HONOLULU (AP) -- A December surge propelled health care sign-ups through the government's rehabilitated Web site past the 1 million mark, the Obama administration said Sunday, reflecting new vigor for the problem-plagued federal insurance exchange.
Of the more than 1.1 million people now enrolled, nearly 1 million signed up in December, with the majority coming days before a pre-Christmas deadline for coverage to start in January. Compare that to a paltry 27,000 in October -- the Web site's first, error-prone month -- or 137,000 in November.
The figures tell only part of the story. The administration has yet to provide a December update on the 14 states running their own exchanges, as the new online insurance markets are called. While California, New York, Washington, Kentucky and Connecticut have performed well, some are struggling.
Still, the end-of-year spike suggests that with HealthCare.Gov now functioning better, the federal market serving 36 states may be starting to pull its weight. The windfall comes at a critical moment for President Barack Obama's sweeping health care law, which becomes "real" for many Americans on Jan. 1 as coverage through the exchanges and key patient protections kick in.
"We experienced a welcome surge in enrollment as millions of Americans seek access to affordable health care coverage," Marilyn Tavenner, the head of the Center for Medicare and Medicaid Services, said in a blog post.
The fledgling insurance markets are still likely to fall short of the administration's own targets for 2013. That's a concern because Obama needs millions of mostly younger, healthy Americans to sign up to keep costs low for everyone. Officials had projected more than 3.3 million overall would be enrolled through federal and state exchanges by the end of the year.
Tavenner said fixes to the Web site, which underwent a major overhaul to address widespread outages and glitches, contributed to December's figures. But the problems haven't totally disappeared. Thousands of people wound up waiting on hold for telephone help on Christmas Eve for a multitude of reasons, including technical difficulties.
"We have been a little bit behind the curve," acknowledged Rep. Joaquin Castro, D-Texas, whose state has the highest proportion of uninsured residents. Nonetheless, the strong December sign-ups send a message. "The Affordable Care Act is something that's good for the country," said Castro.
"Obamacare is a reality," conceded one of the law's opponents, Rep. Darrell Issa, R-Calif., who as House oversight committee chair has been investigating the rollout problems. However, he predicted it will only pile on costs.
"The fact that people well into the middle class are going to get subsidies is going to cause them to look at healthcare...sort of in a Third World way of do we get subsidies from the government for our milk, for our gasoline and, oh, by the way, for our healthcare," said Issa.
For consumers who successfully selected one of the new insurance plans by Dec. 24, coverage should start on New Year's Day. That's provided they pay their first month's premium by the due date, extended until Jan. 10 in most cases.
But insurers have complained that another set of technical problems, largely hidden from consumers, has resulted in the government passing along inaccurate data on enrollees. With a flood of signups that must be processed in just days, it remains unclear whether last-minute enrollees will encounter a seamless experience if they try to use their new benefits come Jan. 1.
The White House says the error rate has been significantly reduced, but the political fallout from website woes could pale in comparison to the heat that Obama might take if Americans who signed up and paid their premiums arrive at the pharmacy or the emergency room and find there's no record of their coverage.
Officials are also working to prevent gaps in coverage for at least 4.7 million Americans whose individual policies were canceled this fall because they fell short of the law's requirements. The administration has said that even if those individuals don't sign up for new plans, they won't face the law's tax penalty for remaining uninsured.
The new enrollment figures were released Sunday while Obama was vacationing in Hawaii. Although the president has spent most of his time relaxing with friends and family, he stepped into work mode late Friday for an update from aides on his signature domestic policy achievement. The White House said Obama told his team to focus on minimizing disruptions for those switching plans.
A few states offering their own updates have also posted encouraging totals, including New York, where more than 200,000 have enrolled either through the state exchange or through Medicaid, a government program expanded under Obama's health law to cover more people. In California, a tally released Friday showed nearly 430,000 have enrolled through the exchange so far.
A key indicator of whether state-run markets are keeping pace with the federal exchange will come next month, when the administration releases full December figures. Overall, the goal is to sign up 7 million people before the first-year open enrollment period closes at the end of March.
Castro and Issa spoke on NBC's "Meet The Press."
- By Josh Lederman