Just one in four people nationwide who’ve enrolled in health coverage on the new insurance marketplaces have done so through the troubled HealthCare.gov website – even though the site serves 36 states.
New figures from the Department of Health and Human Services made public Wednesday showed that 106,185 Americans selected health plans through the exchanges from Oct. 1 to Nov. 2. The bulk of those enrollees – nearly 75 percent, or 79,391 people – signed up through state-run websites that serve 14 states and the District of Columbia.
The report said that California led the nation, with more than 35,364 enrollees. But California’s insurance marketplace executive director, Peter V. Lee, said nearly 60,000 people had signed up as of Tuesday.
But just 26,794 people managed to complete enrollment on HealthCare.gov, the problem-plagued federal government website, which serves as the portal for consumers to enroll in insurances plans available through the federal marketplace.
The federal enrollment figure was in line with the “very low” numbers that Health and Human Services Secretary Kathleen Sebelius had projected in recent congressional testimony. Technical problems with the website have frustrated users, as many became stuck and were unable to create the personal accounts required for enrolling in coverage.
The problems have vexed people across the country working to enroll consumers.
At the Shepherd’s Center, a community social services center in Kansas City, Mo., workers had signed up eight people for insurance by the end of the first week of November.
“We figured we’d have eight people on the first day, in the first hours,” said Pamela Seymour, the center’s executive director. “We continue to struggle with the site.”
In a hearing Wednesday before the House Oversight and Government Reform Committee, David Powner, director of information technology management issues at the Government Accountability Office, said, “A delay in the (website) rollout would have made sense.”
But after six weeks of site repairs by a team of government and private IT experts, HHS has begun asking those thwarted applicants to return to the website and try again. In a telephone briefing Wednesday, Sebelius tried to put the best face on the disappointing start. She said interest appears to be high. Across all the marketplaces, more than 975,000 people have applied for coverage but haven’t selected a plan, according to the enrollment report. Marketplace open enrollment for individual and small-group coverage in 2014 runs until March 31, 2014.
“The promise of quality affordable coverage is increasingly becoming reality for this first wave of applicants to the health insurance marketplaces,” Sebelius said. “There is no doubt the level of interest is strong. We expect enrollment will grow substantially throughout the next five months, mirroring the pattern that Massachusetts experienced. We also expect that the numbers will grow as the website, HealthCare.gov, continues to make steady improvements.”
The White House has sought to lower expectations for weeks, and Press Secretary Jay Carney said in a briefing before the numbers were released that “I promise you that no one will be satisfied with the numbers, because they will be below what we sought prior to the launch.”
He said White House officials had “fully expected” low enrollment numbers during the first month, pointing to a similar experience with the Massachusetts health care law. But, he said, “The lowness will be exacerbated because of the significant problems with the website.”
The new enrollment data also found that nearly 400,000 marketplace applicants are eligible for Medicaid or the Children’s Health Insurance Program, known as CHIP. When coupled with the new marketplace enrollees, some 502,446 people are already positioned to gain health coverage in 2014, which would cut the nation’s uninsured to less than 47.5 million.
“That is more than half a million people who, come Jan. 1, will no longer have to choose between paying the utility bill or paying for preventive care, who will no longer have to worry that a surprise illness might result in bankruptcy,” said Anne Filipic, president of Enroll America, a national organization working to sign people up for marketplace coverage.
The administration wants to enroll 7 million people into coverage by March 31, but the slow start for the federal exchange puts that goal in jeopardy.
“At this pace, the Obama administration will never be able to meet their enrollment goals,” Sen. Orrin Hatch, R-Utah, said in a statement.
Insurance industry consultant Robert Laszewski, president of Health Policy and Strategy Associates in Alexandria, Va., agreed.
“They are in a deep, deep hole, not just in terms of enrollment but in terms of people having confidence in this program,” Laszewski said. “Cynicism over Obamacare has been growing for the last six weeks. There’s really a negative sense in people’s minds for what Obamacare is that they have to overcome here.”
In Stockton, Calif., Gary King had his individual policy canceled last month because it didn’t meet the new consumer protection standards required under the Affordable Care Act.
“I was surprised and disappointed that it was going to be canceled. I was pretty upset for a few days,” said King, who owns a religious supplies store.
His new policy purchased on the California exchange costs $343 per month – $68 a month more than his old policy, which cost $275 per month.
King said he doesn’t trust the government or insurers, but rather than Obamacare, he would have preferred a single-payer system, in which the government pays for health care costs instead of private insurers.
“I think it’s just another way of getting more money out of people like us,” King said of the Affordable Care Act. “I had a plan that I liked.”
That sentiment is fueling a host of new proposals from Congress to allow people like King who received policy cancellations to keep their coverage without penalty. The proposals are coming from Republicans, who strongly oppose Obamacare, and from nervous Democrats, who fear the health law’s mounting problems could hurt their re-election chances next year.
White House Deputy Senior Adviser David Simas met with House Democrats on Wednesday to discuss the website’s problems. Carney acknowledged Democrats’ frustrations, saying they were “similar to the frustration that the president feels.”
“Nobody is satisfied,” Carney said. “Nobody who supports health care reform and supports successful implementation of the Affordable Care Act is satisfied with what we’ve seen out of the website and with some of these other problems.”
Hoping to head off a congressional revolt, President Barack Obama is considering an administrative fix that would allow people to keep their individual coverage, as well. Carney said Obama’s proposed fix is likely to come “sooner rather than later.”
While an administrative fix might help, Laszewski said the credibility of the health law has sustained long-term damage.
“They’ve got to get Obamacare off Comedy Central and off Jay Leno before they have a chance of succeeding,” he said.