President Barack Obama said the White House was weighing options for fixing problems with his signature healthcare law but it may be a complicated legal and logistical task.
Obama, who apologized in a TV interview on Thursday to those Americans whose insurance plans are being canceled since the law took effect on October 1, is facing criticism from Republicans over whether or not he misled Americans by promising that if they liked their policies, they could still keep them.
After open enrollment began some policies were canceled because they do not meet new requirements called for in the 2010 Patient Protection and Affordable Care Act, also known as Obamacare.
There are a range of possible fixes to allow people to temporarily keep their plans, but many are logistically difficult, legally risky, or could undermine other parts of the law, according to policy experts.
"That's not a minor tinkering around the edges," said Ross Baker, professor of political science at Rutgers University. "That's a pretty significant modification that he would be required to make to make good on that promise. I think he's in a very bad position."
Also, if Obama fails to find a solution, he risks further damaging his credibility, which already took a hit in the rocky rollout of the online marketplace set up for millions of uninsured to enroll. The stakes are also high for his fellow Democrats, many of who are already frustrated that Obamacare woes are complicating their 2014 reelection bids.
In Thursday's TV interview, Obama apologized to Americans whose policies are being canceled by health insurers. He said he was looking at "a range of options" to help those people, but did not provide details.
U.S. Health and Human Services Secretary Kathleen Sebelius, speaking at a medical center in Atlanta on Friday, said the Obama administration hopes to help those who received cancellation notices but has "no specific option right now."
Several million people could lose their current coverage, some as early as January 1, because their policies do not comply with new requirements in Obamacare, such as coverage for mental health treatment and maternity care.
Many Americans have complained that alternative policies are too costly, and the administration has conceded that persistent glitches with HealthCare.gov, the federal government's website to buy federally subsidized plans, have prevented consumers from shopping for other options.
Jeffrey Zients, the White House official assigned to get HealthCare.gov operating smoothly by the end of the month, said on Friday that while the website is improving, higher volumes of visitors are exposing new capacity and software issues.
He described HealthCare.gov as being "a long way from where it needs to be."
Lawmakers have introduced a range of proposals to help those with canceled policies, including extending the deadlines for enrollment, delaying the penalties, or allowing those who buy policies by the end of the year to keep that coverage.
A legislative remedy for the problem is unlikely, however, given the intense opposition to the healthcare law among Republicans in a deeply divided Congress that has found it difficult to agree on anything.
Outside of legislation, state officials have had some success in pressuring insurers to extend canceled policies.
California Insurance Commissioner Dave Jones announced earlier this week that health insurer Blue Shield of California said will delay policy cancellations for more than 110,000 customers. Vermont Governor Peter Shumlin, a Democrat, has also sought extensions from insurers.
But it's unclear how many other states will follow, and the federal government itself has limited power.
"It requires federal preemption of state law on a much larger scale than ever before. That's kind of a legal problem," said Joe Antos, a health policy expert at the conservative American Enterprise Institute.
Analysts also said extending health coverage plans slated for cancellation would be difficult, requiring state regulators and insurers to quickly recalculate rates, communicate new prices with consumers and get them to re-enroll.
Other experts said the administration could consider not enforcing some aspects of the law. The administration already announced a one-year delay of the employer mandate - a requirement for larger businesses to provide health coverage for their workers or pay a penalty.
The law, which was passed in 2010 and upheld by the U.S. Supreme Court last year, requires most Americans to have health insurance next year or pay a fine.
The most sweeping social legislation since the creation of Medicare and Medicaid the 1960s, the law offers subsidized private coverage to lower income families through new state insurance marketplaces, expands government insurance for the poor and sets new consumer safeguards and cost-saving initiatives for the healthcare industry.
Republicans say Obama misled the public when he said Americans would be able to keep their current insurance. A spokesman for House of Representatives Speaker John Boehner on Friday said Obama now has little credibility as he seeks a solution for those facing cancellation notices.
"We are highly skeptical that there is anything the president can do administratively to keep his pledge that would be both legal and effective," said Brendan Buck, spokesman for the Ohio Republican.
(Additional reporting by Caren Bohan, Caroline Humer, Lewis Krauskopf, Roberta Rampton and David Morgan; Writing by John Whitesides; Editing by Jackie Frank, Karey Van Hall and Grant McCool)