The Obama administration revealed Wednesday that just 26,794 people enrolled for health insurance during the first, flawed month of operations for the federal "Obamacare" website.
Adding in enrollment of more than 79,000 in the 14 states with their own websites, the nationwide number of 106,000 October sign-ups was barely one-fifth of what officials had projected — and a small fraction of the millions who have received widely publicized private coverage cancellations as a result of the federal law.
In Sacramento, federal health officials said California’s new health insurance exchange tentatively enrolled 35,000 people during its first month of operation, a fraction of the eventual goal in the state with the nation’s largest uninsured population.
A report released by the U.S. Department of Health and Human Services provided the first glimpse into the operations of Covered California, which faces a monumental task to reach millions of people without insurance and sway them to sign up under the federal Affordable Care Act.
As the numbers came out, the White House raced to reassure anxious Democrats who are worried about the controversial program, which they voted into existence three years ago and which seems sure to be a major issue in next year’s election campaigns. The administration, trying to regain the initiative, for the first time indicated a willingness to consider legislation to stave off the wave of cancellations that’s compounding the website technology problems.
Some Democrats are seeking changes in Obama’s signature program, and key Republicans, many pressing for repeal, said that even Wednesday’s feeble sign-up figures appeared to be pumped up. The final number — 106,185 people — would be even smaller if it counted only those who finalized their enrollment by actually paying their first month’s premium, Republicans said.
Administration officials and senior congressional Democrats expressed confidence in the program’s future. "We expect enrollment will grow substantially throughout the next five months," said Health and Human Services Secretary Kathleen Sebelius, who is in overall charge.
"Even with the issues we’ve had, the marketplace is working and people are enrolling," Sebelius said. Responding to GOP critics, she said the first premiums are not due until Dec. 15.
For many Democrats, concerns over the cascade of website problems has been compounded by the focus on Obama’s misleading promise that Americans who liked their health insurance plans could keep them under the overhaul. But millions of people are receiving cancellation notices. They have plans that for various reasons don’t qualify for the law’s "grandfather clause" protection against cancellations.
Obama has said he’s sorry that people are losing their coverage and has vowed to find ways to address "holes and gaps" in the law. Advisers originally said the White House was considering administrative fixes, not legislative options.
On Wednesday, Obama spokesman Jay Carney said, "If we can achieve this administratively, we will certainly look at that possibility," but he added that the White House was also considering legislative ideas.
The day was another blow for the administration and its supporters in Congress, who had been counting on Obamacare as a neutral if not winning issue in next year’s midterm elections.
There was a hopeful sign this Tuesday when Julie Bataille, HHS communications director for the rollout, said that 275,000 people who got hung up in the early days are being invited back to try to complete their applications. The administration is sending the email invitations in batches, so as not to risk any disruptions. White House chief technology officer Todd Park told Congress on Wednesday that system response times are much faster, and error rates have plunged.
But other signals have raised questions. In a blog post on Saturday, Bataille quoted chief White House troubleshooter Jeff Zients as saying improvements would continue in "December, January, February — just like you do with any website."
The Californian report, covering the start of open enrollment on Oct. 1 through Nov. 2, also showed that about 80,000 lower-income people would be eligible for expanded Medicaid coverage under another prong of the overhaul.
California counts nearly 7 million people without health coverage. An estimated 2.3 million are expected to enroll in a health plan through the new agency, known as Covered California, by 2017.
The 35,000 figure was defined in the federal report as the number of people who have "selected" a plan through the insurance exchange. According to HHS, that means the number of people who have chosen a specific insurance plan, whether or not they have actually followed through and begun paying the premium for it.
Covered California said sign-ups have accelerated since then, to about 2,400 people a day so far this month.
"The numbers are better than encouraging," Peter Lee, the health exchange’s executive director, said in a statement. "They show momentum and very high consumer interest."
The report provided no detailed information about those buying plans or what types of plans they selected. For example, it did not say what percentage of those who have selected plans were in the younger and healthier demographic that is sought by insurance companies to balance out those who are sicker and more expensive to cover.
During a Wednesday news conference, Lee said Covered California will have a breakdown of its enrollees next week. He said they tend to be "older than average" and are those who previously could not get any health insurance.
If that trend holds, those who sign up for insurance on the exchanges this year are likely to face sticker shock in 2015 when their policies get more expensive, said Republican state Assemblyman Dan Logue, who represents a district north of Sacramento.
"Covered California is giving you the best-case scenario, but where’s it going to be 12 months from now?" he said. "I’m pretty sure it’s going to be unsustainable."
He also noted the 1 million people in California whose individual health insurance policies are being canceled because they don’t meet the requirements of the Affordable Care Act.
"We have more people that don’t have health coverage now than have signed up under Obamacare because they’ve been kicked off their plans," he said.
"We were always expecting October would be a month when people would do some comparative shopping but not necessarily go through the entire process," said Anthony Wright, executive director of Health Access California, an advocacy group for the needy working closely with Covered California. "You don’t necessarily buy a car on the first trip to the lot."