Miami-Dade County

Obama launches defense against critics of Affordable Care Act

With repairs to the Health Insurance Marketplace at beginning to show promise, President Barack Obama on Tuesday attempted to change the narrative of the faulty federal online exchange and to push back against Republican opposition, with a defiant vow to make the Affordable Care Act — and its centerpiece online exchange — work even if it takes the rest of his term.

As Obama launched a new campaign to highlight the health law — with plans to emphasize a different benefit each day — he accused Republicans of being interested only in repeal without offering an alternative plan.

“My main message today is, ‘We’re not going back,’” Obama said in an afternoon address at the White House. “That seems to be the only alternative that Obamacare’s critics have.

“You’ve got good ideas? Bring ’em to me,” he said. “But we’re not repealing it as long as I’m president.”

Republican opponents of the law say the website troubles are a symptom of bigger problems.

“The American people have been learning about the impact Obamacare will have on individuals and families in the form of higher premiums, disrupted insurance and lost jobs,” Senate Republican Leader Mitch McConnell said Tuesday. “And they’re becoming increasingly aware of the fact Obamacare is broken beyond repair.”

The only fix, he said, is “full repeal followed by step-by-step, patient-centered reforms that drive down costs.”

While the political theater played out, federal health officials reported that received 380,000 visits as of noon Tuesday and hosted more than one million visitors on Monday — the first weekday that Americans in the 36 states served by the troubled website could test drive the revamped system.

The crush of visitors to exceeded the Obama administration’s projections and the system’s optimal capacity of 800,000 daily visits, causing administrators to deploy a queuing mechanism that notified consumers by email of when to return.

About 13,000 consumers requested an email notification on Monday, according to the Centers for Medicare and Medicaid Services, which oversees, and more than 60 percent of those who received emails returned for “high levels of engagement,’’ said Julie Bataille, a CMS spokeswoman.

In South Florida, residents and counselors trying to access the website on Monday reported more problems than they had experienced the week before.

But on Tuesday, the system was working near-optimal levels, said Jason Conner, who manages an enrollment team of 10 counselors for Borinquen Medical Center in Miami-Dade County.

“The system seems to be working, I would say, almost at 100 percent,’’ Conner said, noting that consumers were still encountering some problems, such as having to resubmit information.

Conner placed’s functionality at about 90 percent on Tuesday, compared to about 50 percent on Monday, when Borinquen counselors were able to enroll three out of about 40 consumers who sought their assistance.

“People are getting through the system all the way through the process, and actually accessing it, unlike yesterday,’’ Conner said Tuesday around noon.

By the end of the day, Borinquen counselors had enrolled 11 individuals for coverage — the most for a single day to date. As of early Monday, Borinquen had helped complete 47 enrollments.

Also on Tuesday Florida Blue, the state’s largest health insurer, said the company will expand direct enrollment capabilities to all of its channels, including retail centers, online, and through agents and brokers.

About two weeks ago federal officials announced a pilot program allowing consumers to enroll directly through insurance companies, and to bypass the troubled

The pilot program was launched in the test states of Florida, Ohio and Texas.

Under direct enrollment, insurers estimate what they are owed rather than have calculate the bill. The government then sends the insurance companies the federal subsidies used to help eligible Americans buy coverage.

Mark Wright, a Florida Blue spokesman, said the company has enrolled consumers using the system and is providing feedback to federal officials.

In a written statement, Wright said, “We continue to see improvements including, for example, our testing over the weekend, which indicates the technical fixes put in place by CMS are showing positive results. However, it will take a consistent performance for a sustained time frame to know if the corner has been turned.’’

Wright confirmed that Florida Blue will expand direct enrollment. But his statement also implied that much work remains to be done on’s so-called “back end’’ functions.

That’s where informs insurers of consumers who have enrolled in their health plans, and establishes the financial transaction system for the federal government to directly pay insurers the premium tax credits or subsidies for eligible Americans.

“It is imperative that we focus on the entire process for enrollment,’’ Wright’s statement said, “not just the front end website, including making sure that the data received is accurate and that the payment system is fully operational.’’

Among the government’s priorities for repairing the back-end system of are the so-called 834 forms, which transmit consumers’ enrollment information to insurers.

Without that data, insurers cannot be certain who has enrolled, and consumers cannot be assured that they are covered.

Those forms had been riddled with errors, according to an anonymously sourced report in The Washington Post. The Post reported that errors cumulatively have affected about one third of the people who have signed up for health plans since Oct. 1.

Bataille, the CMS spokeswoman, did not directly refute the Post’s report. But she said that whatever errors may have occurred with the transmission of 834 forms before Nov. 30 have been largely corrected.

“I can tell you that does not reflect an accurate picture of what is happening right now,’’ Bataille said. “I’m sure that with the fixes in place and the improvements we have made to the system, we have made tremendous progress and huge improvements in 834 forms.’’