HONOLULU (AP) — A December surge propelled health caresign-ups through the government’s
rehabilitated website past the 1million mark, the Obama administration said Sunday, reflecting new signsof
life for the problem-plagued federal insurance exchange.Ofthe more than 1.1 million people now enrolled,
nearly 1 million signedup in December, with the majority coming in the week before apre-Christmas deadline
for coverage to start in January. Compare that toa paltry 27,000 in October —the website’s first,
error-prone month — or137,000 in November.The figures tell only part of the story. Theadministration has yet
to provide a December update on the 14 statesrunning their own exchanges. While California, New York,
Washington,Kentucky and Connecticut have performed well, others are stillstruggling.Still, the end-of-year
surge suggests that withHealthCare.Gov now functioning better, the federal market may bestarting to pull its
weight. The windfall comes at a critical moment forObama’s sweeping health care law, which becomes
"real" for manyAmericans on Jan. 1 when coverage through the exchanges and key patientprotections
kick in."As we continue our open enrollment campaign,we experienced a welcome surge in enrollment as
millions of Americansseek access to affordable health care coverage," Marilyn Tavenner, thehead of the
Center for Medicare and Medicaid Services, said in a blogpost.The fledgling exchanges are still likely to
fall short ofthe government’s own targets for 2013. That’s a cause for concern,because Obama needs millions
of mostly younger, healthy Americans tosign up to keep costs low for everyone. The administration had
projectedmore than 3.3 million overall would be enrolled through federal andstate exchanges by the end of
the year.Tavenner said fixes to thewebsite, which underwent a major overhaul to address widespread
outagesand glitches, contributed to December’s figures. But the problemshaven’t totally disappeared.
Thousands of people wound up waiting onhold for telephone help on Christmas Eve for a multitude of
reasons,including technical difficulties.The administration released thefigures Sunday while President
Barack Obama was vacationing in Hawaii.Although the president has spent most of his time relaxing with
friendsand family, he stepped into work mode late Friday for an update fromaides on his signature domestic
policy achievement. The White House saidObama told his team to focus on minimizing disruptions for
thoseswitching plans.For Americans who successfully chose insuranceplans by Dec. 24, coverage should start
on New Year’s Day for those whopay their first month’s premium by the due date, which in most cases hasbeen
extended until Jan. 10.But insurers have complained thatanother set of technical problems, largely hidden
from consumers, hasresulted in the government passing along inaccurate data on enrollees.The White House
says the error rate has been significantly reduced. Yetwith a flood of signups that must be processed in
just days, it remainsunclear whether last-minute enrollees will encounter a seamlessexperience if they try
to use their new benefits come Jan. 1.Thepolitical fallout from the website’s calamitous rollout could pale
incomparison to the heat that Obama might take if Americans who signed upand paid their premiums arrive at
the pharmacy or the emergency room andfind there’s no record of their coverage. Republican critics,
alreadyon the lookout for health-law failures to exploit in the 2014 midtermelections, would be emboldened
to argue that shortcomings with the law’simplementation have jeopardized Americans’ health.Asmake-or-break
January approaches, officials are also working to preventgaps in coverage for millions of Americans whose
individual policieswere canceled this fall because they fell short of the law’srequirements. In one of a
series of last-minute tweaks, theadministration in December said even if those individuals don’t sign upfor
new plans, they won’t face the penalty the law imposes on Americanswho fail to get insurance by March 31.A
key indicator of whetherstate-run exchanges are keeping pace with the federal exchange will comenext month,
when the administration releases full December figures.Overall, the goal is to sign up 7 million Americans
before thefirst-year open enrollment period closes at the end of March.Afew states offering their own
updates have posted encouraging totals,including New York, where more than 200,000 have enrolled either
throughthe state exchange or through Medicaid, a government program expandedunder Obama’s health law to
cover more people. In California, a tallyreleased Friday showed nearly 430,000 have enrolled through the
exchangeso far."The basic structure of that law is working despite allthe problems —despite the website
problems, despite the messagingproblems," Obama told reporters before departing for Hawaii.Anothermajor
unknown is whether the recent surge in enrollments skewed towardolder Americans whose medical needs are
expensive to cover, or whetherthe administration succeeded in recruiting younger and healthier peoplewhose
participation is critical to the law’s success. Those details forDecember are expected to be released in
mid-January.Meanwhile,with the website now able to handle higher volumes without crashing orclogging up, the
government plans in January to ramp up outreach toconsumers to encourage more people to sign up, the
administration said.___Reach Josh Lederman at http://twitter.com/joshledermanAPCopyright
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