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.

HOORAY! FACE-EATING LEOPARDS FOR EVERYONE!!

I don't write a whole lot about Medicare, since just about all U.S. citizens over 65 are covered by it and therefore don't enroll via the ACA exchanges anyway. However, it does come up on this site from time to time, and a good 55 million or so are enrolled in the program, so this little story might be of some relevance:

"Possibly because of my love affair with ships and boats, the Titanic story has always fascinated and still grips me, but one scene in particular always gets to me: the sight of the ship's band, there on the decks as the ship was sinking, not panicking, not running for their life, but doing their duty by sitting there and playing and giving strength and comfort to those who were about to die with them and the lucky few in the boats."

--Jack Chalker, Dance Band on the Titanic

So, this is the type of stuff flying around Twitter today:

Wait, what? Ben Carson reportedly turned down offer to serve as HHS Secretary: https://t.co/rQBEuPRoRo

— Adrianna McIntyre (@onceuponA) November 15, 2016

Lot of buzz around Bobby Jindal for HHS Secretary right now. (See item on Trump transition.) https://t.co/LDlHkrScBb

— Dan Diamond (@ddiamond) November 15, 2016

As you may recall, there was a day or two last week where I was as despondent over the election results as anyone, and I was deeply concerned that Trump being elected—combined with his promise to join the GOP in wiping out the ACA—would cause people to abandon the currently ongoing 2017 Open Enrollment Period...thus making my pre-election projection utterly meaningless.

Instead, the exact opposite appears to be happening...or, at the very least, the election results don’t seem to be keeping anyone from signing up. Some people may be abandoning their plans to enroll via the exchange out of fear that it’s gonna get yanked away from them a few months into the new year, forcing them to scramble later...but many others seem to be realizing that the law, including the federal tax credits and CSR assistance, is still on the books and will continue to be through Jan. 20th at the very soonest...and, depending on how much squabbling and legal steps the GOP has to go through, could potentially stick around mostly as is for up to 2 more years. In any event, many have concluded that it’d be better to go ahead and sign up now so they’re covered for as long as possible.

I noted last week that contrary to my concern that OE4 might get off to a slow start due to people holding off until after the election, the early enrollment numbers appear to be right on pace with my official projections after all. In fact, the single day's worth of data provided for HealthCare.Gov ("over 100,000"* enrollments on 11/09 specifically) is 17% higher than what I was expecting it to be, although obviously that could vary widely day to day. The numbers from Minnesota are also extremely impressive, running over 6x higher than the same period last year, that's mostly due to their unique enrollment cap situation, so that's not much of an indicator of any other state.

*(Update 11:55am: This Washington Post article gives HC.gov's 11/09 tally as 105K instead of simply "over 100K").

Schindler's List

 

UPDATE 1/15/17: Reposting this given this evening's "news" that Donald Trump is "promising" to allegedly replace Obamacare (the ACA) with "insurance for everybody" in some mysterious fashion which wouldn't involve being "single payer" (assuming he even has a clue what that actually means):

Ever since Trump's stunning electoral college victory on Tuesday, there's been a lot of hand-wringing (including by myself) about the Republican Party finally getting to actually make good on their obsessive desire to kill off the Affordable Care Act.

At the same time, there's been a similar number of articles written about why doing so might be trickier than they think. Many of those articles focus on the actual legalities involved (which parts can be killed via reconciliation, which parts can't, what the timeline would be and so on), while others go into the political and economic impact of actually repealing the law and what their replacement might look like. This is what I'm writing about in this entry.

Let's revisit this post from a year and a half ago, back when the King vs. Burwell Supreme Court case was the biggest threat looming over the ACA:

As I keep noting, the DC exchange insists on presenting their enrollment numbers as cumulative since October 2013.

As a result, I have to subtract the prior numbers from the current ones to find out the net increase in QHP selections, Medicaid enrollments and SHOP enrollments.

Here's the latest update, through the end of October:

  • 262,928 people enrolled through DC Health Link in private health plans or Medicaid (includes open enrollment and SEPs):

  • 38,468 people have enrolled in private health plans through the individual and family marketplace;

  • 175,012 people have been determined eligible for Medicaid coverage; and

  • 49,448 people have been enrolled through the small business marketplace (includes Congressional enrollment)

Subtracting the prior numbers (which ran through June 10th) gives us:

As I noted yesterday, it appears that contrary to my concerns, the devastating election results aren't discouraging anyone from signing up for 2017 coverage after all. If anything they appear to have "inspired" people to scramble and sign up ASAP before the door presumably slams shut.

As a result, until I hear otherwise, I'm going to assume that the enrollment rate is tracking my original, pre-election projections...in which case this is where things should stand as of an hour ago:

I've only actually confirmed about 132,000 QHP selections so far, so obviously I could be off on either or both of the above, but I'm feeling pretty confident that if they didn't hit those numbers last night, they will have done so by this evening.

Just yesterday I noted that Minnesota's ACA exchange is full bore ahead, especially due to their unique first-come, first-serve enrollment cap cut-off for 4 of the 5 individual market carriers. They're still moving at a breakneck pace:

From MNsure today:

ST. PAUL, Minn.—More Minnesotans have shopped early and enrolled in comprehensive health care coverage though MNsure than ever before. In just the first nine days, more than 20,000 Minnesotans enrolled through the state's health care exchange. It took about six weeks to achieve this milestone last year.

The results of this week's elections do not change MNsure's focus on providing high quality customer service to Minnesotans shopping for health care coverage and encouraging Minnesotans to take advantage of the financial assistance available only through MNsure.

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