Categories
Government Health Insurance Healthcare

Dear Buddy Carter: Health Care Premium subsidies help people

Buddy Carter, why do you persist in sending lies in your Congressional newsletter? Isn’t the purpose of these newsletters to inform rather than misinform?

Your recent newsletter takes aim at Democrats during the shutdown. You claim that Democrats are keeping the government shutdown in order to provide subsidies for healthcare for undocumented migrants.

You wrote:

Democrats, including Schumer and Jon Ossoff, have now voted for the fourth time to shut down the government, demanding $1.5 trillion in new partisan spending, including nearly $200 billion in taxpayer-funded health care for illegal immigrants.

That partisan spending you’re talking about, is subsidies necessary to keep Affordable Care Act insurance policies affordable for primarily middle class US Citizens and lawfully present migrants. These subsidies were passed into law during the COVID epidemic but now they’re terminating at the end of 2025. This will drive up the cost of health insurance policies for US citizens and lawfully present migrants by an average of 114%. That’s well over double, which most US Citizens and lawfully present migrants can’t afford.

I keep repeating US citizens and lawfully present migrants, because the Affordable Care Act provides health insurance for US Citizens and lawfully present immigrants, only, as this fact check carefully notes.

Now, there is a law, called the Emergency Medical Treatment and Labor Act (EMTLA), signed into law by Ronald Reagan decades ago that does allocate a small amount of Medicaid funds to reimburse hospitals for treating anyone and everyone in an emergency life-saving scenario regardless of the person’s status. So, if an undocumented migrant shows up at the hospital with his hand cut off because he’s operating machinery no US citizen wants to operate, the ER has to save his life.

Now, I realize that you may prefer that this person die. I hope, though, as a country we’ve not fallen so far as to wish death on people in this country solely because of the promise of an American dream.

Regardless of the moral ambiguity of letting people die in the street, what the Democrats are pushing for has nothing to do with the EMTLA and everything to do with helping middle class folk, like your voters, afford the premiums for healthcare.

Of course, you think of me as a screaming radical leftist and therefore beneath your interest, even though you are my elected representative, which means you’re supposed to represent people like me. Still, because of your partisan approach to leading,  you may discount what I say. Well, that’s fine. So let’s look to someone else who you might find worth your time.

Let’s look to the insurance commissioner for the state of Georgia, who has joined with other insurance commissioner of every single state, in sending to Congress several letters, including the latest, pleading with Congressional members like yourself, to please continue the ACA subsidies.

For more than a year, NAIC has voiced its strong support for continuation of the enhanced premium tax credits for Marketplace coverage. The enhanced credits expire at the end of this year, but health insurance premiums for 2026 must be finalized much sooner. Health insurers have already filed their initial rates for 2026, and state regulators are poised to give them final approval in the coming weeks. We must complete this action soon in order to make plans available for the annual Open Enrollment Period that begins on November 1. Without an extension of the enhanced credits in September, insurers and marketplaces will begin to notify over 20 million consumers in all 50 states of major premium increases in
a matter of weeks.

Contrary to what Speaker of the House Johnson implies by continuing to cancel House sessions, there is an urgency to renew these subscriptions now, before it’s too late. As North Dakota’s—note, North Dakota…not a screaming leftist liberal state—insurance commissioner notes:

Democratic lawmakers say extending enhanced premium tax credits is urgent, with open enrollment weeks away. Republican lawmakers say there’s time to negotiate over a policy later, since the subsidies expire in December.

 

Who’s right?

 

“The window is rapidly closing,” says Jon Godfread, North Dakota’s insurance commissioner. He says the enhanced subsidies need to be extended before open enrollment starts Nov. 1. “Let’s do this now.”

 

If lawmakers miss that deadline, he says, “it’s going to be really, really challenging to go back [to consumers] and say, ‘OK, now we fixed it, please come back and shop at this market that you were priced out of.’ I just don’t believe consumers are going to do that.”

Again, this is about renewing the healthcare subsidies that impact on the people you represent: voters in the state of Georgia.  It is not, as you stated in your newsletter, about healthcare for undocumented immigrants. This is a lie, and you know this is a lie. It’s not as egregious as the lie Ryan Zinke told, with his claim that Democrats are somehow trying to kill the $50 billion dollar rural healthcare fund recently passed, but it’s still a lie.

And the sad thing for you is, if you don’t do something now, if Johnson doesn’t stop shutting down the House and actually work with the Democrats, people will know November 1 that you all lied.

Categories
Government Medicare Money

Georgia Social Security offices on DOGE chopping list

Recent updates to the DOGE.gov ‘savings’ page now list Social Security Administration (SSA) office closures in the following Georgia cities:

  • Columbus
  • Gainesville
  • Vidalia
  • Brunswick
  • Thomasville

There is no rhyme or reason for these closures, other than it’s a simple checkbox on a computer screen and a complete lack of concern about the consequences.

SSA offices provide opportunities for people to get help about Social Security, disability, survivor benefits, Supplemental Security Income, and Medicare. Not everyone has a computer or the skills to do everything online. In particular, if you’re a victim of identity theft, it’s likely you’ll have to visit your nearest SSA office at some point.

Most offices have so many customers, SSA initiated a pilot program for advance reservations in Florida and Georgia. Closing down this many offices is going to have a significant impact on Georgia residents. If the office closures are paired with a 50% reduction in SSA workers, the agency will not be able to meet the needs of our nation’s most vulnerable people.

And the savings? When you’re talking about 4 trillion in tax cuts, primarily for corporations and the wealthy that Trump and the Republicans want to pass, the office closure savings don’t even rate a blip on the same chart.

  • Columbus – $51,023
  • Gainesville – $506,527
  • Vidalia – $228,757
  • Brunswick – $215,383
  • Thomasville – $289,139

Today, Speaker Mike Johnson went on Meet the Press and stated that he and Musk don’t want to cut Social Security and Medicare, but want to eliminate “waste, fraud, and abuse.” Yet SSA’s Inspector General found that only about 1% of Social Security payments were improper. And even then, SSA was able to recover 60% of that amount.

Also today, Elon Musk on Jeff Rogan’s podcast claimed that Social Security is nothing more than a Ponzi scheme, and the real problem is not enough babies and we’re just living too long. What wasn’t said was an acknowledgement of the positive contributions immigrants make to Social Security.

So for there’s no indication that Savannah’s Social Security office is among those to be marked for closure. Yet. I will keep checking for DOGE cuts impacting on the Savannah area.

Categories
Government Legal, Laws, and Regs Medical

Dear Buddy Carter

Your compatriot, Rich McCormick, had a town hall recently. It did not go as well as he hoped, especially considering the continued chaos in the federal government. Still, he did what a Congressional representative should do, and met with the public he represents.

And that leads us to you. Exactly when will you meet with the people who you represent? After all, with all the federal firings and destruction of government programs, folks want to know how this is going to impact all of us.

For instance, the latest program trashed was FEMA’s input into new building standards to ensure homes are better able to withstand natural disasters. This is, after all, a win/win for everyone, including the people you represent. We’re all vulnerable to hurricanes, flooding, and strong winds.

The building industry might whine, but the 1-2% cost in construction is nothing compared to the billions, likely trillions, of dollars saved. All we can hope is that there are local and state governments intelligent enough to know that constructing homes that can’t withstand hurricanes doesn’t magically make the hurricanes go away.

Then there’s the talk about the House Budget, and the targeting of Medicaid. At least we assume the effort will target Medicaid, only…targeting Social Security and Medicare being that whole third-rail thing.

I spent some time getting to know the counties you represent. Especially the counties in the south. I discovered from various maps, including several put out by the state of Georgia that you represent counties they are some of the poorest in the state. Not only that, but many have little or no healthcare access other than some regional rural hospitals.

Yet one of the most important elements to ensure rural healthcare access is Medicaid. Because of Medicaid, hospitals and doctors are paid and can financially continue to operate. Because of Medicaid expansion, people can see doctors sooner, when it’s actually cheaper to treat them, then wait until a life-threatening crisis occurs.

Because of Medicaid expansion, many Republican voter lives have been saved. I wanted to point this out because Congressional Republicans like yourself seem to believe that Medicaid expansion only helps Democratic voters  That’s the only reason why I would think that you’d attempt to decimate Medicaid in order to pay for tax cuts for rich folk like yourself.

(You do know that no one is buying that whole tax cut thing is good for the country any more, right? Just wanting to ensure we’re communicating from the same basis of understanding.)

And the talk of work requirements for Medicaid. That’s all hogwash, and a supposedly well-informed member of a health profession would know this. Particularly a member of the health profession who also happens to represent Georgia. You only have to look at the debacle which is the Pathways to Coverage to see how true this is. Even though over 92% of adult Medicaid recipients are working, the complications associated with trying to meet the requirements actually prevents eligible people from signing up.

I suppose this is the intent, though. You can then point to the faulty Medicaid roll out as helping your citizens, at the same time you can gut the expansion and cut the costs by making the rules so arduous and complex, only 1 in 10 can survive the red tape gauntlet.

“We offered, but no one signed up!”

I’d say this is politically brilliant if I wasn’t so overcome with revulsion at the self-serving callousness of it all.

Sorry, that wasn’t very friendly, was it? And I want to be friendly. I want to encourage you to come meet with folks like me, and explain to us why what’s happening in DC is good for us.

But you will have to excuse my cynicism at times. People dying. People sick. People ruined by medical costs. People’s homes destroyed in hurricanes, federal workers lives destroyed because some 19 year old kid is now in control in various government departments….is this what you’re promising for the citizens of Georgia? If not, then there’s a simple solution to getting out the message you want Georgia citizens to hear:

Have a town hall.

Answer questions from the people you represent. Tell us why all the DOGE federal worker cuts are good, and firing people handling the bird flu outbreak is smart, or removing building standards that will actually cut billions in hurricane losses is a win. Explain how Trump can override the Congressional power of the purse and you in Congress are OK with this. Or that Trump can dissolve the independent US Postal service and fire all of its board, in contradiction of laws Republicans helped pass.

(That last one was a new one to me, and I admit even after the last four weeks, kind of knocked the breath out of me.)

We’re just plain folk here in Georgia’s First Congressional district. We’re not politicians or government experts.  We don’t understand all the complicated DC political stuff, because frankly, what’s happening in DC makes no sense to most of us.

Have a town hall. And not by phone, either. Meet us, face to face. We really want to have a talk with you.

Sources

https://www.yahoo.com/news/gop-rep-rich-mccormick-faces-044356470.html

https://www.npr.org/2025/02/20/nx-s1-5303478/fema-trump-building-codes-floods-hurricane-disasters

https://www.npr.org/sections/shots-health-news/2025/02/20/nx-s1-5303475/republicans-medicaid-cuts-trump-hospitals

https://hdpulse.nimhd.nih.gov/data-portal/social/map?age=001&age_options=ageall_1&demo=00007&demo_options=poverty_3&race=00&race_options=race_7&sex=0&sex_options=sexboth_1&socialtopic=080&socialtopic_options=social_6&statefips=13&statefips_options=area_states

https://www2.census.gov/geo/maps/cong_dist/cd115/cd_based/ST13/CD115_GA01.pdf

https://dch.georgia.gov/divisionsoffices/state-office-rural-health/sorh-maps-georgia

https://www.nbcnews.com/politics/doge/usda-accidentally-fired-officials-bird-flu-rehire-rcna192716

https://www.cnn.com/2025/02/21/business/trump-postal-service-privatization/index.html

Categories
Doctors Government Health Insurance Just Shelley Medical Medicare Political

Well now, 2024 didn’t go quite as we planned

I was, and I was not, surprised by Trump’s re-election.

I knew there were too many men who would normally vote Democrat who balk at electing a women to be Commander-in-Chief; particularly a Black/Asian woman. I knew that thanks to the rebound from COVID that prices are high—aided and abetted by corporations using COVID as an excuse to squeeze even more profits from the masses. I also knew that the media had done a poor job of holding Trump accountable, while at the same time blowing up any and all perceived Democratic weakness.

Still, I was not emotionally or mentally prepared for Trump to win again. Worse, to actually get the popular vote, though he ended up with less than 50% of the vote.

So, OK. It is what it is. So what am I planning on doing about it?

Speak truth. Or, more comprehensively, tap into any and all changes reflected in Trump’s administration and be prepared to write about as many as possible. And to continue monitoring court cases, especially in courts tainted by Trump-appointed judges.

However, on the way to this writing goal, real life intruded. Suddenly, a month ago, I started getting a visual distortion in the center of my ‘good’ eye (the one that doesn’t have the cataract that needed removing).

I first saw my optometrist, since I had a previously scheduled appointment. She noted I needed cataract surgery but couldn’t tell, or hesitated to tell me, what was happening to my central vision. She referred me to an eye clinic.

When the clinic didn’t call by week’s end, I called up and said, this is something that can’t wait and I needed to come in. They got me in that afternoon.

Evidently, I have a hole in my macula (macular hole). This is a rare occurrence, impacting on 7.8 people per 100,000. It happens when the vitreous pulls aware from the retina—very common with older folk—but instead of pulling away cleanly, it rips a hole in the macula.

We caught it small and the usual procedure is to wait a few months to see if it closes back up naturally (unfortunately, unlikely to happen). In addition, I have to have cataracts in both eyes removed: the one because it’s pretty bad, the other because the retinal surgeon needs a clear view of my eye for retinal surgery (don’t ask for details on this one).

For now, I have my monitor set to 300% resolution, and I can read and write, but it’s not always easy. It should improve with the first cataract removal, but vision may be a challenge after surgery to fix the macula for a few months at least. We’ll have to see.

I still plan on watchdogging the Trump administration and the courts as much as possible, but I’m also adding in some coverage of our medical industry, particularly in Georgia. Knowledge is power, and it’s too easy to feel powerless when you’re hit with a serious medical condition.

Besides, there’s nothing more wonky than exploring the depths of Medicare, medicine, doctors, and health insurance. And I enjoy the wonky.