Open health care enrollment under the Affordable Care Act is nearing the March 31 deadline.

Looking back on the tumultuous beginning, health coverage guide Cheryl Fleetwood is happy to be far from those early days. “The difference between what we experienced in October and what we experience now is night and day.”

Fleetwood is a Stapleton resident and guide at the Central Presbyterian Church health assistance site.

Enrollment times, page load times, phone wait times and online chat services have improved for users of ConnectForHealthCO.com, the Colorado Health Insurance Exchange.

Every applicant who thinks he or she may qualify for Medicaid or tax credits to help pay for premiums must apply for Medicaid first. In the first few months, Medicaid approval or denial letters were sent in the mail a few weeks after applying. Now people receive real-time responses, and health coverage guides can print Medicaid cards in the office. If a person does not qualify for Medicaid, guides help determine if he or she qualifies for other financial assistance.

An enrollee’s “Wow, I can afford this” reaction makes the process worth it, Fleetwood says.

Debbie, 61, and Mark Sheets, 64, of Northglenn, have health insurance for the first time in 35 years. “Health insurance has been a matter of paying our mortgage or eating,” Debbie says.

They were intimidated by the site but attempted to sign up in early November.

When Mark put “male” for gender to create his account, the website reported “incorrect response.” “We were like, ‘Okay, what does that mean?’” Debbie says. When she put “female” for herself, the website reported “not applicable.”

On each attempt, the website calculated a different premium ranging from $150 to $1,500 using the same information. Having successfully “scooted along” without health insurance for 35 years, they considered paying the annual penalty fee ($95 or 1 percent of income) instead of buying a plan.

Guides at Central Presbyterian helped the two get insured with a Silver Plan that includes tax credits and drug coverage.

“We’re feeling much more comfortable now that we should hopefully have health care for the rest of our lives,” Debbie says.

Denver resident Mary Gould, 63, was less thrilled about her new insurance, but says she mentally prepared for the exchange, realizing she’d have to pay more.

Gould previously received health care through the Bruner Family Clinic at Saint Joseph Hospital. Although it was limited coverage, it was affordable.

“I’m never happy to pay more, but the benefit outweighed the irritation,” she says. Unlike her previous health care, Gould can travel and still be covered on her Silver Plan. The plan also reduces a monthly prescription for multiple sclerosis from $90 to about $30.

“Someone who has not been paying anything, and then all of a sudden has to pay is a big adjustment. There’s a big learning curve,” Fleetwood says. But she thinks there’s a national learning curve toward everyone having access to affordable health care.

During the early months, some people came into the assistance site angry or frustrated about the Affordable Care Act. Some called the Colorado health insurance exchange a scam. “Fighting the noise” or moving past the politics to begin discussing insurance sometimes took up a large part of a session, according to health coverage guide Cindy Widdowson.

“Our goal is to be neutral. We are like Switzerland. The fact of the matter is this is law, and we are just here to help people navigate the process.”

The frustrating occurrences seemed to have passed, but at times the imprint of discouraged consumers is still visible.

“One thing I’ve learned is everybody has a different definition of what is affordable,” Widdowson says. Building a system that satisfies every individual’s situation is a lofty goal. For now, she hopes the system will continue to get more streamlined and as many people as possible will enroll before March 31. After March 31, guides will continue to help people enroll in Medicaid, which continues year-round.