US healthcare site below target despite increased enrolment

US Health and Human Services Secretary Kathleen Sebelius testifies before the House Energy and Commerce Health Subcommittee in Washington DC 11 December 2013  Sebelius has called for an internal investigation into healthcare.gov's botched rollout

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The US healthcare marketplace websites enrolled more than twice as many people in November as the month before, the US government has said.

About 365,000 people are now enrolled in private insurance through the websites, up from 106,000 in November.

But those numbers are still below projections as technical issues remain.

The enrolments came as part of President Obama's embattled healthcare overhaul, which stumbled last month during the websites' rollout.

"I don't think there is any question that the flawed launch of the website put a damper on people's enthusiasm," Health and Human Services Secretary Kathleen Sebelius told the House Energy and Commerce committee on Wednesday.

"Having said that, we are seeing very, very positive trends. We are seeing lots of people re-engage."

In an earlier statement, Ms Sebelius called for an internal investigation into the botched 1 October rollout.

She said she had asked the department's inspector general to review the performance of the private contractors behind the healthcare.gov marketplace website and "overall program management".

President Barack Obama's healthcare law, passed in 2010, established the healthcare.gov website as a clearinghouse for Americans in 36 states to enrol in private insurance plans.

Improved performance

The remaining 14 states and the District of Columbia run their own marketplace websites.

Obama vowed to keep fighting for his embattled signature healthcare law in the face of ongoing negative publicity

The law, known formally as the Patient Protection and Affordable Care Act and to its opponents, derisively, as Obamacare, aimed to insure the 15% of Americans who lacked health coverage and to slow the growth of healthcare costs in the US.

In addition to establishing the health insurance marketplace websites, the law expands eligibility for the Medicaid government health programme for the poor, bolsters coverage requirements for insurance firms, mandates that individuals carry insurance or pay a tax penalty beginning next year, and offers subsidies to assist in the purchase of private insurance.

Republicans have united in opposition to the law, and have sought every opportunity to undermine it.

The federal website suffered debilitating glitches and performance problems during its first several weeks. It underwent a virtually top-to-bottom overhaul through October and November and has seen its performance improve.

Healthcare.gov has cost the US government more than $600m (£366m), according to the Government Accountability Office.

Adding to the political and technological pressure, Americans who want to be insured under the law beginning on 1 January must enrol through the websites by 23 December.

About 137,000 people enrolled through the federally run site in November, up from 27,000 in October. State-run marketplaces enrolled about 227,000 people in the second month, up from almost 80,000.

Officials had originally projected 1.2 million would enrol nationwide by the end of November, instead of the current 365,000.

Despite this gap, Health and Human Services official Mike Hash said the agency was still "on track" to meet a goal of seven million Americans insured by the end of the enrolment period on 31 March.

Those who are uninsured after March will face a tax penalty for 2014.

An additional 803,000 people have been determined to be eligible for Medicaid, a government healthcare programme for the poor expanded under the law.

But state Medicaid directors have reported accuracy problems with some of these applications.

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