Spike in HealthCare.gov sign-ups as Sebelius touts progress

Health and Human Services Secretary Kathleen Sebelius talked up progress made in improving the performance of the glitch-ridden HealthCare.gov website on Wednesday, armed with new figures that suggest a surge in enrollments.

The Obama administration released numbers showing that close to 260,000 people enrolled in health care through state and federal exchanges in November, more than twice the 106,000 people who signed up in October.

When the state numbers are combined with those from the launch of HealthCare.gov, about 365,000 people enrolled during the first two months of the health care exchanges, which are a crucial element of President Barack Obama’s health care reform.

But the total represents less than one-third of the 1.2 million people who officials had originally projected would enroll nationwide by the end of November.

The seemingly better performance of the website comes at a critical time for health care reform. Consumers face a Dec. 23 enrollment deadline if they want to have coverage on Jan. 1. It also came on the same day that Sebelius appeared before a House committee to defend the administration's handling of the health care rollout.

Despite the improved figures, HealthCare.gov, the federal health exchange website serving 36 states, continues to have problems. Just Tuesday there was an extended maintenance outage. In addition to the federal site, some state-run websites are also experiencing problems.

It may add to what critics of the law say is unnecessary stress and uncertainty, not only for the uninsured but also for those currently covered who seek to avoid an interruption in coverage in January. The latter group includes some of the more than 4 million people whose individual plans were canceled for not measuring up under the law, as well as hundreds of thousands who are in federal and state programs for people with serious health issues, from cancer and heart disease to AIDS.

On Wednesday, Sebelius urged those yet to be insured to go onto the website before the deadline.

“Evidence of the technical improvements to HealthCare.gov can be seen in the enrollment numbers,” she said. “Now is the time to visit HealthCare.gov, to ensure you and your family have signed up in a private plan of your choice by Dec. 23 for coverage starting Jan. 1.”

But questions linger over the deeper problems that dogged the website's botched rollout, prompting Sebelius to call for an investigation into management and contracting decisions. The website has cost taxpayers more than $600 million so far, according to the congressional Government Accountability Office.

In a blog post, the secretary asked her department's inspector general to investigate the contracting process, management, performance and payment issues that may have contributed to the problems at HealthCare.gov.

The comments came before a second grilling of Sebelius by members of the House Energy and Commerce Committee over the issues that afflicted the website.

"I don't think there is any question that the flawed launch of the website put a damper on people's enthusiasm," she told the committee. "Having said that, we are seeing very, very positive trends. We are seeing lots of people re-engage."

In addition to the inspector general review, Sebelius said she has ordered the hiring of a new "chief risk officer" at the Medicare agency, which also oversees the new programs created to expand health insurance coverage under Obama's law. That official will focus on making sure technology programs work as advertised.

Sebelius also said she has ordered a retraining of her department on best practices for outside contracting.

In figures released Wednesday, the administration said that in addition to actual enrollments, a further 1.9 million people have made it through the first stage of the process but have not yet picked a plan. Consumers must pay their premiums by Dec. 31 for coverage to take effect at the beginning of the year.

The administration report said a total of 137,204 people had enrolled in the states served by the federal website by the end of November, up from 26,794 in October. The 14 states running their own websites enrolled 227,478 people, up from 79,391 in October.

HealthCare.gov also helped an additional 803,077 people be determined as eligible for Medicaid, the safety-net program shaping up as the health care overhaul's early success story. That's about double the number for October. Nonetheless, state Medicaid directors are reporting accuracy problems with information on prospective enrollees that the federal government is sending them.

The site went live Oct. 1 to much fanfare, but technical problems turned it into a frustrating bottleneck for millions of consumers. A two-month program of fixes directed by White House adviser Jeffrey Zients stabilized the site and made it more workable, resolving hundreds of software glitches and adding more hardware to handle high demand from consumers.

Lawmakers want explanations for dozens of questions about the website's design, workability and security. They also want to know why Sebelius and other top officials repeatedly assured them everything was on track.

Although Republicans have called for Sebelius to resign, and some Democrats have urged Obama to fire those responsible for the launch, the White House has given no indication that a housecleaning is coming. Instead, it has brought in outside management to help Sebelius and her department cope.

The unusual early-morning announcement Wednesday of an inspector general's probe was taken by some as an indication that work still needs to be done to rebuild confidence in the system.

"I believe strongly in the need for accountability, and in the importance of being good stewards of taxpayer dollars," Sebelius said in her announcement. 

The administration had set a goal of signing up 7 million people by the end of open enrollment season on March 31. HHS health reform director Mike Hash says it's still "on track" to meet it. Uninsured people who procrastinate beyond that date will face tax penalties when they file their returns for the 2014 tax year.

Al Jazeera and The Associated Press