Health and Human Services Secretary Kathleen Sebelius testifies on Capitol Hill in Washington, Dec. 11, 2013.
Susan Walsh/AP

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Federal data revealed soaring Obamacare enrollment numbers and a vastly improved health care website on Wednesday morning, as Health and Human Services Secretary Kathleen Sebelius headed into her third grilling before lawmakers on Capitol Hill since the site’s botched launch.

Nearly 365,000 Americans have selected insurance plans from state and federal marketplaces over the months of October and November, according to an HHS report, and a further 803,077 have been deemed eligible for Medicaid or the Children’s Health Insurance Program (CHIP.) That brings the total number of Americans who have gained health coverage through Obamacare to nearly 1.2 million. Enrollment, however, is still on track to fall well below the pre-launch target of 3.3 million through the end of December. 

The report also showed that November’s enrollment number in the federal marketplace was more than four times greater than October’s. But the encouraging trend did little to quell Republican outrage over the botched rollout of

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Testifying before the House Energy & Commerce Subcommittee on Wednesday, Sebelius attempted to strike a balance between focusing the conversation on the law’s progress and taking ownership for what she described as the “flawed, frustrating, and unacceptable” launch. She announced that she had tasked Inspector General Dan Levinson with reviewing the contractor performance and program management behind the technological errors in, and requested an initial report within 60 days. She also announced that the Obama administration would create a new position—“chief risk officer”—at the Centers for Medicare and Medicaid Services, the agency that heads the website’s implementation. 

“I’ve determined it’s time to begin a process to discover the processes that led to the flawed launch,” said Sebelius in her opening remarks. But, she maintained, “the experience is night and day compared to where we were in October.”

Sebelius faced tough questions from the committee’s Republican members over cost, privacy concerns, and cancelled policies. When asked point blank by Republican Rep. Fred Upton whether she would have pushed back the Oct. 1 launch if she knew at the time what she knows now, Sebelius said she would have likely opted for a “slower launch,” with fewer people and more beta testing. Some also questioned the latest enrollment numbers.

“This 364,000 number is fraudulent because it’s not those who have purchased plans yet,” said Illinois Republican Rep. John Shimkus. “Do you understand our frustration with that?”

Sebelius had explained earlier that the numbers released Wednesday reflected just those Americans who had chosen a plan, not necessarily those who had paid for that plan. The deadline to pay is later in the month, meaning the department won’t have those numbers until next year. Once consumers pay their premiums, said Sebelius, their coverage will go into effect.

“Do you know how hard it is to actually make that payment—pull your billfold out and actually make the payment? Have you done that yourself?” asked Rep. Michael Burgess incredulously. “I will tell you it’s almost impossible.”

In another heated exchange, Shimkus took aim against the law’s mandated preventive care services, which Sebelius once again insisted would be free to consumers under new health insurance plans.

“There is no free lunch!” shouted Shimkus, pointing to a conversation he had with a Democratic state senator who oversees insurance coverage in Illinois. “He says when you mandate coverage, it’s rolled directly on premiums, and premiums increase. That’s paying for these services.”

Sebelius pushed back, saying consumers would not have a copay or deductible for the preventive care, and denied that their premiums would increase.

“What a lot of actuaries will tell you is if you have preventive care, and prevent a more costly hospital stay, cancer, episode, down the line, that that cost actually lowers the premium,” said Sebelius.

“We’re just going to agree to disagree,” said Shimkus. “It’s like talking to the Republic of Korea or something.”

The Cycle, 12/5/13, 4:08 PM ET

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