NEW YORK — With the federal government’s new health care exchange beset by technical problems, the number of health plan enrollees through the first month of operation was far below expectations.

Meanwhile, the administration promises that the problems will be fixed by the end of November appear increasingly doubtful.

Secretary of Health and Human Services Kathleen Sebelius revealed that 106,185 people selected private health plans during October, with only 26,794 signing up through the federal government’s health insurance exchange, HealthCare.gov.

More than 79,000 enrolled through the 14 state-run marketplaces, and an additional 846,184 people applied in the state and federal marketplaces but did not purchase a plan.
According to an internal memo cited by The New York Times, the administration projected in September that 464,920 people would sign up during the first month. The nonpartisan Congressional Budget Office had earlier predicted that up to 7 million people would enroll in the initial six-month period that ends March 31, 2014.

While some state-run insurance exchanges have also confronted technological problems, others have operated comparatively well. California reported that 30,830 people joined health plans during October and enrollment accelerated during the first days of this month, with an additional 29,000 enrolling through November 9.

Kentucky, which has its own exchange, also saw a strong initial response, with 27,854 people enrolling in Medicaid and 4,631 signing up with private plans. The state has aggressively promoted its health care exchange, called Kynect, with federally funded print and media advertising.

In some states, early enrollments have included a disproportionate share of older, unhealthy people, sparking fears that insurers will react by raising premiums.

However, those involved with some exchanges predict that the enrollee demographics will even out in coming months as increasing numbers of younger, healthier people sign up.

The federal government’s portal, HealthCare.gov, has been plagued with technical problems that have made the application process slow for some while rendering parts of the program totally unusable. President Obama appointed Jeffrey Zients, an entrepreneur and consultant who is also an economic advisor to the administration, to fix the system by the end of November.

On October 25, Zients said the website “will operate smoothly for the vast majority of consumers” by that deadline. Since then he has said that the increasing number of visitors to the site has exposed more problems.

Recent press reports citing anonymous sources are casting doubt on the likelihood of repair efforts meeting that timetable. A recent story in the Washington Post, for example, noted that the website continues to slow down when more than 20,000 to 30,000 people try to use it simultaneously.

Citing “an official with knowledge of the project,” the article said that the lead contractor in building the site, CGI Federal, had succeeded in eliminating only about 60% of the technical problems it has addressed.

Meanwhile, some congressional Democrats are advocating extending the open enrollment period or delaying financial penalties for failure to enroll by the mandated deadline of January 1, 2014. Under the Affordable care Act, uninsured people are required to purchase a health plan by December 15 in order to have coverage by January 1.

Sen. Joe Manchin III (D., W.Va.) and Sen. Mark Kirk (R., Ill.) have introduced legislation that would eliminate the penalty for 2014 and instead impose a higher fine in 2015.

Sebelius, though, has rejected bipartisan calls for delay in implementing parts of the law.

“Delaying the Affordable Care Act would not delay people’s cancer or diabetes or Parkinson’s disease,” she said. “It would not delay the need for mental health services or cholesterol screenings or prenatal care. For millions of Americans, delay is not an option.”