In the meantime, Obama advised people to use call centers and get in-person help from navigators and non-certified workers called helpers at community clinics nationwide. But for some, that’s a dead end for now.

The navigators and helpers go through 30 hours of training and take a federally administered test. They receive instruction on privacy, and must promise to stay free of conflicts of interest.

The administration awarded $67 million last August to train and pay navigators around the country. Maryland gave $24 million in grant funds to six organizations like Community Clinic, Inc., to get the word out about the exchanges, encourage and help people enroll. The state has trained about 5,000 people total, including navigators, insurance brokers and social workers, to help people sign up.

Across the Potomac River in Virginia, there are far fewer navigators. Virginia opted to let the federal government run its exchange, and much of the work has fallen to non-profit groups.