First Numbers From Health Exchange Expected To Be Low

The administration is expected to report on the number of Americans who have signed up for health insurance on the federal exchange this week.

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The Obama administration is expected to report this week on the number of Americans who have signed up for health insurance on the federal exchange. It's a safe bet that the count will be far below their original expectations.

NPR's Mara Liasson joins us to talk about the political fallout of the early Affordable Care Act enrollment. And, Mara, to start, do we know yet how many people have signed up?

MARA LIASSON, BYLINE: Well, we don't have any official numbers yet. We do have reports from a variety of sources that 40,000 or 50,000 people have signed up on the federal website. We don't know what that number includes. Does it include people who've selected a plan but haven't paid yet - they've put the plan on their shopping cart, but they haven't checked out - or have they gone through the entire process?

What we do know is when the administration releases its official numbers at the end of this week, they are going to release as enrolled, people who have submitted an application and selected a plan but not necessarily paid. People have until December 15th to make the first payment.

CORNISH: And that's the federal exchange. What about the 14 states that are running their own exchanges for people to shop for health care? How many people have signed up there?

LIASSON: Well, NPR has been tracking this and we've determined that more than 50,000 people have signed up. We're still missing a few big states like California. But just as with the estimates of the federal exchange information numbers, the states have different ways of counting this. Some count people who've paid, some who've merely selected a plan.

We do hear that the Medicaid expansion, which is a separate piece of the Affordable Care Act, has registered several hundred thousand people. But again, we're waiting to get official numbers on all of this.

CORNISH: And just how big a deal are these early numbers? I mean, the enrollment period runs until the end of March.

LIASSON: That's right. The administration has been saying all along that early enrollment would be slow and it doesn't matter as much as the final numbers. Of course, the website troubles have really suppressed the numbers. Those numbers should go up when the website is fixed. And today, in a sign of confidence about the website being fixed, the administration said they are sending emails to 275,000 people who got stuck on the website and they've invited them to come back.

But it is true, the later numbers matter more. The numbers at the end of March will matter most. But these low numbers and the sense that the law isn't working could deter people from signing up and create a kind of vicious cycle.

CORNISH: Mara, so much of the conversation about this has been about the politics, though, with this rocky rollout. What are the political ramifications for this president?

LIASSON: Well, the political ramifications are just that the law gets more unpopular, and the red state Democrats who are up for re-elections get more nervous and start breaking with the administration. Today, we heard from one of the most important voices in the Democratic Party, former President Bill Clinton, who said on the online magazine Ozy that the president should change the law to honor his promise that people can keep their policies. Here's what Bill Clinton said.

PRESIDENT BILL CLINTON: I personally believe, even if it takes a change in the law, the president should honor the commitment the federal government made to those people and let them keep what they got.

CORNISH: Change the law. I mean, how likely is such a law to pass?

LIASSON: It's extremely unlikely that the law - that any changes to the law could pass Congress. Don't forget, Republicans don't want to change the law. They want to end the law. And it's also highly unlikely that this fix could happen. In other words - today, Jay Carney, the White House press secretary was asked about Clinton's statement and he said, well, what's not an effective fix is one that would simply tell insurers they could continue to sell substandard plans to people. Those are the plans that are being canceled.

But all of this is an indication of how perilous the politics of health care have gotten for the president. Every day, we see a poll where the ACA is getting even more unpopular. It's also hurting the president's ratings for credibility and competence, which are the two coins of the realm for any president, but especially a Democratic president who promised to make government smarter, not smaller or bigger. And he promised that it could help middle class people and make their lives more economically secure. That's the basic fundamental promise of the Obama presidency.

CORNISH: That's NPR's Mara Liasson. Mara, thank you.

LIASSON: Thank you, Audie.

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