White House struggles with health law signup troubles

12:50 P.M. EDT

MR. CARNEY:  Good afternoon, ladies and gentlemen.  Thank you for being here, as ever.  Happy Monday to you.  I'm sure you were able to hear the President's remarks a little earlier about the Affordable Care Act.  Before I take your questions I had a couple of things I wanted to mention.

First, on Friday, October 25th, President Obama will travel to New York to visit Pathways and Technology Early College High School -- otherwise known as P-Tech -- in Brooklyn, where he will discuss the importance of ensuring that the next generation of middle-class American workers and entrepreneurs has the skills they need to compete and win in a global economy.

In his State of the Union address earlier this year, the President said, "Now at schools like P-Tech in Brooklyn, collaboration between New York public schools and City University of New York and IBM, students will graduate with a high school diploma and an associate's degree in computers or engineering.  We need to give every American student opportunities like this."

Further details about the President's visit to P-Tech will be made in the coming days.  Later that evening, the President will deliver remarks at a DCCC event and attend a DNC event before returning to the White House that evening.

Also, if I could beg your indulgence to try to get me out of here by 1:35 p.m.  I have an appointment.  But that gives us plenty of time.

Nedra.

Q    Just real quickly before we get to the speech today, there's some breaking news of a school shooting out of Nevada.  Can you tell us whether the President has been briefed on that or anything he might have been told?

MR. CARNEY:  I can only tell you that the President is regularly briefed on matters like this.  I don't know that he's specifically been briefed on this yet, although I suspect he has. We will find that out for you after the briefing.  We are, here, aware of this shooting and the limited information available about it at this time.  For more details we refer you at this point to local law enforcement.

** Earlier today, the President was informed by Deputy Chief of Staff Alyssa Mastromonaco of this morning's school shooting in Nevada.

Q    Okay.  And on to the speech.  We understand the President is frustrated, but what seemed to be missing today was any sort of explanation about what went wrong exactly.  What happened to cause all these problems?

MR. CARNEY:  Well, I'd say a couple of things, Nedra.  We are focused on providing access to affordable health insurance to millions of Americans -- millions of Americans who prior to now have not had that access.  And as the President made clear in his remarks, the Affordable Care Act is much more than a website.  The website is a piece of a process that will provide access to these marketplaces.  And this is the important part of the Affordable Care Act that has launched this month, and that is the marketplace, which, on average, in states across the country, provides 50 different options of insurance plans for consumers -- for consumers who have not had access to affordable insurance or often have not had the kind of variety that drives down prices and provides insurance at the price points that they can afford.

So the fact of the matter is the President is frustrated, and he made that clear today, by the problems that we've seen with the website.  But already, because of the efforts underway at HHS and CMS, and the tech surge that they've launched, you're seeing changes to the site that make it more clear to consumers about the variety of ways that they can get information about the health plans out there, shop around, if you will. 

They can now, for the first time -- if you look at the site today, it's different from what it looked like yesterday -- you can easily compare and shop just by entering your ZIP code.  There's also now on the homepage a direct link to a tax calculator that will help you estimate the tax credits you may be eligible for as part of purchasing insurance through the marketplaces. 

And also on the website it prominently features a pathway to allow you to enroll through call centers.  As the President said and others have said, we have beefed up the staffing of call centers, HHS has, to ensure that the obvious high numbers of Americans who are interested in finding out about their insurance options have ways to do that and ways to enroll -- because there are four ways.  It's not just online.  It's by phone, in person, or by mail, in addition to online, to register and to enroll in these insurance options.

Q    But without any fuller explanation of what went wrong, can you say whether it was misleading in the beginning to say that this was an issue of volume?

MR. CARNEY:  No, in fact, I think it's absolutely accurate to say that the volume far exceeded our expectations and that the volume has driven the problems that we've seen and exposed some of the problems that we now know about. 

So no one would argue with the assertion that there was an underestimation of the kind of volume that we were going to see, and obviously that demonstrates the very important and real fact that millions of Americans are very interested in affordable health insurance that had not existed before.  But it's also the case that the models that were in place that tested the website did not account for this kind of volume, and that the volume that we saw instantly on the first day and ever since has both led to these problems and also exposed some of the glitches and kinks that the President talked about today, which is why we're taking the actions that we're taking to improve the consumer experience.

But if I could, just remember, even with these glitches, people are signing up, they're registering.  People are enrolling, and people are being able to explore the options that are available to them.  And as you've seen all over the country, there's a huge demand.  And that is why the President is so focused on fixing the problems that have arisen and fixing the ones that arise, and not on Monday-morning quarterbacking.  We're interested in providing this very valuable commodity to Americans who so clearly want to buy affordable health insurance.

Yes, Jeff.

Q    Jay, the President mentioned bringing in tech people from outside the government, and HHS said that on its blog yesterday.  Who are some of these people?  Are you getting any names or any companies involved that the public would recognize?

MR. CARNEY:  Well, I would say a couple of things.  The tech surge is something that was announced at HHS, and they are bringing in top experts both from inside and outside the government to scrub in with their team and help improve the healthcare.gov website.  These are additional contractors as well as a few experts who are part of the Presidential Innovations Fellows program, which was started by the President in his first year -- rather, his first term -- and it pairs top innovators from the private sector, nonprofits and academia with top innovators within government to collaborate.

In terms of who they are, individually, and the contractors, those are the kinds of questions that you should address to HHS and CMS since this is something that they've launched and are working on right now.

Q    Speaking of HHS, has the President or the White House encouraged Secretary Sebelius to testify at the hearing this week in Congress?

MR. CARNEY:  Secretary Sebelius and other senior members of HHS have, of course, engaged with and testified before Congress on ACA issues and ACA implementation, and I'm sure that the department -- I know that the department has made clear that they are willing to testify and will be willing in the future.  But for specifics about requests to individual departments and officials who will be made available, I'd refer you to those departments.

Q    From a messaging standpoint, this is being taken over largely by the White House, and isn't it sort of a bad week not to have your chief health person show up at a hearing?

MR. CARNEY:  I think you heard the President speak today.  I think Secretary Sebelius and many others at HHS have and will continue to speak about implementation of the Affordable Care Act going forward.

Whether or not it's a messaging challenge is interesting and a worthy subject of discussion and analysis.  The challenge that is far more important in terms of what the focus of the President is has to do with making sure that Americans get affordable health insurance that they so clearly want.

Q    But that's connected to messaging right now, isn't it?

MR. CARNEY:  Well, and that's why they, HHS, is taking the steps that have been announced overnight and you can see clearly on the website, because we're focused on making sure that the obvious and demonstrated desire for information about these marketplaces and information about the tax credits that are available to so many Americans that will make insurance affordable for them for the first time is available to them and that they know how they can get that information, and that 24/7, seven days a -- well, I guess that includes seven days a week -- 24 hours a day, seven days a week, experts are working on fixing the problems, identifying problems, isolating them, and making the consumer experience better for Americans across the country.

Q    And last question, you said to Nedra that you're still standing by the argument that the website has had problems because of unexpectedly high demand.  How do you reconcile that, though, with the fact that the law promises to ensure millions of Americans?  How is it unexpected that millions of people would try to sign up?

MR. CARNEY:  What I said to Nedra is that there's no question that the volume has caused some of the problems but also exposed some of the problems, and --

Q    But why is the volume unexpected?  That's what I don't understand.

MR. CARNEY:  Look, the fact is the number of people who accessed the healthcare.gov website on the first day and every day since has far exceeded expectations and we can Monday-morning --

Q    Why?

MR CARNEY:  Well, I think we noted early on that it exceeded within a few days what Southwest.com -- Southwestairlines.com gets in a month.  So there's no question that the folks who made guesses about -- and even educated guesses -- about the volume were off, and that the tests, therefore, that preceded the launch were based on volume that turned out to be way below what we saw.

And nobody is making excuses for that.  What we're focused on is fixing the problems so that the consumer experience is improved, and making clear to Americans that they can enroll, that they can shop, and that they can purchase insurance that will be available to them come January 1st at prices that they could not before now envision getting with the kind of quality coverage that they couldn't get.

Brianna.

Q    Thanks, Jay.  To follow as well on Nedra's questions, you're saying that a structural problem with the website, unrelated to volume, is not part of the issue?

MR. CARNEY:  Let me first say that I do not have a degree in computer science or a level of expertise that would allow me to answer in-depth questions about the architecture of a program like this.  What I can say is that volume, as I'll repeat, but --

Q    But it's day 21.  Wouldn't someone within HHS have communicated that to the White House at this point?

MR. CARNEY:  What I can tell you, Brianna, is that volume exceeded expectations dramatically and that volume both caused problems and exposed problems that the President made clear he's frustrated with.  He made clear that he's not satisfied with the consumer experience that a lot of folks out there have had, and that's why HHS and CMS have been taking the actions they've taken, have already introduced improvements to the website, have made clear to Americans across the country that there are ways to enroll through the toll-free number, in person, as well as by mail.  We're focused on getting the Americans who are interested in getting affordable health insurance because they don't already have it through their employer the information they need so that they can shop and make choices.

Q    -- I mean, all observers who do have some sort of expertise --

MR. CARNEY:  Brianna, I think we've acknowledged there's a problem.  And that's why this -- everybody is taking --

Q    A structural problem?

MR. CARNEY:  I would refer you to computer experts on those kinds of technical details.

Q    -- there's a structural problem.

MR. CARNEY:  What I can tell you is that, as the President said, as HHS has said, they are working 24-7 to deal with the website issues.  I would simply note that the family of four out there that has enrolled to purchase insurance at prices they could not previously enjoy, even if they had to struggle through the website or call the 800 number, are getting something that is very valuable to them.  And that is what this is about.  It is providing the security to millions of Americans of affordable, quality health insurance that they did not have before.

And acknowledging the problems that have existed with a piece of this, we have to focus and we are focused on making sure that those people for whom the Affordable Care Act was written and conceived are getting the services and the benefits that they deserve.

Q    The President obviously wanted this up and running on day one.  As the problems with the website persist and are not immediately resolved, is he open to delaying the penalty for not signing up for insurance?

MR. CARNEY:  What I can tell you, Brianna, is that we are, as I said earlier, two -- or three weeks rather -- into a six-month enrollment period.  And Americans --

Q    Don't you have to enroll by mid-February?

MR. CARNEY:  Americans who have access to affordable insurance would need to have insurance by March 31st.  People who do not have access to affordable care due to a state not expanding Medicaid, for example, or due to other factors will not be penalized.  That's part of the existing law.

In terms of the February 15th date that you just mentioned, HHS can provide more information.  And there's no question that there's a disconnect between open enrollment and the individual responsibility timeframes in the first year only.  And those are going to be addressed.

But the fact is we are focused now, in the beginning of the fourth week, at the end of the third week of a six-month process, on making sure that Americans out there understand that there are a variety of ways to get the information about the health care plans available to them, the tax credits available to them, and a variety of ways to enroll and purchase insurance.

Q    But you're indicating there's flexibility there in the law if folks --

MR. CARNEY:  I would simply refer you to HHS for more details.  But we're working on -- or they are working on aligning those policies, the enrollment period and the individual responsibility timeframe period, and they'll issue guidance soon.

Jon.

Q    Let me make sure I've got that last part right.

Q    Yes, let's clear this up.

Q    Yes, can we say given all the problems that we've seen with people trying to enroll in this program, is the White House going to be delaying the mandate?

MR. CARNEY:  No.  That's not at all what I was saying.

Q    Well, why not?  I mean you know --

MR. CARNEY:  Jon.

Q    I mean, why not delay?  You're going to charge people a fine for not enrolling.  Why not delay that?

MR. CARNEY:  We're three weeks into a six-month enrollment period.  As I said, the law itself, as written, makes clear that Americans who have access to affordable insurance would need to have insurance by March 31st.  But people who do not have access to affordable care due, example, to a state not expanding Medicaid -- and there are states out there who are depriving their residents of access to expanded Medicaid because they made that choice -- or due to other factors will not be penalized.  That's number one.

And when it comes to the issue I was just talking to Brianna about and the February 15th marker period in terms of enrollment, I would refer you to HHS for more details.  But they are working to align the policies, the disconnect between the open enrollment period and the individual responsibility timeframes, which exist on the first year only.

The point I'm trying to make, Jon, and addressing the question at the end of your question, is we're focused on providing quality health insurance to millions of Americans.  We are three weeks into a six-month enrollment period.  If you enrolled last week or you enroll next week, your insurance does not kick in until January 1st.  And ample prior experience shows that in programs like these, most people don't enroll until towards the end.

If you're able to shop for an extended period of time before you have to buy, you're likely to shop.  And in Massachusetts, for example, where a similar health care initiative was passed into law, the average consumer explored his or her options six to eight times I believe the figure was before actually making a decision.

So, again, we're acknowledging clearly, as the President did, that the problems that have existed on the website are not acceptable to him, that we are focused on making the consumer experience better, providing clear information to Americans about the variety of ways they can get the information about plans as well as the variety of ways that they can enroll to them.  And our focus is on making the Affordable Care Act work and making sure that Americans have access to these plans -- not on figuring out who is to blame for a problem that clearly exists and we need to fix.

Q    I'm just trying -- just basic language.  You can't really charge people a fine for not getting health insurance if you don't fix this mess, if you can't make this website work, can you?

MR. CARNEY:  Jon, I appreciate what you're saying and I have answered now and will answer again that people who --

Q    I don't understand the answer, though.  If the website is not fixed, will people still have to pay the fine?

MR. CARNEY:  First of all, we're way still early in the process.  So you're talking about a February 15th and a March 31st deadline; it is October 21st today.  So let's be clear about that.  We're three weeks into this.  And that's number one.

Number two, as written, the law makes clear that people who do not have access to affordable care due to a state not expanding Medicaid or other factors will not be penalized.

Q    So other factors can be this website having the same problems?

MR. CARNEY:  Again, that's how the law is written.  We're focused on implementing the law and ensuring that people have the information they need.  What I think is important to remember is that even through this, people are enrolling; people are submitting applications successfully.  And we need to make sure that we're doing everything we can, because the interest is so high and the demand is so high, that the consumer experience is as good as possible, and that every American out there who is interested in getting affordable health insurance because he or she hasn't in the past had it available to him or her is getting the information they need and getting it in a way that allows them to make the educated choices about the variety of plans available to them that they need to make.

Q    Can we just ask about the main contractor that helped build this website, CGI?  I mean, they were fired by Ontario, Canada, for problems up there.  Did the administration choose the wrong people to build this website?

MR CARNEY:  Look, there are a lot of people working on this. I would refer you to HHS about contractors.  That's not something that the White House oversees.  The President made clear today that he's not satisfied with what the consumer experience is with the website, and the administration, HHS, and CMS are working 24/7 to improve the experience.

Q    Could you answer this -- the contract, the top dollar, was at -- started at $93 million.  It went up to $292 million, which is where it now -- where is that money coming from?

MR. CARNEY:  I would refer you to HHS for questions about HHS contracts.

Major.

Q    I just want to try to make sure I understand.  So you're saying when you mention other factors that this website issue could fall under that category at some time in the future? You're leaving open that possibility, correct?  I'm just trying to understand what you're saying.

MR. CARNEY:  I am simply explaining to you what the law says.  And I'm also saying --

Q    You're implementing a law and you need to have some flexibility it would seem to me to address this problem, correct?

MR. CARNEY:  Well, that's what the law says -- that if you do not -- let's put it this way.  If you do not have access to affordable insurance, you won't be penalized for not buying affordable insurance.  Okay?  So if you live in a state where a governor or a legislator has chosen not to expand Medicaid, for which you would otherwise have qualified --

Q    (inaudible.)

MR. CARNEY:  Well, no, the Affordable Care Act mandates an expansion -- or tried to mandate an expansion of Medicaid.  The Supreme Court made a decision that the states would make -- and many have, including states with Republican governors -- and others haven't, leaving out many Americans from new access to Medicaid.

Q    A separate issue from this.

MR. CARNEY:  No, no, no.  Look, the Affordable Care Act is not a website.  The issue is, do you have access to affordable health insurance?  And the individual responsibility provision is there for those individuals who, even though they have access to affordable health insurance, do not purchase it and therefore are held responsible for that.  The law addresses that as written.

In terms of the deadlines that Brianna was talking about, I was simply acknowledging that there's a disconnect between the two deadlines in the first year only, and that HHS is looking at that and will be issuing guidelines soon.

Q    Would it be correct for any of us to say that because of this website issue, the administration is looking into flexibility as far as the application of that individual mandate because the sign-up period has become more complicated?

MR. CARNEY:  Whatever conclusions you draw about the way the law is written I think you can draw.  The law is clear that if you do not have access to affordable health insurance then you will not be asked to pay a penalty because you haven't purchased affordable health insurance.  We're focused on making sure that millions of Americans in every state across the country do have access to affordable health insurance.

Q    As you're focused on that, has the President established, or HHS, a new deadline in which he wants certain service factors met or quality assurance standards met?  Has he set forth a timetable and a means by which HHS can report to him and everyone here about what progress they're making?  And can he tell -- on his behalf, can you tell the country when this is going to be resolved?

MR. CARNEY:  Well, first of all, let's be clear.  There have been problems with the website.  People have been submitting applications.  People have been enrolled across the country.  So the idea that something --

Q    Is this a timeline for his own satisfaction?

MR. CARNEY:  Let me get to that part of the question.  But I think it's important to note that the issue here isn't that the marketplaces didn't open on October 1st or that Americans haven't been able to shop for insurance, or haven't been able to submit applications.  The issue is that the website component of this has not functioned as effectively as it should have.  And the President made clear that he's not satisfied with that.

Q    I was trying to get to that focus --

MR. CARNEY:  And what I'm saying is that his deadline -- his insistence is every minute of every hour of every day going forward, this problem has to be addressed and isolated and fixed, and as with any website, as new issues arise, that they're addressed and fixed so that the consumer experience is as efficient and effective as possible going forward.

Q    But there's no timeline he set internally for this to be achieved, or some moment where you can tell the country it's all fixed?

MR. CARNEY:  I think the President made clear today that he wants, and he is seeing action being taken right away and efforts being made right away, to make improvements to the website and to make -- more importantly, make it clear, broadly, to the American people who have such a keen interest in getting affordable health insurance, that there are a variety of ways for them to get access and information about it.

Q    From that podium, the President apologized to the country about the shutdown and the specter of default.  Does the White House owe the country an apology for this particular problem?

MR. CARNEY:  Look, I think the President is frustrated and he made clear, and what the President made clear today is that every American out there who has demonstrated such clear interest in getting affordable health insurance should be rewarded by the best possible consumer experience, and that's what he's insisting on.

We are in the beginning of a six-month enrollment period. And what the experience has told us is that demand for quality affordable health insurance is exceedingly high, and we need to step up our game to ensure that that demand is met in a way that allows consumers to examine the options available to them, examine the credits available to them to make insurance even more affordable for them and their families, and to purchase that insurance so that they're covered, in many cases for the first time.

Q    But no apology for having a system that was not ready for primetime?

MR. CARNEY:  Again, I think the President expressed his frustration in the Rose Garden today.

Q    Jay?

MR. CARNEY:  Yes.

Q    How do you answer criticism from folks who say the problems with the website suggest there may be problems elsewhere in Obamacare down the road -- be it tax subsidies or physician reimbursements?  You should have gotten, they say, the website sign-ups right.

MR. CARNEY:  Well, look, I would say this, Wendell, there is no question that we have seen for many months and years now a concentrated, concerted effort by critics of Obamacare to undermine it.  They've tried more than 40 times to repeal it and other -- by other means sabotage the Affordable Care Act.  They shut down the government because of their opposition to affordable health insurance to millions of Americans.  And there's clearly some joy being taken in some quarters by the experiences that some Americans have had, frustrating experiences that they've had in trying to get information about affordable health insurance.

And my only question to them is, how can you possibly take pleasure in that frustration when it's born out of a desire for health insurance that the very same critics have never provided a plan to provide -- have never developed a plan to provide to those same Americans who need --

Q    I don't think that's implied in my question.

MR. CARNEY:  They've opposed -- but the critics you're talking about have opposed health care reform at every step. They've tried to undermine it at every step.  And they shut down the government over their opposition to it.  And I don't -- it's hardly surprising, then, that they would be critical of the real problems that we've seen in the website part of the Affordable Care Act.

But let's remember what this is about.  It's about getting insurance to Americans who have not had access to affordable insurance, that 15 to 20 percent of the population that -- for whom these marketplaces are designed.  And what we've never seen from those critics is an alternative.  So there shouldn't be, I don't think, celebration around the fact that there have been troubles that Americans have experienced -- real people who have real needs and desire the security of health insurance -- trouble that they've had in getting access to this information so they can purchase affordable health care.

Q    I'm not talking about people welcoming the problems.  I'm talking about people who say a simple thing like setting up a website is much less complex than setting up, for example, a system that deals with tax subsidies and physician reimbursements, and if you didn't get the first one right, why should they be confident you will get the second one right?

MR. CARNEY:  Again, I think the idea that setting up a website is simple would be challenged by a lot of folks in Silicon Valley, A -- especially one of this nature that provides so much information and to so many millions of Americans.  B, if you're going to ask me a specific question about a specific element of the Affordable Care Act, I'm happy to try to answer it, but to say that there are critics out there who don't like it and how do you answer them is to tell me and everybody in America what we already know.

Q    You went through four ways of dealing with this -- on the web, by phone, in person, by mail.  One of our reporters called the number that's now on the website and was told essentially, we'll send you paperwork in the mail in a couple of weeks.  So --

MR. CARNEY:  Well, I don't know what the Fox reporter or producer discovered when he or she called.  What is true is that wait times have been fairly short on the 1-800 number and that --

Q    He talked to a person and they said basically, we'll send you the paperwork in the mail.

MR. CARNEY:  Look, you can -- again, I don't know what experience you guys had.  You can enroll over the phone.  You can enroll in person.  You can be provided an application to sign up and register and to enroll.  And what we're making clear today is -- and what the website itself makes clear today is that there are these other avenues to both learn about the Affordable Care Act and the health insurance options available to you in your state, and to sign up and to enroll.

Chuck.

Q    Jay, I'm just curious --

MR. CARNEY:  I'm always --

Q    No, no, no, I want to be -- five days before the launch, the President said it's a website where you can compare and purchase affordable health care plans, the same way you shop for a plane ticket on Kayak.  Who misled him?  Who misled the President on this?  Are you telling me, five days before, that somebody let the President go out to the American public to give this speech and say this and make this promise -- in fact, the next line is, "I promise you, this is a lot easier.  It's like booking a hotel or a plane ticket."  Who let him down?

MR. CARNEY:  Look, the President is frustrated.  He made that clear in his remarks today.  And we're focused on making improvements so that the millions of Americans who want affordable health insurance are getting the best consumer experience possible, as opposed to Monday morning quarterbacking --

Q    Does he feel let down?  Did somebody --

MR. CARNEY:  Again, what I'll tell you is, as I mentioned earlier I think, is that there's no question that volumes exceeded substantially expectations and that the testing that was done was based on --

Q    If this were a volume issue, adding a server would have fixed it in a heartbeat --

MR. CARNEY:  Well, again, I don't think -- I'm pretty confident you're not a --

Q    I'm not a computer scientist, but --

MR. CARNEY:  -- you haven't written code in your day.

Q    I understand.  But if this were simply a traffic issue, that's fixable fast, is it not?

MR. CARNEY:  Well, what I would tell you is, as I said earlier, is that the volume far exceeded expectations and that the volume both created problems because of how large it was and exposed other problems and glitches and kinks with the system that are being addressed.

You're not going to get an argument from here that this has not been frustrating.  The President himself made that clear.  But what he's focused on is making the consumer experience better for Americans, because even through this process, nearly 20 million folks -- there have been nearly 20 million visits to healthcare.gov.  That demonstrates a sustained interest in the array of affordable health care options available to millions of Americans who haven't had those options available to them in the past.

Q    Why should we assume when HHS puts out on its blog post last night that they brought in this tech surge, brought in people on the outside, that seems to send the message they don't know what the problem is.  Is that fair?  I mean, should we not assume that --

MR. CARNEY:  No.  I think you should assume --

Q    -- they do know what the problem is?

MR. CARNEY:  -- that they identified problems and glitches that need to be fixed, and that they brought in this team to continue the effort and to put in place tools and processes to monitor and identify parts of the websites where individuals are encountering errors.

Q    But if you had solved the problems, wouldn't you be screaming up and down, we have found the problem, we're working on a solution?

MR. CARNEY:  I think we are finding problems and we're working on solutions.  When you have tech experts at any major tech operation, you're constantly monitoring your operations, finding glitches and problems and fixing them.  And that's what they're doing here.

Q    Finally, are you open to extending open enrollment?  This is a separate sort of follow-up to the question about -- considering that this is now going to potentially be a lost month in open enrollment, are you guys open to extending open enrollment an extra month?

MR. CARNEY:  Well, I'd say a couple of things.  One, I'm not sure how you can call a three-week period or even a month a lost month when there have been hundreds of thousands of people who have submitted applications.  And that's not just your name and your email address.  That's the application that much of you discuss and we talked about here that was initially 21 pages, but is now down to three pages to make it an easier experience for consumers.  But that's still a substantial piece of business.

And that's one of the biggest pieces of this process, is submitting that application.  And, again, half a million people have done that, representing more because these are people who have done it often on behalf of their family members as well.

Q    But you don't plan --

MR. CARNEY:  Again, it's far from where we wanted to be, as the President made clear, when it comes to the website experience.  But the answer to that question is that's like writing off those 500,000 people.  We would never do that, because that demonstrates the absolute interest in --

Q    Are you going to extend open enrollment?  Is that on the table?

MR. CARNEY:  We're three weeks into this.  I'm not going to speculate about where we're going to be in a few months.  We're focused on fixing problems now, providing access to information now.

One of the -- when you read that quote, one of the things that the President said on that day is true and remains true about healthcare.gov.  You type in your ZIP code and you can comparison shop.  You can look at all the options available to you, and you can access a tax calculator to estimate for you and your family what your subsidies would be or could be under the Affordable Care Act.  And then you have -- either through the website or through other means -- the capacity to enroll and purchase insurance.

Peter.

Q    Thanks, Jay.  Is it the White House's decision on whether Secretary Sebelius testifies Thursday, or is that entirely her decision?

MR. CARNEY:  The departments decide, and I would refer you to the departments on how to respond to specific requests for officials to appear.  What I can say is that the department has consistently engaged with and worked with Congress when it comes to appearances and other engagements with Congress, and I'm sure that the department will continue to do that.

Q    Does the White House have input into that decision?

MR. CARNEY:  Again, I would refer you to departments when their officials are asked to testify.

Q    Jay?

MR. CARNEY:  Yes, then Margaret.

Q    A question not about the website.  You talk about the individual responsibility period -- is it accurate to say that other than someone literally sitting down and voluntarily writing a check for $95 if they don't have insurance --

MR. CARNEY:  If you're going to ask me how these things are implemented, I would refer you to HHS.

Q    Well, this is an important question because a lot of supporters of the law are worried that the penalty is almost impossible to enforce because other than someone applying for a refund that the penalty can be charged against, there's no other way to collect it.  Are you saying you have no understanding of how the process works?

MR. CARNEY:  I would refer you to HHS and CMS for that.

I think I said Margaret.  Yes.

Q    By the way, there's a report out now that says Sebelius will testify next week.

MR. CARNEY:  How about that?

Q    To a congressional committee.  So do you know whether the website was beta-tested before the actual launch?

MR. CARNEY:  I'd have to know what beta-tested means, but I can tell you that --

Q    You don't know what beta-tested means?  (Laughter.)

MR. CARNEY:  I mean, I'm old but I'm not -- Margaret, what I can tell you is that there's no question that the website has not performed up to expectations or performed as well as we believed it would, based on the testing that was done.

Q    So it was tested?

MR. CARNEY:  Yes -- well, I don't know -- in terms of the types of testing, I would refer -- I just don't want to pretend to be an expert.  What I can say is that the system has not worked as effectively and efficiently, obviously, as we wanted it to -- the President, Secretary, anybody wanted it to.  And that's why people are working as hard as they're working and people are being brought in to work as hard as they can work to help address these problems.

Q    But there was a point before it went live where people in the administration had tested it and thought, hey, this thing is going to work on the day when it goes live?

MR. CARNEY:  We obviously -- again, I'd refer you for you details to HHS.  But we obviously -- the system was tested, and based on the expectations we had, we were confident that it was going to work more effectively than it's been working.  We were, as you'll recall even before, acknowledging that as with any launch of a major web operation like this, there were going to be glitches and kinks.  But I'm not soft-pedaling what's happened.  We completely acknowledge that this has been a frustration.  And that's why the President spoke the way he did in the Rose Garden today, and that's why so many people are busting rocks on this problem right now.

Q    I have a quick foreign policy question.  The Prime Minister from Pakistan -- the Prime Minister is going to be here on Wednesday.  Just in case we don't have a chance to ask you tomorrow, can you talk about how important that meeting is, especially given what the last couple of years have been like between the U.S. and Pakistan, and what the President is hoping can be accomplished in --

MR. CARNEY:  Absolutely.  The President looks forward to welcoming Prime Minister Sharif to the White House on Wednesday. The Prime Minister's official visit comes as we are strengthening U.S.-Pakistan relations.  Ahead of the leaders' meeting, the Prime Minister will see the State Department, the Department of Defense, Department of Energy, Department of Treasury, and the U.S. Trade Representative.  These meetings provide an opportunity to discuss concrete cooperation on issues of mutual concern such as energy, trade, and economic development, regional stability, and, of course, countering violent extremism.

We want to advance our shared interest of a stable, secure, and prosperous Pakistan that is contributing to regional and international security and prosperity.  We want to find ways for our countries to cooperate, even as we have differences on some issues, and we want to make sure that the trajectory of this relationship is a positive one.

So the President looks forward to this.  It's obviously a very important relationship -- the United States and Pakistan.  It's one that's obviously got a lot of complexity to it, but it's enormously valuable when it comes to U.S. national security and to the safety and security of the American people.

Q    Can we expect any announcement or any concrete deliverables?

MR. CARNEY:  I don't have any previews to give you beyond what I just gave you.

Alexis.

Q    Jay, you were talking about the lawmakers that have tried to undermine the Affordable Care Act at every turn.  Can you say whether their refusal, at one point, to increase funding or financing for the implementation phase in any way impacted what we have seen in terms of problems?  And related to that, can you imagine that the President and HHS would come back to Congress and ask for any additional funding to try to remedy these problems?

MR. CARNEY:  I don't know the answer to the first question.  And I think right now we're focused on correcting the problems that exist, improving the consumer experience, making sure millions of Americans -- that they have information available to them and that they can shop for affordable health care, and that they will be able to enroll and purchase affordable health care for the first time.

For other questions around funding streams, I would direct you to HHS.

Q    And related to Chuck's question, can I just clarify if the administration -- if the President would like to extend the open enrollment phase, is that something that he can do through executive fiat?

MR. CARNEY:  Again, we're getting way ahead of ourselves.  We're three weeks into this process.  We're not sugarcoating the fact that the website portion of the Affordable Care Act -- the implementation and rollout of the marketplaces has been filled with some challenges, but we're three weeks in.  And going to the broader issue of the six-month enrollment period, regardless of the number of, or scarcity of, challenges that are going to be with rolling out a website like this, the fact would always have been, based on all the examples that we know of, that the early periods here would have been ones in which we saw a great deal of shopping around and accessing of information, but that the bulk of actual submissions of applications and then enrollments would take place later in that period.  That has always been the case and that's what we expect here.

Q    I'm just asking because you seem to leave it open --

MR. CARNEY:  But I'm not going to speculate, so I guess if that's what you mean by leaving it open -- I'm simply saying --

Q    But you knew you were going to get asked that.

MR. CARNEY:  Sure, but there's a lot of stuff I know I'm going to get asked about that I wouldn't want to speculate about.

I think that we have a six-month enrollment period -- six months -- which is a substantial enrollment period.  For anybody who is, as I suspect most people here are, enrolled in a health care or health insurance through their employer and they have the annual open enrollment period, it's a lot shorter than six months.  And so I think the duration of that was by design and provides an ample amount of time for Americans to acquaint themselves with this new opportunity and the new benefits available to them, and then to make choices according to their family's needs and their finances.

I'm going to make this the last one because I've got to run.  Tangi.

Q    The French government is pretty angry today after Le Monde claimed that the NSA has secretly monitored tens of millions of phones, communications in France earlier this year.  Prime Minister Ayrault said that he is shocked and has demanded an explanation.  So I guess the question is what kind of explanation is the U.S. ready to give to yet another concern by this alleged behavior?

MR. CARNEY:  Well, I would say a couple of things.  One, obviously we have an enormously important and valuable relationship between the United States and France, one of our closest allies and certainly our longest ally.  And as we've said before in response to questions about other countries, we address issues like this related to alleged intelligence activities through diplomatic channels, and that would certainly be the case here.  I'm not going to comment publicly on every specified, alleged intelligence activity.  And as a matter of policy, we have made clear that the United States gathers foreign intelligence of the type gathered by all nations.

As the President said in his speech at the U.N. General Assembly, we've begun to review the way that we gather intelligence so that we properly balance the legitimate security concerns of our citizens and allies with the privacy concerns that all people share.

I would remind you that the National Security Agency is a foreign intelligence agency.  It is focused on discovering and developing information about valid foreign intelligence targets. Its activities are directed against these valid foreign intelligence targets in response to requirements from U.S. leaders in order to protect the nation and its interests from threats such as terrorism and the proliferation of weapons of mass destruction.

Thank you all very much.  Have a great day.

END          1:35 P.M. EDT

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