Obamacare Enrollment: Climbing, but Still Falling Far Short

By end of November, 137,000 had signed up through the federal exchange website.

Mercy Cabrera, an insurance agent with Sunshine Life and Health Advisors, speaks on the phone as she helps a person with information about an insurance policy under the Affordable Care Act at the store setup in the Westland Mall on November 14, 2013 in Hialeah, Florida. (National Journal)

Obamacare enrollment picked up slightly in November but remains far short of the administration's initial targets.

Roughly 264,000 people signed up for private insurance coverage last month through state and federal exchanges by the end of the month, according to data from the Health and Human Services Department. That brings the total to about 364,000 for October and November.

About 137,000 people have signed up so far through HealthCare.gov, the federally run website that serves 36 states, HHS said. Another 227,000 have signed up in the 14 states that chose to set up their own exchanges.

The disappointing report on November enrollment is not a surprise: HealthCare.gov was not working for consumers for most of the month, and HHS wasn't trying to direct people to the site. Enrollment has surged since Dec. 1, when HHS announced that the site is working well for the "vast majority of users" — it recorded a combined 29,000 enrollments on Dec. 1 and 2, figures that aren't reflected in the latest report.

Still, the site's poor performance during November has left enrollment severely off track. The 364,000 people who have signed up through the first two months still fall short of the administration's expectations for October alone. Another 3 million people would have to sign up this month alone in order to hit the initial year-end goal.

HHS had expected 3.3 million people to sign up by the end of December and 7 million by March 31, when the enrollment window closes. Although enrollment will surely miss the mark for this year, HHS officials said they remain confident they will reach their ultimate goal.

"No, we think we're on track and we will reach the total that we thought. We're only two and a half months into a six-month open-enrollment period," said Michael Hash, the director of HHS's Office of Health Reform.

The administration could afford to fall somewhat short of 7 million sign-ups. Although the mix of healthy versus sick enrollees is perhaps more critical to the law's success than the total number, each state's exchange still needs a critical mass of people to remain financially viable.

The law includes several safety nets designed to prevent premiums from spiking if enrollment falls short. Those mechanisms can help the exchanges recover from a rough first year, but experts don't think they're strong enough to offset disastrously low enrollment.

As many as 25 percent of enrollment files processed in October and November contained errors that could affect consumers' coverage. HealthCare.gov sent incomplete, redundant, or faulty information to insurance companies, or failed to send enrollment reports at all, for many of the people who were able to use the site. Some of those errors are minor, while others could result in significant problems — such as people finding out they weren't enrolled in a plan they thought they had chosen.

In addition to the 364,000 sign-ups for private insurance, another 800,000 people have been determined eligible for Medicaid or the Children's Health Insurance Program using the law's new insurance exchanges, HHS said.

{{ BIZOBJ (video: 4623) }}