WASHINGTON -- President Barack Obama said Friday that more than 500,000 Americans had obtained health insurance through the HealthCare.gov website in December, and "tens of thousands" were enrolling each day, as the Monday deadline for selecting insurance that is effective Jan. 1 fast approaches.
The surge in sign-ups on the troubled federal website and continued strong activity on state-run marketplaces have pushed combined enrollment under the Affordable Care Act to more than 1 million people, Mr. Obama said at his hour-long final news conference of the year.
Add to that another 800,000-plus people who will have coverage next year through Medicaid or the Children's Health Insurance Program, and, the president added, "I now have a couple million people, maybe more, who are going to have health care on Jan. 1. And that is a big deal. That's why I ran for this office."
While even those numbers are well below original administration projections, the December enrollment spike is a clear indication that HealthCare.gov has turned the corner on the technical problems that marred its October debut and slowed enrollment activity through November. "All told, millions of Americans, despite the problems with the website, are now poised to be covered by quality affordable health insurance come New Year's Day," Mr. Obama said.
The president's positive enrollment news came on the heels of the administration's latest health care rule change, which allows people whose coverage was canceled because it didn't meet new minimum standards to obtain cheaper catastrophic coverage.
That usually requires policyholders to pay initial medical costs of as much as $6,000 before comprehensive coverage kicks in. Under the rule change, if catastrophic coverage is also too expensive, individuals with canceled policies could receive an exemption from the law's "individual mandate," which requires most Americans to have coverage or face a fine next year.
The change resulted from a request by six Democratic senators for greater flexibility to deal with people whose individual policies were canceled after the president repeatedly had promised Americans that the health law allowed them to keep their coverage if they liked it. That pledge triggered a wave of public anger and political pressure that caused Mr. Obama to let canceled policies be extended for another year if insurers and state regulators allow it. But only about half the states decided to implement the president's "fix," which led the six lawmakers to seek the hardship exemption.
Administration officials don't expect many people to request the exemption, because they estimate that fewer than 500,000 people with canceled policies will lack coverage Jan. 1. The vast majority have enrolled in new coverage, White House officials said.
Mr. Obama defended the rule change as a necessary adjustment to an unforeseen problem. "When you try to do something this big, affecting this many people, it's going to be hard," he said. "And every instance, whether it's Social Security, Medicare, the prescription drug plan under President Bush, there hasn't been an instance where you've tried to really have an impact on the American people's lives and well-being, particularly in the health care arena, where you don't end up having some of these challenges."
He said the numerous changes to his signature legislation didn't negate the fact that the law was working. "Despite all the problems, despite the website problems, despite the messaging problems -- despite all that -- it's working," Mr. Obama told reporters assembled in the White House briefing room.
Consumers who have put off selecting policies because of technical problems with the federal and state marketplaces are expected to jam exchange websites and call centers in the next few days, trying to beat the Monday enrollment deadline to have coverage in effect Jan. 1.
In anticipation, the Obama administration has added 800 staffers at its call centers, bringing the total to more than 12,000 trained customer representatives at 17 sites nationwide. After more than two months of nonstop repairs and improvements, the federal insurance marketplace portal, HealthCare.gov, can handle more than 800,000 online visitors a day and as many as 50,000 simultaneous users, according to senior administration officials, who spoke only on condition of anonymity as a matter of administration policy.
To make enrollment easier for those who sign up no later than Monday, most insurers will make coverage retroactive to Jan. 1 if the first month's premium is paid anywhere from Dec. 31 to Jan. 10.
The deadlines vary by state and by insurer, so consumers are urged to contact their insurers to find out how much grace period they have.