Monday was yet another troubled day for the Affordable Care Act.

Sunday night, the outside vendor that operates two key parts of the website that lets people browse and sign up for health insurance experienced a failure.

The failure took place at a vendor called Verizon Terremark and presumably affected other clients as well as HealthCare.gov, the federal website that people use to sign up for insurance under the Affordable Care Act.

By 7 a.m., federal officials say, the data hub at HealthCare.gov that certifies things like citizenship and eligibility for tax credits was back up and running. And by midafternoon Monday, the rest of the website was back as well, they say. It's unknown how many people tried and failed to get on the site Sunday.

But not all the news was bad. Monday brought good news for the 49 million people on Medicare, with officials announcing that premiums and deductibles won't increase in 2014.

That's the third straight year those patient costs have been less than projected or stayed the same. And Medicare officials also said seniors have saved more than $8 billion since the Affordable Care Act closed the prescription drug doughnut hole gap in coverage. It's a bit ironic because public opinion polls consistently show that seniors are the least enthusiastic about the Affordable Care Act.

Fixing the other problems with HealthCare.gov will be a longer-term project. But last week the new guy in charge, Jeff Zients, said the site should be running smoothly by the end of November, something Health and Human Services officials reiterated Monday. And it does seem that while things are not fixed yet, the website's performance is getting incrementally better by the day.

But we're also hearing about people getting notices that their old health insurance is being canceled, and that could be the next big political issue. Those people are in the individual market who buy their own insurance. That's about 14 million people out of more than 300 million Americans.

Some of them are going to have to buy new policies and some are going to have to pay more, because the policies they have now don't meet the current minimum requirements of the Affordable Care Act. But at the same time, there are people in the individual market who will no longer be paying extra because they're women, or older, or have pre-existing medical conditions.

The fact is, one of the biggest things the Affordable Care Act does is remake the market for individually purchased policies. That's going to cause some dislocation for people in that market now. It's going to create winners and losers. And it's the losers who complain the loudest.

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Transcript

AUDIE CORNISH, HOST:

From NPR News, this is ALL THINGS CONSIDERED. I'm Audie Cornish.

ROBERT SIEGEL, HOST:

And I'm Robert Siegel. It has been another troubled day for the Affordable Care Act. Last night, the contractor that operates two key parts of the website that lets people browse and sign up for health insurance experienced a failure. Things are back up today, but the controversy over the troubled site and the health care law continues.

And with us to discuss the latest on all things health care is NPR's Julie Rovner. Hi, Julie.

JULIE ROVNER, BYLINE: Hey, Robert.

SIEGEL: What happened with the website last night and today?

ROVNER: Well, what they're telling us is that the failure took place at a vendor called Verizon Terremark, and that the problem presumably took down other clients as well as healthcare.gov. By 7 a.m., federal officials say the data hub at healthcare.gov that certifies things like citizenship and eligibility for tax credits was back up and running; and by midafternoon today, the rest of the website was back up and running as well, they said. We don't know how many people tried and failed to get on yesterday and today while things were not quite running as well.

SIEGEL: And what are officials saying about how soon all the other problems with the website will be fixed?

ROVNER: Now, that's a bit of a longer-term project but last week, the new guy in charge, Jeff Zients, said they intend to have the site running smoothly by the end of November, something Health and Human Services officials reiterated today. And it does seem that while things are not quite fixed yet, the website performance is getting incrementally better by the day.

SIEGEL: Let's move on to another issue, apart from the problems just with the website. We're also hearing a lot more now about people getting notices that their health insurance is being canceled. What's this about?

ROVNER: Well, first of all, we're only talking here about people in the individual insurance market, those who buy their own insurance. That's about 14 million people out of more than 300 million Americans. And we're only talking, really, about a minority of them. Now, some of them are going to have to buy new policies, and they are going to have to pay more because the policies they have now don't meet the current minimum requirements of the Affordable Care Act.

But at the same time, there are other people in the individual market who are going to get new policies, who are going to pay less because they'll no longer be paying extra because they're women or older or have pre-existing medical conditions.

SIEGEL: But this is a problem of substance of the Affordable Care Act, not just the procedure of getting online. It could conceivably be as big a political problem, down the road.

ROVNER: That's right. It could. It certainly looks like the next big political issue. The fact is, one of the biggest things the Affordable Care Act does is remake the market for individually purchased policies, and that is going to cause some dislocation for people in that market now. And it's going to create winners and losers; and mostly, it's losers who complain the loudest.

SIEGEL: But today, there is news about some winners from the law, people on Medicare. What's that about?

ROVNER: That's right. And it's kind of ironic 'cause public opinion polls consistently show that seniors are the least enthusiastic about the Affordable Care Act. But today, we learned that Medicare premiums and deductibles will hold steady again next year. This is the third straight year those patient costs have been less than projected, or stayed the same. Medicare officials also said that seniors have saved more than $8 billion since the Affordable Care Act closed that prescription drug doughnut hole gap in coverage.

SIEGEL: Later this week, key officials from the Department of Health and Human Services will be testifying at hearings on Capitol Hill. You'll bring us coverage.

ROVNER: That's right. We're going to see Health and Human Services Secretary Kathleen Sebelius, and the head of the Centers for Medicare and Medicaid Services.

SIEGEL: Presumably, we'll hear Republicans say heads should roll and delay - if not defund and repeal - the Affordable Care Act.

ROVNER: I expect we will.

SIEGEL: And, I gather, Democrats are saying wait till the end of November, they've got this thing under control at the White House.

ROVNER: It will be fun.

SIEGEL: We'll tune in just the same, even though we know that much about what's going to happen tomorrow.

ROVNER: Yes.

SIEGEL: That's NPR's Julie Rovner. Thanks. Transcript provided by NPR, Copyright NPR.

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