Story highlights Sebelius spars with GOP legislators over longstanding criticisms

New figures show increased enrollment in Obamacare policies

The bill for the Obamacare website is $677 million, with $319 million paid so far

Health Secretary Sebelius creates a new job to assess risk from major policy initiatives

Call it a pre-emptive strike.

Hours ahead of her appearance Wednesday before a House subcommittee certain to grill her on the botched launch of the Obamacare website, Health Secretary Kathleen Sebelius announced an internal review of what happened and why.

Then her department released the latest enrollment figures for President Barack Obama's signature health care reforms, showing a big increase in November after the site's problem-plagued rollout on October 1.

The moves appeared timed to blunt criticism by the Republican-led House Energy and Commerce Subcommittee on Health of the reforms known as Obamacare and Sebelius, the Cabinet Secretary in charge of implementing them.

A chorus of GOP critics have called for her to be fired over the failure of the website, and she sparred with several Republicans at Wednesday's hearing over complaints about HealthCare.gov and the overall reforms.

While little new information emerged, Sebelius told the panel the government has contracted to pay $677 million for the Obamacare website and actually paid $319 million of that total so far.

Let's have a look

In a blog post Wednesday, Sebelius said that Dan Levinson, the Inspector General for the Department of Health and Human Services, would review what happened with the "flawed and simply unacceptable" launch of the HealthCare.gov website.

JUST WATCHED What did W.H. know before the launch? Replay More Videos ... MUST WATCH What did W.H. know before the launch? 06:50

JUST WATCHED Party leaders spar: 'Are you kidding me?' Replay More Videos ... MUST WATCH Party leaders spar: 'Are you kidding me?' 02:08

"I believe strongly in the need for accountability, and in the importance of being good stewards of taxpayer dollars," she said, adding that "we need a thorough review of the contractor performance and program management structure that resulted in the flawed launch of the website."

In particular, Levinson will "review the acquisition process, overall program management, and contractor performance and payment issues related to the development and management" of the website, her blog post said.

"We will take action to address the Inspector General's findings," she added.

In addition to that review, Sebelius also said a new position would be created in the Centers for Medicare and Medicaid Services that implements Obamacare to minimize risks from major policy initiatives.

A third step called for better training for CMS employees on "best practices" for hiring and working with contractors.

A few days earlier than planned, the Obama administration announced Wednesday that nearly 365,000 people signed up for health coverage under new exchanges created by Obamacare in the first two months of enrollment.

The figure was a big increase over the 106,000 who signed up the first month, when the computer problems undermined enrollment, but still well below the needed pace to reach the target of 7 million by a March 31 deadline to get coverage for 2014.

At Wednesday's hearing, Republicans challenged the new figures by pointing out they didn't reflect people who had actually paid for new policies under Obamacare.

In a particularly combative exchange, GOP Rep. John Shimkus of Illinois called the new enrollment figure "fraudulent because it's not those who have purchased plans yet."

Sebelius shot back that health insurance under Obamacare remained private policies, requiring people to pay up before they get a card from the insurance company proving they were covered.

That didn't satisfy Shimkus, who cut her off by saying "you're telling us those who shopped are enrolled."

Administration officials say traffic has increased even more since they completed upgrades to the website at the end of last month.

Through November, just over 137,200 Americans obtained an insurance policy through HealthCare.gov and nearly 227,500 through the 14 state-run exchanges, according to the new federal figures.

An additional 1.94 million people have started the process but had yet to pick a policy. Consumers must purchase health insurance by December 23 and pay the first premium by the end of the year for coverage to begin January 1.

Sign-ups vary widely by state. More than 107,000 Californians have picked plans, compared to only 44 Oregonians. Florida leads the way in the federal exchange, with nearly 18,000 people picking plans, while North Dakota has only 265 enrollees.

GOP attacks

Led by conservative Republicans, critics continue to attack Obamacare as an example of big government run amok, and Wednesday's hearing included fresh salvos aimed at Sebelius and Obama.

While some GOP legislators focused on specific provisions or problems with the reforms, others made clear their unhappiness dated back to the passage of the Affordable Care Act in 2010 with no Republican support.

"A lot of this is about the way it was passed," said Rep. Ed Whifield of Kentucky, noting that the Democratic House leadership at the time permitted no amendments. "There are very deep feelings about this still."

Rep. Joe Pitts of Pennsylvania, the chairman of the subcommittee, said misinformation by the administration about the health care reforms had eroded public trust.

"Every major promise the administration made about the ACA, from being able to keep your health plan if you like it, to being able to keep your doctor if you want to, the very premise of health reform in the first place, that the Affordable Care Act would make health coverage more affordable, has proven to be wrong," Pitts said. "My constituents have repeatedly expressed to me that they feel they were lied to by the administration about the real effects of this law."

Democrats lampooned the Republican criticism as overheated rhetoric, with Rep. Frank Pallone of New Jersey saying that "sometimes I think they're living on Mars rather than here on Earth."

"It just boggles my mind to hear these Republican comments about a world turned upside down when Obamacare is working," he said.

The blog post by Sebelius amounted to a sneak preview of her remarks to the committee, emphasizing steps she was taking to find out what happened with the rollout and prevent future problems.

Some Republicans were concerned about problems with the "back-end" operations of the HealthCare.gov website, such as transmitting correct enrollment information to insurance companies.

Sebelius said such issues were being addressed, including efforts to contact people who enrolled online to make sure they follow up with the company they chose to confirm their policies and pay for them.

She was unable to provide details of how many of the more than 360,000 enrollees so far had paid, adding that they would likely wait until the year-end deadline.

"I think most Americans will not pay until the money is actually owed," she said.