WASHINGTON — A surge of Nebraskans and Iowans enrolled in health insurance plans through the new marketplaces last month, in keeping with national trends, according to a report released Monday.
In Nebraska, 14,464 people had enrolled in a plan by the end of December. That's more than seven times as many as the 1,965 Nebraskans who had enrolled through the end of November.
Across the river in Iowa, 7,475 had enrolled, nearly 10 times the 757 reported in November. Nationally, the number of Americans who had enrolled in a plan went from 364,682 to more than 2.1 million.
Obama administration officials trumpeted the latest numbers as evidence that the law is starting to work as intended after a debacle of a rollout. Many people had trouble navigating the balky website that served as a portal for signing up in most states.
Republicans, however, said the report showed that the entire law was proving to be a bust, given that the numbers are well below the 3.3 million people the administration had hoped to sign up by now. Opponents also noted the potentially troubling trend that those signing up tend to be older and more expensive to cover.
The long-term success of the new system, after all, relies on having large numbers of young, healthy people sign up for insurance and pay premiums that will help cover the sick and the elderly. Most existing health insurance works the same way.
Only 24 percent of those who signed up nationally fell into the crucial 18-to-34 demographic. In Nebraska, it was 26 percent; in Iowa, 22 percent.
“There's no way to spin it: Youth enrollment has been a bust so far,” said Brendan Buck, a spokesman for House Speaker John Boehner, R-Ohio. “When they see that Obamacare offers high costs for limited access to doctors — if the enrollment goes through at all — it's no surprise that young people aren't rushing to sign up.”
Administration officials downplayed the danger represented by the demographic breakdown, saying that past experience and common sense indicate that young, healthy individuals will be among the last to sign up for coverage while older, sicker individuals are more motivated to quickly obtain insurance.
Top White House aide David Simas told reporters that the trajectory of young people signing up is similar to what Massachusetts saw when it implemented a similar approach under former Republican Gov. Mitt Romney. He also said the administration will launch an intensive outreach effort, including television and digital advertising and a focus by the president and the first lady.
“We feel that we're in a very, very good place as of right now, with more work to do,” Simas said.
He also made a pitch for states to sign up for an expansion of Medicaid. Many states, including Nebraska, have rejected the Medicaid expansion.
“Why would you deny coverage to an entire universe of people? Especially given the fact that you have Republican governors like Gov. (Terry) Branstad in Iowa, who in negotiations (with the administration) was able to craft an approach to Medicaid that was very, very specific to what he believed was important to Iowans,” Simas said. “We will be flexible with any state that wants to lean forward and cover more of its people.”
While the administration is producing monthly reports on those signing up through the exchanges, Rep. Lee Terry, R-Neb., has pushed it to turn over the figures on a weekly basis.
He has sponsored legislation, expected to pass the House later this week, requiring the weekly reports.
Terry says it's simply a matter of transparency and points out that the Congressional Budget Office has found that it would not cost any money.
The White House opposes the bill. Simas said other federal statistical reports — such as those dealing with job creation, Medicare and Medicaid — are done monthly.
“These are kind of standard reports that allow you to make sure that your data is good and reliable and to do the analysis that's necessary,” Simas said.