Last-minute scramble on critical Obamacare deadline day

Efforts range from the practical – a big message on HealthCare.gov that tells people they should enroll by Monday to ensure their coverage starts on time – to the creative: the District of Columbia government dispatched someone from its health exchange, DC Health Link, to one of the city’s gay clubs to sign people up.

After the rocky rollout of the Affordable Care Act’s federal exchanges, which led to very low enrollment numbers in the first month, the administration has been actively seeking ways to ease the sign-up process ahead of the Dec. 23 deadline (people will be able to enroll in the federal exchanges until March 31 to avoid paying a penalty). On Friday, President Obama announced that 1 million people have enrolled for insurance so far – a huge jump from the end of November, when just 365,000 had signed up, but still far short of the administration’s initial target of 3.3 million enrollees by the end of the year.

“When you try to do something this big affecting this many people, it’s going to be hard,” Mr. Obama said during a Friday news conference before he left for a vacation in Hawaii with his family. “Despite the website problems, despite the messaging problems, it’s working.”

Several last-minute changes to the law could, in theory, make things easier for people rushing to sign up at the last minute. First, the administration extended the enrollment deadline to get coverage by Jan. 1, 2014, from Dec. 15 to Dec. 23.  Last week the board of the biggest trade group for insurance companies, America’s Health Insurance Plan, said consumers will have until Jan. 10 to pay their first premium, rather than Jan. 1.

Then, on Friday, Health and Human Services Secretary Kathleen Sebelius wrote to a group of senators saying she will issue a “hardship exemption” from tax penalties for people whose plans were cancelled but were not able to purchase new insurance by the deadline.

But the additional flexibility has done little to silence critics of the law, including skeptical Democrats. Sen. Joe Manchin, D-W.V., is one such lawmaker. He and Sen. Mark Kirk, R-Ill., have introduced legislation to delay for one year the requirement that Americans purchase insurance coverage or face a penalty.

“This whole 2014 will be a transitional year. To find out where our glitches are and our little nuances that we have to work for, and find out if the market can produce the products that we need to keep this and us healthy. That's what it's all about,” Manchin said Sunday on CNN’s “State of the Union.”

He didn’t sound optimistic about the law’s prospects without such a delay.

“At the end of the day, if it's so much more expensive than what we anticipated and that the coverage is not as good as what we've had, you've got a complete meltdown at that time. So this transitional year gives you a chance to adjust the products to the market. And to see if the market will absorb and buy the product,” he said.

And Republicans, who have kept up a steady drumbeat of criticism on top of several attempts to repeal the law, are sticking to their predictions: no matter how many fixes are implemented, it still won’t work.

“You can’t fix this mess,” said Sen. Tom Coburn, R-Okla., on NBC’s “Meet the Press.”