Health care sign-up figures improve

| Monday, Dec. 30, 2013, 12:01 a.m.

More than 1.1 million Americans signed up for a health care plan through the federal health insurance marketplace during its initial enrollment period, with more than 975,000 enrolling in December alone, the Obama administration announced on Sunday.

The figures, which arrived as the administration reworked its computer system to extend the deadline for a day until midnight Dec. 24, suggest that federal officials are making up ground lost to glitches and processing errors that made difficult to access and navigate during its first two months of operation.

So far, nearly 2 million Americans — who were uninsured or had to change coverage when their plans were canceled — have signed up under the health care law on state and federal marketplaces. About 850,000 people have enrolled through the state-run exchanges, according to Charles Gaba, a Web designer tracking health-law enrollment numbers.

The administration is far short of the enrollment targets it set just before the system debuted on Oct. 1. The Department of Health and Human Services had anticipated that 3.3 million people would have signed up by now, according to a Sept. 5 agency memo.

Still, officials celebrated the end-of-year results.

“We are in the middle of a sustained, six-month open enrollment period that we expect to see enrollment ramp up over time, much like other historic implementation efforts we've seen in Massachusetts and Medicare Part D,” Centers for Medicare and Medicaid administrator Marilyn Tavenner wrote on the HHS blog, referring to the nation's first health-insurance exchange under former Republican Massachusetts Gov. Mitt Romney, in 2006, and the prescription drug coverage expansion enacted during President George W. Bush's administration. “In part, this was because we met our marks on improving the site supported 83,000 concurrent users on December 23rd alone.”

The next critical deadline for enrollment is March 31, after which individuals face a tax penalty if they remain uninsured.

Some health policy experts say the December surge does increase the possibility that the law could meet federal projections for 7 million enrollments by 2014.

“It is starting to track with what people, particularly the Congressional Budget Office, projected originally,” said Larry Levitt, senior vice president at the Kaiser Family Foundation. “December is the first month where federal sign-ups have kept up with state sign-ups, too.”

Senior administration officials have said they anticipated that enrollment would start slowly once the website debuted in October and remain relatively low in November, before accelerating in December as many Americans sought out plans that would take effect on Jan. 1.

That pattern materialized, although at a much lower level than officials expected. As of Dec. 22, 890,000 Americans had enrolled on the federal exchange, according to government figures that had not been made public, meaning that more than 200,000 people chose health plans between Dec. 23 and 24. By contrast, about 137,000 people signed up through the federal system in its first two months of operation.

At least some of the late-December shoppers didn't mean to procrastinate, but technical issues thwarted their earlier attempts to sign up for coverage.

Anita Pinser, 62, tried to buy coverage on Oct. 1 but finally enrolled in a plan on Dec. 22.

“I kept trying and trying,” said Pinser, a former human resources professional who lives just outside Charlotte and who was laid off in 2008. “I called the 800-number and found out everyone was having problems.”

When she saw a posting on Twitter last Sunday night about the impending deadline, she decided it was time to give it a final try. “I had my account set up, so all I really had to do was click on the coverage that I wanted,” she said. “It was really easy. The only bad experiences I had were the first month, when no one could sign up.”

But others still are experiencing serious problems with the site. David and Karen Hart live in Santa Rosa Beach, Fla., and are self-employed. Their Blue Cross Blue Shield policy was canceled in the fall and then reinstated, but they picked a new plan on and paid for it on Dec. 19.

David Hart called Florida Blue on Dec. 27 when he noticed that their payment hadn't been been deducted from their bank account. He was told that the government's computer system had canceled their plan. His wife spent more than four hours on a federal call center hot line on Saturday, at which point she was told the insurer had jettisoned their policy.

“I'm a 56-year-old, and I have had health insurance my entire life. It's just astounding that we've had to go through this,” David Hart, an artist, said. He said that he and his wife support the new law but have been dismayed by how federal officials are implementing it. “We think it's good policy, but what they're doing is atrocious.”

By Sunday afternoon, CMS officials were investigating the Harts' complaint.

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