First Take: Obamacare data are simply grim

Aamer Madhani | USA TODAY

WASHINGTON — The White House set low expectations for early Obamacare enrollment numbers, but the cold hard data offer perhaps the grimmest picture yet of what President Obama faces as he tries to breathe life into his troubled health care law.

Even before the numbers were released Wednesday, administration officials all but said they would be terrible, and not only because of the problems with the federal online health exchange — which accounted for less than 27,000 of about 106,000 enrollees in October.

At the end of October, Obama traveled to Boston and noted that only 123 Massachusetts residents signed up under Gov. Mitt Romney's statewide health care law in the first month of the law's implementation. Human nature suggests that people won't make a final decision on coverage until they absolutely have to, he said.

Whether the White House take is spin or fact, or both, the enrollment figures are bleak and will offer Republicans another opportunity to take aim at the law and push Democrats to insist on a legislative fix that could lead to the law's doom.

Rep. Dave Camp, R-Mich., the chairman of the House Ways and Means Committee, noted that the administration would need to enroll 68,000 people per day to meet Health and Human Services Department's year-end goals — an extraordinarily ambitious benchmark.

The October data show that HHS reached only a fraction of the 494,000 target it had set, according to a September memo from Centers for Medicaid and Medicare Services Administrator Marilyn Tavenner to Health and Human Services Secretary Kathleen Sebelius.

"With the little data we have so far, I fear we could see a fundamental breakdown of the insurance market with coverage gaps and premiums skyrocketing -– pricing millions of Americans out of health care, yet still forced to pay the individual mandate tax," Camp said.

Since being voted into law, House Republicans voted more than 40 times to repeal the president's health care law--what at the time seemed like Quixotic attempts that drew the scorn of Obama and his fellow Democrats.

But the October enrollment data suggests they've succeeded tactically where they've been unsuccessful legislatively. In the 14 states and the District of Columbia, which set up their own exchanges, more than 326,000 completed applications. In the 36 states relying on the federal government operated exchange because state's refused to set up exchanges, less than 520,000 residents completed applications.

"Republican governors refused to set up state exchanges, forcing the federal government to bear more of the workload," said Rep. Elijah Cummings, D-Md. He added, "To me, this is one of the most inexplicable actions I have ever witnessed from elected representatives against their own people, the people who elect them, their neighbors, their family members, their friends, the grocer, the mortician."

Sebelius, who spoke with reporters after the numbers were released, wouldn't say what HHS knows about the demographic composition of enrollees — signing up a substantial number of young, healthy consumers is crucial to the long-term prospects of the health care law.

For Obama, the troubled roll-out is also taking a toll on his personal popularity.

Obama has been battered by Republicans for the millions of Americans who are losing their health insurance plans as a result of the Affordable Care Act, despite his oft-repeated assurances that Americans could keep their insurance plans if they liked them.

Last week, Obama apologized for his "if you like your insurance, you can keep it" remarks. For the first time, a Quinnipiac University Poll published Tuesday showed that, by 52%-42%, Americans said Obama is not honest and trustworthy. His previous lowest marks on honesty were May 30, when 49% of voters said he was honest and 47% said he wasn't.

The enrollment data, coupled with Obama's declining popularity, have the potential of growing the fraternity of uneasy Democrats who are up for re-election in 2014 — a group that includes Sens. Mary Landrieu of Louisiana, Mark Pryor of Arkansas and Kay Hagan of North Carolina.

The trio are among those pushing for a legislative fix that would allow Americans on the individual insurance market who are getting cancellation notices to keep their coverage.

Such a move could prove to be the most serious threat to Obamacare, potentially creating a situation where sick people purchase health insurance policies that comply with the ACA, while healthy people who are on the individual insurance market can insist on staying on policies that are cheaper but don't comply with the law.

Obama was already on shaky ground in his defense of his health care law. The enrollment numbers only make his difficult situation more untenable.

Contributing: Gregory Korte