resource, for many reasons, many, many cultural and many other reasons, you know? but also economically. and we need to make sure that that resource is being managed well, both now and looking to the future. and so we, you know, we look forward to working with the senators and with the representatives as the business community to really form an aggression law that will help everyone, help immigrants, help the dreamers and the dreamers are such a critical part of our workforce needs going forward. but, of course, of our communities. and i certainly recognize the dignity of people as people but i wanted to bring up this economic aspect as well, because it's important for the well being of everyone. and so we look forward to working on that and have an immigration bill that will really work for iowa and for america. [applause] ..

>> businesses get it and now how important it is for the vitality of america and endorsed by the afl-cio, so labor understands it also. we thank both labor and business community for supporting the immigration bill. [applause] so, nick, you've been involved in ufcw, packing house workers

and stuff, and it's been my experience as i toured them, and i didn't work in them like durbin did. he was a meat cutter in packing houses, but as i've traveled around, i see more and more of the latino community working in our packing houses and meat cutting places you represent. tell us about that. >> i'm with local cw222 from northwest iowa. we have a packing house in cherokee, iowa, and dakota city, nebraska. too-- together, that's roughly close to 5,000 employee, and 75% of them are latino. >> 75%? >> yes, yes, so 75% of the membership who we represent are latino and immigrant workers, so, again, good morning, ladies and gentlemen, of the panel and audience, senators, i'm honored to be here to talk about an

issue that affects us all. these united states, our united states, have been the place of dreams and opportunities for immigrants for years. this dream lives today. the opportunity to achieve this dream has become tarnished by political rhetoric and partisan politics. comprehensive immigration reform must create a path to citizenship. there are as many as 1 # 1 million immigrants aspiring to be americans living and contributing in the united states today. this path must be streamlined for dreamers brought here as young children with immigrant parents. these people are part of the drive and the will of our economy. they open shops, restaurants, and stores. they work in fields, factories, and in meat packing. giving life blood to the middle class like irish and germans and

other immigrants centuries before. congressman king has made comments about immigrants that are wrong and offensive. congressman king also feels that today's imgrants in some way are sub standard compared to everyday americans. well, let me tell you as a real blue collar iowan, i worked in meat packing at the largest beef plant at 18 #. as a young man out of high school, i had never been around that environment that meat packing involves. i worked many jobs with most of the men and women being immigrants. unlike some would have you believe, the immigrants working there pay their taxes, just like me. [applause] they paid their insurance, just like me. most important, they were working for a better life for

their families, just like me. [applause] in my years of working in the meat packing industry, and the last four years as working as a union representatives, immigration reform will improve the standards for all workers. it will help end the exploitation of any worker. [applause] it will help reunite families without living in fear or being separated for up to three to ten years waiting to try to bring their families here legally. [applause] friend, brothers and sisters, this current system is broke p. every american worker deserves fair pay. every american worker deserves

the opportunity to live this dream, of our fathers, grandfathers, and great grandfathers. now is the time for america to create a modern twenty-first century immigration system. now is the time for reform to create an effective mechanism during the employment eligibility, and reform must not be piecemealed or incremental. it must be comprehensive and timely. [applause] this is our chance, our chance to make our mark in history giving today's american dreamer a fair and equitable chance to become an american citizen. i leave you today with a quote from the labor activist, caesar chavez. once social change begins, it cannot be reversed. you cannot uneducate the person who has learned to read, you

cannot humiliate the person who feels pride. you cannot oppress the people who are not afraid anymore. [applause] we have seen the future, and the future is ours. thank you. >> wow. [applause] that was powerful. [applause] [cheers and applause] >> that was really good. woah. [applause] >> well, that was powerful. [laughter] thank you. i guess i'm -- i just thought of this. i think, you know, i have to be a mediator, so i just got to thinking, every time you pick up

one of those chicken wings or chicken fingers or the barbecue ribs on the grill or cooking that steak, just think, chances are three times out of four that was done by a la teen owe working in a packing plant someplace to provide that food for you. [applause] reverend barb? >> i too want to thank you. thank you very much, senators, for bringing us together. thank you, all, for being here, the panel, i don't have to say anything, they said it all and very eloquently. we come together because, really, what we are talking about is people and how government policy affects people, people who are sometimes not visible. people who sometimes intentionally remain hidden out of fear, and because of the role i have in the community as a

pastor in the united method dis church, i see that impact daily. the fear is real. in the old days, in 2006, we had the raids, and in 2008, weh the horrible raid at postville. everybody saw, everybody knew hundreds of people were being rounded up treated unkindly, inappropriately, not given their civil rights. we have hearings on that, and now, i ask people, so do you know about what's happening to the immigrants, people who don't have working documents? a lot don't, but that doesn't mean it's not happening. we see what's happening to real people through government policies that we want for a

common good; right? that's the purpose. immigration reform will help people not be fearful and help our community and our businesses. it seems to be a no-brainer. i don't get it so that's where i continue to stay, but i see people -- i have a family, for example, that live in fear. four little girls, they are citizens, their mom and dad aren't because the little girls know that uncle over here was arrested and aunt over here was arrested, and the little girls say, mommy, don't let them get you today. they live with that daily. they say, you know, we had a fire in our kitchen, but we didn't call the fire department because we thought maybe the fire department would turn us into immigration. that will not happen, but that's the fear they live with. they don't do things they can because they live in fear, so

this change in our immigration laws can only be good for everybody in my mind. i come from the faith perspective. that's who i am, and all people that come out of the mon thee yis tick religions, muslim, jewish, christian, they have an ancestor called abraham who was a wanderer. i challenge people who do bible studies, all that, do you know anybody in the bible that didn't wander? didn't immigrate? didn't migrate? any, please, i stand that way. please. [applause] i've had them say, yeah, there's one, but it's not a good example. soddam and gamorah, but you don't want to go there. [laughter] i stand. if we're people of faith, want

to do good for the community, i don't get it. i'll remain that. people want to become citizens. we have an english program at the church, around 100 to 150 people, and as soon as people thought there was going to be a possible immigration reform, we had 270 people last year. there's not an english class in the des moines area that's not fill to the max because people want to do whatever it is they have to do to be a citizen. pay taxes, pay taxes. learn english, learn english. take citizen classes, take classes. know your rights. what do you have to do to become -- it went like this. if immigration system is changed, if the law changes, what do you need to do to get prepared for it? we had 80 people there. people want to know.

i thank you very much for your attempts. please, don't give up. we're here behind you. how can we help you? this is good for iowa, the united states, for the world, so thank you. let's keep going. [applause] >> i think what you've just seen here is really what i hope this really represents iowa. the business community, the labor community, the faith community, our new dreamer

community, political dreamers, and people of all political stripes. this is not a partisan thing. it's not. never has been in the past, it shouldn't be today. it should be something that brings us all together to recognize that we have a broken system, and we need to fix it. we worked very hard in a bipartisan fashion in the united states senate to craft a bill supported across a wide spectrum, business, labor, faith community. as i said, both political parties. now, i we had a situation happen in the house lately. i mentioned the docket bill -- well, not a bill, something president obama did a little over a year ago, i think? >> last august. >> pardon? >> last august. >> last august, deferred action for childhood arrivals policy,

and that takes -- that says to the dreamers, those that fall under your bill, the dreamers, that they can get kind of a -- correct me if i'm wrong, a provisional status, a work permit, a work thing, where that if they can show that they came as a young dreamer, that they are going to school. they don't have a criminal record, they get a work permit, and they will not be kicked out of the country. they will not face what you talked about, the specker of getting kicked out of the country if you're picked up in the back of the car for speeding or anything like that. that has been a great policy. that's only been in existence since last year. we applauded the president for doing that, and i thought we all supported it. just a week ago, there was an amendment in the house of representatives on a bill to sprit funding and end that program. that means that people like our

two friends here would have that taken away from them. they could then vote -- could both be kicked out of the country after all this time. that amendment, i'm sad to say, passed by 224 to 20 # 1. it is just -- so that amendment was sponsored by the congressman from this district, congressman king. [audience reacts] now, the only reason i say that is because we have an immigration bill passed in the senate, broadly supported, as i said, by labor, by business, the faith community, bipartisan, and it's sitting in the united states house of representatives, so those who want to denigrate our imgrants, our dreamers, they

had their vote. i now call upon the house of representatives to bring up the senate past immigration bill and let us have our vote in the united states house of representatives. [applause] dick, i'll yield to you, but i believe the votes are there, if they bring up the senate bill, up on the floor, i believe it passes, don't you? >> we passed the immigration reform bill in the senate because it was a bipartisan bill. i worked on it for seven months. four democratic senators, four republican senators. the democratic senators, chuck schumer of new york, chairman of the immigration subcommittee, bob menendez of new jersey, and michael bennet of colorado. across the table you think, well, what republicans would sit

down with you? they must have been pushovers. on the republican side, john mccain, former republican candidate for president of the united states. senator graham, republican senator from south carolina, marco rubio, tea party republican from florida, and jeff flake, the new senator from arizona. we set there for seven months. it was a lot of work, over 40 # face-to-face meetings. we went through everything under the sun, things we have not mentioned today, h1bs. these are visas we offer to specialized training people, special professionals. for example, 50% of the ph.d.es awarded at iowa state university in stem subjects, science, technology, engineering, and math, go to foreign-born students. they get the best education -- [applause] wait, wait, wait, they get the best education in america, they

develop the best skills in america, and then we point them to the airport. now, this bill says we will offer them, if they can find a job, a chance to stay, use those skills to build jobs in america. to build businesses in america. so -- [applause] we came together on a bipartisan basis so at the end of the day, some parts i hated. some parts of it i hated. that's how you compromise. we ended up with 54 democratic senators and 14 republican senators giving us 68 votes to past the bill out of the senate. my message, and tom's message to the speaker is give us a chance to do things and come together, both political parties, give the house of representatives a chance to come up with a bipartisan approach. we have one. maybe they have one too. let's get it done. it's time for america to fix this broken immigration system.

>> first of all, i want to ask if either edwardo or hector, do you have anything to and? i guess since -- you are under the bill; right? >> yeah, uh-huh. >> this is one guy right here that is under the thing i mentioned, and if that thing -- if that is done away with, as congressman king got that vote in the house, it won't pass the senate, but if it did, would what happen to you? >> i have no idea. live under the shadows again -- i probably would. or go back to a country i really don't know, so i'm not sure. >> takes away your plans for the

future though. >> absolutely. >> sure it would. >> anything to add? hector? >> it'd be very, you know, upsetting to me if the bill passed through the senate, you know, and if they defunded and ended the program for myself, it would be devastating. a couple month ago, when the iowa dot was in the decision not to grant driver's licenses, i was at the forefront. i said, we need to get this. we need to have this happen. if they were to take back the program from us, from other dreamers, it would be everything we've been doing so far would be for nothing. even then, i think, for myself, i would try to get that program to come back, but devastating, no doubt about it. >> listen, we have two microphones -- sorry, reverend? >> i helped register some of the kids when they had the

opportunity and there was a free clinic, and many of them had great fear turning over their name and all of their information to the government that this exactly might happen, what would happen if they do away with this? they'll have all our information, where will we go? what happens? they will come after our parents. that fear actually kept some kids from -- and their families, from moving forward. >> thank you. we have two microphones out there, omar has one and senator durbin's staff has one if anyone has a comment, statement, or a question for the panelists. we'll try to get -- >> senator harkin, jim hudder, senator durbin, first of all, thank you so much for being here. ?afort harkin, thanks -- senator harkin, thanks so much, is it four service of decades to iowans? [applause]

when senator harkin ran for office for the u.s. congress, he lived here in ames, iowa and was elected from ames, iowa. let me change the focus slightly. you're talking to people in the country who support you and the dream act, but we need to talk to the people who oppose it. i go back to george and his notion that we have people who are anxious to enforce laws, and people broke the laws. we ought to build a fence. how high a fence they want? 70 feet? whatever, it's racist. how do we know this? they don't want it up north. you said, both of you, you referred to if we pass the dream act, make people citizens, they will pay taxes, but as he said,

no, they already pay millions and millions and millions of dollars of taxes. sales taxes, property taxes, and yet some states don't want to let them go to public school. who funds public schools? income, social security says that more than after -- half of them pay social security and can get no benefits. >> that's rights. >> i think we ought to be talking about -- we ought to be fair that we're not providing what they are paying for. >> i have to add those of us in our committees working on social security, one of the best things to do to preserve and extend the life of social security and make it better is to make sure we bring people out of the shadows and so they are fully paying into social security in their working years. >> can i have one other element

to add? this bill is not a powder puff, easy bill for those who want to become citizens. it suspect. they come forward, register with the government, who they are, where they live, where they work. they go through a criminal background check. it's tough. if there's any serious crimes in the background, they are gone. no, ifs, ands, or buts. it's black and white. it's problematic in some cases, but that's what it is. it's a tough standard. they pay the initial $500 out of $2 # ,000 as -- $2,000 as a fine. they are now on the books, and they are paying taxes. what does that mean? well, for many of them, there's no government benefits coming their way for ten years despite the fact they are paying taxes. for those who have been working here, using some other identification number, they get no credit for the quarters worked under social security before this bill passes into

law. none. if you work 20 # years in america, paid into social security on somebody else's number, and you can prove it, not worth anything in terms of your social security in the future. you start at that day, when this bill becomes law, having a chance to accumulate eligibility for social security. that's it. in terms of school, hector, they may not face it directly, but there's no pell grants available to the young people. they can have work study loans, and they can -- they have to pay it back, but that's it. it's a very limited, tough temperature years, and people who say it's amnesty, for goodness sakes, you know, these folks pay a heavy price for having come here illegally or over staying a visa. two things we have in the mentioned. we establish an e-verify system. from this point forward after the bill becomes law, whoever applies for a job in america must present a government id with a photo.

the employer enters this into a computer in the e-verify system and watches for the photograph to come up. if the official government photograph for that name does not match what they have in their hand, they can't be hired. this is going to be the workplace a lot tougher, and any employer who hires someone, who p doesn't match up, they are subject to fines and penalties. finally, hector told the story of overstaying the visa. 40% of the undocumented people in america over stayed their visas, visitors, tourists, whatever it may be. we are now going to have a system under this law that's going to track people, not only as they come in on visas, but as they leave on visas so this is a tough enforcement bill. those who say it is not, have not looked at it. with the border, i had to grit my teeth with another 700 miles of fence and billions of dollars on the border. those who say we don't have enough border protection, keep this in mind.

ten years ago, we had 10,000 border patrol agents, 10,000 for our southern border. today, we have almost 20 # -- 20 thousands. this bill raises it to 40,000. those who argue this is weak on border enforcement, trust me, i think we went too far, but as i said, when you're in a negotiating situation, you want path to citizenship, the dream act, we listen to the other side of the table and put more money in border enforcement than ever spent in the history of the united states. it's a tough bill. it's a rough bill. these imgrants have had enough determination to stick is out through thick and thin for ten to 20 years. they will make it to the finish line, and they are going to be citizens someday. [applause] we only got time for one more. i'm sorry. one more. >> i'm jim, i live in ames. i want to touch op something that's. eluded to just a little bit, but not much.

i have ancestors who came to this continent from 1620 until 1895. none of those people had to ask permission to land on these shores. none of them. [applause] the first of them had to ask permission to get out of england, but other than that, you know, as far as i know, i'm the first person in my family, my lineals to come west. some of you folks -- your ancestors came in boats, i came here in a chevy. i'm the first person in my an sees ri to get a four-year college degree and a masters at iowa state. like i said, none of my people had to ask permission to get here, and doggone it, i'm not going to stand in the way of anybody else who wants to come here for a better life like my ancestors it, and i'm flattered

people still want to come to america. thank you. >> that's a good note to end on. [applause] >> well, we thank you all for coming. a great note to end on. i think that what you can see is that -- and i hope, nick, you know this, but i hope others take away from this that we're proud in iowa of our history of welcoming new immigrants to this state. everybody from my mother to the boat people, the among, the somalians who are here, the people who came here from cambodia, and those who came from south of our border, those who came from mexico and qawt mall la, honduras, other places,

they came here as this gentleman just said, they didn't come here to criminalize or be criminals or take advantage of anything. they came here just because they wanted to provide a better life for themselves and their families. ..

what we have to do is set up a better structure to get this bipartisan agreement. a new structure that will allow people that have come here to do that to work hard, to point out all they have to go through to bring them out of the shutters and make them full members of the american family so the we can make this country grow and prosper in the future. this wave is no different. [applause] >> thank you very much for being here, senator.

>> recently michigan republican congressman justin amash held a town hall meeting at the calhoun in michigan. he serves in the congressional district of the state that includes the city of grand rapids. he talked with voters about president obama's healthcare law, immigration reform, voting walls and the national security agency data collection program. in july, congressman amash tried unsuccessfully to amend the bill barring the nsa from using funds to collect the data records from citizens on the subject and investigation. >> she's my chief of staff. he doesn't just work for me. if you have questions or concerns here in the district you can always reach ben. he is primarily in my grand

rapids office. you can find that on my website, amash.house.gov. we have a satellite office in battle creek so if there's something you would like to schedule, an appointment you'd like to schedule if you contact the grand rapids office we can make sure we have someone here to meet with you as well in calhoun county. my district director is jordan bush. he is also a valuable resource. if you want to contact my grand rapids office, feel free to do so. he's always around except for today but for good cause he's not here today. but he is a great resources with any number of issues. i do telephone town halls from time to time. so if you would like to get out those phone calls please let the staff know. you can talk to ben before you leave. as we do those from time to time

that gives you another way to stay in contact. what we do is have a phone call that goes out to the house maybe six or 7 p.m. and you can get on the line and ask questions and that is a convenient way for people who have maybe more difficult time getting out. if somebody can't make it to a town hall but be involved that is one way to do it. i'm the only member of congress who does this who finds an explanation of every single vote on facebook.com/justin amash. i explain its meeting it, not a staff person. so you can contact with me directly that way. you don't have a facebook account to see the post. you only need a facebook account if you want to comment. you don't have to have one to actually see the post.

you can still go to facebook.comrepjustinamash. i will talk to you very briefly here or as briefly as i can make it. that's something i've been very involved with trying to rein in the out of control nature of what's going on right now with our surveillance programs. that's something that i have spent as you have seen in the news a lot of time dealing with over the past several months. what the nsa has been doing has been declassified now but collecting the phone records of every single person in the united states regardless of whether you are under suspicion of anything. so in other words, the nsa has a data base and they actually collect every time you call someone they collect buckholtz i

was made, the duration of the call and other sorts of what they call medved data -- meta data. they've been doing this for quite some time but was recently disclosed. the problem is of course they are doing it without any suspicion. it doesn't matter whether you have a connection to a terrorist or not. they decided that they have the authority to just gathered up everybody's data. and of course this violates the fourth amendment. you can't simply go about collecting the data, the information of all of the americans in the united states without any suspicion. so something i have been fighting against as a representative for the past couple of months. and in fact, a few weeks ago we had an amendment on the house floor that i offered to the

department of defense appropriation bill as the amash amendment and 205 members of congress stood up and said we don't approve of the nsa collecting the phone records of every single person in the united states without any decision. unfortunately 217 members said that they were okay with it. i think the tide is turning and i think that things are shifting as we hear more and more things in the news about what the nsa and what the government is doing to the we have heard other reports about how the nsa might be for example sharing information with the dea and the irs. according to reports, the incidentally collect your information, inadvertently collect your information and then use that information to go after people for domestic prosecution. and of course this violates our

rule of requiring the specific warrants. you can't have a system where the intelligence agency with it is the nsa or any agency. here you go now you can prosecute people. according to the reports they are covering their tracks so the defense attorneys don't even know where the data came from. so there are a lot of shocking allegations, revelations of their and reports. we don't have very much oversight and government of these programs. there is a secret court that interprets things like the patriot act and the sports opinions are not available to the members of congress. so the patriot act into law

related to the data gathering and members of congress have a particular interpretation when they pass it. i voted no to be clear when was up for reauthorization. [applause] they've been horrified at what they found and that the act is actually being interpreted by the court in a much more expensive way than what they expected. they wouldn't have known about that except for the recent disclosure because the court opinion that interpreted the act or secret. members of congress don't get access to those court opinions. you will have access to the intelligence committee and the white house with access. but the rank-and-file members of

congress don't have access and of course i represent people just like anybody on the intelligence committee represent people. when i am asked to vote on something, i deserve to have the information about a law that everyone else has. they shouldn't keep most of congress in the dark and what they are voting on. yet that is what has happened repeatedly. representative john conyers on a bipartisan measure -- we don't agree on a lot of things, but we agree that people's rights are being violated here. that the constitution is being violated. so we have teamed up on a bill called the liberty act. with the liberty act will do -- and this is a bill that has 50 bipartisan co-sponsors and it's getting more everyday split between the republicans and democrats. so it is very bipartisan. what the act would do is narrow,

it would be to narrow the scope of the patriot act so that the government can only collect information that it actually pertains to a person that is the subject of an investigation under the patriot act. and it would also provide greater access to the members of congress for these court opinions so that we can over see what's going on. right now we just don't have the access. now, there are people on the intelligence committee and the white house who will tell you members of congress didn't promise of disinformation. they were debriefing. let me tell you how these work without revealing that classified details of the briefing. you go to a briefing on the patriot act and it's basically a one-sided affair where they tell you how good the patriot act is and how it is bordered and then

they say any questions? when they say they have the opportunity to ask questions about this program, the tone records collection program, even if we have the opportunity would be asked about it? we didn't know. you're not able to ask questions -- it doesn't make sense to think that you're going to ask questions about the secret program. in my going to guess what the program is? it becomes a game of 20 questions. do you have a secret program? no. what if i say it this way, do you have the secret program? so you sit there forever trying to find out what they have if they do not volunteer the information for you. so there is no real oversight and the fact we can ask questions isn't helpful because you have to go back briefing after briefing. and i have been to almost all of the briefings. you have to go back briefing

after briefing refining your question in each briefing so that you get the answers then you need. if you don't ask it in the right way, you're not going to get the answer that you need. for the white house, which recently said all members of congress were deemed declassified now so they said we've received a classified document that outlined this phone records collection program. well, the white house's white paper -- they've released a white paper recently that actually indicates that we didn't receive the document. because it says the document in 2009 was shared with the intelligence committee and both intelligence committees shared it with their members and then it talks about an updated

document released in 2011 shared with the intelligence committee and is headed the senate intelligence committee shared it with its members the was silent about the house did. this was in 2011. a large number of republicans in particular were elected in the 2010 election and started in 2011 so for that large class of representatives we never saw the document. and in fact none of us remember seeing the document. the administration white paper hinted that we didn't see the document so i had my staff asked the intelligence committee and they admitted that they didn't share the document with us. so, we didn't receive the information that we needed and a lot of my colleagues particularly the ones that voted yes on the patriot act to were upset about this so there's a lot of work to do. this is not a partisan issue. there are people on both sides of this issue, republicans and

democrats but i know the american people are on one side of this issue. they don't want to be spied on. with that, i want to open up for questions. >> i don't expect you to answer this in a way that would compromise yourself, but i am curious as to whether or not edward snowden, did his actions actually stimulate what is going on here with the national security administration? did it come out of that? >> we would have never got to the point that we have these types of boats like on the amash amendment or these type of discussions if it were not for that. yes.

>> my question is about homeland security. they have come out and said anybody living within 100 miles of the border and they've shown a map of michigan is included in all of florida no longer have fourth amendment rights by decree. >> i don't know the particular reference. i did hear the 100 miles from the border in shoofly brought up with affected drones. is that what you are referring to? >> they can search your computers and sulfone at any time because they have a blanket warrant. michigan and wisconsin is included in that the border -- this is the border between indiana and michigan. >> that is outrageous and false.

>> this came from homeland security. >> the fourth amendment protect you regardless where you live in the country if you are near the border or not near the border. succumbing you know, if that is what anyone is alleging more claiming -- but it's coming from homeland security itself. >> if homeland security is saying that the homeland security is wrong. >> we have to hold them accountable and so far, congress hasn't. >> let me ask about the patriot act. did anything in your amendment or legislation get rid of the presidents of devotee to have just disappeared? without warrant indefinitely. >> the indefinite provisions would be under the national defense authorization act.

>> let me ask about the senator from california that now wants to redefine the the first amendment says by defining what a journalist is. >> i think that is wrong to define the first amendment in such a way that only protect journalists. everybody has first amendment protection and the right to free speech whether you are a journalist or not. >> but not just journalists. >> there is a long series of the civil rights not just you. i trust you actually. [applause] now what am i supposed to do when the homeland security starts charging into my house? >> i.t. understand.

i can tell you the culture is changing. the culture is changing because on the amash amendment, you have the white house, democratic leadership, republican leadership, the intelligence community, all sorts of high-level officials saying do not vote on this amendment. it will be a disaster if you vote for this amendment. and still, the majority of democrats and nearly half of the republicans voted for the amendment so things are changing that it's going to take a little bit of work. we have to get people in there because the people that have been there for a long time are not really getting the message. >> i am here representing the capitol area of the libertarian party and we are preparing to have our session in november and at that event we celebrate those michiganders that have done the

most in the name of liberty and you of course are of the top of our list especially because of the amash, years amendment. the topic this year is the impact the war on terror has had on our personal liberty. the one thing that concerns me that goes a little bit further is the impact that it has on our ability to get the truth about what our government and the executive branch is doing. given that we are now involved in and addressing the secret threats, the secret actions, how can we be sure that when we are told of there's been a victory that the threat even existed to begin with and more important, how can you have the response ability to oversee the executive branch and know whether they are credible and the actions are affected? >> as i said before we need better congressional oversight because while there are plenty of people in congress who might

think are not that interested in bringing out the truth and doing what's right there are a large number of people in congress who are interested in doing what's right. i have a lot of good friends and allies who i trust on both sides of the nile and if we have better congressional oversight you'll have enough people watching it in my opinion who will be willing to say something and stand up for what is right so that is a part of the process but it's not the only part. the public needs to have confidence in what we are doing and the ability to see what is going on. anytime you have all like we do now, the public needs to know what it is. you can't have laws that are hidden from the american people in a free country to this

pachauri moving john boehner as a speaker? >> i don't think so in the short run. i didn't vote for him as the speaker. i voted for idaho. but in the short run, he is the speaker of the house. and i will tell you that there are a lot of people who do a much worse job than john boehner i don't want to name names but i will tell you that one thing about speaker boehner, whether you agree with him or not and i often disagree with him but whether you agree with him or not, she has been straightforward with us, straightforward with members of congress coming and we know where he stands on issues. he has not for example told me he's going to do something and then done something else. he stuck to his word. i may disagree with the direction that he takes, but he has stuck to his word.

>> going back there. >> is the subject purely homeland security? >> no, anything you want to talk about. >> the supreme court ruling bringing us back to converse with the situation in south carolina i need to know what is the government ied. this is being done to a small black college. my second question is why haven't you supported the jobs bill with michigan having a situation in the unemployment? >> the first question is about whether what counts as a government ied? >> that's one. but the civil rights of 64 mcclurg the congress has to prove to be all to vote again for the civil rights act? >> i will take a look at that. the issue has come up recently

and there was a supreme court decision that it's something i would like to take a look at and it's everyone's right to vote to be protected and that is a critical element of our society so that is something i will take a close look at. the issue about the jobs bill, the house republicans have passed a number of jobs bills legislation aimed to boost the economy and those haven't been taken up by the senate or the president either so it goes both ways and we want to make sure that whatever we do to help our economy is done in a way that isn't directed towards the big corporations to give a special benefit to look at all the people and how can we create a free economy that everyone can prosper?

>> [inaudible] -- of the federal or the state level? >> i wouldn't support during a meeting of the federal level and from my perspective is a state and local issue to the estimate as a michigan legislator, you would support -- >> fortunately i'm not a michigan legislator. >> but i'm saying a federal legislator for the state of michigan. i'm not saying you are a state level i just mean you're from michigan and you are a legislator. >> that's something i'm leaving to the state and local officials there was an article that i read in the paper the other day and talked from this gentleman here.

yesterday a surgeon informed me that because of my age i could qualify for this. i didn't qualify for the less invasive for the more expensive medical treatment required to correct a serious health problem. anyone over the age of 60 take note to the affordable care act is beginning to show its ugly head. the in the independent payment advisory board on the panel will be making a decision and those are from the irs. it's pretty questionable at this time. we expect our government to keep the medical costs lower on the backs of those most likely to need that same care. the extended themselves from this monstrosity. why is it that the president and

the congress doesn't have to follow all that they make not just obamacare but all of them. [applause] to estimate everyone should follow the same wall in the country. we shouldn't have different ones for different people. i believe very firmly in net. the congress isn't exempt from obamacare. congress and their staff have to go on obamacare. in fact, we are booted off of our health care coming up in the near and we have to go on to the exchanges. >> [inaudible] >> i don't think the president has to. the problem right now is you have the white house and the federal employees don't have to go on to obamacare. they don't have to go on to the exchanges. but the members of congress and

the staff because of an amendment was put in place before the obamacare past due have to go on to obamacare. scaap [inaudible] >> address the subsidy. >> there is a premium payment the members of congress and their staff get that is the same that they've been getting all along currently as part of our benefit from our employer which is the government. just like any other employer might get a premium payment towards their employees. we are in a situation because we are getting off of our employer's health care and getting kicked off of the exchanges. the question is whether you can still get the premium payment from your employer if you are kicked off of the exchange's. nobody else in the country actually gets kicked off of their health care and kicked off

of the exchange's. there is no change in terms of for example premium payments you're getting from your employer as a member of congress or staff. it stays as it currently is. and also members of congress and the staff are not eligible for the tax credits and other things that others might be eligible for. do you have to pay income tax at your wages? >> some of the question here hard-working recipient friend despair's the low-paying part-time jobs and no benefits. he could barely pay.

he watches the tip of congressional members hastening down the capitol steps on thursday afternoon after a three day work session that is if they are not one of the five week vacations around the federal holiday. they have achieved the american dream getting the premium health care in the office staff and travel allowances for part-time work at the capitol. surely one will think of struggling workers and vote for job stimulus funds and support health care for the middle class working poor. with skepticism he penned these words. many congressional members seeking reelection are promising good jobs come creation and less government regulation. they speak as examples for their pre-requisites.

as a do little congress it is all speculation. now these are some of the thoughts that i think go through all of our minds. we are concerned about the congress and we are so suspicious of the government today and the irs thing is just bonkers. we just can't believe or trust the government. i guess that is all that i have to say. i am as skeptical skeptical of the government's as you are. if you follow my work and follow my vote you will find that i have more than a healthy dose of skepticism and the government including many of my colleagues.

>> is there any realistic chance the irs will be fundamentally restructure or go through either consumption or flat tax? >> i don't think so in the short run, no. i think there's too much pushback. members of congress like having a complicated tax code because the more complicated the tax code is, the more big corporations and others have to come to them and big for favors. the more favors they can handle the war, campaign contributions they get. there is a sense in which it is rigged like that. i think it will take some time. i would support undoing our income tax. of course you need the

constitutional amendment to get rid of it completely. they were very heavy against the state government was doing in the targeted tax breaks and benefits it is the exact same problem. the more complicated to make the tax code, the more benefit the special-interest and wealthy people. >> they are going to have a hard time even because they use migrant workers to get their crops and the immigration reform bill passed by the senate has something in there about that. i wonder how to help the michigan farmers and if you support a bill like the senate or something different to get the immigration reform past. >> i wouldn't support the senate

bill but i would support immigration reform and immigration reform has to have three things. you have to have border security that includes visa overstays because some people come here illegally and then the overstay their visas. you have to have a better legal immigration system so people can come here and become residence legally. currently it is very hard to come to the united states whether as a guest worker or if you want to make residents here. it's a very difficult thing to do so that as an important system. that is where we did a lot of push back from the democrats in congress. a lot of my democratic colleagues don't want to improve the of legal immigration system. they are interested in providing a path to citizenship but not improving the legal immigration system. it will help our border security because as you make it more accessible for people to come here you are likely to have

fewer people fenty cost legally but as any compromise you deal with the 11 million or 12 million people who are here il illegally. you have to find a way to give them legal status over a long period of time. once they obtain legal status, then they are treated like anyone else that is here as a legal resident. if they want to maintain citizenship they are not put ahead of anyone else. they are treated like anyone else. so this isn't a special path to citizenship. to give them a special pet to citizenship and the devotee to be here legal and then they are treated like everyone else. they are not moved to the front line or anything like that. >> question on gun control and your stance.

where are we as a government now with the gun control situation? second is executive orders. our president is bombarding us with. as a congressman what type of control do you have against the executive orders the we put a stop to it and the people here have no control because we don't have a voice. what can we do? >> on the question about gun control, i'm skeptical of the federal law enforcement in gun control. the second amendment is an important as any other part of the constitution. there is a reason in place. you have to consider the context that was put in place after americans have fought in the armed revolution against their government and they wanted to make sure the people would be protected and always have the right to defend themselves. so i think it is important that the federal government not infringe upon their rights.

that's where i stand with respect to gun control. with respect to the executive orders, some executive orders are okay. a lot of the workers that have come down from the obama administration haven't been okay because what they do is to give all all and interpret that to provide some authorities to do something new. when congress doesn't want to pass law because they don't think it's appropriate, the white house says we are going to use this old wall that will allow us to do it. that is wrong and unconstitutional, and i think that we should do what we can to defund those activities. congress holds the purse strings and they have to come through the republican controlled house and we don't have to fund activities that we think are unconstitutional.

>> yes? >> i think you are the youngest person to ask something at a town hall. >> i have a question about prism to be among the internet a lot and when i heard about this i was really mad because the government shouldn't be spying on us and i'm not even sure why anyone had second thoughts on this. this is unconstitutional and against the founding fathers of america. why does anyone have a second thought on this? >> that is a great question. the prism program that we have heard about them but report is largely classified so there have been some talks about it so i

have to be careful about what i say. but the bottom line is there are too many people in congress right now who are forgetting that there is a constitution that restrict what they do. the point of the constitution is to restrict with the federal government does. and in the name of security they are forgetting that their first priority is toour liberty. that's why we have a government to ensure that we have liberty as a people and that is what they are forgetting. they are focused on the security aspect, and they think as long as the nsa or some other agency is stopping the bad guys they can go after and collect information on all sorts of good people and have no consequences. but of course there is a huge threat to that and we don't want the government having this kind of data to use against americans

sometime in the future. >> also, what i'm also worried about is all the gay rights stuff. i'm thinking like this could be of their racism thing where it's the same thing but gays and non-gays. like who cares? does it really matter? [applause] >> that's a great point. i don't think the government should be involved in deciding who can get married. i think that is not inappropriate role for the government. marriage is a private institution between people in their personal lives. i'm orthodox christian. my wife and i don't need the government telling us if we can

get married. no one else needs the government telling them if they can get married. so i agree. [applause] the contras is holding the purse strings of our country. i am eminently interested in what is going to happen with this so-called affordable care act. what are the chances of congress actually holding the purse strings on that and defunding it entirely? >> great question. i think they should be found it and i don't think they should pass an appropriations bill in september that funds obamacare. right now that is the the date that is going on. the republican members of congress who should fund obamacare and there are other

ones who shouldn't. i think law is unconstitutional. it's going to reduce choices. the more regulations you have on the insurance industry, the more that you create a monopoly of insurance where a few players control the market. what you really want to have is more competition. you want less regulation on insurance so that more types can be offered, so people can make decisions for their own lives about what they want to purchase. and you also have to find a way to move away from the third party paid system that we have. you have to incentivize and moved away from that. because right now what you do is you buy insurance, you go to the doctor's office and patience and doctors don't know how much procedure costs and how much medication costs. there's no incentive people have right now to keep the cost down. because if you know everything

is covered by insurance, you are mistaken. so their ends up being an overview slash u with a lot of medical care. >> my advice to people before they got involved in this is the fact that you go to the hospital or the doctor you have the insurance pay you and then you pay the medical expenses out of pocket and they always have a little bit to pay. as a young man, two of my kids were born without insurance. i paid payments.

this affordable care act i'm going to have bureaucrats telling me what kind of services are not going to qualify. >> and what kind of insurance you can get, too. i can imagine what the price is going to be. i have medicare right now but they took $750 billion out of that. what is that going to do to my coverage? to be honest with you, i'm scared to death. estimate a lot of people are very worried about this. i have held a number of telephone town halls. it's the number-one issue that comes up. people are concerned about obamacare. as i said, i think it is a train wreck. i don't think it is going to work. we have to move to a system that

is more free market oriented and a system that allows people to make traces for their own lives and where prices actually mean something. yes, in the back the head. >> [inaudible] >> the folks in this room are seniors. every one of them so far will have benefited in some manner to the services and screenings they would have never before. there children are able to be on their parents' insurance. i'm more concerned why congress can't work together. why can't the republicans and the democrats fix it? the affordable care act has a lot of good things a net. six it. don't vote it down.

you are wasting resources. 25,000 seniors over 60. they are all anxious because of the misinformation from both sides. help fix it. don't try to get rid of it. the republicans try to stop social security, medicare and medicaid and a number of things over the year that were in this line similar to this. the affordable care act was based upon the massachusetts governor that helped develop the model. it's not all bad. don't try to just the little clout. you are making mistakes. there are a number of good things in it. fixate that -- fix it. you'll get some annual screenings. you will find out that it's not

going to miss you that if you were on medicaid. all of the hospitals or bodying each other out because it is a privatized system that we have already. that is what is making it expensive to go to the hospital. >> let's all be respectful, please. let's all be respectful, please. the problem is you can't lower the cost of health care by just mandating everyone beyond the insurance is regulated beyond the government. you can't do it. you can't over regulate the industry and the prices go down to the it's not going to go down. and i've heard from republicans and democrats who are very concerned about it. so, it is not just one side at this point it is certainly not one-sided and it is important to remember when we talk about

working together when obamacare was passed with one party passing it, the one-party basically passed it over the objections of the other party. the other party completely objects to but i think that is a serious flaw in the way that was passed. you have to have an agreement between the party on the issues. >> i commend you for doing these town halls. i have only two questions. if you have been in jail free

dui and got out those that take away your voting rights for life? >> i don't think so. >> what if he is out of state and has now moved to michigan? i have a friend who thinks he can't even come here because he might have to prove a voter card. >> i don't think that's true but you can ask someone on my staff >> i have one more question -- if you have an answer? >> if you are not incarcerated as a felony and once you have served your time if you obtain a

eighth ccw and planted it to california and other states will all of the states along the way -- >> then you can get in trouble. i wouldn't recommend taking that trip with you. >> i am jane wilson. i'm very concerned about something that has been passed that affects all of our children. it hasn't come through the legislature. it's come from the department of education arne duncan and it's a

federal takeover of our education including all the children, not just public school but private school home school children and it's called common core. i'm very concerned about it. its data collection and putting all of our children into a national data bank with a lot of extremely private information. 415 items on every child and it's not only collecting the data banks but they are breaking free federal walls going against the tenth amendment which says the states are to be in control of education, and also they've changed the family rights and privacy law so that they can

collect all of this information and the purpose is to dumb down our children and indoctrinate them with this leftist ideology so that they will accept a left wing idea of our government, i mean that our country and of our country's history. it is dumbing them down and teachers and parents that you know about it are very concerned. i just talked to the teachers last night here at the county fair. very, very upset. but the thing that most parents don't even know about because they sneaked through going from the state department of education they are the ones assigned us on to the consortium that we are part of. it is on a line that we have never passed before because it takes away any from anybody in

the state because it has been given control to this consortium there is nobody to go to if we don't like it or if we want to change it. but i think that arne duncan needs to be -- denney to be some hearings on him and his activities. and i just learned yesterday that our foundation that has given $400,000 to this state department of education so that they can form data information on all of the preschoolers. >> i am against common core. [applause] >> i don't want the federal government telling our schools what to do. i think that is a bad idea. teachers don't like it and it's not good for students. education is something that should be handled locally.

you should have states competing to have the best system rather than one standard that creates problems for the whole countryside against common core and i think we should return the control to local families and governments. >> [inaudible] >> i don't know what the standards are, so i cannot comment on them. >> thank you. >> yes, in the yellow. >> i am from battle creek. we have thousands of people doing things that were illegal like recruiting them on the eligible voters to vote than they were being funded by the federal taxpayer money.

okay. now a great number of these people work with other organizations doing the same thing. are they being funded by federal money? that's the question. >> i don't know. i haven't voted for any of those appropriations bills. the appropriation bill i voted for in the veterans affairs. but the other appropriations bills i haven't voted for because they haven't -- the want me to have a 17 trillion-dollar debt. i couldn't tell you the details of every bill but i haven't supported it. >> there were other organizations that these people were gathered in. anyway, one other thing here back in the last year i heard a president say everybody should vote. i don't want anybody to have to

show a legal id to vote. they should vote. and was even an executive order. but just because you're here these people are voting, they are not even here illegally or a citizen, the people here in the country with a green card. >> that's what i read in the paper. what are we doing about it? >> only citizens should vote. i don't know how to address the issue other than that other to see people who are legal voters and the citizens should bode. >> -- vote. i haven't called on you have i? let me go to someone else first.

>> when we were talking about obamacare, he made a comment that i have heard from many representatives and senators that have been reported, your comment was we need more competition in the system as opposed to more regulation. the problem is i have never heard anybody explain who is competing against who. as a patient i am the end user on the system. i can't shop for quality or price. i can't call five doctors to find out who is going to give me the cheapest operation on my arm and then call five hospitals to find out which ones are going to charge me so much for the amnesty -- anesthesia. the typical capitalistic model doesn't seem to apply. who is going to compete? >> the insurance companies are.

>> why would we want to trust insurance companies to run the entire medical system? >> that's not true. also you are trusting the government to run the system which is far more monopolistic. >> yeah, but we don't have doctors -- we don't have doctors being employed by the government like they do in some countries. most hospitals are private operations. it may not be for profit but they are private operations. if you don't have any regulations at all, how would you achieve equality under the system? >> through all of the competition that's how you achieve the quality to it >> that's all i am saying. if there is less regulation, the more regulation you have in any industry the less competition you have come and in fact as a state legislator and as a member of congress, the people that come to me and ask for the

regulations the most are big corporations. they are constantly in the office saying we want regulations put in place. the reason they want a regulation is because they want to limit the competition and drive out competitors who have fewer employees and don't have the ability to manage the type of regulation so they can then monopolize the market, raise prices and have fewer choices out there. if you have the government telling you that an insurance has to have 100 different items in order for it to be sold, you have the prices go up. that is the only way it works. you have to allow the companies to offer all sorts of products. some cheap products and expensive products and let people decide how they want to spend their money. ..

you will have better insurance companies that offer better products at a lower price. >> the doctors and hospitals will accept a cut in at the end they will accept a drop in the cost? >> you have had a competitive market one way or the other. >> the patient can do it. [inaudible] >> we will probably take a few more questions. we'll try to get to as many as we can. >> i've already called on you, right? so let me go back there.

>> representative amash, as one of your constituents and someone who voted for you, i would like to say that i'm very pleased with what you have performed in congress. i would like to say that about some of the gop leadership, but, unfortunately, i can't. my biggest issue at this point, so many of them, is in obamacare and the upcoming vote to fund it or not find it. and in listening to the national discourse, it appears that the republicans are divided as to whether or not you're going to fund or defund, and there's a very strong argument or a

movement towards funding it and then getting with it piecemeal at a later time. -- dealing with the piecemeal at a later time. this vote to fund or defund is probably the most important and the most critical of them all. and the big, the big issue is, will you shut down the federal government? and already, the republicans are being blamed that if they defund they will shut down the u.s. government. well, i would like my voice to be heard, that i think you should defund it. and if the federal government gets shut down, it isn't going to be the republicans but it's going to be the president of the united states. okay?

and the gop leadership needs to understand that sometimes the best defense is a good offense. [applause] >> and as i said, i support defunding it. >> first off, in the interests of obamacare, i would just like to say that no good idea ever had to be mandated. also, i was just wondering if i'll be able to vote for you for carl levin's senate seat? >> i can't talk about campaign issues at this town all. >> that's a secret, right? >> let me go in the back there. >> [inaudible] >> any topic you want.

>> i'll just say, i went to the hospital recently. we had to go to two different hospitals and one -- the next one took them. but we ended up sitting in the waiting room watching the entire movies of cars before they even helped us. we have four different people come in and ask the exact same question. fill out all the paperwork. one sitting and watching my son scream because he got bit by a dog. i him in a situation where i kind of want to buy a book and learn how to do it in stages so i don't have to deal with this. i'm wondering of what point we just abolish the federal government? [applause] >> the federal government has an important role, and and you have to follow what the constitution says. there are enumerated powers for congress in the constitution. and most of those relate to national defense and that's what the federal government should be focused on is national defense.

>> if it's national defense, they're really, really poor at it. shouldn't we get a new one? >> they haven't done a great job of focusing their efforts properly, or following the constitution when it comes to national defense, but that is one of, that is covered in several enumerated powers for national defense but that should be the priority of the federal government. >> [inaudible] >> i'd like, i'm from battle creek, i would like to bring up the topic of geoengineering. currently, we're having tons of fine particles spread through the atmosphere, and primarily, i believe aluminum oxide.

if you go on the internet instead of what aluminum oxide poison does, you will find diseases like alzheimer's, nerve diseases, asthma and things like that. and with so much of that going around i just have to think that we are being poisoned rather than, rather than having all these degenerative diseases just happen to us because we are living. i mean, i think there's action is something going on there. and i wanted to bring up that topic. >> is there a question associated with that? >> you know, who decides, who decides -- i know yesterday over battle creek i could've played tic-tac-toe on the sky because there was cross hatch is going every different way. you could sit there and you could watch the material spread out and form clubs. it was supposed be a lightly cloudy day yesterday. it almost look like is going to

pour down rain before it was all over. but from personal experience, my lungs started burning and within five minutes of putting a mask on, my lungs stopped burning. i don't know who is the citing this. you know, it's like we don't have any control over anything. whether we can breathe air or eat or anything like that. so i don't know. >> [inaudible] >> i'm a guy that likes, i like to ride around with my windows open. now i started writing about with my air conditioned on. >> people should not pollute the environment without consequences, so -- go ahead. >> as a key region in the area, how concerned are you about egypt right now and defunding

our aid to the area since they don't seem to want it, or are assistant. >> i'm very concerned about our foreign policy. i think it's been disastrous with respect to the middle east. they have been, the government has been sending money to countries that are actively against us, or whether there's total instability and we don't even know who the money or weapons are going to, whether it's egypt or syria. i think we have to stop meddling in those places, and really when it comes to places that are facing these types of civil wars, we need to be careful to mind our own business or we get ourselves into something that we don't want to get ourselves in into. >> i wanted to talk to you about the national debt, because i think that's the armageddon that's coming down the road for us. i heard you quote $17 trillion,

but really the national debt is $70 trillion. because when you look at the budget bill or budget proposal that goes out, in the center of that is all the unfunded mandates that are not in the new math that creates the deficit. including social security, medicare and a bunch of others. those alone are 35 trillion or so we look at $70 trillion. we've had three quantitative easing's, $85 billion a month. we're looking at a rate now increasing to 2.8% as the bond yield increases, so does our payment on the national debt. but what is our plan for the national debt? how are we going to decrease this and how are we going to get our sovereignty back? when you're done in indiana, i travel a lot. indiana's toll roads are owned by the heirs. most of the garages in chicago, ted rogers are owned by foreign companies, our countries. so what are we doing there?

>> unfortunately the government had has -- hasn't had a real plan to do with the national debt. is both parties that have ignored. i put together business cycle balanced budget amendment. what we do is require the spending levels be no higher than the average tax over the previous threer. if it has a smoothing effect because they use an average, and because of of the nice way in h it would work, i've had republicans and democrats signed on twitter contact as the most democratic cosponsors of any new balanced budget and in recent years. it's a new type of proposal the way it works by using averages. i think we need something like that in place before congress to get together and work on the issue. because you have, democrats who don't want to deal with social security, medicare or medicaid reform, but those are three of the four largest areas of government. and get republicans who often

don't want to do with the military spending reform, which is another large areas government, the second largest area of government. and the fact that national defense should be the number one priority of the country it doesn't mean there's no waste and the pentagon. there's plenty of ways. so both sides have to come together and work on these issues and fashion some compromise that deals with our deficit and deals with our debt. you have to take from all these areas. i'll criticize my own party to there's plenty of criticism by the other side. i'll criticize my own party on this. when we have appropriation bills, for example, that going through congress now, all the appropriations come in at the question level or less. except for one bill, the department of defense appropriation bill which comes in about this a question level. you can't have it both ways. he gets we want to cut federal

spending and then when it comes to department of defense, you decide we are not going to go there, we're going to ignore this question, ignore the law and just keep spending. so the two sides have become together because the four largest areas of government, social security, military spending, medicare and medicaid. the fifth largest area is interest on the debt. like you said, if interest rates go up a little bit, interest on the debt becomes almost equivalent to defense spending. you could run into a situational interest on the debt is five, six and a billion dollars per year. >> the other problem is we just sold off two of our largest -- hormel just sold to the chinese. what we are doing quietly selling off assets of the united states to the highest bidder. i'm really concerned about that we may have a lot of foreign interests that own america. >> i think the bigger problem is what the federal reserve does.

>> how come the administration and the federal reserve work hand-in-hand and spend independently like his post there? >> good question. i mean, they don't. they seem to be working together instead of working independently. but the federal reserve itself is a problem, that we have a system where basically one person can decide the money supply for the world. that's a problem. >> shall rewrap it up? all right. i want to thank you all for being here today, and we'll wrap it up there, but i appreciate it. we will hold more of these town halls. please stay in touch. thanks. [applause] >> thank you. thank you so much.

>> can we get a picture for facebook? >> oh, sure. let me get -- >> [inaudible conversations] >> congressional republicans continue to press for added oversight over the national security agency's domestic surveillance program. lawmakers are pushing for more details about the scope of the nsa's activities and are considering legislation aimed at scaling back the program, and deposing new measures to oversee it more closely.

>> about five hours remain and c-span2's congressional town hall program for today. here's what's ahead. >> here's a preview of senator ben cardin's town hall. it's coming up at 6 p.m. he's a maryland democrat. >> partisan politics played in washington these days, i am trying to stay above that. i mean there. i want people to make the right

decisions for what is best for them. this bill is not going to be repealed. do you think the republicans in the house would've gotten the message here for the 30th time to try to repeal it, and it's still here. this bill, the public wouldn't let us repeal this bill. they don't want to the benefits that gotten from the affordable care act, or seniors don't want to go back to our cost of prescription drug. families don't want to see their young 25 year old kids off their health insurance policy. people like getting the check from the insurance companies that have been charging more than what we think is acceptable rate for their health insurance. and quite frankly, americans are tired of paying the cost of other people who should be responsible for the own health care needs. that's what this is all about. how do we implement it in a way that makes the most sense for the american people? >> senator ben cardin. a short preview of his hour-long town hall meeting scheduled for tonight at 6 p.m. eastern time. our final town hall program for

the day. senator cardin talks with voters about health care, budget cuts, and the upcoming budget debate in congress. >> oklahoma senator tom coburn held accountable meeting recently in moscow the oklahoma to hear questions from his constituents on a range of issues. they include the federal health care law, privacy concerns, government accountability and second amendment gun rights. in brief opening remarks, senator coburn talked about the problems of government debt, self-reliance and personal responsibility. the concentration of power innocent government and the need for a constitutional convention to address these issues. this town hall runs an hour and 10 minutes. >> you good? good afternoon. we are on time. welcome. happy to have you here. it's good to visit with you.

i'll be a little slow this evening. this is the fifth one of these i've done today, so bear with me. it drags you down more than you think. i won't spend a lot of time talking, but i do want to hear from you. there are a lot of concerns in our country, not any of them unsolvable, but they are still nevertheless big and problematic. if i were to assess where we were as a country today, i would say that the constitutional republic that we have is at risk for the very reasons our founders and forefathers talked about. the abandonment of constitutional principles, especially the enumerated powers. has created situations in which we find ourselves leaving a legacy to our children that i

certainly can't be proud of, and i know most of you will not be proud of. our unfunded liabilities right now are $126 trillion. when you add them all up. that includes the 17 trillion that we owe, plus the rest of the unfunded liabilities. the total net worth of the united states, all the assets that the whole country has together is 84 trillion. so essentially the game is up. and the problem is, if we don't have any visionary leadership in our country in either party that will stand up to talk about what the real principles and problems are. we have undermined self-reliance in the name of being charitable. we have abdicated personal responsibility in the name of being fair.

and we are following in the footsteps of what every historian has noticed about every constitutional republic, is they don't last. and the reason they don't last is because we concentrate power of the central government, and end up giving away freedom and create fiscal policies that undermine the very economy that supports the growth and vibrancy of our country. i think they're all solvable. the questions i ask, i asked privately and publicly is why are we not addressing them in congress? and i hear often from oklahoma's about the fact that you all need to work together. i have enough -- we will have an $800 billion deficit this year. i would say we're working

together way too well. we have agencies that are rife with fraud and programs that are rife with fraud. congress has agreed not to do anything about it. i think we are working to well together. our biggest problem, in my estimation is not a country and not our people. it's the elitism that comes from the career politics that dominates our congress and our country. and i was asked today -- [applause] and i get asked it a lot, very sincere, well, what do we do about it? what do we do? >> [inaudible] >> throw them out doesn't work unless you replace them with people that are different. you know, 70% of the senate

essentially has never had a job out of career politics. cell, they are wonderful people. i mean, i get along great with dick durbin. i like him as an individual. our philosophies are totally different. he means well, as well as many of the other people that promote what i would consider policies that will undermine our future liberties. the thing is they lack a frame of reference from experience in the world, like our farmer who is sitting over here that knows, like her insurance agents that are here, like our policemen that here, like other people who are here with isa done something with allies outside of elected politics. so it doesn't do any good to throw them all out. in the last week or so i've read a book called the liberty amendments.

[applause] i just had to chile, i used to have a great fear for the constitutional convention. i had a great turnout of not having one. three-course other states would have to prove anything approved through the comps i don't think there's a lot of danger to our republic. i do not think there's a lot of danger. on the tenth amendment, enhancing federalism, and re-creating a sense of personal responsibility, accountability. not only at the individual level but at the city level and at the state level. i had a fire chief get upset with me today because i don't see any role in the federal government according to the constitution for us to be fine -- for us to be buying fire engines were cities and states. the danger with that is, issue become addicted to the largess of the federal government who says they're giving you something, but they are actually

stealing it from your children and grandchildren. and so again, i don't think we have problems we can't solve. we lack leaders who are thinking long-term and understand what makes our country great or has made our country great is that very fact that we enhance personal responsibility. we enhance hard work. we don't condition dependency more so than what is needed, rather than to create an environment where you don't have to help yourself. so, i'm thankful that each of you are here today. we've had big turnouts at town hall meetings. and we're actually talking to the corner. you wouldn't be here unless you're actually concerned, had an interest in a. slot want to thank you for being here. and what we're going to do is questions, and i'll try to answer to the best of my ability. we have one rule, is we don't

let go of the microphonmicrophon e. i learned a long time ago if i let go of the microphone, it maybe 20 minutes before i get it back, and for this large, i'll go as long as you want to be here, but almost as long as you want to be here, until my blood sugar gets so low that i'm going to get some ribs. that wasn't a commercial. just my favorite place to eat. who wants to ask the first question? we have a microphone right here. writer, tommy. >> i appreciate you being here. [inaudible] we touch on the topic, i want your personal resnshere's no accountability, , you come up with all these great research papers on fraud and waste like you said, nothing

happens. the constitution doesn't seem to matter anymore. obama is just, well, i can work with them so i'm going to do it this way. and nobody seems to object. benghazi is a disgrace but the only people where the money speed i'm going to make you get to the question because if we go at this rate we'll only have 10 questions asked. >> my point is, let's not talk three years to the next president. would've we going to do in the next 12 months to correct the course? are you going to go on his show and talk about his book? >> right now i don't think it's a smart strategy to shut down the government as a message to defend obamacare. don't do it on shutting down the government because our economy is so precarious right now, and shutting down the government won't stop obamacare one iota.

it will continue to roll out. we are limited, and it's hard, a couple of points i would make, is republicans control the house of representatives. that's one-sixth of the total government. we don't control the presidency. we don't control the senate. and we have, according to recent court decision, very little influence on the allegiance of the court. so it's hard for us to do things. the second point i would make is when they do those things, as a u.s. senator, i don't have stand in a court of law. so you know, i've got letters out right now chastising the justice department, asking them why they have not cooperated with the government accountability office. by law, they have to cooperate. except this administration is refusing to do so, on multiple events across multiple agencies. ..

i mean, they actually -- i have a little bit on the medical side about health care and insurance and medicare. i guess the point is, my desire is great. my ability to continue to push boulders up is limited because there are not the votes there to help me. we have great people. i love mike lee. we differ on the shutdown

strategy. he is a great patriot. guys like him, we have 20 or 30 that will do it, but that's not enough. and until you change to is there, your not going to change it. so i don't have a great answer for you. what i am going to do is keep fighting, keep over siding, keep putting up reports. no one has offered as many amendments as i have. as a matter of fact and i have offered more than everyone else combined. held more opponents than almost anyone else there. my first rule book is the u.s. constitution, not the republican party. is the u.s. constitution. so we will keep fighting, but remember, the present balance in this country, there is a bias, a hard leftward bias. so even when we put it out there, and it makes common sense. it's a smart thing to do.

all right. next one. >> thank you for being here today. >> you're welcome. >> last week representative bowen, the first time i have been out to one of these. the first time i've been here. i am very proud of what you do for our state and how you represent us. i just wish there were a hundred like you. i am reminded because i have been around a few years, when strom thurmond said a million here, a millionaire. pretty soon we're talking about real money. i wish those days were still year. the reason is now we're talking about billions. we are getting desensitized to about money, where it goes and what not. we have got a debt limit coming up next month, actually in

october. i am reminded that we pay our bills. this is not to raise money to spend, it's to pay what we have already spent. that is a whole point. wenner you going to quit spending so that we don't have to keep raising the debt limit to pay airbills. that is the problem as i see it. >> so your question is? >> why do we keep letting them spend our money? where does that come from? i thought congress was the one that allocated money. how did they get all these billions of dollars to give way? we have serious problems in this country. >> well, the answer -- first of all, the federal budget under the johnson administration was unified. so you confused social security excess with money which started running a deficit of five of six years ago with everything else.

so there is mandatory spending which congress is not appropriate. the vast majority. it will stop obamacare. 85 percent of it is mandatory spending. there is good news on the front. over the last two years we spent about a hundred and $60 billion or less on discretionary programs limited to two years before and. thus the first time that happened since the korean war. in 1996, when we did as a package when i went to the congress which ultimately resulted in as balancing the budget because the extrapolation of the $64 million came out to be about 120, 130 billion per year. it was a big deal. this is a bad way of doing it, but it is all lot better than not doing it at all.

a sequester is like when your wife asks you to go out, you take the lawn mower and crank it up and know everything. so if you go on our website, we put out a lot of sequester letters. you know what we are hearing from the president, how bad sequester will be. all of this, what was going to be 17 days of furloughs is now down to four. necessity is the mother of invention. there is still, after the sequester, $250 billion of pure fraud, pure waste, or pure duplication in the federal government every year. a quarter of a trillion dollars. and we have done nothing about that. so the question is, where is the to do that? and what i am telling you, it's not there. i don't see it. it's not in my party or the other party, and it's certainly

not what the president. he thinks we need to be spending more money, not less. a good portion of social security and medicaid, veterans' benefits that are all mandatory spending. unless we reform the programs they're going to continue to go. i did not get prepared by today. vendor show it tomorrow with. projections of revenues. it's totally unsustainable. we eric at $17 trillion worth of debt. in ten years we will be a 30. well, i don't know. that's a great sidebar. whether we will get there, whether the international community will continue along this money was a federal reserve will continue to print money.

historical interest race today we would have another trillion dollars worth of deficit just interest. were paying over one quarter and now. instead $233 billion interest we can have a trillion. and that's a trillion dollars when the you're not going to pay do kids a underpaid. markedly decrease in the living. the inability to purchase a home, the inability to send your kids to college is what is going to happen. we need to change it. that's why as said the pretty outlandish statements after what point. i'm afraid not to have a constitutional convention. i don't think we have time to wait. he's done a great service to this country by raising those issues. he is pretty harsh sometimes, but the fact is we have real

problems, and any real solutions. that is when nobody else is offering. all right. sphene. >> welcome home. >> thank you. fox. >> are you aware of the bureau of land management is currently proposing to consolidate obama's city at a cost to taxpayers of two and a half million dollars? -it will take 20 years to recoup >> no, i am not. i would love to have the details on a. give that to connie or one of the other staff, the details on it. we spend 5 billion per year maintaining the buildings at the federal government owns a guarantee. and rather than cut moving into buildings and buying and none of the agency's possum -- valleys

them. the suit it's a stupid accounting rule that said if you buy a building year after expenses in the year the budget. eighty-one it is ever bought a commercial building as you don't rack up the whole building. if the government will let you. there's no way that the federal government cannot save tremendous amounts of money by owning their own buildings and getting rid of the excess profit. i've been trying to do that for five years. i have a bill and attached the real property reforms. so is going to be coming through with it periods we're not taking it out. we're going to reform real property, the way it's handled by the federal government, and save the top money, four, five, $6 billion a year. >> i believe it was john locke he said the purpose of

government was to protect private property shall revile look at what is going on now, irs collecting all of financial data. the collector e-mail hamel be using our kids to college family data. plus we don't get a salary and so the government takes their percentage. freddie and fannie. retirement is nine years until you pay a 10% penalty. my question is -- >> wait a minute. sixty-five is not forever. don't put me in that cockpit to leave. >> okay. anyway, look in the republican party. the senator, a group of senators restore our privacy and this

stop the progressives, the tax cut to steal the rest of our property. >> i think -- [applause] let me state a philosophical first. we had an election in 2012. republicans did not do real well, did they? my observation is everybody in the world knows what we are against, but nobody knows where for. and when all you hear about is what we are against, they quit listening faugh 130 -- personal liberty and private property. you forgot to mention that all these a going to look every bit of your tax stuff when everybody

medical stuff, and these are people who have not had the background screen, not unlike that. it is going to just the average person on the street, some of the most personal affirmation you have if, in fact, you want to enroll. and if you don't, we're going to find you with the tax that this appraisal recesses manipulated half. so i think the first thing we have to do is talk about that provision. and success. that means something different to everyone of us. our success means i'm a great poet or a bill to business or i'm a physician or emigrate carpenter a policeman, but we need to every enhance what it means 56 this will. and contrast with what it means to be dependent. i've been working on this for six months, staff. you have a great staff in washington.

they're not careerists. most of them are young, but there are very, very smart. they're average age is -- average age a steady five reform . we've been researching all government benefits. right now if you are a family taking advantage of every government program available, you can receive almost $50,000 for without tax per year. my fate says i am to help those that need help. that's not helping. ultimately that's hurting. and it's hurting everybody. and that would recommend -- i may have done this at a town hall meeting before here. there's a book, i believe, every concerned citizen not to read. and it's called the treasury of american compassion.

it's written on a guy to cover my guy named marvin alaska. the outlines the history of how america used to help people in need help. and it was highly effective in terms of turning people around in terms of if, in fact, they want to continue. in other words, kind of like you discipline your child with a chain spadix. i think we have a long ways to go in terms of doing that. all of these programs are well intentioned but administered in such a way can run in such a way as that they totally undermine self-reliance. we need to change that. it is a big deal when it comes to the money that the kids are going to have to pay in regards to those programs. two is next? >> thank you. of want to thank you.

i'm proud of you. i'm proud of everyone of our representatives. i really appreciate that. he brought up, it's only two ways. one of them will be really bloody. the other one is a state convention, which you just mentioned. is there any conversation going on about the state? and individual. what do we need to do to get them started? we also made the point, it's going to take awhile to get it done. >> what do you need to do is you need to, first of all, read that book and have a good understanding of the case to be made so you can defend your position.

number two, love your state legislative picket their the ones who have to make that decision. i don't agree with everything in his book, but i certainly agree with his attempt at a solution where we find either political party tends to have the courage to stand up and do the things it is supposed to do. just an example today, i mean coming it is plain english in the constitution. fire control and a local community has nothing to do with the federal government's. and yet now we have become an entitled class because we have been given these grants since 911. everyone thinks you have to have more money for your fire department. is your responsibility, same with your police. education, somebody mentioned that. we spent over two and a half trillion dollars as the education department was founded, and there is not one parameter in measuring of education success that is better. there are multiple that are worse. thomas jefferson's "on education

was this, he is the father of our modern university system. he started the university of virginia. the federal government to be involved in education, you have to have an amendment to the constitution to be involved. he is one of the authors of the constitution specifically stating the federal government has no business and education. as a matter of fact allow we made a mockery of it. we send this money down but then we send all these requirements. there really love our children, the administrators, and the parents to make the decisions that are best for their kids. consequently we are not succeeding. today the acp reported less central percent of the people have taken this year that is a disaster for our country. >> all right. over here.

>> you don't get to hold onto it. >> i know. i have a couple of comments. now we are talking about -- first, i want to thank you for being here. when our leaders won't allow congress to do some of the things and hear some of the bills they're being heard, it is not some months that could men and women that we have serving in congress as it is people like the speaker of the house that will keep things from being heard. you have stated, you know, we talked about obamacare. and, of course, the supreme court did not give us the ruling now we wanted. in 2012, of course, the elections did not give a steady it. when you ran last time, you stated you were the most opposed

to obamacare of anyone that could be. and we've reelected you to not only represent us, but to fight for us. and because of that we need men and women that have courage, who are not looking for excuses. the heritage foundation, freedom works all have some arguments on why obamacare should be defunded. some my question to you is, have you sat down with any of these organizations to discuss this so that, perhaps, your opinion would be changed? if you have not, would you please consider doing so? >> i have dinner every tuesday night with jim demint, the head of heritage foundation. i live with mike lee and mark arubia, two people that are behind this. they claim that because you won't sign a letter you are for obamacare is utterly ridiculous.

i don't disagree we need to get rid of obamacare. i disagree with the tactic. you don't set a strategy out to, in fact, try to accomplish something ignoring the couple of realistic facts. one is the only way you get rid of obamacare is with 67 votes in the u.s. senate. and two-thirds of the house of representatives. unless obama is this going to roll over and say, i made a mistake. i don't think that's going to happen. that's number one. number two, i'm glad you raised the issue because it means you are involved in the future of our country, and i think that is admirable. i think mike lee, marco rubio, the purest of intentions. i think they are dead wrong on tactics. and if you will recall, we had a government shut down in 1996, and we lost 15 seats in an

off-year election when we should have added 150. you're missing my point. you're missing my point. that is not my excuse for doing it. but my reason for not embracing their strategy is i am 100 percent convinced it won't work, and let me explain why. let's say we carry out the full strategy. what do you think is going to happen to of the week need, soft spines members of the republican conference of which i am not one? after around three or four weeks , if it is another election i will go get reelected. and that is exactly what will happen, so we will have gone through all this exercise, not accomplished our goal when, in fact, if we strategically look at it is better place. you don't impact the economy negatively in the short run. you don't alienate all of the

federal employees to are disrupted, i good portion of them are your neighbors to work hard every day. you don't send a signal that you are way out here and you don't have any idea about what realistic consequences of what you're doing. finally, you recognize the career politicians to care more about getting reelected than solving the country's problems. and so it can't. no, it cannot. i understand that is what they have put out. i spent an hour and a half on the phone with centrally sunday afternoon. he is going to keep going a direction he is going. mike gray hair is just eight times longer than his. my judgment with people, having been a physician for 25 years, is pretty good. the fact is, they have a failed

strategy. i don't disagree about getting rid of obamacare, but if you're telling me i'm not a principled person because i now want to sign a letter that says we should do that, i disagree with you. nobody, nobody -- 300 amendments in committee on obamacare. i led the fight. i made bernie sanders read this bill and tell me. my amendment, which was a common-sense way to fix it never got on the floor because they knew it would get over 50 votes, which would then make obamacare look foolish. it did not happen. the differences, i don't agree with the tactic. i am 100 percent sure it will fail. and so why would i do what i no will fail because a lot of outside interest groups disagree with me and think i should go another way? you elected me to represent in the u.s. senate the best interest of our country. that is what i'm doing by refusing to sign a letter.

let me give you an -- let me give you an aside. i have never voted for a continuing resolution off. it will probably have my vote anyway, but i cannot be intellectually dishonest until you agree with the strategy if because i think it absolutely is intellectually dishonest because it is setting a pope that we can do something that i am convinced we can't. we will not accomplish. and so it is great you are here in great you are fighting for that. i just think it is misguided. so you're not going to change my mind. i mean, i have had debates late into the night with marco arubia and mike lee on this. they are on one side, and i am on the other. we are just not going to agree. i am not going to support it. i will be their accomplice anyway because see ours are a stupid way to run the federal government. [applause] >> hi. >> zillow. >> this is the first time i have

ever been. it is great to be here. >> well thank you for coming. >> i don't want to take away from obamacare. >> i have heard and let it all day long. >> i'm interested in tech common core for my grand kids going to private christian school. safe there, even the home schoolers. so how do we -- i know texas opted out of it. how could we opt out of its? and they were there. >> let me give you of the background. first of all, it does not emanate from anything the senate has done. common gore is a program developed by the governors' association. so if you don't want them coming to be a part of a commodity have to do is change it. it's not anything that goes through me. in other words, it's a state up to then opt out deal. that is a state-run a shoot they you all need to deal with.

i don't think the goals behind a common core are necessarily bad. i think probably the implementation is very dangerous, but the point is improving the educational standards of our children, you know, the best way to do that is put parents, teachers, administrators back in charge. [applause] >> senator, thank you very much for your representation. i am -- proud of what you have a vested. i am really concerned in maybe a generation are less we are going to lose our second amendment rights. the americans and oklahomans. and no pun intended, under the

gun. what can we do? senator feinstein, senator reid, you would think there is no common sense. the east coast, west coast, federal politics, anyone that holds a gun is a criminal. what can you do? >> let me give you a little reassurance first. i think all the ten amendments, probably the one that is safest is the second amendment. i actually believe that. that is why i voted to proceed for a debate on the gun bill. i want to have that today all the time. you cannot stand up to the logic and consistency or the supreme court rulings that have instituted your right to defend yourself.

and so i am not worried. you know, the ban on assault weapons got the lowest number it ever got. i feel really good. the national rifle association. there is a lack of knowledge. the balance of town this as being the guns fall rather than the individual. and there is no question, there are tragedies, but they discount the number of tragedies that are averted because of the same thing. so i would just want to reassure you that i think that is pretty secure. i believe with rights, responsibilities. so i think gun owners ought to set the example for being exemplary citizens b bng

totally responsible with guns, who they sell them to, how they sell them, how they handle on, how they keep them locked up, how they keep children from getting to them, how they teaching people about the. i think with every one of our rights comes real responsibilities, and that think if we were to example that to the far cose some bowfins they might send have an understanding . in no, gun violence in this country are the last 40 years is 46% less than it has ever been. a decline of 46 percent over last 20 years in this country in gun violence. and the number of guns about fivefold. so there are a lot of arguments to be made. the tragedies associated with violence are terrible. my wife and i have this debate. she is totally anti-gun, and i understand your situation. the one reason our funders one

to protect our rights under the second amendment. defending every designer a. the think if you look at the fiscal situation in the country and some of the lawlessness of the branch agencies of this demonstration in terms of ignoring what the lions, i think we have real reason to protect the right. casino in congress is a growing group of want to protect that right. i would tell you there worry more about your intellectual rights, your property rights, your privacy that would the second and. >> thank you for coming. back to obamacare committee said they disagree with the strategy that they're offering up to defend obamacare. what other alternative is out there to keep the formal bill

from being implemented on october 1st? >> the debt limit. the debt limit. the debt limit. you attach it to the debt limit. but the point is, they're going sarah peale the mandatory spending to the debt limit. otherwise it doesn't allow. let me make a point. i don't want to get into a debate. the one thing that average americans agree about is that the government wastes money. one thing that the average american agrees about is trimming down the size of the federal government is a good thing. that's an 80% issue in this country. restricting the debt limit does both that and repeals the obamacare or at least delays it for a couple of years because

it's an absolute disaster. why don't we go where strength this. my strength as a conservative is to cut down the size and scope of the federal government and do that through the debt limit rather than have a fight. remember, we lost the 2012 election because no one knew what we were for, we also lost the independent voter which republicans will always have to have simply because we didn't seem reasonable to them and our approach to give the. people did not know we are for. we talked about what we were against. we ought to do is put out a message. here is where we can actually make something and will make a difference for our kids. not only will we have an impact on obamacare, we will also have an impact on spending want all

of movement. >> last time because they strategically were licking their wounds van. we did it by combining the budget control act. >> i see john baena once every two weeks or once every ten days . asked in the critical question, were you thinking? one of you planning? remember, he doesn't have a solid to get a republican conference. all right? so the point is -- well, but you still -- there is a majority. you have to govern. if you don't cover you are going to get thrown out. he does not have an easy job of

doing things i would like for him to do because it is not have the votes to do it. there are not enough conservatives in the house yet. so until we get there, it's kind of like the conversation i had with jim demint, the head of heritage, the brainchild behind all of this, i would love for their to be 60 conservatives in the senate. how many of the of think that is a realistic expectation that it will happen in my lifetime? it isn't going to happen. it is not going to happen. so the point is is we ought to go with mark levine recommendation and take back. >> o obamacare. >> and a stand that. where are we? >> di fine obamacare. what i am hearing from my cleat commercials on tv, heritage foundation is that they will find everything back obamacare.

how does that shut down the government? >> first of all, the only discretionary portion of obamacare is there is less than 50 percent of the total cost. so i don't care whether we shut down the government or don't shut down the government. obamacare, 85 percent of it will be implemented. if we shut down the government, all the president has to do, and he has already done it, declare all the employees associated with obamacare as essential. that means everything with obamacare is going to have to whether we shut it down and not. it is still going to get implemented. it is still going to happen, and that is a congressional research issue. i ask him to do it. the fact is, the irony is shut down the government to stop obamacare and obamacare keeps going. [inaudible question]

>> to you think the president will sign that bill? okay. let's go back to the matter of contention. how big a megaphone to you think the president as? yes. it's about seven times bigger than our voice. if every republican was preaching the same song and all of the conservative slanted news outlets, we still got out numbered 7-1. so here's the thing. you are here. how many of your neighbors are as concerned about this issue as you are? half of them don't even listen to anything. in terms of the electorate, will it be positive? in terms of trying to grow a majority in actually changing

things. what i could say, if you have a coach is going to do that, rather than create that strategy , the ones that look good trying. would rather try to score them look good trying. so that's the difference. mandatory spending happens no matter what. discretionary spending has to be appropriated. in a shut down all the president has to do is say, these are the essential employees and get funded. regardless of what congress says. they already said that. the irony of this whole strategy whereas on the debt limit the government is still running. we have to decide which route we are going. the first one is interest in redeem the bonds dividend of a sudden if they can't borrow more money, to they have to do? necessity becomes a mother of

invention again. we start shrinking the federal government again. we have not even begin what we can do in terms of shrinking the excesses of the federal government. the average federal employee with health insurance and everything else is hundred $38,000 a year. to have ties with the family. that is the average federal employee. so it's a lot of things we can do. how about a hiring freeze? , stopping? how about using videoconferencing instead of spending about $580 million a year. -- when we have to pinch pennies you know, we create priorities. we say what is first to know what is second, what is most important. that is starting to happen only

because of the sequester. we went from 17 days and everyone will be furloughed. where do you get the money? then made some decisions. certain moneys did not get spend that were discretionary that could have been spent. so all of a sudden the sequesters turn out to be not a bad deal overall for our kids. it's a bad deal for some federal agencies it is not to give way to do it, but it's a whole lot better than not doing anything. but i would tell you is my approach would be not to use the sea are, but use the debt limit. let's have the fight on grounds that the american people agree with this on. they agree with us about obamacare. they don't agree with us about of better shut down. it think it's incompetency. berson legitimate factors.

>> we have the fbi here. it will funnel them. my partner and i got here. i didn't quite and s&p. i you for defunding obamacare or against it? >> i am for deep funding obamacare. >> that is what i want to here. i think most of the people in this from one to hear that. we can count on you to vote that way because we are going to be looking and watching you? that so we want you to do. how many people here -- want to

see your hands, the defund obamacare. >> let me ask you this question. how many of you want me to defund obamacare if it will force the government shut down? how many of you want that? so you have three at of this whole group that wants to do that strategy instead of, -- you missed my point. i don't code for cr anyway. nobody has led the fight. do you realize, we have six components already out of obamacare? [inaudible question] >> no, it is not. it is 30 days after that. uni going to have to disagree. i think the tactic is a failed tactic. [inaudible question] >> you are missing my point. let me set one record straight. it will defend -- offend some of

you. you have elected me to follow the constitution and to make my business the long-term interest of this country. that is what you elected me to do. you're not going to like every one of my votes, but i do have a 99% conservative rating. no other senator in the u.s. senate has that have an average. i have pretty well drawn the line at abiding by the constitution. you are asking me to commit to making a policy of that is something i think will work. so i am not -- i am totally against obamacare. i think this is a foolish way of getting there. yes? next question. >> yes, sir. i am really sick of the government. i am sick of the big, federal government. in oklahoma we have a pipeline that should already be under way . last week the justice department put in an 11-hour stop on the merger, an airline.

it makes me feel like these unelected people, the epa, the irs, on and on and on. you can go on and on and on, sir. it's like they want us to be detroit. you got no votes from the state. thank you, oklahoma. but we are paying for it. and he does an end run around everybody. what can we do to get oklahomans working, to get these things implemented without them sitting up there and saying, this is what you're going to do? instead of the people that run this country. >> gosh -- [applause] >> you know, i would tell you, don't blame it all on obama because there were uncontrolled bureaucracies under george bush. it goes back to the thing we kind of started out with. the federal government is out of control. but it has been predicted by all

of the historians that the republic would fail. the question is, how do we teach history, go back, every embrace the thing that made america great? and as i said earlier, i think we have to get in charge. i have been working for nine years to try to make a big difference. i have made a small difference. i worked every day trying to do things. i am convinced the only way we do that is half the state start exerting their temporary authority and reassessing -- [applause] -- changes to the constitution that restore federalism in the constitution. and so i think that is the way. you are frustrated. you want to see me in washington. asked my staff. as my wife.

i want to pull my hair out. you know, i see two things. i see the constitution, and see what is happening to it. then i see grown men and women who know what the constitution says you don't care. that is what really makes me want to pull my hair out. they ignore what the constitution says because it is better for their political careers they do. and that is an abandonment. >> the airline mergers. just done and over with. >> oh, no. it is not over with. first of all, when you approve delta and northwest and you approve united and continental and then you don't approve u.s. air and american, what you have done is to condemn those two airlines to eventually go out of existence. so, if, in fact, it was not anti-competitive for those other

two, the only reason this is happening is because they want to look tough on airline companies. it has nothing to do with the facts of the case. [inaudible question] >> that may be. that may be, too. the point is, it is arbitrary and capricious. it is not based on common sense or sound judgment or true antitrust laws. they found seven share of votes. of all those those that were anticompetitive. there are going to stop the merger on the basis of that. it just shows you how lawless this administration is. and i don't say that word lightly. all right. >> center, my name is carl. i am one of those federal employees you were talking about i can assure you, i don't make anywhere near hundred $38,000 a year. i'm actually a federal public

defender here in skokie. i live up and wagner. and you were talking earlier about the sequester and how it is actually been a good thing in decreasing the size and scope of the federal budget. has certainly done that. i guess my question is, a little background, my agency -- we don't have all lot of discretionary spending. as you might expect, the public defenders don't get the biggest budget for the whole federal government. it is pretty lean. and so there is a big percentage of cut, the sequester is imposing. that means we can't people, and we have already lost three employees because of that. we might have to lay off more people to start the fiscal year. and the funny thing is, we are constitutionally mandated. when you prosecute people you have to have people defend those people. and so if we don't take a case

because we lose attorneys, it will go to an appointed attorney who gets paid by the hour and it is actually ended up costing the government more money when we can't take these cases. so my question is, as a doctor, would you rather perform surgery without hatchet or a scalpel? why doesn't congress step in and pass a budget and say, these are the good programs that are efficient that are necessary. these are the programs the wake think there is waste. why doesn't congress make that decision instead of just imposing and tightening down on some agencies that are necessary and efficient? >> i basically agree with you, the indiscriminate nature of the sequestered. and i think i said earlier, better sequestered and nothing. but your agency, by the way, is one of the most wasteful

agencies in washington. it is not my fault that money does not come to you. he spent $480 million last year on conferences. the justice department -- and half of those could have been done -- let me finish the point. half of those could have been done on video conferencing. but we decided to spend $300 a night or $400.9 on rooms. the judges are taking a big trip here in the next few -- i have already criticized it, and it has not stopped them. $600.9 rooms. the fact is if we are broken out of money, who do you think, should we have a concourse tough conference where judges could together or public defenders? nobody is making that choice. so i don't disagree with you that it is unfair the way it is rolled out, but let me tell you, there is no place in the federal government that is not rife with waste. let me just give you an example. you never heard one thing from

the state department about the sequester, did you? not one people. why? because there is some much waste in the state department. for a half, 5% cut. and if you have any common sense applied to the management of most agencies, it -- the second point i would make as president obama made the sequester much harder than a need to be. had the choice of doing two things. he can make the sequester is a wide which may perhaps pacific, or he could make it just to the department and let them meet the goals. he chose to make a specific. so it would exert the most pain on the most people said that he can win the battle of increasing spending. that is what he did. so they had a choice. and your department probably cut it off at the managers to do it. the smart way, the way a prudent person would do it is cut the

waste and keep the good. but they did not do that. they went by department, by line-item, by facility. and so we have -- the problem that we have a sequester, because of the choice that the president made to make it as painful as possible. >> welcome. the you please explain to the audience, has to do with using the office of personnel management to accommodate the health care needs of staff members in congress. go onto obamacare. [applause] >> i actually raise the question because i turned back about 20 percent of my budget every year in running the office. and i want to say thank you very

much. i wanted a decision made so that i can plan my budget for next year because i think employees who work for me not to get insurance. and on the -- i think members of congress ought to be doing anything we ask the american citizens. but think asking people to work 15 to 18 hours a day some days he put. there contribution portion of that health insurance from the seven office is not fair to those employees. just like it's not fair for you. that's my opinion. the stomach right. it's my opinion. i wanted to know what the position would be because i want to prepare my budget to be a will to buy health insurance for the employees that work here in the state of oklahoma and outside. every other federal employee has a very generous 72% payment to their health insurance.

and, in fact, staff are federal employees. we all are. so we accepted those. i offered an amendment in the health committee during the obamacare debate that would put members of congress into the exchange's. i think we ought to experience what americans aren't after experience. no contribution from the federal government. i totally disagree with the ruling on that. i don't disagree with it on the employees to work free of that are employed by the federal government. so i think the ruling was totally erroneous, and again, outside the law here is what is said, and it is time again, another instance of lawlessness or at least the very loose interpretation of executive privilege which i assure you is not there. [inaudible question] >> okay. right over here. let's get one back over here,

and then we will finish up. >> okay. on behalf of my family, i appreciate what you have done for us. your sacrifices have been tremendous, no. i have a very difficult question for you. we talked a lot about the constitution. we talked a lot about lawless administration we currently have . the constitution provides for three branches, executive, judicial, legislative. we have an executive sitting president who is rewriting loss, failing to enforce laws he is chosen that he wanted to have passed, selecting which part of glossy once and forced. i want to know who he is accountable to an two is responsible for enforcing his

constitutional requirements cars possibilities jack. [applause] [inaudible question] >> i believe it is the attorney general. we know that is no good. you is that next -- >> well, is that as representatives. [inaudible question] >> is the judiciary committee. what you have to do is you have to establish the criteria that would qualify for proceedings against the president. and that is called impeachment. [applause] but, you know, that is not something you take lightly. you have to use a historical precedent of what that means. you know, i think there is some intended to violation of law in this ministration.

i also think there is a town of incompetents. people who are making decisions, you know, and homeland security 15m the 17 top spots right now or nt. i would just tell you, the general portion of the nominees are absolutely incompetent. [inaudible question] >> the irs forces me. >> i agree. i agree. my little wiggle out of that, i believe that needs to be evaluated and determined. think it it does not have to happen in the senate until they bring charges in the house. those are serious things, but we are in serious time. so i don't have the legal background to know if that rises to high crimes and misdemeanors, but i think you're getting perilously close in terms of --

let me share with you. u.s. cis employees, the people who do the background investigations and immigration, told me personally to managers that homeland security told -- ignore all the background. this is the management telling the career employees to do something against the wall. so, you know, and documented, all this stuff as it goes along, but i don't know where that level is. i'm kind of like the lady in the back. i am fed up. i am frustrated. and, you know, i am happy to raise an issue at every point. barack obama is a personal friend of mine. he became my friend and the senate. but that does not mean i agree in any way with what he is doing or how he's doing it. and quite frankly, i think he is in a difficult position he has put himself in.

and if he continues, i think we're going to have another constitutional crisis in our country. >> strictly. >> oh, sure. it is not just his failure. look, i will make this point. the rule of law is the one thing that this country has better than anything else. the rest of the world looks at us and says, that is the glue that holds them together because no matter whether you are poor, a minority, rich, insider, outsider, you have this gentleman in the back who will defend you and make sure that your side of the story gets told . and when you have an administration that undermines the rule of law, here is what happens, the next time i am at a decision point on the rule of law, well, gosh, if the administration does not have to follow the law and the president does not follow the law and the

senators to not follow the law, why should i? and all the sudden you have a declining, crumbling republic. and what we really need is enhanced fidelity to the rule of law, rather than the opposite of what we see in this administration. all right. we are through with questions. we have gone over. i will hang around about ten or 15 minutes to visit with anybody wants to visit. i want to thank you for coming out. i am glad you are year to pressure points. think it's great. i just don't agree with it. and i have been -- i have a little bit of an artist stricken make an independent streak, but that is the one reason why i am challenging things in washington. so you may have heard something here tonight you adamantly disagree with. i have an e-mail. i am about 10,000 letters behind right now. so i won't get in answer to you quickly, but i will answer, and

i will read it. so e-mail me if you heard something you did not like and want to educate me on. let me know your thoughts. i will try to a -- one of my cost savings in the sequestered is not have quite as many people help me write letters. it takes a little longer to get a letter to you. god bless you, and thank you for being here. .. [applause] ..

>> nace, virginia democrat bobby scott talks with voters about the health care law. he is joined by state and federal officials who reviewed how people would be able to get insurance through the federal marketplace is known as exchanges. after that at about 4:50 p.m. oklahoma republican tom cole discusses immigration, health care, energy and the irs with his constituents. our final town hall meeting starts at about 6 p.m. as maryland democratic senator ben cardin holds his gathering in baltimore with health care and budget cuts the main topics at that meeting. >> earlier this month virginia democratic congressman bobby scott answered voters questions about the health care law at a town hall meeting in his district. he was joined by state and federal officials to talk about how people would be able to get insurance through the new marketplaces, known as exchanges.

medicaid expansion was also discussed. this town all last about an hour and 18 minutes. -- 50 minutes. >> good evening, everyone who has come out tonight. i do want to, ou on behalf of or senior pastor and our mayor, my name is pastor derek jones. i'm the pastor of first baptist church in south region. we want to welcome you all to the imani center, the only full-service tailoring center right here in the south richmond community. we certainly don't want this to be your last time, if it is your first time. we want to welcome you here anytime to any of our array of community activity, any of our menu of services or on sunday. we're very active and socially conscious church. and so we want you to know that you are welcome, one and all. we're here tonight, and we're glad to c-span broadcasting live, and because of that we

will be cognizant of time as this is a live feed. so we're going to move right into what we came here tonight. we are here tonight here's some good information about the affordable care act. when that legislation was passed, it was a great victory, and still is, but there are many questions still laying out there. many people want to know how does it affect my family, how does it affect my future, how does it affect my community. we are here tonight have those questions answered, not by a novice or not by someone who doesn't know what they're talking about, but we're glad to have one who's been through thick and thin with this community, who, over the years we've been able to count on him, not going to ask the right questions but also to bring us back the right answers. and so i'm pleased to bring to you tonight our congressmen who have decided to make south richmond one of the stops as he goes throughout the district,

his congressional district to bring the information to the people. and i'm pleased is here in south richmond tonight. i want you to help me to receive our congressmen, the third district congressman, robert c bobby scott. [applause] >> thank you, reverend jones introduced himself as a pastor here at the first baptist but didn't introduce himself as a member of the school board. so thank you very much for your leadership there, state delicate betsy carr is also with us today. lacey any other elected officials? thank you. good evening, and i like to thank everyone for joining us this evening as we discussed the affordable care act, better known by most people as obamacare. and i'm pleased to be joined here by three great speakers, and understand some action had

to rearrange their schedules to be with us tonight, so we thank you for your willingness to be with us. the first speaker, when i finished will be joanne grossi was appointed by the obama administration as the regional director of the u.s. department of health and human services for region three, which includes five states including virginia and the district of columbia. as regional director, she works with federal, state, local and tribal officials and a wide range of health and social service issues. prior to her appointment, she served for seven years with the administration of governor edward rendell in pennsylvania, first as deputy secretary of health and later as first ever director of the office of women's services. she earned her masters degree at international public policy at johns hopkins university and completed additional graduate work at johns hopkins university school of public health and hygiene. our next speaker after that will be dr. bill hazel who received

his civil engineering degree from princeton, and then attended the university, duke university school of medicine where he completed his orthopedic residency at the mayo clinic. he is a founding member of the commonwealth orthopedic and rehabilitation, is also a former chair of the american medical association council on legislation, speaker and president of the medical college, medical society of virginia, president of the fairfax county medical society and chairman and over health systems medical affairs council. among his accomplishments as secretary does far include the virginia health care in the virginia health reform initiative and the creation of the virginia center for health innovation. jill hanken his staff attorney at the virginia poverty law center where she specializes on health issues. she graduated from boston college law school and work as legal services in charleston,

south carolina, before coming to virginia and the virginia poverty law center. during a brief hiatus from the poverty law center she worked as an administrative law judge for the virginia department of medical assistance services, she's been one of the key advocates for promoting the development and improvement of public health insurance programs for low income virginians. but for someone to give you a little background on where we are and how we got to where we are before getting to our speakers. and let me just say briefly that we, silver years ago, we recognize we needed to reform, because employer-based coverage was declining, thousands of americans were losing their coverage, about 14,000 a day were losing their coverage. small businesses were struggling

to provide insurance coverage will but fewer and fewer small businesses were providing coverage, from 57% in 2000 to 46% in 2009. about 1% a year declining coverage. the premiums were skyrocketing as a percentage of your income, and in 1987, health care premiums are costing about 7% of the families income. by now, it's about 17%. if we don't do something it's going to be about 20% by 2020. and so we recognize that if we're going to come up with any kind of plan that works, it has to be comprehensive. one of the groups we want to make sure we cover of those with preexisting conditions, and we found out that if you allow people to wait until they get sick before they buy insurance, people will wait until they get

sick before they buy insurance. the only people with insurance to be sick, and, therefore, the average cost for each premium would be unaffordable. and so we have to have a comprehensive approach. and just briefly what we did, was proposal summer to other proposals with at&t the issue of insurance, responsibility of employers, individual mandates, subsidies tell people that can't afford to buy injured, to help them buy insurance, and increase market regulations, is an element of the republican plan in 1983, and governor romney's plan in massachusetts along with other similar proposals, virtually have all this, elements, and that's what we have in obamacare. some of the benefits, first of all, if you're a small businesspeoplsmall businesspeope effect of small business. you've got less than 50 employees, you are exempt. but if you provide health insurance, we give tax credits to the small businesses that

provide coverage. young adults can sit on their parents policies until they are 26. the caps on out of pocket expenditures this so that when you reach an affordable cap, there are no more co-pays and deductibles. it's all on the insurance company. there's also no lifetime limit. if you have a chronic disease, many times people are bumping up on the maximum of the insurance policy would pay. after that you have no coverage. you also have a preexisting conditions we can get any other coverage. now under obamacare, there are no lifetime limits and no annual limits. and no recession of benefits. a lot of companies figured once you pay premiums all these years, finally get sick, insurance companies figured they can cancel the policy right then, they can save some money. so we have prohibited canceling peoples policies for any illegal

reason to you just can't arbitrarily cancel somebody's policy. if they don't pay, that's one thing. but if they didn't paying their premiums all along, you can cancel the policy, and that was a real problem. you can't fail to cover somebody because they have a preexisting condition to whatever your health situation is, you can get coverage at the standard rate. cost-sharing protections for families under $94,000. if we expect people to be able to buy insurance, some people just can't afford it. so from around $30,000 to $94,000, there will be tax credits to keep the cost of the insurance from zero up to about 10% of your family income. so that it will be affordable. we are closing the doughnut hole in the part d. if you're on party, i think most of you know what that doughnut hole is, after you go through a couple thousand dollars worth of benefits, you end up with no

benefits, still have to pay your premium, then after a couple thousand dollars out of pocket it kicks back in, but that doughnut hole is a real problem and we're closing the doughnut hole. security, you can get insurance regardless of your situation to a lot of people are in what's called job lock. they get insurance on the job. they can't leave the job because they can't get insurance anywhere else. because of obamacare, you can switch jobs without worrying about health insurance. preventive care, without kobe or deductible, preventative, when you get cancer screenings or your annual checkup, no co-pay or deductible. people are finding that they have cancer but finding it out early when it is curable rather than late when it's generally fatal. transparency, we can see what's going on and make sure that insurance companies are doing what they're supposed to be doing. now, for virginia specifically,

one of the things that we require under transparency is that insurance companies, when they take your premium dollar, they spend at least 80-85% on health care, not corporate jets, ceo salaries, emissions, advertising and other overhead. 80-85% to health care. a lot of them, for virginians, $12 million was saved thanks to policy rebates when we caught them not spending that much, they had to rebate to the policy holders. virginia got about $12 million. we've got 66,000 young adults in virginia, now on the parents policies. over 400,000 virginia and children already are getting health care without being discriminated against because of a preexisting condition. some are born with a congenital defect. you can get insurance. now they can get insurance.

2 million virginians have already gotten their preventive care without the co-pays and deductibles. medicare have saved about $157 million already on prescription drugs. medicare recipients, and there is more competition and better prices. right now it is expected when those without insurance today get insurance, we expect them to be paying 25% less than they're paying now. in new york, the bids are coming in at about 50% of what they're paying, 50-60% of what people are paying now. and other states, huge savings. so the fact that you actually have to compete, and everybody is insured so that when you go to the hospital with insurance and pay, you just say for yourself, not a little extra because people showed up at the

emergency room and couldn't pay. that little extra today is about $1000 on every family policy, and we're not paying that. so people with interest that don't have to do anything will probably find some savings because they are only paying for themselves now, not for everybody else. now, the marketplace with those without insurance will go, i see those without insurance, because if you already have insurance you will get the benefits. you don't have to th insurance that you have. but those who are buying insurance from the marketplace, it will be run not by the state. some states are running their own. virginia elected to let the federal government do all the work, and so is being run at the federal level. medicaid expansion is uncertain. they are huge benefits for expanding medicare. excuse me, medicaid. but if we expand medicaid under obamacare, 400,000 virginians ld ge health care.

virginia has some of the stripped his eligibility standards now for a lot of people working for, would be able to get medicaid coverage. we have found that because virginia covers a lot of things like if you go to mc hospital and can't pay, the state has depicted a. if you go to the health department get services and can't pay, the state takes it a. committee service boards provide general mental health services and under the obamacare there is no health parity. you have health insurance for mental health. virginia carries it now but if we expand all those people will be coming with medicaid, 90% are 100% paid by the federal government so that things pay for today on state time will be paid for with a medicaid card if we expand. one calculation estimated that the general fund of virginia, if we expand and pay the state

match, digital -- the general fund will be $555 million better off because a lot of things we're paying for with the state time would be paid for with federal monday, we would ask would be better off than it would if we do not expand. billions of dollars, about 30,000 jobs, and 400,000 virginians would get benefits. we have paid our taxes, and so we're entitled to get those benefits. now, virginia hasn't decided yet, and dr. hazel, i served on the general assembly in the house in the senate. and i know we like to do things carefully. so no one should be offended by the fact that virginia hasn't decided yet they're going through a process to make sure whether it's the right thing or not. so let's not get mad at them because they decided to do it slowly but surely. but hopefully, dr. hazel, they will come up with the conclusion it's a good thing to do. we will now have presentations

from ms. grossi. >> good evening, everyone. thanks for having me here this evening. i would want to thank the imani center for graciously hosting this event, and more important, to congressman scott who is a champion for the health and well being of all the citizens here of the third district. some always so grateful to the congressman to inviting me to do if it's within. it's a pleasure to be with you here in the great city of richmond and the commonwealth of virginia. and so the congressman said that perfectly for me by telling you a little bit about the transfer and some of the provisions. now i'm going to tell you about the marketplace. and how you're going to get insurance. so again, you might of heard sometimes it's called exchanges, but we actually refer to it as the marketplace.

so that's how you hear me speak about it going forward. so again, come january 12014, all states in the country are required to have a marketplace set up and again, what's important to note, and the congressman mentioned this by want to reiterate it, this is for people who currently don't have health insurance or to buy their own health insurance. so if you already future insurance from your employer or for medicare or for medicaid, or from chips or from tricare, this does not affect you. you are not be affected by the marketplace. this is for the 48 million uninsured americans, and those who by their own private insurance. states have decisions to make and again the congressman mentioned this. didn't want to partner with us to run it, federal-state partnership like we're doing for example, in west virginia, or did they decided that they wanted the federal government to run it. that's called a federally

facilitate market place. and as a coxswain mentioned, we will be running the marketplace for you at hhs, we will be running for you here in virginia because the government and administration decided not to run. it's important to note that states can change your mind even though virginia, for example, is going to be run by us at hhs starting in 2014. states can change their mind down the line and decide you still like to run it for themselves and, in fact, they can apply for funding from us at hhs to set up the marketplace through december of 2014. so now i want to give you some details on th on the marketplac. the best way to think about this is kind of like expedia for health insurance. this is going to be private health insurance that yo you're going to be purchasing and you're going to be able to make real apples to apples comparisons. so again you're going to look at what works for your life in terms of their health status and your finances. one of the things i want to tell you about, as you can see i have

actual values list to be. who is going to be for metalevel sieges on, a bronze, silver, gold or platinum. then within those levels that we many different plans that you can pick them. so it's important to note about the actual barrier, actuarial values you see next to each one, bronze 60%. that means the plan will cover 60% of the benefits you are going to be responsible for the other 40. going up to platinum what means this plan will cover 90% of the benefits, you will be responsible for the other 10. just for an example medicare isn't 80/20 plan to the equivalent of a coal plant pictures even ip -- get what medicare, the plan pays 8%, you're responsible for the other 20. i hope they give you an idea of what you'll be looking at. you will be able to look at and make real decisions based on what medal level works for you and then within that, what plan that's in the medal level works for you.

i can the other thing i want to tell you about is if you're a young person, for example, back to the medal level come if you can imagine, if your young person, 20, healthy can you might think a bronze plan works for you because a bronze by a lower premium but higher co-pays and deductibles. you are taking a risk you're not going to get sick. if you're 55 and you're a cancer survivor or have diabetes, you might think the platinum plan is better because the color a lot of benefits of the premium is going to die and you have much low co-pay and deductible. again i hope that gives you an idea how this is bring private health insurance and you're going to get to make a lot of different plans and decisions. somebody's going to say to me, what if i'm 55 and have diabetes by can't afford the premium for platinum plan? because the truth is the platinum plan will have a higher premium. we've thought about that as well and the congressman alluded to but if you make up to 400% of the federal poverty level, which is about $94,000 a year for a family of four, about $46,000 a

year for individuals, you are going to financial assistance from the federal government to pay for your premiums. and again, you're going to notice -- you're going to know this information right up front. we're grading a date have between irs, social security, department of justice and homeland security. you will know right up front when you're making a decision what can you want to buy, what plan you want to buy, how much financial assistance you get from the federal government. you will know that up front. at math will help you make that calculation on what plan is the best for you. i hope that makes sense but i would be happy to answer questions about that later. the other thing that's important to note about that, the money does not come to you. the money goes directly automatically monthly to those in the assurance -- health insurance company, health plan. you will know what financial assistance you're getting, but the money doesn't come to you. it will go automatically to the health insurance plan that you picked.

in addition to this, if you make up to 250% of the federal poverty level, which is about $50,000 a year for a family of four, about $28,000 a year for an individual, you get additional financial assistance to pay for your co-pays and deductibles. you will know all this information up front. any financial assistance for the premium, and again knowing that data will actually help you make the decision about what plan you want, what medal level and what plan within the medal level you want to buy. and here's a list of the essential health benefits. what does that mean? that means under the affordable care act my boss, sector cities have the statutory authorities had what were the benefits that must be covered in every plan? from matter if you brought pashtun if you bought a plan, no matter what the premium, no matter what medal level, these categories of service must be covered. so you can see the categories up

there. just so you know, no matter what plan you buy, all the services you see them all these benefit you see listed up there will be in the plan. so that's what we call them the essential health benefits. that's important for you to know. next, you're going to ask how am i going to enroll for this. it's going to be four different ways you can roll. you can enroll online via computer, by phone, by regular mail, or in person. i'll get into all of those in a minute, but again, one of the things that's important to note is you will know what qualified health plan, what plan you want, what financial assistance you get before you make the decision, and what's important to especially if you do it online, you will be able to buy your insurance right in real-time. that's what i said kind of like expedia. you can look at all the plans, no financial assistance you get, make that decision, take the plane you want and you by your health plan. so really it's a real-time purchasing of health insurance. it's an important thing to know.

so help is available for you. we actually already set up a 24 hour a day, seven do we call center that started june 24. you see the number listed up there. that number actually if you call, so can speak to you in english or spanish vote also have another go 150 additional language lines of a look at again, you can get help up to 150 different languages. you can sit also have a 24 hour a day seven days a week web chat of able for you. again live chatting so people can help you should try develop the application, make some decision. but again when some people are really going to need help in person, that somebody will be able to sit down with you at a computer and help you. we know that some people it will be the first time they are buying insurance, some people might have literacy issues or some people might have language issues. we know that's we set that up as well. we've created to programs, one called a navigator program, and one called and in person a sister program. as vintages i hope navigators

will help you navigate the system as you try to make some decision, same thing with in person. they will sit with you at the computer and help you kind of negotiate the system and make some choices. what's important to know? navigators or in person and sisters must be neutral. they cannot -- they will not try to trash at one health plan or another. but again we have assistance for you. navigator grants are actually facilitate marketplace. we will be announcing within the week the grants the would be given out to. virginia will be giving out $1.5 billion to virginia for navigators and we've already given up 2.4 million taking in the health centers for in person assistance. so again federal funding coming to virginia to help you sit down and get the assistance you need. by the way, some people always ask me but there is still a big role for agents and brokers. we started training last week.

we really do save there's an important role for them going forward. finally, i know jill and secretary hagel talk about this and the congress and mentioned it as well. i can't sit down for telling you about medicaid expansion but as you know that on a little over hundred thousand uninsured virginians. we expect about 520,000 virginians will get the health insurance now through the marketplace. the other 400,000 would get health insurance if you did medicaid expansion you. so that's an important issue that is really two parts of the puzzle. it was always envisioned under the affordable care act that we're going to be medicaid expansion and the marketplace. if he did medicaid expansion that's what people who really are low income, working poor. these are working people. taking up to 133% of the federal poverty level which is about $30,000 a year for family of four, $14,000 a year for an individual. we are trying to expand the safety net for the most vulnerable citizens.

so we know the administration a considering it and we hope there will. the congressman mentioned this and it's worth repeating, the first three years, it's 100% funded by us, the federal government. so 2014-2016 we pick up the cost 100%. takes down every year to 2020 will we pay 90% of the cause. the state pays the other 10 and it remains that formula going forward. we really are going to pay for the vast majority of funding for medicaid expansion. you can see in the first six years we estimate virginia would get over $9 billion. as you heard, creating over 30,000 jobs. jill and the secretary will talk more about so i will be with the. a couple of resources for you. i will help you have and as for in the back so you have to memorize this. really hope you go to healthcare.gov, you can go right now and said something called my account. you to put in some information about yourself and start getting braver when this which starts october 1. that's the other thing i should mention the open enrollment is

october 1, only 49 days away. so we are working feverishly. it goes through march 31, ma 2014, but if you enroll october 1 through december 15, your coverage starts january 1, 2014. you'll have about 10 weeks to make the decisions about what plan works best for you. but again, open enrollment starts at dover first. you can start getting ready now with questions to the call center, or setting up something called my account on healthcare.gov. i know we're out of time but finally the last one, that is for anyone whose primary language is spanish i hope you go to bed. finally, forever here, that is my personal e-mail address. it's my honor and privilege to be you a public servant. i mean this sincerely but if you have anything i can help you with i hope you will contact me. thank you very much a plot next. >> -- [applause]

>> dr. hazel? >> thank you, congressman. and thank you, imani center, for having this tonight. let me recap a little bit. just so that we're all clear. if you have insurance today through your employer, large employer greater than 50. the employer will likely continue to cut the. that's what you get your insurance. okay? if your ex military, if you have served in the military, you would be eligible for veterans benefits. that doesn't change. if you're over 65 or disabled and you are on medicare, that doesn't change. i know a lot of people get confused about medicare and medicaid, so that doesn't change. in virginia, if you're on medicaid currently, that does not change. okay, so really a couple things change. number one, if you make more

than 138% of the federal poverty level, that's about $28,000 for a family of four, and under 94,000, then you will be eligible for the tax benefit that ms. grossi as described in the marketplace. that's where you go to the marketplace, and the open enrollment starts in october. the benefit doesn't kick in into genuine. just want to be clear. i know i'm repeating a little bit but they taught me in school, say it again and again. so that's what happens. the difficult problem that you have in virginia is if you are under 138% of the federal poverty level and are not currently covered by medicaid, those rules -- those rules have been changed. they haven't change. in fact, the general assembly in the budget set up a commission called the medicaid innovation and reform commission, or the merc. there are five delegates and five senators, and they're meeting again next monday here for the second meeting.

and what they basically said in the budget to us, they said we need some reforms of medicaid before we will expand medicaid. and so they basically said secretary hazel, go reform medicaid. i will to you on the bit about that. we reform medicaid in virginia back in 1997. and we are one of the few states that runs most of our insurance for most people on medicaid through private companies, managed care plans. so we have already done that. that's something we won't be able to do it again because we've already done it. what we know is there are a lot of people who are not in the managed care plans, and we call that fee-for-service, ffs, and some call it fend for self. so what we are trying to do is bring people in, more into the managed care plan come and some say that's just a hassle. it's just insurance companies and so forth. what we know in today's world, when you go in for treatment, i can think about my mom a few

years ago. she had been right here. this is her right upper quadrant. can anybody tell me what my mom had? she was 70, about cover 50th wedding anniversary. what was her problem? her gallbladder did some basic? yes, it was. i'm an orthopedic surgeon. i was anyway before i came secretary. mom didn't like that either. but, you know, so i know now mom calls me and says i'm having pain. it's her gallbladder. she has to go to the primary care doctor and to the hospital and then go to the cardiologist and then finally gets to the general surgeon and then just to go, two weeks later she is on the floor in pain in the house and my dad calls and says the summary want to take care of your mother? that's unfortunate will we've been doing to people. standing here and there. what we are working with the plans is to try to be better about ensuring that everybody has a medical home, a place where a doctor and his team know you. they are paid to take care of you and keep you well.

90% of health has nothing to do with what we call health care today. the other 10% of health is what we are spending most of our money on in health care, and we think that there needs to be some change towards keeping people healthy, and that involves a lot of things. poor choice of parents come we can't do anything about. but what we can talk about is how we eat, how exercise, whether we can walk in your community. those types of things. whether you're tested for cholesterol. where the get prevented testing. we need to begin to think about how we put this into the package in the medicaid program. what this merck is going to do is they've asked us to do several things. one is to move more people into managed care. another is to look at changing some of the rules. we defined that it makes a difference whether people are spending their own money or somebody else's money. we like for people to maybe just

have a primary care doctor instead of going to the emergency room where they don't know you. they won't see you again. its most expensive place. we would like to get you in early. how can we help people get the right incentives to do that? we have reached an agreement with cms, ms. grossi's agency, to help work with people who are dual eligibles, folks on both medicaid and medicare. currently, you are kind of defend for itself the what we're hoping to do is create a better coordinated care for those folks so that maybe a stay home instead of going into nursing homes in many cases, trying to keep folks in the community is a way of working with it. another thing that we're doing is around behavioral health. we've seen a lot of increased in behavior health services that are offered, maybe no change in the folks with diagnoses, no change in the number of folks getting medication. but we see a lot of changes and

we're wondering whether that's adding any value. so we are looking at created a behavioral health organization to help manage the care for those people. so we have a number of things that are in the works that we're working with cms on right now, and will present this to the mirc and they will get decide whether it's efficient. now, why are we worried about and why would someone listen to all this and say, we are not ready to expand medicaid? out give you a couple of points on that. the united states of america spends 18% of our gross domestic product on health care. 18%. does anybody know what the second most expensive country in the world is? switzerland. spends 11.5% of their gross domestic product on health care, and covers everybody. now, that 6.5 is a difference, do you know how big that is? 6.5, the whole u.s. defense budget is only 3.5% of gross

domestic product. so we are spending almost twice the u.s. defense budget in excess of switzerland on health care. switzerland is not a cheap country and they cover everybody. why is that important? it's important because the employers are paying their share, and employer thinks if they're paying that much more, what happens to our jobs? so we're trying to find a balance. how can we be sure that what we're getting in health care actually works, how can we help people to stay healthier so that they don't consume as much health care. health care today is kind of like the body shop after the accident. what we want to do is prevent the accident. so these are real concerns. the folks in virginia, general assembly conversing we already said -- spend one in $5 on the medicaid program. we already cover about 985,000 virginians through the medicaid program. the reason that the transportation package and the

tax and transportation is because there is money for transportation when you're spending it on health care. there isn't money for education but there isn't money for homelessness. there's not money for substance abuse. so we're trying to work out the package that will ultimate be sure that we're getting a good quality and health care, as we go forward. i could go on for a long time, but just the keys to this or that october 1, if you fall into that category of where your uninsured, work for small business that's not counting a, then you go to the federal exchange. if you're a medicaid patient, then we want you to come to common health which is our portal in virginia for medicaid so that we can get you signed up properly. and with that i wanted it back to you, congressman, and you can introduce jill. [applause] >> good evening, everyone. >> it's really great to be here. thank you so much for the invitation to join me tonight.

i do have a few slides but before i get there i wanted to just say a few words about how hard everybody is working right now to be ready to launch the biggest part of the affordable care act starting october 1. i know that people at the federal level are working literally night and day to make sure everything is in place so we can flip a switch on october 1 and be ready to accept applications. from people who are applying for new affordable health care options. and at the state level starting with secretary hazel, the agencies are working really, really hard to make sure that this is going to work. now, no one expects a huge new program like this to be trouble-free. there are always glitches. i think you can understand from what we've been discussing today, this is a huge, huge undertaking. the idea of trying to find ways

for 50 million uninsured americans, finally to have access to affordable health care. it is just huge. there will be glitches. there will be issues. some of the rules are complex i really encourage all of you to spend the time looking at information, calling and asking for help that you need so that you can access the best health care possible for your family. and with that, i wanted to talk more about the medicaid expansion, and this is going to be somewhat repetitive. i guess as we said earlier, that's the way we learn. but in my mind one of the biggest question is whether or not there is going to be coverage for the lowest income virginians. because the affordable care act was pieced together very carefully in congress so that everyone would have options. but as a result of the supreme court decision last year, the

medicaid expansion, which is in my mind one of the core essential pieces of the entire affordable care act. that was made an option by the u.s. supreme court. that's why states all across the country are making decisions about whether or not to expand medicaid. right now in virginia we don't have a positive energy it. as congressman scott said, in virginia we have one of the most restrictive medicaid programs in -- which way do i stand? one of the most restrictive medicaid programs in the united states. we are ranked like 48th in per capita medicaid spending, and our eligibility levels for parents are really reload. we don't do anything in virginia for childless idols, even if they have zero income. people that poor still can't get medicaid in virginia. so what the affordable care act

would you set a new income eligibility level at 138% of the poverty line, which would be for an individual around $15,000 a year comfort family of four around $32,000 a year. we believe that up to 400,000 virginians could qualify if virginia adopts the medicaid expansion. who are these people? you all know who they are. what about children who are on medicaid? they turn 19, suddenly they are not eligible but they still of allergies. they still have diabetes. they still have medical issues that they need to have taken care. it doesn't mean the health care needs stop. the parents, even adults without children don't get health care through their job. and fair and ensure. and because of our low income levels right now in medicaid,

they can't get medicaid under the affordable care act they could. a lot of people receive state-funded health care services. was mentioned earlier the mental health services, team unity services board, indigent care, at our hospital. those are folks up probably would qualify for the medicaid expansion. older adults who are waiting for medicare, you know, we are getting older and lots of problems start happening to us as we get older. but you don't get medicare and tell your 55. so what about those folks get their low income people, they could get medicaid expansion if virginia adopts it. people who are declared disabled also have to wait for medicare. digenova have to wait 24 months after being declared disabled i suppose is good administration before they can get medicare. so these are the kinds of people who we believe would qualify for the medicaid expansion in

virginia. it's a great deal the federal government pays 100% of the costs for the first three years, and dr. hazel and his folks, one of the things they did to work really hard on this was to crunch numbers and to try to get what the costs would be to the state, to adopt medicaid expansion. and the numbers up your site it all. we would be bringing in over a 10 year period about $20 billion of federal dollars because they pay 100% of the cost at the beginning and no less than 90% thereafter. because of all the offsets we would experience, because of the folks who we pay for right now for state-funded health services, that could be enrolled in the medicaid program, the cost to virginia over the same 10 years is $137 million. you are comparing it to 20 billion. think it's a good gift before.

as congressman scott said, that money doesn't evaporate into space but it's money that goes into our economy. it goes to support health services. the experts say that about 30,000 jobs would be created. so these are the kind of economic benefit that would occur in virginia if we expand medicaid. and without it, this picture, and i have some handouts in the back, without the medicaid expansion we really end up with this terrible gap in coverage which was not the intent of the affordable care act. current medicaid at the left hand side which is about 30% of the poverty line for low income parents but it's 0% of the poverty line for other childless adults. and the exchange, the marketplace is only available with tax credits for people have 100% of the federal poverty

line. so without the medicaid expansion we have this enormous hole in our health care system, where about 400,000 uninsured people in a. so it's a real problem. secretary hazel talked about the medicaid innovation and reform commission. these are some of the reforms that they are looking at. there are 10 legislators on this commission. they meet again in a week. here are the legislators who are on the medicaid commission, and we're fortunate that there are four legislators from this area, the richmond area, greater richmond area, senator scott and senator watkins, delegate o'bannon and delegate massey, and secretary hazel is on of the commission. you don't vote your your ex officio. thank you for your service.

so here just to wrap it up, find reasons to adopt a medicaid expansion. number one, the federal funding is available to us to cover more uninsured virginians. our federal tax dollars, which support the medicaid expansion ought to come back to virginia and tell people in virginia instead of helping people in other states. health insurance improves health obviously but also provides security and peace of mind to families so that they don't have to worry if they need health care than they would get huge bills that they can't afford. so they don't have to worry about bankruptcy from unpaid medical debt. and i think all virginians should really reject the idea of a coverage gap. we are 400,000 people fall into that routine without any option for health insurance. and finally, that economic

argument really ought to speak to everyone. 30,000 jobs, $20 billion over 10 years. it's great for virginia's economy, and we need to move forward. without i will stop and in the we will have a chance to answer questions. [applause] >> thank you. we were joined briefly by mayor jones who was here briefly, but had to leave. but i believe some of the city council, cynthia new bill is here. [applause] and members city council michelle moseley. [applause] there's a mic of your questions if anyone has any questions. if there are no questions we -- yes, ma'am.

if you'll come to the mic. >> and if other have questions, line about the mic, that would be helpful. >> high representative scott. i am proud of which are doing. i do work, and i insurance through my company, but i'm just wondering how can i gany, but it wondering how can i get on it? because they pay a lot, but, you know, if i couldn't pay a $15 co-pay, there's no way i can pay 1500 or me and my boy. so i'm just like them how long would it be for someone like me to wait before i can try and get onto this plan? >> when it says employer provided health care, they have to provide a certain amount of coverage. they just can't call it health care. do you want to answer that?

>> if you get health insurance from their employer, and to provide minimal coverage that's considered a 60% plan, the bronze flanges soccer if you get a plan where 60% of the benefits are paid for, that's considered minimal coverage. so, therefore, you're considered a credible coverage and then you cannot go into the marketplace because your employer is already giving you credible health care coverage. >> if you're a small import, i don't know he worked for, but they may opt not to cover and let you into the exchange and additional penalty. if it's a small company under 50, you still may end up as the exchange being your best option. the other thing is we just were discussing there is an affordability requirement for your employer but if it doesn't meet the minimum required, that effort was made in the law to make it roughly equal if you're covered through your employer or not. >> i should've mentioned that.

the insurance would cost you more than 9.5% of your income, that's considered that the employer is offering an affordable coverage and then you'd be allowed to go into the marketplace. >> thank you. >> good evening. first of all i would like to thank you for being here spent the want to identify yourself? >> harold greene. i'm a practicing physician for 33 years in the richmond community. i have just a few questions. most of them come from medical area. you stated 80% of the cost of the businesses would have to go to medical related costs. have a defined of those medically related costs? and will we know what they are? that's one question. the other question is on prescription drugs. is there going to be through the hmos, or are they going to

cover generics? are they going to cover, just how they going to do it? isn't going to be just like a tier system? my other question is, i have a lot of patience of being hit hard because they have dropped -- particularly insulin. insulin is covered but depends, they are not being covered. so are they going to cover a lot of that? also, are they going to have anything for the doctors? 60%, 70% to 80% or 90% seems like a nightmare to my office. i don't know how we would do it. is it going to be on the card? is a co-pay? i just don't know. the other question is, how ball, when they sign-up how long is it going to take? are they going to stay on the phone forever like we have to

stay on the phone forever to get to the plan? >> i've been there not too long ago. [applause] >> the other thing that i want to defend, the state as far as medicaid. we have a gap as you say, but through this program called dcc, virginia cares. we do cover this gap, in richmond. really in the state of virginia. in the state of virginia. they can come. we do cover that gap so i just wanted to defend medicaid for that because i see a lot of people on vcc. that's all my questions. [laughter] >> that's a bunch of them, thank you. >> i'll start and then another secretary wants to add on to your first one, i think you're asking about what we called the

80/20 rule where insurance companies must provide 80% of them must spend at least 80% of their premium dollars on your medical services. that's what you're asking. that's the definition. they must pay 80% of their premium dollar. must be spent on your medical services. it can be for billing or ceos or trips to the bombers. it has been defined. and, in fact, insurance companies have to start reporting to us at hhs starting this summer of 2012 that they are adhering to the form and is not as the guardsmen said they had to give your rebate and the fact 12-point a million americans got a rebate totaling debate over $2.1 billion. that is working. the way t that we hoped would. so yes, that's been defined and, in fact, the reporting to us and have been since last summer. on your call center court you don't mind i'm going to answer that but i just for the data from that this morning as a matter affecting the average wait time so far is three

seconds to get an answer from the call center. working exactly the way so far we're hoping it will. we hope you'll call back if you have any questions. call the call center number and see. 1-800 318-2596. so the average wait time you've been getting an answer and three seconds. on drugs, you're a doctor so you know this but it's just a private insurance. people, it is private insurance, it is private insurance. so people are going to get to make decisions about what plan they want and what pharmaceutical co-pays t there e but you will know that just like you know it now and you take anyone's private insurance. it is private insurance. i hope that answered all your questions, thank you. >> one more. will it include everyone, felons, everyone? >> there are nine extensions for people are required to provide health insurance starting january 1. one of those is incarcerated individuals are not covered.

they are not allowed to buy insurance to the marketplace. >> if they are out of jail -- >> one of the ways -- >> out of jail. >> yes. the group that is not covered our people who are not here, probably properly document immigrants. >> what happens to people if they leave the premise for the night and under a different group, they are automatically eligible for medicaid. it's not an exchange or market place but they would be eligible for medicaid. one of the savings if virginia looks like you get over a ten-year period is we would save roughly $190 million because instead of paying for them in jail, corrections, medicaid picks that up when they're getting service outside of the facility. that's one. i can't speak to your question related to the private plane. i just don't know the answer to that.

the drug formularies would be very much what a private formulate would make. and what's interestiinteresti ng, we went to the essential benefit package, dr. green, it matches up pretty well what a medicaid packages. the base package. now, the 60, ma 70, 80, 90% of something that's worked out through the exchange or to the marketplace with the individual. you won't be involved as a finish. they will come as an insurance card and will like like any of insurance card which will have the coping and deductibles. that's always a problem because we had it, too. by way of admission, i think vcu gets the credit for vcc more than medicaid does. but i will tell you that one of the things that we're asking for in the medicaid reforms with the feds is we want a pre-negotiated set of parameters in which we can innovate. in the prototype, because when it's expanded we will have a lot of adults that will come in who

have been previously uninsured and we expect a lot of them to be high needs individuals. what we want to do is sit down with the vcc program and say, we would like to use you. but when you use bcc, the current medicaid rules don't allow restriction on networks and restriction of access. would have to get that. the way it works they would have to take that program the cms and we would have to ask for permission and they would have to blessed. frankly, by the time that was over we would all be gone. what we are asking in advance is be able to do innovative programs like that across the state. that is one of our requirements. >> there was one question asked about doctors. doctors will not be, this is not directly affected doctors. you will be taking insurance just like you take insurance but you will be, you'll be asked a lot of questions. so we need to have a session. so we will work with you in set one up. >> i said because of that navigator. most of the time we are the navigator.

>> you are going to be the one asking the questions? [laughter] .. is the correct? >> no. since it is employer based based

on your husband's situation, his former employer, i don't think it's going to be the considered employer based insurance. in your not positive about this answered this may be an option for you to go into the exchange to find something that is more affordable for you. >> so the income is qualifier and applies to his income, not my income or is it a joint income? >> the joint income they look at is your family using the tax code rules. that is what your family is and in come is. >> so i have to go into the exchange and find out.

>> with a question like that you really do want to go to the marketplace. we have been living this thing for three years and we haven't gotten into the new window yet. but in a situation like yours if you are not dealing with a broker individually, then i would go to the market place and ask. >> is it better to deal with a broker? >> i think you could get your question and answer that the marketplace. that's what it's designed to do. >> again, the call center is already set up for questions like this. again, 1-800-24 hours a day. so that is a perfect example of something you can already be calling the call center to find out if the market place is something you can enter. i would encourage you to call the call center and find out.

islamic there's a call center on the material in the back? >> i just want a little more clarity on the pre-existing conditions. i notice you have an example of their about asthma verses diabetes, etc.. >> it doesn't matter what you're pre-existing condition is you will be able to get injured into the standard rate just like everybody else. >> it wouldn't be more if you have as much or diabetes there won't be another rate or anything like that? >> that's one of the great things about the affordable care act. from now one of you have a pre-existing condition not only cannot be denied, you cannot be charged more. that becomes true for everyone january 2014 and it's already become true for children in

september of 2010. you cannot get charged more or be denied insurance if you have a pre-existing condition. >> what i can tell you is virginia hasn't called debate could of what we called community rating. but the maximum ratio on the most expensive to the least expensive will be 3-1. what will happen is the folks that would have been otherwise healthy will end up with a little more. that's how insurance works in general. >> for pre-existing conditions they can't charge you more. they can charge people more if they smoke it will also be an

allowable distinction for different ages and geographic locations in the state. but preexisting conditions don't matter at all. sex doesn't matter at all. it used to be that women were paying more for their health insurance just because they are women. that's gone. so really there is a lot less discrimination going on in the new plan. >> i just want to say one last thing. like those that are denied health insurance because of pre-existing conditions 47% of americans have a pre-existing conditions over ross we think this is a great day no one can be denied health insurance because the if a pre-existing condition. thank you for asking that. >> thank you. >> this only works when people

sign up because you cannot be denied for pre-existing condition you should sign up before because it's not everybody paying in and participating of those who do the right thing and the responsible thing are going to end up having to pay more. it's the way that it works. so you have to sign up. >> my question is if i stay or will i need to go out and buy health insurance? >> it's hard to know just on that but my guess is that because you are on dcc you don't qualify for the program which

means he will stay on until virginia decides how it is going to handle medicaid. >> what we are trying to get to happen if these folks can stay on at we have to see it. >> so i can go out and buy insurance if i want to be injured i don't have to stay on? >> that would depend on a lot of things you probably don't want to tell the room about like how many kids you have, how much money you make and things like that so there are a lot of things that go into those decisions that we would know. if you think you would be eligible for medicaid, you would theoretically have a choice through medicaid if it is expanded, but it isn't yet. you could also change the exchange to see if you qualify for that but you would have to have a family of four in come

with 28,000. >> one of the problems is if we don't expand, people who wouldn't have wrought in the medicaid card are in a situation that we haven't anticipated and expected that everybody would get a medicaid card up to about $37 for a family. if you do not -- if we do not get medicaid, you cannot afford the cost of insurance in the exchange. so you have to make a certain income to get into the marketplace. under that you're supposed to get a medicaid card so there is an awkward mess if we do not expand. and i assume if you are above medicaid but probably would get covered if we accept the expansion of the 400,000 people. if we don't expand, we don't know what is going to happen. so that is one of the reasons that we are pulling for the doctor to do the right thing.

let me tell you like i said, va -- >> you're going to get me fired, congressman. >> let me tell you we cannot be offended with virginia going through a thoughtful process. before they found out anything is the reason they are in a lot better financial shape than the federal government. so, hopefully when they get to the end of a thoughtful process, they will notice many of the problems were not expanding and expand. let's go through the process. >> there is a third or another option for the individuals that fall in that gap right now. we have things called federally qualified health centers or community health centers. and they welcome folks that fall in the cracks to become to be their medical home. they like for those folks to come in the center period to these community health centers and qualified health centers.

it's not a substitute for an insurance package but it is a place to go and get care and the patriotic to their services. >> it is a wonderful place to go but they cannot meet the demand. >> what he is talking about is the center here in richmond. >> it's not a perfect option, but it is something in the interim. >> frustrated insurance agent. you mentioned in the this is one great outreach program. very happy to be here. you mentioned about the tax credit for the small-business owner under 50. on that tax credit -- >> three years.

>> second question i have -- i'm sorry. can you hear me now? notte aver rise in commercial. [laughter] how do you feel about august 2nd and washington 2995 as far as eliminating a limit on but to thousand dollars deductible for the small employer plan? i have clients in richmond that the $3,000 deductible plan and the employer plays the last thousand of the deductible to the time being told that cannot be offered come generate 2014. to eliminate that little caveat. how do you stand on that? >> i'm not sure exactly -- >> i don't know who the sponsor is. mr. thompson of california and

mr. tiberi. to eliminate the limitation on the deductibles from the employer sponsored health plan. small employers aren't required to offer a health plan. they are good people and want to do something for their employers. >> if a small employer isn't required to do anything, whenever they do i don't see where the limitation would be. they don't have to do anything. the large employer is different. they have to provide affordable coverage which means the minimum -- >> the issue here is i don't believe those higher deductible plans meet the minimal coverage that had been put into place. >> but if you are a small employer you are not obligated to do anything. >> that's true but if it doesn't meet the requirements for coverage, then the individual i think goes to the exchange because it is too much out of pocket i believe that is the

requirement so the employee loses the contribution of the employer. >> but he gets the tax credits? >> possibly. spaghettis making less than $94,000 a year. >> for a family of four. correct. >> i will get that because i don't think that has been debated at all. >> the only thing i want to mention you asked about the tax credit it is up to 50% just so you know you must get a tax cut by purchasing the health insurance through the shop that is the market place for the small businesses if you have 25 full-time he equivalent employees or fewer. if you have any more questions about the marketplace please contact me at that e-mail address i gave you and i would be happy to help you out.

>> thank you some congressmen space and you're distinguished panel for the new things coming down the pike. my name is henry and i vietnam veteran in the retired navy. we work with a loss of homeless veterans, females that have been sexually traumatized but most of all incarcerate people. you touched somewhat on the incarceration and as you know we stand down in afghanistan, iraq and pakistan we have a lot and that is going to be at the high rate of ptsd which will take a lot of dollars to take care of a

and treat and as you know we have male and female and backend yep, was mostly males. now when we look at tricare, plus it's good enough, how will this new program be able to participate in that if they can't meet all of their requirements? >> do you mean if they were not able to qualify for tricare what happens to them? is that what you're asking if they don't qualify they can't get their health insurance through the health insurance market place. and also be able to get the tax credits what we call the financial assistance for the premiums if they meet that

federal poverty line. anyone who doesn't qualify can go into the health insurance market place. >> okay. the everything. will you be so do the cutting some time but training orientation because a lot of the veterans are homeless plus of dealing with a the ptsd. then we have the highest unemployment rate that we must address. >> on bup ptsd, one of the things that about the policy is that there will be available on january 1st. they will contain a significant mental health coverage. so that will be extremely helpful from that perspective. if they are unemployed they can run the medicaid expansion if we expand medicaid they would be eligible for the medicaid card.

>> as we try to finally claim for disability but if they have a bad discharge they can't qualify for disability service for health care unless it is combat related. >> if they are about $30,000 they would get a medicaid card and above that on a sliding fee a little less than 10% of to $94,000 they would be able to buy insurance at an affordable rate. >> i wanted to mention that part of the outreach and enrollment work that needs to be done needs to reach out to the uninsured veterans. there's tens of thousands of fun injured veterans. we know that. so they work directly with the veterans and have some options

to become ase certified application counselor and get training from the federal government to help provide information and it's to give advice to the people you're working with and the application of sisters can help people with this process. but a lot of different groups are stepping up to the plate to do that kind of outreach and application systems. and i agree that the veterans represent a very important group the would need good counseling and advice as we move into this new world. >> i can be reached 804 - 142033. 804 - 142033. by the way, congressman scott, we also work with the [inaudible]

>> she is not finished with you, sir. >> i want to reiterate something the congressman said. if they get insurance to the marketplace they are part of the central health benefits so every plan must offer mental health services and secondly we are doing everything. the documents to the pages, lots of pages of the affordable care act and what it means for veterans and i also encourage you to go to the veterans administration website. >> again i strongly encourage you to the orientation as you know, most of us come back and it takes a lot of patience and training and getting a proper

diagnosis. when you go to the different places and some are not used to the -- nor do they have the patience. i want to if i may add a couple things. it's good to have the coverage but one of the things we are very concerned about is the lack of the folks to get the work and take care of people. we do not have the army of mental health professionals that we need to handle the volume and that this something we are working on. we are going to be asking for innovation. one of the things we haven't talked about in the affordable care act is the innovation fund and there's something called innovation state model funding. we are trying to do a better job of incorporating mental health and to the practice as a way of expanding capacity. so it's a couple things.

have you hooked up with the wounded warrior program in the state? >> meeting with kathy wilson and in fact i think that you had a family veteran workshop -- >> yes. so there's a couple things there. we produced their rate by 18% this year we are faced with a disproportionate number of veterans in the group and so having the better involvement in the program is important because the veterans cristobal for those that don't know if you ask folks if they are veterans they don't respond to yes so we have changed the programs to yes have you served. then we can identify them because they were not answering the questions. we are trying to bring more piers into the program for counseling because you just

don't know unless you have been there. >> with the incarcerated grouping working with another gentleman in the construction trade and we have these abandoned houses hopefully we can put veteran sen. thank you for the opportunity and for your service and for helping in mcgwire. >> are there other questions after these two? okay. another question? these are the last four. yes, ma'am. >> my name is gloria. i and a schoolteacher. last year we went through some

unique changes as our contributions to social security and our health insurance policies changed. the company that we were dealing with, the cost of insurance went up and a lot of us found that we had to do some unique things. i myself on my insurance policy it was cheaper for me to stay with my ann jones with my job at another insurance policy for him because it was cheaper. i found a lot of us had to do that. as a matter of fact some of my colleagues or other people that did work for the city actually had to -- they were unable to afford that insurance.

when you think about social security, furlough days, those kind of things, you have to become very creative and when you do so that you can get the coverage. fortunately my son got a part-time job and what is unique is the company he works for did offer him an insurance policy which was again even at cheaper than what i was paid in for him. the thing i'm concerned about is the uninsured. the gap that he may become one of those because part-time job is even less secure than a full-time job so i'm kind of wondering what his options will be if that happens. will i be required to cover him under my insurance because i don't right now. >> so you're not required to him that certainly you are welcome

to. >> he's 21 and a college student so i can cover him to 26 but like i said with all of those changes that affected my take-home pay i had to come up with anything that was more feasible and a lot of us have found ourselves in that situation. >> a ander stand that. so you are not required. the other thing that is available if he's under faludi and they can get a catastrophic plan available under the marketplace specifically for young adults under the age of 30. it's very low premium and as the name implies it is catastrophic. hospitalization, etc.. so again, catastrophic plans will also be available under the health insurance marketplace and is something that you can look into. >> and that is even if he lives with me? thank you. >> sure. and as we mentioned before if he

is employed making up to 400% of the poverty level he can get financial assistance from the federal government to help pay for the premium so again he would want to look into the marketplace and see what he won the catastrophic plan or what it even be cheaper or benefit him to get regular insurance through the marketplace and what he get the subsidy to pay for the premium and the co-payment. >> i would like to confirm affordability. i work for a company that has about 4,000 employees nationwide. our insurance this past year doubled on premiums a full 50%. the minimum plan the offer is 45% of our income. does that qualify me or my wife for affordable care in the marketplace plan because it is 35% of my income when i'm working? that this minimum.

estimate your employer based insurance offers 35% of your income. do you know if it was an employee only plan do you know what it would cost if it was just knew that was covered? because that unfortunately is the way they are going to evaluate the coverage. >> it drops to 26%. >> then it would be deemed unaffordable because it exceeds your income. but they do look at the cost for the employee he only coverage as it is over 9.5% of your family income you could go to the exchange and probably find something that is cheaper and that would bring you a tax credit. >> when the plan was brought out there was brought out as a bill or a care plan yet when they went before the supreme court they targeted and they taxed. since it was argued as a tax by chief justice roberts and it did

pass, what gives president obama the right to xm to anybody from the tax? if they passed the bill which most of them didn't even start with -- >> are you trying the mandate? >> first technically the supreme court called it the monnet attack before they called it an attack. so the first threshold question was it a tax? and law is you can't sue the tax if they rule that a tax it

wasn't a tax then later you can do it under your taxing authority. but on the question of whether or not the president has the authority to delay the implementation of the tax to some people, the answer is they have been doing it all the time. ..

washing the affordable care act, but delaying the effective date happens all the time. and the authority of the president to do that has only been questioned when president obama did. [applause] >> my question -- [applause] my question was not about the delay. my question was the exemptions such as was granted to u.s. your entire staff. $0.8 from this program. and then he gave it to all the unions that he did, ten different unions. >> well, what happened in congress was in the bill. the only employee in the country, members of congress and

their staff, all the employees in the country will lose their health insurance and have to go into the exchange. we still want to get some benefit. having insurance. and they're working that out. i'm not sure if they have the regulations fix, but the idea is that we are going to be no worse off than we were before. that is what is going on with congress. i think you were talking about the employee mandate policy. >> to exempted. >> thank you. yes, sir. >> my name is there good. i am of licensed -- i don't particularly care for health insurance. medicaid.

i do have to go and read. so sometimes there are a whole lot of definitions when you go into the training. it pits -- in reading the literature, i time to talk about the health insurance, talk about the same choices the members of congress. is that mean that the members of congress have a bronze plaque, solar plan, and a gold plan? that is one question. >> let me just say, members of congress will be in the same kind of plan that the marketplace allows everyone else because members of congress, like as said, the only employees in the country that cannot keep the insurance they have. all of that stuff, i was paying attention, just like you were. >> so that my answer my next question. here i have the deductible and everything, copays.

>> like us said, go on up there. >> now, my other question, we have the same congress. anytime you try to repeal the law that is lower than what had been approved by the supreme court, you try to repeal it 40 times. that is a massive practitioner of insanity, doing the same thing over and over. different results. when is it so bad that those other communities -- you know who i am talking about. come on. they are accountable to us, but they don't want to be. you might already have this. they want to repeal this.

they don't want to have the same type of insurance the people. i don't know what they want to do. >> congressman, to you want me to try to interpret? i could go there. >> what is so bad about it. >> certain, served, i will try to answer a little bit. the congressman and his staff will have the same insurance that is in the exchange. that is required as a result of that they lost what they had before, which was through a good program called the federal employee health benefit which was a really good deal. now he is going to get the same insurance plan, one of those that you might get if you're in the exchange. there are some differences about the employer contribution to it. that is different. that is not the reason the republicans a been going after

this. i can assure you of that. that is the least thing that they care about and all of this. >> i don't know what else. >> do you want me to tell you what i think they're doing are not? i will tell you. >> hold lot. >> i will tell you, and this is the hard part of the discussion. wind -- i have a three year-old granddaughter. and when my grandmother was born three years ago, her share of the federal debt was $44,000. now, the unfortunate thing is that this year's per-share the federal debt is about $54,000. every man, woman, and child in this country owns a piece of that debt. now, what congress has not figured i have to do is to balance the budget. and that think that the essence of this problem -- and we talk about the money coming in being 100 percent federal money for three years. 90 percent forever, the question is, who is paying for it? we barred all this money from

china. china has a billion people in the navy. you have to pay them back one day. that is what the essence of the discussion is, and it boils down to -- and i am not trying to judge when i tell you that i think the essence here of what they're arguing about is, what is the proper role of the government? what is the proper role of the taxpayers? how much more of this should be taxed, paid for, how much for the spending cuts. that is what this is caught up. and it is not about the benefits, not this time anyway. >> one of the things that we did when we passed obamacare was to make sure that it was fully paid for. we made some changes in medicare i think everybody in here can remember the number 716, the number of billion dollars. we took it out of medicare to pay for health care, helps pay for obamacare. we raise taxes. when the dust settled the congressional research service

estimates that there will be more pain for them there are services, about a trillion dollars in services, so the budget will be about $100 billion better off at the end of ten years. a lot more better off in the future because of obamacare. the question -- the suggestion that it is a fiscal responsibility issue, nothing wrong with looking at the numbers. if you look at the numbers in stark contrast to the part b medicare party prescription drugs, that $400 million just went straight to the bottom line deficit. that is where the deficit is coming from. past tax cuts that paying for. that is how we got to where we are. obamacare, we very meticulous in a short. that tv commercials, everyone is running on how you pay for it. we like to run on benefits.

unfortunately, if you're doing it right you have to do both. when they talk about repealing obamacare, you get the sense that you can repeal obamacare without repealing the tax is that pay for. or if you repeal the whole thing, that taxes paying for it, the cuts that went into affect and everything else, starting from scratch the deficit would be worse. and so we went to great lengths to make sure it was paid for and took a big hit because it. but there is nothing long -- wrong with raising the question. the answer is that obamacare was more than pay for. the next ten years it will be even more. one thing about health care, one thing about health care, people saying that medicare and medicaid, going up and up and up, every year, out of control. well, that is not a medicaid or medicare problem as much as it is a medical care problem. you ask any of these businesses

in here that provide health care for their employees the last of your 30 years, and it will save the first 30 or 40 years ago everybody got family coverage, no problem. then after a few years, we will give you coverage and do have to pay fair family. after a few more years, you pay for your family and some of your own. and then it's about 5050. and then we would get a group policy because it is cheaper, but you have to pay the of thing. if you draw that line, medical care has been going out of control. and if the medicaid programs are paying for medical care expenses, obviously they're trying to have big challenges. so we have to get the medical care expenses under control and to a large extent obamacare is open to do that. by encouraging hospitals to get it right the first time, we're not going to pay, gun laws will come back. we are not paying for that

second admission any more than you put your car in the shop, to get out, and it breaks away, and you go back, it's going to pay for it again? no. they're going to fix it. a lot of other things. some of the things that the secretary was talking about to my how you pay the doctors, fee-for-service, more comprehensive, trying to get the health care medical care costs under control is a big challenge. medicaid -- whenever the medical costs are, if we don't pay to medicaid or medicare programs, then you're paying it. so you're not help to anybody by cutting back on medicaid and medicare. you won't get sick, and those will be your expenses. if medicare does not paid, then you're paying it. same expenses. so one of the challenges -- and we have seen of the last year, although somebody got a lot better, bigger hit than most people on average, a health care

costs going up every year. last year's increase was the smallest and about half a century. and next year people will be paying -- a lot of people will be paying 25% last tear individual policy than they're paying now. in new york it's about 50%. so obamacare, making sure everybody is covered means that everybody will be paying just for themselves and not everybody else, and that is going to help control the cost a little bit. but the medical care problem is the challenge of we are dealing with. medicare and obamacare. >> said mend it still not pay for? >> well, it was paid for. it's lot. it's being paid. basically there were no new taxes to pay for it. it basically just adds to the deficit -- does if it --

deficit. >> last question. >> hello. brenda hex. i have a question in regards to participating providers. is there a mandate for providers to participate? is great to have insurance, but you need somebody to accept it. are there going to be done at tiered system the way they pay for medicaid and medicare, like the private insurance? so are they going to be -- is there some kind of mandate to compel for these hospital operations? that once you have this insurance somebody will actually accepted for payment? >> the answer to be sure is no. some states like massachusetts have tried that in the past, but the answer to that is no. it is not a mandate. i think one of the challenges that we find in the medicaid side right now is, we pay hospitals about 70% of cost. there is a formula that is used to look at what hospitals cost

per procedure. we pay a 70 percent of that as the state. it's one of the things we have to consider because we are already cost shifting 30% on to everybody else. we in the government programs, medicaid, medicare typically has been a little below cost. and so it becomes a little bit of an unfunded burden on providers that has to be worked out. you cannot have a sustainable long-term program when you promise something but don't afford. >> one other thing that obamacare is doing, providing funding for -- to increase the number of providers. there will be provided there, scholarships to doctors, national health service to encourage doctors to go into an serve various. nurses, physicians assistants, building a the number of providers. >> that is actually, again, it is just a reminder. private health insurance.

just like now your doctor does not have to accept private health insurance. no doctor will be required to take the health insurance of someone to the marketplace. the other thing i did want to mention that the congressman just said, under the affordable care act, one half billion dollar investment to increase the health care work force. everything is a primary-care doctor, no special commissioner, nurses, physicians assistants. it is a great time right now if you're interested in getting into the health care field that you can get loan forgiveness or scholarship funding because, again, we realize it will be important to increase the health care work force. >> and i think that obamacare is a great start for will be doing. >> thank you. [applause] >> we ought to remind everyone, we had information passed at the table. the number to call is 1-800-318- 2596 for your answer given.

[laughter] so call that number. they can answer some of the questions that we had trouble with. i want to thank everyone for coming in participating. october 1st of october 1st, we open enrollment and can start signing up for our coverage on october 1st. tell your friends. january 1st, everybody, all americans will be able to afford health insurance for the first time after 100 years of trying. thank you. give our panelists are round of applause. thank you very much. [applause] >> president obama signed the health care bill into law on march 23rd, 2010. since then many parts of the law began to take effect. the next key date is october 1st when enrollment for the state based health care exchange gets underway. coverage from those exchanges stores january 1. some states have refused to set up the exchanges, and a federal court recently ruled that oklahoma move forward with a lawsuit against the federal

government over employer mandate issues. more town halls in just a moment here. here is the schedule for the rest of the day. next up, republican tom gould discusses immigration, health care, energy, and the irs with his constituents. our final town hall meeting starts at about 6:00 p.m. as maryland democratic senator ben cardin holds is gathering in baltimore with health care and budget cuts on the main topics. and then washington journal spotlight on magazines. last year colorado residents voted to legalize recreational marijuana use. in rolling stone magazine jonathan lang wrote about the marijuana based economy developing in that state. we will speak with him about his article and that issue. oklahoma congressman tom cole says he is for defunding the

2010 health care law, but not at the expense of a government shut down. he made the comment in response to a constituents question concerning the health care lot during a town hall and oklahoma earlier this month. sequestration, immigration, the benghazi attacks, the irs scandal and the administration's energy policy were also part of the gathering. this town hall is just one of three representative call will be holding during the august recess. this town hall lasts about an hour and ten minutes. >> gosh, this was a bigger turnout than we usually get short of obamacare passing which was pretty tumultuous, but first of all, thank you very much for taking the time in the middle of the day to come. just so you know, there is media here. you should be aware of that. always nice enough to tell us, not that we would tell you anything differently with the camera. for those of you that have not come to one of these before, let me quickly tell you now works. normally has been just about five for ten minutes trying to

tell you what i think is happening in washington d.c. and we opened up for questions, any question and all is appropriate. we will stay here until every question that you have is answered. for some reason we have to leave, i will hang around outside. don't worry if you will be able to make your point or ask a question. if you have a particular issue, you know, might be a veteran's case or social security case, please, please, please make sure we get your contact stated. we have staff year, numerous places. it would be more than happy. privacy releases and work with you on those kinds of things. if there is something that is private, that you simply don't want to talk about in front of other people, that's fine as well. i will stick around after words. more than happy to visit with you about that. finally, for those of you, we are at an unusual time. this is my hometown. this is where i have lived for 53 years.

very proud of this community and how it has come together. we have some people from fema here as well. as some of the know, if you have not registered -- where is pat at? back year. but they have done a phenomenal job trying to help our community through an exceptionally difficult time. i had an opportunity to visit, you know, where the new schools are going and, frankly, where those kids will be going to school and see the sights and visit with the superintendent. the city manager. we have been talking through it. there are always issues and concerns. i must say, we have seen a fair number of these things in this area. this has been a model program in terms of trying to help the community get up and operational again. again, time is of the essence here. if you have not registered or have a concern or need fellow please do that. i think august 19th is the last date. think they're trying to do it by

the 15th. sort of closing up. that part will be gone. we will still be here to help. please don't let that opportunity slip by if you have a concern or question. if you have a friend or neighbor that has been traumatized and just as not, you know, been able to deal with this, please let us know and we will try to get in some help. trying to get through this. okay. let me quickly talk to you about what is going on in washington. usually when i'm coming into one of these meetings somebody is always really nice and says, hey, congressman. how is it going in washington? my stock answer is it is just as bad as you think it is. there are some difficult times and some really contentious issues right now. i am sure we will talk about it. i would say there is a good, the bad and the ugly to borrow an old plenties would lie. frankly most of the bush tax cuts in january or may permits

for almost every american. 80 percent of the tax cuts for 90% to the american people. a compromise, not a complete deal. now what is going to get everything it wants. we have a big fight, and discussion over sandy relief for the northeastern part of the united states. the passage of that legislation is what is helping us because their refills the disaster fund which is tens of millions of dollars to help people here through all of this and will continue to help. so that was actually pretty good. the government could have shut down in march. it did not. there was a bipartisan compromise in the extended funding through the end of september. we had some call violence against women act, like anyone is for it, but that was a big contest this issue that got passed and helps people that are in domestic violence situations.

just this last week we passed, for those of you that have kids in college are maybe have student loans itself, that problem got fixed in a bipartisan compromise, actually, a republican congress and democratic president. in one of the more contentious issues, which i am sure we will talk about today, national security agency, you actually had a republican house, majority supporting a democratic president against the majority of the democratic members. so don't think there is not some flexibility on those issues when you debate him and discuss them. they're sometimes is. that is the gate. the bad, well, one other good thing, kind of good, kind of bad two years ago, two and a half years ago. trillions of dollars per year. it is down to about 650 to 700. so it is come down a lot, but that is still an extraordinarily high deficit. it is going to need further

attention, and that is going to be very contentious. the neck and of its work done they have not pass a single appropriations bill. the house passed four of 12. we each pass the farm bill that had not come together. pretty important. not as much in this area, but the district as 14,000 farms and ranches in. a pretty important part of our economy. so i would say, congress is working not very well. the ugly is kind of what probably goes from labor day to about the end of the year. we have two big things in front of us, and another issue that i think will take longer to resolve but is in the makes. first, all government spending in is on september 30th. and that literally means, if there is not a compromise reached in the entire federal government we shut down. in places like this, like every

civilian job, 15,000 employees, it means the district has for veterans' centers. veterans hospitals closed down. you know, the national weather center they gave us as much morning as you can get anybody about the tornadoes would not be operating. that is a pretty contentious issue. we will also hit the national debt ceiling sometime probably in mid november. that creates, you know, not the government shut down scenario, but if you don't find a way to resolve that a sort of across-the-board 35 percent cut in all government agencies immediately could not finance government. finally, the immigration issue has been a very contentious this year. the senate has passed a bill. it is not likely to be a bill that the house would pass. the house has passed for smaller bills through committee, through judiciary committee. come to the house floor, considering a couple of others. i think there might be good

immigration discussion late in the year. i think we will come after the government shut down and a ceiling if at all because that two sides are a part, but it is still, certainly, in the next for this year. with that, you know, i can drone on and on, but i would rather cut it off and start answering your questions. and if you will wait, we have microphones that will -- yap. right up here, and that way the whole audience can hear your question. >> do you have it turned on? okay. it takes a minute to heat up. go ahead. >> mr. tom cole, says the president is getting around congress by passing these executive orders, why are the republicans not to filing a lawsuit and let the courts say

is unconstitutional? >> a question, in case you did not hear it. the president is getting around congress by executive orders and executive actions. not all these are orders. why is in congress filing a lawsuit? in some cases, we are. as a matter of fact, the attorney general of the united states as recently -- we filed against him, contempt of court case. we have multiple subpoenas to force testimony. and there is legal action there are also things congress can do in terms of not approving the presidential appointees. there are things it can do in terms of withholding funding, and we have done some of that in some area. particularly where obamacare is concerned. so there is a constant tension and struggle here between the executive branch, but i agree with your point. i think that the president has more than any president a recall, operated outside of the

normal legislative framework. since he lost control of the house and the senate. an example, you know, we went to war in libya. i would consider war. when you fire 212 talk missiles and 100 predator missiles and fly at thousand combat, the guys on the other side think it's a war. never was approved by congress, not a dime ever voted for it. if george w. bush had done that i think we would have an impeachment. part of our immigration laws unilaterally suspended by the president when the year before a city could not do that. you know, just a variety of issues like that worry is going outside. you know, we have to engine oil and gas -- system, starred as between congress and the president. at think you will see it continue. but there will be legal cases. all the way back here. i'm going to try and bounce around a little bit. again, we will get to everybody. we will where wells legs out. >> i am a little concerned to

find out you were not in support of making the continuing resolution contingent upon removing what optional spending you can. >> i feel very strongly. at think others do. i speak from appointed you -- [applause] >> i think they do, to. >> this is not theoretical for me because two weeks ago today by has been denied paid in cash for our son to have major surgery, 4-hour procedure. that is the price i pay for the liberty of my children. i'm self-employed. anniston the consequence of that, as i have limited options thanks to our government on insurance. i understand that i pay for a limited coverage. limited i can take. i don't pay a thousand dollars a month or two dozen dollars a month. i do not look for the government for recourse on that. we are individuals who are responsible, and we will make that sacrifice for our child, and i think even if you do not believe in your our number one it will pass or number two is appropriate, you need to represent us and we are tired of

having to come back on this again and again. [applause] >> a great question, and i appreciated very much. i do try to represent people here. you know, let me what -- first of all, do i want to defund obamacare? absolutely. i voted against it. i voted for the times to repeal or delay. we have been able to pass seven pieces of legislation. if your small business are you don't have to file at 1040 on every $600 purchase. that was in the original of. republicans get rid of that, quite frankly, and forced democrats to accept it. those of you, there was part of this that was an assisted living program. financially not sustainable. would have bankrupted the government. even the democrats, they look at the financing. we were able to get that through. i still think there are parts of this, like the tax on medical devices. can you imagine, they give you

health care by taxing your oxygen tank and a wheelchair, or artificial limb. nobody is opposed, and i think we should do it now. ..

so those things are real. because you shut down the government doesn't mean the other side has to give in. it doesn't mean the senate has to pass a legislation. we can send it to the senate, they will refund obamacare, send it back to last and they would have to shut down the government. i think politically that is extraordinarily dangerous to do. and i don't think it will work. if it works, that's one thing. but i don't think it will. i think it will put millions of people out of work and will damage the economy and hurt a lot of innocent people. it's from the standpoint the house can pass to versions that excludes obamacare that has that go forward.

but at some point obamacare was passed against the will of the people. we look to the supreme court to stepped in and they failed us. we looked to the congress to do that and 40 times you have come in and said to get rid of it. insanity definition is that we keep doing the same thing again. that isn't going to cut it so this is our last chance and it's more than just who wants to win the political power play if we want to shut down government. what will the future of our country look like in a decade. it's to late to dial at back. it's worth that risk. and i also don't think it will come to that. look, we can do as you suggest.

there is no problem passing the original bill without it but it's not going anyplace in the united states senate. it's going to have an attachment and comeback. i think about the consequence of this kind of stuff in the facilities and i know you do, too. but it is true. i agree that this is passing the american people. there has never been a poll that says its popular but the american people didn't give us the last election or the senate. we actually lost ground in the senate. the house is the last thing between the replay in 2309 and 2010 which is what we would see if there were total democratic control like the cap-and-trade, card check and another expansion those things would happen. so i will take what you have to say literally, very carefully and consider it. i would expect we would have a lot of discussions about it, but

i don't want to be disingenuous and tell you that i think shutting down the government is a good a deal because i don't. tn -- and again i'm with you if not the only guy that thinks that. i don't think that james langford are dangerous liberals or tom coburn who also feel strongly about this and from other parts of the country like roy blunt or richard burke who happened to be around for the last shot down. if it would work, that's one thing. but you know, i think it is a very high risk and it's very reckless with people whose jobs are on the line into the security as well. i think it would be very damaging. we will see what the legislative options are on the shutdown. that is a great question. we are going to this side of the room to the >> give us a second and we will give you the microphone. >> of the government shuts down this that man the of the

legislatures and the judicial people don't get a salary as well? because then that what -- >> absolutely. [applause] >> that what some how motivated the senator or the president to work on some political opinion if they get no salary. >> we can certainly do that. that's fine. but neither would anybody at the air force base. >> they won't let it go very far. they will work on it if that is the issue for the citizen. i've had to deal with this day after day as well and i think it is a terrible policy. if we have enough republicans in the house or the senate it wouldn't have passed in the first place. it barely passed as it was. every person in the state of the time voted against it.

every one that we put on the bill to the it's not like we've elected the president. we didn't. shutting down the government is a very dangerous and risky thing to do and not likely to work. >> so many issues and such little time. i share the concerns people talked about obamacare and trying to do what we can to stop that. i think the biggest part of the frustration most of us have is we say okay this is going to be a monstrosity please do something to stop at. and then he essentially what we hear back is well, you know, we would try to do what we can but it's just too hard. it's too difficult. and i think it really frustrates

a lot of people considering that once it goes into effect and all of the taxes that are ret devin obamacare that it's really going to destroy a lot of things and change the economy in the country and none of us want to see that happen. we see people on the other side who fight tooth and nail and that is the problem that, you know, the other side doesn't care what the rules are. they don't care what the normal code of conduct or. all they want to do is win and we are playing by the rules. you are playing by the rules but they are playing dirty and we are just really not. really the issue that i want to get to is the world we find ourselves in, which is the situation is growing where officials the right now you have a government agency and everybody's tax dollars are going to fund the nsa who every three months is going to

disguise the cord touches a secret court nobody can appeal to and they are getting more to get cell phone records. you have an fbi who believes if they went to court to say that they don't need a warrant to put a gps tracking device on your car. you have an irs whose official position is that they do not need a warrant to check your e-mail. this is the same that has no compunction about the authority which they have done and they've targeted tea party groups. and so far, nobody has paid a price for that. really the situation that i find, and i might be the only person that feels this, that nothing is being done to rein in these government agencies. so for my perspective it's like the only privacy that you really have is what the government says

you have. and i was really pumped when you voted against. that was all some. was really happy about that. i was disappointed that you voted against restricting the nsa because you had an opportunity to do that. so number one, i would really like to know why you voted against restricting the nsa from collecting the data. nobody is saying they're listening to the phone calls and collecting the information. i would like to know why you decided to do that and second, if you really thought that it wasn't such a big deal and that there is no expectation against those records, then when can we expect you to publish your calls on line so we know who you called? [applause] great question that is a great question. this is one of the most important discussions in the

country and i think it will continue to be and it's the internal debate the true liberty and security. let's talk about the nsa vote and i would be happy to again if you have additional stuff you to throw when we will certainly give you the opportunity to do that. look, i looked at this issue really, really carefully. number one, nobody likes the fact that any government agency is collecting massive amounts of data. they are not of reading your e-mails but they certainly have the ability to know who you call number two, we have had several judges. number three, we know we stopped about 50 terrorist attacks inside of the united states and 40 from outside information to deal with this sort of stuff.

and i look at who is on the intelligence committee. you know, one of the guys on the intelligence committees tom coburn and i was at the oklahoma press association with him and watched him stand up and said this had the best oversight, the most accountable and was absolutely saving american lives. there's also 14 other members from both parties. every single one of them. they felt this way except one, i think there was one that didn't so 13 out of the 14 voted that way. both the speaker and the minority leader voted that way. if bush and obama felt that way we have had the snowden revelations he didn't give us a single bit of abuse. i'm not telling you that it couldn't ochre. look at the irs which you mentioned in another context with terrific abuse of power. but so far, no individual cases have come forward. the people that are supposed to,

you know, the on the committees and supervise it all feel strongly that the two people would have been the leader of the country and in the last decade they feel the same way. the amendment in front of us would have totally stopped, you know, the program. now i applaud for having blocked the amendment. i told them this in conference. i think it was a really important debate to have. i don't blame you for using the only legislative vehicle that you have, which is amending the the defense bill on this issue. what we really need is like what we are having at the irs right now is a series of hearings and investigations where you actually hold people accountable what they've done anything wrong and the catalog and see it if you need to. we say nothing has happened at the irs. i would say not enough has happened. but you don't have the same director, there are multiple people fired and removed. there are people that are under criminal investigation right now.

there will be walls if you look at the financial-services bill that has gone through the subcommittee on appropriations. not only is the irs funded from obamacare. if there is a real cut in this budget in the response to this. so i think the same thing needs to happen in terms of a really detailed and thoughtful examination of the nsa. but i don't think that we ought to immediately toss out a program until we think about it and look at eight all the security people on both sides of the dial phyllis it's a different pittard i will certainly give you an opportunity to respond >> okay. so i appreciate your answer. one thing i would like to point out is if a secret program was abused, we wouldn't know it. >> let me rephrase that. we wouldn't know until that is too late. the thing is i know or have read

the way the bill was supposed to work is that when the controversy first started when bush was president is that well we are going to monitor the phone calls and get the record for someone who is a suspected terrorist outside of the borders of the united states. when that person contact someone within the united states, then we are going to go and get an order for that person if that suppose that terrorist is contacted. i felt a little uneasy about that but remember thinking well, you know, if the person -- if there are two people contacting, maybe. but i like to bring up the point that coming to know, there are things we can do to make the united states safer without saying we need a database for the phone calls. we need a database for this and

that. regardless the fact is they have the capability of doing it. we don't necessarily what they are doing. we hope that they are saying no we aren't doing this, that supposedly they really aren't. but my biggest thing about that is what we do know is if they have the power eventually it will. so my larger point to you is and hopefully that you will take a look at that. hopefully we can continue this stuff and, you know, people are saying i know these people that are running the program are good people. my point is that good people aren't always going to be there. and i sure that the people that work for the irs that were of using taxpayers' were great people living with the boss told them to.

and so really that is the only response that i have and i would just really like for you to reconsider that and keep in mind there is no way that you can trade freedom for social security. >> i agree. [applause] >> i agree with your point. the congress will reconsider this and keep looking at it and will probably come out with a legislative ankle. but the key part to me is so far i want to emphasize so far we haven't found any individual users. no person has come forward, no whistle-blower. the guy that says america isn't free and runs off to china and russia isn't exactly my idea of a great american patriot. but i think the issue is worth looking at. but i do put a lot of trust in people that have defended the

united states of america their entire career 30 and 40 years with distinction and honor and valor and put their lives on the line for the country. when they walk in and tell me this is what it is and we are not doing this or that and ask any questions that i've got to know more than that before i jerked the rug out or congress will keep looking at this and that is the one thing that has come out of it. it will continue to be in the press and in scrutiny. while i always worry about concentration in power of individual liberty that is what keeps america free. individual citizens are passionate about that and serious about that. at the same time you have to see the abuse and know where they are and i don't think that, you know, we have lost our freedom. if we had, we wouldn't be having this discussion on c-span.

it's still a pretty remarkable country. it's not china and it's not russia for a world dictatorship. you mentioned if i called the fbi case and they lost that case in court. they lost the initial round. we will see what happens. i think the congress will intervene and pass a law to that effect because nobody likes that. >> the attorney general makes a good point. [applause] sadly we didn't win and we don't get to appoint the attorney general. >> [inaudible] >> let me get a microphone to you. thank you for coming and joining

us, congressman. >> there are two petitions to audit the fed and i'm glad to say congressman kolbe voted to audit the fed. whoever is keeping that and not letting it go anywhere, please let it go so other people can. the other is for nalubaale and obama and i'm glad the congressman who voted for appealing about on the federal level. my question to you in the latest edition of the freedom index that i'm holding here, both number two had to do with raising the debt ceiling and i probably need my glasses to read this, but you are one of three congressmen who voted to raise the debt ceiling that basically empowered the spenders to keep spending whatever they wanted to spend and i take issue with that any business voting to raise the

debt ceiling that continuing resolution was over a trillion dollars and as it was mentioned earlier. if there is anything unconstitutional but you do not find an article 1 section eight of the u.s. constitution you have no business voting for that as an expenditure. >> sure. absolutely. >> one of three oklahoma congressman. obviously the majority approve of that and it was part of honestly a negotiated deal with the president of the united states, $2.1 trillion of long-term debt and spending. and this worked. that is why the deficit is half of what it was two years ago. the consequences of raising the debt ceiling for not raising the debt ceiling is the media across-the-board around 40% cut. >> it takes a while to sort of

turn the ship around and get it moving in the right direction. that's why i voted honestly for the lowest budget every single year i've been in congress and the budget we have about 120 to 30 people. that's why we have been awfully tough on spending. but again, we want to think twice about destroying the the financial markets in the system and shutting down recently crippling the country so that was my rationale. yes, sir. let me get to the microphones of the can hear you back there. right here. >> thank you, congressman. >> thank you when we have to go into default can you speak about what will happen in the market has to how much we will have to pay beginning almost nothing i

think it is free%. what happens to the stock market but is the total impact on our country and after that country goes down, what will happen to the worldwide economy of the entire world? and keep in mind that the pigs are almost down now. what will happen to the bricks? >> it is a compelling question and one that is hard to answer because it is theoretical. the most credit for the institution in the history of the world is the united states government because for over 237 years it has paid its debt in full and on time to whomever it owed money to. so that as the central pillar of financial stability and it goes all the way back to the founders. that's one of the thing hamilton talked about where he borrowed money to pay off the

revolutionary war debt to redeem the bond that had been given to the revolutionary soldiers because they thought that they were never going to get their money and establish the basic credit of the united states. so i think it is a very dangerous thing. if you think it won't affect you, i can promise you that the most creditworthy institutions in the world falls your interest rates are going under homes come on your car's come on your credit cards, you name it. they will all go up. what happens to the rest of the stock market i guarantee you it will take a terrific hit. you saw what happened to it the last time that there was just a struggle going on about this. to back to the door for into default i think would be much more dangerous. and you put your finger on another point a lot of other countries are in even worse situations than we are so if we go down you are probably looking

at something like the great depression again. dubai know that for a fact? no. do you want me to run that risk? i'm not sure but i would say it would be pretty catastrophic if the united states start in defaulting on its obligations. and by the way its obligations are not just that. the interest on the debt is about 6% of the federal budget, but it's not gigantic. our obligations are also let me tell you okay, you know, being the medicaid system europe and to get medicaid. pay into the social security system you're going to get social security. sign up and fight for the united states you are going to get paid you will get penchant or whatever you are entitled. there are obligations to americans and of those things also get cut. it's not as if you just cut the money from people that he borrowed the money from.

it would make you sort of a dead beat but if you quit moving the obligations that he made commitments with. we balanced the budget before although we've only done it four times in 50 years. the democratic president in the republican congress and the deficits were considerably lower over the last five years than who they have been since then and we are making some progress but i think you have to be very careful about the option on the fault. i think it is a very dangerous thing to do. yes, sir over here. what we get the microphone to you. everybody is going to get to ask their questions. i promise. >> some time ago there was an article written by george will to believe he stated it was his opinion that obamacare was failed under its own weight. and i have more hope for that happening than i do if congress

changes that. [applause] i was just wondering what your opinion was on this. >> there are some days i share your frustration. first of all, the congress would change it if the american people would change congress. the congress showed when you change the house of representatives in 2010 its voted 40 times to get rid of this thing that we have to get the senate and the president will work with us instead of against. the ultimate solution is of the ballot box and it's frustrating when you are in the state as conservative as oklahoma and you voted against the president on two different occasions and the elected of remember you've got and every vote you had. we didn't win enough places. the second thing there have been some changes and again i mentioned those a little bit earlier.

they get lost in the debate. it's not as if we don't change what we can and when we can. getting rid of the ten forties. getting rid of the assisted living plan that is when to talk to the cost trillions of dollars. there have been a real changes. because even the guys that pass this thing sometimes think, you know, it really is pretty bad in this area. i think that there are some others like the price tag. the senate has voted on a bipartisan basis to get rid of it. we would get credit hartley in the house that they have a peaceful legislation giving it the last thing is less just be real it isn't working real well. he is the one who said i want to push the business mandate of year because we are not ready to do that. let's not forget every individual in this room. you're going to have to pay it but the business isn't. that's crazy. they should both -- they should

both certainly be pushed off together. we have a guy like howard dean who is supportive of the legislation in "the wall street journal" look the independent payment advisory board, which is the cost control isn't going to work is going to collapse and that tells you something. so, look i understand folks who think that there is a lot and it is a do-or-die moment, that i actually see the trend moving forward. i can tell you what it was like to sit on the floor and have fought for months and months when there's only 178 of us. we took it to the last play until i finally had some democrats that voted on it and see this thing happened. i remember thinking my gosh, it's the end of the world. remember how popular the republican party was in 2009? not very popular today. think back to 2009. you talk about road kill, you know, yet months later because

the republicans put every vote on against that, they became the majority in the house and picked up the seats in the senate. so i think that you keep the site of every single day. you come out of it every which way you can and appealed to the parts of it that you can and try all the time to change the electoral balance because i think it is really bad policy and it is the most fiscally irresponsible piece of legislation that is promising benefits things that we will never been able to afford in the long run in my view. >> yesterday i read an article that stated that we already have a shortage of 12,000 doctors and they are being replaced by 18,000 agents. >> with the agents there is a good chance you are never going to see because we do find those. [applause] democrats have a hard time sometimes defending that. you are right about the incentives.

just because we promise you coverage doesn't mean we promise you care. if there's not enough physicians and health care providers out there because they think that this thing is to delete go too burdensome and restrictive, then that is what we are really going to push up prices even higher than they are today. and i talked to a lot of physicians and particularly the physicians that tend to be in their 50s that say i'm getting out of here. i don't have to stay anymore. i am done. i'm not going to practice. believe me, i agree. i think it is a dangerous piece of legislation. and fortunately, more and more people understand that because they have been trying to sell this for three years. honestly we have to get some people in other parts of the country to see it the way that we see it here. i think the number of people the

vote for democratic senators or the president also feel this way about it but the have other issues that are more important to them than obamacare and they will vote on those issues pitting it but i think fundamentally this is a really dangerous policy. >> yes. go ahead. you have the microphone in your hand. >> thank you. i don't know if i am just uncomfortable or what but i can't seem to get it through my head why we have so many financial problems for social security or any number of things. but yet the countries that voted against this. [applause] >> every time i hear that i put my hand on my wall which because there's usually a pretty smart question or point that comes after that. you make a very good point.

we just passed in the committee a 24% cut in foreign aid. i also want you to understand, you know, how big or how small it is in the overall budget. the overall budget in the united states and that is everything from social security to medicare, everything is about $3.5 trillion. a lot of money. about 16 or $17 trillion economy. so around 20% or a little bit more. the foreign aid budget that includes the operation to the state department and every embassy in the world is about $50 billion. the deficit this year will be 650 or 7 billion. so, you've got, you know you can save some money but it will solve the problem and you should save the money. one thing i would tell you about you need to stop sometimes and ask some big questions about whether it is in our interest. that is what we get the aid for

mostly. we get the humanitarian aid mostly what we try to affect the behavior. let's take the country like egypt. okay? egypt fought israel in the 40's, the 50's, the 60's and 70's since 1973 we began giving aid in 1978. we have a vested interest in that. they fly thousands of flights over the territory to supply the american troops first and iraq and now in afghanistan. each of the warships go to the line flying through the suez canal. the intelligence has actually cooperated with the united states extensively in the middle east and has actually been very helpful. is that a good investment or bad investment given the turmoil right now? that is a question that every year gets evaluated. remember changed many times

democrat, republican, conservative, liberal to read the congress has been indifferent control different times so it's not as if it is up for review or we don't change where we give money to get cut it off from behavior. but to the point that we are stretched thin, yes and we ought to be saving money every place we can. second, in each of the individual country as a calculus to go through if it is in our interest or not and sometimes it does and sometimes it is not. >> the vote against as 100% of the time. >> some well and some won't. it varies whether they will or not. you always hear the example but nobody is going to tell you the times that they are supported. i can tell you one thing, intelligence operation or the movement of american planes over somebody else's aerospace to help american troops that to me

is a lot more meaningful sometimes. so i get the point. all i can tell you is these things do getoked at and they do get changed. we are cutting the foreign-aid budget in the house. my guess is the senate will cut some, probably not as much as we will in the house and there will probably be some reduction, you know, going forward. but these are also tools of diplomacy. sometimes -- i've never talked to a general on the defense appropriations subcommittee. i would sure like to have my friends when i arrived. we sit down and some of what we do is military arms sales and some of it is humanitarian. it's very seldom by the way just to check. it's usually some commodity and the game is in ways that help

the united states. i can't tell you that we always get it right because we don't and we can clearly make mistakes. we will continue to be deutsch and continue to try to be vigilant in this area. but it's a great question and it is something that we are wrestling with. >> there are about three of you in a row. so whoever gets the first microphone, right on the all back here. >> i've been hearing a lot about change here one of them as the cost of living which is going to hurt a lot of people for a long period of time. >> we've cut the discretionary budget three years in a row. we spend less on defense this year than two years ago and less on almost everything.

60% of the budget are things that are popular. medicare, medicaid, social security, food stamps, veterans' benefits and nondiscretionary. that is the automatic. nobody is talking about cutting them absolutely. but the rate of growth is pretty phenomenal. now, some of this may be some change up front. we changed socials to be before. if you are my age, i'm 64. i didn't retire 65 and get a full social security check where my dad could. it's great to be 66 and a half or something. back in 1983 we were living a lot longer. so what are the changes you can make at the margin that add up to a lot of money over time that are not devastating to people? those are the kind of issues that i think sooner or later the country is going to have to deal with. but the spending is not just

congress appropriating less money than its appropriated. less than three years ago the other side of the budget, the popular site is growing very, very rapidly. no big surprise. the baby boomers are retiring. that is the largest generation in american history. and you are going to live longer than any previous generation. now that i'm 64 that is a really good thing. you know, but when we sit social security up, didn't have medicare until 1965. the average person in this country live about 62 or 63. you got your first check at 65. only in america. and the average person was there for about five years. today to get to 65 you have a better than 50% chance of getting to 85. about a 25% chance of getting to 92. again i think that is a pretty good thing. that is not a bad thing. but what do we have to look at things? everybody on the program isn't

going to be affected. nobody is talking about things that really hurt people around the programs now. those are going to be on the table for debate. but again if you think these adjustments are not happening, they already are. collecting $600 billion more in taxes than it was enginery. that is what the fiscal what was. so there is more revenue coming into the system. we also held by the way it the economy started growing that is one of the biggest disagreements it's growing at three or 4% with a lot more tax revenue in the economy growing at 1.7. and the lower the unemployment rate, the less people are taking out. people don't want to be unemployed. but then they got medicaid and they are working and paying. they are getting the economy moving again every that as much as this as taxing and cutting. it's trying to get a more robust

growth going. let me get right here in the back on this side. you what have i should say. >> is this on? >> yes, it's on. >> our mailbox is constantly full of conservative republican organizations requesting money. many of these organizations are dealing with exactly the same issues which means money is being fragmented. i am certain that a certain percentage of those are scams where the money is pouring into the private pockets and i'm also sure that some of those are actually filter and money into the little hands. you can say well just put your

money into the republican party. well if you are talking about the oklahoma republican party that's a great idea. but i cannot in conscience get the national republican party. [applause] scan all of it is eastern liberals involved. so what is your advice? >> this isn't a partisan gathering and my guess is there's about as many democrats as republicans. and i think they get their mail box full, too. mabey from a different point of view. look, my instinct is read as much of it as you want. i think number one, you don't have to get a dime. if you don't want to do it, you don't have to. and certainly, if you are having

trouble, please don't do it. now, if you want to do it, i think the best thing is to get to know the candidates or the individual. chairman you can call him up and get an appointment. i promise you. it's pretty easy. i used to be one of those guys. we were happy if anybody called. there's a party organization, same thing with candidates putative i usually think -- i tell you the guys that have the toughest time raising money are the people running for the county commission school board, get to know know them. he determines whether your garbage gets picked up hour not. he is a pretty important night. succumbing you know i try to help the people that i felt comfortable with. and they come in all shapes and sizes and varieties and plans of view. most never give a dime. never write a candidate to any check up or party.

only 4% get more than a couple hundred dollars. i will tell you having been in politics and this isn't a statement the person that will knock on doors and put out a yard sign and actually cut your bumper sticker on the outside of the window, that's commitment. my mom was a state representative in this town. she was a bank teller with a high school education and my dad was a master sergeant. she knocked on a lot of doors and talked to a lot of people. this was a democratic town first elected in 1978. but she was active in her church and she had the great political asset of being the first drive-in window bank teller and more. so she gave chiklettes to the kids and a dog biscuits to dogs. that is the kind of politics but

i think ultimately works. if you want to, you know, play at the presidential level and -- he raised more money than anybody has. he raised a lot of it in very small -- go online. we have tools today that no previous american had. if you have the ability to get on your computer and find out a whole lot about anything and find any point of view by the way that you want to find, the whole political spectrum is over but don't just immediately send a check. check them out, see what other people think. what ever. but that's kind of the way that i would approach it. believe me, you will get more requests than you have dollars. people always used to come in and say why are they wasting all that money? when you stop sending them money they will stop sending you mail. they don't send it help if they are not making more money than it costs. so don't worry.

you just decide where to use your dollars. i took the local candidates are like for the local office but again, if you want to do the of the stuff that's fine, too. people will tell you -- and i will end on this point. i'm getting more of a political science lecturer here than you want. but american politics is expensive. but, you know, one aircraft carrier costs more than all of the political contributions given at the federal level. they can decide to build aircraft carriers but actually if you look at it in terms of the size of our economy is pretty cheap, it's pretty responsive and it is pretty open and you can have an impact if you choose to do it. but again it is always your choice. in australia they make you vote. in australia and you don't vote. you have to pay a fine. i think that would be very anti-democratic. it isn't up for us to tell you to vote. it's up to us to persuade you to

vote. although i think you ought to. yes, sir, right here. >> right up here. but again, we are going to get to everybody. >> i'm partly in the minority because ina rhino. anybody know what a rhino is? it is a republican in name only. i would like to ask the audience is their anybody here that wouldn't like to save 50% on their health insurance, would not like to? because of the affordable care act, the people in new york and california are saving 50 percent because of the insurance exchanges. the insurance companies are competing against each other. so that is one result of the affordable care act which is positive. and as we all know, things come

from the east and west coast and they come in here to us. the other thing, my actable question is related to this comment, the definition of insanity. the house has voted 40 times to try to repeal that. if we know it isn't going to be repealed, and it is a law that is taking place, why do we continue to do that? >> it is an interesting number. because sometimes it is not a repeal of the whole thing. it is a targeted part. and some of these things are things like getting rid of the 1040 which were written in the original bill and on reflection, democrats hearing from

small-business people in the committee decided, you know, they were against that too but they changed their mind. we have been screaming for a long time that the stream of revenue coming in for the assisted living has been supporting the program is too low. it's going to collapse. if you look at it the study says we pass legislation. sometimes you do it and to succeed. sometimes by the way you get surprised with all of it. we just passed a bill not as interested, but they certainly will be on the student loans. and originally the president threatened to veto the bill it was kind of a surprise to us. and when they looked at it they found it was close to what he represented in his own budget. and at the end of the day he ended up working with the republican house and the democratic senate and we got that bill in that will link the

interest rates long-term to the ten year treasury interest rates on student loans and get politicians out of the business of setting the rate which they are not very good at. so again, and honestly sometimes new members coming and i guess if every soldier wants to be in combat, every new democrat and republican wants to be on one side or the other they will say i voted to repeal it and want to be able to go home. it doesn't take a lot of time and it does continue the argument. and i always tell people whether you are for it or not, it is a very contentious and complex piece of legislation. we are going to be debating it, arguing about it for a long time to come. and we will also be reshaping -- even the opponents will tell you that. they suggested that it's been a really good idea. we should have done it that way

in the first place. so, just strap on your safety belt and we are going to be in this game here for quite some time because the case has not yet been made to sell it. and i say this to study the does not believe in it, clearly the case hasn't been made to get rid of it or we would have a different person in the white house. but the american people evidently want this to continue because they didn't change it and they kept the same balance of power after the election and most of the politicians thought this is going to be decided one way or the other. you know, you are either going to have the president reelected in the democratic house and a stronger majority in the senate but surely we will beat this guy this time. nobody's ever had unemployment is high end of the elected. the first president in history to get elected with a lower

percentage of the vote, fewer popular votes and electoral votes. that's never happened before in 200 something years. so it is a pretty close argument between the two sides on this. and i think it will continue. as you suggest if this turns out to be a great success, it will win. the facts on the ground will win the argument. if as some of the others believe it turns into a overly complex and burdensome, with ever, it will be modified in some acceptable form over time. that's just the american political process. we will let you have the follow-up. >> am i follow-up is we are the richest per-capita nation in the world. what is wrong with this picture that 30 million people who are working do not have health

insurance? >> it doesn't mean we don't have health care but it does mean we don't have health insurance. there's a lot things we should do that would help in that regard. for instance, you ought to be able to sell insurance across boundaries and create markets in the same level. you ought to be able to allow small businesses -- [applause] to combine at the same rates that large businesses do because they have a larger pool. and that's called associated health care plan. we ought to have medical liability insurance. the rates for the providers are unbelievably high in the united states. nobody else pays anything remotely like them. those are common sense that don't cost a lot of money that expand accessibility and bring down the price. so to me those step-by-step changes aradhana the way we

ought to go. i am sharing the concern with a lot of folks that it is an overreach and it is and sustaining physically. and i have to tell you we do have insurance mandates in this country. but i have a hard time telling you. i have a pretty good idea of what i think you ought to do. i think i would be very careful about telling you what you have to do. this is the united states of america. it's a free country. a lot of the people that do not have health insurance -- some of them by the way our young and dumb having them there. and actually it is a gamble for them. it's not smart but most of them will win to be a start to think a lot more of insurance in my mid-30s than i ever did in my mid-20s. some people are so rich they don't need insurance and they are not buying it because why? so, you know we have actually done an analysis of the market and there is a significant percentage of that either don't want it, don't need it,

whatever. but we are on this thing now and i think the political debate is not going to stop. and it shouldn't stop until the country makes up its mind. it's not that somebody is agitating. peoples and seeley are very opposed to this. my friends on the other side would have a hard time understanding this. i always say you lost congress over the steel and you didn't get it back even though you got the president really elected. you can't show me a political poll for the majority of the american people who think that this is a good idea. there's always a plurality that think it is a bad idea and smaller numbers that think it is a good idea. some people are not 100% sure one way or another to make up their mind. i've never seen that kind of resistance before, which tells me that politically it wasn't put together very well. and i can tell you it was jammed through. once scott brown was elected he couldn't get back 60 votes to

the end of the house, the arms and legs you could hear them cracking of the aisle in terms of the kind of pressure that was brought on democrats because there wasn't a single republican vote for it and there's a lot of democrats also like instead. there was never any bipartisan body in it. that wasn't true in medicare or social security. so again and you don't negotiate it through and i wouldn't be surprised on the other side that resists to the bitter end and that is what is going on right now. this gentleman right here. it's my understanding that we have lost our way to it we have

no leadership in the 535 people that run this nation. [applause] >> and i think part of the problem -- and i share your frustration. my wife is a democrat and i had in my time -- what i don't understand is why we can't come up with good ideas with about democrats or republicans, i am american and i was not able to vote for the person that i wanted in the last election because oklahoma's rules are so harsh. i think the big problem i think it would be a good idea to fund the federal government. most of it is stuff that we do the local level that is doing okay. but i have an idea that maybe if we started as a state paying our federal taxes to the state to let the state to decide when they are going to be the federal government, we might actually get something done that way.

[applause] >> i have a lot of things and they don't expect you to -- my big question is i don't think a lot of people understand that since 1970, the fed is creating a currency of nothing but a thin air. the only reason that we have been able to go on as long as we have is because it is the world currency. once people decide to quit taking american dollars which looks like china and russia have already started that process we will be in the world of hurt and there's nothing the federal government will be able to do about it. what is your opinion about that? senate let me ask you some of the others issue because i think it's going to be one of the really big debates that we have going forward. you know, on your plate about running everything i actually agree that things do work pretty well. we have a great municipal government here and we saw the race on really well when we had this disaster and we had a good state government i think the

legislature has done a pretty good job. on the federal level there is a disappointment but we did try that solution that is recommended before recall that the confederation. that's why we have a constitution today because it didn't work. putting the federal government on handouts from the state government and continental soldiers didn't get paid during the revolution and stuff didn't get done. so the framers decided that they needed that kind of mechanism that they were very afraid of it. let's say washington wide. say the government is dangerous in the fearful mass and something like that, and it is. they put lots of checks and balances and limitations and the bill of rights and things that nobody else had done before. but that's why we operate this way. and when we say we don't want to send money to the federal government if you are getting a social security check or medicare check that is a sizable

portion of the federal government. more of it is going to medicare, medicaid, social security and those kind of programs. >> space made the point about auditing the fed and i don't think that is a good thing to do. i am extraordinarily worried about the amount of currency that has been created out of thin air to be alive then surprised i must say that we haven't seen more inflation in the wake of what's happened since 2008. ..

i will tell you this. i talked to a lot of bankers and a lot of people. now wall street bankers. i'm talking about the guys who run the local banks here. i've never found any of them that thought they could get rid of it were that wanted to get rid of it. they argue you have to have some mechanism to control the conservancy. this was created in 1917, 1913, somewhere in there. we have a lot more boom and bust before her. we had a great recession and the great depression that did the fed was created. from what i read, a lot of what the fed did was the wrong staff

and made it worse. again, let's see what they're doing. let's have this discussion and debate. i share your concern about the wholesale printing of money, i really do. they need something more to back it up and we have right now. >> at this point there were technical problems at the taping. representative tom cole with select it in 2002 and is currently serving his sixth term in the u.s. house. he sits on the appropriations, budget and rules committee. >> congress is still in its annual summer break. when lawmakers return on september 9, house members will have just nine legislative days to get a short-term government funding bill approved by october 1st. the start of the government's fiscal year. house speaker john bodnar says he intends to make quick work of a temporary spending measure would lawmakers get back.

this would keep the federal government operating a current sequestration levels past september 30th. also in the wings is a republican push to define the implementation of president obama's signature health care law. live coverage on c-span and c-span 2 when the house and senate return september 9th. >> the universe they been for his justice, but it doesn't ban on its own. to secure the gave this country has made requires constant vigilance, not complacency. whether it's by challenging those who erect new barriers or ensuring that the scales of justice work equally for all of the criminal justice system and not india pipeline from underfunded schools to overcrowded jails. it requires vigilance.

>> maryland democratic senator, cardin said states are facing challenges to implement the health care law because of the lack of the federal budget agreement and sequestration cuts. he also said the public won't let congress repeal the health care laugh despite house republicans efforts to do so over 30 times. senator cardin made these remarks at a town hall meeting in baltimore, where he discussed the implementation of the health care law with health care professionals. the event was held a baltimore medical systems new highland town healthy living center.

[inaudible conversations] [inaudible conversations] >> thanks for joining us. this week is national community health centers me, so all over the country there are events like this and other types of events happening for the health center organizing to make sure that the country knows our special brand of medicine, i would bring our a game to the table every day to save america's communities that have

many times little access to health care and remake it a point to bridge that gap for them. i wanted to welcome you all to the room. i wanted to vote than senator ben cardin to the room, who is no stranger to baltimore medical system. has been around, existing baltimore medical system since i got here and that's like 300 years ago. so the senator was at the very beginning a great access to baltimore medical system and we had her municipal waiver, a project through cms for many, many years and every time it looks like it was going to anoraks fire, the senator could be counted on to not only assure that it would be continued, but to lead the effort and work with

a number of other legislators around the country to make sure that happened. when we wanted to build a brand-new building here in highland town, he was the first one i came to we started the conversation when he was on one side of the hill and we ended the conversation on the other side because it took that long for us to get the job done. the senator was responsible for the first public money coming into this venture that eventually grew into the building you are all sitting in now. the senator has been here before. he was here for the grand opening. we will see what it looks like what is in operation in full. so i wanted to thank the senator for stopping by again and help wean us work our way through national health center week. i want to introduce for a moment, to talk about the community health centers around the country, dan hawkins from the national association of community health centers to just

let you know what is happening legislatively at the federal level and how senator cardin's appearance today is. >> i will do that. it is a pleasure and an honor, senator, to sit next to you. they know that senator cardin is one of the cochairs of her senate committee, and he has but it just in a visionary way, kept us all moving forward. it's been a tremendous help in this ensures that we continue to enjoy the bipartisan support and i know you believe in, we believe then that a program like this deserves and should have. i'm only going to say this. this week alone there are over 1100 events across the country, over 100 with members of congress going on, celebrating the work of the 150,000 people

who work at health centers providing care to 22 million americans in more than 9000 communities across the country. and that is a legacy for you. you've helped build the system and it continues to carry on providing care to those as jay said otherwise would be forgotten or left behind and that is critically important. here's a beautiful facility providing care to so many people. this is what it's all about. as a proud organizer and sponsor of health center week, it's just an honor to be here. >> well first well first, let me thank you all, this is national health center week. i am very proud of what we've done here in our community. jay wolvovsky and i do go back a long time and i do remember visiting him in storefronts that were not exactly facilitating in

the day. and it's very interesting. the people that receive the services and that is very cramped quarters love the facility and what the health data are getting in community. they were getting access to quality, affordable health care, which was the model that you really developed here locally. and i really do congratulate health and medical assistance that jay wolvovsky was figuring out creative ways to keep the model after an extremely challenging times. we did have a medicare demonstration that lasted many years. the reason that lasted so long was what he was working. the problem was we couldn't figure out a model so you could get the type of funding you need it in order to maintain that type of service. so we finally caught up to you. we have. finally it's caught up to what you're doing here. the affordable care at is the right model. we want everybody in the system. to have everybody in the system,

you have to have facilities for mass of the community health centers all about. making sure, particularly in areas that are underserved, modest income people, these are areas that traditionally have been underserved. so we have large concentrations of elderly mother income people in rural parts of our country. the health center has had really filled the void. but they're going to have to do a lot more. we are anticipating the numbers will increase dramatically. 800,000 maryland that are not insured today that have fallen through the cracks within the next couple months we expect a couple hundred thousand of those people to come within the system and some will be coming through the work that you're doing. i know you were able to get running to help help assemble people in the health system and that's critically important to get people in the system because that's going to drive down the cost. regardie seen some positive signs. my purpose for being here is to

let you know where we are and take your input as to how they can implement this bill as effectively as possible. let me start by saying a large part of the affordable care act, obama carried 30 been implemented. 150,000 marylanders are getting checks from their insurance companies. hundreds of dollars. they may not know why, but they're very happy. [laughter] that's fanatical loss ratios. insurance companies today have to give you value for their product or they have the refund, but they're not getting you the benefits. for the people of maryland that some hundred 50,000 getting checks. that's been implemented. for a medicare population, 50,000 seniors on prescription drug broker have received hundreds of dollars of additional coverage for the prescription medicines. they're very happy about that. the so-called doughnut hole coverage gap, we're getting rid

of it. it will take a couple more years, but they already see the tangible benefit of that. they're getting free preventive health care under the medicare program. no one's talking today about the solvency of medicare because it extended the solvency of medicare for a considerable period of time. for young people, we've already eliminated preexisting conditions and now you can extend her parents policy to to age 26. these are changes in the lots at a party taken place. we talked a lot about patients bill of rights and were never able to get it passed. the affordable care act would not pass the patients bill of rights issue of the right to choose their own primary care doctor. we are receiving emergency care. these are changes that have already taken place. the minority health initiative, which i'm particularly proud about, our office initiated a

program to elevate the national institute of minority health and health disparities to a full institute at nih and develop minority health offices and help departments to look at ways that we can provide and to cap the coverage and services we provide to all people in our community. that's been implemented and has been implemented well. re: implemented a large part of the affordable care act. a lifetime limits on insurance policies. the next critical date -- actually january 1st, but it really starts at over first. that's when the exchanges are up and running. maryland is a state that has stepped forward from day one. thank you, governor o'malley for what you did to recognize what you could do to help the people of our state. the congressional delegation has worked closely with state officials. let me thank my colleague in the united states senate, barbara mikulski. you know her because she chairs

the senate appropriations committee, but is also a key member of the labour pensions committee that is very much involved in the creation of health policy and our state. and our congressional delegation, john serbians who holds the seat i used to hold onto first are working on these issues has been a real champion on the energy committee for the conference committee to help us deal with the health care issues and elisha cummings and rupert sprecher we have a real team moving forward to make sure this implementation as smooth as possible. now here's the challenge. there's been some difficulty in implementing this bill in washington because we haven't had resources made available through the budget process so it could be done as seamless as possible. there's been no real effort in the congress to take a look at the affordable care act and to make minor changes we need to make minor changes order to make it easier. that has not been that because

of the partisan divisions we've not been able to do that. so we are up against deadlines that are going to be difficult for us to meet, but we need your help in meeting those deadlines. the first is october 1, when the public will have a chance to enroll in the exchanges. now, here's what the opportunity is all about. were talking about hundreds of thousands of people in maryland who don't have health coverage today, who want the opportunity to have affordable health coverage. 75% we estimate will be eligible for subsidies. for a family of four in our state that's about $95,000 or below will be eligible for some help if they don't have employer provided health benefits. so we need your help in getting that information now. were going to also see some additional help calm through the expansion of medicaid to also

provide additional coverage we can get people enrolled. so there's a lot of exciting things. come january 1st, the preexisting condition exclusions are overweight and we've been able to implement a lot of new changes in the law. we've already provided small businesses with credits to help them provide insurance for their employees. not also go to get insurance for the exchanges if they meet certain standards. companies under 50, there's no new requirements under the affordable care act. i was like to say that because we are mindful of the impact that the affordable care act has on small businesses. i serve on the small business committee and the congress we want to make sure this is workable for all businesses, but we're particularly concerned about small companies. there's no new requirement. they can get credits to help pay for the cost of their employees. taking a competitive race and they have a lot of different things they can choose from

under the exchanges that they could before. more opportunity out there. the question is how do we implement this? that's where you come in. you're the community people. you know the target group are trying to get enrolled. at this very moment, it's very difficult yet to see how you are going to work your way through the different plans that are offered. the information is just now becoming available. we need people to help us translate that in a way that's most effective for the people we are trying to reach. now, there are a lot of young people out there who don't have coverage. we know that. they're going to on a policy that works for them. most young people who have not experienced a difficult health issue think they are invincible. they don't look at why they need health insurance. we need your help because we know how many young people get into a medical situation.

they either don't seek health care for their responsible sometimes for their own personal bankruptcies. a lot of people go through bankruptcies because of health care costs. we are trying to avoid that. what i would like to get from you is how we can help, what tools you need from us, what can we do to make it easier for people to get the information they need. we want people to make or break decisions about their health care needs. we know there's a lot of partisan politics played in washington these days. i'm really trying to say about that. i want people to make the right decisions for what is best for them. this bill is not going to be repealed. you would think the republicans in the house would've gotten a message for the 30th time they try to repeal it and it's still here. the public wouldn't let us repeal this bill. they don't want to lose the benefit they've gotten from the affordable care act.

seniors don't want to go back to a higher cost of prescription drugs. families don't i see that young 25-year-olds kick of health insurance policies. people like getting a check from the insurance companies that have been charging more than what we think is an acceptable rate for their health insurance and quite frankly, americans are tired of paying the cost of other people who should be responsible for their own health care needs. that's what this is all about. so how do we implement it in a way that makes the most sense for the american people? two weeks ago i was in southern maryland was steny hoyer. read a group like this together and got into a great discussion and some of the things we can do to help them in prince george's county on a similar type of roundtable discussions, talking with the health care people are. for the people of baltimore, what can we do to help? what changes do take need to be made? what tools do you need for this to work?

how can we get more people the information they need to make the right decisions for themselves and their families? what would you like to see congress do? what would you like to see senator stuart congressmen do or what would you like to see the local health people do? we are in this together, maryland. we are working to implement this bill as easily as they can. >> let me pick it up in that we will open it up to the table. baltimore medical system among the other health and chairs in baltimore and in maryland are fully engaged in the process of open access. one thing he did mention the aca did was give out capital grant to organizations like us. we are expanding and rebuilding our center at saint agnes hospital, which is going to be 9000 or 10,000 square feet to allow us to grow services on that side of town, on the west

side of town to allow access. use the translate and information for patients who might need assistance. we translate a lot of services here because we have such a large speaking population. were going to be very much involved in the navigator program. we have nine full-time equivalents that are going to be involved in outreach and enrolling people into the program. so we're going to be everywhere this community and around town to try to bring people into make sure that they are getting access to the information they need and they can sign up for the plans they are eligible for. we are going to be doing a lot of that together. i have a college here from the community health center center. you may want to say a couple words of the things going on at your center. i'd sell it all bird who represent community health centers at the end of the road down name and may want to say a

couple words an envelope and up for everybody else. >> before you start, thanks for reminding me. one of the reasons there was a delay of several years before we required people to get insurance to go into the exchanges was to develop facilities in the community so we could handle the numbers. we didn't have enough people trained in primary health care. we didn't have enough physical facilities. we were at the same time asking me to health centers to expand coverages for his handling oral health care or do that with mental health services, counseling services as well as increasing the number of people coming through the community health centers. so we wanted to give time for structures to be in place. $11 billion is provided in the affordable care act to community health centers. i was part of the movement they made sure the money was included early in the process so you have some help.

interested as you call my people from the community health centers, whether some of the money has in fact been years and how is that working and i'm obviously interested in the entire country, very interested in maryland. we found that some of our rural areas we still don't have enough facilities and place. quite frankly we are not going to roll all of the uninsured one year. it will take us several years to get this up to the numbers we expect. ultimately we will be in the system. kevin, are you getting the money? isn't helping? or facilities increasing in size? >> health care for the homeless receive a grant to establish a mobile program. we have a new facility that opened around the same time as this one about three years ago, about three and a half miles from here. we began to realize that the time that they were serving us coming to us, but there were a

lot of vulnerable populations experiencing homelessness, living under the bridge, would become part benches and we needed to do more to go want to encampments to engage people and get them off the streets and back into the mainstream. for us, one of the main benefits of health reform that we appreciate your leadership is medicaid expansion. currently 23% of the 6000 different baltimoreans we see every year has medicaid. after 2014, as many as 85% will be eligible for medicaid in many cases for the very first time, eligible for additional specialty services in the community for an organization like ours is making a transition from primarily grant funded organization to an organization that builds insurance companies. that is a fundamental business transformation for us in the time that you reference over the last couple of years has really allowed us to dig into our

billing systems that overhauled them and change them such that we feel quite ready in advance of 2014 to go out onto the street cinema where people. we'll be receiving as many as six new staff members who will go out to the streets, two shelters, to sit kitchens and very actively enrolled individuals and families into care in many cases have been set for the very first time. we appreciate your leadership and look forward to the transformation. the question i have for you, we also participate to the national health care for homeless council. on policy calls for even individuals who are very excited about medicaid expansion of what it means for organizations that we have about half that of in-state, who are not expanding medicaid and it's going to be the same old same old for the vulnerable populations they are serving. what is your from capitol hill?

it is my hope in every state participates. once the political rancor begins to die down, more and more states will come over, take advantage of an hundred% federal money to meet some pressing needs. am i being polyamorous? >> i think that's exact to what's going happen. more and more governors in states that resisted the obamacare, now applying for funds to implement obamacare. we are finding more and more examples where communities very same services in other areas of the states and saying why are we having the here and our own state? so i think you're absolutely right. as the affordable character fully implemented in states expand to medicaid population is maryland will be doing msdn insured come into the system, i think the states that have been resisting what they have to wait

to the people of our state? were losing money and were losing services. that doesn't make sense. plus, it's working. it's a lot more efficient to provide services to people on a reimbursement structure than to rely on third-party grants that may or may not be there the following year. it is wonderful with programs at the national level that help during that help homeless and target groups and minorities. the funding source hasn't been very steady, what would happen with sequestration. it would be much safer smarter and less expensive if we had third-party reimbursement for these types of funds. more and more states will realize that. the last thing as states pride themselves in wanting to regulate their own businesses and states, particularly insurance businesses. with the exchanges now will be up in many states operated by the federal government because

the states full text forward. there's going to be real challenge to have the states can regulate a federal exchange and i think more and more states will realize that they're compromising their capacity to protect their own citizens without taking over the exchanges. more and more states will start to take over the exchanges. i agree with you. i think it's a matter of time in this will be implemented in a seamless way and we will have a uniform policy. part of why we expanded medicaid was to make sure we didn't have people falling through the cracks. we did it as a famous model. but the supreme court decision, it validated the constitutional authority of congress to pass the affordable care act, but it did provide caps than we originally intended because of the expansion of medicaid. we think states will recognize that and want to come forward and let it work as best way.

>> we are thankful for maryland leadership. >> it's not just the expansion of medicaid. it's not just working on the exchanges, but the fact he gave confidence to insurance companies, gave confidence to health care providers that the state would be a full partner in mass so that there is much more willingness of providers and insurers and companies to step forward and say, how can we make this work? regarding the partnership in our state thanks to governor on maoist leadership. >> let me take a moment to recognize dr. alan and who also want to into the room. >> thank you, jay. good afternoon, senator. good to see you again. there's a lot going on in every one of her 15 health center's in large part, not only to the states doing because they've been a real partner. medicaid has a program going on

through thm h., department of health and mental hygiene as early as now, trying to enroll as many people in our pack program so they automatically convert in january as well as working with health care for all, an organization in baltimore city to identify people who potentially could be enrolled if we have a good ground game going on and of course the exchange of medicaid have a partnership in which they are going to be partnering with the health centers in order to get the word out through various kinds of social and other forms of media so that we can reach as many people as possible. ii think the her some money, the 105th $2 million is helpful because it helped our centers to add additional staff that they can do in reaching make sure our

uninsured patients get converted to medicaid or get the exchanges that superb. as well as going out into the community. and again, trying to reach people and bring them in not only for care, but also to get enrolled in medicaid or if they're qualified coming in now, channeled to the exchange. so i think we have a lot going on. the health centers have been busy but the funding over the last two or three years, trying to recruit providers, renovate facilities, and large facilities. we just open one up thursday at franklin park in prince george's county,, which is very exciting. and so, i think we've had a lot going on. what concerns me, and you mention it, this is not a one-year pact today. we are going to see the

continuation of enrolling people in medicaid, getting them into exchanges, identifying new population. for the next three, four, five years. so i'm very concerned that we continue to have the level of funding these had over the last few years in the subsequent years. we've tried to make projections. we've done all kinds of reports and calculations. we really don't know what the volume is going to be because everyday or health centers identify somebody new for medicaid eligibility. i think we are going to continue to need to recruit providers to expand our facilities, to identify areas of the state coming in now, where services are needed to develop new partnerships as we try to integrate somatic and behavioral health care. that is my question in my

challenge to you is what can we also do to ensure that we continue to get the level of funding the pad under the aca through 2014? >> now, the funding authorizations are pretty stable. we have a federal appropriations process. two problems there. one is there operating without a budget agreement that we desperately need a budget agreement. sequestration is really hurting this country badly and it unnecessary. it's mindless across-the-board cuts. we have to replace sequestration. no one's talking about eliminating it without comparable savings. we can get savings. part of the savings in health care by bringing everyone into the system. every time the joint tax committee congressional budget office has scored a health savings have always been very conservative. so we need the funding is

spinning a budget agreement to the expense. they allow for the proper funding of government. the second is we have acted over the political hurdle we talked about before. i want to raise the point here because there's been a sharp difference in how the opponents of affordable care act has handled the policy of health care in previous problems if i can help you expansion. under george w. bush cannot be expanded prescription drug part d. i opposed it. i opposed it because there was not a governmental plan available. there was not universal pricing, which would bring down the cost dramatically. i think i'm right about both of those points, by the way. i worked a lot with people who oppose the bill to make sure it was implemented as best we could. we worked together to make it

work. we are seeing almost apolitical isolation of this issue, which is kind of politics rather than trying to make it work best you can in seeking changes you think the change. hoping we can get to that point and the resources necessary to make sure the spot implemented fairly because you're absolutely correct. it's not going to be one year and the mentation of the personal mandate. it's going to take a long time. it's going to take years. we also don't know what type of what will enroll in the first year. i may surprise people and be very much typical of the risk, which will alleviate a lot of concerns of private insurance can and is participating. in the act bring down the race and you might have more choice in the implement faster than we

anticipated. it may be just the reverse. we don't know, but we need your active help throughout this process to keep on target so we can get by the end of a couple years, we hope it's three years, four years we can get the overwhelming majority of people in the system, whether medicaid or exchanges into the system and we think we can within a short period of time, but we do need your participation, which means them to make sure programs are adequately funded. >> outtake prerogative one of our time and then open it up. both he and the host here. so at the ground level, at the patient level, it's really important that this program continue, that this program be implemented well in that we have the means to do all the various things that we talked about here. but i do care, and with a population come and meet the needs of folks who need an

integrated model, a patient centered type of model. dr. emily sipple is at the end of the table here. she's a family physician who works in the center and has been for a number of years and who i think can give really a patient side view, provider side view of what it means to deliver care about access to additional insurance might mean for the populations they serve here. >> absolutely. one of the biggest mysteries honestly is that while i'm very thankful for the addition of the pac program, as so many patients showing up expecting full service is and i'm the one that has to tell them i'm sorry, you need the sultry sound coming in to stress test, but you have to pay for it. so, i am so excited to the affordable care at that those patients will find they get the full care they need and i won't have to worry he might have a heart attack because he can have the stress test.

i will add also that while i'm excited that will be able to finally serve as the entire community, i am worried we don't have enough clinicians to provide the services. i am hopeful that their son for foresight there as far as making sure that we have the clinicians that we need. honestly, this will sound a little cynical, but money talks until primary care is reimbursed, it will be a losing battle. just in size for my side. >> we agree to. we try to put some of that policy into the affordable care act. there was areas to help deal with the cause of training for those that go into primary care. there's an emphasis to get more people trained in primary care. one of the issues we have not taught with you, which could be dealt with as early as this year is what do we do with the

physician reimbursement structure under the medicare system, which is the huge issue, sustainable growth rate. there's general agreement that we've got to fix that. the current system doesn't work and we have to start with the current emperor sent as the base. the good news is we can do it this year for about as cost them a share. the reason is health care costs are down. we can do that. now what do we replace it with moving forward? you really push your finger on the challenge. we want to do things on the replacement answer your question. one is we want to reward which you do here. we want to reward taking care of the patient rather than taking care of one of the same terms of the patient. so that if you can understand that and taking care of a person's diabetes, you're also dealing with their heart, also

dealing with the blood pressure. so much of this is interpolated in your managing the full services rather than just taking it piecemeal and billing separately. that's a particular problem of hospital care in our country. how do we manage it or send any way that can reduce hospital admission rates and can reduce the unnecessary duplication of tests that take place and also better care for the patient herself. so that's one of the issues we are trying to deal with on the sgr replacement. the other is how do you do with the relative value of services, particularly primary care? there's been some studies the way we now provide basically on physician groups to tell us how many hours it takes to get various services. there is a "washington post" or "new york times" article. i think it was "washington post" that showed for certain

specialties, the doctor would've had to work over 24 hours a day to equal the number of hours they were charged with. so we've got to get a better handle and the people who are disadvantaged under the current system are primary care. and that's what we have to fix. you're exactly right if were going to get the right mix, the right work for us next next i have to have the right reimbursement structure. a lot of that means replace the sgr, which is not part of the affordable care act. a separate issue we clearly have to deal with. i will ask the question if i may. and that is -- those of you that have to sort of figure out and advising people how to enroll in the exchanges, i don't know if you had a chance yet to take a look at the type of plants approved and the different levels of plan, major companies involved, different plans are

offering and how they offer pediatric dental in some cases differently, some cases the same. have you figured out what we can do to make your job a little bit easier? or is it too early to make that calculation as to the information? they are not going to have it ready until close to october 1, so i know we are talking here. what keeps you up at night if you think about trying to enroll people? >> the training is not even happened yet. it is her scheduled to happen in september. >> let me just raise that question. how are you going to get it done, ready for october 1? >> chip is in the same position trying to roll out the sisters who will be the ones on the street. he deals with the mentally ill population for the most part in the service area, so maybe let him fill about one.

>> first off, it's delightful to be talking about it and then we services. luscious star but that premise. this has been exceptional. and the executive director of mosaic new services. we are committing adult health provider. we serve about 6000 folks here. the benefit package buries me that particularly in my specialty area, which is behavioral health it is not sufficient. one of the discussions that we talk about access, we can enroll people, but we really to make sure we are making the folks that have been locked in a safety net before that the services accessible and available in a way they will. all of us have been talking about how do we reach people where they are? that is under a bridge, but also how the services are delivered. i really like what you said earlier about how do we manage

the total health of consumers in a way that very important? particularly behavioral health. coming in to see a psychiatrist for treatment is only the tip of the iceberg. there's a range of services from housing to a planet to communicate there that are essential to help the person be successful, maintain whole health needs and all that needs to be in play. so to answer your question, first off, i believe all the planes frankly are not sufficient in terms of scope of coverage for mental health and addictions. the second issue for me, which is particularly with mental health is that we aren't federally qualified. community health centers are not. one of the excellence in mental health act moving to the senate we really would urge your support in anything you can do to that that particular piece of legislation because going back to what the doctor said, we

think there's going to be enormous numbers of people who have not had full medicaid. people with addictions who haven't been able to access the total package of services. we really, really hope we can move that forward. the other piece that's really exciting and i particularly want to thank sally and, jan particular were doing a lot of partnerships together to reach a unique population out there. without funding yon simply improving the rates, the capital, ability to recruit and retain confessionals in mental health while primary care as a challenge to my behavioral health is unique in keeping the people who want to do this work in the community. >> well come a thank you for observation. we have come a long way on mental health parity in this country and the affordable care act took another giant step forward on mental health parity. we are not there yet.

part of it is we still don't quite understand how to bring about the type of parity that is necessary and how do we do it in a way. so this is an evolutionary process and more nature observation as to how we should expand the services that are covered for mental health, addiction, counseling, those types of areas where we know we have made strides, but we know we still have somewhere to go. we are proud about the expansion of facilities for mental health services. take a look at the health centers over the last decade are the last five years. it's been an incredible expansion of services now available in communities that didn't have services before. it's been very cost effective. we see hospital admission rates go down because we have services that could have followed rather than have a person go to

emergency rooms. a lot is to reduce the needs of using emergency room care because it is so expensive and it's not very fact dave if you have an ongoing issue. so if we get into community centers, we do a better job on that. as far as facilities for construction, that has been very difficult to get at the national level for health facilities. there's always been the money available, but not a lot. the affordable care act to provide help for building and construction. it's an area we understand we still don't have enough facilities out there, but we do look for you to tell us what is the best way to expand capacity using a model that is working the health centers. so we will look for ways to expand that. one of the nice things about the affordable care act was the health centers had bipartisan support. not a controversial issue to provide more services in the

community, particularly in a cost effect of setting where you can provide comprehensive care, taken the pressure off of emergency rooms. >> will see how long that lasts. >> i think so. i must tell you, i think there's knowledge about the importance to continue that expansion. i think the expansion of mental health services, i know an oral health, we think that will continue. >> collaboration really is the key to this because we can operate in silence anymore. all the health care organizations are really needing to work together to kind of make this work. they've got to create a seamless whole. we are working with jeff on a collaboration on the idea that of his clinicians outbreeding baltimore medical assistant, providing mental health and

substance abuse services. we've been working with saint agnes hospital for a long time coming to an a lot of on-site collaboration and we had an emergency room diversion program for a while. trey sutton is the vice chair of our board. she represents saint agnes hospital and all may invite her to talk in a second. stewart dell is the cml at union memorial hospital and we're in conversation right now to create collaborationist union memorial to do exactly the same thing. do we want to say a couple of words? >> first of all, senator cardin, we are proud of what you and the governor had done. it was a courageous act to move forward irregardless of the outcome of supreme court. speaking for saint agnes, we certainly have worked very, very hard over the past three years trying to figure out a way to manage people in our emergency room. i will say we have some concerns

that as more people get coverage that some of that work will have to sort of either expand or look at how we can improve because we expect even more people with that concern over primary care access will actually slide our er rooms. so you know, working with vms, but also west baltimore care, another organization that we work with mosaic. we think we will deal to manage people and not just within the hospital doors, but outside in the community a lot better. that's one of the goals of saint agnes and saying once we leave, we still have ownership that go out into the community. >> about 14 other organizations are involved you want to help enterprise zones in west baltimore, so were involved in the process as well is another partnership we have going on.

>> the concern we have from a hospital is ob access as well as primary care. i am just wondering if there's any book at how we can expand and key providers into the community available and accessible to medicaid as we expand because quite a few are beginning to exit that delivery system and so we do have some concerns about that. >> you're raising a very important question. but it's how you why we have to get away. it is better management of care because we had to bring down the growth rate of health care costs. for many reasons, from a governmental point of view, the cost of medicare is a dominant factor in our budget. the state level across medicaid is a dominant fact your. you've got two choices to do with this cost issues in the

future for government. one is to shift the cost by paying more. that's got her poor people, particularly medicaid. initiative medicaid will hit our most foldable. medicare seniors are to pay a large percentage of their income in health care costs. you are going to shift it to the wrong people. or you have a system, which is exactly what we need to do. cutdown hospital readmission rates. we know we can do that. our state has developed a plan where they put their own money on the table and say we can get better follow-up care. we will send nurses out, pay for it and will save money and they do. so we know we need to do a better job of the admissions that point of view people following up their care after they leave the hospital. it's more than that. how do you talk in the holistic aspect of a person's health care? it's not what we do under the

affordable care is how we handle hospital rates. as you ireland, the governor is looking at a model for a hospital reimbursement rate that is more visionary from the point of view of overall health care results. these are ways that you save money and ran down the cost and get better quality care. so yes, we want to reduce people in emergency rooms, but you're right. if you don health center, a person who has an insurance card, they will services, were they going to go? you're absolutely right. that is a concern we have. how do we make sure that doesn't happen? >> i think were in the midst of a reinvention and it's how we do care. the way we have to do it has to be complete different from how we've done it in the past. these collaborations we talk about our key. hospitals reinvent themselves as would now become will become cost centers other than profit