Kelly Kennedy

USA TODAY

Enrollment surged as Dec. 24 deadline approached

Numerous problems held enrollment back in October and November

Congressional Budget Office says 7 million new customers needed by end of 2014

WASHINGTON — More than 2 million Americans will start the new year with private health insurance they didn't have before, Health and Human Services Secretary Kathleen Sebelius said Tuesday.

"Tomorrow, Jan. 1, will be a new day in health care for millions of Americans," Sebelius said. "More than 2.1 million people have enrolled in an insurance plan through the marketplace."

More than 4 million people have also enrolled in Medicaid, Sebelius said, adding that "we expect those numbers will continue to grow over time."

The announcement capped three months of frustration, finger-pointing and scrambling for the Obama administration and its political opponents following the Oct. 1 opening of the federal and state health insurance exchanges at the heart of the 2010 Affordable Care Act. Despite assurances from Sebelius and other officials, the federal exchange was plagued by numerous outages and glitches and only a "tech surge" of consultants and industry experts got the website working as advertised by Nov. 30.

Those problems have left HHS far behind the projection by the Congressional Budget Office that the exchanges need to enroll 7 million new private insurance customers by the end of 2014 if the market is to work.

Despite those problems, Sebelius emphasized the positives Tuesday and touted changes that will start Wednesday.

For example, she said, beginning Jan. 1, insurers may no longer preclude people from buying insurance because of pre-existing conditions; they may not charge older people much-higher premiums than younger people; they may not charge women more than men; and they must share pricing and benefits information to their consumers in a meaningful way.

People have until March 31 to buy private insurance and avoid paying a penalty for not having health insurance.

Sebelius said the administration is committed to making sure people realize they need to do more than enroll in health insurance to be covered: They also have to pay their insurance premiums.

Drugstore chains CVS and Walgreen's have said they'll provide transitional prescription coverage if a person can show proof they have enrolled, Sebelius said.

Still, Sebelius made several recommendations for people to make sure they had, in fact, enrolled in a plan:

• Call the insurer and ask.

• Get a copy of an insurance card with the new plan's information. Or, call and ask for that information.

• Pay the first premium by the day it's due. Depending on the state in which a person lives, some deadlines for paying the first premium have been extended.

• Make sure necessary doctors and pharmacies are within your network before trying to fill a prescription or make an appointment.

• If you don't know if you're enrolled or have information for your insurer, call HHS's call center at (800) 318-2596.

Phil Schiliro, senior adviser to the White House, said officials have been working with pharmacies and providers to make sure there's as little problem in the Jan. 1 transition as possible.

Enrollment in both the state and federal exchanges surged the last week of December to meet a Dec. 24 deadline to gain coverage beginning Jan. 1. Enrollments started at fewer than 1,000 a day in October, rose to 3,800 a day in November and rose again to about 40,000 a day in December. As the deadline approached, as many as 100,000 people signed up a day.

About 83,000 people were able to use the site at a time Dec. 23, much more than the 25,000 officials said it could handle after announcing it had been fixed at the end of November.

New York and Washington also announced their numbers this week. As of Dec. 24, 168,999 New Yorkers had enrolled in private plans through the exchange, and 61,625 had signed up for Medicaid. Since then, enrollment has continued to go up, with 175,146 in private plans and 66,376 in Medicaid as of Monday.

As of Dec. 23, more than 65,000 Washington residents had enrolled in a private plan.

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