problems throw state Obamacare programs a curveball

The problems plaguing shouldn't impact Californians trying to join Obamacare -- their state is one of 16 running its own Obamacare website. Still, the ongoing problems with the federal website have left California residents confused, prompting state officials to change up their outreach efforts.

"Instead of advertising about affordability," Peter Lee, executive director of Covered California, told reporters Monday, the state-run program is changing its marketing to "address directly the consumer confusion."

As of Nov. 12, around 59,000 people had picked a health insurance plan on Covered California, Lee said, saying that initial enrollment numbers were "much larger numbers than we expected."

Still, he said, "We've had enrollment reduced because of the drumbeat of information that websites don't work. Many don't understand there are separate websites for the 16 states."

Kevin Counihan, CEO of Connecticut's new Obamacare marketplace Access Health CT, said the problems have also impacted enrollment in his state.

"There's clearly confusion in Connecticut," he said. While some consumers are confused about whether the state's Obamacare website is working, others are concerned that the federal IT problems may slow down the distribution of subsidies some are being promised to help pay for their new insurance plans.

The ongoing problems, Counihan said, have created a "cascading effect, to some degree."

The confusion created by's technical problems is just one of the unexpected complications that state-run Obamacare programs are facing because of the federal government. However, officials from some of those state-run programs say their new marketplaces are enduring the hiccups and have performed well so far.

"We all know there has been a lot of consumer confusion over elements of the rollout," Counihan said, noting that enrollment in Connecticut has been stronger than expected. "In my view, personally, this is a three- to four-year implementation, and we have to be careful about drawing too many inferences" about Obamacare's future. "We're going to ride all this stuff out."

California's Lee added, "We're in the beginning of the first inning of a nine-inning game."

Last week, the Health and Human Services Department announced that as of the end of October, more than 106,000 people had enrolled in Obamacare insurance plans nationwide, while another 975,407 had successfully applied for insurance but had yet to choose a plan. In September, the Obama administration had anticipated nearly 500,000 enrolling in plans in the first month of open enrollment.

It's unclear at this point whether the administration will come close to reaching its goal of having 7 million enrolled in private Obamacare plans by the end of March, when open enrollment closes. Yet as Lee and Counihan pointed out, the development of the marketplaces is a multi-year process: the nonpartisan Congressional Budget Office in May projected that the marketplaces would reach peak enrollment of 25 million in 2018.

The administration has promised to have running smoothly for the vast majority of users by the end of this month. However, citing unnamed officials, the Washington Post reported Sunday that the administration would consider it a success if 80 percent of users can buy insurance on the site by then.

On Monday, White House spokesman Jay Carney said the 80 percent benchmark accounts for users experiencing technical problems, but also users who decide to leave the website themselves for other reasons. For instance, if a user's personal health issues are very complex, they might prefer to enroll with the help of an official over the phone.

In addition to dealing with the confusion created by the technical problems with, state Obamacare officials now have the unanticipated task of responding to President Obama's new directive, which gives insurers the option of renewing existing health plans on the individual and small group markets for another year. Lee and Counihan, as well as Danielle Holahan, deputy Director of the New York Health Benefit Exchange, all said Monday that their respective states are still deciding whether or not to go along with the plan. A few state insurance commissioners are already objecting to the plan, arguing it would destabilize the Obamacare marketplaces.

Lee said California should make a decision by the end of the week.

"The right way to address this issue is not going to be a blanket answer across the nation," he said. States will respond differently, depending on the functionality of their websites, their respective insurance markets, and their regulatory environment, among other things.

With the continued federal problems, some have called for more accountability in the Obama administration. Former White House press secretary Robert Gibbs said on NBC Monday morning, "If this were to happen in the private sector, somebody would have probably already lost their job."

Carney responded Monday that President Obama and his team are focused "on getting this right for the American people... Monday morning quarterbacking is not what we're engaged in."