With Enrollment Slow, Some Democrats Back Change in Health Law

WASHINGTON - Anxious congressional Democrats are threatening to abandon President Obama on a central element of his signature health care law, voicing increasing support for proposals that would allow Americans to retain the health insurance coverage they are losing because of the Affordable Care Act.

The dissent comes as the Obama administration released enrollment figures Wednesday that fell far short of expectations, and as House Republicans continued their sharp criticism of administration officials at congressional hearings examining the performance of the health care website and possible security risks of the online insurance exchanges.

In addition, a vote is scheduled Friday in the Republican-controlled House on a bill that would allow Americans to keep their existing health coverage through 2014 without penalties. The measure, drafted by Representative Fred Upton, the Michigan Republican who is the chairman of the Energy and Commerce Committee, is opposed by the White House, which argues that it would severely undermine the Affordable Care Act by allowing insurance companies to continue to sell health coverage that does not meet the higher standard of Mr. Obama's health care law.

But a growing number of House Democrats, reflecting a strong political backlash to the rollout of the health care law, are warning the White House that they might support the measure if the administration does not provide a strong alternative argument. The approaching House vote is shaping up as an important test for both the health measure and the unity that Democratic leaders have so far been able to maintain around the health law despite a fierce Republican attack against it.

In a closed-door meeting Wednesday of House Democrats and White House officials, tensions flared as several lawmakers upbraided the administration, saying that the president had put Democrats in a tough political position by wrongly promising consumers that they could keep their existing health care plans. In fact, hundreds of thousands of Americans have received cancellation notices from their insurers because their health care coverage does not meet the minimum standards dictated by the new law.

'I'm frustrated in how it rolled out, and I let them know in no uncertain terms,' said Representative Mike Doyle, Democrat of Pennsylvania. 'The point I was making in caucus to the administration is don't give us this techno-babble that you're going to do some administrative fix down the road. There's a bill being put on the floor on Friday.'

The overall message of the meeting, said several attendees, was that the White House and the House Democratic leadership have until Friday to come up with a satisfactory alternative, or House Democrats might be forced to support Mr. Upton's bill, which already has two Democratic co-sponsors: Representatives John Barrow of Georgia and Mike McIntyre of North Carolina, who represent more conservative districts.

'I think the Upton bill is terrible, but we need something else to vote for in order to keep our word to the American people,' Mr. Doyle added. 'We told people in those plans that they were grandfathered in, and if they wanted to stay in them, they could, and we need to honor that.'

A similar proposal, which would allow people to keep their current health insurance permanently, is also drawing support in the Senate under an effort led by Senator Mary L. Landrieu, Democrat of Louisiana. Ms. Landrieu said she remained committed to her bill, despite resistance from the White House. But she drew a distinction between her plan - which she said would maintain the key provisions of the Affordable Care Act - and those offered by Republicans that would dismantle the law, like the one introduced in the House by Mr. Upton.

'That bill guts the Affordable Care Act. It does not fix it,' she said. 'It guts it, and I don't support it and would urge the Democrats in the House not to support it. My bill is not meant to undermine the Affordable Care Act; it's meant to strengthen it.'

She expressed confidence that more Democrats would sign on to her plan, which is designed to encourage people to eventually move to better insurance on the federal exchanges. 'Every day I think we'll pick up co-sponsors,' she said, pointing to Senator Dianne Feinstein of California, who said Tuesday that she was on board. On Wednesday, Senator Jeff Merkley, Democrat of Oregon, also signed on to her plan as a co-sponsor.

Senator Harry Reid of Nevada, the majority leader, said Wednesday that he had had 'quite a long conversation' with the president on Tuesday evening about the health care law, as well as other issues, and would be holding a special Democratic caucus meeting on Thursday with White House officials to discuss the next steps.

Administration officials conceded that the bungled health care rollout had produced a turbulent political situation in Washington. But they said they were confident that fixing the website would help Democrats in next year's elections.

'Politics follows policy here,' Jay Carney, the White House press secretary, told reporters.

Mr. Carney said that the president's top aides were working quickly to try to come up with an administrative fix to the problem of the cancellation of health insurance plans. But he declined to say when that would be announced or whether it would come before Democrats are asked to vote on legislation on Friday.

'Sooner rather than later,' Mr. Carney said several times.

White House officials said they recognized the need for Democrats to vent their frustration about the health care problems. Mr. Carney said that the dissatisfaction felt by Democrats on Capitol Hill 'is similar to the frustration that the president feels.'

'Nobody is satisfied with what we've seen out of the website,' he added.

But they continued to oppose Mr. Upton's bill, saying it would create more problems than it would solve.

'Intentionally or not, the bill would not just address the problem,' Mr. Carney said, adding that it would 'essentially allow insurers to sell new plans that are substandard and potentially undermine the central promise of the Affordable Care Act.'

Insurance companies, already deeply worried about the low enrollment in the plans they are offering on the insurance exchanges, say congressional proposals to force them to allow canceled policies to be reissued could be disastrous. Robert Zirkelbach, a spokesman for America's Health Insurance Plans, the industry's lobby, said insurers 'have significant concerns on how it would work operationally.'

'The ideal situation is to get the website up and running so insurers can start signing people up,' he said.

But with no alternative proposal from the White House as of Wednesday, Democrats in both chambers were becoming increasingly critical of the administration, and seeking to find solutions of their own.

'If you can't take constructive criticism as truly being helpful and you think it's being harmful, then we're going to have problems,' said Senator Joe Manchin III, Democrat of West Virginia and a co-sponsor of Ms. Landrieu's bill.

In the House, meanwhile, Representative Patrick Murphy, Democrat of Florida, said that without a competing option from the White House, 'You're going to have some Democrats in the House who are going to support the Upton bill.'

'This has been a complete embarrassment,' he added. 'It doesn't matter what party you are. The focus needs to be how do we get this right.'

Jonathan Weisman and Jeremy W. Peters contributed reporting.