Both agree that since December, access hasn't really been an issue. The site still kicks people off at times. But now that usually occurs around enrollment deadlines when volume rises. "The marketplace lets you know that it's overloaded and puts you in a queue," Trevorrow said.
Improvements haven't been confined to the website. Navigators have gotten better at explaining the law and comparing plans, thus reducing meeting time to under an hour. Experience has also taught navigators a few tricks, and they can deal with problems that might have run them aground early on.
Take the case of Miroslaw Kozlowski, 55, of Philadelphia. The microbiologist and naturalized citizen tried for months to buy insurance on the marketplace. So he called healthcare.gov's customer service. After no one there could help him, Kozlowski contacted RHD and Trevorrow.
"He figured out the glitch," Kozlowski said. "He got me through pretty quickly. I am very grateful."
It turns out healthcare.gov gets confused when processing a person's naturalized citizenship and Social Security numbers. So it stopped the application. Trevorrow resolved it.
And yes, there have been cases that have stumped Trevorrow and Picher. But then colleagues jumped in. At a recent navigator meeting, Trevorrow described a vexing immigration case, and almost before he finished, two colleagues suggested a fix. It worked, and Trevorrow sent the solution to healthcare.gov.
The cases that RHD's two navigators find most rewarding are those that help people with serious health issues or preexisting conditions. Before the ACA, they would have been faced with huge costs, if they could have found coverage at all.
"Helping people who have not been covered," Picher began. "We see that in their faces."
The toughest cases, Picher said, are telling people they don't qualify for Medicaid because Pennsylvania did not accept the program's federal expansion, and they are not eligible for a subsidy.
Navigators also see and hear from people who disagree with the ACA. They come to vent. Others complain that plans cost too much or want to know if the rumor is true that all the navigators are criminals, given jobs by the government. For the record, each navigator is fingerprinted and passes a background check.
And most users don't go on a government program. They choose a plan from Independence Blue Cross or Aetna.
The navigators, reachable at 1-855-668-9536 , expect to stay busy through the March 31 deadline to buy insurance for this year. Both expect to be back in October to again help consumers buy insurance.
"We've reached critical momentum," Trevorrow said. "In three to five years, this will be part of the fabric of our society. We won't have people leading miserable lives because they can't afford to be treated for health problems."
This article was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente.