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.
A week or so ago the Centers for Medicare & Medicaid Services (CMS) issued a semi-final 2025 ACA Open Enrollment Period report, which noted that 23.6 million Americans had selected 2025 plan year coverage via the various ACA marketplaces since November 1st...as of either January 4th or December 28th, depending on the state.
Those thru dates are important, of course, because the 2025 OEP was still ongoing in every state except Idaho at the time...and in fact it's still going on in several of them, including CA, DC, MA, NJ, NY, RI & VA. In some of these states the final deadline is still up to 2 weeks away.
The 2025 ACA Open Enrollment Period (OEP) officially begins on November 1st.
This is the best OEP ever for the ACA for several reasons:
The expanded/enhanced premium subsidies first introduced in 2021 via the American Rescue Plan, which make premiums more affordable for those who already qualified while expanding eligibility to millions who weren't previously eligible, are continuing through the end of 2025 via the Inflation Reduction Act;
A dozen states are either launching, continuing or expanding their own state-based subsidy programs to make ACA plans even more affordable for their enrollees;
Update 12/09/24: As expected, a federal court has shot down the eligibility of DACA recipients to enroll in ACA exchange coverage in the 19 states involved in the lawsuit. In theory the roughly 2/3 of DACA recipients living in the other 31 states +DC should still be eligible.
And remember, millions of people will be eligible for zero premium comprehensive major medical policies.
If you've never enrolled in an ACA healthcare policy before, or if you looked into it a few years back but weren't impressed, please give it another shot now. Thanks to these major improvements it's a whole different ballgame.
Here's some important things to know when you #GetCovered for 2025:
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:
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:
Below I'm posting a similar breakout of total ACA Medicaid Expansion enrollment from January 2014 - June 2024, via the Centers for Medicare & Medicaid Services quarterly Medicaid Budget & Expenditure System reports (warning: That link could be broken or blank by the time you read this under the Trump Administration).
Unfortunately, the MBES reports currently only run through June of last year, so the last half of the year is missing.
No further analysis or comment here; I just think this is a pretty cool graphic...and keep in mind that most of the people represented here would have been utterly screwed from early 2020 - early 2023 without the Affordable Care Act being in place when the pandemic hit.
Click the image for a higher-resolution version. I'm not bothering to include the state labels since some would be too difficult to make out, but it starts with Alaska at the bottom and works its way up to West Virginia at the top (remember, neither Alabama nor Wisconsin or Wyoming have expanded Medicaid under the ACA). It also includes Guam, Puerto Rico and the U.S. Virgin Islands.
There's still likely up to perhaps ~30,000 or so Qualified Health Plan (QHP) enrollments to be added to the 2025 Open Enrollment Period (OEP) tally from the states which haven't reported their final, data (in fact, CA, DC, NJ, NY & RI haven't ended theirs yet), but I decided to throw this together today for the hell of it.
The table below charts the the first twelve years of ACA Open Enrollment Periods, broken out by state. I've also included Basic Health Plan (BHP) enrollment in Minnesota, New York and (new last summer) Oregon, the only states where BHP programs have been implemented to date.
No further analysis or comment here; I just think this is a pretty cool graphic which demonstrates visually how the ACA has grown over time to become firmly embedded into the U.S. healthcare landscape. Source: CMS Marketplace Open Enrollment Period Public Use Files for 2014 - 2024; Semi-final OEP Snapshot Report for 2025 (along with some nominal updates from a few of the state-based exchanges):
Connect for Health Colorado Sets a New Record: 282,483 People Enrolled in Health Insurance for Plan Year 2025
Denver, Colo. – Connect for Health Colorado, the state’s official health insurance marketplace, announced today a record 282,483 Coloradans have enrolled in health insurance for plan year 2025, with 80% receiving financial assistance to reduce the cost of their premiums.
The total number of people who enrolled in health insurance plans for 2025 is 19% higher than the number who enrolled in 2024.
Over 110,000 Nevadans got enrolled, marking the largest enrollment in the history of Nevada’s marketplace
CARSON CITY, Nev. – Nevada Health Link has achieved a historic milestone this year with its record-setting Open Enrollment Period for Plan Year 2025. With over 110,000 Nevadans enrolling in affordable and comprehensive health and dental coverage through the state-based marketplace, this achievement underscores the critical importance of providing accessible and affordable health insurance options to Nevadans across the state.
“Reaching the highest enrollment numbers in Nevada Health Link’s history is a milestone we’re incredibly proud of,” said Russell Cook, Executive Director of Nevada Health Link. “Health insurance is more than just a safety net in case of a medical emergency – it's peace of mind, financial security, and, ultimately, a pathway to better health outcomes for individuals and families across our state. This record-setting enrollment underscores the importance of our mission to prioritize the well-being of Nevada’s communities.”
