(Bloomberg) -- About 2.1 million people have medical coverage as of yesterday through Obamacare after a late surge in enrollment helped regain ground lost to the botched debut of insurance exchanges created by the U.S. health-care overhaul.

More than 1.6 million Americans signed up through state and federal exchanges in December alone, according to calculations from data released Dec. 31 by the U.S. Department of Health and Human Services. The December tally is more than quadruple the first two months of the government’s sign-up period.

The December surge provides a boost to President Barack Obama, whose fumbling of the October rollout of the insurance exchanges initially thwarted the high participation needed to spread the costs of his health-care expansion. The Patient Protection and Affordable Care Act is supposed to offer private coverage to as many as 7 million people by the end of March.

“The new law is transformational for our entire health-care system and for millions of Americans who finally have health security,” Kathleen Sebelius, the U.S. health secretary, told reporters on a conference call.

In addition to those gaining private insurance, about 3.9 million others have been newly determined eligible for Medicaid plans for the poor, or for state children’s programs. It’s not known how many of those people actually enrolled, since that process must be completed with state governments in most cases.

CVS Caremark

The government is preparing for newly insured people to begin seeking care at doctors’ offices, emergency rooms and pharmacies today, and is coordinating with hospitals and insurers to smooth the process, Sebelius said.

The government considers people enrolled after they select a health plan; the final step to sign up is to pay the first month’s premium directly to insurers. Those payments aren’t due until Jan. 10 for most of the country, and officials said they don’t know how many of the 2.1 million have already paid. CVS Caremark and Walgreen Co., the largest pharmacy chains in the nation, both said they would provide up to a month of prescription medications without any upfront cost to customers who can show they enrolled in an exchange plan, even if they don’t yet have an identification card or plan number.

People who experience trouble using their insurance at doctors’ offices, hospitals or other health-care settings should first call their insurer, Sebelius said. If that doesn’t resolve the problem the government is putting 10,000 call center agents on duty to field questions about coverage from a toll-free number, 1-800-318-2596, Julie Bataille, a spokeswoman for the U.S. Centers for Medicare and Medicaid Services, said on the call.

Under spotligh

Insurers, pharmacies and hospitals are used to handling patients’ changes in coverage from year to year, Phil Schiliro, a White House health-care adviser, said on the call.

“Usually there’s not a spotlight on what they’re doing,” he said. “Over the next few days, there will be.”

By 2016, about 34 million people are expected to gain coverage by private health plans sold through the law’s government-run marketplaces or by expanded Medicaid programs, according to the Congressional Budget Office. If those projections prove accurate, the sheer size of the Affordable Care Act’s constituency may secure its place in American society for decades to come.

For all its promise, the law’s future still remains uncertain. While it survived a constitutional challenge before the Supreme Court in 2012, the law faces further court battles as well as a Republican-controlled House of Representatives that has voted more than 40 times to repeal or limit the statute.

Public support in November also fell to its lowest level in a Kaiser Family Foundation survey after the Oct. 1 debut of the insurance marketplaces greeted consumers with website breakdowns, higher prices and potentially broken promises.

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