More than 7,000 Illinois residents signed up for private insurance coverage in the first two months of the troubled HealthCare.gov website, less than 30 percent of the federal government's projection for the state's enrollment at this point of the rollout.
Enrollment figures released Wednesday by the U.S. Department of Health and Human Services showed the pace picking up in the state and nationally; 364,682 Americans signed up for private coverage under President Barack Obama's new federal health law, including 7,043 in Illinois.
In October, when the website was barely working, only 1,370 Illinois residents managed to select a health plan and sign up. The new figures mean an additional 5,673 people made it through the process in November as the government scrambled to make hundreds of website repairs.
Catching up on enrollment will be challenging. The target for Illinois was to have 24,310 people signed up by the end of November, according to an internal federal memo first obtained by The Associated Press.
The state's 1,500 enrollment counselors would each need to successfully sign up more than one person every single day of this month -- about nine people each week -- to catch up with what had originally been projected before the website failures: 67,210 Illinois residents signed up by the end of December.
The administration had set a goal of signing up 7 million people by the end of open enrollment season March 31.
State officials said there is still plenty of time for people to enroll.
"These numbers show the federal website has improved but there is still more work to do," Jennifer Koehler, the chief of the Illinois insurance marketplace, said in an email. "A lot of people still need coverage and have been exploring their options on Getcoveredillinois.gov. We can see this from the traffic on the website and from the reports we are getting from our statewide network of community partners, who are helping consumers sort through their options and enroll every day."
Online insurance shopping is a key part of the nation's health care law. Illinois is relying on the federal website because the Legislature didn't approve a state-run marketplace.
The federal site serving 36 states, including Illinois, continues to have issues. Just Tuesday there was an extended maintenance outage. Some states running their own websites are also having problems, but in general, the state-run sites are performing better than the federal site.
Consumers face a Dec. 23 enrollment deadline if they want to have coverage starting Jan. 1. Enrollment continues through the end of March. The health law requires nearly every American to have insurance coverage or pay a tax penalty of $95 or 1 percent of income, whichever is higher.
The new enrollment report said 67,036 Illinoisans have submitted applications on the new insurance marketplace since Oct. 1. They were applying for coverage on behalf of 124,252 people -- for example, themselves, their spouses and children.
Of those Illinois residents deemed eligible to buy insurance on the marketplace, about 40 percent qualified for financial assistance. Federal tax credits will make premiums more affordable for households earning between 100 percent and 400 percent of the federal poverty line. That's $11,490 to $45,960 for an individual, $23,550 to $94,200 for a family of four.
The health law also expands Medicaid in states that have chosen to do so. In Illinois, Medicaid enrollment has been mostly handled by the state and has been far more successful than the private insurance signups. Illinois has received more than 206,000 Medicaid applications on its website, through an early expansion of Medicaid in Cook County and through an "express enrollment" program for people who qualify for food stamps.
Secretary Kathleen Sebelius assured Congress on Wednesday that "we are seeing very, very positive trends" now that HealthCare.gov is working reasonably well. She also announced that she'd asked the department's inspector general for an independent investigation into contracting and management factors that contributed to the technology failure.
Yet the revamped federal website serving 36 states continues to have issues, and some states running their own sites also face problems. Oregon had signed up only 44 people as of Nov. 30.
That's created stress and uncertainty not only for the uninsured but also for other people who now have insurance but are seeking to avoid an interruption in coverage in January.
Those who are trying to preserve their coverage include some of the more than 4 million people whose individual plans were canceled because they didn't measure up under the law -- as well as hundreds of thousands who are in federal and state programs for people with serious health problems, from cancer to heart disease to AIDS.
"Unless there is a proactive attempt to enroll these groups, you are likely to see a significant number of people whose coverage will lapse in January," said Dan Mendelson, CEO of Avalere Health, a market analysis firm following the rollout. "That might not be a big deal, because they might not get sick, but some of them will."
Democratic lawmakers say they are relieved the website is finally working, but some are not convinced the turnaround is complete.
"How confident I am? I'm hoping that we're moving in the right direction," said Rep. Eliot Engel, D-N.Y., after Wednesday's Energy and Commerce Committee hearing. "And if we find the day has come and we find that it's not what we had hoped, then I think there should be changes." The law should be fixed, not repealed, he said.
Sebelius said at least 1.9 million people appear to be waiting just offstage to sign up. They've been found eligible to enroll but haven't yet picked a plan.
If they're all procrastinators who rush forward on Dec. 23, the website would be overwhelmed. It can only handle 50,000 people at a time.
The administration report found a total of 137,204 people enrolled in the states served by the federal HealthCare.gov 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.
California, which is running its own program, led the nation, with 107,087 sign-ups. New York, also running its own market, had 45,513.
Among states with federally run markets, Florida was the leader with 17,908 sign-ups. Texas, which has a bigger share of its population uninsured than any other state, had 14,038.
Nationally, an additional 803,077 people have been determined to be eligible for Medicaid, the safety-net program shaping up as the health 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.
Obama's law uses a two-track approach to expand coverage for the uninsured. Middle-class people who don't have access to job-based insurance can buy government-subsidized private plans. Low-income people are steered to an expanded version of Medicaid in states accepting it, though not all do. The website is supposed to be the portal to both kinds of coverage.
The administration had spent $677 million on website technology through the end of October, aiming for smoother operations, but with results still well short of perfection.
Republicans have called for Sebelius to resign and some Democrats have urged Obama to fire those responsible for problems, but the White House has given no indication of a house-cleaning. Sebelius' request for an inspector general probe is a sign that there is more explaining to be done.
She seemed to be pointing a finger at the Medicare agency, which is part of her department and oversees Obama's coverage expansion.
In addition to the inspector general review, Sebelius said she has ordered the Centers for Medicare and Medicaid Services to hire a new "chief risk officer" to make sure technology programs work as advertised. Like other major federal operations, the Medicare agency already has several senior tech executives.
HealthCare.gov went live Oct. 1, and consumers immediately got bogged down. A two-month program of fixes directed by White House troubleshooter Jeffrey Zients made the site more workable, resolving hundreds of software glitches and adding computer equipment to handle peak demand.
Zients also concluded that the technical problems were compounded by inadequate oversight and coordination.