Press Secretary Jay Carney says enrollment is always slow with these kinds of programs. W.H. fires up ACA spin machine

One thing we know: The first Obamacare sign-up numbers will be disappointing.

Another thing we know: The White House isn’t waiting to put its spin on things. Administration officials have been lowering expectations since before sign-up began Oct. 1, urging reporters not to make a big fuss over the initial enrollment numbers.


But after the website debacle, the bad press of people losing their health plans and President Barack Obama’s defense and then walk-back of his “if you like your plan, you can keep it” slogan, the White House has a tougher job on its hands. There’s essentially no avoiding a bad news cycle, but there are ways to mitigate the damage.

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Here’s POLITICO’s list of what you’ll hear when the enrollment numbers come out:

1. One hundred twenty-three

White House press secretary Jay Carney on Tuesday offered the White House’s daily reminder that only 123 people signed up for the Massachusetts health insurance program — i.e., Romneycare — during the first month it went live.

“The history of these kinds of programs, and Massachusetts is the best model, is that enrollment is very slow early on,” Carney said. “I think there were only 123 people in Massachusetts who enrolled in the first month and while it’s a small state, it is a reasonably populous state and 123 is a very low number.”

The idea is that people don’t sign up for things when they’re first available — they shop around, they aren’t paying attention or they wait for deadlines. Young and healthy people, for instance, won’t sign up until there’s a deadline, the White House has argued.

But this version casually forgets that the administration’s earlier estimate that 500,000 people would sign up in the first month was itself couched as a conservative figure that officials hoped would be exceeded. But that’s already 10 times The Wall Street Journal’s reported figure of only 50,000 October enrollees on the federal exchange.

It’s also a far cry from the first days of the rollout, when Obama himself blamed heavy traffic on HealthCare.gov for the “glitches” that stopped people from clicking through the enrollment process. And it belies any sense of excitement the White House was hoping would come out of the ability of Americans to finally buy health coverage through the insurance exchanges.

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And still, whatever the official number is, Carney said Tuesday that it won’t necessarily represent the number of people who are paying for plans obtained through the federal insurance marketplaces — just those who have clicked through to the end of the process.

“The marketplace experience or process ends when a person selects a plan, essentially presses ‘enroll in a plan,’” Carney said. “After that it becomes a contract between the private insurer and the individual.”

2. The website stinks

You can’t sign up for health insurance if you can’t log on to the website.

Even though the HealthCare.gov debacle is a self-inflicted wound, it’s one the administration has mostly owned up to, even if officials have been stingy with details about how the failure occurred.

The Democratic wagon-circling is already in full swing, with Massachusetts Gov. Deval Patrick telling health care organizers at an Organizing for Action summit last week that universal health care is a “way of life,” not a website.

“The fact that the website has been so challenging, so problematic in the first month means that enrollment numbers will be even lower than expected,” Carney said.

The techies also will keep bearing the burden for Obama’s discredited promise that people can keep legally substandard health insurance plans if they want to — a problem that even former President Bill Clinton suggested the administration should fix.

If only the website worked, Obama said last week to NBC’s Chuck Todd, people could see that things aren’t so bad.

“The majority of folks will end up being better off, of course, because the website’s not working right, they don’t necessarily know it,” Obama said. “Even though it’s a small percentage of folks who may be disadvantaged, you know, it means a lot to them. And it’s scary to them. And I am sorry that they, you know, are finding themselves in this situation, based on assurances they got from me.”

3. If only Republicans would cooperate

It sure is hard to roll out a national entitlement program when half the country’s politicians are actively trying to stop it.

Obama visited New Orleans last Friday and pressed Louisiana Gov. Bobby Jindal — who was in the audience — to expand Medicaid in the state. And there are constant reminders that Republicans refused to allocate money for the federal exchanges that are now serving 36 states.

Democratic officials will point to states like Kentucky, where a conservative population has embraced a state-based exchange and expanded Medicaid funding.

And White House officials have repeatedly said House Oversight and Government Reform Committee Chairman Darrell Issa’s attempts to subpoena administration officials like Chief Technology Officer Todd Park about the bungled website would serve only to delay the necessary fixes. Todd is on the witness list for Issa’s Wednesday morning hearing, although the White House has tried to postpone his appearance until next month.

“I can guarantee that the number that is released will be lower than we had hoped and anticipated because of the problems with the website, and that is why it is so important to focus on our energies on fixing the problems,” Carney said Tuesday.

“And that goes to … the attempt to remove somebody who is very much a key part of the effort to fix the website from his job for a certain amount of time. And it raises questions about how sincere critics are when it comes to joining with us in the effort to fix the problems that exist.”

4. George W. Bush did it, too

The Medicare Part D rollout in Bush’s second term didn’t start out so well, either, but the programs has since become an overwhelming success.

Bill Clinton made headlines Tuesday when he suggested that Obama should “honor the commitment” to allow people to keep their existing health insurance plans, even if it meant a change in the law, but he also brought up the Bush administration’s problems.

“The enrollment period didn’t come off well because the national website wasn’t ready,” Clinton said during an interview for the website Ozymandias.

“But this happened once before. It happened when President Bush put in the Medicare drug program for seniors, which was not as complicated but had exactly the same problem with the rollout. It was a disaster. There were people that lost their prescriptions for their existing medicine. And they fixed it.”

5. It gets better

This is the running theme for the White House. The website is being fixed. People thrown out of health insurance plans will get better and cheaper ones. A host of new consumer-friendly rules are good for women and the chronically ill.

If only people knew the benefits of Obamacare, Obama told an Organizing for Action summit last week, the law would be more popular.

“It’s important sometimes to just step back and say, all that stuff is already happening,” he said after ticking through the list of things already accomplished under the law. “A lot of it got underreported, kind of crept up on people. And as we move forward, you’ve got to keep that in mind.”

And there is plenty of time, Obama said, for people to enroll, even if they have to wait for the website to operate properly.

“Everybody who wants to get insurance through the marketplace, they’ll be able to get it,” Obama said. “It’s not as if this is a one-day sale or something. So we’ve just got to keep on working.”