By the end of November about 365,000 Americans had selected a health insurance plan through HealthCare.gov, the government reported Wednesday.
In the most comprehensive report to date about the federal website that suffered from a disastrous rollout in October, the U.S. Department of Health and Human Services said site access improved and enrollments picked up dramatically last month.
Although the report didn’t break out October results, it was estimated that just more than 100,000 Americans had completed the enrollment process that month.
Despite the November surge, the overall pace of enrollments nationwide in the federal Health Insurance Marketplace is dramatically lower than what the Obama administration had expected. Health and Human Services had estimated that by now 1.2 million users would have registered for health insurance coverage in 2014.
But HHS Secretary Kathleen Sebelius told a subcommittee of the House Energy and Commerce Committee in a hearing on Wednesday that she was encouraged.
“Evidence of the technical improvements to HealthCare.gov can be seen in the enrollment numbers,” she said in a statement.
Sebelius said in a blog post before the hearing that she was asking the department’s inspector general to investigate the contracting process that preceded the botched website rollout.
“The launch of HealthCare.gov was flawed and simply unacceptable,” Sebelius wrote. “We must take concrete action to prevent these problems in the future.”
Despite the November surge in completed enrollments, the government’s report said most buyers used websites operated by their states rather than the federal site. Just 137,204 of the total 364,682 individuals who selected an Obamacare plan came through the federal marketplace.
The federal system applies in 36 states, including Missouri and Kansas. The report showed that about 4,000 people in Missouri had fully completed the enrollment process and selected a plan. In Kansas, about 1,850 have done so. The report didn’t say whether those signed up have paid for their plans yet.
The department’s report for October and November said 1.9 million people in all had made it through an eligibility determination for the Affordable Care Act but had not actually selected a health policy to buy. Selecting a plan based on the affordability of the premiums, its coverage options and deductibles is the final step in the enrollment process. And then payment must be received for coverage to begin.
The report said that 803,077 people were found to be eligible for Medicaid or the Children’s Health Insurance Program, which means they would not be required to buy health policies.
HHS officials, in a conference call with reporters, said it expected the pace of enrollments to quicken this month as Americans became more aware of the law. Federal officials said they still believed the nation was on track to sign up 7 million people to buy health insurance coverage next year.
But time is running short for sign-ups this year. Enrollments are due by Dec. 23, with premium payments received by health insurers by Dec. 31 for coverage to begin on Jan. 1. For coverage starting later next year, open enrollment continues until March 31.
Newell Mitchell, an insurance broker in Overland Park who is helping individuals with sign-ups, said access and response times improved markedly. Last week, Mitchell said, he helped a user buy a policy in 45 minutes — “start to finish.”
There was a temporary outage on the federal site on Tuesday, however, so the much-maligned glitches are not gone.
The data released Wednesday indicated that about 227,000 people had signed up for health insurance through their state-run sites in 14 states. In general, state websites have fewer problems than the federal system.
The report showed that 12,900 Kansans, seeking coverage for 26,617 individuals counting family members, had completed applications for health insurance.
Of those individuals, 19,038 had been determined eligible for a federal marketplace plan, with 7,210 qualifying for a federal subsidy to buy insurance because of their household income. An additional 2,353 had been deemed eligible for Medicaid or other federal health care coverage.
So far, though, only 1,855 individuals in Kansas had actually selected a policy for purchase.
In Missouri, the data showed that 31,474 people, seeking coverage for 62,964 individuals, had completed applications.
Of those individuals, 43,661 were considered eligible for a marketplace plan, with 16,911 eligible for a federal subsidy. Another 6,487 were found to be eligible for Medicaid or another government health plan.
By the end of November, 4,124 Missourians had selected a marketplace policy.
Consumers in Missouri and Kansas are able to choose from subsidy-eligible policies offered by Blue Cross and Blue Shield and Coventry Health, the only two insurers that chose to participate on the exchange offered to Kansas City area residents.
As HHS released its report, Sebelius faced another grilling on Capitol Hill because of the problem-plagued launch.
“I don’t think there’s any question that the flawed launch of the website put a damper on people’s enthusiasm about early sign-up,” Sebelius said at the House energy subcommittee hearing. “We had a lot of visitors early on who got very frustrated and have not re-engaged.”
Republican members said they felt lied to about the promises and progress of the health law.
“Words start to lose their meaning when they’re delivered by individuals who have either misled this committee or were woefully ignorant of the disastrous consequences that have unfolded since enactment of the ACA,” said Rep. Joseph Pitts, a Pennsylvania Republican who led the hearing.
Sebelius said that in hindsight she might have done things differently.
“I would have probably done a slower launch, maybe with fewer people, and done some additional beta testing, which is part of what has happened, frankly, in the early months of the launch, to identify what problems we had,” she said.
The White House has brought in outside management to cure problems on the site, which has cost taxpayers more than $600 million so far.
Sebelius said she is hiring a new “chief risk officer,” focused on technology, for the Health and Human Services Centers for Medicare Medicaid Services office that oversees the ACA.
In discussing the numbers with reporters, department officials said that with just over three months left before open enrollment ends for coverage for the rest of 2014, the administration will make a push for sign-ups in states with large numbers of uninsured, such as Florida, Texas, Illinois and Georgia.
“We expect to have a bump in enrollment at the end,” said Nancy DeLew, acting deputy assistant secretary for planning and evaluation.
Officials are also spreading the word that the website’s capacity has grown to handle 50,000 simultaneous users and up to 800,000 site visitors each day.
“While our door is open for new consumers and we invite them in, we are placing particular attention on those who still need questions answered in order to complete their enrollment process,” said Julie Bataille, communications director at the Centers for Medicare and Medicaid Services.