Almost 27,000 selected insurance via HealthCare.gov

Kelly Kennedy | USA TODAY

WASHINGTON — Just 26,794 of the 106,185 people who selected health insurance last month used the troubled federal exchange site, Health and Human Services Secretary Kathleen Sebelius said Wednesday.

The remaining 79,391 people used the state exchanges to enroll, for a total of 106,185 people enrolled from Oct. 1 to Nov. 2. That's a fraction of the 7 million people the government estimates will buy insurance during the first year of the Affordable Care Act.

Of the overall total, 35,364 were in California, which is one of the states most targeted by the Obama administration.

"No one will be satisfied with the numbers because they will be below what we sought prior to the launch," White House spokesman Jay Carney said.

According to an Associated Press report, the administration had hoped that 500,000 people would enroll by the end of October.

Officials emphasized that 975,407 applications — for 1,081,582 eligible people — have made it through the enrollment process but haven't selected a health insurance plan. And 396,261 have been found eligible for Medicaid and the Children's Health Insurance Plans. The state and federal exchanges had 26,876,527 unique visitors.

Despite the low numbers, Sebelius touted the overall level of interest in buying health insurance.

"Even with the issues we've had, the marketplace is working, and people are enrolling," Sebelius said. "As more people shop and talk things over with their families, we expect these numbers to rise."

Sebelius said she did not find it discouraging that people have gone through the process but not purchased a plan. People will visit the site multiple times before making a decision, she said.

The states with their own exchanges outperformed those in the federal exchange: 3,736 signed up in Colorado; 4,418 in Connecticut; 5,586 in Kentucky; 16,404 in New York; and 7,091 in Washington.

Some of those states spent the day bragging. In California, 35,374 people enrolled in the first month, but 59,000 people have enrolled since Oct. 1. Officials said 370,000 people began the enrollment process.

"[The numbers] show momentum and very high consumer interest," said Peter V. Lee, executive director of Covered California, the state's exchange.

A new survey found that 70% of consumers found California's application process "easy."

"The fact that the majority of consumers who actually used the website to enroll found it 'easy' should put to rest the drumbeat of stories about glitches and website problems and instead focus on the big story that Californians are enrolling in care easily and every day," Lee said.

Sebelius and other officials have said the enrollment numbers would be low given the rough opening for the HealthCare.gov site, which has been plagued with glitches, crashes and delays. They also say people would wait until closer to the March 31 deadline before purchasing a plan, as has been the case with past government programs, such as Medicare Part D. Payment is not due until Dec. 15 for January coverage, Sebelius said.

"By the 15th of December, we'll be able to tell you how many people have actually paid for the first month of coverage," she said.

"There's no doubt that particularly the earlier experiences with the website were frustrating," Sebelius said Wednesday, adding that people can enroll through the call centers or in person.

"It is running right now," Sebelius said, adding that people are enrolling every day. It's running "quite a bit better than October," she said. "It is very much up-and-running."

Congressional Republicans, who have attacked the law since its passage in 2010 and repeatedly tried to kill it, reacted quickly to the enrollment statistics.

"Even if this data was an accurate picture, the administration would need to enroll 68,000 people per day to meet their year-end goal," said Rep. Dave Camp, R-Mich., chairman of the House Ways and Means Committee. "However, the website isn't even designed to handle that much traffic and is currently capable of only handling less than half that much."

Anne Filipic, President of Enroll America, an organization formed to help people enroll in the exchanges, said she found the 1.5 million people who had submitted an application encouraging, while the enrollment numbers were "what we have been expecting."

The website is flawed, Filipic said, adding that efforts such as Massachusetts' 2007 start up of its health care program went through similar problems. "We know from past enrollment efforts that numbers are always low in the beginning, and we're still just over a month into a six-month process," she said.

The numbers make sense when taken in context with normal consumer shopping patterns, said Brian Haile, senior vice president for health policy at Jackson Hewitt Tax Service Inc.

Haile cited a recent Gallup poll that shows that most of the uninsured haven't visited the website yet. Both the government and organizations like Enroll America are now beginning the second phase of their marketing push. He also said consumers may wait until January, so they have more to spend for the holidays. Others may wait until they receive tax-refund checks.

Improved enrollment depends on the website performing better by Nov. 30, when administration officials said it would be fixed. But White House chief technology officer Todd Park would not guarantee that during his testimony before a House committee Wednesday.

His "team is working incredibly hard to meet that goal," Park said.

Julie Bataille, spokeswoman for the Centers for Medicare and Medicaid Services, said that as of Wednesday, the site's error rate was down to less than 1%.

"By the end of the month, the site will be working smoothly for the vast majority of users," Bataille said, repeating what she, Sebelius and President Obama have been saying for the past couple of weeks.

The new data show the state and federal exchanges processed eligibility determinations and assessments for 98% — or 1,477,853 people — of the 1,509,883 people who have applied for coverage.

The Nov. 30 date is important because customers must buy insurance by Dec. 15 to be covered on Jan. 1. However, anyone who signs up by the end of enrollment March 31 will avoid the individual mandate fee for not having health insurance in 2014.

Park said the site can register 17,000 and provide access for 25,000 people per hour, but the administration hopes to provide access for 50,000 people per hour.

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