Instead, the White House is signaling with increasing strength that the early enrollment numbers will be low — perhaps very low. President Obama will attempt to temper public expectations in a speech in Boston on Wednesday.
Previewing the president’s remarks in a conference call with reporters, David Simas, White House deputy senior adviser for communications and strategy, dwelled on the recent history in Massachusetts, which established a system in 2007 that served as a model for the Affordable Care Act. The “arc of enrollment” in the Bay State, he noted, began with only 123 sign ups in the first month after the state’s exchange — known as the Connector — opened. By the first deadline for Massachusetts residents to obtain coverage, however, 36,000 had signed up.
In other words, no one should have expected many people to enroll in the opening weeks of Healthcare.gov, either. Low numbers released next month wouldn’t indicate that Obamacare is failing. Low numbers released in March of next year — right before people will be penalized for lacking insurance — would be a different story. “Insurance is a tough sale,” said Jon Kingsdale, who ran Connector when it opened and was also on the conference call. “It’s a grudge buy, and so there’s going to be a lot of browsing.”
That’s all true. But currently low enrollment figures would also be a direct result of a dysfunctional Web site that hasn’t allowed many people to buy coverage for next year. The numbers will certainly be even lower than they would have been had the interface worked from Day One. Assuming that most people who need to buy insurance on Healthcare.gov would have signed up weeks or months from now, regardless, the number who would have obtained coverage but for the Web site’s technical problems probably isn’t terribly high right now. But it’s not zero.
More concerning than the raw number of people blocked from buying early, though, is that their experience will dissuade many more people from trying later, when the experts assume applications will flood in. One way in which the national rollout is different from the Massachusetts experience is the intensity of the attention Obamacare is getting — and was bound to get. Healthcare.gov’s technical problems are dominating American politics. An entire political party is focused on broadcasting every one of them. Millions of people had a lousy time visiting the site earlier this month. Comedians have been making jokes about it since. Even after Healthcare.gov is working better and deadlines begin to loom, perceptions about how well it and other elements of the Affordable Care Act are functioning will have to turn sharply.
The comparison to Massachusetts is useful, up to a point. If the national experience ends up mirroring the Bay State’s health-care rollout in the end, the Obama administration will have pulled it off in the face of considerably stronger headwinds, some unavoidable, some self-imposed.