WASHINGTON (AP) — Add simmering Democratic discontent to the problems plaguing "Obamacare," now that first-month enrollment figures are out.
The White House is rushing to come up with an unspecified fix as early as this week to counter the millions of health coverage cancellations going to consumers, at the same time it promises improvements in a federal website so balky that enrollments totaled fewer than 27,000 in 36 states combined.
The White House also is taking a more open approach to changes in the law itself. "We welcome sincere efforts," presidential press secretary Jay Carney said Wednesday at the White House as Democratic impatience grew over a program likely to be at the center of next year's midterm elections for control of Congress.
After weeks of highly publicized technical woes, the administration had said in advance the enrollment numbers would fall far short of initial expectations.
They did, easily.
A paltry 26,794 people enrolled for health insurance during the first, flawed month of operations for the federal "Obamacare" website.
Adding in enrollment of more than 79,000 in the 14 states with their own websites, the nationwide number of 106,000 October sign-ups was barely one-fifth of what officials had projected — and a small fraction of the millions who have received private coverage cancellations as a result of the federal law.
The administration said an additional 1 million people have been found eligible to buy coverage in the markets, with about one-third qualifying for tax credits to reduce their premiums. Another 396,000 have been found eligible for Medicaid, which covers low-income people.
Republicans were unmoved.
"Even with the administration's Enron-like accounting, fewer people have signed up for Obamacare nationwide than the 280,000 who've already lost their plan in Kentucky as a result of Obamacare mandates," Senate Minority Leader Mitch McConnell, R-Ky., said.
Administration officials and senior congressional Democrats expressed confidence in the program's future. "We expect enrollment will grow substantially throughout the next five months," said Health and Human Services Secretary Kathleen Sebelius, who is in overall charge.
"Even with the issues we've had, the marketplace is working and people are enrolling," she added.
Despite the expressions, the White House raced to reassure anxious Democrats who are worried about the controversial program, which they voted into existence three years ago over Republican opposition as strong now as it was then.
Senate Democrats arranged a closed-door meeting for midday Thursday in the Capitol with White House officials, who held a similar session Wednesday with the House rank and file.
So far, five Senate Democrats are on record in support of legislation by Sen. Mary Landrieu, D-La., to make sure everyone can keep their present coverage if they want to. The bill would require insurance companies to continue offering existing policies, even if they fall short of minimum coverage requirements in the law.
The measure has little apparent chance at passage, given that it imposes a new mandate on the insurance industry that Republicans will be reluctant to accept.
At the same time, a vote would at least permit Democrats to say they have voted to repair some of the problems associated with the Affordable Care Act, as many appear eager to do.
In a statement, Landrieu said Sens. Jeff Merkley of Oregon, Kay Hagan of North Carolina and Mark Pryor of Arkansas were now supporting the legislation, as is Sen. Dianne Feinstein of California. All but Feinstein are on the ballot next year.
Across the Capitol, majority Republicans in the House set a vote for Friday on legislation to permit insurance companies to continue selling existing policies that have been ordered scrapped because they fall short of coverage standards in the law.
While House passage of the measure is assured, each Democrat will be forced to cast a vote on the future of a program that Republicans have vowed to place at the center of next year's campaign.
The promise of keeping coverage was Obama's oft-stated pledge when the legislation was under consideration, a calling card since shredded by the millions of cancellations mailed out by insurers.
Obama apologized last week for the broken promise, but aides said at the time the White House was only considering administration changes, rather than new legislation.
WASHINGTON (AP) — Just two weeks after President Barack Obama saw his Democratic Party put up an unyielding front against Republicans, his coalition is showing signs of stress.
From health care to spying to pending budget deals, many congressional Democrats are challenging the administration and pushing for measures that the White House has not embraced.
Some Democrats are seeking to extend the enrollment period for new health care exchanges. Others want to place restraints on National Security Administration surveillance capabilities. Still others are standing tough against any budget deal that uses long-term reductions in major benefit programs to offset immediate cuts in defense.
Though focused on disparate issues, the Democrats' anxieties are connected by timing and stand out all the more when contrasted with the remarkable unity the party displayed during the recent showdown over the partial government shutdown and the confrontation over raising the nation's borrowing limit.
"That moment was always going to be fleeting," said Matt Bennett, who worked in the Clinton White House and who regularly consults with Obama aides. "The White House, every White House, understands that these folks, driven either by principle or the demands of the politics of their state, have to put daylight between themselves and the president on occasion."
Obama and the Democrats emerged from the debt and shutdown clash with what they wanted: a reopened government, a higher debt ceiling and a Republican Party reeling in the depths of public opinion polls.
But within days, attention turned to the problem-riddled launch of the 3-year-old health care law's enrollment stage and revelations that the U.S. had been secretly monitoring the communications of as many as 35 allied leaders, including German Chancellor Angela Merkel. And with new budget talks underway, Democratic Party liberals reiterated demands that Obama not agree to changes that reduce Social Security or Medicare benefits even in the improbable event Republicans agree to increase budget revenues.
The fraying on the Democratic Party edges is hardly unraveling Obama's support and it pales when compared to the upheaval within the Republican Party as it distances itself from the tactics of tea party conservatives. But the pushback from Democrats comes as Obama is trying to draw renewed attention to his agenda, including passage of an immigration overhaul, his jobs initiatives and the benefits of his health care law.
The computer troubles that befell the start of health insurance sign-ups have caused the greatest anxiety. Republicans pounced on the difficulties as evidence of deeper flaws in the law. But Democrats, even as they defended the policy, also demanded answers in the face of questions from their constituents.
"The fact is that the administration really failed these Americans," Rep. Allyson Schwartz, D-Pa., told Medicare chief Marilyn Tavenner at a hearing this week. "So going forward there can be just no more excuses."
In the Senate, 10 Democrats signed on to a letter seeking an unspecified extension of the enrollment period, which ends March 31. "As you continue to fix problems with the website and the enrollment process, it is critical that the administration be open to modifications that provide greater flexibility for the American people seeking to access health insurance," Sen. Jeanne Shaheen, D-N.H., wrote.
Another Democratic senator, Joe Manchin of West Virginia, has called for a one-year delay in the requirement that virtually all Americans have health insurance or pay a fine.
Democrats who have talked to White House officials in recent days describe them as rattled by the health care blunders. But they say they are confident that the troubled website used for enrollment will be corrected and fully operational by the end of November.
The spying revelations also have created some tensions between the administration and Democrats. Sen. Dianne Feinstein, chairwoman of the Senate Intelligence Committee and until now a staunch supporter of the NSA's surveillance, called for a "total review of all intelligence programs" following the Merkel reports.
She said that when it came to the NSA collecting intelligence on the leaders of allies such as France, Spain, Mexico and Germany, "Let me state unequivocally: I am totally opposed."
With Congress renewing budget talks Wednesday, liberals have been outspoken in their insistence that Democrats vigorously resist efforts to reduce long-term deficits with savings in Social Security or Medicare. Sen. Bernie Sanders of Vermont, an independent who usually votes with Democrats, has been the most outspoken, saying he fears a budget deal will contain a proposal in Obama's budget to reduce cost-of-living adjustments for Social Security and other benefit programs.
Obama, however, has proposed that remedy only if Republicans agree to raise tax revenue, a bargain that most in the GOP firmly oppose. Moreover, leaders from both parties as well as White House officials have signaled that budget talks are looking for a small budget deal, not the type of "grand bargain" that would embrace such a revenue-for-benefit-cuts deal.
WASHINGTON (AP) — "Obamacare" escaped unharmed from the government shutdown Republicans hoped would stop it, but just as quickly they have opened a new line of attack — one handed to them by the administration itself.
While Congress was arguing, President Barack Obama's plan to expand coverage for the uninsured suffered a self-inflicted wound. A computer system seemingly designed by gremlins gummed up the first open enrollment season. After nearly three weeks, it's still not fixed.
Republicans hope to ride that and other defects they see in the law into the 2014 congressional elections. Four Democratic senators are facing re-election for the first time since they voted for the Affordable Care Act, and their defeat is critical to GOP aspirations for a Senate majority.
Democrats say that's just more wishful thinking, if not obsession.
Although Obama's law remains divisive, only 29 percent of the public favors its complete repeal, according to a recent Gallup poll. The business-oriented wing of the Republican party wants to move on to other issues. Americans may be growing weary of the health care fight.
"This is the law of the land at this point," said Michael Weaver, a self-employed photographer from rural southern Illinois who's been uninsured for about a year. "We need to stop the arguing and move forward to make it work."
It took him about a week and half, but Weaver kept going back to the healthcare.gov website until he was able to open an account and apply for a tax credit that will reduce his premiums. He's not completely finished because he hasn't selected an insurance plan, but he's been able to browse options.
It beats providing page after page of personal health information to insurance companies, Weaver said.
Under the new law, insurers have to accept people with health problems. Weaver is in his mid-50s, with high blood pressure and high cholesterol, but otherwise in good health. He says those common conditions made it hard for him to get coverage before.
Although Weaver seems to have gotten past the major website obstacles, he's still finding shortcomings. There's no place to type in his medications and find out what plans cover them. "I wish there was more detail, so you could really figure it out," he said.
Such a nuanced critique appears to be lost on congressional Republicans.
"#TrainWreck: Skyrocketing Prices, Blank Screens, & Error Messages," screamed the headline on a press release Friday from House Speaker John Boehner, R-Ohio. A House hearing on the "botched Obamacare rollout" is scheduled for this coming week. GOP lawmakers want Health and Human Services Secretary Kathleen Sebelius to resign.
Administration officials, in their most detailed accounting yet of the early rollout, said Saturday that about 476,000 health insurance applications have been filed through federal and state exchanges. But the officials continue to refuse say how many people have enrolled in the insurance markets.
Without enrollment figures, it's unclear whether the program is on track to reach the 7 million people projecting by the Congressional Budget Office to gain coverage during the six-month sign-up period.
The president was expected to address the problems on Monday during a health care event at the White House. The administration has yet to fully explain what has gone wrong with the online signup system.
"To our Democratic friends: You own 'Obamacare' and it's going to be the political gift that keeps on giving," said Sen. Lindsey Graham, R-S.C.
"Irresponsible obsession," scoffs Rep. Sander Levin of Michigan, ranking Democrat on the Ways and Means Committee, which oversees much of the health law.
Democratic pollster Celinda Lake says she doesn't see how going after the health law rollout will help Republicans by the time of next year's election.
"Americans are technology optimists," said Lake. "You tell them the website has problems today, and they'll assume it will be better tomorrow. I mean, we're Americans. We can fix a website."
There may be a method to the GOP's single-mindedness.
Republicans are intent on making the health law an uncomfortable anchor around the neck of four Democratic senators seeking re-election in GOP-leaning states, weighing them down as they try to unseat them. Republicans need to gain six seats to seize the majority in the Senate, and any formula for control includes flipping the four seats.
Sens. Mark Pryor of Arkansas, Mary Landrieu of Louisiana, Mark Begich of Alaska and Kay Hagan of North Carolina will be facing voters for the first time since they were among the 60 Democrats who voted for the health law in 2009.
More than a year before the election, Republican Rep. Tom Cotton is airing an ad that criticizes Pryor for his vote, telling Arkansans that Pryor "cast the deciding vote to make you live under Obamacare." The commercial's final image shows Pryor with Obama, who took a drubbing in Arkansas last year.
"The bottom line is these candidates will have to answer for why they voted for this bill," said Rob Engstrom, senior vice president and national political director for the U.S. Chamber of Commerce.
If the website gets fixed, other problems may emerge. Republicans can still try linking 'Obamacare' to rising premiums, anemic job growth and broader economic worries.
Will the strategy work?
The chamber spent millions on ads in 2012 criticizing Senate incumbents such as Jon Tester of Montana and Bill Nelson of Florida for their health care votes, yet many of those candidates overcame the criticism and won re-election.
The economy, not health care, remains the top concern of voters. By putting opposition to the health care law ahead of all other priorities, economist Douglas Holtz-Eakin says tea-party conservatives may have overdone it.
"Obamacare was an effective campaign weapon," said Holtz-Eakin, and adviser to Republicans. "The question is, have they damaged it beyond its political viability?"
The online health insurance exchanges are now open in both Missouri and Illinois. The online marketplace is a key component of the federal health care law.
Illinois officials have set up their own marketplace at GetCoveredIllinois.gov.
Missouri voters chose to bar their government from setting up its own marketplace. So the federal government is running the exchange for Missouri residents at Healthcare.gov.
Consumers have until December 15th to sign up if they want coverage to start on January 1, but enrollment is open until March 31.
On October 1st, the federally mandated health insurance exchanges open enrollment. And that includes Missouri.
State voters passed a law last year that effectively barred the governor from setting up an insurance exchange, but that doesn't mean there isn't one.
The federal government will operate Missouri’s online marketplace, which is currently being set up. The federal website, healthcare.gov says it will be ready in time for enrollment to begin.
Under the new healthcare law, those who don't have insurance through their employers, schools, parents, a private policy or a public plan like Medicaid or Medicare will face fines next year. And many of them are expected to be young adults. The St. Louis Post Dispatch reports that 25% of young adults in the Missouri are currently uninsured.
Illinois did set up a health insurance exchange.
Residents in both Missouri and Illinois can get more information about affordable coverage at healthcare.gov.
WASHINGTON (AP) - U.S Solicitor General Donald Verrilli says employer challenges to the birth control mandate in the Affordable Care Act will likely be decided in the Supreme Court term that begins next month.
Dozens of employers have said that providing contraceptive coverage would violate their religious beliefs.
In a panel discussion Thursday, Verrilli predicted that the case could hinge on the justices' interpretation of the Religious Freedom Restoration Act. He said the federal law declares that "government shall not substantially burden a person's exercise of religion unless the government has a compelling interest, and the burden imposed is the least restrictive means of achieving that interest."
Verilli says at issue is whether corporations have religious rights, whether the burden on them is substantial, whether government has a compelling interest in making contraceptives available, and whether the mandate is the least restrictive means of doing so.
Lower courts have issued conflicting rulings, with some blocking enforcement of the mandate until the issues are decided.
An important healthcare safety net in St. Louis is laying off more than half its staff.
The St. Louis Post-Dispatch reports that St. Louis ConnectCare has issued 60 day layoff notices to 88 employees, including nurses and other medical personnel. The non-profit organization runs an outpatient clinic at the former St. Louis Regional Medical Center and provides outpatient specialty medical services for the poor.
ConnectCare CEO Melody Eskridge told the Post that about 60 percent of the patients they serve are uninsured and about 23 percent receive Medicaid. She says ConnectCare must reorganized because for financial reasons.
Both Eskridge and St. Louis Mayor Francis Slay say the Missouri Legislatures failure to expand Medicaid is at least partly to blame for ConnectCare's bleak financial outlook.
The study by the Society of Actuaries says the amount paid by insurers who sell policies to individuals in Illinois will rise more than 50 percent by 2017. The jump is even greater in Missouri, where the cost of medical claims could grow by almost 60 percent.
The report says costs will rise largely because of spending on sicker people and other high-cost groups who will gain coverage under the Affordable Care Act. The study did not make similar estimates for Employer-sponsored plans.
The White House disputes the study's claims because they didn't consider other cost-saving aspects of the new law.
States with large and diverse immigrant populations have the added challenge of reaching people who speak limited or no English, and they have little time to do it. Enrollment in the exchanges begins in October.
California has the largest minority population of any state, about 22.3 million people. That's followed by Texas with 13.7 million, New York with 8.1 million, Florida with 7.9 million and Illinois with 4.7 million.
Spanish is the second most popular language, followed by Chinese.
Advocates say the success of the national health reforms will depend on the success of enrolling these communities.