To call the first time Tammy Wampler helped Pennsylvanians sign up for health insurance through a nightmare is an understatement.

The website didn’t work correctly months after open enrollment began in November 2012. When it did work, the federal health insurance marketplace dragged. Consumers were unsure what was required of them under a new federal mandate requiring Americans to get covered or face a tax penalty.

Halfway through the fourth session of open enrollment, signups on the federally facilitated marketplace set up under the Affordable Care Act are running smoothly — most days.

Wampler is one of two federally facilitated marketplace navigators at Family First Health on George Street. Along with Arlene Feliciano, Wampler offers in-person assistance for Pennsylvanians who need help to shop for or enroll in marketplace coverage.

Mostly, she sets up in-person appointments — about five per counselor each weekday — but on Dec. 13, walk-ins were accepted during business hours at the George Street center.

With the earliest deadline looming Dec. 15, Wampler came into the office to 26 voice messages. Twenty-four of those were messages from people trying to get in by the next day.

“Knock on wood,” Wampler said before starting the day's session.

​A Pennsylvania Department of Insurance spokesman said he is unable to verify how many people use navigators to sign up for marketplace coverage without calling each organization, but he said the positions are paid for by more than $3 million in federal grants from the Centers for Medicare and Medicaid Services. At Family First, the positions are federally funded by a grant from the Health Resources and Services Administration.

As of Dec. 2, more than 680,000 Pennsylvanians had signed on to to pick a plan or sign up for expanded Medicaid, according to the Pennsylvania Department of Human Services. County-level data is still not available, and new sign-ups aren't tallied each day.

Enrollee: Despite the onslaught of messages, it wasn’t until an hour after setting up shop in a third-floor conference room that Feliciano had her first enrollee. A 59-year-old Hanover man walked in just after 1:30 p.m.

“When I tried to do it on my own, I couldn’t, so I figured I’d get professional help,” Nathaniel King said. “She was thorough."

Some customers, Feliciano said, are able to sign up on their own. Some even manage to sign up for health insurance using their cellphones, although despite being somewhat tech savvy, she’s not sure how that’s possible. The additional paperwork and verification required by the federal government to prove everything from identity to income can be a burden.

“Don’t they want that $1,100 from the marketplace and the $80 premium from the client?” she asks of health insurance companies that send additional paperwork. More than 75 percent of those enrolling on the federal marketplace qualify for money-saving tax subsidies, according to the federal government.

Wampler wonders why federal departments, which verify information for Medicaid, don’t communicate with each other.

“If they can tell what their income really is,” she said of the Medicaid office across the street, ”why can’t the marketplace?”

Wampler said each counselor helps about five people a day. She expects to help about 300 people sign up for health insurance by the end of open enrollment on Jan. 31.

King, who said he came in because his no-deductible Capital Blue Cross marketplace plan would no longer be offered for 2017, said the system is "not very customer-friendly."

“You can put in all this information and get to a point where you get kicked out and have to start all over again,” he said, referencing his own attempts.

For others  who aren’t able to do it on their own, he said the center's occasional glitches are worth the wait.

After hiccups with multiple email accounts, a lost password and a slow server, King said he was leaving Family First better off than he came in. After 45 minutes, he said he had his problems sorted and enrollment information sent in. In February, he’ll be a year older and qualify for Medicare.

“I see so many specialists, I can’t go a month without insurance,” King said.

Open enrollment on the federal health insurance marketplace ends Jan. 31, but the deadline to have coverage starting Jan. 1 is Dec. 15.

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