WASHINGTON For the first month alone, the Obama administration projected that nearly a half million people would sign up for , according to an internal memo obtained by The Associated Press. But that was before the markets opened to .
If the glitches persist and frustrated consumers give up trying, that initial goal, described as modest in the memo, could slip out of reach.
The Sept. 5 memo, for Health and Human Services Secretary Kathleen Sebelius, lists monthly enrollment targets for each state and Washington, D.C., through Mar. 31, 2014, the last day of the initial open enrollment period under President Barack Obama's health care overhaul.
The new online insurance markets, called exchanges in some states, are supposed to be the portals to coverage for most of the nation's nearly 50 million uninsured people. Middle-class people without job-based coverage can shop for subsidized private plans, while low-income people are steered to an expanded version of Medicaid in states that have agreed to expand that safety net program.
Although the Oct. 1 launch of the markets was a top priority for the White House, the rollout was quickly overwhelmed by computer problems, and. Insurers say signups are coming through, but slowly.
A surge of interest by consumers going online appeared to trigger the problems, which also seem to involve underlying software flaws and design shortcomings undetected or overlooked in testing. The administration is holding the explanation close, while working feverishly to fix the glitches - with incomplete results so far.
In the memo, officials estimated that 494,620 people would sign up for health insurance under the program by Oct. 31. And that was portrayed as a slow start.
"We expect enrollment in the initial months to be low," said the memo, entitled "Projected Monthly Enrollment Targets for Health Insurance Marketplaces in 2014."
A big jump was expected after Thanksgiving, since Dec. 15 is the last day people can sign up so their coverage will take effect Jan. 1. Starting in the new year, the health care law requires virtually all Americans to have insurance or face fines. At the same time, insurance companies will be forbidden from turning away people in poor health.
The memo projected enrollment would reach 3.3 million nationally by Dec. 31.
Signups were expected to spike again in March, as procrastinators noticed the approaching end of open enrollment season. "We anticipate a surge of enrollment in December and March," the memo said.
By the end of March, total enrollment through the markets was expected to surpass 7 million, an estimate originally from the nonpartisan Congressional Budget Office and then used by the administration as the foundation for its projections.