And this was supposed to be a friendly hearing.
One of the most liberal members of the U.S. Senate laid into the executive heading the Obama administration's health insurance website Tuesday, saying she feared people had lost confidence in the whole effort.
Republicans have been on the attack for weeks, holding hearings to highlight the glitches that have made the site unworkable for most people and embarrassed the administration. Maryland Sen. Barbara Mikulski, D-Md., a strong supporter of health reform and of the administration, said she was reluctantly weighing in, too.
"I believe there has been a crisis of confidence created in the dysfunctional nature of the website, cancellation of policies and sticker shock for some people," Mikulski said at a hearing held by the Senate's Democratic-led Health, Education, Labor and Pensions committee.
But Centers for Medicare and Medicaid administrator Marilyn Tavenner, the sole witness at the hearing, pushed back.
"Do you think you are going to restore confidence in this plan?" Mikulski asked.
"Yes," Tavenner answered. "I would encourage folks, if they have not gone onto the website in the last few days, to go onto the website."
CMS says the site is being repaired and will work far better for most people by the end of November. Tavenner says this will be plenty of time for people to enroll if they want coverage on the first day possible, Jan. 1, 2014. "We have always believed that the first enrollment surge would come mid-December," she said.
She said CMS expects a second surge of late enrollees in February and March. People who do not already have health insurance have until March 31 to sign up for coverage, either on the new exchanges, in some other form of private health insurance, or Medicare, Medicaid or another government program.
Sen. Elizabeth Warren, a Democrat from Massachusetts, said her state's experience supports this. Massachusetts set up its own health insurance exchange in 2006. "What we learned in Massachusetts is when it comes to enrolling in health care, many of us wait until the end to get it done," she said.
Mikulski says most people are confused. ”I really want this to be a success and my job is to pinpoint solutions. I think it’s very confusing ... about where you go,” she added. “We hear about the navigators and this and that. But I can tell you, people really don’t know. They really don’t know.”
Sen. Tom Harkin of Iowa scheduled Tuesday's hearing with the clear intent of making it friendlier to the administration official who has been taking the heat for the website's failures. And while many senators said they welcomed the changes the law would bring, even close administration allies said recent fumbles could undermine the law's goals.
The health insurance exchanges, the centerpiece of the 2010 Affordable Care Act, fizzled on the very first day they opened. Technical problems ranging from software glitches to complete hardware failures have kept all but a few people from getting through the complex sign-up process. For the first week or so, almost no one was able to sign up.
The White House hasn’t released recent figures on how many people have tried to get insurance, but at last count said 700,000 people had at least started the process. Tavenner says details of how many people have completed the process will be available next week.
Harkin, the Democrat who heads the HELP committee, expressed confidence that the website would be repaired. “This is, after all, a website — it’s a machine that will be fixed,” he said. “Americans have until the end of March next year to sign up.”
And Harkin pointed to other popular aspects of the law. “It’s benefits to the 105 million Americans who have been protected against lifetime limits since 2010; it’s the more than 3 million young people that can stay on their parents’ policies; it’s 7 million seniors who have saved $8 billion in discounts on prescription drugs," he said.
“It’s the 71 million people on private insurance that have used free preventive services; and it’s the 129 million non-elderly Americans with preexisting conditions who can no longer be denied or discriminated against by health insurance companies.”
Sen. Chris Murphy, a Democrat from Connecticut, agreed. "I have confidence that this product will fly off the shelves once people are able to get onto the website," he said.
States that have successfully set up their own exchanges — California, New York and Kentucky among them — say their sites are working well. Kentucky officials say 32,485 people signed up for health insurance on its exchange the first month. More than 40 percent are under 35 — the “young invincibles” needed for policies to work well without having to charge high premiums.
Tavenner said her department was taken by surprise by the problems.
"We knew all along we would have bugs in the system," she said. "I think we had more than we realized."
Even some critics expressed some confidence. "I am sure you'll be able to fix the website," Sen. Lamar Alexander, a Tennessee Republican, told Tavenner.
On Wednesday, Health and Human Services Secretary Kathleen Sebelius will testify before the Senate Finance Committee.
Matthew DeLuca contributed to this story
First published November 5 2013, 7:02 AM