2014: Make or break for O-Care

2014: Make or break for O-Care
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President Obama is taking a bruised and bandaged ObamaCare into 2014 after a year of unprecedented problems for his administration and its signature law.

While the White House insists its efforts are on-track, the blundering on display in key portions of the reform's rollout surprised even Obama's most ardent critics in 2013.


Obama sought to ward off criticism on Friday, even as he indicated that the botched rollout was his biggest mistake of the year.

"The basic structure of that law is working. Despite all the problems, despite the website problems, despite the messaging problems, despite all that, it's working," he told a news conference.

"You don't have to take my word for it. We've got a couple million people who are going to have health insurance just in the first three months," he added.

The comments came just hours before Obama departed for his annual vacation in Hawaii and less than three days before the first ObamaCare enrollment deadline.

They underlined the president’s hope that the disappointments of the rollout period will fade as enrollments pick up and the website works more smoothly. Obama during his news conference emphasized the growing number of people who are signing up in advance of the deadline.

Consumers using HealthCare.gov to buy health insurance must choose plans by Dec. 23 in order to receive coverage that begins Jan. 1. The same is true in many states.

California is reportedly averaging 15,000 sign-ups every day, and Obama revealed Friday that HealthCare.gov enrolled 500,000-plus people in the first three weeks of December.

The surge in enrollments had always been expected as the cut-off date drew near. Even so, these figures are welcome relief for an administration that has weathered months of negative coverage about its healthcare law.

But the biggest challenges are perhaps yet to come: if 2013 was the law's proving ground, 2014 will be the battlefield.

Republicans are already pouncing on opportunities to hammer vulnerable Democrats for the rollout's problems as part of the GOP's attempt to maximize its chances of winning seats in the midterm elections.

A new campaign ad against Sen. Jeanne ShaheenCynthia (Jeanne) Jeanne ShaheenBiden administration resists tougher Russia sanctions in Congress GOP holds on Biden nominees set back gains for women in top positions Sununu setback leaves GOP scrambling in New Hampshire MORE (D-N.H.) echoed Obama's widely discredited promise that "if you like your coverage, you can keep it" under the healthcare law.

"Next November, if you like your senator, you can keep her. If not, you know what to do," states the 30-second spot by conservative group Ending Spending.

The GOP — which found itself running even with Democrats on the generic ballot in one poll this week — has a lot of choices when it comes to criticizing unplanned changes in the rollout.

A rough count puts the number of delays enacted by the administration over the last year in double figures.

From the employer mandate to the online enrollment system for small businesses, the deferrals have substantially changed how the law will operate in 2014.

What has remained largely untouched is the individual mandate. Most people will still be required to carry health insurance next year or face fines.

But even this bedrock principle of the healthcare law was slightly modified this week.

The administration declared Thursday night that people with cancelled plans can now purchase cheap, "catastrophic" policies under the law's hardship exemption.

"We just wanted to make sure that the hardship provision that was already existing in the law would also potentially apply to somebody who had problems during this transition period," Obama said Friday, defending the move.

The administration argues that the changes to the rollout will all help to ease pressure on consumers.

But allowing hundreds of thousands of customers to purchase bare-bones plans will also sow chaos and force insurers to re-price their products on the fly.

This change is one of many that will test insurers and consumers as the new year begins.

New policyholders could face a long list of hurdles if things go wrong, particularly when the time comes to use their coverage.

There is widespread confusion about the deadlines for people who want health insurance that begins on New Year's Day.

Under pressure from the administration, health insurance companies are now allowing people who select plans by Dec. 23 to pay their first premiums no later than Jan. 10.

While these plans will still take effect on Jan. 1, patients could have trouble navigating their initial trips to the doctor's office if providers are mistaken about the timetable.

There are also outstanding issues with consumer information coming from HealthCare.gov, insurers say.

The industry says it is working to rectify bad forms — past and present — in partnership with federal health officials, but experts acknowledge that some errors could slip through the cracks.

The administration has suggested that these issues are the final hurdle for repairs at HealthCare.gov, the site whose massive technical errors thwarted millions of users in October and November.

But Republicans redoubled their attacks this week in response to the problems, previewing what will become brutal arguments during campaign season next year.

"Our entire health care system can't be fundamentally changed at any given time subject to the random impulses of President Obama," House Majority Leader Eric CantorEric Ivan CantorRepublicans eager to take on Spanberger in Virginia Virginia emerging as ground zero in battle for House majority McAuliffe's loss exposes deepening Democratic rift MORE (R-Va.) said in a statement Friday.

"The White House actions clearly prove ObamaCare can't work as designed. It's time for ObamaCare to be delayed for all."