going to be. why? it's because we created private-sector competition. we didn't create government plans. it probably would have been much easier just to say, okay, we're going to supply a benefit for every senior in the country. i can assure you had we done that, we would have been well over what we projected the annual cost to be. but we're 50% under because we have private-sector entrepreneur companies that are out there competing for the business, that are smart enough to look at the type of coverage and they're custom designing it to meet the needs of seniors in this country. i dare say that the current health care plan that's going to be implemented and fully executed by 2014 was not personalized for anybody in this country. it looks at a 17-year-old the same way as it does a 77-year-old. yet, the health challenges, the

income are different for both ends of the spectrum. and that's because government can't look at us as individuals. they can't group us and design something that addresses not just the coverage needs, but the cost long term and the solvency. so, we only have one choice, and that's to fix the things that are broken. and it's amazing how there's great agreement on those things that would be damaging long term and those things that are actually positive and move the ball in the right direction. mr. enzi: that prescription part-d actually drove down the cost of medication and now we're ending up in a situation where part of that will be in trouble because of what's happened to medicare with $500 billion being stolen. i see that we've been joined by the senator from utah, senator lee. utah has had a health care system there that's been a model for other states and now is possibly in jeopardy. i don't know if you'd care to comment on medicare or on that.

we appreciate your comments. mr. lee: utah does indeed have a health care system that functions well. it functions well not withstanding the fact that it's not managed. it's not governed by the federal government. this is one of the great wonders of our federal system. you know, when we became a country about 200-plus years ago, we did so against the backdrop that's informative for us still today. we became a country in part because we discovered through trial and error, through our experience as british colonies that local self-rule works best. people govern themselves much better than a large distant government can govern them. that's exactly why we became a country is because we learned that local self-rule works, and

we learned also that there is great change to our individual liberty with any government, because whenever any government acts, whenever it does anything to regulate our lives, it does so at the expense of our individual liberty. we become less free by degrees whenever government does just about anything. but the risk to our liberty is especially great, it's at its highest when the government acting is a large one, when it's a national government. national governments, as we learned in our experience with our national government before we became a country, our national government that was then based in london, national governments tend to tax us too much, they tend to regulate us too heavily, they tend to be inefficient, they tend to be slow to respond to our needs in part because they are operating so distantly from where many of the people reside. and so when we became a country, we left most of the powers at the state and the local level. we eventually came up with this

document, this almost 225-year-old document that has fostered the development of the greatest civilization the world has ever known, and in that document, we came up with a list of powers that a national government must have in order to survive. and we kept that list fairly limited. we said the national government needs to have the power to provide for our national defense, to regulate commerce or trade between the states and with foreign nations and with the indian tribes, to protect trademarks, copyrights and patents to establish a uniformed system of weights and measures, to come up with a system of bankruptcy laws, laws governing immigration and naturalization, and a few other powers, but, you know, that's basically it. there is no power in this document that gives our national government, that gives us, congress, as a national legislature the power to regulate anything and everything. there is nothing in this document that gives congress what jurists and political

scientists refer to as general police powers. that is, just the power to come up with any law that congress might deem just and good and appropriate and advisable at any moment. and that, again, was because of the calculated assessment made by the founding generation that we needed a government possessing only limited, enumerated powers, protecting individual liberty and to ensure that we in america could continue to live as free individuals. over time, we have drifted somewhat in our understanding of what those powers mean. over the last 75 years, the supreme court has been applying a really deferential standard toward congress in reviewing laws enacted under the commerce clause, clause 3 of article 1, section 8. the supreme court has since about 1937, at least since 1942, said that congress may regulate without interference from the

courts under the commerce clause, activities that when measured in the aggregate, when replicated across every state could be said substantially to affect interstate commerce. that's more or less the guideline that the court has given us. they are not necessarily saying that anything and everything that fits within that is necessarily within the letter and the expired of the constitution, but that at least insofar as the courts are concerned, insofar as the courts have been willing to step in and validate or invalidate, that will be what guides the courts in making that assessment. beyond that, the debate has to be hammered out within the halls of congress. now, the affordable care act, also known as obamacare, contains an individual health insurance mandate that takes congress' powers to a whole new level. for the first time in american history, our national legislature has required every american in every part of this

country to purchase a particular product. not just any product, but health insurance. not just any health insurance, but that specific kind of health insurance that congress in its wisdom deemed appropriate and necessary for every american to buy. this is absolutely without precedent. it is also, i believe, not defensible. even under the broad deferential standard that has been applied by the united states supreme court since the late 1930's and early 1940's. among other things, the limits that have been maintained by the supreme court, notwithstanding its deference to congress dunder the commerce clause, have been limbed by a few principles. first, the supreme court has continued to insist that although some intrastate activities will be regulated by congress under the commerce clause, some activities

occurring entirely in one state, activities that historically would have been regarded as the exclusive domain of states, activities like labor, manufacturing, agriculture, mining, although some activities might be covered by congress, those activities at a minimum have to be activities that impose a substantial burden or obstruction on interstate commerce or on congress' regulation of interstate commerce. the supreme court has also continued to insist that the activity in question that's being regulated needs to be activity, first of all, and not inactivity, but it also needs to involve economic activity in most circumstances, unless, of course, it is the kind of activity that while ostensibly noneconomic, by its very nature undercuts a larger comprehensive regulation of activity that is itself economic.

finally, the supreme court has continued to insist time and time and time again that congress cannot in the name of regulating interstate commerce effectively obliterate the distinction between what is national and what is local. now, the afford care act through its individual mandate effectively blows past each and every one of these restrictions, restrictions that even under the broad deferential approach that the supreme court has taken toward the regulation of commerce by congress over the last 75 years or so, even the supreme court, even under these broad standards isn't willing to go this far. there are very good reasons for that, and those reasons have to do with our individual liberty. they have to do with the fact that americans were always intended to live free, and they understood that they are more likely to be free when decisions

of great importance need to be hammered out at the state and at the local level. that is, unless those decisions have been specifically delegated to congress. specifically designated as national responsibilities. this one is not. decisions about where you go to the doctor and how you're going to pay for it are not decisions that are national in nature, according to the text and spirit and letter and history and understanding of the constitution. they are not and they cannot be. if in this instance we say well, this is just important so we need to allow congress to act, if we do that, we do so at our own peril. we stand to lose a great deal if all of a sudden we allow congress to regulate something that is not economic activity. in fact, it's not activity at all. it's inaction. it's a decision by an individual

person whether to purchase anything, whether to purchase health insurance, or if so, what kind of health insurance to purchase. our very liberties are at stake, and that's why i find this concerning. the presiding officer: the senator's time is expired. mr. enzi: i would ask unanimous consent that we get another two minutes. the presiding officer: without objection. mr. enzi: thank you, mr. chairman. i thought i had two more minutes. i appreciate the comments. this is the anniversary, the two years of passing what is the so-called affordable patient care act. the court, the supreme court has chosen next week to begin the deliberations on it. they are going to take three times as long as they do on any case so that they can divide this up into pieces, and that mandate piece will be the second one. one that they probably won't be going into is this medicare problem. we're going to have seniors that are going to be without care

because we have taken $500 billion out of medicare when it needed a doc fix, a whole bunch of other things. particularly in rural areas, rural health clinics. can any reasonable person believe that you can cut a half a trillion dollars from a program and not -- and not affect its impact on patient care? i'd like to have more time. i would ask that all my remarks be -- i have a prepared statement that be a part of the record to show there is this left, there is fraud involved, that there floor. mr. franken: madam president? the presiding officer: the senator from minnesota. mr. franken: thank you, madam president. i'd like to associate myself with the words of the senator from california and commend her for the tremendous work she did on the transportation bill, a bipartisan bill that passed overwhelmingly here in the senate. madam president, i'd like to join many of my colleagues who

this week are talking each a little bit about the affordable care act which tomorrow celebrates its second anniversary of being signed into law by the president. even though the law won't be fully implemented until 2014, millions of americans and minnesotans are already enjoying benefits from important provisions in the law. for example, no child in minnesota, no child in new hampshire, no child in america can now be denied health insurance coverage because he or she has a preexisting condition. parents across minnesota and around the country can sleep a little bit easier knowing that if their child gets sick,

they'll still be able to get the health coverage they need. that's a big deal. speaking of parents, young adults can now stay on their parents' health insurance until they're 26, thanks to the affordable care act, 32,189 young adults in minnesota are now insured on their parents' policy. because of this law, health insurance companies can no longer impose lifetime limits on health benefits. just a few weeks ago i heard from a minnesotan in his 30's with hemophilia. he had already hit his lifetime cap three times. but because of the health reform law, he still has insurance. and no american can ever again

have their health insurance taken away from them because they've reached some arbitrary lifetime limit. and i am proud of that. now let's talk about seniors. i go to a lot of senior stph*ets around my -- i go to a lot of senior centers around my state. i know the presiding officer goes to senior citizen centers around new hampshire. because of the health care law, more than 57,000 seniors in minnesota receive a 50% discount on their covered brand name prescription drugs when they hit the doughnut hole, and an average savings of $590 per senior. by 2020, the law will close the doughnut hole entirely. you know who likes that? seniors. you know what else seniors like? the fact that in 2011, 424,000

minnesota ans received mammograms and free wellness visits with their doctors. i could go on and on about what we've already gained but i want to talk a little bit about a provision that i wrote with the catchy name medical loss ratio, which is sometimes called the 80-20 rule because of my medical loss ratio provision, which i based on a minnesota law. health insurance companies must spend 80% to 85% of their premiums on actual health care. this is 85% for large group policies. 80% for small-group and individual policies. they must spend 85 -- large groups, 80%.

and small group and individual policies on actual health care, not on administrative costs, not on marketing, advertisements, not on c.e.o. salaries, not on profits. but on actual health care. and we've already heard the medical loss ratio provision is working. plans are already lowering premiums in order so that the companies can comply with the law. for example, aetna in connecticut lowered their premiums on an average of 10% because of this provision in the law. another key provision in the law is the value index. the value index rewards doctors for the quality of the care that they deliver, not the quantity. for the value of the care, not

the volume. my home state, minnesota, is a leader, if not the leader, in delivering high-value care at a low, relatively low cost. and traditionally, we in minnesota are, our health providers have been well underreimbursed for it. for example, texas gets reimbursed 50% more per medicare patient than minnesota does. now, this isn't about pitting minnesota against texas or florida. it's about rewarding those states, those low-valued states to become more like minnesota. imagine if we brought down medicare expenditures by 30%

around the country. while increasing its effectiveness. it will bring enormous benefits not just to minnesota, but across the country because it will bring down the cost of health care delivery nationwide. that's what we need to be addressing, the cost of health care delivery. because we all know that bringing down health care costs is key to getting our long deficits in order. in fact, there's probably nothing more important that we can do, and that's where the value index is so important. i've gone over a number of the benefits of health care reform that have kicked in but i obviously didn't mention them all. for example, health care reform is already adding jobs to our

economy. according to something called the "wall street "wall street j" i barely touched on the great stuff that kicks in in 2014, like the exchanges, which will allow individuals and small businesses to pool with others to get more affordable health insurance if it's the right fit for them. and of course while presently no child can be denied health insurance for a preexisting condition, starting in 2014, no american will be denied health insurance or penalized for having a preexisting condition. the congressional budget office, a nonpartisan agency of congress, has crunched the numbers and reported that the affordable care act will insure

31 million additional americans and bring down our national deficit by billions of dollars in its first ten years and by approximately $1 trillion in the second ten. i ask the american people not to fall victim to this information. there are no death panels. the affordable care act cuts the deficit. under this law, businesses under 50 employees don't have to provide insurance for their employees, and won't suffer penalties if they don't. they won't have to pay fines and won't be dragged in to prison. there is so much junk, so much junk out there that is just plain false.

and it's just doing everyone in this country a giant disservice. mapped, my colleagues and i disagree on many things. can we all at least agree to talk about this law in a factual manner? the benefits of this law are tremendous, and americans across the country are already experiencing them. i urge all my colleagues to acknowledge these benefits and to support the continued implementation of the patient protection madam president? the presiding officer: the senator from mississippi. mr. wicker: we are in morning business, are we not? the presiding officer: we are. mr. wicker: i rise to speak on the second-year anniversary of the health care patient protection and affordable care law. i will be joined shortly by a few of my colleagues. i would ask unanimous consent

that at that point we engage in a colloquy. the presiding officer: without objection. mr. wicker: thank you. madam president, on friday of this week, two years will have passed since president obama signed the patient protection and affordable care act into law. this actually is a sad anniversary, because more than enough time has gone by to reveal the failures of this massive, burdensome piece of legislation. the fact that 26 of our 50 states, more than half of the states, are part of the legal challenge currently under review by the supreme court points out the inevitable truth. this is a law that simply does not work. the case which will be argued in a few days will be one of the most consequential supreme court cases of my lifetime. consequential not only because it deals with this massive,

burdensome piece of legislation, but because the implications goes so much further. the implications of this supreme court case will decide the scope of the commerce clause. and, indeed, madam president and my colleagues, if the supreme court decides that this law can withstand constitutional scrutiny, then this large, massive federal government can in fact do almost anything. there will in fact be hardly any limitations under the constitution in the bill of rights on the power of the united states federal government. americans are right to be disappointed with obamacare, and they're right to want to repeal. and regardless of the outcome of the supreme court case, this congress can decide -- and as a matter of fact, the people of the united states will have a chance in november, as we do every two years, to decide.

a recent gallup poll shows that twice as many americans think the law will make things worse for their families than those who believe it will make things better. 72% of americans believe the individual mandate is unconstitutional. the truth is that americans deserve affordable, high-quality health care. not a 2,700-page, big-government piece of legislation that taxes, spends and regulates. the president's health care law has not lowered the cost of health care as promised. it has not created jobs as promised. it has not reduced the deficit as promised. and so, this week we mark an anniversary, not with progress but with bitter realities. president obama and his joint session to congress in 2009

assert that his plan -- quote -- "will slow the growth of health care costs for our families, our businesses and our government." in fact, last week the nonpartisan congressional budget office and joint committee on taxation updated their outlook of the health care laws' impact on the federal government. not surprisingly, their latest analysis says obamacare will cost even more than anticipated. and the anticipated costs were high indeed. but they say that the health care law will cost nearly $1.8 trillion over the next decade, or double the estimated cost that accompanied the bill when democratic majorities, democratic super majorities passed it in 2010. this is hardly the relief that president obama promised. during his campaign, the president said the plan would

reduce health care premiums by an average of $2,500 per family. instead premiums have grown by nearly that much since he was elected. i see i'm joined here by two of my colleagues, the distinguished senator from wyoming and the distinguished senator from kansas. there are a number of other promises that we can talk about today. i will -- i know we don't impugn motives around here. it's against the rules. but one has to wonder did advocates of this massive law actually believe these promises or were they simply duped and mislead? and i don't know which is worse. but i know that my colleague, dr. barrasso, himself a physician, who is on the front line of this issue, has griffin this a great deal of thought.

so at this point i ask him to join into this colloquy. mr. barrasso: madam president, i stand here with my friend and colleague from mississippi because he and i both attended in his home state of mississippi, a meeting at a hospital where we met with doctors, also met with patients, met with people from the community while the debate and the discussion was being conducted about this health care law. at the time people were asking the sorts of questions because they had heard the promises. would this actually lower the cost of insurance by $2,500 a family? that's what people wanted. that's what they expected. the other question: will i really be able to keep the care that i have and the doctor that i have if i like it? now here we are a couple of years later, the second anniversary of this health care law being passed, and i'm here with my friend and colleague from mississippi, and it just seems to me that the questions

that were asked by your constituents, by the doctors in those communities who take care of the patients, by the patients, the hospital administrators that we talked to that day in his home state of mississippi, and it does seem that many of these promises have been broken. the costs seem to go up higher than had this health care law not been passed at all. the numbers and the statistics that we're hearing now from the budget office on the cost seem to be much, much higher than what the president promised. parts of this health care lawmakers the so-called class act -- law, the so-called class act, it comes out with schemes to make it seem like the cost of the health care law would be much less than what the american people now know it to be. it's no surprise to me -- and i see this in wyoming and i'm sure you see it in mississippi, and i would imagine the senator from kansas who is on the floor, has

seen the same thing at home. he has gone to hospitals, in just about every hospital in the state of kansas as he's traveled around. what we're all seeing is this health care law is even less popular now than when it was passed. that's what i hear at town hall meetings. when i ask do you think you're going to actually pay more under the health care law, every hand goes up. when you say do you think the quality and available of your -- availability of your own care at home is going to go down? again every hand goes up. if i could ask my colleague from kansas if he's hearing the same things. then i know we're also joined by the senator from arizona. mr. moran: i appreciate the opportunity to join my colleagues on the senate floor today, especially the senator from wyoming, a doctor, who is such an expert on the topic of really not just the moment, not just the day, but the topic of what our country faces. i would tell you that i do spend a lot of time in hospitals across our state talking to health care providers, talk to go patients, to doctors, to

administrators, trustees. in fact, there's 128 hospitals in our state. i have visited all of them. and there is just genuine concern about the future of the ability for health care to be delivered in communities across our state. and you add to that the physician and other health care provider community, this health care reform act is creating significant challenges. my interest in public service started a long time ago with the belief that we live our lives in rural america, in my state of kansas, in a pretty special way. when i came to congress, it became clear to me that if our communities were going to have a future that it was dependent upon the ability to deliver health care close to home. and those rural communities across our nation often have high proportions of senior citizen populations where medicare is the primary determining factor of whether or not they can access health care. and so when the affordable care act was passed, many promises

were made. but one of the things that was sold to the american people, or at least the attempt was made to sell to the american people was there will be greater access. i would certainly say that one of the promises that is not being kept about the affordable care act is the likelihood that there is going to be greater access for americans across our country to health care. because this bill is underfunded, it's not paid for. the consequences are that the administration is already proposing, congress will always be looking for ways to reduce spending when it comes to health care. and the most lickly target is the payments that medicare phaeuplts -- makes to health care providers which sometimes doesn't cover the services. when we look for access to health care, every time a decision will be made in order to try to make this more affordable, we're going to see fewer and fewer providers able to provide the services

necessary to folks across the country, but especially in rural communities where 60, 70, 80, even 90% of the patients admitted to the hospital are on medicare. one of the problems with the affordable care act is the reality that it will reduce the access to health care by people who live in rural america. and we will see fewer physicians accepting patients on medicare. we will see fewer hospital doors remain open, all done in a way that, as this bill takes $500 billion out of medicare to begin with, we set, the congress that passed this, the president who signed this legislation set the stage for there to be less affordable health care available to americans across the country, but especially for constituents of mine who live in a rural state like kansas. mr. wicker: if i could jump in on the issue of medicare, because i have a quote here from president obama, july 29, 2009,

quoting specifically from the president. medicare is a government program, but don't worry, i'm not going to touch it. as a matter of fact, only months later, he signed into law the obamacare act which takes half a trillion dollars from medicare and it touches on the very issue that the senator from kansas was referring to with regard to medicare access for people in rural kansas. i yield to my friend from -- mr. mccain: i point out to my friend from mississippi that the first amendment we had on the floor of the senate when we were considering obamacare was to restore that $500 billion and it was voted down on a party-line basis. i want to thank my friends for allowing me to engage in this colloquy. i'd like to discuss with my friends, probably in my view what really encapsulates the problems with this legislation.

the commitment began was that we would provide affordable health care to all americans, which meant we had to put a brake on inflation in health care because health care was becoming unaffordable, the highest quality health care in the world. nothing in my view -- i'd like to ask my colleagues -- describes that more of how this whole plan went awry than the so-called class act. late in the debate, the class act was thrown in to provide long-term care for seniors, which seems like a worthy cause, but the whole thing was a gimmick. it was described by senator conrad, our distinguished chairman of the budget committee, called it a ponzi scheme of the first order, the kind of thing that bernie madoff would have been proud of. so they foisted that off on us. why? well, initially because of c.b.o. scoring that it would

show an increase in finances into -- and revenues into the whole obamacare program. but as soon as those people paying in became eligible, then obviously the reverse happened. thank god for senator gregg, former senator of hall of fame, who had an adopted -- amendment adopted that said the program would be solvent over 75 years before the program could be implemented. if it hadn't been for that, the class act would be here today. and then in october, last october, the secretary of health and human services issued a report confirming that what many of us knew was inevitable, that the secretary could not certify. the class act solvency is required under law. here we went through this exercise franticcally searching for ways to increase revenue, at

least the way that c.b.o. does scoring, so we did the class act, and thank god senator gregg of new hampshire put in an amendment that said it would be viable over 75 years. there is no way. not a snowball's chance that they were ever going to be able to certify over 75 years that it was going to be a viable program. so it was kind of entertaining. guess what late on a friday night the secretary of health and human services said that she could not certify that the program would be solvency throughout a 75-year period. so the result of this was obviously that they didn't have the false revenues that c.b.o. could score, they didn't have a program that could provide long-term care for seniors, and again, as the senator from north dakota aptly pointed out, this ponzi scheme of the first order

faced and met a well-deserved death. but that's why the american people, the overwhelming majority of the american people, disapprove of this whole exercise, disapprove of obamacare. they want it repealed, they don't support it, and i'm proud to say that in this election, we will decide whether we repeal and replace obamacare or not, and the american people care about it. mr. wicker: let me summarize what the senator from arizona has just said. the class act was sold to the american people as a budget deficit reducer. it was going to reduce the deficit. no sooner was it signed and they started looking at it that the administration itself said we know it's unworkable and we abandon it, we're not even going to try to enforce it. that's the result. mr. mccain: they would have

kept it on the books had it not been for the amendment of the senator from new hampshire that said they had to certify that it would be solvent over a 75-year period. now, if it hadn't been for that amendment, we would have the class act today, a ponzi scheme in being where people are paying in and that is scored as revenues, and then some years later when they retire, obviously, the reverse would have been true. and i have yet to hear one of my colleagues come over and admit that they were wrong about the class act. i'd love to hear some of those who strongly advocated for it. my friend from iowa, senator harkin, said so we get a lot of bangs for the buck as one might say with the class act that we have in this bill. senator whitehouse said certain colleagues on the other side of the aisle have argued that the class plan would lead to a financially unstable entitlement program and would rapidly increase the federal deficit. that is simply not accurate. i look forward to my colleagues

who supported and voted for the class act to come over and agree that it was, as senator conrad pointed out, a ponzi scheme. mr. wicker: i know our friend from south dakota has joined us and is eager to join in this discussion, so i wonder if he has anything he would like to add about the broken promises that were made during the passage of obamacare. mr. mccain: let me just say, the point is, the whole point of reforming health care was to reduce the costs of health care. that was the -- that was the goal. we all know we cannot sustain, medicare cannot be sustained for the american people if the inflation associated with health care continues. so the whole object of this game was to reduce the costs of health care and preserve the quality of health care. does anybody think that that was achieved with this legislation? that's why the american people have figured it out. i'd ask the senator from south

dakota. mr. thune: i would just echo what the senator from arizona has said about the class act. he was down here as was i and i think many of us when we were debating this to say this is a program that is destined to be bankrupt. in fact, if you look at what even the independent medicare actuary was saying, that was described, the class act was, as unworkable, and they said it would collapse in short order within the health and human services department, there was a nonpartisan career staff who privately called the class program -- quote -- a recipe for disaster, end quote. there was plenty of advance warning that this thing wasn't going to work. as the senator from arizona correctly pointed out, it was used as a gimmick to make the overall cost of this thing look less and therefore bring it into balance. we now know, of course, that the class act couldn't work. they have had to acknowledge that and the amendment that was put on by the senator from new hampshire, senator gregg, that forced them to certify and made that abundantly clear. but to the senator from mississippi's point, the whole purpose of the exercise was we

have got to do something about the cost of health care. we have got to get health care costs down for people in this country. in fact, the president of the united states when he was running for president said, and i quote -- "if you have got health insurance, we're going to work with you to lower your premiums by $2,500 per family per year. we won't wait 20 years from now to do it or ten years to do it. we will do it by the end of my first term as president of the united states." end quote. i'm sure the senator from arizona probably remembers very well many of these statements. but the facts tell a different story, madam president. if you look at what health care costs are doing and even what was predicted by the congressional budget office, they said that the law was going to increase health insurance premiums by 10% to 13%, which means that families purchasing coverage on their own were going to have to pay an additional $2,100 a year more because of the new law. that's actually been borne out. if you look at the cost of health insurance for people in this country today, it's gone

up, not down. it's gone up dramatically since the president took office, about 25% for most americans. so all these promises about getting costs under control, all the promises about being able to keep what you have, all the promises about, you know, this being done in a way that would protect medicare, we all know that medicare was slashed to the tune when it's fully implemented of a trillion dollars. and if you look at the taxes that were imposed by this, a trillion dollars in new taxes, the american people got a bad, bad deal. they know it. that's why the public opinion polls show that. mr. mccain: even though we have shut down the office, the class act, even though the secretary of health and human services has said that they can't certify that it will be fiscally sustainable over 75 years, it's still on the books. isn't the class act still on the books? do you think that it might be appropriate since we can't

comply with the law that maybe we could repeal that portion of the law? would that be something we might think about? in fact, i think it might be a pretty good amendment. mr. thune: a good amendment. and by the way, we have that amendment. we would be happy to offer it. we tried to call the bill up. it was objected to by the democrats to get rid of it. because the bad thing about bad ideas around here is they tend to come back. this is a bad idea that ought to be put away once and for all, and yet it is on the books, as the senator from arizona has pointed out. i don't know why after all the evidence out there now that has been put forward, including the health and human services secretary saying this will not work, we continue to maintain this on the books in hopes i think that for some at least in the administration that it can be resurrected at some point in the future. but this is a bad idea. it was a bad idea then, it will be a bad idea in the future, because it can't -- it just doesn't pencil out.

you cannot make it work. the only thing it does is saddle future generations with massive amounts of debt. mr. wicker: let me ask my colleagues about another promise. i know they are going to call time on us in just a few moments. does anybody recall hearing this staple from the president of the united states in 2009 -- if you like your health care plan, you will be able to keep your health care plan, period. no one will take it away, no matter what. unquote, the president of the united states, june 15, 2009. what happened to that one? mr. barrasso: even the administration admits that wasn't true. small businesses, people who get their insurance through small businesses are going to have a very difficult time continuing to provide coverage for people because of the mandates, the washington mandates that say you have to provide washington-approved insurance. i mean, that's the problem, is that people have what they like. it may be something that they

want, that they need, they can afford, and now they are being mandated to have something that they may not want, may not need and may not be able to afford. so, again, you have another broken promise, which is why senator coburn who has practiced medicine for about a quarter of a century -- and i practiced medicine for about a quarter of a century, have come out with a report released yesterday, called warning, side effects, a checkup on the federal health law. fewer choices. that means people can't choose to even keep what they had. fewer choices, higher taxes, more government, less innovation. none of those things are the things that the american people have been promised by the president. mr. mccain: in addition to that, could i ask the senator how many new regulations have been issued and how many new regulations do we anticipate as a result of this legislation? mr. barrasso: from the looks of this over 2,000-page law is going to result in over 100,000 pages of regulations, pages worth of regulations. i know there is one part of the law, a couple of pages, four to

six pages, they had 400 pages of regulations and 50 pages of legal guidance. you talk to hospitals, and i know that those of us travel and visit with hospitals in our states. they say we're spending money on consultants and lawyers to help us understand the law, and it's money we ought to be spending on patients and on equipment and on technology for our hospital to provide care in our community. the senator from kansas has visited over a hundred hospitals in his state. i think he's heard exactly the same thing. mr. moran: it's certainly true. the point that was made earlier about benning this cost curve down, it doesn't do it, it can't do it. that creates the problem that we now all face, how do we have access to affordable health care if you're not reducing the cost of health care. and so the end result, in my view, is that americans will have less options, less options for their own plans. as employers, they will provide

either less options or no options for employees. so the idea that you're going to get what you -- keep what you have, that begins to disappear if you're employed. if you're a senior citizen and medicare has been your primary provider, again back to this idea we didn't bend the cost curve, so in order to make health care affordable, when the legislation fails to do that, we find other gimmicks to do that. and one of the things that this bill creates is ipab, this so-called independent agency that is going to make decisions about what is covered by your health care plan, and the goal will not be to be better quality health care. the goal of the ipab will be to reduce expenditures. so as the promise was made you get to keep what you have, it becomes something totally different than what you experienced in your health care plan, either in your own private health care insurance or as a beneficiary of medicare. and so even though presidents

own medical actuary estimates that the law will increase overall national health care expenditures by $311 billion during the first ten years alone and that private health care insurance premiums will rise 10% in 2014, so if we're complaining today about the increase in premium costs, there's more to come. 2014, the medicare actuary says another 10% increase in your health care premiums. at the center for medicare and medicaid services, their economist found that the increasing growth rate in health care spending will occur in every sector of health care, and more recently the congressional budget office, our neutral provider of analysis, says the cost of the health care law may be substantially higher than earlier estimated. one of the things that i would suggest that we should have done that never happened -- if you want to keep what you have, if you want to have access to

health care in rural and urban and suburban places in the country, one would think we would do something permanent about fixing the reducing payments to physicians, so-called doc fix. one would have thault in health care reform -- would have thought in health care reform that would have been front and center because if you don't have a physician providing the service, you don't have health care. yet, we have a medicare system that's going to reduce the payments. in fact, expected this year it would have reduced payments to physicians 30%. the reality is that no longer will physicians accept medicare patients, and that option you were promised to keep what you have disappears one more time. in fact, town hall meeting parsons, kansas, this year a physician on the front row says senator, you need to know that i no longer accept medicare and medicaid. i will take cash, but i'm not able to afford to provide the services based upon the medicare reimbursement rate that i get. and you add all the paperwork in trying to comply with medicare and medicaid, and it's no longer

financially feasible for me in this small town to provide the services that my patients need under medicare. we're going to see a lot less access because, once again, the failure, the promise that have made to reduce, to bend the cost curve down, to reduce health care costs, to reduce premiums, was totally false. mr. wicker: so the promise was not to touch medicare. that promise has not been fulfilled. the promise was to reduce the deficit. that turned out to be an empty promise. you know, also we were told by the president and by speaker pelosi that this bill would create jobs. the president said it was a key pillar for a new foundation for prosperity. how has that turned out? former speaker pelosi said in its life, the health care bill will create four million jobs. 400,000 almost immediately.

of course neither of those has come true. the nonpartisan c.b.o. has estimated that the health care law will reduce america's workforce. this is a bipartisan c.b.o. reduce americans' workforce by 800,000 jobs over the next ten years. and that fact has been confirmed by the united states chamber of commerce. mr. thune: i say to my colleague from mississippi is one of the areas where jobs may be created is in the federal government because it's going to take an awful lot of federal bureaucrats to oversee and lots of new i.r.s. agents to complement this legislation -- to implement this legislation. when it comes to private-sector job creation, the thing about this is it raises the cost for hundreds coverage -- for health insurance coverage for employers. it raises taxes on a lot of people involved in health care -- the presiding the presiding officer: the senator from washington. mrs. murray: i ask unanimous consent the quorum call be

lifted. the presiding officer: without objection. mrs. murray: thank you, mr. president. mr. president, two years ago, health insurance companies could deny women care due to so-called preexisting conditions, like pregnancy or being a victim of domestic violence. two years ago, women were permitted to be legally discriminated against when it came to insurance premiums and were often paying more for coverage than men. two years ago, women did not have access to the full range of recommended preventative care like mammograms or contraception and more. two years ago, the insurance companies had all the leverage, and too often it was women who were paying the price. mr. president, that's why i am proud to come to the floor today, two years after we passed the affordable care act, to highlight just how far we have come when it comes to making sure women across america get the care they need at a cost that they can afford.

because of that law, women will be treated fairly when it comes to health care costs, deductibles and other -- costs. deductibles and other expenses will be capped so a health care crisis doesn't cause a family to lose their home or their life savings. and preventative care will be free so women never have to delay care because they can't afford to see a doctor. because of this law, women will have more options. they can use health care exchanges to pick quality plans that work for them and for their families, and if they change jobs or they move, they will be able to keep their coverage. because of that law, maternity care is now covered and women won't have to skip prenatal care because they can't afford it. mr. president, because of this law, women are now in charge of their health care, not their insurance companies. that's why i feel very strongly that we cannot go back to the way things were. while we can never stop working

to make improvements, we owe it to the women of america to make progress and not allow the clock to be rolled back on their health care needs. now, i know some of my republican colleagues are furiously working to undo all of the gains that we have made in the health care reform law for women and for their families. i'm disappointed but i'm hardly surprised. republicans have been waging a war on women's health since the moment they came into power. after they campaigned across the country on a platform of jobs and the economy, the first three bills that they introduced in the house were each direct attacks on women's health care in america. the very first bill they introduced, h.r. 1, would have totally eliminated title 10 funding for family planning and teenaged pregnancy prevention, and it included an amendment that would have completely defunded planned parenthood and cut off support for the millions of women in this country who count on it. another one of their opening round of bills would have

permanently codified the hyde amendment and the d.c. abortion ban, and the original version of their bill didn't even include an exception for the health of the mother. and finally, they introduced a bill right away that would have rolled back every single one of the gains that i just talked about in the affordable care act. mr. president, this law is a winner for women, it's a winner for men and for children and for our health care system overall. so i'm proud to stand here today with so many of my colleagues who are committed to making sure the benefits of this law do not get taken away from the women of america. we will keep fighting attempts to take themnd senator coburn. the presiding officer: without objection. mr. johanns: thank you, mr. president. mr. president, we rise today to engage in a colloquy on an issue that is certainly front and center and has been for a long time in our great nation, and that is the issue of the health care bill.

this bill is hurting working americans and small businesses, and they are the lifeblood of our economy. let me, if i might, talk about a company from nebraska, toba, inc. toba is located in grand island, nebraska. they are a food distributor in central nebraska. they employ about 200 to 300 people, depending upon a given time of the year. it is companies like this that really are the heart and soul of the nebraska economy. tony wall is the chief executive officer of toba, and he shared with me recently that their health care premiums recently increased by 26%. tony's insurance agent talked to him. of course tony wanted to know what's going on here. what's wrong?

the insurance agent said to tony that there were several provisions in the health care law that were the reason for the increase. well, let me put this in perspective. that 26% increase is an extra $188,000 increase that ultimately falls in the laps of the employees of toba. hundreds of working americans will see their premiums go up as a result of this health care law. now, let me point out something that is very obvious here. that is a broken promise. then-candidate obama promised that americans would see their premiums decrease -- decrease -- by $2,500 by the end of his

first term in office. well, that has not been the experience. this health care law drives up premiums, and toba is a perfect example of that. but i need not stop there. let me talk about yellow van cleaning and restoration services in carney, nebraska, just down the road a bit from grand island. this small business employs 48 employees. the owner is a fine gentleman by the name of dave kitener. and he believes he's positioned his company correctly to grow it. in fact, some recent market research that was done shows his company is poised for growth. they have done all of the right things to take this small business and lay the right foundation so they could grow.

well, dave was faced with a tough choice, a choice not caused by his competitors, a choice not caused by a bad economy. he was faced with a tough choice caused by president barack obama and his administration and democrats in the house and senate that passed the health care bill. what is his tough choice? well, he had to choose not to expand because it's obvious where he is at. he will run smack dab into the employer mandate if he grows his business. you see, this law requires that employers with at least 50 full-time employees offer

government-approved health insurance to their employees or pay a fine of $2,000 per employee. well, dave did the calculation on this. small business, tight profit margins, doing everything they can to make the right decisions, but dave's calculation indicates that he will be penalized more than $50,000 a year if he grows beyond his current 48-member staff. there is no doubt about it. this law is stifling job creation. let me talk about american enterprise group. they point out that not only is this law preventing jobs from being created, it's forcing businesses to actually eliminate jobs.

an iowa-based insurance company recently decided to entirely exit the individual insurance market, abandoning sales directly to individuals and families. so what happens? 35,000 policyholders lose that insurance through that company, but it doesn't stop there. 110 employees will lose their jobs. 70 in nebraska. a driving factor is the medical loss ratio provision in the law which micromanages how insurance companies spend their revenues. the c.e.o. of the insurance company said that job loss was -- quote -- "a fairly predictable consequence of the regulation." unquote. now, mr. president, these aren't

hypothetical situations. before the law was passed, i came to the floor many times with my colleagues and pointed out the flaws in this ill-conceived legislation. well, now we're not pointing out the flaws anymore in terms of it being a hypothetical situation. these are real stories, real-life stories and real people who have lost their jobs and are being impacted by this ill-advised law. well, there is more but i can directly point out that 70 nebraska as -- nebraskans lose their jobs. the law will mean 800,000 people lose their jobs in the next decade. like yellow van cleaning in

nebraska, other businesses are holding off hiring. in a recent gallup survey, 48% of small businesses are not hiring because of the potential cost of health insurance under the health care law. the financial sector analysts at u.b.s. have stated that the law is -- quote -- "arguably the biggest impediment to hiring, especially the hiring of less-skilled workers." unquote. those are the people that need the job most. the congressional budget office estimates average premiums increase by 27% to 30% under this law because the new health care law's coverage mandates force premiums up. it's no wonder that toba in grand island, nebraska, have seen its health care costs go up a staggering $818,000 per year.

the medicare actuary says this law will increase health care spending by $311 billion over the next ten years. i think that's enormously conservative. well, two years have passed, and things are only getting worse. this law is suffocating job growth around the country. let me, if i might, now turn to my colleagues. i have a question, if i might start with senator portman. start with senator portman. >> life to the white house for today's briefing. here's the spokesman, jay carney. >> everybody is outside still. good afternoon, ladies and gentlemen. thanks for being here. those of you who are here for your daily briefing. i don't have any announcements to make. i do have before me the week ahead which i will make after i forget and you remind me. i would deliver that at the end

of the briefing. but with that i will go to questions. >> j., why has the president decided to weigh in on the shooting death of trayvon martin? >> the president has given us a number of interviews in the last several days. this has been a major new store, as you know so you certainly prepared to answer a question if you were to get one. it is also true that some of you have asked me over the reason is whether or not the president was aware of the incident, what he thought about it. and i chose not to talk about private conversations. but as you could tell from and to the president gave, obviously is aware of it and was aware of it and has thought about it. and he shared his thoughts on the case today with you. and that's, that's my answer.

[inaudible] was there some development, something that touched a nerve with the president where he wanted to speak of? >> no. again, i think given that he is president of interstate and is going to speak with you all and other reporters with some regular it was inevitable given the high profile nature of this story that he would be asked about it. he was certainly, had thought about it, was aware of what's happening with regard to in terms of the investigation locally come by local enforcement, the task force now that has been established by the governor of florida, as well as the department of justice investigation. given all that, it was inevitable probably to be asked about it so he had thought about and was prepared to answer that question when he got it. >> does he have any intention to call trayvon's intentions? >> i don't have any information in that regard, no.

>> in the aftermath of this announcements, the comment about the world bank, could you tell us a little bit about how the president chose mr. kim? at what point did he select him, and what some of the background, details that exist? it seems to be a surprise. >> first of all, he looked at all the reports in the press with lists of names, and he took those. any attitude and other candidates. now, this was a very deliberative process. the president understands the importance of the world bank, as he mentioned today. its name doesn't really convey everything that the world bank does. that's important work. and he wanted to find someone who is really perfectly suited for the world bank's activities, especially now in this time and in history.

dr. kinnamon represented with his combination of strength and expertise the variety of things he has done in development and health, as was of course being president of dartmouth college. he represented to the president the ideal candidate for the job, and that's what he chose to nominate him. [inaudible] >> i don't have that information but i'm not sure when they first met. [inaudible] >> certainly secretary of state hillary clinton, secretary of the treasury tim geithner were advocates. i believe secretary clinton might've been the first to suggest dr. kim, both those individuals were supporters of the idea, which is not to suggest that others who are under consideration were not also seriously considered and

supported by very senior advisers to the president. they were. there were a number of highly qualified individuals considered. >> can you talk about some of those names now the has announced the winner? >> i'm not going to go, you know, some things that event out there are accurate. look, a lot of them are people that the president relies on to this day for advice and counsel and guidance, including larry summers, including ambassador rice, including senator kerry, among three names that have been talked about. you know, those three individuals certainly are people that the president depends on quite a bit for their wisdom and counsel. [inaudible] >> i think some of it's been reported. others have spoken to this. i let him do it. for themselves. i just wanted to make the point

that while the president feels very strongly that dr. kim's combination of experience and expertise and vision making the ideal candidate. there were a number of very qualified candidates who, people who were considered by the president and two, some of whom were not interested. some of them, all of them the president relies on very strongly for advice, and will continue to rely on. >> was dr. kim the first choice? >> absolutely. >> are you in the week when the president -- the trayvon martin case, he said but we're not going -- [inaudible] what has changed between then and now that change? >> two things. the president as i just mentioned was inevitably going to be asked is given the prominence, and two, the

president -- that's clear. he could have a he felt, he did have some thoughts on the meta. he made clear at the top of his comments that the importance he attaches to being careful about it because of the investigations that are ongoing. but he clearly had some thoughts about it, and as a parent, express those to you today. so, i mean, i'm not going to elaborate on what the president said because i think he spoke pretty eloquently about it. >> one other question on health care reform law. today, you've no doubt seen all of the attacks that have been brought on this white house, this administration on the two-year anniversary. the rnc in a statement said that president obama is not celebrating but rather americans forget about the signature a competent because today it is a massive undeniable failure of

the broken promises. what is your response to some of this talk from republicans, and other americans out there, who are clearly still unhappy with the health care reform? >> i will tell you a couple things to your last point. there's a story just recently about the disparity and the amount of money spent in the propaganda, pr wars on this issue, three to one at least spent against the affordable care act in efforts to mischaracterize it, mislead americans about what is, versus those who advocated in favor of expanding health care coverage for 30 million americans, expanding coverage for young americans, expanding coverage for seniors. by building on private sector system that we have, the private health insurance system that we have. there's a lot of misinformation about what the affordable care act is. the fact is, as you know we

released a comprehensive report on the affordable care act, and at its two year anniversary today, the president is very proud of the work that congress did and his administration did to make this 100 year quest a reality. and where our focus on implementing vat bill, that law. thanks to the affordable care act. 2.5 million more young adults have health insurance on their parents plan. to 5.1 million seniors with medicare said $3.2 billion on prescription drugs. everyone on medicare can get preventive services like mammograms now for free. insurance companies must been at least 80% of your premium dollars on health care and not overhead and cannot raise your premiums by 10% or more with no accountability. it is illegal now for insurance companies to deny coverage to children because a preexisting condition, and in 2014,

discriminate against anyone with a preexisting condition will be illegal. now, what the rnc and others who are critics of this leave out in their attacks is that they want to go back to a system where insurance companies have all the rules on their side, not consumers, not the american people, where they can deny coverage like that if you have a preexisting condition, where they can say no if you want to add your child your health insurance policy. where they can throw you off your insurance policy if you get sick. those are some of the benefits that critics would reveal. -- repeal. and the president strongly believes that his mistake and he certainly will not shy away from the opportunity to debate that vision versus his own when it comes to providing health care to the american people. >> thank you, jay. the president, with his

constitutional law background, does he have an interest in looking at what they will argue on monday? [inaudible] >> honestly i don't know if he has reviewed the briefs. i know this great confidence in the solicitor general, and great confidence in the argument that would be made that, as we've said repeatedly, that the provision under review by the court is definitely constitutional. [inaudible] >> i know that he's been briefed on it, and he has had discussions about it, but nothing to substantive that i'm aware of. >> the florida shooting, the president mentioned that he should do some soul-searching, notches on the law but the context on ho how to happen. does he think this is another one of those teachable moment of? >> i'm not going to elaborate on what the president said. i think he spoke about it, you

know, i will leave it at what he said. the fact is, as many have said, today in previously, the president believes this is a tragedy, and as a parent, he can feel that, as you and other folks who are parents can understand, even more keenly the kind of grief that the martins are suffering right now. and i think that's an observation that is broadly and widely shared. beyond that we will not, i will at the presents were stand and will shortly that the investigations proceed. >> back on the trayvon martin issue, you said -- [inaudible] as a major new store what has the president -- >> i don't, sorry, go ahead.

>> has he listened to the case? what kind of, on the tick-tock issue, what kind of information, is he being updated by justice? i understand the justice had holding under a part of the week, they were kind of forgot how to handle the situation out and see me people there to help. hull house the present been involved been lit up to the day in this? >> as far as how he gets his news, i think i said on a number of occasions, he largely reads the news, and i'm sure -- [inaudible] not that i'm aware of the, but, of course, i am with him a lot but not all the time. in my presence he did not, but i think he mostly reads about stories like this. and i think it's not a question of believing if this is a big news story. if you watch the news i think it is definitely a big story, and that's why he, we certainly expected that he would be asked about it at some point.

on the other matter, i'm not, not that i'm aware, he gets regular briefings from his senior advisers, and updates on things, but not, that has not been to my knowledge any focus, conversation or meeting involved with the president on this issue. >> you have not heard that the president reached out and called the martin family, yet he is typically done things like that in the past in other situations. you expect that could there possibly? >> i think that's what i've asked if he planned to, and i don't have any updates on vocals he may or may not make in the future. >> is he reaching out to al sharpton and others about the situation, particularly as -- >> not that i'm aware of. not that i'm aware of, april. >> what do you think about this, the controversy about the etch-a-sketch? >> i have one at home. my children have one. i didn't bring that in, no. [inaudible] >> i was asked this i think yesterday or the day before on air force one, and you know, i

and others watch with interest the developments in the republican primary but we are focused on the work we're doing here. the president is very focused on the work he's doing. i don't have much comment on the. >> eight months out from general election all he has to do is shake and reset himself. you think eight months out a major candidate should be shaking himself? >> i appreciate the effort, but i will not -- [laughter] i really -- [inaudible] >> how much does across? $5? >> you said you have wanted on? >> i have two children. yes, we have an etch-a-sketch. it's been a while. my kids are getting a little older. i have not brought it in. [inaudible] [laughter]

>> i did say mark was next. >> despite what you said about the second anniversary of the affordable care act, it's still not clear to me why the president didn't choose this anniversary to do anything, make a statement. yes, you have done report, but it just seems natural. you see this as a political liability? >> no. look, again, i would refer you to the campaign to talk about what the campaign is doing. as many of you have, and helping millions and millions of americans have, you know, or maybe millions and means of americans have, you know, the campaign has put out a video editing features among other things that significant a competent of the affordable care act represents. we put out the report today that includes statements by the president on the anniversary of the affordable care act. we are focused as an

administration on implementing the affordable care act so that all of its benefits will be in place for americans who are seeking -- were receiving health insurance and health benefits. that is i think a pretty full plate of things that we are doing, with regards to the affordable care act, and specifically to make note of and mark the anniversary of the signing. but look, this was come to poor thing about the affordable care act is what it does. and that's what the administration is focused on. and secretary sebelius, secretary solis, valerie jarrett, others have been involved in highlighting some of the important provisions of the affordable care act this week, and will continue to be. and the president speaks frequently about the affordable care act at events.

so i made the point the other day that the anniversary is not something that the president is going to have an event around, but it is quite clearly a major compliment for him and for the administration, for the congress. one that was the result of literally a century's worth of effort by leaders in washington. and which has resulted in already the benefits that i had a number of an answer to a previous question. >> is the administration making any preparations for the possibility that the supreme court will -- [inaudible] >> i would refer you to hhs, but not that i'm aware of. we are of course actively working with the states to implement the law, the exchanges, the other provisions of it.

and believe very strongly in the argument that the affordable care act in its entirety is constitutional. >> on trayvon martin, since the president does have strong -- [inaudible] why did take the justice department so long to intervene? this young man was killed off every 26. we are not perfect ago that somebody got national attention right away. however, justice department is supposed to protect people's rights. in retrospect you think the justice department was too slow to get involved? >> i would refer your question to the justice department. justice department, justice is investigating this. i would refer you to the justice department for their procedures and have a look to matters like this and make decisions about it. i just don't have a comment on the. >> tsa, there's been some controversy by the industry to

try to cut back an armed pilot program the flight deck officers programs. is that anything that you focused on? >> i would have to take that question. i'm sure you largely secure answer over at tsa. >> the presiden president annout for his nomination for the world bank, there's been blowback, some harsh criticism from people in india, brazil and others. the argument is it's about time for a non-american to take that position, should be an automatic. what's your reaction? >> i would so they say that the president nominate someone today that he believes will be an exceptional president of the world bank, and whose experience in the field that is the central principle behind the world bank's mission, that is, to reduce poverty and develop,

broad and extensive. we have already seen extensive support for the nomination, statements of support. not just from americans like former president bill clinton and paul farmer, but the rwandan president who says i was delighted to learn that jim kim had been nominated for this post as he is a true friend of africa, and well known for his decade of work to support us in developing an efficient health system in rwanda. so we certainly, hope and have seen already that dr. kim will receive broad international support. >> wendy's citizens of emerging economies get their shot? when is it something automatic that is not an american? >> might extensive, are not so extensive research, into the history of the world bank and how its leaders are chosen has

been exhausted already. so i think you ought to take your question perhaps two state or treasury. >> the president won sense that the president uttered out there, if i had a son, he would look like trayvon. is the thing that is really driving the coverage of that, his statement today. what exactly does he mean by that? can you elaborate on that? >> i think he spoke very clearly and thoughtfully on a personal side, his reactions to this case, and i'm not going to elaborate on that as the president has spoken, and i will point you to what he said. [inaudible] >> let me move around a little bit. >> jay, when the president marked the anniversary of the legislation like the lilly ledbetter act, or when he marks the anniversary of major events,

and i'm sure that there might be something on may 1 for the anniversary of the death of osama bin laden, anniversaries do matters i guess i apparently don't understand why, even compared his siblings, other legislation, i mean, even statements for things like roe v. wade, so state legislation, supreme court decisions, major events, why does this one on its siblings not get some kind of bigger mark or? >> i'm not sure how else i can answer the question. i think i've answered it in a number of ways over a number of days. the implication is somehow that it is not an anniversary that is significant, and, therefore, the underlying accomplishment is not significant to everything we have done and he is done and he has said proves otherwise. the lack of an event on a day when he announced to the world bank, a day when you fly to korea should not suggest

otherwise. we are focused on the implementation of it, and again, i think you need to examine the premise behind these questions. because if the implication is that we are somehow not, and the president is not fully taken ownership of the affordable care act, i mean, look at everything else that says that's a ridiculous assertion. including again as somebody who assembly watched it as anyone else can on my, look at the campaigns of video. because this is all, like most questions are asking, in the context of the campaign and some he said oh, is it problem politically. well, certainly it looks to me as an observer that the campaign doesn't think so. the president's campaign doesn't think so. and the report that we put out today suggest we don't think so, and the fact that the critics of the reform have no answer to the question, would you then have it be the way it was before went

insurance companies could throw you off? if you got sick or they could prevent you from getting and choose -- insurance or your child from getting interest because he or she has a preexisting condition? they have no answer to that. so this is not a debate we will shy away from. >> the president, when he was on an official event last night there was interaction with someone who was interrupting the president, and said, jenny, something something along the lines if you want to have your own rally, with the per patch that was the president campaigning that matter even in that moment? the word rally seems like a load campaign work. was this an official event? >> gerrit, he was at ohio state university where they have developed the fastest electric car in the world, at 308 miles in a. they're developing one that can go 400 miles per hour.

that's an amazing thing, right? he wishes he could test driver, as i do. but as part of a two-day trip, the highlight is all-of-the-above energy strategy which includes obviously the focus on development of battery technology, which is the essential ingredient to these kind of automobiles. so the answer to your question is no. the gentleman that you were referring to was very persistent, and anybody who was there obviously wanted to have himself heard, and the president accepted the book that he passed up, but that was really all there was to it. [inaudible] >> no, he doesn't. thank you for the question. [inaudible] the president has been to korea before. this is the first time he is visiting the dmz.

i can ask you on camera, is this a poke in the eye for the new green leadership that has taken place? >> no, it is something that obviously previous presidents have done. this president is looking forward to visiting the dmz. i think it is, reflects the commitment to our south korean allies, the security of south korea. it reflects the president's appreciation for the u.s. troops who are stationed in korea. it is not about change of leadership in north korea. our issues with north korea are today as they were in the past, and we are continuing to focus on thatcome as part of the overall issue of nuclear security. this its of which the present an issue with someone he held within washington to express his ex ord a commemorative issue of nuclear security globally because there really is no

greater threat to the city of the american people that the potential for terrorists to acquire nuclear weapons. and that is why he has focus both on the supply and demand of this problem, the demand being terrorist groups personally al qaeda that seek to harm americans. he has focus very aggressively the fight against al qaeda, as you know, and he is focused and is entire administration has focus on working with the 50 nations you are a party of the summit on the issue of securing loose nuclear materials and prevented him from gaining into the hands of terrorists. >> d.phil. north korea, -- [inaudible] >> a deal of? >> let's rephrase that. on the separate developments that are expected, north korea's nuclear freeze, the shipment, however you characterize it, is the hope for breakthrough with north korea better because of

the satellite launch of? >> i think i'm a very clear and others have our view of the proposed launch, and it's a violation and represents north korea's nuclear obligations. and a very dim view we take of that and how the impact might have on the food program, but it on any updates for you on that. roger? >> just a quick follow up. will he be addressing the satellite launch perhaps to the dmz? or how will he address it or will he? >> we will have to see. i don't have any announcements the president might make or the statement he might make that i'm going to make from your. on trade? >> a follow-up. my follow-up was on the world

bank. does the president intend -- [inaudible] >> he certainly made. he feels very strongly that dr. kim is an excellent nominee, an excellent candidate, the right person for this job at this time. i certainly wouldn't preclude that possibility. i haven't had that conversation with them, or heard it discussed within the context of the summit, but we are certainly advocating for dr. kim. >> secondly on the same thing, the nigerian finance economy that was put forward as a difficult man, but she has a solid reputation and professional -- [inaudible]

>> i'm not going to get into the comparison of this candidate to others. other than to say this candidate is extreme qualified, has a broad diversity of experience within the very fields that are central to the world bank's mission, and the president certainly hopes that he will win the support at the world bank, and from the board, and become the next president. >> on korea's? >> yes, on korea. >> on the korea trip, as the president heads to south korea, does he regard north korea or iran as a greater threat to political security regarding nuclear weapons? >> union between a to? >> yes. >> i don't think whatever ranking. we are concerned about both nations and in the case of north korea the fact that what they have done on nuclear weapons and then on iran, the obvious violations of the international obligations, and their refusal

to give up their nuclear weapons ambitions. actions by both countries by both regimes threaten regional stability, and threaten the nuclear security of the globe. so that's why this administration is so focused on preventing iran from acquiring a nuclear weapon, and why it is focused on making, you know, working with our allies to get north korea to give up its nuclear program so that it can rejoin the community of nations. these are both very important issues. >> do you know -- on the trayvon martin shooting, was he eager to talk about a? did he want to talk about a? i know you said it was inevitable. >> to answer a question or not,

so he chose to answer this and had some thoughts to offer on it, but i'm not going to psychoanalyze him. [inaudible] does he have a full confidence in the ministerial council that he committed you to position to -- [inaudible] spent i do have an update for you on a position about that. i think the state department has provided information on this. egypt is an important ally in the region. we have worked closely with egypt in this period of transition, and we will continue to do so, but for specifics about the decision with regard to military a, i think i would point you to the state department. steve. [inaudible] very critical to me at ron and social security proposals to raise the retirement age to slow the growth of benefits. what's the white house position

on social security? will we see any proposals, specific proposals before the election? >> i think you saw in the president's, both in a state of the union last year and the president's deficit reduction proposal from september that we believe that we can work together to take steps to improve social security, and, but the immediate, with regard to in times, the more immediate issue that needs to be addressed is medicare. and the president put forward in his budget proposals on anti-limits, part of a balanced approach to getting the kind of significant deficit reduction that we need to get our fiscal house in order. i don't have any new proposals to suggest to you that we're going to me, but the president is very focus on the need to deal with our deficit and debt

problems, and do it in a way that does not unfairly burden certain segments of society. and that would include obviously seen it. one of the problems that we have with the ryan republican proposal, both iterations, which is clearly becoming the republican proposal, i think the candidates for office have endorsed it, is that it is so unbalanced. the essential, key element to any plausible proposal to get our deficit and debt under control is that it have balance. so that it is not unfairly burdensome to any sector of american society. that has been recognized by not just democrats, not just the president, but republicans. republican leaders on this issue has said it has to include not just discretion cuts, not just defense cuts, not just in front of and programs, revenues.

for some reason, even though this is established, moderate, reasonable thinking from leaders of both parties on this issue, the ryan budget, the republican budget, the budget the republicans seem to be rallying behind doesn't do that. it does the opposite. it gives more tax cuts to the wealthiest americans, and to pay for them, ask seniors and others to foot the bill. [inaudible] spent i don't have any updates for you on -- >> you talk about about a brooch to that, are you? >> the president has a plan is put forward. i have no proposal beyond the presence plan to provide to you. the fact of the matter is, we can get a handle on our deficit and debt if we take the balanced approach that the president put forward, that the simpson-bowles commission put forward, that the

ribbon domenici commission before, that the gang of six put forward. the three, the last three included republicans. the president supported, proposal i mean, you guys conclude on your own perhaps and make it an analysis of that's why the republicans don't support it. because leading republicans have supported balanced approach, pounds approaches to this provocation support a balanced approach would have to actually getting it done. yes, in the back. >> president's trip to korea. [inaudible] i just want to know what is the reaction of the white house spent i haven't heard that statements i don't have a reaction for you. yes, sir. >> jay, given the worldwide financial -- world leaders have

been talking about reforms of the global financial system. with the heads of imf and world bank still coming out of europe and the united states, does the white house believe that such reform has been proceeding on satisfactory pace or anything? >> well, i'm not sure i understand that this is a question that is loosely pegged to the announcement of our nominee for world bank but i think the world -- not the international financial system, but this president in the midst of a dire financial crisis that threatens to cause a global meltdown, acted quite aggressively to prevent the meltdown. and has passed with congress' support, a law that reforms wall

street and ensures that we don't have the same kind of situation that helped precipitate the global financial crisis in 200 2007-2008. and that expense is an experience that we share with others around the globe, and the lessons we learn from it, and this i think is summit i've talked about when we have discussed the european, the eurozone crisis and the efforts there to get ahold, get a handle on the. and the fact that secretary geithner has been very engaged with his european counterparts on that issue, and offering a kind of advice that he can, having personally been involved in the crisis here and the efforts to end it. so, but beyond that i am not sure that the announcement today goes particularly to your question.

>> i want to go back a minute to the health care anniversary. the republicans obviously are celebrating the anniversary. i think they put a banner up in all this. you said earlier today that the propaganda against the health care law was like three to one. and my question is, wouldn't an appearance appearance on an event by the president help offset that? >> we are focused on implementing the affordable care act. we also support those who are marking the anniversary. those who support, who are marking it and in our supportive of the affordable care act we have put out our own report. there will be, you put in the poker context which is the only context within which republicans put it, because they have a policy that isn't answered to

the need for health care reform. and it will be an opportunity for the president to debate the merits of reforming our health care system in a way that builds on the private sector, private insurance system that we have, that does not allow insurance companies to deprive americans of health insurance because they have, they develop an illness or prevent them from getting health insurance because they have preexisting condition. to ensure that this penalties 80% of your premium dollars on health care, and not over a. that they can raise your premiums by 10% or more with no accountability. this is the other side of the argument, and that debate will be engaged when, you know, in the fall if the republican nominee feels so strongly about it. they will be an interesting debate, no doubt, should come at a political level one of the

architects of this health care reform be the nominee for the republican party. because as many have noted in both parties, the individual mandate provision of the president affordable care act bears striking similar to the individual mandate those put in place in massachusetts. any others? chris. >> elizabeth warren told me she wants the president to complete -- [inaudible] >> i saw a story about you, chris. >> anyway, it is morally right. with the president take her advice? >> chris, i have no updates for you on that issue. [inaudible] ms. born oversaw the district of hundreds of of dollars to banks on the verge of collapse. why wouldn't he do so on the very simple issue of marriage

because the president appreciates it is that the warrants advice and service that she provided on these very critical issues that you talk about, and he gets advice from people he respects on a variety of issues, and he listens very carefully to that of vice on those varieties of issues. and then he makes his decisions when he's ready to make them, and talks about them when he has got things to talk about. [inaudible] >> yes. >> why didn't he say so? >> again, my knowledge of the history of this is not complete, but when you know me for a job i think it is true when your lease in our system when we nominate potential cabinet secretaries to you don't come out and make your

case. i don't think that is always the case. but i am certain that dr. kim has graciously agreed to serve if confirmed. [inaudible] >> i would graciously provide -- [inaudible] >> i just said -- i said, please. what? [inaudible] >> you, to? week ahead. on sunday morning the president will arrive in seoul, republic of korea. later in the morning the president will visit demilitarized zone, also known as the dnc. after the demilitarized zone the president will meet with american troops serving on the korean peninsula in action the present will hold a bilateral meeting with prime minister ariel one of turkey at the grand hyatt hotel. later the president will visit the blue house what he will attend a bilateral meeting with president lee of the republic of korea, hold a joint news

conference with president lee and attend a dinner with president lee. the president will spend the night in seoul. on monday morning, the president will deliver remarks at the university in seoul on his ongoing commitment to our continued efforts to stop the spread of nuclear weapons. later indicated the present will hold bilateral meetings with president medvedev of russia, president hu jintao of china and president of kazakhstan. in the evening the president will attend a nuclear security summit working dinner. on tuesday the president will attend a nuclear security summit. later in the day the president will depart seoul en route to washington, d.c. the president will arrive in washington due to the change in time zone, on tuesday evening. on wednesday and thursday the present will attend meetings at the white house or on friday the present will attend campaign events in burlington, vermont, and portland, maine. he will return to washington, d.c. that evening. that is your week ahead. thank you all very much.

>> on monday, the supreme court starts three days of hearings on the constitutionality of the new health care law. you're the oral argument for yourself in its entirety as the court releases audio at around 1 p.m. eastern each day with coverage on c-span3 and c-span radio, and at c-span.org, listen and add your comments for our coverage starts monday morning live on c-span with "washington journal," and continues through the day from the supreme court, and then the oral argument on c-span3. >> president obama has nominated dartmouth college president and global health expert jim yong kim to lead the world bank. dr. kim is a korean born

physician and a pioneer in the treatment of hiv/aids and tuberculosis. president obama said he has the breath of experience on development issues need to cut at the financial institution anti-poverty mission. recovered his appearance in 2005 when he outlined the findings of a report in the global aids epidemic. in this portion he talked about the role of the church in preventing hiv/aids. >> you know, let me just say that the american, if you called evangelical churches the american conservative organizations, you can trace their participation in a number of ways. i credit them with bringing to the attention of president bush and jesse helms and others the problem of hiv deaths in poor countries. and they are the ones who really pushed the republican politicians to move forward on the path for program. so they played excellent important role on bringing attention of the number of deaths from epidemic. they were losing their

missionaries and the stars of their work in poor country. and i commend them on that. in terms of the role of conservative organizations in areas like prevention, what we know is that we will never really know for sure exactly what particular intervention led to a particular change in a persons behavior. and so what we recommended is that the full range of prevention interventions must be utilized. this is absence messaging, certainly for children, behavior change when it's relevant, when it's relevant and can be hopeful. and, of course, can't amuse. we know that condoms prevent the spread of hiv for effectively, and heart reduction. anytime you take one of the other out of it for ideological or political reasons, you are really putting a country, and individuals come at risk. so this is our position specifically. are there particular conservative groups who want to focus more on one than the other?

guess. there's no question that there are. there are groups would like to see abstinence only programs, to which we just say flatly you can do that, but then you are really pulling three legs out from underneath a four-legged chair. >> and you can see the entire event with dr. kim at our website. go to c-span.org. president obama nominated him to spring to head the world bank. the actual selection will be made next month by the banks 25 member executive board. the united states has the world's largest economy and as the largest percentage of the vote. dr. kim is expected to travel around the world on a listening tour to rally support for his nomination ahead of the board's vote. >> the genetic scientist who finally nailed down a rough day for an hiv epidemic starts describes tinderboxes. there's not that much hiv and get some places there's a ton

and its incredible destructive. so understanding it, that these two sort of categories exist and allows you to think okay, what are those factors that keep this virus moving and what can we do as a world to end it? >> on afterwards author craig timber tracks the history of aids, sunday night at nine, part of a booktv weekend on c-span c-span2. >> epa administrator lisa jackson testified recently on her agencies 2013 budget request before the senate environment committee. the epa is asking for $8.3 billion, and 1.2% decrease from current levels. according to minister jackson, 40% of the epa's funding request is directed toward state and tribal assistance grants for him to many environmental laws such as the clean air and clean water act. senator barbara boxer of california chairs this thing. it's about 90 minutes.

>> good morning i would like to begin by welcoming administrator jackson to the oversight hearing on the 2013 budget for the epa. epa is charged with implementing critical public health and environmental protections, including programs that address clean air, children's health, sacred water, and water quality in america's lakes and rivers. epa's mission is to protect the public health, including children and families. the agency was established with bipartisan support and has demonstrated repeated success in improving our families health and keeping the nation's a air and water clean and safe. the president's budget makes tough choices, some which i don't agree with. but i believe overall it maintains a strong commitment to epa's mission. for example, the president's budget would make investments in enforcing our nation's public health laws, including assisting state and local efforts to reduce dangerous air pollution. the budget also maintains a strong commitment to protecting

children by requesting an increase in funding to the office of children's health, something that is extending near and dear to my heart. the budget proposes reductions in the clean water and safe drinking water revolving loan fund. in recent years, congress and the administration has supported significant investments in clean water and drinking water infrastructure, and i don't believe we can stop now. recent studies highlight the need to maintain robust funding for these infrastructure programs. the american water works association estimates that drinking water systems will require at least $1 trillion over the next 25 years, and the american society of civil engineers anticipates a water and wastewater infrastructure funding gap of $126 billion by 2020. i'm also very concerned about a proposal to phase out epa's beach protection program, the small but important investment helps states to monitor water quality at public beaches and protects the public from sickness caused by water

pollution. the budget asked to eliminate $8 million for state and tribal programs that reduce health threats caused by radon, as was to end funding for epa's regional work to reduce the risk of radon exposure. according to epa, this radioactive gas is the nation's second leading cause of lung cancer, and i'm concerned about these budget cuts, given the continuing need to address the serious health threats posed by radon. as we examine epa's budget, we must keep in mind the positive impact of epa's work for our economy and public health. as i often say, if you can't read, you can't work. the economic benefits of epa's work are clear. the clean air act provides $30 in benefits for every $1 invested, and it was responsible for preventing 160,000 cases of premature mortality, 103,000 heart attacks, 13 million lost workdays, and 1.7 million asthma attacks in the year 2010 alone.

and i often say when i go to schools to dr. ochoa, i always ask them, do they have asthma or do they know someone. and honestly between the third and half of the kids raise their hands. and asthma is not anything to laugh at. it is very, very serious. and i think when you look at what epa's programs have done, they fostered a significant and growing clean tech industry. we are the largest producer and consumer of environment, technology goods and services. the industry as 119,000 firms, supports 1.7 million jobs, generates 300 billion in revenues, including $43.8 billion in exports. these programs provide clear health and economic benefits for america, but here's the good news. and administrator jackson come usually very pleased because the american public strongly supports the epa. there's a brand-new bipartisan poll released yesterday by the

american association. it finds that two-thirds of the voters favorite epa's efforts to set stricter air pollution standards, and a two to one majority believe that strengthen safeguards against pollution will encourage innovation and create jobs. i stand with the american people and, as chairman, will fight any efforts to undermine your work. u..

to be a part of the record but we will have to put that in there. >> without objection. >> it's always good to see you coming in your visit to the epa committee today is timely. it comes a time when president obama my state of oklahoma touting the virtues of fossil fuel, and that's wonderful. i don't expect the president is going to say much about the things that happened here because it isn't going to sell to welcome all the wife and told the audience is restricted to 150 of his personal friends and the media that has been hand selected so we will see what happens. let me tell you again i have a great deal of respect for you and always have in relationship in large part because you and i have always been straightforward and honest. i understand your job is to carry out the policy of the presidents. that's when you do, that's your job description. it's not mine. and in some of these areas that we've had a disagreement i

always say we do we put smiles on our faces and do it in the spirit of friendship. and it didn't go unnoticed, madam chairman to the administrator when i visited before the meeting when i was on the racial madow show a diprete y fever globalist bet rachel and barbara boxer and lisa jackson. >> i don't like the order. [laughter] >> actually i did have you first. but you are not third, rachel was. anyway, right now the president is in oklahoma standing in the middle of the oil field, talking about the virtues of fossil fuel. it's kind of interesting that he is doing that and that his budget that he's put forward have been very punitive to that industry. he's made the statement how explicit it would be in his

agenda is one that has specifically increased the price of gas at the pump and the energy and our homes. remember as president obama himself said his policies would necessarily under his energy cost would necessarily skyrocket. those are his words and that's true and that's what's happened. now the global warming movement has collapsed and i can see why president obama is trying to associate himself with oil and gas development in oklahoma. at cnn, you might have listened to this, madam chairman, cnn road a piece about oklahoma and it's about 40 miles west of my home town. quote, the place is booming. there is a shortage of workers around. we know nationally there is actually a shortage of engineers and oil workers and skilled and unskilled laborers in foot petroleum engineers were originated from school and upwards of $90,000 with oklahoma

secret is we are developing our own resources. oklahoma has over 83,000 producing wells and 43,000 producing natural gas wells. oklahoma city university found that in 2009 oklahoma oil and gas industry supports 30,300 jobs and contributes $51 billion to the state's economy every year. that is exactly why oklahoma as unemployment rate is consistently much lower than the national average. and we are seeing that another aerias by the way. i would say in north dakota their biggest problem is finding workers and happened to harold ham who has been a witness twice before this committee to an oklahoma is up there right now in the deposits really cranking that stuff out. but there is no unemployment in that area. and so, this is -- i really think with the president's campaign growing he must take credit to defer part of the

keystone pipeline that will be constructed from cushing oklahoma to port arthur, texas. i would like to remind -- i don't have to remind everyone, everyone knows the president unilaterally stopped the xl pipeline particularly that area going through nebraska. it happens that his authority does not allow him to do the same thing to the south, and therefore she is -- he is they're making statements about how friendly he is to oil and gas. but even as president obama stand is in the oil field pretending to support the pipeline, he continues with his efforts to regulate fossil fuel out of existence, spearheaded by your agency, the epa is moving forward with an unprecedented barrage of expensive rules from greenhouse gas regulation to hydraulic fracturing to clean water regulations to the utility with expressed purpose of eliminating fossil fuels. i just want to make sure i have

in the record the specific things he has done or attempted to do on successfully in his budget over the last four years would be to the percentage of depletion, the section 199 in the expensive and tangible drilling cost. those are things that would have been very, very damaging to the industry. so, right now in a minute we will get a copy of the speech he has made and perhaps will still be in session. let me say also, madam chairman, once again, not your fault, malling or anyone else. but this coincides with the armed service committee so i will be going back and forth. >> the senator went over 40 seconds i am going to take 30 seconds to save this: president obama has always endorsed in all of the above strategy to energy. this is in the energy committee, it's the environment committee but i feel i want to put this in the record. we've had more domestic drilling

to the point where in 2011 american oil production reached the highest level in a decade and gas production, the importation of oil has gone down every single year since president obama took office and natural gas is at an all-time high in terms of production. so all this talk about how the president is against this is incorrect coming and he is for in all of the above strategy. he may not want to drill in the places where it hurts the fishing economy, the recreation economy, but he sure is showing by fact, not just yesterday and not since gas prices went up but since he came in and that he is going to move forward. so why do think the facts lie on my friend's comments. i really do and we will move on. >> since he went over your 30 seconds by a minute and a half let me have 30 seconds of your

time. >> no, i didn't. >> that's exactly what you did. >> but i am happy to give you 30 seconds more. >> i was saying in spite -- you know, that's why we agree. we agree that in spite of all his punitive things he has tried to do, which is already set in my opening statement, fortunately a lot of the deposits in areas where the marcellus is up in pennsylvania and new york people think normally it is all out west but it's not. we've had tremendous opportunities and in spite of the policies we are -- to increase our production and will continue, and if we can get all the politicians out of the way, we would be able to be totally independent of the middle east not in a matter of years been a matter of months. >> we've 2% of the world -- >> that's not true. >> -- proven. we are not going to go up -- >> i would leave it at that though, that's not true. >> we are not going to do this -- senator inhofe, my friend --

>> -- the reserve of any country in the world. >> i just want to say this is not the energy committee to be this is the environment committee. you use your time to slam our president, and i take offense to that. and i will tell you right now if he is so punitive, why are the oil companies making more money than ever before in history? record profits are singing in the board room. and we are going to move off this, and we are going to go to senator lautenberg. >> thanks. i didn't want anybody to hear what i was going to say. [laughter] not that i take sides here. [laughter] pick on somebody your size. [laughter]

>> are you talking to me? [laughter] >> i have 45 seconds. serious business here. thanks, madam share for holding this hearing. it's hard to believe we are essentially friends on this committee, and i hope we can continue to be after this hearing. politicians talk a lot about how congress needs to balance its budget the same way that every day americans do. they sit at their kitchen table, plan household budget, crunching the numbers to see what they can or can't afford. but no american would try to balance their family budget by cutting out money for batteries or smoke detector or putting off will get a new breaks for the family car. it would be as reckless for

congress to sacrifice the public health and safety in the name of this fiscal austerity. yet that is precisely what our colleagues on the other side of the aisle have proposed when they say we should cut the environmental protection agency's budget. the epa performs critical service for the country and enforces the law that keeps the air and our children breathed and the water they drink clean. administrator, lisa jackson has provided able leadership to the agency and we miss her in new jersey when she was at the department of protection that such a good job and carrying forward on her task here. we are very proud of your work. over the last year we have seen the epa to important steps to protect the health of our families and restore our environment after years of delay by their allies, the epa finally

finalized the new standards the woodcut mercury and toxic air pollution. these standards will prevent asthma attacks and heart attacks and even premature death. they also protect children from brain poison and for children that can cause developmental problems and learning disabilities. the epa also worked with the dot to set although pollution and fuel efficiency standards for cars and trucks built by nearly doubling the performance of our vehicles caught these standards will cut america's oil dependence clear the air and save consumers money at the gas pump. but despite its record of success, the epa is once again under attack. for example, some senators have launched efforts to subvert the epa's ability to carry out the clean air act. i think what they ought to do is if they are opposed to in

approving the clean air act, may be pulled their constituents and ask for the homes that have an asthmatic person in the household ask them how they feel about saving some dough on the backs of their kids. my family will never forget an asthma attack that took my sister's life. she was at the school board meeting, tried to get the respirator that she had in her car, collapsed in the parking lot and she died three days later at the age of 52, and i have a grandson that has asthma and when my daughter takes them to play ball or whatever sports he is engaged in, she checks to see where the nearest emergency facility is. so, it's serious stuff, and we ought to stop playing games with this. since it became law in 1970, the clean air act has protected our health, the environment from the dangers of toxic air pollution.

in 2010 alone prevented more than 160,000 premature in the deaths and more than 1.7 million child respiratory illnesses. these are more than just statistics, just like administrator jackson i have family members mentioned. our families know that asthma is a serious disease that can mean life or death and its growth in our population is enormous. the clean air act economic benefits are also clear when air pollution is severe, health care costs soar and productivity plunges. business is no employees to canned brief and employees who can't work cutting the clean air act will do nothing to help our economic recovery and nothing to close the budget deficit and i agree. we have to fix the nation's budget challenges. but no america would balance their household budget by stepping on the family's safety and comco shouldn't be putting

austerity of public health. i applaud the epa for making irresponsible traces in the budget though i am concerned about the cuts such as the e elimination of each act. funding. so i look forward to hearing from administrator jackson about this budget and about how this committee can help the epa continue its vital public mission, improving the health of the american people. >> thank you, senator. senator sessions? >> thank you very much. it's good to be with you administrator jackson you have an important agency. as the ranking member of the budget committee, i know how tight our spending is. you do important work, but you have to be accountable like every other agency, and i know you would agree with that and we would expect a smart and cost-effective program of action on your agency. senator inhofe, i noticed since yesterday's "washington post" had their pinocchio honesty

report and the quote president obama saying if we went to your house and to a mall and put up those rigs everywhere we would have only 2% of the world's known oil reserves and watch them close. the president is on an energy tour this weekend on wednesday he once again made the claim and we hope he finally drops this logic from his talking points to pinocchio. the budget picture. in 2013 would be the fifth consecutive year of a trillion dollar deficit under the president's 2013 budget annual federal spending reaches 44,000 per household 2022 and federal that reaches 200,000 per household by 2020 to. at the size of the federal government grows, the middle class is being squeezed from all directions. wages are declined, food and energy prices are rising, the

job prospects remained scarce. one area has received extraordinary increases in funding and that's environmental protection agency. my constituents ask me frequently what is the epa so much involved not impacting our lives like we have never seen before. and our complaint is to a degree on administrator jackson and i have never heard since i have been in washington the answer since taking office president obama has epa operating at a surge to budget. since 2009, the epa has received $12 billion more in funding than the 2008 baseline level would have allowed and when he took office, the administration and the democratic controlled congress gave the epa a 100%

increase in its budget counting the stimulus. the money came as a policy decision from the administration unfortunately, on this rapid increase its lead to problems and waste dhaka, the epa spent over $1 million for a sample on a large square 2.7-foot green roof of the top of the world wildlife fund headquarters in d.c.. in 2010 the epa received a 48% budget increase over the 2008 levels and every year since they've been funded well above that baseline. what are the priorities? while the money is being allocated, the epa budget says the number one priority is climate change. they are asking for a least 32 million of increased funding

for climate change protection. in fact the epa plans to spend 140 million more on their regulations and management programs that means we expect to see more costly mandates from washington. we also plan to increase their spending on epa regulators and scientists at the same time the epa plans to cut spending for the state $257 million. the state partnerships are important and they do play a major role in how we conduct our efforts to improve in the environment. you also plan cuts for brownfield development. i was disappointed that your agency would ask for 15 million increase funding for the enforcement efforts while the justice supreme court rules nothing in the case of the epa had abused its authorities.

the tsunami of the costly regulations are driving up energy prices and are entering economic growth. the utility map, cross state air rules, cooling water intake rules on farmers and regulation of pesticides taking that away from states would together in pose a significant burden on our economy, and would result in multiple complaints to me from my constituents that these rules are not realistic, they are being imposed too fast and the costs exceed the benefits. 21 billy of annual cost on the u.s. economy would be imposed by these new regulations. the annual cost, that's about half of the highway bill we worked so hard to try to find the money to support.

the epa declared the rules and would only result in a 3% increase in electricity rates, but it looks like it may be as much as ten to 20%. madam chairman, thank you for the opportunity to have this hearing. all of us are going to have to tighten and i would encourage the epa to do the same and i believe you need to be held accountable and less aggressively to see if they justify the taxpayer dollars being invested. thank you. >> senator sessions, thank you. senator whitehouse? petraeus mix before. i would like to welcome administrator jackson back to the committee. i have some concerns about protection but that we can discuss as the budget process moves forward. a very important to ruda island. and i want to mention another thing that's very important to rhode island is that there be proper enforcement of the clean

air act. we are a downwind state on a bright summer day you drive in to work and the drive time radio is often saying today is a bad error day and intense should stay indoors and seniors should stay indoors and people should not engage in vigorous outdoor activity all because of toxic emissions that are being caught on to us by midwestern coal plants and power plants, so that sentiment has been echoed not just for her violent and the downwind states that the american lung association has a poll that shows 73% of americans understand you can have the cleanest air standard and the strongest economy that they go together, 78% of independent voters agree 60% of republicans agree with that. the polls show 72% of americans supported the new protections on carbon emissions from power

plants, so i know you've got a lot of static here in d.c. about what you're doing. this is a unique place where special-interest particularly polluting special-interest having a disproportionate voice but in the bellmon states and among the general american population, we are in accord with you and indeed we are counting on you. so i think you. i will close by mentioning a show that i watched when i got home last night on the nova science program about what is happening in at the polls in the antarctic and the arctic regions , and once again we have a situation in which washington is disconnected from the real world. my furious that it is disconnected by special-interest money from the real world by polluting special-interest money from the real world and so the

fact of what you're doing with our carbon pollution to the ocean and the atmosphere are being manipulated and propagandized, but i believe that out there in the real world where people are looking at real facts and are not under the shadow of the special-interest people have strong support for your efforts to get the carbon pollution under control, and i urge you to continue to stand strong and appreciate very much that you have stood strong and anything we can do to make sure we have your back on that i'm interested in doing. a very important to rhode island as a downwind state to have clean air for our citizens. thank you very much madame chair. >> stat thank you madam share. the obama administration officials regularly try to justify their excess of red tape by citing misleading in complete health statistics. meanwhile they completely ignore

how these exact same regulations destroy jobs and destroy communities. when americans lose their jobs, their health and the health of their children suffers. these are the findings of the new minority reports that i am releasing today as ranking member of the subcommittee of clean-air and nuclear safety. the support is entitled red tape, making americans sick. the new report on the health impacts of high unemployment. this is a comprehensive report, and it contains expert testimony before this committee and the best scientific medical research from institutions such as johns hopkins, colombia, yale and others. this key medical research and testimony tells the public health consequences of joblessness, and the joblessness is caused as a result from the cumulative impact of the epa's ongoing regulations. specifically these impact from joblessness will increase the likelihood of hospital visits,

increase the likelihood of illness and premature deaths in communities. the joblessness will raise health care costs, raise questions about the claims health savings of the epa regulations and the regulations through this impact kurt children's health and family well being. as the tilt in the report, the committee has heard some of these findings before. dr. harvey brenner of johns hopkins university testified before the committee on june 15th and he warned that, quote, the unemployment rate is well established as a risk factor for the elevated ilves and mortality rates in epidemiological studies performed since the early 1980's it is true studies as far back as 1985 have warned of the health impact on employment. the study published that here in the american journal of public health by dr. margaret flem found that, quote, after unemployment, symptoms of civilization which includes

payne, a gastrointestinal symptoms and a bunch of symptoms also depression and anxiety were significantly greater in in the unemployed than in the employ. more recent studies include yale researcher dr. william released a study in 2006 and that found that, quote, results suggest the true cause of late career on employment exceed financial deprivation and include substantial health consequences. on and plant health impact on children is also discussed in the report. the national center for health statistics has found that children in poor families were four times as likely to be in a fair or poor health as children and families that were not poor. the research in the report speaks for itself. the concern about unemployment impact on public health is a concern for of least one former

obama white house official. as reported in "the new york times" on november 17th of last year, white house chief of staff william daley asked one interest group lobbying for stricter epa rules and interest group lobbying the administration for even stricter epa rules. mr. daly said, quote, what are the health impacts of unemployment? i and my colleagues in congress have urged the epa to seriously consider the cumulative impact of the rules and how they negatively impact jobs, families and the elderly. finally on tuesday the guilaume administration made a surprising announcement in this regard. the white house announced a new policy on studying cumulative impacts. now, finally much of the damage has been done to implant in public health v. obama administration now wants to find out what is happening across the

united states because of the rules. here's the answer their rules, closing plants, raising gasoline and electricity prices, costing jobs they all cost jobs and make people less healthy as stated in this report. so, i will release this report, red tape making americans sick, the new report on the health impact of high unemployment, studies show the epa rules cost americans their jobs and their health. i would recommend it to every person that works at the environmental protection agency. thank you, madame chair. >> thank you, senator, i look for treating it. we have a report called the strong epa protect our health and promotes economic growth and the executive summary find out that since the passage of the clean water act, the clean air act, the safe drinking water act superfund and many of these but most of these signed by republican presidents are in gross domestic product reason by

207%, and it remains large in the world. i find it rather amazing that one small agency would be blamed for all the trouble we are going through and i would say if anyone cares about jobs, half the house ask speaker boehner to bring about a bipartisan transportation bill. 3 million jobs are at stake. this committee has a great role indefinitely creating jobs through this transportation bill which i am so proud is bipartisan and we will call on senator udall. >> thank you and welcome come administrator jackson, great to have you here again. i wanted to talk about a couple of issues in the questioning that i thought i would highlight at the beginning here the fact the president just visited mexico and oklahoma on an error energy trip promoting the all of

the above energy strategy where he says that all of our energy sources should be developed in new mexico we have an area that is rich in oil and gas called the premium base in which is having an extraordinary boom at this point, and he highlighted by the visit to mexico that boom that was going on in the increase of oil production in the united states and went to oklahoma following the mexico and there was a problem with the type lines not being able to get supplies out and he issued an executive order to move that along. so i think the president's working very hard, madame chair, to try to do everything he can come and it seems to me we are seeing from republicans a lot of change in position especially mitt romney. in 2006, governor mitt romney said in the this is a direct

quote commentary much in favor of people recognizing that these high gasoline prices are probably here to stay. the new republic covered in an article just recently here but i would like to submit for the record, madam chair, the title of the article when he liked high gas prices in fact highlighted he was very much for a lot of the plans of president obama has put forward today. on the issue of gas prices i would note the associated press recently conducted a comprehensive statistical study going back 36 years. the study shows no correlation, underlining no correlation between u.s. drilling and gasoline prices. gasoline prices are driven by an oil prices which are set on the global market. the u.s. has the highest count in at least 25 years but we do

not control the global supply and demand. so that's something that i think consumers need to realize and understand. even if we were totally oe all in dependent, my candidate is we would still pay global prices since it can be treated globally. in fact, u.s. gasoline prices are some of the lowest in the world do to our low gasoline taxes. we live in a market economy. the last time the president could set the gas price was one republican richard nixon imposed price controls. president obama as i said highlighted on this trip all the things he is trying to do and i think that he is making a good solid effort to try to move us in the right direction in terms of renewable energy and also making sure there's a strong domestic industry. so with that, madam chair, i

would yield back. >> thank you. so now we are honored to hear from administrator lisa jackson. >> thank you so much, madam chairman, ranking member. thank you for inviting me to testify on the president's fiscal year 2013 budget. it's good to see all the members of the committee here today. fiscal year 2013 budget for the epa. i'm joined by the agency's chief financial officer barb benet. the request of $8.34 billion focus is on fulfilling the epa core mission of protecting public health and the entire met while making sacrifices and tough decisions for americans across the country are making every day. the epa budget request fully reflects the president's commitment to reducing government spending and finding the cost savings in a responsible manner while supporting clean air, clean water and safeguards that are essential so that america is built to last. in some cases, we have had to take a step back from programs to read the budget reflect savings of $50 million through

the elimination of several epa programs and activities that have either met their goal or can be achieved at the state or local level or any other federal agency. let me spend a moment discussing major elements of the budget request. this budget recognizes the importance of your partners of the state and local and tribal level and as you know, they are at the front lines of implementing our environmental law like the clean water act and the clean air act. in fact, the largest portion, 40% of the funding request is directed for the state and tribal appropriation to support their effort. specifically the budget proposes 1.2 billion nearly 15% of the epa requests be allocated back to the states and tried in the categorical grant. this includes funding for the state and local quality management grant, pollution control and the state's general assistance programs to read the budget also proposes to combine the $2 billion from another 25% of the request goes strictly to

the states to the clean water and drinking water state revolving fund. the funding will help support efficient system of investment and development of water infrastructure in the community. we are working collaboratively to identify efforts to fund the green infrastructure. projects that can reduce the solution efficiently and less expensively than the traditional infrastructure. additionally the epa budget request would fund the protection of the land and water and local community. reflecting the president's commitment to restoring and protecting the great lakes would request the contras maintain the current funding level of 300 million for the great lakes restoration initiative. the support will continue to be used for collaborative work with partners of the state, local and tribal level and also a non-profit and municipal groups. the budget requests the protection of the chesapeake bay and several other economically significant water bodies to the budget reflects the importance of cleaning up contaminated land in the communities by requesting $755 million for continued support of the superfund cleanup

program and maintains the agency's emergency preparedness and response capability. epa budget request because major investments in science and technology $807 million. our almost 10% of the total request. the request includes 576 million for research including $81 million in research grants and fellowships and scientists and universities throughout the country for target research as a part of the science to achieve results or star program including children's health and eyre monitoring research. also as a part of the request, epa includes funding increases to the key areas that include green infrastructure and hydraulic fracturing. as i mentioned before, the natural gas is an important resource which is abundant in the united states but we must make sure the way that we extract do not risk the safety of public water supply. the budget continues the ongoing congressional directive hydraulic fracturing study which we have taken great steps to

ensure is independent, peery viewed and based on strong scientifically defensible data. building on these ongoing efforts, the budget requests $14 million in total to work collaboratively with the united states geological survey. the department of energy and others to ask questions regarding hydraulic fracturing. so science meets finding answers to tough questions and epa request does that. we are making investments to support standards for clean energy and efficiency in the budget. specifically the budget supports epa efforts to introduce clean vehicles and expand the use of home grown renewable fuels. this includes funding for the federal vehicles and fuel standards and certification programs that support certification and compliance testing for all emissions standards and implementation of the president's historic agreement with the auto industry for carbon pollution and fuel economy standards in 2025 for the cars and light duty vehicles including testing support for the fuel economy standards.

taken together, the administration stands for cars and are projected to result in $1.7 trillion of savings and 12 billion barrels of oil consumed. the funding would help support implementation of the first carbon pollution and fuel economy standards for heavy-duty trucks. thank you for the opportunity to testify today. while my testimony reflects only some of the highlights of the budget request i look forward to answering your questions. >> thank you very much. we are going to each have six minutes. i want to start off there was a big critique of going over toxic air pollution from the power plants specifically to senator sessions, and i wanted to talk to you about that. because we fought off a couple amendments already and we know we are going to face congressional review act repeals on either the utility map. when i get into this, i saw the

amazing progress we could make if you are able to move ahead. because we are talking here about cutting marketing, arsenic chromium and other hazardous pollutants that can cause cancer and harm the reproductive developmental systems of our children in particular. but it's a threat to everybody. so as i look at your work that you've produced on this coming you say that once led all is implanted we will see it to 11,000 premature deaths of waited every year. we will see 2800 fewer cases of chronic bronchitis. we will see 4700 fewer heart attacks, 140,000 fewer asthma attacks and i know senator lautenberg, every time use began talking to senator lautenberg.

i just want to say every time you speak about losing your sister to get asthma -- i'm glad that you're reminded me of this because a lot of times you hear these speeches about bureaucracy and jobs and things which i think are off base, but we forget about why we set up this entity and what it means hapi that when the epa implements the utility max and starts to control hg, arsenic and chromium and other hazardous air pollutants we will see 140,000 fewer asthma attacks every year. we will see 5700 fewer hospital emergency room visits and we will see 3 million fewer restricted activities, so i guess my question is -- that's why the people support what you do come administrator. when you sit there and you'd hear this criticism coming from

the other side of the aisle and it is the perfect right to think the way they think and do what they do, and we have a big disagreement and it's very respectful. when i look at you sitting there with your people that must feel pretty darn good to have a job that you know at the end of the day is going to save 11,000 jobs a year just from one rule and chronic bronchitis and heart attack and asthma etc.. so i want you to put on the record how you come up with these stats so that people know about your review and who are the people making these investments. what is the process before you come up with these benefits? >> certainly. there is a well-developed body of science and scientific research are around the air pollution impacts on public health. it is probably that part of pollution that is best studied from an economic perspective,

and what happens is we look at the two main drivers and these are peer reviewed studies. bigger based on the work of our scientists who first look at hospital admissions and the track those controlling for other factors and they also do clinical test where the expos people to levels of pollution. the correlation between small and premature death and asthma is not speculate as possible because it is quite real. it's been estimated in the case of the mercury in the air toxics standards to save up to 11,000 premature deaths a year that has cost to the american people. that's very important to remember that the strong mercury and other harmful emissions have real benefits to americans. we've to put a price on life sweeten monetize this but

there's also the cost of lost workdays, sickness, children missing school and their care givers with them. all of that goes into our economic analysis. they are pure reviewed and widely accepted. >> i wanted that on the record, because we battle on the floor on this and we are going to keep on battling and we are been to keep on fighting because you have the facts on your side and we know if it is our mother or our father or our daughter or son or sister or our brother it could easily be one of those heart attacks one of those hospital missions that we feel it in the gut and it is our job to protect american families the way we protect our own. i wanted to close to ask a question about the ryan budget. this budget of the president puts the epa by 1% in the valvista to i'm not happy about it. i feel that the program is

essential because again, that saves lives. i don't like to cut the program. and i think it is essential. and i'm going to try to add back the programs. i'm not going to ask you about your feelings on them. i'm sure you fight for these programs, but we know that the president had to do something. but the rise in budget cuts the epa by 14%, and it would amount to a billion in cuts and i wanted you to respond to whether you thought that level of cuts would in fact threatened the health of our children and our family, that level of cuts. >> the agenda and done the analysis of the budget yet, madam chairman. let me simply say that the epa has taken painful cuts to get down to the 1%. it is misleading to say 1%, because we have actually increased the grants to the states and tribes. the document was put out is very

misleading. all that money passes to the epa to the states and tribes on purpose, and i would be very concerned about our ability to protect human health when we start looking at that. stat will you send us both senator inhofe had i the impact of the budget once you have studied it? and i would put in the record -- i just wanted to defect in the record you make a point i should have made that funding to the states, and that includes the tribes account for the largest percentage of your budget request. is that correct, 40%? in 2013? so these past the funds to the states. senator inhofe? >> thank you, madame chair. getting back to all of the above which was our mantra we were sincere that would include coal and there's been a lot of concern that the standards for the new electric generating

facilities are so strict that no new generations can be built. we know the existing ones and what their suffering under because the contracts are being cancelled as we speak. information and the rulemakings indicates that the new unit standard was set using performance data from the chambers units but the epa posted a chart showing the six separate test results for logan with logan trailing the standard five out of six times in a similar situation in the chambers. we have told the public the new unit standards would not prevent them from being built, and yet you're own data seems to show that the units used to set the standard would fail the compliance test. am i wrong on that? >> i believe i disagree with you on that, sir. the mercury toxic standards are based on be achieved technology

for the 12%. they look at individual contaminants like come arcuri, gases individually, and one of the concerns we work closely with is looking at the condensed and total particular matter as a surrogate for some of those pollutants. so we believe that they are achievable and the standards meet the requirement of the act in that regard. >> back to flow again, is not accurate that they failed five out of the six tests? >> i can certainly look at the individual data that you are citing the the plant i know well performing in new jersey so i know it fairly well. stomachs before, i actually -- that is one out of three unrelated questions, but one of them is i remember i was -- was 14 years ago and at that time i

was the chairman of the subcommittee where the majority and you might remember they were trying to regulate on the farms and all this stuff very similar to what is going on today under the same program the epa is trying to force the retailers to report when da silva custom fertilizer directly to their customers even though wall xm best of fertilizers held for sale to the ultimate consumers. now, farmers don't buy their fertilizer from wal-mart and they have to be custom blend it come as a technically that is selling to the ultimate consumer and i just want to get some kind of a commitment that we are going to let them enjoy the exemption that is in all right now in terms of the fertilizer sales. as an eccentric, i try to know everything about the epa for give a free program that he's managed to give me one that i am not familiar with.

i'm happy to look into the matter and answer your questions. >> welcome you know it used to make sense of though there is a reason we have infil all that they are exempt and i think the mistake is the way that it's being applied is they consider the ultimate consumer actually coming from a wal-mart or something like that. now, i would say that at least in responding to this for the record i think it's important that we see at least when they have to custom blend which is every case that they should be considered as selling to the ultimate consumer because there's a reason for that exemption and that is what i would like to do is get back from you and then be able to if there is -- i think this is the area that you agree and so i would like to get that. >> you will be submitting a questions -- >> i'm already doing it. why shouldn't the exemption stand as selling to the ultimate

consumer because it actually is. okay. that's good, that's good. here another unrelated thing is on the february 22nd epa guidance regarding the waters covered under the clean air act to omb for the counter a few. this goes way back. i can remember sitting here back when senator feingold actually introduced the clean water restoration act, the congressman oberstar did the same thing. we had this before us many times. it's turned out that this would be the most damaging thing and the other groups like that have said this is something that is and is not livable so consequently i was disappointed when we sent the guidance to the omb for the review, and not only

has the congress rejected the efforts to such a pearly expand the scope of the clean water act the majority of the justices including -- concluded the case, yesterday the epa government was exceeding its regulatory authorities and how to regulate our waters and i was asked how does the administration policy as articulated in the new guidance differ from the overreach that was overturned by the supreme court and that was only yesterday. however, it's been rejected twice before the case and in the swancc case. my interest here is to do something about this role in terms of the water treated. >> the case started yesterday

goes to process. at what point under the procedure since the clean water act is silent on the matter are those who are the recipient of the epa action allowed to challenge it in court, the court spoke obviously very clearly to that point and we will of course be abiding by that decision. they did not speak unanimously as a part of the decision to the issue of the continuing issue of which waters and the wetlands in the country are jurisdictional we have heard from a number of stakeholders around the country about the confusion that has resulted in the lack of protection on certain lands in certain areas, and that is what the guidance is which has been out for public comment and is now in the process of being finalized. >> if you probably know that senator barrasso is that the and not an effort and we're going to be supporting him senator session and senator heller adel

the stultz epa from finalizing guidance -- from using the guidance to make decisions about the scope of the claim and water act or turn this into a rule. so we are going to be doing what we can to stop that but i would like to get your response is how the court decisions are going to impact what you are going to be doing with of the water issues. >> thank you, senator. senator lautenberg? >> thank you very much, madame chair come and thank you come administrator lisa jackson. we are proud of the work that you and/or department has done. a dedicated people come and i met with many of them over the years starting with my superfund days and i know how much they feel is their commitment to their work and they will go to work under the circumstances and fulfill their missions.

we had a brief discussion i don't know whether any of you heard it the energy committee, of but one thing i learned here today is it might be part of the budget committee what we are talking about constantly is the costs of these things. i ran a few large business before i got here and i know one thing. we had to have revenues could carry the business alone that was higher than our expenses, and here we have a new economic theory that says it doesn't matter what your revenues are. we don't look at that side of things, yet we dwell on the fact that there are more rules and more position on the business and so forth, and i needed a

reminder, and i got a quote here from dr. george benjamin, president of the american public health association, pretty reliable, they simply hazardous emissions are linked to a wide range serious and immediate human health risks. but here we can't seem to get the message across because we are always talking about cost. and when you talk about cost don't you sometimes talk about the lives saved, can we convince our colleagues on either side somehow or another that it's not a good idea to put your kids up like a canary in decline and ignored what the consequences are? we had a fellow testify the hearing we had on the mercury emissions coming and was from a small town in ohio, she was a

councilman and they had to be careful about shutting the plant down. but cost maybe 50 or 60 jobs if we shut the plant down. but i went further and i found out that in the year 2010 of 440 asthma attacks, 47 -- 29 premature deaths, they ought to go to the members of those families and asked that the day continue saving money on the lives of the well-being of their children. i don't think so. over the past year, epa has set new standards that would cut the toxic air pollution from the power plants and industrial facilities. unfortunately, of now they are here to block the new toxic

standards. how many severe illnesses and even deaths could be prevented by the epa pollution limits? >> the mercury standards benefits are estimated to be up to 11,000 avoided premature deaths a year once fully implemented up to 130,000 avoided as asthma attacks or sometimes cases that require attention, 2500 fewer cases of bronchitis, and i don't have the number of heart attacks here as well, but the numbers are quite significant. >> that's how it is with you bleeding hearts. what about the money, come on. if you want to have something? >> we can monetized was benefits, and that is about --

sorry come up to $90 billion in 2016 and that's and you will. so it isn't fair to say that only cost. there are benefits. another way to think of it is you can pay a dollar to clean up the mercury and the arsenic and you can pay $10 to give yourself and your family to the doctor to deal with all of the pollution and the effect of the pollution. you pay either way. >> i am pleased to see that the epa budget increases funding for the chemical safety programs by $36 million. but there's still more than 80,000 chemicals on the epa inventory. and the current laws have limited the epa to testing the health effects of the just 200. that's over more than 30 years. even with this additional funding do you still believe the toxic substances control must be modernized in order to protect the public?

.. >> our belief is that they are able and confined in a variety of ways, so programs, as we don't believe there'll be an impact on health. >> and i closed by saying that

here, what we are saying is that if you don't, if you need oil for the car, you don't put it and, just drive faster to make up for it. thank you very much. >> senator whitehouse? >> thank you, chairman. administrator, to follow up on senator lautenberg issues, as you know, rhode island was scheduled to take a very, very big hit, and you reduced the hit that rhode island takes a little bit under the section 105 program. but when you add in taking the particular matter section testing and move it over, that adds to rhode island's hit. and when you pile in the elimination of the beach protection grants program, you know, we end up taking it pretty hard in this budget, relevant to other states, it seems to me

anyway. so i just want to let you know that we are going to be working very hard to try to redress that with you. once again, it was a downwind state, i don't believe we're grading a lot of pollution out of rhode island. the rest of the country has to worry about. and so the fact that our hit seems to be going way up when we are one of the less polluting states, we're downriver of most of the river pollution that comes. where downwind of the air pollution. we don't really harm anybody else. and so we'll be working with you on that. i just wanted to make sure you not important this was to us to have that recognized. there has been some suggestion that the new epa clean air rules could be responsible for fuel shortages in the northeast this summer.

i think the suggestion has been that pennsylvania in particular might suffer a fuel shortage. and i wanted, everything that has to do with what you do is often surrounded with propaganda, rumor and speculation. and i just wanted to get your sense of what the facts are on this. i know that washington has been largely fact-proofed by special interests in a lot of environ mental issues, but what are the facts on the? >> there is a specific issue in one specific area of the country it is not related to epa regulations that epa is working closely in monitoring the fuel supply situation. due to market factors, several refineries, which prefer to process light, sweet crude have decided that they would rather shut down than process heavier sour crude, which is on the

market these days. that simply means that we need to ensure that with those refiners gone the buckeye pipeline which serves them doesn't result in their not being a reliable supply of gasoline to the economy and customers in that marketplace. so -- sunoco has said they have plan in place to deliver a reliable supply of products in the areas that they serve, even if they failed to find a buyer for that one refinery. however, epa has been working with the department of energy. we work with the private sector, and continue to work with them. the concerns revolve around clean air act and the portions of the clean air act that lower the volatility of gasoline in the summer. because as you know, that's when gasoline is up rates and causes smog in our air on hot summer days, and it becomes a bit of a

cycle. we have well-established authority way to fuel standard in the event of any kind of actual fuel supply shortage with d.o.e. conference, use that authority, and we're certainly working closely with the state of pennsylvania and industry and d.o.e. on those issues. >> we will follow up with some questions for the record on the funding and its affects on rhode island, and i would ask if you could respond to those fairly quickly. because in the budget cycle, if we get stalled on that, then we are stuck waiting. so i would ask for your cooperation in providing a pretty quick answers. and i'd like to ask that a providence journal article from the summer of 2011 just be admitted into the record. madam chair, i ask unanimous consent for the article to be admitted into the record.

>> without objection. >> it describes a success story, contaminate swimming waters decreased by 35% in 2010, from 2009 level to antiquated some of the big projects that rhode island has done. the day commission has built enormous tunnels and receiving chambers underground to store storm water from our combined sewer overflow, storm systems. so that they don't have to bypass sewage treatment and they can be held and when capacity is restored, at the treatment plant they can be pumped and treated properly. newport has built a $6 million ultraviolet treatment system for a storm water that discharges onto easton beach. we are doing our job, and we have put a lot of money behind keeping our waters clean, and so it really hits hard when this

funding is cut off to rhode island to as i said, as a largely non-pollution producing state for the country. we are certainly deal with a lot more pollution from other states then we create for other states. our department of environmental management has reduced its air resources staff from 30 to 20 in the last three years because of budget cuts. so we're up against it, and i will be looking for support to work our way through this, but particularly a rapid entry to the question. thank you. >> thank you. senator sessions? >> thank you. madam chairman, and administrator jackson, you have had pretty good budget run in the last few years by any account, and i do have to say that this country does not have sufficient money to continue all our government agencies and departments at the same level of funding.

he just do not have it. and the house republicans have produced a budget. it's a long-term budget. it changes the debt course of america. it will keep us, hopefully, from eating a financial crisis. as erskine bowles, the chairman, president obama's of the day commission, warned that we're heading to. so i'm just looking at the numbers here, and i want you to recognize that everybody is going to have to tighten their belts onto the proposals for the defense department, would take by far the biggest reduction. that's not were funny. that's not coming down on its own. i talk about the basic defense budget. they're taking significant reduction in spending. under this question would be very dramatic. but wouldn't you recognize that even though we are having their

greatest deficits in history of the republic, that your budget has been continued upwards since 2008, and remains considerably above that level? >> sir, i think that, that, i don't agree with that. we did get a bump up primarily to fund water infrastructure. that's state money, and the great lakes program which is grant money. that does not get spent primarily by epa, by any means. we took a 15% budget cut in 2011, 3% in 2012, 1% in 2013. and those numbers are misleading because in those times we've increased our funny as i sit in my opening remarks to try to continue to fund a state-based programs. because we know that state budgets are such that the state needs the clean air and clean water act funding so they can keep their programs going. >> with regard to the state funny, i notice you seem to

react adversely to my comment based on looking at your budget request. if i'm wrong i would like to be directed company seems to me that in fact on this years budget your numbers for epa go up in the amount of funding to the states go down. we have the chart. i could show that. that's numbers we score. you don't dispute that, do you? >> i do indeed. i don't dispute it and i'm not saying you're wrong. i would say i would look at those numbers differently. i think the chart is a bit misleading. the decrease in state and tribal funding that you are showing is because the money for the state revolving fund program is being cut. that is the same money -- >> is that part of your budget? >> it is but speed is you're supposed to cut the revolving fund money while increasing goes, aren't you? >> no, so we are not. we are proposing to cut the places where the largest increases happen in the 2010

budget, which is the s. r. f. funding. >> well, it seems to me that that's what happened. >> well, sir -- >> and i'm just kind of taken aback. the numbers are the numbers. so whatever it is, the revolving, the money that goes to the states, that has been reduced, and we do not, you value the state participation, and they are partners in our efforts to make our environment better. so i'm just concerned about that. with regard to your statement about reducing spending, your base budget was 7.4 billion in 2008. it jumped to a 10.2. it is basically not been dropped down to 8.3, which is still a

15, 12% increase over where you were. after having substantial increases over a number of years. i guess my only comment to you, and to the chairman is, we'll all have to tighten our belt we would like for you to give every folks you possibly can on containing costs. i believe they can be done better. i also think, you have to consider the impact that the regulations are having on the american people. its impact on job creation, the cost of electricity, the cost of gasoline, and those kind of things that are placing our economy at risk. how would you respond to my constituents who are telling me that they have never seen such a surge of regulatory impact as they are now on the

environmental protection agency? they think much of it is not responsible and unwise. >> i would say that, first, whether it is the pace of regulation, which i find -- signed fewer regulations per year than my predecessors, or the fact that several of the regulations that we have done, the mercury and air toxics standards, across the state air pollution rule were the result of the court decisions that reman did and found previous versions of those regulations illegal. and the last i would offer is that those regulations, murder and air toxics is a great example, it's $10 of health benefits savings for a dollar invested in our economy. it creates 46,000 short-term construction jobs and 8000 long-term utility jobs. so the american people get health protection and savings in terms of what they have to pay to keep themselves healthy.

>> administrator jackson, i don't believe that when you mandate a company to employ more people to meet a regulation, that they otherwise would not be employed, but that is really a jobs creator. because it reduces their will. it reduces their ability to hire people to do productive items. the question is whether not the regulation justifies the cost, i believe. my time is up. so that's the kind of thing, and as to your statement about the health impact on mercury and so forth, et a's numbers with regard to health benefits are widely exaggerated, in my view. and i would be glad to see the documents that would justify that number it and would you submit that to me? >> they're part of the richter impact analysis for the rules. happy to do so.

i would also like -- >> i examine some of them in the past, and they do not back up what you're witnesses have said. >> okay. senator sessions, when you're gone i asked the same question about are these peer-reviewed studies, and so i would like to get that transcript, the answered that administrator jackson gave me. but in addition i would be very interested in being copied on this, because the point was made that if we ever had a regiment that is clear, it's the scientific studies that look at hospital emissions and the rest. so i think we ought to look at it. >> the studies with some sort of polling data about whether people would pay more. it was not a real health study they were citing. so i would just like to see it, navy, i hope we do get that health benefits from improved environmental quality. >> i think it's good to go back to i have so much respect for my friend, and we were together on certain issues. on this one we are miles,

planets, let's face the fact that i think it's good for people to see this today. i just don't let it go unanswered because there's no way under the clean air act you take a poll to find out how many premature deaths are being prevented. we have that all documented. so would you please send a copy? and i would ask unanimous consent to place in the record and october 4, 2011, a very interesting op-ed written by bruce bartlett. he held senior policy in the reagan and george h. w. bush administration, and he served on the staff of jack kim and ron paul. so it's really interesting, and i will put it in but here's the opening. republicans have a problem. people increasingly concerned about unemployment but republicans have nothing to offer. the gop of poses additional government spending for jobs programs. it will likely lead to further layoffs. he concludes by saying come in

my opinion regulatory uncertainty is a canard advanced are republicans that allows them to use problems to pursue an agenda. supported by the business community year in and year out. in other words, is a simple case of political opportunism, not a serious effort to do with high unemployment. ivc senator sessions, they would all disagree with this, but i think it's interesting. and the other is i think a very important poll that runs, you know, senator, i believe you when you say that people come up to you when you are at home. the impact on allies is that they've ever seen before. that's basically what you said. i totally agree with you. that that happened in your state. i wanted to say, i have never and never heard that when i go. i haven't had one person, to me and said, please cancel the clean air act regulations. you know, i need more pollution, barbara. fight against the. and if you look at this, look at

this poll, where's the one about the bipartisan poll, broad support and spectrum. when asked about setting stricter limits, on the mercury that power plants and other in it, and that is a reg that is fiercely opposed by my colleagues on the other side, 78% said of likely voters, they were in favor of the epa updating standards. so they're such, we see the world so differently, i find it so intriguing. the way we come to this. but i am very interested in seeing the data that senator asked for. >> madam chairwoman, just briefly you took liberty and it's an important issue for us to talk about, but there's an article by stephen malloy, and he says the epa said the air

pollution kills tens of thousands of people annually. this is on par with traffic accidents, fatalities. while we can identify traffic accident victims, air pollution victims are unknown, unidentified. and as far as anyone can tell, statements of epa's statistical imagination. that's what he said it ought not to be too much to ask epa to produce some tangible evidence that air pollution is causing the actual harm to real people. so that's what i'm asking for, i guess. let's see the numbers that justify the back, the data, that justifies the numbers but i think the chairman and i agree on that. >> we do agree and i did ask the question before. i ask unanimous consent to put in the record a sheet put out by the american academy of pediatrics talking about how much they support your work. but that in the record. senator udall come your the last word, and most other centers, and then absolutely i will call

on you. >> great. thank you, madam chair. administrator jackson, the u.s.-mexico border stretches for over 2000 miles and is home to many thousands of people who need to be connected to modern water and sewer systems for the first time. i'm glad you're requesting 10 million for border environmental infrastructure, but this amount is a fraction of what this program has traditionally received. latches appropriations act only provided 5 million. we hear a lot about water infrastructure needs, but if all our states face will we see on the new mexico border, it would be a national emergency. will you work with us to ensure that the appropriations committee includes at least 10 million requested in your fy '13 budget? >> certainly i'm happy to give you any information to support what is clearly an important program, senator.

these are tough choices and we are proposing less money. we're proposing more than what was in last years in active but only slightly more. so we're happy to get you information so that you can make that case. >> but you're going to aggressively support your 10 million, which is what's in the president's budget i believe? >> i believe it is for a half, but -- i'm sorry. i have the information. it is. i'm sorry. and we're actually in accord. please forgive me. >> thank you. the epa's border 2012 program is coming to an end. and i understand a new border 2020 program is being developed to replace it. will you ensure that border environmental issues receive a top level attention at epa headquarters going forward? >> yes, sir. it is a priority. >> and you're going to be time in terms of getting out as the one program expires, 2012 or

2024 up rogue ran? >> it is scheduled, the border 2020 program launch is scheduled for august 2012. >> great, thank you very much. i wanted to talk a little bit with you about the san juan generating stations and epa's regional haze plan. this an ongoing disagreement between the u.s. epa and the state of new mexico about the clean air act regional haze plan for the san juan generating stations in the four corners region in new mexico. both epa and the state. to be dug in on opposite sides with competing plans and cost estimates and complex technical disagreements. i believe most new mexicans want epa and the state to follow the clean air act and preserve the visibility of our great western landscapes and improve public health. but many are also concerned about a potential increase in electricity ways. i hope all five, i hope that all mindful think constructively

about win-win solution here. i realize that region success primary responsibility here, but will you ensure the epa headquarters is also engaged on this issue and that the epa continues to work cooperatively with the state of new mexico and our local utility to work through this issue in the best possible way? >> yes, senator. >> thank you very much. and on green infrastructure for the state revolving funds, or what sometimes is called smart water comic epa's budget request continues a 20% set aside for green infrastructure qualifying projects within the two state revolving fund. i want to stress that when we talk about green infrastructure, we're talking about two kinds of green. reducing the amount of concrete and using the natural landscape for storm water systems, or installing energy-efficient improvements at a water

treatment plant, or both. these are both good for the environment. but just as importantly these kinds of projects save green money for water, utility ratepayers by reducing construction costs and energy bills. with you continue to advocate for these set-asides and assure the epa provide appropriate guidance to states on how to implement in? >> yes, sir. i'm a very strong supporter of green infrastructure. and so are, by the way, mayors and local communities who get win-win results. >> i know many of our mayors are very involved in this and very supportive of it. u.s. water utilities waste an estimated 7 billion gallons of treated drinking water through leaks and ruptures. does epa plan to become more involved in promoting smart water systems that detect leaks and better manage water systems to reduce losses, energy use and contaminations? >> yes. we're happy to be so supportive

both through the funding wise, for the state revolving fund, but also through technical assistance, working both with the industry, the practitioners and, of course, with the state and local government. there is such a need out there, as we heard earlier, that would to prioritize with the states where we can be financially able. >> thank you, administrator jackson. and i know that you have a very good, solid professional staff at the epa, and with very much appreciate all of their hardware. thank you, and i yield back. thank you, madam chair. >> senator udall, i think is a much in sitting through and asking such good question. and administered, we really do appreciate you so much. and you just tell the truth from the hard, and you caring actress possibilities to the people, and all i wanted it as chairman of this committee is make sure that you keep that out until up.

everyone is counting on you. the kids and soon-to-be born and our families. thank you very much. we stand adjourned. [inaudible conversations] >> [inaudible conversations]

>> [inaudible conversations] ..

>> think of the fdr memorial. it wasn't just designed, it was three plus designs and designed when they got to the final plan

and so i think that we shouldn't be afraid of looking at this issue because we are building something for the centuries and we want to get it right.

>> the house budget committee earlier this week approved chairman paul ryan's 2013 budget plan 19-18. it cuts more than $5 trillion in spending and changes the tax code from six individual tax brackets to two. a 25% top rate and 10% lower rate. the rain plans which is medicare from ac for service to a voucher like program. the committee ran through the planned this week. this is a one-hour portion. >> the assumptions and the budget resolution are the savings for the affordable care act and they medicare should not have gone to expansion in other entitlement programs. >> that is the same entitlement program. >> no, they should be used to cover the exchange subsidies and expansion and medicaid. instead they should be devoted to the solvency of medicare and to the deficit reduction.

to achieve that result the budget is sam's expansion in the affordable care act and are repealed. in terms of the assumptions in terms of how that is exactly implement beyond that or what congress may do that will be up to the ways and means energy and commerce committee. >> they could decide they're going to find money elsewhere that would actually leave the additional expansion as you say of coverage for medicare beneficiaries, the seniors of this country through very specific expansions as you call it under medicare. one was that the doughnut hole is going to be closed and they have got real benefits, additional expansion as you call them benefits for prescription drug coverage. they no longer have to pay the 20% co-pay for preventative primary care. that is an expansion that goes way. the attention to primary care and patient-centered medical homes, those additional dollars in the expansion in medicare so

those three in particular but there are others. do you consider expansions inappropriate? they are going away sometime in the future and this committee could change their mind and reinstate that if they could find the money but under this but budget the assumption is that as an expansion, that was a bad idea and it goes away? >> the chairman smark assumes that the affordable care act as a repeal. >> those benefits go away. >> in terms of specifics we can go through the individual some shins but the budget committee does not determine what happens with the doughnut hole and these very specific assumptions. we have an overall number and it sets overall numbers. the committee is the jurisdiction to determine the details. >> right but again because the house law will be repealed at least for now the assumption has to be that those expansions, you have answered the question but it is very clear that those will be repealed and again i am committed to decide to do

something other. really on that, the budget also is sam's the $500 billion in savings under the affordable care act, those savings or referred to last year as cuts to medicare. they remain in the budget? they are accounted for in the budget as a savings of the $500 billion? >> we assume those savings and devote into both into the solvency of medicare and the deficit reductions that of covering the expansion. >> but if they stay in place and there has been some confusion about that so i just wanted to be clear that remained and i did just want to be -- to follow up on what the chairman asked about the 1% increase if medicare goes above the 1% increase. as you point out in this competitive system for private insurance companies decide to spend more, charge more than a 1% of gdp, the government would

no longer pay more than 1% of gdp. that is what you said before. you would cap at 1%. who would pay that difference than? wouldn't save god -- dollars to the government but who would pay those since it's not defined in the budget? who would actually pick up the difference? is there any prevention are anything in the budget that doesn't allow those private insurance companies to charge more to the beneficiaries or is it silent on that? >> the assumption is the competitive bidding with bring us well within the .5% above gdp. >> but if it didn't? >> the premium support would be capped at that level and it's the same -- under the present policy the ipath has the same issue. it's not clear how the ipath is going to achieve those savings. >> you also embraced this notion

about 1% cap on government spending and the potential that exists out there for that shift to be made to individual seniors if insurers decide to the competitive bidding that they will still charge more that shift is made toward our seniors. one question and i have to yield back. [inaudible] [inaudible] assumptions are that the medicare savings go toward solvency of the program and deficit reduction, not expansion. [inaudible] >> yes, sir. >> thank you.

mr. van hollen and mr. chairman, i want to understand how you treat transportation. under this bill, can you give a sense of exactly how much is going to be available if this were somehow to be inactive? would it be available for the transportation funds and she -- functions? >> the transportation function we go through and make comparisons and the largest program is the transportation function of the highway program and they are financed by a trust fund and under current law that trust fund is going to become insolvent in the coming fiscal year articulately 2013 helped by the budget resolution. as a result, the budget reflects a policy funding for the highway program and transit programs should be as it is then when the program was first created which

would be the user fee findings. we start with that assumption that we are going to rebalance highway expenditures with the revenues coming into the highway program. next, we do three things. we send three things to the budget. the first is in the past and recently there then general fund transfers that it amounted to about $35 billion into the highway trust fund. right now those are recorded as a cost and we think they should be recorded as a cost that they would be recorded as a costs going forward. the second thing we do is the budget resolution is sam's expansion of oil and gas on federal lands. the u.s. has huge resources, energy resources and the federal government is the largest land holder in the united states. we assumed the additional proceeds from that exploration activity will go into the highway trust fund.

we rely on cbo's and recollection it is $5 billion over the 10 year period. because it takes a while for those lands to become available and cbo is conservative on their estimates and we used cbo's estimates there is still going to be a large shortfall which is in the program so as a result we create another sort of mechanism called the reserve fund and the chairman has the authority to adjust the aggregate in the budget resolution committee aggregations and so forth to ensure that legislation comes along to offset, it finds other ways to offset the shortfall and he can adjust the allocations, provide additional funds to the highway program and the transit program. >> i would like to understand how much money under this proposal would be guaranteed for the transportation functions

next fiscal year? [inaudible conversations] >> our total level for function 400, for fiscal year 2013 is $57 billion. total outlays are $49 billion, around 50 billion for 2013. >> how does that compare to what you spent this year? >> the current spending is $89 billion in budget authority and $92.7 billion in outlay. >> okay. $92 billion this year in outlay.

89 billion-dollar budget authority. you would take that down to $57 billion in authority and about $50 billion in outlay? >> correct, sir. >> thank you. >> thank you it is the budget we were confused about so i just wanted to make sure i understand it. so, your budget for sam's that compare to the level of transportation funding in this fiscal year in outlays, you will reduce that by 40 or $50 billion in the next fiscal year, is that correct?

is going to start having to make dramatic reductions under current law to rebalance bring spending down in line with revenue before the chairman's mark has a policy to deal with that. one of the resume funds allows congress to find additional savings elsewhere that can be used to avoid these reductions from occurring. >> just so i understand your budget presumes that those changes will not occur, right? is that right? >> the levels reflect current law, but the budget resolution policies are to provide a new source of revenue by virtue of

oil and gas exploration. it will take time before that shows up and in that it provides a mechanism such that if there are additional savings now that they can be used to offset the shortfall and about the highway program to continue at whatever level congress needs to be the appropriate level. >> but it assumes that for purposes of this legislature it assumes that there will be the 5 billion for oil and gas use and it will be available in this budget? >> yes, and that for $5 billion, we do not use that for deficit reduction. goes into the highway program and offsets the shortfall. >> yes, partially. >> i shouldn't have said that. [laughter] >> so had cbo scored that particular proposal? >> we have been working with the

congressional budget office. it's a complicated area and that the contract of the wording for the program is controlled by the authorizing committee. in the case of the tni committee. it's a program that states ultimately manage it. the outlays on the other hand are controlled by the appropriations committee. they said various obligations. we have been trying to get a sense rss in terms of what happens under current law and the budgetary impact of that in the chairman's mark is designed to reflect that. >> i guess i i'm also asking with respect to the revenue generated from the oil and gas royalties, whether or not cbo has scored that particular provision? >> we gave them assumptions and the estimates on oil and gas exploration rolled based on the congressional budget office

estimates, based on the assumptions that we gave them. 's being and are assumptions available? >> let me just check. i just want to doublecheck and get back to you on that in terms of what specific areas are of where additional exploration is. >> understand what my question raises. the distinction between cbo looking at a policy proposal and concluding what is a reasonable amount of general revenue would be and they list the specific assumptions and they just calculate mathematically how much revenue is generated. there's a fundamental distinction between those two approaches. >> i believe in the transportation bill the tni committee reported the resources committee they had about $4 billion based on specific language provisions, specific revisions of the bill that the

cbo scored. that is what our estimate is based on. >> thank you. before we finish this, i think it would be useful for us all to probe a little bit here because my understanding is that on the order of magnitude of $56 billion in outlays that are anticipated for 2013. these are already legally binding and transportation and it goes beyond the highway trust fund as a series of things. that no new contracts, no salaries, no new projects. these agencies would still be committed to $56.3 billion in

commitments that have been made in prior years. >> in terms of exactly how executing a situation where the highway trust fund and the department of transportation, they are bound that they cannot spend more than what is available in the trust fund. in terms of how that is executed we don't know how that is going to happen. there a series of different players in the state and federal government and government and so forth. >> i just want to, in the department of transportation there are more commitments because the highway programs that you are allocating as i understand it, $50 billion. there are $56 billion of outlays that are scheduled, so that if you shut everything down, no new programs, you are not paying people, you don't have enough to satisfy the obligation.

i mean, i just read an analysis last night and this was what i was told. and i would like some help to understand the situation we have got. >> their other assumptions in our budget resolution in terms of reductions to the transportation function. by far the largest one is the highway program but there are other assumptions. for example we resent high-speed rail money and their other reductions we make but overall we have a what assumption that the highway program would have to, would have to act very quickly to stop spending and that would bode for the entire system not just the federal level but the state level as well for the programs they administer. >> it will in fact hammer our people back home who rely on this. there are contracts and their projects underway that we have all dealt with but i will give you a copy of the article.

again it's from transportation weekly. a line it out. they say that its $56 billion already committed and you are telling us that you'll have less than $50 billion available to satisfy these obligations? i think we just ought to know that going forward and to be able to explain to our friends at home what the consequences are of this budget next year as we are going into a construction cycle now. i hope, again hope, that the house would actually approve the bipartisan senate bill that is significantly above this level for the transportation side to have god forbid some new revenues that they have three-quarters of the house and senate, excuse me, three-quarters of the senate approving so that we would be able to give people an answer as

we are going into a construction cycle for the next year and a half. but i would, if you would have some of your team look at this article from transportation weekly and help us understand what we are getting into, i would appreciate it. >> yes, sir. >> thank you very much. >> i think my colleague and i think this committee will have a position on what the gentleman is talking about moving forward on that transportation bill. bill. if i could go back to asking some questions about the income security function, function 600, where there is a savings showing us savings totaling $380 billion, and i wonder if you could identify how you assume that savings will be achieved? >> the largest savings are in the mandatory area.

the savings, the two largest items are food stamps, or s.n.a.p. program where we assume the program moves to a block grant in 2017 i believe, 16 excuse me and grows with the population and the food inflation adjustment after that. the other large savings is in the area of retirement reform for federal employees, civil employees. i believe we have $112 billion a 10 year savings and through reform of that area we increased the match. our assumption is we increase the match of the federal employees paid at the same level that the federal government pays for their retirement contributions that were made. >> let me just focus for a

minute on snap. i know it seems to pay for just about every bill that goes to the house these days and i think that is a huge mistake, but i'm just going to focus on the budget question here with respect to snap. you loch rannoch snap and make receiving a contingent on work or job training. how much do you assume would be saved by applying that condition? >> to specific savings we have in the s.n.a.p. program beyond block granting bar, there is a provision, where if you qualify i believe, actually let me get ted to walk through this. >> there are two provisions outside of the block grant. one that would and categorical

eligibility which allows for individuals to be automatically eligible for food stamps if they receive tanf funded service. that basically means if you receive a tanf brochure or the 1-800-number program you would be eligible for under less restrictive eligibility -- eligibility rules. the form here requires individuals to be eligible for cash assistance rather than broad-based general tanf funding. the other assumption is sending the practice known as -- certain states are providing individuals with de minimis life checks and when they receive that, the individuals automatically receive increased food stamp benefits. >> let me just break that down a little bit. how much are you assuming is being saved just by virtue of the block grant itself?

>> $133.5 billion over 10 years. >> how much is saved by the tanf requirement? >> that is the total less than all the savings and that would include both the categorical savings and the block grant. >> and cents, since job training is a condition of receiving s.n.a.p., am i right about that, that you do make that a condition? >> we want to replicate the reforms that were achieved in a well formed area in the 1990s so we want to move more towards work requirement and so forth. and we have built those assumptions into our budget. >> as you may remember that reform provided at that time funds to help enforce training

so my question is in jamaica workforce training a condition of receiving food stamps, how much do you assume in the budget will be spent in providing that workforce training? >> food stamps have gone through a huge growth in the past. i think it has quadrupled over a period of time, just an enormous growth. there've been a number of legislative expansions so the assumption is to move to a block grant to make sure that there are working training requirements but just in the case with other programs where we have given the states greater flexibility, it would be their responsibility to figure out how to allocate the funds and -- >> i don't want to get into it, i just want to get an answer. as i understand what you are saying, this budget does not provide those states with any funds to provide the job

training that would be required as a condition of receiving food stamps. is that correct? >> within food stamps it would be addressed by virtue of the, through the block grant. the federal government has a host of other job training programs and 49 of them spread across several agencies. there is another reform in the chairman's mark to consolidate those programs to better target and to get better results from job training at the federal level. >> the answer is, you have the block grant and the work requirement for the job training requirements. there's another provision in the budget we propose to consolidate the 49 different various federal job training programs and career scholarship so we have a job training proposal in another part of the budget to streamline federal job training programs to go to the individual career scholarship so there is a job training program in this budget.

let's also not forget the fact that as a result of the 99 welfare reform, new job training programs were begun in those states as well which are still in place. >> thank you. okay, insurance. >> i do want to ask one other question on health care, and that was, one of the aspects of the budget is a fairly dramatic cut in medicaid. now this has been explained as a flexibility to our governors, our states and being able to think differently under medicaid. states right now i've quite a bit of flexibility under medicaid. they set the rates of reimbursement and have made it very difficult, but the cuts in this budget in a sense basically start at 30% and go up to almost

70 or 75% over time. you may want to correct me on that but i understand the $800 billion are the numbers that we have. if we are misreading that, that would be a good thing. >> we don't make up 30% immediate reduction in medicaid. over the ten-year period, medicaid is disbursed with rapid growth in the space program and on top of that there is a large expansion under the affordable care act. i believe the block grant is $810 billion relative to -- in terms of the percentage, we could go back and find that out for you. >> that would be helpful. it is about 30% so some of this is cutting the expansion that came from the affordable care act by one of my questions for u.s., what standards or is there anything in the budget that would suggest that we are going to hold states and government

accountable for providing the services under dedicate? women and children, poor women and children but also you know nursing home and frail six seniors. we will talk about that a little later but is there anyway, is there something in the budget that holds governors accountable or states accountable for continuing to provide support for seniors in nursing homes, the very frail, elderly or disabled or is that up to the governor's? >> our assumption is that would still be required to send their medicaid allotment on their medicaid eligible population. we don't go into that in the budget. that is the assumption. on the medicare side too i just want to point out you will see over the long term even though the medicare members are going down in the medicaid numbers are growing in part because the medicare reform assumes responsibility for the dual eligible population so will we

have an additional low income supplement given to the medicaid eligibles and those just above medicaid eligibility. >> do you have some definition about that? i have read that is the assumption. we have only heard it for play. could you provide us with some greater information about how the assumptions you are make thing about how that would be handled because that is actually something that is certainly new for us. >> we can provide this information. >> there are some questions we will follow up later with the assumptions you are making about whether the states would have adequate resources to be able to do what they are doing now for frail, elderly and our nursing homes under medicaid, given the reductions that we made in this budget. i yield back. >> let me interrupt for just a second. it's not the final legislation. that is what the author rise committee is doing. the budgetary resolution contains certain assumptions and

it also assumes in its assumptions that medicaid money goes to the medicaid population. a government cannot take it and use it for roads or something like that but the level of specificity only rests with the commerce committee which actually would write that type of legislation so it's important that you know in a budget resolution you don't have that level of detail. that is what the operation to end up doing. >> the category between women and children is a broad category. seniors, they can provide a variety of services there. there is no way of knowing at this point in the budget without the detail coming later about how this money might be used and how it might actually affect our frail. >> the assumption is that moscow for the intended population. >> mr. chairman, may i comment as well? is that possible? i just want to point out that the medicaid system right now is, makes it such that we spend a lot of money that is wasted on folks who are by and large

healthy. right now and the in the state of georgia for example, a third of the folks on the medicaid rolls. >> i think they are are submitted so why do we get into this conversation then. we will sticks within the ways -- the lanes of the procedure. city can we turn to education and employment function, 500, where that function is cut by 166 billion below the baseline over a ten-year period. how much of that is from the student aid programs? >> again we have assumptions in terms of what happens on these programs ultimately to be determined by the authorizing committees. with respect to the mandatory program in education, there were some expansions that were done

and some bills and in fact one of them was even a reconciliation bill, expansions that were done for income-based repayment programs. we assume that expansion would be reversed. there are other assumptions on the mandatory side that we may. >> do you have any assumptions regarding programs? >> upheld grants, we assume, we do not assume an increase in the maximum. we assume that the current award level, the president's budget has the higher award level but his budget does not sustain funding for that higher award level. heel they funded it for two years for some shin on the pell grant it would be funded within the discretionary them out. we also assume that the pell grant funded to the discretionary program and has this bifurcated treatment now and a portion funded with discretionary funds. we assume the program is funded

with discretionary resources and that the maximum award is being paid. >> but that is actually a portion of that 166, the shift from mandatory to discretionary. >> do you assume the doubling of the staff with low interest rates that are coming up? >> we make no change in the assumption based under the current law. >> okay. let me turn to the function 920, allowances. your budget shows for each of the functions, certain spending. i assume they are targets for the different areas, defense, international affairs, education and then you have god 900 alien dollars in your own allowances function. could you explain what that represents? >> the era couple of things

going on. the first is that the cbo with respect to the sequester savings, put the savings and function 920. in addition, when we focus on discretionary programs we are really focused on the budget year, fiscal year 2013 in terms of what is going on in our specific assumptions. we carry some of those in assumptions into the out-years but it will be something that is revisited through the appropriations process so we didn't spend a great deal of time i'm going through individually what are the specific assumptions for the next 10 years in the discretionary programs? that will ultimately be determined by the appropriations committee. the other thing, when you look at the president's budget, he carries all olive is all of his out your savings, all in an allowance and i specify allowance. we have specified a fair amount of our savings but we haven't, we haven't listed them. also within 91020 we have

specific proposals that cut across the government. a couple of examples are in attrition, in the federal workforce savings, the cbo baseline has disaster funding that was enacted last year. we move that funding and there are couple of areas where we have specifics as well. >> just so i understand, those allowances, this $900 billion in cuts which is an unusual amount of money in that category. so the appropriators could cut defense by that amount if that is what they decided or by any amount up to that. is that right? >> our overall discretionary levels in the out-years in the budget control act levels under, after the joint committee, beyond 2013 we assume total discretionary spending at those levels. our defense spending is frozen at this year's level which is higher than the president's budget this year and then we

have a real growth in the defense budget so we did not assume any reductions in the defense budget in the out-years. we assume those savings are achieved in non-defense programs. >> if i could just for clarification? you are showing in your function tables you go out for 10 years, you are showing a certain level of spending but you're also showing levels of spending in the other functions, right? >> yes, sir. >> yet you have this allowance of $900 billion so is there anything in your budget that says defense spending would remain the same levels and all those functions in the out-years anymore than any other function? >> if you look at the baseline, has very very large savings already. that was our starting point to mark up the budget. additional savings were on the order of about $200 billion.

we did assume specific savings that are difficult to distribute in the individual functions from attrition in the federal workforce. i believe the pay freeze we have, those savings in function 920 because they are difficult to distribute across the functions but yes there are unspecified savings. they are not as large as the $900 billion. >> i gather that the appropriators are free to distribute those $900 billion among different functions, including defense? >> they are always free to do that. we cannot define how the appropriations committee appropriates bandhs. >> but we could appropriate a appropriator appropriate a firewall. >> we did not create a firewall. scheme my last question mr. chairman, last one. with your indulgence we have some minor ones that we think hopefully the staff could answer in more detail. just with respect to the overall

discretionary cap for this year in your budget, which of course there has been much discussion about. as you know mr. chairman, we believe that there is a level set and was put in place and signed by the president. one of our budget reform was to do that so that it would be predictable. apparently that is not predictable in this case, but i want to know, what exactly is the discretionary spending cap in this proposed budget? >> i think it might be useful to start to describe how the budget control act works. the cap was established for 2013 was $1,000,047,000,000. the joint select committee on deficit reduction was assigned

to achieve savings. if the joint committee did not achieve the savings which he did not that cap is going to be reduced to $950 billion on january 2, 2013. so there are really two caps in the budget control act. there is 1047, and $950 billion but to answer your question, the level we would set for the appropriations committee in this resolution would be 1 trillion, 28 billion. >> alright, now it is 1:45 and we have a half-hour before the vote i believe so let's proceed to amendments. >> may i make one request? i referenced an article, -- >> without objection it will be included in the record. >> thank you. >> we will now proceed to consideration of fiscal year

2013 current resolution on the budget. the staff will give an overview. sorry, i am on the wrong page. under committee rule nine the committee will consider the budget aggregates functional categories and other matters. amendments may be offered subject to disagreement between the majority and minority. after the stockman has been imprint approved it will be incorporated into the current resolution up on the final vote whether to report the measure to the house. the committee will now proceed to consideration of the functional categories and other matters. the ranking member and i have agreed to limit the time for consideration of each amendment and amendment process. the committee, the ranking member and i have agreed to limit time for the consideration of each amendment so that there will be ample opportunity for all members to offer amendments or good list of amendments has been distributed to members. as part of this agreement the time for each tier 1 amendment

will be limited to 20 minutes. tier 2 limited to 15 minutes in tier 3 will be limited to 10 minutes. debate time will be evenly divided between the sponsor of the amendment and a member of pose. the proponent of the amendment will have one minute reserve to close so it will go nine, 10 and then back to one. were example in tier 1. the document will be considered as considered as read and open to an amendment at any point. >> since we may have votes at any time during the day, does that give the chair the ability to recess? >> the gentleman asked for unanimous consent. without objection, agreed to. are there any amendments? i think you are first up ms. schwartz. >> i do have an amen. >> the clerk will designate the amendment and staff will distribute copies of of the amendment. >> an amendment offered by

ms. schwartz, and amendment relating to medicare. >> it's an amendment that would prevent this budget to end medicare as we know it. and i want to just begin and there are couple of others that want to speak to it. for decades medicare has been a lifeline for older americans, providing quality and affordable health coverage for all seniors in our country. the creation of medicare in 1965 address the fundamental challenge of ensuring aging seniors that their health care costs increase in incomes decline. prior to medicare a little over half of those over 65 had insurance and private insurers were permitting coverage to those in need of care. medicare is a promise to our seniors that they will not be left alone to manage the burden of health care costs in their most vulnerable years. house republicans are now again proposing to break that promise.

the republican medicare faucher planned and medicare guarantees of a specific set of health benefits to our seniors. against a wide array of choices currently available under medicaid from traditional fee-for-service in which 97% of physicians participate and providers, to medicare advantage, new innovative delivery model. at the voucher offers vital not only limited in the mouth or by limiting choices for seniors will have depending on their ability to pay but will also make no guarantees that they can keep their current benefits or their own doctor. this year's republican plan, just like last year's proposal, not only eliminates guaranteed benefits and shift costs to beneficiaries but does nothing to address the underlying causes of growing health care costs. they cost rising seniors alone will bear the financial burden the future.

last year's republican budget will have increased health care costs to a 65-year-old by more than $6000 in 2022. and yet knowing that, they are proposing this very same agenda again. there is a better way to confront the growing health care costs for seniors and for all americans. thanks to the pill we put in place and the republicans repealed under this budget, we are moving from a highly fragmented health services to innovative payment and delivery models that improve quality while reducing costs. the patient-centered medical home's, bundled payment, fewer readmissions to a hospital, better transition of care and improve care coordination for those with chronic diseases billions of dollars will be saved for seniors and to taxpayers. this republican budget walks

away from health care savings in the affordable care act that protects seniors access to care and reduces our nation's deficit. their budget weakens medicare and reverses the potential transformation of health care service delivery. this republican budget walks away from coverage for prevention, primary care, prescription drug coverage at a cost to current seniors as well as future seniors. this republican budget walks away from our seniors in nursing homes. every day 48 million elderly and disabled americans across this country, and medicare for their lifesaving medications, doctor visits and hospital care. denying this guarantee of health care by privatizing medicare is not responsible budgeting. it's a betrayal of our nations seniors and this administration will not let it happen. with that i yield to my good friend and the ranking member,

congressman chris van hollen. >> thank you ms. schwartz and thank you for offering this amendment. as this committee knows very well, the increase in costs for beneficiaries in the private market have been going up at least as fast in most years faster, then the increase of costs in the medicare program. we also know by looking at data care advantage itself, that until the passage of the affordable care act, we were paying 140% in many cases of fee-for-service. let me say that again. we were providing private plans with a huge subsidy paid not only by taxpayers but by every medicare beneficiary in the fee-for-service program. so to suggest this is a solution that is counter to the facts. now, and it's pretty clear from the structure of this proposal that at the end of the day you

realize we cannot rely on the market. because unlike the federal employee health benefit program, unlike medicare part d prescription drug, which republicans say is a model, in this case, in this case you are capping the amount of the voucher, whatever you want to call it, regardless of the increase in health care costs. and when you do that, when you do that, you are transferring the cost and risks of rising health care costs to the seniors, who are going to have to pay a lot more. that is why cbo did this analysis last year based on the other assumptions. now there are different parameters here but again the consequences are the same and as mr. smythe just told us in response to the questions, the reality is if those costs rise

at a rate that is faster than gdp plus .5, seniors are going to be left holding the bag with respect to the amount they get for the voucher and do you know what? if they can't find a plan with current benefits without faucher, they are going to have to take less benefits, or if they find a plan with current benefits it may cost a whole lot more and the reality is in our view, that is a violation of the medicare guarantee because everyone should always be able to be assured that the existing benefits without having to pay a whole lot, so with that ms. schwartz thank you for the opportunity. >> thank you. this amendment does protect guaranteed benefits and avoids the kashif to seniors in this country.

as somebody who has worked for a long time to contain the growth of cost of the right way and protect our seniors, and i would like to reserve the balance of my time to close. just one minute? >> had two now but you will get to one at the end. >> than i would be happy to add one other comment if i may. i just received hot off the wires, aarp has sent a letter that does talk to the fact that -- >> no, no i'm sorry. please continue. i apologize. >> thank you. they have sent us and i would like to quote the house republican budget proposal lacks balance, jeopardizes the health and economic security of older americans and puts at risk the bipartisan agreement on discretionary spending levels. i think that is, medicare is

something that is important to all of our seniors and their families and the fact that this budget puts a great respect guaranteed and the promise to americans and we should be working together to make sure that we save money in the right way, not jeopardize our seniors or in fact some of our healthier seniors as well. and a senior in this country can be bankrupted by the cost of health coverage. i want to yield one minute if i may. >> 37 seconds. >> i didn't see you get here. >> we had substantial progress in trying to address the problems with medicare and the rising health care costs last year when we, the year before last actually when we added 12 years to the solvency of medicare through the affordable health care act. it is a real mistake to fundamentally change medicare in a way that asks more from those who have the least, when the

same budget simply helps more those who have the most and i believe that the approach that the gentlewoman takes is the right went towards a balanced-budget. >> the time of the gentleman has expired. >> thank you. >> no problem. i promise i'm not going to claim time in opposition to myself and everyone of these amendments. i would like to debunk the entire political attack on the strength of medicare. i understand it pulls quite well. a voucher is like going to the mailbox in getting a check in the mail and then taking that check them in going and doing something with it, buying insurance, school tuition for your kids or something like that. that is not with premium support is. actually all of the should know what it is because of his what

we have for federal employees. premium support is coming get a list of guaranteed coverage options that are preselected in this case by medicare in the medicare exchange and in this case he can't be denied care based on your health status. your guaranteed issue with community rating. you pick that planted the medicare subsidizes your premium. you will get a check in the mail. you will get a voucher but they subsidize your premium based on who you are. full total coverage if you are of low income person and more coverage as you get sicker. now let's review a stunning chart on medicare as you know. i'm not going to yield. vets reveal a stunning chart on medicare's future under the president's approach and the house republican approach. let's start with a republican budget. let's look at how this budget puts medicare spending on a sustainable path.

this shows you the growth rate of medicare and to the republican budget over the long-term. this shows you how we can do a plan where there are no changes for people in and near retirement. and, how we have more choices for people in the future, 54-year-olds and below. this year's budget, the the fact that people don't like to hear on the other side but it also guarantees the traditional fee-for-service plan forever. these are guaranteed coverage options. now the gentleman talks about a cap. the cbo themselves tell us they don't know how to measure competitive bidding. we have the cms actuary saying it works. now let me compare this to the president's proposal to use ipac the unelected unaccountable bureaucrats of appointees for current seniors. here is the president's budget

and what he is proposing. this law by the way, this is the law that is in the affordable care act, here is what it proposes for medicare. let me do that again. so this is the republican budget and what it proposes, here's what the affordable care act in current law does for growing medicare. do you see much difference there? get my friends on the other side complained that this is draconian cuts to seniors. how can that be if our trajectories are the same? let's talk about the main difference between our approach and the affordable care act, the president's new health care law. it's not the proposed spending path and you can see they are the same. the differences who is in control? 15 bureaucrats or 50 million empowered seniors? that is the difference. now look at what happens if the

iatap does not work because unlike cms, they think ipap is going to fail by 2021 because the actuaries at seamus tell us 40% of medicare providers under the affordable air -- care act will go bankrupt and god business. providers have to pay 80 cents on the dollar and then 30 cents on the dollar they will just go bankrupt or just stop taking medications. here is what happens if we referred back to current law. medicare grows at the unsustainable rates. that jeopardizes this program not just for future seniors but for current seniors. now if ipap ends up failing cometh price controls were simply to deny care and it's up failing than we go to that red line. here is what that red line does to our budget deficit and more importantly to our debt. the debt over the last four years, this is the debt into the

future. this is what the cbo is estimating art debt becomes in the primary major driver of our debt is medicare and if ipap fails, if all those providers go bankrupt, the budget controls don't work with the relapse back to the status quo, we have the debt crisis on our hands. here is what our plan proposes. i guess the next question, we pay the debt off. so let me go back to it one more time. we are proposing growth at this rate. the affordable care act closes its rate and if we go up there. if we go up to the top, we bankrupt the country. we bankrupt medicare. so at the end of the day the difference is this. medicare in order to save medicare, in order to keep it guaranteed, for the current and

future seniors, in order to prevent the debt crisis from running our country and giving our kids a diminished future must be reformed. the president's health care law which does reform medicare, it says 15 political appointees will decide how that line is going to be. they will decide how to cut medicare to providers which will lead to denied access for seniors. we are saying but the seniors decide. empower 50 million seniors to make choices. more to the point, force the insured to compete against each other for business as the beneficiary and also give her the choice of traditional medicare systems if she still wants to choose to do so. we think that is far more rational, far more humane and more importantly, we do not want to subject her medicare of benefits to the discretion and control of 50 political appointees. one other point we think is

this. wealthy people, because they are wealthy can afford more out-of-pocket. low income people can't so we distinguish. we say, cover that low income person with out-of-pocket. give people more money, the less they have. give people more support if they get sicker and require higher income individuals to pay more out-of-pocket. doing it this way saves medicare and with that i will yield to the gentleman, the doctor from georgia, mr. price. >> thank you mr. chairman and i just want to say to my colleagues on the other side who have dubbed this amendment the end medicare as we know it amendment, the fact of the matter is as the chairman pointed out that is what the president's health care bill does. bad as the bill you all adopted which is removing $500 billion plus from the medicare program and putting it in and elected order 50 bureaucrats, which we understand and appreciate if necessary in their plan and your

plan because you have got to control costs because you don't couldn't trust people. when bureaucrats choose, patients lose. when bureaucrats choose, patients lose and that is the program you'll have all put in place. the chairman has eloquently outlined how we propose to do that. i would draw your attention to page 61 on the budget which goes through the four main points of the medicare program, those in or near retirement would see no changes whatsoever. future generations are provided a guaranteed health coverage. line five, those living in their homes guaranteed health coverage. on page 51, line five. in addition as chairman said those with a higher health challenges, those with lower income receive more assistance and finally the fourth program puts medicare on a sustainable path and become solvent over the long-term which the president's proposal does not in your proposal does not so i urge the

rejection of the amendment in adopting the underlying budget. >> we will yield the remainder of our time and i recognize the gentlelady, ms. schwartz for one minute. .. what it says is the same in terms of medicare costs. the red line in medicare savings. what the red line shows is the

risk if things go wrong and under your proposal for risk for when things go wrong if this doesn't work is put on the scene years. the cost is put on the seniors and the reason that is different from what we have for ourselves as members of congress and federal employees is under the current plan for federal employees you don't bear the entire risk. you will always get 75% of whatever the increase in costs are picked up by the federal employees benefit program whereas under this proposal the senior eat it all and that is why we call the voucher premium support suggests support from medicare rises and healthcare rises. the way you do this is the risk is the opposite of what was put on the senior. >> my time is up and i want to say it is a huge disagreement here. some of the assumptions on the other side were so inconsistent. there's a lot more discussion here. we are committed to keeping

medicare continuing. >> we have another medicare amendment. going to the next one. the question agreeing to the amendment offered by the gentlelady from pennsylvania. those in favor say aye. those opposed no. the nos have it. [talking over each other] >> recorded vote is requested. the clerk will call the roll. [roll call vote] [roll call vote] [roll call

vote] [roll call vote] [roll call vote]

[roll call vote] a [roll call vote] [roll call vote]

[roll call vote] >> are there any other members looking to vote or change their vote? if not the clerk shall report. >> on that vote the eyes are 13. the knowns are 20. >> the amendment is not agreed to. further amendments? miss castor i think. i do but i just want -- go ahead and offer -- >> thank you. the amendment offered by ms. castor is on the desk. >> amendment on the desk. >> gentle lady from florida, clerk will designate. >> relating to medicare. >> gentle lady recognized for nine minutes. >> the plan that break the

promise of medicare and ends medicare as we know it. the republicans propose to raise the cost of prescription drugs and cut the smart new benefits and popular consumer reforms that have been in place for two years and are working very well. this is a double whammy for our older neighbors across america. here's what my amendment does. it proposes to retain the closing of the doughnut hole and the money going back into the pockets of our older neighbors, parents and grandparents and propose to retain those important new screenings, mammograms and colonoscopy is that are saving lives and retain that important new wellness that has become popular and is very smart policy. so first on the doughnut hole. under the affordable care act that has been in place for two

years with is currently happening is that cliff many of our older neighbors were falling when it came to paying for their prescription drugs is closing. right now seniors are getting 50% discounts on brand-name drugs under medicare part d. that doughnut hole will be closed by 2020 and it has helped 3.5 million seniors with high drug costs. on average, it saved the average medicare beneficiary over $600. florida district alone, over 6,000 seniors in my district have received prescription drug discounts and it is predicted that through 2021 this will save our older neighbors $2,400 and our parents and grandparents no longer have to struggle with

those very expensive prescription drugs. unfortunately in the republican budget republicans proposed to put these costs back on our seniors with high drug costs and have them make very difficult choices. secondly the affordable care act also right now has provided an estimated 32.5 million seniors and disabled individuals with a preventative screening such as a mammogram or colonoscopy. because of the affordable care act in my fourth district over seventy thousand of my older neighbors have received this preventative screening. without an additional copayment that often kept them out of the doctor's office. the republican budget unfortunately will increase costs and they will now have to go back and pay additional co-payments if they want to go in for those screenings. one of the most popular reforms under the affordable care act

has been the new wellness business. they get one annual wellness visit. in 2011, 2.3 million seniors in traditional medicare took advantage of this new benefit. through the republican budget the repeal would take away this important tool that patients and their doctors realize is saving lives. it is smart policy and the republican budget shouldn't break the promise of medicare and shouldn't rollback these important reforms that are making a difference in the lives of our older neighborhoods. this time i will yield to miss swartz to speak on the amendment. >> 8 q very much for this amendment. the republicans keep saying that their voucher plan, they prefer to call a support plan, would not change anything for current seniors. that is simply not true.

it was just said again in response to the previous amendment. there will be no change. no shift in costs. only future seniors but not current seniors. simply not true. appeal--repeal of the affordable care -- >> president obama nominated dartmouth college president and global health expert jim young kim to be the world bank. he is korean born physician on the treatment of hiv aids and tuberculosis. president obama said he has the breadth of experience on development issues needed to carry out the financial institutions and anti-poverty mission. we covered the appearance in 2005 when he outlined the findings of report of the global aids epidemic. he talked about rule of the church in preventing hiv aids. >> let me just say the american -- if you call evangelical churches american conservative organizations you can trace their participation in a number of ways. i credit them with bringing to

the attention of president bush and jesse helms and others problem of hiv death in poor countries. they are the ones who really pushed the republican politicians to move forward on the pet smart programs. they played an extremely important role on bringing attention of the number of deaths. they were losing their missionaries and the stars of their work in 4 countries and i commend them on that. in terms of the role of conservative organizations in areas like prevention, what we know is we will never really know for sure exactly what particular intervention led to a particular change in a person's behavior. what we recommend is the full range of prevention intervention must be utilized. this is abstinence messageing certainly for children. behavior change when relevant

and can be helpful and we know condoms prevent spread of hiv and effectively. and harm reduction. any time you take one or the other out of it for ideological or political reasons you are putting a country, and individuals at risk. this is our position specifically. are there particular conservative groups who want to focus more on one than the other? yes. no question that there are. there are those who want to see abstinence only programs to which we say flatly you can do that but then you are really pulling three legs out from underneath the four legged share. >> you can see the entire event with dr. kim at our web site. go to c-span.org. president obama nominated him to head the world bank. the actual selection will be made next month by the bank's 25 member executive board. the united states has the world's largest economy and largest percentage of the votes.

dr. kim is expected to travel around world on a listing for to rally support for his nomination ahead of the board's vote. >> the genetic science nailed down a rough date when the hiv epidemic starts describes tinderboxes and wet moss. in most parts of the world there's not much hiv and yet in some places there is a ton and it is incredibly destructive. understanding that these two categories exist allows you to think what are those factors that keep the stars moving and what can we do as a world to end it? >> on afterwards dr. craig tinder tracks the history of aids at 9:00 on booktv weekend on c-span2. in march of 1979 c-span began televising the u.s. house of

representatives to help -- households nationwide. to their content of politics and public affairs, nonfiction books and american history is available on tv, radio and on line. >> we put that force together in desert storm. everyone of those youngsters is somebody i had a responsible for -- press the responsibility for. general schwarzkopf felt the same way. we knew they were going into a very dangerous conflict perhaps and we wanted to give them every benefit that would allow them to come home safely. i am as distressed -- more distressed than any member of this committee that there are veterans who are suffering ellises that may have been a result of their service in the gulf. i do not know if those illnesses are result of the service in the gulf or not but i think we have to keep that as an operating hypophysis until we find out otherwise. we have to get to the bottom of this to find out what the source of their illnesses were. >> c-span created by america's

cable companies as a public service. afghanistan war commanding general john allen says recent events in afghanistan like the killing of 16 civilians last week have struck a blow at the core of the relationship. speaking before the senate armed service committee general allen said recommendations on further troop reductions would not be made until after the last of the surge forces leave that country in september. it is just over three hours. [inaudible conversations]

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[inaudible conversations] [inaudible conversations] >> good morning. the committee meets to talk about the campaign in

afghanistan. our witnesses are dr. jim miller, undersecretary of defense for policy and general john allen, commander of the 50 country international security assistance force and commander u.s. forces in afghanistan. a warm welcome. thanks to you both. i am going to interrupt at this moment to take care of some nominations because we have a quorum present so i will ask the committee to consider a list of 246 pending military nominations. they have been before the committee the required length of time. is there a motion to favorably report the 246 military nominations? is very second? all in favor say aye. opposed nay. the motion is carried. our troops in afghanistan are being asked to perform demanding and often dangerous missions and carrying them out superbly and professionally. general allen, on behalf of the

committee, pass along our unwavering support for our military men and women serving with you in afghanistan. our gratitude for their courageous and dedicated service in support of their families. talking about families i know you have with you this morning your wife, kathy allen and your daughter bobby allen. i hope i got their names correctly. i temporarily got them mixed up earlier this morning. i am not sure if i need forgiveness from either one of them but in any event we are delighted they are here. the success of our mission depends on building the capacity of afghan security forces to take the lead for security in their country. u.s./afghan partering is critical at all levels from nato training missions to par during with units in the field and on up to advisers in the ministries of defense and interior. that partnership has been tested by the disturbing events of the last few weeks including the

violence following the unintentional and regrettable burning of korans at the u.s. military base. the tragic and incomprehensible killing of 16 afghan civilians in canada are --kandahar. last week president obama and president hamid karzai reaffirmed the commitment to completing the process of transition in afghanistan in a coordinated press statement, the two presidents reiterated support for the approach agreed upon at the 2000 -- the 2010 nato summit in lisbon which calls for afghan security forces to assume, quote, full responsibility for security across the country by the end of 2014. this morning i want to focus on another part of the jointly issued a statement. president obama and president

hamid karzai said in that coordinated press statement they share the goal of building capable afghan security forces so that afghans are increasingly in charge of their own security and this is the quote. with the lead for combat operations shifting to afghan forces with u.s. forces in support in 2013. general allen assured me in a discussion in my office that nato's plan transfer of security across afghanistan in 2014 always assumed shifting the lead in combat operations to afghans in all five so-called areas of afghanistan. by 2013. that is good news to me. i say good news because it has always been my belief that success in afghanistan depends

on building the capacity of the afghan army and police so that afghans are in the lead in providing security for their own country and to ensure that that happens by continuing to reduce our forces. the afghans want their own forces providing for their own security. that is what we heard when we met with village elders at their council meeting in helmand province two years ago. when i asked how long u.s. forces should stay one elder told me only long enough to train security forces. after that he will visit not only as soldiers but as guests. witnesses will explain in some detail how the 2013-14 dates are in sync. the process of face transaction

will unfold over coming months and years. i hope that you will explain what that transition to an afghan lead will look like and transitioning to afghan lead in the final part of afghan -- afghanistan can occur in 2013 when the transition is not to be completed until 2014. in addition we need to know what this transition means for the u.s. coalition forces. secretary panetta said as afghan security forces assumed the lead for security, isaf will move to assisted role but will remain, quote, fully combat capable. it appears even though afghan security forces will be in the lead, starting in 2013 throughout afghanistan, u.s. and

coalition forces may still be participating in combat operations with afghan forces in parts of afghanistan while the transition process continues to completion in 2014. i also understand that the plan after 2014 is for the afghan security forces to still receive coalition's support in key enablers such as logistics, arabic and intelligence support and u.s. special operations forces will likely be partnered with their afghan counterparts in conducting counterterrorism operations. we also need to know what the transition process means for the pace of u.s. troop reductions in afghanistan. last june president obama said at after the 33,000 troops u.s. surge force was brought home by the end of the summer that u.s.

troop levels would continue to draw down, quote, and this is the president's quote -- said a steady pace. yet the fiscal 2013 defense budget for overseas contingency operations is based on an assumption of 68,000 u.s. troops remaining in afghanistan for route the 2013 fiscal year. so we will be asking if you will support continuing to draw down u.s. forces at a steady pace and we would like to know when you expect to make your recommendation on sir reductions in u.s. forces in afghanistan starting after september of this year. given the importance of having capable afghan national security forces take over the security lead throughout afghanistan, i

was surprised and concerned about news accounts of a proposal to reduce the size of afghan forces by a third after 2014. apparently based on questions of the affordability of sustaining a larger afghan force. according to wall street journal article last month, united states has proposed reducing the size of the afghan security forces from 352,000 in 2012 to 230,000 after 2014. that article cited lieutenant-general boulder, head of the training mission and afghanistan as saying this proposal is based in part on, quote, with the international community will provide financially. i believe that our commanders should be providing their military advice based on what

they believe the afghan security force will need to successfully maintain security not based on their guests about affordability two years down the road. in my view it is cost-effective to sustain a larger afghan security force when compared to the cost. in billions of dollars and alive of our military men and women having u.s. coalition forces maintain security in afghanistan. it may be penny wise but would be pound foolish to put at risk the hard-fought gains that we and our coalition partners have achieved rather than support afghan security force that is the right size to provide security to the afghan people and prevent a taliban return to power. our relationship with afghanistan will continue beyond completion of the security transition in 2014. the strategic partnership

agreement being negotiated between the united states and afghanistan will play an important role in defining the shape of that bilateral relationship. the recent memorandum of understanding and tension operations signed by general allen addressed one of the main obstacles to concluding the strategic partnership agreement. another controversial issue in the strategic partnership talks is the conduct of night raids by coalition and afghan forces. afghan officials have repeatedly called for a end to night raid alleging such operations are disruptive to afghan lives and lead to civilian casualties but what is often ignored in the united states and in afghanistan is afghan soldiers participate in all night raid operations and in december general allen asian and isaf directive to minimize the disruption and concern

caused by night operations to law abiding afghan citizens. that direct clearly states all-night operations are part robbery nations carried out alongside specially trained afghan soldiers and policemen who are increasingly taking on responsibility for the command and control of night operations with a view to transitioning this responsibility to them entirely if their capacity develops. it directs the same directive the afghan security forces on night raid should be encouraged to take the lead, should be the first to make contact with local afghans in their homes and be the first force seen and heard by a local villages. searches conducted by afghan security forces when available and female personnel are always to be used for searching women