waiting at 4 am, an hour before we even opened our doors.

HORSLEY: Sean Wherley is with the Service Employees International Union, which is helping people sign up for coverage today at several offices in California.

WHERLEY: There's a long line of people waiting patiently and we think it's going to continue if not get even heavier. Just like a voting day, there's always that surge after work. And so, we are planning to help people right up until midnight.

HORSLEY: The Obama administration says anyone who starts the enrollment process by midnight will be allowed to buy coverage. The federal website was down for several hours of extended maintenance this morning. And a technical problem later in the day temporarily blocked new customers from signing up. In general, though, the website has held up well, despite demand. Forecaster Charles Gaba, who's been tracking the surge in enrollments, says the government exchanges are now on pace to sign up roughly seven million people.

CHARLES GABA: Just like we saw there was a last-minute rush at the end of December for people to get covered by first of the year, I knew there was going to be a spike. I just didn't know if it was going to be twice as many, three times as many. I know it's big, I just didn't know how big.

HORSLEY: Seven-million first-year sign-ups was the original target for the government's exchanges, one that seemed out of reach following the disastrous launch of the website last fall. Drew Altman, who heads the Kaiser Family Foundation, says the website has clearly recovered from its early technical problems. But, he says, the national enrollment figure at midnight is less important than what happens in the months and years to come in roughly 500 local insurance markets.

DREW ALTMAN: People don't want to hear this because we're so quick to want to know if something's good or bad or won or lost or worked or didn't. But it's going to take a couple of years, really, as people use services to know how well this is working. And really, it's not going to be a simple picture and it's going to vary across the country.

HORSLEY: Congressional Republicans are not impressed by the millions of people who've been signing up as the deadline nears.

SENATOR JOHN BARRASSO: I think they're cooking the books on this.

HORSLEY: Wyoming Senator John Barraso spoke yesterday on Fox News.

BARRASSO: Once all this is said and done, what kind of insurance will those people actually have? Will they be able to keep the doctor that they want? How much more is it going to cost them?

HORSLEY: A Kaiser poll this month found 46 percent of Americans still dislike the health care law, while only 38 percent approve of it. That gap is only half as wide, though, as it was two months ago. Democratic pollster Geoff Garin says even if the late surge in sign-ups doesn't turn any Republican heads, it will help to reassure nervous Democrats, many of whom were demoralized during the dark days of the roll-out last fall.

GEOFF GARIN: My guess is that we'll see an increase in Democratic enthusiasm about the Affordable Care Act. And having that greater enthusiasm among Democrats is very important for these midterm elections.

HORSLEY: Garin says health care reform will continue to be a hard-fought political battle right through election day. Scott Horsley, NPR News, Washington.

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