Health and Human Services Secretary Kathleen Sebelius described the numbers in upbeat terms. “At the end of the day, the promise of quality affordable coverage is increasingly becoming a reality for more and more Americans,” she said.
The enrollment picture emerged as the White House tried to quell growing upset in Congress, including among many Democrats, about a related issue: complaints from people whose individual policies are being canceled because they do not comply with new coverage rules. White House press secretary Jay Carney said Wednesday that “sooner rather than later” President Obama will announce a strategy to deal with such cancellations.
In the meantime, lawmakers from both parties are gathering support for legislation that would make it easier for people to be able to keep their policies if they wish.
The enrollment tally is the first official indication of the desire and ability of uninsured Americans to get coverage under the 2010 law. Slightly fewer than 27,000 enrollments, or one-fourth of the total, occurred in the 36 states that rely on HealthCare.gov, the troubled federal Web site. The rest were in 11 of the 14 states that have created their own marketplaces, which are generally working better than the federal one. A few states are not yet reporting.
The figures, which cover Oct. 1 to Nov. 2, are significantly lower than the administration’s only known forecast, which suggested that nearly half a million people would sign up for private health plans during the first month of the initial six-month enrollment period for the exchanges. The Congressional Budget Office has predicted that 7 million people will buy coverage through the exchanges by spring.
HHS officials took pains to put the low numbers in the context of other recent expansions of government insurance, which also began slowly.
The health plans available through the federal and state marketplaces are a central feature of the Affordable Care Act, Obama’s signature domestic accomplishment — one that has become a source of embarrassment because of the marred launch of HealthCare.gov. The president’s friends and foes alike had eagerly awaited the first enrollment “snapshot,” as HHS officials termed it.
Republicans used the figures as fresh ammunition to disparage the law. Calling the numbers “abysmal,” Sen. Marco Rubio (Fla.) said they are “another early warning sign that this legislation . . . ultimately cannot be fixed.”
Democrats lavished praise. “Even with the difficulties of the Web site, we have seen tremendous demand for what the Affordable Care Act has to offer,” said House Minority Leader Nancy Pelosi (Calif.).
The administration report counted people as having enrolled in a plan if they selected one, even if they have not begun to pay for it. The marketplaces are intended mainly for those who cannot get insurance through a job.
In Virginia, a state that relies on the federal marketplace, the figures show, 1,023 people — out of about 32,000 who are eligible — chose a health plan last month. In Maryland, which is running its own exchange, 1,284 out of about 3,500 have signed up. The report did not include enrollment figures for the District, which also is operating a separate exchange.
Richard Sorian, a spokesman for DC Health Link, said that, unlike the federal figures, the District’s exchange does not track individuals but that people in 1,115 households had signed up for coverage.
Nationwide, in addition to the people who have signed up for a private health plan, about 396,000 lower-income people have been told they are eligible for Medicaid or the Children’s Health Insurance Program.
The figures show that many more people began to shop for a health plan than have signed up so far — especially in the states using the federal marketplace. Federal health officials told reporters that they could not tell how many of those people stopped partway through and how many were unable to finish because of HealthCare.gov’s problems.
The numbers came out as the politics surrounding the health-care law has become more heated.
On Capitol Hill, House Democrats from across the ideological spectrum criticized the administration’s handling of the issue at a closed-door meeting Wednesday attended by David Simas, the White House deputy senior adviser for communications and strategy, and other administration aides.
Pelosi said that the more than 200 Democrats in her caucus have grown restless and are firing off their ideas to administration officials about what to do next. “We’ve all been making suggestions. We know what the possibilities are, but I don’t know what they will choose. It’s a long list — how many members do I have?” she told reporters.
On Thursday, White House Chief of Staff Denis McDonough is scheduled to meet privately with Senate Democrats to discuss the law’s implementation.
Democratic irritation with the White House is mounting as the House prepares to vote Friday on a bill sponsored by Rep. Fred Upton (R-Mich.) that would permit insurers to continue to sell health plans after this year even if they don’t meet new federal standards. Democratic leadership aides predicted that at least some Democrats will support the measure.
In the Senate, Democrats have offered proposals to calm consumers who are angry about canceled plans. Sen. Mark Udall (D-Colo.) introduced a bill Wednesday that would require insurers to give customers the chance to renew enrollment on certain health plans through the end of 2015. A measure sponsored by Sen. Mary Landrieu (D-La.) would require insurers to allow Americans to renew their plans indefinitely.
At the White House, Carney said that “we welcome sincere efforts” in Congress. He did not specify when Obama plans to announce his approach but said, “When the president says or asks his team to work quickly to come up with policy options, people respond quickly to that request.”
The jockeying came as the House Oversight and Government Reform Committee on Wednesday grilled several administration officials overseeing the technical work on the federal exchange. One of them, U.S. Chief Technology Officer Todd Park, an adviser to the president, turned up only after the committee’s chairman, Rep. Darrell Issa (R-Calif.), issued a subpoena demanding his presence. Park reiterated the administration’s assertion that the Web site will be working smoothly for the “vast majority” of Americans by the end of the month, but he sidestepped repeated requests to be more precise.
The spotlight at the hearing was trained, in part, on an official with direct oversight of the technical aspects of the Web site: Henry Chao, deputy chief information officer for the Centers for Medicare and Medicaid Services.
Republicans on the panel accused Chao and Park of not including adequate protections for consumers’ privacy. They suggested that political considerations came into play when officials were deciding which features would be available on Day One. At times, they referenced testimony Chao gave during a recent closed-door session that lasted nine hours.
Chao, who has worked at CMS for two decades, repeatedly said that his comments were taken out of context and that he was not worried about the privacy of consumers’ personal information. “There was some rearrangement of the words that I used,” he said.
Sandhya Somashekhar, Juliet Eilperin and Lena H. Sun contributed to this report.