President Obama and his supporters are encouraging Americans to "get covered" in the final hours of the health care law's enrollment period, a six-month trial that courted disaster and criticism but could end with the White House claiming victory on its own terms.
Uninsured Americans have until midnight Monday to select health care plans on the Obamacare marketplace or through their state exchanges, though consumers may self-attest that they have started the process and qualify for extra time to finish it.
The allowance is emblematic of the slippery deadlines that marked the sign-up period from Oct. 1 to March 31, after a disastrous online rollout and confusing penalty thresholds threatened to sink the overhaul in its infancy.
"They were basically in triage mode," Timothy Jost, a health care policy analyst at Washington and Lee University School of Law said of the law's early stumbles. "What needs to be done right now? What can wait a little bit?"
The White House's unilateral changes to the deadlines and requirements were freighted with political risk but might pay off in terms of total enrollment. Administration officials say more than 6 million Americans have selected private health care plans, and analysts said "special enrollment" periods for people who experience life changes this year could put the tally closer to 7 million.
Health and Human Services Secretary Kathleen Sebelius last year embraced the 7 million figure — an early target set by the Congressional Budget Office — as the definition of success in the law's first year, but that was before HealthCare.gov and various state-run portals crashed in October.
Since then, the law's cheerleaders have said there is no magic number to define success and that interest in the law is growing.
"There really is a huge surge," Sen. Angus S. King Jr., Maine independent, told "Fox News Sunday" host Chris Wallace.
Critics of the law say that confidence is misplaced because the administration has not said how many enrollees were previously uninsured or who paid their first premiums.
"I think they're cooking the books on this," Sen. John Barrasso, Wyoming Republican, told Mr. Wallace.
To get to 6 million and counting, the administration issued a series of rule changes to bring in as many enrollees as possible. First, it had to turn around the balky HealthCare.gov website, which serves 36 states, by relying on tech and management gurus to add capacity and fix embarrassing software glitches. Then, the White House staved off a public relations disaster by allowing people to keep bare-bones plans that do not comply with Obamacare.
Around Jan. 1, the administration blurred deadlines to let more people pick health care plans for the new year, even if they paid later and received retroactive coverage.
The administration also decided that Americans should have until March 31, instead of Feb. 15, to acquire insurance without facing fines under the law's individual mandate. Based on official data, the six-month cushion may have spared 2 million people from penalties for failing to hold insurance for three months or more.
It is hard to tell if consumers noted the switch and changed their behavior, analysts said. Still, it streamlined the law's implementation and likely amplified the March 31 deadline.
"One of the things that has been driving enrollment is people finally realizing there is a penalty," Mr. Jost said.
The Obama administration resisted calls to delay the mandate and its tax penalty, but it released a slate of "hardship" exemptions for people who lost their coverage or were facing other hurdles to remain insured. The law had built-in exemptions for — among others — prisoners, religious groups such as the Amish who have long-standing objections to insurance, and participants of health care sharing ministries.
For 2014, the penalty for lacking insurance for at least three consecutive months is the greater of $95 or 1 percent of a household income over the filing threshold. The Internal Revenue Service will extract the penalty from any tax refunds the violator would receive next spring.
Meanwhile, Mr. Obama wants volunteers and hired "navigators" to redouble their efforts before the enrollment deadline.
In-person assisters in the nation's capital plan to hit up 7-Eleven convenience stores to reach Monday-morning commuters.
The District, like several states with their own exchanges, is giving applicants until mid-April.
"We know from the December experience that there are many last-minute shoppers" said Mila Kofman, executive director of the DC Health Benefit Exchange Authority, predicting that requests for in-person assistance will spike as well. "Continuing enrollment is the only way we can ensure that all consumers can get the coverage they need."
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