Sign-up shutouts get time to enroll

WASHINGTON - The Obama administration said Tuesday that it would provide more time for people to sign up for health insurance if they could show that they missed the Tuesday deadline for applications because of problems with the federal health-care website.

In effect, the administration was stretching the deadline once again, after a last-minute surge of interest from people seeking coverage. The administration hailed what it described as “amazing interest” in new health-insurance options and said the federal website alone received 2 million visits Monday.

The original deadline was Dec. 15 for people to sign up for coverage that takes effect in January; it was later extended by eight days. On Monday, the White House added a 24-hour grace period, to 10:59 p.m. Central time Tuesday.

Then Tuesday, in another bid to expand coverage, the administration provided details of a “special enrollment period” for people who would miss the deadline.

“If you weren’t able to enroll in an insurance plan by Dec. 23 because of problems you had using Health-Care.gov, you still may be able to get coverage that starts Jan. 1,” the administration told visitors to the website. “Even though we have passed the Dec. 23 enrollment deadline for coverage starting Jan. 1, we don’t want you to miss out if you’ve been trying to enroll.

“Sometimes despite your best efforts, you might have run into delays caused by heavy traffic to HealthCare.gov, maintenance periods, or other issues with our systems that prevented you from finishing the process on time. If this happened to you, don’t worry - we still may be able to help you get covered as soon as Jan. 1.”

Consumers who believe that technical issues prevented their enrollment by the deadline can appeal beginning Thursday to gain coverage effective at the start of the new year, the Centers for Medicare and Medicaid Services said Tuesday.

Critics of President Barack Obama’s signature program seized on the one day grace period as more evidence that the overhaul is in trouble.

“The amazing, ever-expanding deadline? It’s clearly a sign of desperation by the administration to do everything they can to increase the number of people signing up,” said health-care economist Gail Wilensky, who ran the Medicare agency for President George H.W. Bush.

For their part, administration officials said the latest move was a common-sense response to heavy website traffic, which they cited as evidence of the need for more affordable insurance.

Some 48 million Americans are estimated to be uninsured.

Traffic on the website was not as heavy on Tuesday but still high, White House spokesman Tara McGuinness said. She had no immediate estimate of visitors or how many succeeded in obtaining insurance before the Tuesday deadline.

“The site is performing well under intense consumer traffic,” said Kurt DelBene, a former Microsoft executive appointed last week to take over management of the online marketplace. “With the highest volumes we have seen to date, response time is fast and the error rating is low.”

Error rates were lower than 1 in 200, and pages loaded quickly, in less than a half-second, officials said.

For a multitude of reasons, including technical difficulties with the site or trouble understanding the instructions, thousands of people sought telephone help and wound up waiting on hold on Christmas Eve at the government’s call center.

More than 110,000 people had called the government’s help line by Tuesday afternoon, with wait times averaging 27 minutes, officials said. On Monday, the call center received more than 250,000 calls, a one-day record.

Obama has struggled to deploy the centerpiece of the 2010 Patient Protection and Affordable Care Act, the biggest overhaul of the U.S. health-care system since the 1960s. The law has been hamstrung by delays, website failures and political backlash. The late changes probably are necessary to smooth the transition to the new insurance system in January, said Henry Aaron, a health economist at the Brookings Institution in Washington.

“That kind of willingness to do things manually, do whatever it takes to be done to make sure people do not get disappointed at key dates, is absolutely critical right now, and there are indications that the feds are belatedly figuring that out,” Aaron said in a phone interview.

Insurers had agreed to begin coverage at the start of2014 for people who selected policies by the deadline as long as they send their first payments by Jan. 10. With the enrollment extension, people who buy plans from today through Jan. 15 will get coverage Feb. 1. The last deadline to sign up for a health plan in 2014 remains March 31.

“Our highest priority is making sure that everyone who wants to enroll to have health-care coverage by Jan. 1 is able to do so, particularly since consumers had a hard time accessing healthcare.gov in October and November,” Julie Bataille, a spokesman for the Medicare agency, said Tuesday in an email.

The federal enrollment system has been functional since repairs to the site were announced Dec. 1, though it is still slow, said John Foley, a supervising attorney at the Legal Aid Society of Palm Beach County in Florida, a group authorized to help people sign up for coverage. Foley said his organization’s six “navigators” need about 90 minutes, on average, to enroll a customer, and the group can sign up about 30 people on a good day.

“It’s like molasses getting through it,” he said Tuesday in a telephone interview.

Errors at the site no longer halt a customer’s progress, as they did in October and November, though “we thought we’d be able to get people into the system a lot quicker,” Foley said.

While acceding to some of the late changes requested by the administration, insurers have resisted other concessions such as retroactive enrollment and out of-network coverage. The enrollment extension was another irritant to the industry.

“Health plans will continue to do everything they can to help consumers through the enrollment process and mitigate potential confusion or disruption caused by all of these last-minute changes to the rules and deadlines,” Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, the industry’s Washington lobby group, said Monday.

While enrollment had been sluggish from the Oct. 1 introduction of the marketplaces through November, sign-ups accelerated in December, Obama said at a Friday news conference. More than 500,000 people in the 36 states served by the federal exchange selected plans in the first three weeks of the month, the president said.

Administration officials have said they anticipated that the pace of enrollment would increase as the year end coverage deadline approached. Similar increases have been seen by many of the 14 state-run exchanges, state officials said.

In New York, about 157,000 people signed up in private plans sold through the state exchange, John Emery, a spokesman for New York State of Health, said Tuesday in an email. In California, which also runs its own exchange, “our preliminary numbers are we’ve topped 400,000” enrollments in private plans, Covered California Executive Director Peter Lee said.

California planned to close enrollment Monday for policies starting Jan. 1, Lee said, although anyone who started an application then will have coverage at the first of the year.

“We’ve been very clear that the 23rd is the deadline,” Lee said. “We’ve also been very clear that we’re going to help people get across the finish line if they’ve made a good-faith effort.”

In addition to the private plans, at least 3.9 million people have been found eligible for Medicaid, the state run health program for the poor, or for state children’s health programs since the exchanges opened Oct. 1, the Centers for Medicare and Medicaid Services said in a report. It’s not known how many of those people have enrolled in the programs.

The administration had set a goal of signing up 7 million people through the new federal and state insurance marketplaces by the March 31 end of the six-month enrollment period.

Obama earlier pushed back a key application deadline, delayed a small-business health exchange and extended a program for “high-risk” pools of sick Americans. On Thursday, his administration said hundreds of thousands of people whose health plans are being canceled because their coverage doesn’t meet the law’s rules will be exempt next year from the health law’s mandate that all Americans carry medical insurance.

In other developments, the Roman Catholic archbishop of Washington and the archdiocese’s schools failed to persuade a judge to delay her order that they provide cost-free coverage for contraceptive services to employees to comply with the health-care law.

U.S. District Judge Amy Jackson in Washington on Monday denied the archbishop’s request to freeze her Friday order, in which she rejected arguments that the requirement violates religious freedom, while the U.S. Court of Appeals in Washington considers an appeal by the church and the schools. The request was filed on an emergency basis as the deadline for the mandate is Jan. 1.

After Jackson’s rejection, the archbishop’s lawyers asked the appeals court to put her ruling on hold. Determining whether insurance coverage for contraceptives violates religious beliefs is “for individual believers, not courts,” the archbishop said in a filing with the appeals court.

The U.S. Supreme Court on Nov. 26 agreed to hear two cases brought by business owners who object on religious grounds to the birth-control mandate. The lawsuits by the for-profit employers, the craft-store chain Hobby Lobby Stores Inc. and Conestoga Wood Specialties Corp., will be the court’s first look at Obama’s biggest legislative accomplishment since a majority of the justices upheld the core of the Patient Protection and Affordable Care Act in 2012.

Previously, appeals courts in Chicago, Denver and Washington ruled the mandate may violate religious freedom, while appellate panels in Philadelphia and Cincinnati had sided with the government.

Information for this article was contributed by Robert Pear of The New York Times; by Alex Wayne, Alex Nussbaum, Jodi Schneider and Joel Rosenblatt of Bloomberg News and by Carla K. Johnson of The Associated Press.