Political battles are usually won based on appealing to emotion, not to facts, policy or logic.
However, you should still have those facts at your disposal for two reasons: First, they still help you craft appeals to emotion. Second, they also help you craft the actual policy. Besides, I'm a data guy; my primary job is to help put facts & policy into easily-understandable context.
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.
Over at Evensun Health, Wesley Sanders has written about two newbulletins from the Centers for Medicare & Medicaid Services (CMS) which, if followed to their conclusion, would cause massive changes to how ACA individual market policies are priced and marketed...along with dramatic changes to net premiums, deductibles, co-pays & other out of pocket expenses for exchange enrollees.
Warning: This one is not only absurdly wonky, it requires me to fire up the Wayback Machine and dig deep into the ACA's 15-year history. I actually wrote about this prospect back in January, but I haven't read or seen anything else about it since then...until today.
There's two new stories out about where things stand with Congressional Republicans obsessive desire to gut Medicaid & kick millions of people off their healthcare coverage in order to give massive tax cuts to billionaires. The first, from Jessie Hellmann, Sandhya Raman and Olivia M. Bridges at Roll Call, has some pretty positive-sounding news:
...Johnson, R-La., said leadership had ruled out two Medicaid policies that could go a long way toward meeting the Energy and Commerce Committee’s $880 billion, 10-year savings target but faced strong pushback from blue-state GOP centrists.
First, Johnson said the emerging package wouldn’t touch the Federal Medical Assistance Percentage, or FMAP, rate — the portion of state Medicaid costs borne by the federal government — for the Medicaid expansion population, which is currently 90 percent.
Johnson also poured cold water over a provision that would implement per capita caps on Medicaid benefits for enrollees in expansion states, though he wasn’t quite as definitive on that front.
Gov. Whitmer Releases Top Lines of Alarming Report on Federal Medicaid Cuts, Finding Cuts Would Terminate Health Care for 700,000 Michiganders
MDHHS report also shows federal cuts to Medicaid will increase costs for hospitals and small businesses, and significantly strain state budget
LANSING, Mich. -- Today, Governor Gretchen Whitmer released toplines of an alarming report from the Michigan Department of Health and Human Services (MDHHS) on the impact of federal proposals to cut Medicaid. According to the new report, these proposed cuts would result in a loss of health care coverage for hundreds of thousands of Michiganders, reduce access to providers for all residents, increase financial burdens on hospitals and small businesses, and significantly strain the state’s budget.
Two years ago, with all the controversy over the frighteningly quick expansion of machine learning technology (popularly known as Artificial Intelligence (AI), even though it's not really that) over the few years into every facet of our lives, I decided to run a quick experiment using ChatGPT. My request was pretty simple:
"Write a blog post in the style of Charles Gaba."
I didn't include anything about healthcare or the Affordable Care Act...just my name.
You can see what it came back with at the link. I concluded at the time:
Aside from the fact that I'm not a pirate and don't generally use "themes" for my blog posts anyway...the larger issue here is that the text generated by ChatGPT doesn't include any specific information.
Every year around this time I start my annual individual & small group market rate filing analysis project. This involves spending months painstakingly tracking every insurance carrier rate filing for the upcoming year to determine just how much average insurance policy premiums on the individual market are projected to change.
Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need.
The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier: How many effectuated enrollees they have in ACA-compliant policies this year; the average projected rate change for those policies; and, ideally, a breakout of the rationale behind the changes.
Usually the reasons given are fairly vague things like "increased morbidity" (ie, a sicker risk pool) or the like. Sometimes, however, there's a very specific reason given for some or all of the premium changes. Major examples of this include:
In December 2024, 78.8 million individuals were enrolled in Medicaid and CHIP.
71.5 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
41.4 million adults were enrolled in Medicaid, and there were 37.4 million Medicaid child and CHIP enrollees.
Medicaid and CHIP Applications Received
In December 2024, Medicaid, CHIP, Human Services agencies, and State-based Marketplaces received 3.0 million applications, or 11 percent more applications, as compared to November 2024.
The number of applications received has increased by 30 percent since December 2023 and increased by 84 percent since December 2022.
Total Medicaid/CHIP enrollment in December 2024 dropped slightly from November, by 171,000 people or 0.2%.
With all the understandable focus on Congressional Republicans efforts to effectively end Medicaid coverage for nearly 21 million Americans enrolled via ACA expansion, there's been much less attention paid to the other looming threat to healthcare coverage: The expiration of the upgraded financial subsidies for ~24 million ACA exchange enrollees, which are currently scheduled to end this New Year's Eve.
As I've explained numerous times before, the ACA's original premium subsidy formula was always far too stingy to make individual market policies affordable for many people...and worse yet, the subsidies cut off entirely for households making more than 4 times the Federal Poverty Level (FPL).
