With Monday's deadline - now extended to Tuesday - to sign up for health insurance starting Jan. 1, hundreds of thousands of people flocked to the federal website and sought help from local organizations.
About 850,000 people had visited the website by 2 p.m., five times more than the same time the previous Monday, on top of 1.2 million over the weekend, a federal spokeswoman said, and there were few glitches.
"Yes, everybody waited until today to enroll," said a harried-sounding Laura Line, corporate assistant director for Philadelphia-based Resources for Human Development, who had to rush off the phone at 5:15 p.m. to help a new arrival get insurance.
Schwenksville resident Ken Lyle, uninsured for 18 months and unable to get medical attention for the after-effects of a car accident two years ago, showed up midday at the Haverford YMCA. He had recently logged onto www.healthcare.gov and found 17 plans to choose from.
"I got nervous about picking one out and wanted to talk to someone," said Lyle, 41, who just started a limo service.
When he heard that Independence Blue Cross would have specialists available at the Y, he drove in and talked it through with a company rep. He picked a plan, and 20 minutes later had health insurance.
His $20.49 monthly premium is due Dec. 31 for coverage starting the next day, although IBX, going beyond President Obama's request for flexibility in light of the website's problems, will cover subscribers retroactively if they sign up by 11:59 p.m. Tuesday and pay by Jan. 28. Many other insurers, including Aetna and Horizon Blue Cross Blue Shield of New Jersey, have agreed to wait until Jan. 10.
Most consumers must have coverage by March 31 to avoid paying a penalty of $95 per adult and $47.50 per child, capped at $285 or 1 percent of family income, whichever is greater. The penalties rise in future years.
Monday was surprisingly quiet after weeks of drama and bad news, beginning with an almost unworkable website. That was followed by cancellations of millions of policies despite Obama's repeated promises that people could keep their old insurance if they wanted.
A government spokeswoman emphasized that the deadline had not changed but that sign-ups would be accepted through Tuesday "to make sure that those who tried to enroll today but had delays due to high traffic have a fail-safe."
In a symbolic step, Obama was quietly signed up for health coverage through the new insurance exchanges, showing solidarity with Americans still struggling to figure out what his signature health-care law means for them. As commander in chief, the president receives health care through the military, so his new coverage will go unused.
Obama selected a "bronze" plan, the least-expensive plan available for someone his age. The White House said the plan Obama chose will cost him less than $400 a month. His wife and daughters, who already have health care, did not enroll.
With the recent surge in traffic to the website, it was impossible to tell how many people have signed up. Obama said Friday that "more than one million Americans have selected new health insurance plans through the federal and state marketplaces" since Oct. 1, a dramatic increase in a few weeks.
As of Nov. 30, 11,788 Pennsylvania residents had selected a plan - third-highest of the 36 states that opted to let the federal government run their exchanges - and 3,259 had done so in New Jersey. But the numbers could be multiple times higher now.
Stephen Loidolt started studying plans a month ago. While Shauna Alterio, 37, entertained 10-month-old Sawyer across the room at the Haverford Y on Monday, Loidolt waited patiently for the website to come back online so he could finish making his transaction. He had chosen a "silver" tier - midlevel - PPO plan with cost sharing.
"I spent 18 months on COBRA and paid a lot," said Loidolt, 37, who is self-employed and lives with Alterio and Sawyer in Media. He said that the family's new monthly premium "is almost free."
The law's complexities, partisan fighting, and repeated deadline extensions have contributed to widespread confusion.
"Some folks come in and they can tell you kind of the basics of the health-care law," said Antoinette Kraus, director of Pennsylvania Health Access Network, which in the last week doubled the number of people it had enrolled since Oct. 1.
"Other people have no idea what the law means or anything about it. So they come to us and say, 'We heard that we can get health insurance. What does this mean?' "
Confused about deadlines? There's a good reason. They keep changing. Here's a tally:
Deadline to sign up for insurance on the exchange marketplace originally was Dec. 15. That was extended until Monday. Consumers now have through Tuesday to sign up at www.healthcare.gov.
On Thursday, the administration announced that people whose individual-market policies had been canceled would be exempt from penalties scheduled to begin next year for not buying insurance, and would also be allowed to enroll in catastrophic plans that previously had been open only to people under 30 or to some facing economic hardship.
States and insurance companies earlier were urged to allow those whose plans were canceled to remain on them through 2014, although it was not clear how many actually have that option. New Jersey law already allows early renewal for a year.
Insurers were asked to cover people retroactive to Jan. 1 if they missed the Dec. 31 payment deadline. The industry's largest trade group said its members would accept payment till Jan. 10.
The government this month also announced a one-month extension of what had been a stopgap program, due to expire Dec. 31, for people who cannot get insurance due to preexisting illness.