The woman at the center of the Obamacare enrollment site, Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner on Tuesday was the first government official to testify before Congress since the government's health insurance exchange went live on October 1. After nearly three hours of questions from both Republican and Democrats on the House Ways and Means Committee, here's what we learned:
1. Finally, an apology
After four very tumultuous weeks of open enrollment, Tavenner became the first government official to publicly apologize for the rocky rollout of HealthCare.gov.
"We know that consumers are eager to purchase this coverage and to the millions of Americans who have attempted to use HealthCare.gov to shop and enroll in health care coverage, I want to apologize to you that the website has not worked as well as it should," Tavenner said during her opening remarks.
President Barack Obama has admitted his frustration and Health Secretary Kathleen Sebelius has expressed regret, but on Tuesday, Tavenner accepted responsibility for the site's failures.
"Obviously, I'm accountable for this," she said later in the hearing.
But Tavenner was insistent that the site is not beyond repair.
"I want to ensure you that HealthCare.gov can and will be fixed and we are working around the clock to deliver the shopping experience that you deserve," she said. "We are seeing improvements each week, and as we said publicly, by the end of November, the experience on the site will be smooth for the vast majority of users."
Despite Tavenner's claims of responsibility for the program's failures, none of the members of the committee signaled that she should be reprimanded. On the other hand, more than 30 House Republicans and at least two prominent Republican members of the Senate have called for Sebelius' resignation.
2. Insurance plans are being canceled
No fewer than 10 Republicans on the Ways and Means Committee held up or cited letters sent to constituents saying that their health insurance plans were going away. Most of these legislators quickly followed up with references to a talking point at the center of Obama's pitch to consumers both before and after the Affordable Care Act was passed.
"If you like your health care plan, you can keep your health care plan," the president repeated in speeches, weekly addresses and even the 2010 State of the Union address.
At Tuesday's hearing, Republicans called that promise misleading.
Tavenner acknowledged that while some insurance companies had decided to stop offering certain plans on the individual market, the ACA did not force them to make that decision, and consumers whose plans have been canceled now have more comprehensive plans available to them.
"If, in fact, the issuer has decided to change the plan -- it didn't have to," Tavenner said. "Plans were grandfathered in in 2010 if they didn't make significant changes in cost-sharing and this sort of thing, they could keep the plans that they had."
Companies that decide to create new plans, Tavenner continued, must conform to new mandates under the ACA. These include a ban on rejections due to preexisting medical conditions, and new mandated benefits such as hospitalization, emergency services and maternity care. In response to repeated Republican questioning, Tavenner recommended that consumers who lose their coverage explore the options available to them on the new federal exchange.
"They can call the call center today and we will help them," Tavenner said. "They can go online and if they're not successful we can help them through the call center. We also have people in their individual markets that can help them in person. So there are more methods than just the website. And I think that's important."
3. Initial enrollment will be low
Since the ACA passed in 2010, Obama administration officials have pointed to the initial months of Massachusetts' health reform implementation as a predictor of how the nation-wide rollout might go. While repeatedly emphasizing that her agency wouldn't be releasing any enrollment information until mid-November, Tavenner used this example again on Tuesday as one reason why the first round of numbers might be lower than expected.
"We expect the initial number to be small," Tavenner said. "And I think you've seen that in our projections, and that was the Massachusetts experience as well."
Later Tavenner expanded on that explanation saying, "The Massachusetts experience was very slow initially and then it started to ramp up over time. We expect the same type of projections."
In recent days, White House officials have cited a study in the New England Journal of Medicine that found the vast majority of the consumers who enrolled in the first month of the Massachusetts health insurance exchanges were Medicaid eligible.
The study found that just 123 premium-paying enrollees signed up in Massachusetts during the first month, compared with 10,000 people who signed up for Medicaid or plans with no premiums.
4. The partisan gulf remains wide -- and Democrats are standing by Obamacare
As Republican after Republican read testimonials from their constituents about the disastrous effects the Affordable Care Act is having on insurance policies, and the tortured experiences many have had trying to enroll online, the stories coming from Democrats were quite different.