A little after noon on a Saturday in mid-March, Amit Vora stood in line, his aunt and uncle at his side, hoping to find some answers to their health care questions.
Vora said he was at the end of his rope. He had done research online and called hotlines for help when he wasn't getting the answers he needed. But he still didn't have any details about his relatives' new health care plans.
Vora, who lives in Washington D.C. but whose aunt and uncle live in Laurel, said he had spent between 15 and 20 hours on the phone trying to figure it all out.
"There's no one that knows what to do," he said. "Every time I've called in, there's no one who could figure it out. I'm hoping to figure it out."
They were among nearly 350 people who attended a health care enrollment fair in Columbia March 15, one of the last pushes to get residents signed up for insurance under the Affordable Care Act before the March 31 deadline.
To encourage people to enroll, the state announced last week that anyone who begins the enrollment process by the end of March will be able to get coverage in 2014. To alert the state that they've started the process, Marylanders can call a new hotline at 1-800-396-1961.
Uninsured people who have not enrolled, or started the enrollment process, by March 31 will be fined the greater of $95 or 1 percent of their income. In 2015, the penalty will rise to 2 percent of income or a $325 fine, and for 2016 and all years afterward the penalty will be 2.5 percent of income or $695.
According to a report released by the state on March 21, the exchange, the Maryland Health Connection, has seen "a spike in interest and activity" as the enrollment deadline nears.
Since Jan. 1, according to the report, 248,230 Marylanders have enrolled in health insurance. Of those, 203,394 enrolled in Medicaid and 44,836 signed up for a private health insurance plan. The state's goal is to enroll 260,000 residents by the end of the first open enrollment period.
While there's been no county-specific data released yet, Eric Masten, the director of health policy, advocacy and communications for Healthy Howard – which has been coordinating health care enrollment in Howard County and five western Maryland counties through its Door to Health Care initiative – said he was encouraged by local enrollment.
"We're confident we are on track for our success both here in Howard County as well as the region," he said.
Healthy Howard Executive Director Christine Hall said she sees between 250 and 300 people a week coming through the doors of the Ascend One building, where Healthy Howard's headquarters are located, to get health care information.
"We do believe that we're on a pretty good track to reaching the goal for the region," she said, "and it's been very busy, so definitely the interest is there."
In addition to those who come to Healthy Howard for health care help, the organization has also made it a point to reach out to members of the Healthy Howard Health Plan, a joint partnership between Healthy Howard and the county that provided access to health services and discounted prescriptions for county residents.
According to Hall, there were a little more than 700 people enrolled in the Healthy Howard plan when it expired at the end of December last year, and the organization has called to check in with the plan's members to remind them of the deadline for transitioning to an insurance plan under the Affordable Care Act.
Masten said of all the members they had reached, 72 percent had obtained health coverage.
Enrolling in health insurance through the Maryland Health Connection represents a step up for Healthy Howard Health Plan members, she added. The exchange "provides more coverage and more care" than the health plan, which could only be used in Howard County.
"We're checking in, checking on the status, if they haven't done anything to initiate the enrollment or application process, right then and there we make an appointment for them to come to the Door [to Health Care]," Hall said.
While people of all ages have sought enrollment help from Healthy Howard, Hall said the average client was in their late 30s or early 40s. And clients weren't just limited to Howard County or even the western region – she said the organization has helped people from Baltimore City and Baltimore, Anne Arundel and Montgomery counties, among others.
"Individuals… from other counties are coming through our doors because they've heard of the great customer service and the experience of our staff," she said. "Word has obviously reached beyond Howard County."
Colette Dominguez, 60, and her daughter Vanessa Dominguez, 34, drove down to the enrollment fair March 15 from Frederick.
Colette Dominguez, who had a Maryland Health Insurance Plan, received a letter from the state informing her that she needed to be enrolled in a new insurance program by March 15.
"I tried to go onto the website, and you can't necessarily figure out what to do," she said.
Her daughter also had problems using the website, MarylandHealthConnection.gov.
"I went through the website and it kicked me out twice," Vanessa Dominguez said, adding that she hoped to find some answers in person.
Technological problems were a common complaint among visitors to the fair, many of whom said they had started the process online but had become too frustrated to finish.
Vora, who was juggling the health care enrollment process for both his aunt, Hersha Vyas, who at 61 qualified for the state's health care exchange and his uncle, Bob Vyas, 68, who did not, called his experience with the website "terrible."
Without his assistance, he said, his aunt and uncle, who don't speak English as their first language, might not have been able to make sense of the process.
"This is probably the worst thing I've ever had to deal with," he said.
But after about an hour and a half meeting with a health care enrollment expert at the fair, Vora had a much more positive outlook.
"This, for us, was very helpful," he said. "We've probably figured everything out now."
The same was true for Mark Ashland, 57, an Ellicott City resident who is temporarily unemployed.
He said he hadn't had "much luck online" so decided to come to the fair to enroll in person.
"It's been a very smooth process," Ashland said. "It's been straightforward."
Pat Gussio, a health care "navigator" for the Door to Health Care, said she hoped people would distinguish between the website's technical issues and the Affordable Care Act itself.
"The disaster that is the IT has nothing to do with the wonderful things that this fantastic program is doing for so many people," she said.
Gussio, who estimated that she's helped hundreds of people sign up for insurance since October, has witnessed a lot of touching moments in the process.
One man she helped had been cancer-free for years but couldn't get coverage after he was dropped from his ex-wife's insurance plan.
After she helped him sign up through the health exchange, "he sat here and cried with me," she remembered. "And he said, 'I just can't believe I finally can get insurance.'"