A shocking shortfall

100K enroll in health exchanges; White House wanted 500K

WASHINGTON The bottom- line number on HealthCare. gov didn’t even meet the lowest of expectations: 26,794.

That’s the number of people who were able to navigate through the troubled federal health exchange’s website to select a health insurance plan in its first month of operation, the administration said in a highly anticipated announcement on Wednesday.

All told, 106,185 individuals have selected an insurance plan through state and federal exchanges — and another 396,261 were found to be eligible for the expanded Medicaid insurance. Still, those numbers represent only 1% of the estimated 48 million Americans without health insurance, and are far short of the 7 million the Congressional Budget Office had said were expected to sign up in the first year.

Health and Human Services Secretary Kathleen Sebelius noted that more than 1 million people have

“Even with the issues we’ve had, the marketplace is working and people are enrolling.” Kathleen Sebelius, Health and Human Services secretary

made it through the application process.

“Even with the issues we’ve had, the marketplace is working and people are enrolling,” Sebelius said. “As more people shop and talk things over with their families, we expect these numbers to rise.”

The numbers came during what was already an all- out assault on the 2010 Affordable Care Act by congressional Republicans. The House has scheduled a Friday vote for the Keep Your Health Plan Act, which would allow people with existing insurance to keep their policies even if the plans don’t meet the minimum standards under the health care law.

And in two simultaneous hearings Wednesday, two committees grilled seven government officials about the technical missteps and potential security flaws behind the roll- out of HealthCare. gov, the federal website which has been plagued with problems since it went online Oct. 1.

“This was a monumental mistake to go live and effectively explode on the launch pad,” said House Oversight and Government Reform Committee Chairman Darrell Issa, R- Calif., at a hearing to investigate the website’s problems.

Uninsured people in 36 states must use the federal website to sign up for health insurance by March 31,

or else pay an additional tax. Fourteen other states and the District of Columbia have set up their own exchanges, and every one of them outperformed the federal exchange in its first month, according to the administration’s report.

California had more people select a health plan on its exchange ( 35,364) than all 36 states in the federal exchange combined.

“Numbers coming out of state based exchanges are stronger than the federal exchange,” said Kevin Lucia, a research fellow at Georgetown University’s Center for Health Insurance Reforms. “They offer a clear example of how well the federal exchange could do on the enrollment front once it is fully functional.”

FAR SHORT OF THE GOAL

The administration had hoped that 494,620 people would enroll by the end of October, according to internal memos obtained by the House Ways and Means Committee. The Wall Street Journal, citing two unnamed

“This was a monumental mistake to go live and effectively explode on the launch pad.”

Darrell Issa, R- Calif., House Oversight and Government Reform Committee Chairman

sources, had reported last week that the site had 40,000- 50,000 sign- ups.

The report was so highly anticipated that the Ways and Means Committee, unwilling to wait for its release, issued a subpoena for the raw data last week. Chairman Dave Camp, R- Mich., said even the low numbers released Wednesday are optimistic because they include both people enrolled in a health plan and those who are still shopping.

“The real truth is even worse than we are being told,” he said.

The administration is so far behind that it would need to enroll 68,000 people a day to meet its yearend goal, Camp said.

The White House response was muted. President Obama and his aides had been setting low expectations for weeks. “No one will be satisfied with the numbers, because they will be below what we sought prior to the launch,” said White House press secretary Jay Carney before the totals were released.

Sebelius said she did not find it discouraging that people have gone through the process but not purchased a plan. People will visit the site multiple times before making a decision, she said.

“By the 15th of December, we’ll be able to tell you how many people have actually paid for the first month of coverage,” she said.

The deadline for enrolling is Dec. 15 for policies that begin on Jan. 1, but people can continue to enroll through March 31 and still avoid the annual penalty levied by the Internal Revenue Service for people without insurance.

VERMONT TOPS THE LIST

Of the states reporting complete numbers, Vermont topped the list with 24% of all applicants selecting a plan on the state exchange. Former Vermont governor Howard Dean, a long- time champion of health care reform, said he “wouldn’t push the panic button yet.”

Dean said he wouldn’t allow people with substandard plans to keep their insurance — but he said state and federal exchanges should “give those people priority to enroll” in the private plans provided under the Affordable Care Act. “What people are going to find out for the most part it’s not more expensive,” said Dean, a 2004 candidate for president.

Insurers say the enrollment numbers have been disappointing. Optima Health, which sells insurance on the federal exchange in Virginia, has sold 106 policies to date. These cover 144 people, as some are family plans. “Enrollment is lower than anticipated,” said spokesman Bobby Pearson, who cites all the trouble people have had logging into HealthCare. gov.

Obama’s top technology adviser, Todd Park, told Congress on Wednesday that the problems are “unacceptable,” Park said officials are working around the clock to make fixes. The site can now handle 17,000 new users an hour, and response times have gone from eight seconds to less than one second, he said.

He promised that the site would be fully functional for the vast majority of users by Nov. 30. Pressed to assure the committee that he will meet that date, Park said, “The team is working very hard.”

“As a former Web developer, that’s what I was telling clients when I was about to miss a deadline,” said Rep. Blake Farenthold, R- Texas.