Tilda Elias had reason to be optimistic when she opened the HealthCare.gov website on Monday, ready to help her first client of the week find health insurance. Technicians had made fixes to the online insurance exchange over the weekend. Even more promising, her client, Giovanna Romano, had managed to complete an online application at home with no problems. But after Ms. Romano logged in, the system made her reconfirm everything in her application, a process that dragged on for 40 minutes. Then came the screen message that tens of thousands of people shopping for insurance under President Obama's new health care law have come to hate: "Sorry, our system is temporarily down."