Charles Gaba's blog

But actually, he thought as he re-adjusted the Ministry of Plenty’s figures, it was not even forgery. It was merely the substitution of one piece of nonsense for another. Most of the material that you were dealing with had no connexion with anything in the real world, not even the kind of connexion that is contained in a direct lie. Statistics were just as much a fantasy in their original version as in their rectified version. A great deal of the time you were expected to make them up out of your head.

For example, the Ministry of Plenty’s forecast had estimated the output of boots for the quarter at 145 million pairs. The actual output was given as sixty-two millions. Winston, however, in rewriting the forecast, marked the figure down to fifty-seven millions, so as to allow for the usual claim that the quota had been overfulfilled. In any case, sixty-two millions was no nearer the truth than fifty-seven millions, or than 145 millions.

Note: Yes, I'm aware that the upcoming MAGA trifecta will likely make much of this moot over the next couple of years, but that's kind of the point: To see where things stand as of this moment.

9 years ago, I compiled the best breakout I could estimate of the healthcare coverage status of the entire U.S. population, in a post (and graphic) which gained quite a bit of praise. It even (to my surprise) ended up as a finalist in the National Institute for Health Care Management (NIHCM) Digital Media Awards in 2017.

Seven years, two administrations, one federal insurrection and one global pandemic later, I figured it was time to finally update the breakout of what I've since decided to refer to as the Psychedelic Donut, and did just that in 2023.

It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

This morning the Senate HELP (Health, Education, Labor & Pensions) Committee held the 2nd round of questioning for Donald Trump's nominee to become the U.S. Health & Human Services Secretary, Robert F. Kennedy Jr.

I watched the full 3 hours of the hearing and liveposted the entire thing on Bluesky. Needless to say, there are some typos and grammatical errors, and much of what I posted is paraphrasing, but it's as accurate as I could make it in the moment:

Here comes Round 2 of RFK Jr's confirmation hearings.

Sen. Bill Cassidy (R) is the chair. Sen. Bernie Sanders (I) is the ranking member.

Nomination of Robert F. Kennedy, Jr. to serve as Secretary of Health and Human Services | The U.S. Senate Committee on Health, Education, Labor & Pensions

The U.S. Senate Committee on Health, Education, Labor & Pensions

www.help.senate.gov

I recently posted Congressional District-level breakouts of total enrollment in ACA Exchange Plans & Basic Health Plans as well as Medicare (both Fee For Service and Advantage plans). The master spreadsheet also includes enrollment in Medicaid (both ACA Expansion as well as non-Expansion) and the Children's Health Insurance Program (CHIP).

However, for no particular reason, I included the methodology for Medicaid & CHIP data in with the ACA enrollment post, since it ACA Expansion Medicaid overlaps with that.

via Covered California (by email; no link yet):

Covered California Reaches Record-Breaking 1.9M Enrollees Before Open Enrollment’s Jan. 31 Deadline

SACRAMENTO, Calif. — Covered California has surpassed 1.9 million enrollees, bolstering its record-high enrollment before open enrollment’s Jan. 31 deadline for California’s remaining uninsured.

This open enrollment, 299,060 Californians have signed up for 2025 coverage as of Jan. 26, a 13 percent increase over the same period last year.

Another 1,638,954 Californians have renewed their health insurance plans, a 10 percent jump over the same date last year, with more than 100,000 total enrollees in 2025 as compared to the record enrollment in 2024.

Combined, that's 1,938,014 QHP selections thru 1/26, or 8.6% higher than last year's final OEP tally of 1,784,653 QHPs.

It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

The first official press release from the Centers for Medicare & Medicaid Services (CMS) under the Trump 2.0 Administration is out, and not only is it pretty innocuously worded...it's actually complimentary of the Inflation Reduction Act, which is noteworthy given that the IRA was passed & signed into law exclusively by Democrats & President Biden:

CMS Statement on Lowering the Cost of Prescription Drugs

Lowering the cost of prescription drugs for Americans is a top priority of President Trump and his Administration. In accordance with the statutory requirements of the Inflation Reduction Act, the Centers for Medicare and Medicaid Services (CMS) released the list of 15 drugs selected for the second cycle of the Medicare Drug Price Negotiation Program on January 17, 2025.

Via Marisa Kabas of The Handbasket (later confirmed by various other news agencies):

Early Monday evening I received a copy of a memo that will impact thousands of institutions supported by funding from the federal government. 

A copy of the memo from the Office of Management and Budget (OMB) was provided to The Handbasket at approximately 5pm ET by a source whose anonymity is being protected for fear of professional retribution. The memo was sent to the heads of executive departments and agencies with the subject, “Temporary Pause of Agency Grant, Loan, and Other Financial Assistance Programs.” I shared the news on Bluesky at 6:04pm ET, and my reporting was confirmed by the Washington Post a few hours later.

It is a truly unhinged document that sounds like it was written by the world’s most petty 4Chan poster—but then again, that’s who’s currently running our federal government. Here’s the first paragraph to get a feel for it (emphasis mine):

It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

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