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Only 3,600 Floridians Enroll in Affordable Care Act’s First Month; Obama Accepts Blame But Questions Abound

| November 14, 2013

'It's on me,' President Obama said of the Affordable Care Act roll-out's failures.

‘It’s on me,’ President Obama said of the Affordable Care Act roll-out’s failures.

The numbers are in: only 3,571 people have successfully enrolled in a private insurance plan in Florida in the first month of the Affordable Care Act’s federal marketplace, according to the Department of Health and Human Services. The target was 33,400, resulting in a success rate of just 11 percent. Nationally, a dismal 27,000 people have enrolled through the federally run marketplace.

State-run websites have enrolled 79,000 people, but Florida refused to run its own website.

Some 67,366 additional Floridians have completed applications but have not yet been enrolled. Among those, 12,887 Floridians were deemed eligible for Medicaid or CHIP, the children’s portion of Medicaid. Almost 124,000 Floridians applied, though one in five Floridians–or 3.8 million people–are without insurance. The latter figure does not reflect the number of people who have received notices that they will no longer be insured due to requirements of the new health law that they buy more extensive coverage.

Hundreds of thousands of Floridians have received cancellation notices, feeding into something of a revolt across the country by formerly insured individuals who had heard President Obama pledge previously that if they wanted to keep their insurance, they could. The plans were cancelled because they don’t meet the minimum requirements of the new health law, which calls for better coverage, including broader coverage for prescription pills, while eliminating bare-bones plans and capping deductibles.

Those cancellations will stop.

Repeatedly saying that the largely failed roll-out of the Affordable Care Act’s website was his responsibility, President Obama this afternoon conceded that some changes to the law will be necessary to stop people from losing insurance plans they would rather keep, at least for an additional year. It’s not yet clear if the fix will be done as a rule change, which could be put in effect swiftly, or as a change in the law, which would be more laborious.

“Insurers can extend current plans that would otherwise be canceled into 2014,” Obama said, giving in to pressure from his own party. But people enrolling freshly in the marketplace will not be eligible for those bare-bones plans. A Republican proposal is being floated in the House of Representatives to give people the option of enrolling in such plans regardless.

“I think it’s fair to say the rollout has been rough so far,” Obama said. “This fix won’t solve every problem, but it will help a lot of people.”

Meanwhile, the Affordable Care Act is under intense questions as Republicans continue their efforts to scrap it while Democrats hope it will survive the bad rollout, beyond which it may be impossible to reverse course. The Q&A below clarifies some issues.

Q: Can the federal portal be fixed in time?

A: Many don’t think so, and some worry about the consequences.

“Given where they are right now, it would be an unbelievable feat if they were to be ready” even by Jan. 1, said Bill Copeland, a top health care consultant at Deloitte.

The administration faces a credibility problem if it fails to meet the Nov. 30 deadline, said Dr. Ezekiel Emanuel, a former White House health care adviser. Signup delays could distract consumers from the benefits of coverage and cause many to tune out, he said.

Q: Why not wait until the websites are fixed and then have people line up? Or extend the enrollment period for individuals to gain coverage into the middle of next year?

A: Many can’t wait. Their policies expire Dec. 31, and they fear a gap in coverage. Others are uninsured and had expected ACA benefits starting in 2014.

Waiting worries insurers, too. They designed and priced marketplace policies based on the idea that consumers would enroll between Oct. 1 and March 31 for coverage starting as early as Jan. 1. Delaying signup could leave carriers with disproportionately sicker and more expensive customers, they say.

Q: What about a bigger fix? Let people keep the policies they have for another year. Or create a bailout pool for those who need emergency coverage until the websites presumably work in 2015.

It’s getting late even for extending this year’s policies. In many cases neither insurers nor state regulators are prepared.

“If we had known this was going to happen in September, early renewing (of existing plans) probably was going to be the answer,” said Joseph Antos, a health economist at the American Enterprise Institute. “Now that we know in November it’s not looking too great.”

Anything more ambitious, such as a new, national “risk pool” similar to the temporary coverage given those with existing illness starting in 2010, would probably require Congress to pass a new legislation.

“Since Congress can’t agree on big things like debt ceilings and a budget,” said Copeland, “I don’t know how this is going to get solved.”

Q: What’s the worst-case scenario for those unable to sign up?

A: Millions, including those with existing illness, could have trouble getting coverage. The administration may be working on a plan to have consumers contact insurers directly, but some worry they could end up buying the wrong policies if they don’t see the full online menu.

“We have had concerns about direct enrollment,” said Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities, which supports the law. “Consumers won’t have the full ability to shop in the short term.”

Those who do obtain insurance could have trouble gaining online premium subsidies, which so far are available through the government portals.

If computer breakdowns disproportionately deter the young and healthy from joining the ranks of the covered, insurers could lose money. That could set the stage for premium spikes and the kind of instability in the individual insurance market that the health law was supposed to solve.

Q:  What about the law’s safety valves for unexpectedly large claims in the early years?Measures to compensate insurers with high initial expenses are supposed to keep them from making it up with higher prices for the first three years.

A: Because a quick solution for signup bottlenecks seems increasingly unlikely, those buffers could become more important. Even with extremely low first-year enrollments, some experts argue they could keep prices stable until portals are fixed for a smooth launch in 2015.

“In the long run, our view is that the exchanges and the entire ecosystem are going to be fine,” said Bryce Williams, a health benefits and technology consultant at Towers Watson. “But you’d have to talk about a two- to three-year horizon.”

Successful websites and signup efforts in big states such as California and New York will show that the online marketplace can work and should lead to acceptance elsewhere despite short-term problems, said James Morone, a political science professor at Brown University who specializes in health policy.

“Bottom line: No, they won’t be working” soon, Morone said of many marketplace portals. “And double no, they are not going away.”

Q: How badly do Web failures threaten other aspects of the Affordable Care Act?

A: The health law didn’t just offer commercial insurance on the Web. It expanded Medicaid for low-income consumers in states that chose to accept it. Because the programs have years of enrollment experience, Medicaid expansion is progressing better in many states than efforts to expand access to private insurance.

While the federal site “has been nowhere near as easy to use and efficient as anybody would have dreamed, we’re hopefully in the early innings” of the larger goal of expanding coverage, said Bob Kocher, a partner at venture capital firm Venrock and a former Obama health adviser.

Nor may Web problems have much effect on the health law’s other grand goal of containing costs and making care safer and more efficient.

Accountable care organizations” that reward better care have been formed across the country. Medicare is penalizing hospitals with too many readmissions of recently discharged patients.

Online government insurance portals have inspired similar, private sites that are transforming employer-sponsored coverage.

“The notion that one website associated with one part of the law is up late — that the whole law should be thrown out — is an extreme reaction,” said Alan Weil, executive director of the National Academy for State Health Policy.

— Jay Hancock and Phil Galewitz, Kaiser Health News

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35 Responses for “Only 3,600 Floridians Enroll in Affordable Care Act’s First Month; Obama Accepts Blame But Questions Abound”

  1. m&m says:

    Now he throws himself to the mercy of the people for his fool hardy to cram this Obamacare down our throats.. It’s great to watch him squirm, He’s a phony and this should open a lot of eyes as to his true color..

  2. Random Citizen says:

    You lied to the American people Obama.

    It will cost billions upon billions.

    • A.S.F. says:

      @ Random Citizen–And where, exactly, was all this indignation when Georgie Bush and his gang of thugs in 500 dollar suits lied and lied and lied to get us into a war that has changed the entire world for the worst and cost us “billions upon billions” as well as countless lives? What hypocrites Republicans are!

      • I/M/O says:

        Now President Obama is extending our stay in Afghanistan indefinitely.

        I’ll wait for your indignation or will you choose democrat hypocrisy? .

    • dlf says:

      Lets blame Bush again for Obama’ s poor record, that is getting old. But, what else can you do when you have a community organizer running the country?

    • john R says:

      The ACA will reduce the deficit over a 10 year period.
      That means it will create more revenue that it will cost.

      where are you getting your numbers?

    • john R says:

      The congressional Budget Office said the cost of Obamacare would be $940 billion.
      Here’s a summary of the taxes imposed by Obamacare,
      which would bring in an additional $567 billion in revenue:

      Hospital Insurance Tax – $212 billion.
      Non-compliance tax – $64 billion.
      Cadillac Health Insurance Tax – $32 billion.
      Medical Device and Insurers Tax – $107 billion.
      Raising medical deduction limit to 10% – $104 billion.

      In addition, there were five areas where cost savings of $477 billion were implemented:
      Reduce drug subsidies to wealthy – $87 billion.
      Reduce Hospital DSH Payments – $37 billion.
      Reduce Medicare Payments – $197 billion.
      Reduce Medicare Advantage Payments – $135 billion.
      Education – $20 billion.

      total savings $1.044 trillion – Cost $940 billion = about 140 billion. (other estimates have it around 200 billion.
      Other estimates say that Obamacare is projected to cut the national deficit by over $200 billion during its first 10 years and over $1 trillion over the next two decades.
      According to the CBO, most of the savings is because the Act makes sure 95% of citizens have health care insurance. This lowers health care costs by making preventive health care affordable for most of the 33 million Americans who have no health insurance. They don’t have to wait until their illness becomes so critical that they wind up using the hospital emergency room as their primary care provider. That lowers national health care costs for everyone.

  3. Outsider says:

    This is very simple: the president is the top executive in the country. He was elected with zero executive experience. Those of you who elected this man did yourselves, and to a greater extent, Obama himself, no favors. He is unqualified for the presidency.

    • A.S.F. says:

      @Outsider says–Let’s forget about our economy improving, Al Queda being decimated, progress in the area of immigration reform… Unless he magically turns Caucasian, to some people, Obama will always be unqualified and a failure.Healthcare Reform is necessary. The system, as itwas, was failing millions of people miserably. Something had to be done. Obama just happened to have the guts to try to do it. I pray that he rights the course after this stumble and doesn’t let the vultures, waiting to pick the meat of his bones (and the bones of those who elected him), devour everything else in their path.

    • John Boy says:

      Yea, experience is a great indicator. McConnel and Boehner each have been sucking at the tit for 30+ years and can’t do much more than getting a Post Office named after a local constituant. Republicans have experience but are simply dumb, dumb. dumb.

  4. Random Citizen says:

    This isn’t politics. Obama is swindling billions from unsuspecting seniors and innocent hard working Americans.

    He has also screwed every student working so hard in college for a future. Now they are FORCED to finance 20% of the U.S. GDP (healthcare) so there goes the thought of buying a home within the first 10 years of graduating. There goes the vacations out of town.

    His inexperienced and morally deficient worldview is attempting to FORCE healthcare upon Americans from drug companies and docs who want 90% of Americans on meds with side-affects that demand more meds. To bloody hell with that Pelosi and Reed!

    And now he thinks he can spin the blame on the health insurance industry in a few 30 second sound bites because they caused all of it somehow?

    Why people are not rioting on college campuses and the streets yet, is beyond me. He promised a new kind of American Freedom and tried to deliver commune-ism cloaked in the word progressive. Throw the leach overboard with the tea – metaphorically speaking that is.

    So should it be, “God bless Obama.” or, “Obama, yo mama!” (Bumper stickers anyone?)

    But wait, Al Sharpton would spin that into another campaign to finance another wing on his house, so never mind.

  5. A.S.F. says:

    Sebelius needs to step down from the helm. She can stay on in a lesser position to ensure continuity but she has lost the confidence of a lot of people, probably even those from within the Department she heads.. While the buck stops with Obama, the hands-on, day-to-day failure was hers. A team of experts should take over the helm. This a massive effort. It is crucial that it not fail. There are too many special interests vying to take advantage of any opportunity to push Healthcare Reform back on the shelf indefinitely. People’s lives are at stake here. Those with MONEY, MONEY, MONEY on the brain don’t care about that. We are handing them a chance to stop changes that are necessary to safeguard the health and welfare of the American public on a silver platter. Personally, I think a single-payer system is the only way to go.

    • Dennis says:

      Sebelius! This is Obama’s signature legistlation. He’s been lying to the American People all along and you want to blame someone other than Obama for this disaster. This was rammed through by Obama even the polls showed the majority didn’t want it. Back door deals and bribery to get the votes from his fellow democrats. After all this it’s some how Sebelius’s fault.

      • A.S.F. says:

        @Dennis says–The majority wanted it. That is one of the reasons OBama won BOTH elections. You have no proof of either bribery or back door deals. Politics done behind the scenes is as dirty a deal for Republicans as it is for Democrats. Obama has bent over backwards trying to work with people and private factions who can’t be worked with. The ACA, as it stands, is modeled after prior Republican plans put forward in Congress and the one put into effect in Massachusetts by Mitt Romney. Mr. Romney had a mess on his hands when he rolled it out there at first and, now, the citizens of that state wouldn’t do without it. The truth is, we want every major thing to happen instantly and perfectly without any hitches and that just isn’t realistic. If we throw out the baby with the bath water, many people will suffer. And Republicans simply don’t seem to care about that. The recent government shutdown is just the latest example of their concern for the welfare of our country and its people.

      • I/M/O says:

        The President insists that none of his aides told him anything was wrong.

        Don’t you believe him?

  6. Freddy says:

    To all you Obama supporters out there are you happy and proud with your choice of president now?

    • A.S.F. says:

      @Freddy says–Yes, as a matter of fact, I am. He’s done pretty well in other areas and, in this one, he’s proven he can admit mistakes and he’s strong enough to persevere and try to correct them. No one is perfect. George Bush never admitted his mistakes, did he, even though he got us stuck in a disastrous war and brought us to the brink of financial ruin? His mouthpiece, Dick Cheney (or, was it George Bush who was HIS mouthpiece?) is STILL going on the media every chance he gets, defending the indefensible while knocking the current administration every chance he gets. What a patriot! Saint Ronald Reagan brought us sky-rocketing inflation. And let’s not even talk about Richard Nixon. George Bush Sr. got us into that moral war for Quwait that really was about oil. What an honest stand-up guy! Given the track record of Republican Presidents (and the dismal examples of recent Republican presidential candidates like 47%-strap-my-dog-up-on-the-roof-of-my-car Romney), I find your gloating over our President’s current predicament hard to swallow. You do know that the Medicare and Social Security roll-outs during previous administrations had difficulties in the beginning too, don’t you? In fact, the last Medicare roll-out had some pretty bad ones which were ascribed to (I kid you not) the roll-out occuring over Yom Kippur!. At least, Obama is honest enough to take accountability and responsible enough to try to correct errors. If I can fault him on one thing, it’s his insistence on thinking that he can work with people who have no interest other than to bring him down in their blind quest for power and profits. Other than that, they couldn’r give less of a damn.

      • Anon says:

        A.S.F you have to be kidding me you have President OBama on a cloud .You say he is doing a good job and you blame George Bush for all the failures.Bush has not been in office for over 5 years.This President has done nothing for the country but ruin it.For one there has been more Soldiers killed and wounded under Obama than Bush.Sure you will say Bush started it.He has had Plenty of time to end it.The mid east is in total shambles.A total loss.Iraq ready to fall back to civil war.As Far as Bin Ladin he has been no threat for a while.You say Al Queda has been decimated.I say they are growing in force all over the mid east.
        Obama care is a total failure.You might say the poor need health care.I would agree but I don’t need to pay for it.My cost doubled.
        This President says he is accountable .Well what happen with fast and furious he claimed Executive privilege.Bengzi he has tried to seep under the carpet along with the Irs scandal.

        You keep on wanting blame Bush and Cheney why don’t you let Mr Obama man up and take credit for all his failures.

    • John Boy says:

      Yes, compared to the Mormon in 2012 or the idiot who pick palin in 2008, Obama has been great and has done a lot even though the bigots have done nothing but to obstruct his every effort.

  7. Sherry Epley says:

    I believe there will be a time in the next year when the web site will be fixed, when EVERYONE will finally have access to GOOD health care and when people will not be penalized by the “for profit” insurance companies for being a pregnant woman or having high blood pressure. Once this happens, everyone will benefit and finally see a better way to a healthier life.

    The insurance companies and Rick Scott are to blame for insurance prices going up . . . not President Obama!

    • Genie says:

      @ Sherry Epley: May I respectfully submit that when you enlarge the coverage to include a ‘one size fits all’, and you include NOT being able to turn anybody in bad health down, you should not expect cheaper rates.

      This most certainly is the dear leader’s fault. It is he who authorized all this, who has been changing the regs as to what must be offered.

      A few million people are not feeling so optimistic right now. Their new coverage is going to cost them a second house payment.

      Let me know when the celebration begins, please.

  8. Nancy N. says:

    Low enrollment numbers doesn’t necessarily mean lack of interest. THE SYSTEM IS BROKEN. I’ve been trying to sign up but can’t get the @#$%& computer to take my application. Called on the phone and they took my info but my again, my application is in limbo because the computer isn’t actually processing them.

  9. Genie says:

    I think the insurance industry have made it pretty clear they will not honor the President’s whim. They have been following the regs written into the ACA by the administration. These regs are now law. The President does not have the authority to wipe it all away.

    Now he wants to place the blame on them?

    • A.S.F. says:

      @Genie says–Actually, Genie, he is, as I write this, meeting with the CEOs of the Top Insurance Companies. Why President Obama persists in bending over backwards to try to work with people who have NO interest other their own fiscal ones mystifies me. It was HE who the maojrity of the American people elected. It is HE who has the mandate. You can’t count on people who are rooting for you to fail for anything; not fairness, not reason and certainly not concern for humanity.

      • dlf says:

        Its a little late for this one sided God acting President to be meeting, as always he is a dollar short. But ,again we elected a community organizer to run the country and that is what we got a crook dishonest Chicago raised political want to be God.

  10. Sherry Epley says:

    President Obama is NOT to blame for cancelled policies and higher health insurance premiums in Florida. Florida Governor Rick Scott has done everything in his power to STOP the citizens of Florida from receiving decent health care. . . all as a political act against our TWICE elected president. He has stopped the expansion of Medicaid and stripped our Insurance Commissioner of the authority to negotiate insurance premium rates. He has done this without regard to our thousands of citizens who suffer every day because they do not have high quality health insurance.

    How about looking at some myths that are being spread by those that have obstructed absolutely everything our president has tried to accomplish:

    This from the Sun Sentinel:

    Myth #1: Next year, everyone who doesn’t have health insurance will have to pay a $2,000 penalty.

    The most basic problem with the individual mandate is no one seems to know exactly what it is. I’ve heard people throw out all sorts of numbers, most of which make it sound more expensive than it really is.

    Here’s what the ACA actually says: Next year, in 2014, every adult who doesn’t have health insurance will have to pay a $95 penalty. Every child will have to pay $47.50. If you file taxes as a family instead of an individual, the penalty is $285 or 1 percent of your family’s income, whichever is greater.

    That’s a far cry from $2,000.

    In 2015, the penalty goes up to $325 for adults, $162.50 for children, and $975 or 2 percent of income for families. In 2016, it reaches its peak of $695 for adults, $347.50 for children, and $2,085 or 2.5 percent of income for families. That’s probably where the $2,000 figure came from. As you can see, it’s not nearly as burdensome in the proper context.

    Myth #2: The individual mandate can be postponed with little or no negative consequences.

    Beginning on Jan. 1, 2014, insurance companies will no longer be able to charge different premiums to different consumers based on health status, a.k.a. “pre-existing conditions.” The only factors they can consider in setting premiums are geography, age, tobacco use, and individual versus family plans.

    They cannot charge women more than men. They cannot charge sick consumers more than healthy ones. They cannot charge you more if you work in an industry that happens to have higher health care costs. They cannot raise your premium if you’ve gotten sick while you’ve been on their plan.

    This is one of the most popular parts of the ACA. It appeals to our sense of basic fairness. Most Americans consider it an outrage that insurers have been discriminating against women and the sick.

    But there’s a problem with these new rules: If insurers charge the same premiums for healthy and sick people, the healthy ones can no longer pay the cheaper rates they’ve been used to. As a result, they won’t buy insurance, leaving only the sick people in the pool. Sick people are expensive for insurers. They receive more health care than they pay for. Insurers will have to raise premiums in what is known as a “death spiral,” making insurance unaffordable for everyone.

    That’s why we need the individual mandate. In order for these new rules to work, everyone has to buy insurance, including healthy people. If Congressional Republicans get their way and postpone the individual mandate, we could be looking at astronomically high insurance premiums in 2014.

    Myth #3: The individual mandate was first invented and proposed by Democrats.

    In October 1989, the conservative Heritage Foundation, a leading Republican think tank, published the first policy paper proposing an individual mandate. In November 1993, Republican Senator John H. Chafee introduced the first bill in Congress that contained an individual mandate. The bill had 18 Republican co-sponsors.

    The individual mandate was a Republican invention from a time when it was not yet heresy for a Republican politician to advocate providing affordable health insurance to every American without a government takeover of the industry.

    Myth #4: The individual mandate is socialized insurance.

    Why are we still talking about Canada and England? Just the other day, I received an email from a Republican reader reciting the problems with government-run health insurance. So what? ObamaCare is nothing like the Canadian or British system.

    The individual mandate requires Americans to buy private insurance. That’s why insurance companies have posted double-digit gains on the stock market since the ACA became law. The values of Aetna and UnitedHealth have nearly doubled in only three years.

    In fact, no major American politician is proposing a government-run system. Like it or not, private insurance will be around for a long time to come. The only question is, will everyone be able to afford it?

    Anthony W. Orlando is a resident of southern Florida and a Lecturer in the College of Business and Economics at California State University, Los Angeles. He runs a blog at

  11. Bob Z. says:

    In a year from now this will all be a distant memory and more people than not will have been helped by the ACA…the needs of the many outweigh the needs of the few.

  12. fruitcake says:

    add this to the long list of impeachable offenses

  13. dlf says:

    Even Clinton came out and was just one sentence away from calling this president a liar, which he is. At least we cannot elect this fool again

  14. NortonSmitty says:

    I am starting to think that the Biracial Trojan Horse has bet all-in for this Liberal wet dream, and has set it up to fail. First, due to the crony capitalism that has become the only reality in Sodom-on-the-Potomac, to get the bill passed the usual insider vultures had to be fed. So vampires like Booz-Allen, Fairchild and others would have to leech billions from the Gov’t Teat, or their vassals in Congress would find a way to get their real bosses $Billions or it would be judged un-American to give us all lifesaving health care if we hadn’t the money to pay for it.
    The biggest contract was given to a Canadian company with experience in insurance and hospital billing programs, Quality Software Solutions Inc. (QSSI). For $55 Million, they were hired to write the core of the program. But lo and behold, a few months later United Health Group purchased QSSI in September 2012, raising eyebrows about conflicts of interest. UHG being one of the major health care chains whos bottom line would be diminished by Obamacare. No shit: You don’t think they would sabotage the program, do you?

    And beyond that, if you were going to hack a website, who got a better team than ol’ Carl “Turdblossom” Rove. I mean, if he could deliver Ohio to Bush in ’04 with such blatant fraud and not be called out on it, flooding the new and untried website is nothing,

    Or maybe as I’m starting to think, this whole thing was a setup to destroy the progressive foothold left in Washington once and for all.

    If the Insurance parasites won’t co-operate, why didn’t the Socialist in the White House just let us all buy into Medicare like we all wanted in the first place and let the “Free Market” show us how it can compete when you take the profit margin out of the equation.

    I’m willing to bet i have a better chance of my foreskin growing back than of living to see that ever happen during this administration.

  15. confidential says:

    Stop the Obamacare bashing please. Forget about the web site and call the 1800 numbers here:
    Jason J. Monday
    Florida Blue
    Blue Cross Blue Shield of Florida
    Toll Free: (855) 767-7302
    Fax: (813) 200-1740

    My child healthy, non smoker over 40 years old and independent contractor, enroll today starting coverage December 1, 2013, for $178/month including dental plan with regular annual doctors visits and test and meds at no charge and only a $2,200 deductible for hospitalization when needed.

    • Cindy says:

      I am signed up too and very happy with the cost my new improved plan with subsidies and out of pocket assistance. I just wish Florida Blue would mail the cards.

  16. confidential says:

    By the way I am very happy with my choice for President so far!!
    Those complaining that lost “their rip off plans”, just call the number provided and talk to Jason in Blue Cross and Blue Shield of Florida 855-767-7302 and find out 4 and more plans to choose from with better coverage and no gouging…. and stop whining!

  17. I/M/O says:

    This is the cheapest Gold Plan on the Florida Exchange for a person over 50 years of age from BC/BS
    It will cover 90% of your medical expenses.

    Monthly Premium
    $6702.00 per year.


    Out of pocket max: $6,250

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