As the U.S. government partially closed down Tuesday, online marketplaces to shop for health insurance — a key reform in the Affordable Care Act — opened up, and promptly added to the anxiety and confusion about what’s widely known as Obamacare.

The rollout went forward despite the shutdown that was sparked by Republican efforts to derail the health-care law or at least delay parts of it from taking effect. The Republicans repeatedly tried to attach provisions related to Obamacare to a routine government spending bill and each time they were rejected by the Democrat-controlled Senate. With no agreement on funding reached by midnight last night, Americans woke up this morning to a government shutdown.

But they also woke up to a whole new world when it comes to getting health insurance. President Barack Obama called it a “historic” day when he made remarks at the White House, surrounded by a group of citizens who plan to sign up for coverage.

Health Overhaul Illinois

Deborah Mitchell waits as she attempts to log in to an insurance marketplace site in Chicago, searching for a better rate on health insurance on the first day the new websites launched on Tuesday. (M. Spencer Green/Associated Press)

The new websites set up to help uninsured Americans shop around for insurance plans and enrol in one were inundated with traffic when they went live Tuesday morning and it caused a series of delays in accessing them. The federally run exchange that is aiming to sign up seven million Americans during the first year had a rocky start, but officials said experts were quickly working on it.

At least 2.8 million people had logged on to healthcare.gov as of Tuesday afternoon. The glitches were expected by the White House but Republicans are expected to seize on the delays as evidence that Obamacare is a flawed program that should never go ahead.

New York state said there were more than two million visits on the state's health insurance exchange within the first two hours, leading to access issues. Heavy traffic also led to reports of delays and other issues in California, Rhode Island and New Hampshire, among others.

Meanwhile, in Connecticut, Access Health CT reported that 18,000 people logged on the state's exchange website.

Americans want to know costs

Even though the law was passed more than three years ago and has been the subject of continuing controversy because of Republican attempts to get rid of it, many Americans still don’t know what it all means and how they are affected by it.

A survey by the Kaiser Family Foundation found that most people who were asked did not know that Oct. 1 marked the launch of the online insurance exchanges. More broadly, it found that public awareness of many of the law’s key provisions hasn’t increased since 2010.

The foundation’s latest polling from the last month shows 51 per cent of those surveyed and 67 per cent of those without health insurance continue to say they don’t have enough information about the law to know how it will affect their families.

The number 1 question people want answered, according to the survey, is how much Obamacare will cost them? They are also seeking straightforward, basic information about how it works.

A poll by the Wall Street Journal and NBC also found that 76 per cent of respondents didn’t understand the law and other polls contain similar findings.

Health and Human Services Secretary Kathleen Sebelius has acknowledged in interviews that “there is a lot of confusion” about the law and that her administration is partly to blame because it couldn’t cut “through a lot of the noise,” she said.

Obama says law is 'life-changing'

The debate around the health-care law has been a bitter one, and the White House has been trying to dispel some of what it says are myths and “misinformation” spread by opponents to the plan.

Obama Budget Battle

President Barack Obama gestures while speaking at the White House in Washington, Tuesday, about the government shutdown and health-care reforms that took effect. (Evan Vucci/Associated Press)

In the lead-up to Tuesday’s rollout , the White House ramped up its public relations campaign to explain the changes. Even former president Bill Clinton was recruited to help with the effort. Sebelius toured parts of the country holding events to talk about the law.

Obama has also been touting the benefits of the health system overhaul and on Tuesday he once again tried to convince skeptical Americans that they should get on board. He also tried to clear up confusion.

“If you’re one of the 85 per cent of Americans who already have health insurance, you don’t need to do a thing,” he said. “But for the 15 per cent of Americans who don’t have health insurance, this opportunity is life-changing.”

Obama explained how the website works and why people should log on and also gave the phone number for a toll-free line that people can call to sign up and ask questions.

“We can get America covered once and for all so that the struggles that these folks have gone through and that millions around the country have gone through for years finally get addressed,” Obama said.