LEWISTON — By midmorning Monday, the state’s only health insurance co-op was getting so many calls — How do I get insurance by the deadline? Did the federal marketplace send over my sign-up information yet? How do I make a payment? — that its CEO grabbed a free desk and started answering phones.

So did its chief human resources officer. And pretty much every other employee at Maine Community Health Options in Lewiston.

The insurance company normally averages 1,000 to 1,100 calls a day. By 3 p.m. Monday, the nonprofit had received 1,611 calls — and had at least three more hours in its day to go.

“I think today it’s going to be busy all day,” Jane Cariello, director of service operations, said. “We stay here until every call is answered. . . We’ve offered overtime to everybody today.”

Monday marked one of the biggest deadlines for the Affordable Care Act, also known as Obamacare. Uninsured Americans had until midnight to begin signing up for health insurance, with the six-month open enrollment period winding to a close. Those who started the process have until mid-April to finish it.

Those who failed to start the sign-up process — or don’t complete it — must either qualify for an exemption or pay a penalty.

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Individuals will not be able to buy health insurance between April 1 and Nov. 15 unless they have a qualifying life event, such as a divorce, job loss or birth of a baby.

Although Americans could buy insurance from any company or through a broker, they can only qualify for a subsidy, or discount, by buying through the marketplace.

Maine has emerged as a leader in enrollment, signing up more than 25,000 people for private health insurance through Healthcare.gov as of March 1. That beat the target set by President Barack Obama’s administration for the entire open enrollment period.

Experts expected thousands more to follow as the March 31 deadline loomed. Across Maine, health advocates were swamped with questions as residents rushed to sign up in time.

Many were stymied by technical problems with Healthcare.gov. The website, which serves as the federal government’s gateway for the marketplaces in Maine and 35 other states, stumbled twice on deadline day, pushed beyond its capacity with 1.2 million visits through noon. Many consumers couldn’t start new applications, while others were invited to leave contact information so they could be contacted when the call volumes diminished.

Maine Community Health Options is one of two Maine companies that sold plans through the marketplace, along with Anthem. MCHO wasn’t quite as busy Monday as it was leading up to Jan. 1, the last big ACA deadline, but calls were steady.

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Many had just signed up and were told by the marketplace to call to make sure MCHO had their information. The problem: It can take days for that information to get forwarded to MCHO.

“People are anxious about that because they want to have coverage,” Cariello said. “We want to help them, but we can’t see them (in the computer system) yet.”

Other callers had tried to sign up through the federal marketplace online but couldn’t. A message on the site asked people to leave their email address and try again later.

Kevin Lewis, MCHO’s chief executive officer, believes the two-week grace period will help those caught in the last-minute rush.

“I think it works better for everybody and doesn’t leave people out in the cold,” he said.

In South Portland, Theresa Grainger of Limington found a new MCHO health insurance plan with help from Kate Albert, a certified navigator at the Opportunity Alliance. Monday’s first Healthcare.gov outage prevented Grainger from actually enrolling in the plan, but she created an account, qualifying her for extra time past the official deadline.

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Grainger, 51, lost her health benefits on March 3 after leaving a full-time retail job and now works part time as a gas station cashier and school bus driver in Saco. She took time off from both jobs to meet with Albert on Monday morning.

“I want to make a logical and virtually sound financial decision,” she said. “I don’t want to just take anything because I’m on a deadline at the last minute. It wasn’t planned this way.”

Grainger’s eyeballing a plan that would cost her an estimated $110 monthly in premiums, the same amount she contributed toward her last employer plan. She qualified for a subsidy to help her afford the premium, and a tax credit to offset her out-of-pocket costs, which would top out at $1,000 a year. With the policy, which carries a $500 deductible, Grainger could also visit her longtime primary care doctor in Sanford for just $10 a visit.

Healthcare.gov has pledged that a representative will call her within the next few days to formally sign her up for coverage.

“I made the deadline, I’ve picked a plan, I’ve become educated in the health marketplace, and I’m going to be on time for work,” she said.

Advocacy groups in other parts of the state reported being busy or steady during the day.

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Phone lines remained lit up through early afternoon at the advocacy group Consumers for Affordable Health Care in Augusta.

“We are hearing from lots of people who need a little guidance completing the last steps of enrollment, as well as some who are just getting start[ed] (and everything in between),” staffer Emily Brostek wrote in an email.

Community Concepts in Lewiston hosted its last walk-in enrollment event from 11 a.m. to 4 p.m. Monday. By 1 p.m., a pair of application assistants had helped three people and were speaking with two others. Two more were waiting in line.

“Most of them we’ve seen have tried to navigate the system and are having difficulties. So it seems like we’re seeing people that are already part way through the process,” said Lisa McGee, director of community support services for Community Concepts and an application assistant.

Kathy Peters, of Sumner, was one of those people.

Self-employed and unable to get on her husband’s insurance, she has been uninsured for three years.

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She tried to sign up online through the marketplace before.

“I’m not very good at it, I discovered. Every time I went into the website it told me something different, and I got really frustrated and just stopped. And then I realized the options were coming to an end,” she said.

Peters hoped to get help Monday, though she wasn’t really worried about missing the deadline.

“They said as long as you had your name in time, they could still hold it over for a couple of days,” she said.

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FAQ: A big day for the ACA

March 31 is the deadline to enroll in health insurance?

For most people, yes. But the Obama administration will allow anyone who tried unsuccessfully to sign up through Healthcare.gov — because of technical issues or other problems — by March 31 extra time to submit their application. How much extra time? The feds have been vague, saying mid-April. They’re also taking Americans at their word, asking consumers to attest to experiencing technical glitches, without requiring proof.

If you didn’t start to enroll by midnight Monday, you won’t be able to get private health insurance as an individual until 2015, unless you experience certain life-changing circumstances that grant you a special enrollment period.

Circumstances like what?

If you get married, have a child, lose a job, get a divorce, move out of state, or experience some other change that affects your health insurance, you may qualify for another chance to sign up. But if your life rolls on much like it did last year, then Nov. 15, the start of the 2015 enrollment period, will be your next chance to sign up.

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So, I must have health insurance now?

Yes, unless you are very poor (under the federal poverty level) and live in a state that didn’t expand Medicaid (like Maine).

If you have affordable insurance through your employer, you’re all set. Likewise if you get health care through the military, Veterans Affairs, Medicare, Medicaid or some other insurance program.

What if I don’t sign up for health coverage?

Unless you apply for and get an exemption, you’ll have to pay a penalty.

You can get an exemption to the penalty if:

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• Your religion prevents you from accepting insurance benefits.

• You’re part of a health care sharing ministry.

• You are a member of a federally recognized Indian tribe.

• You lack insurance for less than three months in a row.

• You have suffered a certified hardship.

• You can’t afford coverage because you’d have to pay more than 8 percent of your household income for coverage.

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• You’re behind bars.

• You are not a U.S. citizen, a U.S. national or an alien lawfully present in the U.S.

The penalty’s $95, right?

Not exactly, you could pay a lot more.

First, to be subject to the penalty you have to meet the threshold that requires you to file a tax return. That’s $10,150 for an individual, $13,050 for a head of household and $20,300 for a married couple filing jointly.

For 2014, the penalty will total 1 percent of family income OR $95 per adult and $47.50 per child (up to $285 per family), whichever is more. In 2015 the penalty jumps to 2 percent of income or $325 per adult and $162.50 per child (up to $975 per family), whichever is more. And in 2016 the penalty will be 2.5 percent of income or $695 per adult and $347.50 per child (up to $2,085), whichever is more.

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So someone earning $25,000 annually would face a $150 penalty if they lacked coverage all year.

What happens if I don’t pay the penalty?

The IRS may dip into your income tax refund next year to collect the penalty, but not much beyond that. The health reform law prohibits the IRS from garnishing wages or imposing liens in cases where individuals fail to fork over the penalty.

Can I apply for MaineCare after March 31?

Yes. You can punch your information into Healthcare.gov to see if you’re eligible, but to actually sign up, go the old-fashioned way — get an application from your local DHHS office, download a copy of the application, or call MaineCare Member Services at 1-800-977-6740.

Affordable Care Act 101

We break down the ACA, what it does and what it requires you to do.


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