you want to know what chris christie did? fine, absolutely fair game. we know what he did when he found out what his people did about the traffic jam. he fired them. and he got up in front of the whole world and said i'm embarrassed, it's my fault. i'm going to fire the people who did this bad thing. name one person that has been name one person that has been i. name one fern that the state department who has been fired for ignoring repeated request for additional security on the conflict coming from people in libya. and, by the way, the accountability review board. what if i learn in my interview with a survivor? i found out for the first time that bill b. and c the places attacked the state department consulate, had been renewed in july for an entire year. i didn't know that.

for hundreds of thousand of dollars. well over a half million dollars. you're going tell me they're going do close the consulate in december? that was the conclusion of the accountability review board? that's not accurate. i'll tell you what i think they're going. i think hillary clinton was going to go down in december and announce the permanent facility will be open in benghazi, and to her credit, and susan rice's credit. these twrot women that pushed the president to keep benghazi from being overrun during the war with gadhafi. they got involved, to their credit, they pushed the president to get involved militarily to prevent the slaughter of everybody in benghazi. i've been told that the plan for benghazi was to have a permanent footprint, and for secretary clinton to go down in, as one of the last acts say we're here to stay. the problem with that scenario is the security deor it

deteriorated because we had no plan after the fall of gadhafi. >> i ask one other question. i think a lot of people who are observers really have to view this, and these actions on the part of the administration. a statement by now national security adviser susan rice on every talk show -- sunday talk show this was resolved of a hateful video, a respondent use demonstration. al qaeda has been decimated. you can only view that and some of these actions in the context of the fact that it was a political campaign. a presidential campaign going on where the rhetoric time after time rally after rally and president of the united states and the surrogates said bin laden is dead.

you cannot understand why two weeks later, before the united nations, the president of the united states was still talking about respondent use demonstration and hateful video. you can only understand that, in my view, that it is in the context of a story line that was propose all gaited throughout the 2012 presidential campaign. >> i think the white house, in my view, this is a reasonable conclusion but not a fair conclusion. we don't know exactly what happened yet. i can tell you this, somebody at the white house on 14th of september pressured the intelligence committee to change the story of benghazi. and on the -- 15th of september why did they pick susan rice? she said secretary clinton was tired and went through a the

lough trauma. i'm sure that's true. i know, secretary clinton pretty well. i think she's tough. let put this way, she couldn't be on tv to talk about what happened in the state department because she was distraught? i don't buy that. does anybody believe that about secretary clinton. it it's true, it's something the american people need to consider. i don't believe it's true. i don't believe she was incapability of going on television as susan rice says. i believe they picked the person very loyal to the president who say whatever needed to be said. what she said was so far away from the truth it need to be investigated and what she said was so beneficial to the president's reelection it need to be investigated. she was speaking definitively about benghazi on 15th of september while the fbi was interviewing survivors. on the 15th, 16th, and

17th. why would any administration go on national television and tell the world what happened while the fbi is still interviewing people who were in the attack. where did the fbi interview goes? he said not one person interviewed by the fbi in germany ever said there was a proit's. all of them said it was a terrorist attack. saying there was no protest. it was a terrorist attack. that not get to the system. did the fbi just sit on those interviews? who did they give the interviews to? and how could susan rice tell the american people and the world we know what happened in benghazi before the interviews were over. she bent on television to spin this story. how could the president of the

united states, after the interviews were taken go before the american people time and time again for weeks and tell a story about a protest that never occurred. ladies and gentlemen, this may not be a big deal to you. it's a hell of a big deal to me. when it blew up, senator mccain myself said this is not a few rot rotten apples. it's system failure. when iraq was falling apart, we said it's not working no matter what people in the bush administration are telling you. we know better. we've been there. when gitmo was a mess, we didn't sweep it under the rug. we worked with senate levin and senator feinstein, two great americans to get the definitive truth as we could.

we call for the resignation of secretary of defense because the failure. >> yes, you did. years later. the families have no clue as to twhoopped their loved ones had fought for his own death. chris was in benghazi. that's where he's supposed to be. doing what american wanted him to do. trying to hold libya together. there's no blame in the dead guy. i would like to ask the question of senator ayotte. you followed it as well as anybody. from your point of view, the unanswered questions, and whether or not you think there is evidence this was a preplanned terrorist attack versus a protest. >> i want to thank my colleague, senator from south carolina. the senator from arizona who has been relentless in finding the truth about what happened in

benghazi where ambassador and three brave americans were murdered. there are so many questions. i would start with the accountability question that the senator from south carolina raised. no one has been held accountable. who has been held accountable for the failures? if you look at this intel report, it's very clear that the intelligence community, according to the report, provided ample strategic warning that our people in benghazi were at risk. there were failures and no one has been held accountable. why? i would like to know, as i look at these talking points, the question that was raised. why was the reference to al qaeda removed from the talking points who did that? and the context for presidential campaign, but also, take a look at the talking points. there is no reference in these talking points to a video.

look at the actual language of the talking points. so why is it that the spoke man for the president on january 13th is out there saying that the protests we're seeing -- or that this is a reaction to this movie? why is it that susan rice, the ambassador, is on television on multiple shows blaming the video? not only was it absolutely wrong when she said al qaeda was decimated and misleading, particularly the fact that al qaeda had been removed from the talking points, but there is no reference in the talking pointses to a video response who in the administration made up the video story? i think that's important for the american people to know, because it wasn't just ambassador susan rice to rely on the video story. it was our president of the

united states who talked about the video. and talked about it, frankly, after the ambassador went on all of the sunday shows on september 16th. in fact, the president said as late as september 18th when asked basically he talked about the video and said you had a video that was released by somebody who lived near a shadowy character. here is what happened. who made an extremely offensive comment. so here we have the president of the united states as late as september 18th. then on september 20th, you have the president saying on network responding to the possible involvement of al qaeda. he's asked is al qaeda involved? here is what we know, that the natural protest that arose because the outrage over the video were used as an excuse by extremist to see if they could harm u.s. interests.

where did the video come from? even what the intel community came up, which was deficient, and which clearly was subject to political influence because it removed the reference to al qaeda has no reference to a video. so i think there's a lot of questions that need to be answered. here is the most important question: why has no one been brought to justice? the president stood, i believe it was september 12th, and said we will find out who did this. we will bring them to justice. to those families, those victims, no one has been brought to justice. in fact, you have people who is a former commander believed to be there that night sitting in cafes in libya giving press interviews, and yet, we have -- and there is much to believe that he is likely to be involved in this. and many other terrorists.

no one has been brought -- so why is that? how come no one has the curiosity not only to answer the questions of twhapped night, but also to ensure -- >> would the senator yield? >> i'm trying to find the press statement on september 10th from the white house official that says the president has consulted with his national security team. i'm para phrasing, about the threats we face throughout the world. we are ready. this is on september 10th. what does this report tell us about september 11th? we were far so away from being ready, it is unnerving. there's a lot to be asked. why would somebody in the white house issue a statement on 10th of september talking about ready for any contingency anywhere and basically assuring the american people the president is on top of this, when clearly he was not.

>> another question -- >> my colleague -- the attack -- as i recall. over that period of time, would the hundreds of airplanes -- air dlaft we have and ships and other military capabilities that we have in the area -- in the mediterranean, we were not able to get any real significant help. no, there is a number of thing are team supposedly landed held at the airport, not allowed to move in. all of that. all of these are questions that have not been answered. general hamme told you and i over the phone that he didn't have any assets that were capable of reaching benghazi. you mean we don't have the capability over eight or nine hour period to get some relief an ongoing attack? and again, what was the hangup

that kept people at the airport finally -- >> if i could follow along with that thought, it's a very good question. number one, if the secretary of defense and the chairman of the joint chiefs publicly testified, they knew it was a terrorist attack from the moment it started, and told the white house. how did that get lost? how can you start talking about a protest and a video when your own secretary of defense and the chairman of the joint chiefs in real time tell the white house they only spoke to the president once with a prescheduled meeting when the attack started. the secretary of defense -- >> still don't know what the president did that evening. >> well, we know after he answered one question. he said he wanted to be transparent and open and let everybody read the story of benghazi. we have destroyed a small forest asking questions. and he answered one question. did you call anybody in libya,

mr. president, that night? no. you've got a rescue team held up at the airport for two and a half hours. >> i add too that young, you know, -- the president we heard testimony that obviously the secretary of defense others knew right away it's a terrorist attack. let's not forget the 60 minutes interview where he's asked about that on september 12th, and he said it's too early to tell exactly how it came about when he asked directly if it's a terrorist attack. he would not identify it as a terrorist attack. i will also add this, what is so sad about this, is no one has been held accountable. the warnings were there, not only were the warnings there from the august 16th cable that came from the embassy from ambassador stephens saying that the conflict is not -- what has been lost in all of this, when we talk about the new york city "times" try to erase

al qaeda from this, well, the day before the hearing, the head of al qaeda, released a video just before september 11th of 2012. just before this terrorist attack, which, by the way, occurred on september 11th, of course, which should have given us a pretty direct clue it was a terrorist attack. but the head of the al qaeda issued the video acknowledging and yule guising -- yule guising in a drone strike and calling for terrorist attack. it was a libyan who served as a second in command in al qaeda under him and was a top leader in the libyan-islamic fighting group. think about it. the evidence that was there before not only what we didn't do to protect that consulate, but the warnings that a terrorist attack was coming. >> if i may, who was the person

who decided to approve a year lease on this piece of property in july after it had been attacked in june? they blew a whole in the wall that 40 people could go through on june 10th. so somebody said, hey, it's a great sight. let's extend the lease for another year to july 2013 and never reinforce it. never added any appreciable security, denied all the security requests inspect goes on and on. if you want to know about the bridge, great. do you know what christie knew when and what he should have known? great, go for it. all fair. does anybody care what our president did that night? does anybody really care if the president of the united states, for two weeks, talked about a protest that never happened and just all the evidence suggests otherwise? does anybody really care that the consulate was a death trap

and nobody in washington ever responded? does anybody care that nobody has been brought to justice? does anybody in this country care that somebody in the white house, on the 14th of september, obviously for political reasons, took the intelligence and turned it upside down. does anybody care that susan rice, who has nothing do with benghazi, was the spokesman for the country telling a story not founded in fact, founded in political advantage? i think americans do care. >> let me ask the senator from south carolina, does anyone care that the secretary of state claimed that she had knew nothing about this august 16th cable? didn't know about the cables leading up to the fact that what had happened in benghazi, the warning the red cross left, the french left, the blown hole through the consulate, the

august 16th cable? yet secretary pa then that and chairman dempsey was aware of it. but the secretary of state? >> the secretary of defense know about the security environment in ben benghazi and secretary of state does not? all i can say it does matter. >> no one, -- no one to this day has been held responsible for the tragic deaths of four brave americans. no one. intelligence committee report, i appreciate it. they hold bureaucracies responsible, individuals are the ones that run bureaucracies. i'm disappointed at the intelligence committee had not had the courage to name the names of the people responsible. president obama will announce changes to government surveillance programs at data collection. the president is expected to focus on steps that increase

oversight and transparency. we'll have live coverage tomorrow from the justice department at 11:00 a.m. eastern on c-span. in the afternoon, also on c-span, we'll get reaction to the president's speech and proposed changes to federal surveillance programs. a former cia analyst and a establish defense official will be at the brookings institution. live coverage begins at 2:00 p.m. eastern. yes, internet service providers gate keepers, and they also are two-sided networks or two-sided gate keepers. like any gate keeper. there is somebody on one side and somebody on the other side. so the situation, then, is a very similar to the credit card industry. so we all have credit cards, and then there's the credit card company. on the other side of that there's the restaurant. it's very useful for restaurants that we all have credit cards and it's useful for us that all

the restaurants will take them, but it's not so useful if the gate keeper says some of these restaurant we're not going allow them to participate in the system. translating that to the present, if the internet service provider were to say, you know, not all the people that are putting the content on their computers. we don't want all of them to be able to access all of the users. that's a problem with the gate keeper behaviors that way. this weekend on c-span, a look at the impact of the d.c. circuit court ruling on broadband and high speed internet regulations. saturday morning at 10:00 eastern. on c-span2's booktv gary young exam "the speech ." the story behind martin luther king, jr.'s dream. saturday at 3:30. part of three days of programming this holiday weekend.

more people could read, write, comprehend. i know, that. we would be to be compete with the rest of the world. we wouldn't have these children who are committing crimes. they don't have jobs because they can't read. i think every thinking american is coming to that conclusion. we have got to educate our children. we've got educate their parents. it's not just a whim. it's a necessity. we're going compete in this world. >> first lady barbara bush, monday night at 9:00 eastern.

live on c-span and c-span 3. also on c-span radio and c-span.org. next a senior official involved with implementing the health care law testifies before a house panel. he was asked about problems with the healthcare.gov rollout. the energy and commerce oversight subcommittee hearing is chaired by congressman tim murphy of pennsylvania. [inaudible conversations] good morning. i convene this hearing on the subcommittee on oversight and investigation to review the implementation of the patient protection and affordable care act. our witness today is mr. garyree cohen. the deputy administrator and director for consumer c information and insurancewe oversight at the center for medicare and medicaid services. i would like to read you

insurance oversit. your likeo two quotes before the committee. on april 24, 2013, you said i think the keys, and i quote, are we are on schedule and on tract with the i.t. bill we are doing and then you added i think it is just as important to take a look at the steps and make sure we are on track but i am confidence in our program. here is another quote where you said consumers will be able to go online and get a determination of what tax subsidies they are eligible for. they will look at the plans available where they live. they will be able to see the premium net of subsidy and chose

a plan and get enrolled in coverage beginning october 1st. those unqualified statements that the exchanges would be ready are contrasted against what we have learned since the health care website failed upon launch. three weeks before you told the committee you had no question about the exchanges being ready, the mckinsey program briefed you on a number of risks facing the website and federal market place and those included late policy, delayed design and unlimited time to test the website. i mind like to know why you feel confidence telling the subcommittee everything was on track. and similar, cms's own e-mails from the summer of 2013 shows officials were worried the wb

site would crash on takeoff. and you told us everyone would be able to go online, learn their subsidy and enroll starting october 1st. i thank you for being here and i know the number of times you have made yourself available to testify and i appreciate. but it seems hike you are faced with knowing about the problems or you did and didn't inform congress. promises made and promises broken are disheartening. we have spent over $6 million on the website and no warning was giving that a disaster was coming. after years of saying if you like your plan, you can keep it and the president apologized.

and what about the decrease the president promised in the premiums? news reports are providing narrow networks as a consequence. will americans be able to keep their doctors? and now we ask if they will be able to afford their deductib deductibles. i would like us to start fresh in 2014 and our ability to do so depends on you explaining fully and honestly about what you knew. this is about more than a website. people are to trust and rely on this system. and trust something so critically important to a family their own health care, this administration needs an open dialogue with the public about the status of the

implementation. there are many issues to examine about how they are operating. why didn't you tell congress about the problems with the website? how many people have paid their premium and exchanges? how many were uninsured and how many had plans canceled? how much will the taxpayers spend on the website and where were you getting the money? news is stating not enough young people are enrolling -- when will we know about the corridors and if they are sustainable. i will yield to the ranking

member. >> i think there chairman, we can stipulate the website had issues. but as long as the problems beat the dead horse about who knew when. and the worse it is going to be for their people because after all isn't the desire to encourage people to sign up for health insurance? if they are eligible for medicaid to sign up. if they are eligible for subsidies to get them to help pay for their insurance. i hear colleagues on the other side of the aisle and i can taught help but wonder if they want their people to have insurance. last week's vote on the floor was a good example. where we voted on this bill that said that we were going to have

security in health care's website. everybody thinks we need to have security on the website. but the clear impression given during the floor debate and the committee before that was that somehow health care's website isn't secured when in fact there hasn't been one breach and in the briefing the federal it people said they have not have anymore attempts to breach the health care website. and private website's are not exempt from that either like target. so i can't help but think the other side of the aisle doesn't want to implement this. they want to shell people from signing up. that is a darn shame. the good news is, and believe

me, i was a critic on the implementation. it was rocky. but people are beginning enroll in a robust way. last week connect for colorado, which is our state site, announced the figures for my state. we are about halfway through the opening enrollment and 50,000 people have signed up for private insurance and about 90,000 have enrolled in medicare. so this is as a 140,000 people who didn't have health insurance before. now this represents real progress. this represents a family that doesn't have to worry about how it will pay for treatment if a child is sick or has an accident. it represents moms who can get preventive care from breast cancer screening to vaccines.

it represents small businesses who don't have to worry about loosing their livelihood if they have an accident. i am proud of the leaders of connect for colorado for allowing it to get going. we will continue to have glitches. but sitting around and trying to figure out what happened last fall when around admits it was a disaster doesn't help us in the future. the whitehouse issued enrollment numbers and over 2 million on the exchanges and 4 million in medicare and that is 6 million people who had no insurance before. minority staff released a memo showing affordable care act is ahead of where the medicare

part d enrollment was at the time that program went into affect in 2006. right now, the affordable care act enrollment is at 31% of projected enrollment with half of the opening enrollment period to go. and it hit only 23% of the projections on part d. and i ask you to put that memo in the record. i didn't vote for medicare part d. but we worked together to make it a success. and i think that is what we should do here. one of the things i continue to be concerned about with implementation is enrollment of the young people. i know a lot of people say they will enroll at the end. but i would be interested to know from the administration to know what we are doing to hit those targets.

they will not work if we don't have that going. let work to get people enrolled and let's not sit around griping about what happened. >> we will recognize mr. upton now for five minutes. >> today we are going to continue the oversight of the president's implementation of the health care law and the affect on americans in michigan and across the country. we welcome you back and you have testified a number of times and we appreciate you coming back. we went back to review the testimony from last year and when asked what to expect at the start of the enrollment you assured us once in april and once in september that everything was on track. during the more than four hours of testimony there was no

mention of the facts you were breached by mckinsey twice and warned about the risks in the website or there was any talk on the fact that cms employees were aware the website was riddled with problems. today's purpose isn't to rehash the launch, but we have to know what you knew before moving forward. you looked us in the eye and said everything is on track. it is time to be transparent with congress and the american people. the administration needs to be open and transparent about the facts kw and what americans

should expect going forward. the american people deserve the piece of mind there is no more surprising and the information available is the entire, true story. and i think you will help us with this. i yield to dr. burgess. >> thank you for yielding. i appreciate the time you devote to our oversight efforts. here is the central question: how in the world can we expect people across the country to trust this administration when they have been continually told everything will be ready and it wasn wasn't? it is clear the administration new far more about the concerns prior to the launch of october 1st. and yet you came before us on september 19th and each time

before that you promised the health care website would be functional october 1st. you insisted the subcommittee that everything was on track less than three weeks before launch. i will stipulate some parts are working but only because a glitch department had to know launched. it upsets me you came before the committee and told us everything was okay and we spent hundreds of millions and you had three and a half years to get it right and we have to appoint a glitch zar to sort it out so people can enroll on the health care site? the enrollment numbers are meager, i think. perhaps you have a different story. but errors and canceled plans

and broken promises are the start. now we have the health and human services failed to head internal warnings about the lack of readiness. it is my hope you have come prepared to answer the questions. you owe this to your superiors at hsh, the secretary, and the committee. it requires we look at the past and the future. i think the problems of the fast show there is going to be significant problems and you need to be prepare today work with the committee to mitigate the damage that is going to be visited on america's health care

system and american people. >> now we will recognize ms. catts for five minutes. >> this is our first hearing of the here on the affordable care act. last year, in this subcommittee and the health subcommittee and the full committee, the majority health 12 hearings. they were frustrating because they were not held to examine exactly what the law is doing or to work in a bipartisan faction to improve the law. they were part of an effort to criticize the affordable care act, spread misinformation, and build support for repeal of the afford. the majorities focus on appealing the affordable care act is one of the reasons i believe why this congress has been one of the least productive

in the history of our country. but we are at a different place today. approximately 10 million have coverage because of the affordable care act. over two million have coverage through private plans sold through the market places. and more than 4 million have enrolled in medicaid and now have access to a doctor or health services they didn't have before. more than three million young adults age 26 and under have coverage through their parent's plans. and millions more have coverage directly from an insurer. as the ranking member explained the rollout of health care's website was anything about smooth. and i directly expressed by dismredi displeasure to the president.

and moving forward there are going to be hurdles. but the law is working. members who want to appeal the affordable care act will have to explaining to the ten million americans why they should lose their coverage and their new rights and protecting them. coming from the state of florida, they will have to explain to our older neighbors why they want to take away the improvements of in medicare? the new preventive care and wellness visits that are available and the fact we made medicare stronger. the 129 million americans with pre-existing conditions need an explanation as to why they don't deserve the same access. and explain to american women why they want to go back to a world where they can be charged more for a same coverage as a many. and why people in blue color jobs should pay higher premiums

and explain to the millions getting coverage why they would be better off uninsured. ... they said the nation was not ready for the changes that were coming. they said the new rights and protections the laws guaranteed the laws guaranteed for a fellow

americans were not important and now we cannot imagine our country without a basic safety net for our seniors or equal rights for all of our citizens. in the years ahead all the hyperventilating about broken web sites and roman trajectories and demographic mix will quickly be forgotten. instead we will look back and wonder how we ever had a health system that spent double what every other nation spends double double -- double per-capita and allowing rampant discrimination against the people who needed the coverage the most. i hope this hearing will be the start of a productive and cooperative session of congress and i hope we can start to work together on the aca rather than spending another year in the never-ending campaign against a law that is doing enormous good for the american people. i yield back. thank you. >> the gentlelady and yields back so then i would like to introduce a witness for today's hearing. gary cohen is the director for consumer information insurance

oversight at the insurance for medicare and medicaid services. he served as general counsel for the california benefit exchange and service the director of the division of insurance oversight and the ceo for two years prior to becoming that director of the ceo. i will now swear the witness. mr. cohen you are where the committee is holding an investigative hearing and in doing so you'll testify in her oath. do you have any objection? you're entitled to be advised by counsel. do you desire to be advised by counsel? do you swear you are about to give the whole truth, and nothing but the truth? under oath and subject to the penalties under united code and we now give a five-minute summary of your written statement. >> thank you and good morning chairman murphy and ranking member to get. i appreciate the opportunity to update you on the insurance

marketplace as we talk about the millions of americans who many for the first time are able to purchase high-quality affordable health coverage. when i appeared before the subcommittee shortly before the beginning of the enrollment is that while we may encounter bumps when open enrollment began we would solve it. clearly the problems being countered in october were far worse than i or any of us had anticipated. simply put the system did not work nearly as well as it should have or that we expected it would. this wasn't a time to get discouraged and wasn't it time to give up. it was a time to roll up our sleeves and get to work and solve the problems and that is what we did. since that time we have fixed healthcare.gov piece by piece and a prioritize metrics driven manner. if you fix the software to improve its capacity speed instability. by the end of november healthcare.gov was able to support more than 800,000 consumer businesses per day with the response time of less than

one second and error rate below 1%. consumers have responded overwhelmingly to the improved site. enrollments in the federal marketplace in december alone represent a sevenfold increase over october and november combined. by the end of december nearly 2.2 million people had selected plans from the state and federal marketplace is. sometimes we lose sight when we talk about numbers that are this big but these enrollments are more than just numbers. they are individual people any of whom have not been able to obtain the needed care or the peace of mind that comes with having health coverage for years. for example nathan aldrich a cancer survivor from virginia now has a plan without having to worry about paying more because of his pre-existing condition. he had been paying for a plan a 483-dollar monthly premium and a 5000-dollar deductible. now he is a plan with a 111-dollar monthly premium in $1750 deductible. emily wright university student

in tennessee enrolled for the federal exchange and picked a top-tier plan that will cost or only $125 a month. she's been able to get an appointment with an obstetrics gynecology practice the first step before needed surgery. we hear stories like theirs every day. because of the affordable care act americans like nathan and emily can be confident that the plans offered in the marketplace are high-quality and affordable. the affordable care act standardizes essential benefits which ensures much offer including doctors visits hospitalizations prescription drugs in maternity and newborn care. marketplace plans are designed so that consumers can compare plans with similar levels of coverage and make more informed decisions. insurers are now prevented from charging higher premiums to enrollees because of the help albums and from charging women more than men making pricing more fair. at the same time premium tax credits and cautioning reductions are helping consumers pay for their health care coverage. of the nearly 2.2 million are to

play sign-up so far nearly 80% of those consumers are receiving financial assistance. insurers can no longer refuse to accept consumers because of a pre-existing condition. plans are required to enroll individuals regardless of health status age gender or other factors. finally insurance coverage is fair when the people most need it because plans can no longer impose annual or lifetime dollar limits on essential health benefits. americans no longer have to worry about the dollar amount which could force bankruptcy or cause them to have to forgo necessary care. the health insurance market in 2014 looks dramatically different than it did in the years before the affordable care act. as with any change this major there's bound to be some disruption cities the transition to the market cms is working closely with ensures consumers and other stakeholders working together to ensure consumers

have coverage and receive needed medical care. in december cms announced number of steps to help consumers including requiring insurers to accept payment through december 31 of 2013 for coverage beginning january 1 and giving additional days to sign up for marketplace coverage. insurers have also stepped up with many agreeing to voluntarily extend the deadline for consumers to pay their first month's premium grade many pharmacies announced plans to ensure a smooth transition by providing consumers with transitional supplies of prescriptions. i continue to believe what i said in september, the ultimate story of the affordable care act will not happen in the early days as the web site went live oregon the first taste of january as people use their new coverage. the last ring we will see will be people like nathan and emily able to get the health care they need and have the security of knowing they will be able to pay for it because of the changes made by the law. thank you and i welcome your questions. >> it thank the gentleman. mr. cohen you testified several

times before this committee that hhs would be ready october 1. can you tell us why you are wrong on that? >> when i testified mr. chair, we referred to april and september and each time i gave you the best information i have and give you truthful testimony based on the information i had at the time. turned out that the problems that we face when the web site went live for as i've said and as everyone knows, just dramatically different than i think what any of us expected. as to why we didn't anticipate or what was going to happen when we went live, i'm not sure i know all the answers. i think some of the people who are responsible for designing and building the web site might be able to get the better answers. i know initially we were overwhelmed by the volume of people who came and but by this time went by that was clearly

not the sole-source of the problem. there were other problems as well. >> well but you were there for the report which is being discussed on the subcommittee the disaster that they talked about to a number of people in the administration. so you have that information but you also said you were told something otherwise so who told you otherwise the things would be fine? >> may i ask -- i attended the meetings that the mckinsey folks did and there's no question they identified a number of risks that they saw in april whether we would be successful, october. at no time did the mckinsey people say to us you are not going to make it or you are not going to be successful. they identified a series of risks and some steps they recommended we take in order to mitigate those risks and in crease the likelihood that we would be successful and i think we did those things. i think a number of the concerns

that kinsey expressed for example whether the hub would be working or the larger states like new york and california would succeed did not to -- prove to be a problem. the hub has worked very well in new york and california have done very well. we took very much to heart with the mckinsey people recommended that we do and we proceeded forward and tried to do the best we could to maximize the likelihood that we would be successful. >> again we looked at the mckinsey report. it was not settled. it was strongly worded in terms that there were serious problems but in that same month when you are before us you said before us you said things are fine so who on your staff told you that things were going to be okay and who informed you specifically? >> i received regular briefings from the various parts of cms that were responsible in overseeing the web site. the person that i heard from the most was henry chow.

>> henry chow told you despite the racing from mckinsey that things would be okay? >> henry chow, we had regular reports on the status of the bill and certainly when i came here in september the testimony that i gave was based on briefings that i had for mr. chow and others as to what the capability of the site would be. [inaudible] >> i don't know whether he saw the briefing himself. >> did you discuss the context of that briefing? >> i think we talked about the issues that were raised in the briefing. >> i'm puzzled as when mr. chow was here speaking he said he didn't know anything about it. >> that is why i say i don't know that we told him or he saw the report itself but we talked about the issues. >> let me ask you it was significant enough that the secretary said that she hired mckinsey to give them a briefing and look at this analysis.

very important and significant problems were identified. these things were not small but now we are not sure whether or not the key person who is advising you on this was even told about this report to identified what to do about the major problem so there's something pretty inconsistent. >> i think that we adopted a number of the recommendations that mckinsey had for us and put into place a number of the things that mckinsey recommended that we do in order to increase the likelihood of success and that is what i mean. those things happened so mr. chow was aware. >> to go to the document can you tell me what the specific symptoms or problems are and if you don't tell the doctor they can't properly diagnose and treat so what specifically did you tell mr. chow and what specifically did he do in response to that? >> i'm not going to be able to recall or tell you exactly what we told mr. chow. but i can tell you is there were recommendations for example in

the report with respect to how we should be organized and some changes that they recommended that we make in terms of how the process was managed that we implemented as result of the report. >> thank you. you are recognized for five minutes. >> thank you very much mr. chairman. this hearing today, i just noticed this after my opening statement, is called 2014 seeking ppaca answers so i would really like to ask you mr. cohen some questions about where we go from here. as you acknowledged in your opening statement and your written statement, the problems with healthcare.gov were far greater than the ones you anticipated before october 1 and we are all now well aware of the administration's efforts to fix the problems. i wonder if you could tell me as we sit here today january 16,

what problems do you still see with the federal web site and what steps is the administration taking to remedy them? >> thank you. they continue to address specific issues with respect to the way that the site is functioning and that effort has not flagged at all. it is ongoing, so as we continue to identify any aspects in the way the system is performing -- isn't performing as properly as it should whether those be designed an architecture or whether they be software coding types of problems that we are not getting the right result we continue to address a lot of those issues. the major one that we are dealing with right now i would say in terms of the big picture has to do with the financial matters and making sure that the plans are in mitigating the process right now because we

don't have full functionality for that particular process. >> as we heard in november and december the administration was focusing first on getting people enrolled and then worrying about the backend backend so without backend, what kind of problems are we still seeing and what are you doing to try to remedy that? >> right now payments will be going out next week for the first time without advance premium tax credits to issuers but a process where they are providing us with the data from the issuers based on their records as opposed to be able to use the records that are generated by the ffm and that automated process will be going into place in the next few months. >> and are you working, his administration working with the insurers to make that happen? >> yes, absolutely. we have actually had tremendous response from the insurers and

they have told us they are very pleased with the way the process is going. it is not ideal but it will work to get them paid. >> mr. chairman of think that would be a good follow up to bring the insurers in to see how that's working. let me ask you mr. cohen we have heard about the number of people that signed up both on the exchanges and in states like mine that have stayed exchanges am also healthcare.gov. what is your opinion about the number of people who have signed up and also the age makes? >> so in terms of the number of people who have signed up obviously there's no question we got off to a slower start than we would have liked or that we owed hoped that we had tremendous response in december and we are continuing to see very good numbers as we go into january. i think in terms of the total if we are able to maintain the peace that we are at now and if we see another uptick towards the end of march as everyone expects because that's the deadline for the end of open

enrollment, we still have almost three months to go so i think we are very encouraged by the enrollment we are seeing now. there clearly is tremendous demand for this product. >> i will say though that because of the glitches with the web site in the early days the enrollmenenrollmen t had been lower than the administration expect did, correct? >> that's correct. >> what about the enrollment of younger people? >> we were encouraged by the response we have gotten from younger people. the percentage of younger people that we reported this week is actually comparable to the% of the age group in the general population so i think that's looking good. >> i'm sorry, if you could just briefly tell me what the administration is doing to bump those numbers back up the between now and the end of march both for the general population

and also for the younger enrollment? >> absolutely. i think you're going to see a step up media campaign. obviously as we as well as the health insurance companies help back in the beginning because the site wasn't working well but now that it is i think we will see a significant increase in that. it's going to be very much targeted at the younger audience so we have a magic johnson avenue is coming out now and we will be advertising during the olympics. we are trying to advertise in ways through social media as well ways targeted towards the younger group. >> thank you very much. >> we can also have ads during the super bowl because i know that will appeal to the colorado voters. >> that will be costly. now i will recognize dr. burgess for five minutes. >> thank you mr. chairman and mr. cohen. have to bring this up.

need to do it. have to have the address it. september 202013 i asked you will be enrollment be ready january 1 and you said consumers will get its determination of what tech-savvy cities are vulnerable for an book that plans available where they live. they will be able to see the premium subsidy they would have to pay and be able to choose a plan and get enrolled in coverage beginning october 1. do you recall that exchange? >> i recall it very well. >> knowing what you know now would you like to revise that answer? >> clearly it was wrong but it was also what i believed and what i understood. based on what i had been told -- i would like to answer your question if you would permit me. i knew that i was going to be asked that question when i came here on september 19 i knew is close to -- and i was careful to give a thorough briefing from the

people responsible for overseeing the web site and the answer that i gave you was exactly what they told me her functionality with the umm october 1 come exactly. >> who told you that exact the? >> mr. chow was in the briefing among others. >> you have heard me say before and i will continue saving the future. i simply don't understand why no one's been held accountable for an air that egregious. if i were you i would fire some one under me some one underneath that happened october. if i were the secretary i would have fired you and that would have happened in the tovar cover and if i were the president i would you still mortified and embarrassed by what has been the disaster of my signature piece of legislation signed into law i would fire the whole lot of you. i don't understand, why should we believe you now when nothing you said over the past year or year and a half has been accurate?

>> because the site is working. >> because it has been built on the backend and subsidies that are supposed to go through the insurance companies they tell me her coming as a result of a paper process. this thing is a disaster and the providers are going to be the ones who'd take it on the chin because we are obligated to see those patients when they show up no one can verify benefits at 3:00 in the morning. we take care of the problem after-the-fact. who pays the bill? as the secretary said she would not be responsible for paying those bills so i asked doctors and hospitals around this country that are asking you who is responsible for paying those bills? >> the insurance company that has enrolled the person is responsible for paying those bills in the payments and tax credits to those insurance companies will be flowing next week it will begin next week

rates pr would submit to you that part of the web site is a painfully slow process. i've been told numbers as low as five to 10% of those payments are going through. i would appreciate if you have additional information that you make it available to the committee and i hope we will have the opportunity to discuss it because it does concern me a lot. we are charlie at risk from your mismanagement of this problem. now, there is something that is receiving a lot of attention right now, the concept of risk adjustment. are you aware of that? >> yes. >> the risk report or program does not contain specific appropriation law so are you going to be seeking an appropriation for the risk quarter language in the law? >> i'm going to have to refer you to the office of management and budget for those issues. >> would you be willing to share with us the ongoing discussions that are happening between you and omb on that? are their there e-mails? i their memo's?

is there information could make available? >> i will certainly take that request that. >> appears up to a lot of us say you are going to be needing taxpayer dollars in order to handle this problem. can you assure the committee today but that will not be happening, that the risk adjustment will be done from within the balance is available in affordable care act and those amounts from insurance companies have not come from the taxpayer? >> i think -- i don't have an answer for you today. i understand it's an issue. we are working on it and i will certainly work with you and understand it's an important issue is that you are entitled to know about. >> you have a legal memorandum that has been prepared for you and your department will you share that with the committee? >> that is not a decision i get to make that i will certainly take the request that rate i haven't seen such memoranda myself, no. >> you have not? do you anticipate seeing one? >> i don't know the answer to that. >> is committee needs that memo

and i want you to take that request back with you. again we will have an opportunity to talk again i believe. i yield back mr. chairman. >> mr. cohen i wanted to give you a chance to answer mr. burgess' question. >> automated process is still being built but we have a process in place that is working in payments will be going out. >> you have an anticipated date? >> i don't have an answer to that as i sit here now. >> mr. chairman could we have him supplement that when he finds out when it will be built? yes, ms. castor you're recognized for five minutes. >> good morning mr. cohen. the headlong -- the headline in florida last week was florida enrollment surges under healthcare.gov during october and november due to the problems with the web site he only had 18,000 floridians sign up for coverage but in december we had 140,000

floridians sign up for coverage. florida continues to lead the nation in enrollment among the three dozen states that are using the federal marketplace. so this is good news. in fact, on monday in tampa, the mayor of tampa bob buckhorn had a great announcement and this is something that other members of congress can use and work on with their elected officials. mayor buckhorn -- mayor buckhorn announced that all the recreation centers in the city of tampa would be available to host navigators and assistance sign-up many of our neighbors for coverage. i think this is a very creative move. secretary sebelius gave him a pat on the back as well. we have got to make it easy for folks and one of the things that is i guess a good robin to have is we have such a competitive

marketplace in the tampa bay area. we have over 100 private insurance plans that people can examine and see what works best for them. but you know that could be a little daunting for folks as well if they just go on to -- i guess there are people that can go onto healthcare.gov and figured out and utilize it and determine what works best for them but there are many many old all across the country they need to sit down and work with a real person and sort through those options, understand what the tax credits due in florida. two-thirds of those that are eligible for coverage will be eligible for the tax credits. already over 80% of the people who have signed up have used those tax credits. what can we do to get more help out on the ground to help people understand the options? >> so thank you congresswoman. i think it's very important as you say to get some work from

state and local offices to get the help to direct people to assistants assistance who can help them. there is a local help section of healthcare.gov where people can say what area they are in. >> that people if they don't have a computer if they don't even know about that. how are we going to reach them? >> for the people who don't have a computer obviously the effort has to be to bring them in to a location where a navigator is working or other the sisters are available to help them through the process. i think the more system so we can get from people in the community who know these folks rather than just coming from the federal government is a big help >> our community health centers have been helpful, churches, truly communitywide effort but i appreciated that you said,

talking about the millions of folks who have signed up that these are not just numbers. these are real people and really one of the biggest obstacles right now for many of our neighbors to realize health care coverage is what republican governors and state legislators have done in blocking the medicaid expansion. for example in the state of florida we have almost 1 million floridians who are being blocked, the access to the doctor's office is being blocked just because they won't accept the $50 billion available to the state of florida over the next 10 years. that's our tax money. we want that tax money back to work or our neighbors to help our families get to the doctor's offices to create jobs and help our hospitals. mr. chairman i think we need an oversight hearing on the states that have blocked medicaid expansion and what that's going to do to the health care marketplace.

mr. cohen what is hhs' plan to continue to work with states on this issue? >> we certainly you know and courage every state to take up the medicaid expansion. it's a great deal for the state in his grave deal for the people and state. it's a great deal for providers in the state who will see a decrease in uncompensated care, aid tax that falls on all of us and we have been working as creatively as we can with different states, but different ways of doing this. some states have different approaches that they have wanted to take that we have been working with them on so we continue to work with all the states and hope that more will take on the expansion. >> thank you very much. >> the gentleman yields back. the vice chair of the full committee is recognized for five minutes. >> think you mr. chairman. mr. cohen you just said you

testified to mr. burgess that -- was based on staff reports? is that correct? >> i said it turned out to be wrong. >> let me ask you this if you are basing your testimony today on staff reports, how do we know that this is correct? ..

>> that's true. >> okay. so it is fixed. that is going to change as you come back. just let me move on. you had three promises and obamacare. it was going to save family study of hundred dollars per year, and the second to promises, one, if you like your plan you can keep it, and did you like your doctor you can keep it. let me ask you this, says the president premises every family with the premium decrease of 20400 the year under the law,

has that happened? >> i'm not sure that's what the president said. >> yes or no? >> of russia but the president said. >> yes. >> many americans are able to obtain better coverage at lower cost. >> that is not what the president said, and asked for a yes or no answer. let me move on. if you like to play a key bit. is he kept that promise? >> the law allowed companies to maintain grandfathered policies -- >> no, sir. that was not the promise. the president apologized for this and offered abortion relief >> i was about to save the all-american as were able to keep their plans because of the decisions that the industry had made. so we announced a transitional policy that enabled -- >> how long will that a transitional process last?

one-year, two years, forever? >> well we announced so far is one year. >> a lot of those people could not keep their plans. you talked about emily from tennessee. let me tell you. she had an coverage because amelie has lupus. guess what, under obamacare her plan was cancelled. amelie does not have health insurance. she's having a tough time getting it under obamacare. i am having he inasmy ..ate of the union. maybe you can help family work this out because your promise that was made by you and this administration have not been kept and did you want to give us a qualified definition of fixed, and you are still depending understaffed. you are just running in circles. and you cannot give us a definitive answers. so let me ask you this.

she had a doctor she like to. is she going to be able to keep that dr. even though she has no insurance in because of obamacare her insurance was canceled in she is trying to be treated for lupus and work 40 hours per week. >> you know, if you will get us information about, if she is interested in talking to someone from cms in helper understand what her options are. >> i appreciate that very much. >> it would be happy to do that. >> she is a classic victim of what has happened in the federal government stepped in and said, all these plans the you have that work for you, that fit for you, we're not going to let you keep them because we, the federal government think we know better. how you can handle it your lupus. that is what you have done to the american people. when you come in here, you give us misinformation and then we ask you a question you cannot be

specific. mr. cohen, i agree, you ought to be fired. >> the latest time has expired. i recognize the madam lady from vermont. >> thanks you, mr. chairman. a lot of things in the affordable care act, but many of those provisions are above consumer protections to ensure that they do have a diverse choice in health care providers. but as with many new laws, there are some wrinkles in the implementation and some disagreement between the debate about congressional intent. i want to ask you about one of those opposed to the ca. have been hearing from some providers and some of my colleagues have been hearing the same concerns about the interpretation of the provider nondiscrimination provisions in section 2706 air agencies of

regulatory guidance in their view in the view of many legislators is inconsistent with the statutes in legislative and send. the concern is this, the guidance could lead come in fact, to discrimination against some providers by health insurers which this provision was designed to prevent. are you aware of these concerns? my question is, what are your plans to address their entering short that the statute is implemented as intended. >> thank you, and, yes, i am aware of the concerns. i have had meetings with the number of providers, groups have expressed the concern that you raised. frankly, it has been awhile since we looked at that issue. so what i would ask is that we

could have folks, you know, talk to you and your staff and move forward to understanding what the concerns are in seeing whether there is something we can do to clarify the guidance. then maybe some colleagues on the other side of the aisle. make sure we stay on that intent. >> just a couple of things. one of my concerns from the very beginning is health care costs. i don't care how we pay for it, employer based in the taxpayer base commander vigil based. the cost is going up. we're just not going to have a sustainable and the affordable system. what we are learning alloys that medicare spending is growing slower than the inflation --

inflation rate. that is a welcome development. the program's been only seven tenths of a percent to five. seven more per beneficiary and in 2011. the annual increase was five and a half percent. also, just overall health care spending less than half of their growth rate a year ago. two questions. one, do you attribute any of this to the law, number two, what are the implications for the deficit over a 10-20 your time print? i think that the law does contain a number of provisions. they are attacking the question of health care cost. i think that that is an issue that we need to continue to work on, and that think that the law does give us some tools to continue to do that.

unlike ford to using our process of certifying qualified health plans going forward. we were quite liberal, i guess is the word would use, took them all the first year to get the market up and running, but going forward we can at least look at what we can do said in a carriage health insurance companies to work to keep costs down. and certainly, you know, we know that health expense is a huge part of the american economy in the federal government. so as we're able to attack that problem it will have a great, positive impact on the spending and the deficit's going forward. >> the chairman yields. >> i ask you the last time you were here why you had concerns about young people not signing up for obamacare and cause an

increase in cost to the rest of the risk pool in the following years. you responded that you research shows that most people want health care and that you are looking forward to people, including young people, enrolling in coverage. with the latest figures showing that your people are enrolling in a much lower rate than you originally anticipated, are you now or read, are you still worried the premiums will increase next year, that it is not just the natural tendency for young people, indeed for all of us got to procrastinate, that there are some other concerns such as may be these overwhelming numbers of mandates with which we knew to in years ago were driving up the cost of health care insurance on the individual states properly of 50 states including mine of georgia , these eight spending rules that were put in obamacare

rather than five to one maximum premium increase for all the people compared to youngbear is now three to one. community ratings. these things are there, and i am really concerned. do you continue to be concerned? >> we certainly want to do everything that we can to encourage all americans and in particular young americans to get health care. it is important to keep in mind the risk pool is not just the risk pool of the marketplace is that the entire market. silly you have 3 million people who have been able to get health coverage of their parents plan to those of unnecessarily in the marketplace. 3 million young americans to did not have insurance before who do end up part of the risk pool. i would point to a recent study by the kaiser family foundation which actually said that a reduction in the percentage of people coming and people come

into the risk pool really will have an impact on health care premiums. >> of course some of that is anecdotal. and this day when you're saying. let me move to my next question. i have had concerns. i have heard that navigators are actually going door to door. this came up last time. and he said that navigators would not be going door to door. they are. if you recall, during that same hearing you told us that you would be issuing instructions to navigators that they should not be going door-to-door. did you see these instructions? >> says, we have. if you are aware of instances where the fetus, grantees going door-to-door, we certainly want to hear about that. >> i think you because i am aware and would like to ask to put up a brief clip, a video right now in regard to that

since you asked me to show you some evidence. >> the affordable care act also known as obamacare. health insurance. >> and navigator hired by taxpayer dollars to help people enroll in one of the new health insurance plans. came through the nonprofit southern united neighborhood in new orleans. she canvasses neighborhoods -- >> okay. that's good. mr. cohen, what do you say to that? >> i have not seen that before. we will look into it. thank you for calling it to our attention. >> i hope the well. you know, very strong in saying that you should be fired. my dad told me one time when i was in college and my grades came in and there were not so good. i said to my dad to mind doing the best again.

he said, son, unfortunately your best it just isn't good enough. on not calling on you to be fired, but we are concerned. you have a big job, he does possibility. you know that, we know that. you know, back to the drawing board. absolutely. with that, mr. chairman, i yield back. >> checking to see who is next. >> thank you, mr. chairman. welcome back. it is good to see you again. i would like to start off by getting something clarified for the record. this relates to her question. it is my recollection that what the president said was that after the affordable care act was implemented that insurance premiums, people would save $2,400 per year opposed to what they would have been spending is, compared to what it would have been spending if it were

not for the passage of the affordable care act. is that your recollection? >> that is my understanding. >> not that people's insurance would cost to $400 less. >> that's my understanding. >> and has been alluded to earlier, health care costs are rising in a much slower rate than they have historically. while the numbers may not be precise, there is evidence to suggest the president was actually correct and insurers would have cost more. >> i think there is no question about that and it is because many americans are seeing actual reductions in what they're paying over what they were paying. >> the stock above the in roman history. first of all, it gives me an opera to the to boast about my state, kentucky, which is widely recognized as having had one of the most successful rollout of the affordable care act. karen the numbers to win in the

state of florida 778,000 visitors to connect their website. what better 23,000 plus have enrolled. 300 -- i'm sorry, 559,000 kentucky hence have been screened to it's a rather they were eligible for medicare subsidies. we are talking about already having insured about 20% or more of our entire uninsured population in just over half the -- well, this would have been exactly half the enrollment. and by the way, 40 percent of those are under 35. terms of kentucky's experience and i think there is reason to

become as he said to optimistic that going forward we will have adequate numbers of young people in the risk pools the couple of weeks ago there was a chart that broke down enrollment according to three categories the state's the 14 states and the district of columbia which expanded medicaid and said there are exchanges, using the federal exchange and then states that had not expanded medicaid. well i did not do the math, it was pretty clear that at least two-thirds, maybe even 75 percent of all of the enrollments, the 6 million are so enrollment or in those 14 states where there was inserted government support for the program. i would like you to comment on that and whether you are seeing

that the degree of enrollment seems to be correlated to the degree of support at the state and local level for the program but said the that is absolutely right and is true for many reasons. kentucky is a great example. in his to spend a stoic advocate for health care reform and for the kentucky marketplace and getting it going. i think that contributes to the success that the states that had in terms of developing their marketplace in their nineties systems. if the administration and the state is doubly behind that, it certainly helps of the of reach. it helps with sending a positive messages to people, the community as to how important this is and what a good benefit this is for people. there is no question. >> we saw video of navigators going door-to-door. there is another side to that point. i talked to some people in florida where they have actually been handing of fliers discouraging people from signing

up. have you seen much evidence that there was a concerted effort to discourage people from exploring there options under the exchange? >> efforts of that. i would not be able to say how expensive it is. obviously it is unfortunate that anyone would try to encourage people from taking advantage of an opportunity to give health care. >> last question, is there any effort in your organizations niihau to try to find out or give evidence as to whether that is happening? >> i don't know that we are investigating that. >> thank you. i yield back. >> now recognize mr. olson. >> i think the chair and welcome mr. cohen. but the really facilitated exchange. >> yes. >> impose apostates, the providers.

crise the health care plan. my own state of texas. is that required by law from the affordable care act? >> i think it is authorized by law. we set the feet. on the insurance companies based on the premium that they did in the market. >> surprised that hhs rules authorized? >> we issued a rule that created -- that implemented. >> is a three and a half%? >> yes. >> is the administration fully using that fee? >> i don't believe that the amount of that he will fully cover the costs of operating chief. i don't think it will be enough to pay all the costs of running the marketplace.

>> so resources, private-sector, to pay the shortfall. >> no. we are tapping resources from within, you know, our budget. the fee is the fee. the fee from one year. do you expect to extend one year? >> yes. >> okay. my second question is about the navigator's. the video was pretty damning. september 19th, taxes, they were having border registration cards going door-to-door. we will be issuing instructions to navigators, they should not be going door to door. my question is, this is serious, and the issue those instructions gosar no? >> yes. >> me we get a copy of those instructions? >> sure. i can tell you how we communicated, but i know that we

have regular communications with the navigator's in we put out that information to them. it was something that they were not supposed to go door-to-door gerald people. they could drop off information, but they were not supposed to go door-to-door general. >> new york and florida, new york times, they come down with these navigators. make sure fraud does not happen because it is a big one no opportunity. >> in the situation that we have learned about that involves any misconduct by navigator we have responded to. we have -- including requiring individuals that were involved to be dismissed and not to serve as navigators, including issuing corrective action plans to any navigator organization that if we feel they are not supervising their employees adequately. >> one follow-on question about the disaster of obamacare in the

problems that continue. misinformation, all over america. for example, the exchange year. the small business exchange, my wife called up last week tried to make sure that we could keep the specialist. its record 30 minutes diaz similar telephone, and she was asked to read the information, data new card, read it. they said, we have no record of that. so the old guard and worked with this agency to be confirmed that we can keep the doctor on our plan. and so my question is given this disasters rollout and the continued problems, have you ever been a part of a conversation or a debate or discussion about delaying the laws were putting a hold on it? any discussions? >> no. >> okay. i yield back the rest of my time.

thank you. >> you're recognized for five minutes. >> thank you, mr. chairman. welcome back. i am shocked to see the news report. and navigators to not go out and go door-to-door. we have not for profits that are not federally funded going in, and i am encouraging them in our district to let folks know they have this ability to do. the federal navigators that we have canal, they will come out to someone's house be it at a request for because they need someone to help the family. so i am glad you're going to investigate that happening. i want navigator's helping people do the paperwork or in this case filling out the effort. as one who supported the affordable care acted continued, if we need the law, and i would love our committee to be a will to work on it and fix some of the flaws that we have the we

have discovered, what i am pleased with the enormous increases in the last few weeks. hhs received -- release some earlier this week and we know that 2 million have signed up for the private insurance plan as of dec. 28. 4 million more were signed up through medicaid to when that lets us forget that millions of adults who are still getting insurance to their parents. to these general but estimates sound accurate? >> so, yes. i'm sure there are as accurate as we can make them. >> they are not as much as we would like, and i know the administration, but i have a memo from a democratic staff of my committee that puts these numbers in context. enrollment in the affordable care act could change as a head of the party enrollment at a similar time in 2006. republicans may call part be a success.

now they insist the affordable care act is the failure. we have a lot of work to do, but there is a doubt that a lot of people -- no doubt a lot of people of finding access to quality affordable health care. i hope my republican colleagues will sit down and work on legislation to fix of the problems we have because nothing congress ever passes is perfect. we know that, particularly with this. instead of just going run apple's maybe they should look back on what happened in 2003 when we passed the prescription drug plan that i did not vote for. i was also helping my seniors sign up for it encouraging people to do it even though i thought the law was flawed in 2003. it has -- you know, we want to make sure those folks get it. based upon that experience, implementing health reform, would you expect enrollment numbers to look like what over

the next few months? >> we are encouraged role we saw in december, the tremendous interest that there remains in the plan. clearly americans are now very much aware of health care as a result of what has happened of the last few months. and i think everyone expects that as we move toward -- we still have, you know, two and a half months left to the open a roman. everyone expects as we get toward the end of march when the real deadline, we will see another real uptick in the number of people enrolling. if that happens that they will have some very good total enrollment numbers. >> well, we know that the federal exchange, seven times the amount of people signed up. frankly, partly because of the website. a lot of us have concern because

the website was down. houston denial of november, we actually had about 800 paper applications. i no there is an issue. piper applications in spanish and english, but that is not the way we can get to the numbers we need. the website has to work. finally, can you talk about out reach plans the demonstration has a place to insure as many people as possible learn about signing up for the new health coverage during the remainder of the roman? >> i think we will be seeing significantly more paid media. there is a plan, as i mentioned, to advertise during the olympics saw particularly geared toward younger people, sporting events and instead of things. social media activities a very much picking of, and from what i am hearing we're going to be seeing a very significant investment by the private health plans in marketing and advertising as well, a number of

them held back because of the issues are leon with the website, but now that the cd-rom that is coming through, i think we will see a significant, you know, investment on average on their part as well. >> thank you, mr. chairman. >> i recognize mr. kravitz for five minutes. >> the queue, mr. chairman. thank you for being here. in your responses you indicated that many americans a better plans and a lower cost. you recall indicating that? >> yes. >> under oath. >> yes. many americans have better health coverage and what they had before and is costing them less. at the commission at least one of them a mile testimony. >> yes, you did. you mentioned a couple, one from my district. also, you would have to acknowledge under of the many americans have lesser coverage and greater cost. isn't that true? >> that is now a restaurant for.

>> sister know, i'm asking you a question under of. you know that many americans have lesser coverage of the affordable care act and the greater cost than they had before? isn't that true? >> i don't know that. >> you don't know that? i received an e-mail from a constituent of mine when know very well. his premiums in marcher going to triple command is deductible is doubling. that is lesser coverage at a greater cost. there is one. i will tell you that i have received numerous communications from members of my district, people live in my district along those lines. yes, there are some winners, but there are also many losers, and the shocks me that you cannot acknowledge that here today when you are testifying under oath in front of this committee. there are losers under obamacare , aren't there? >> can i answer? >> it is yes or no.

you know that there are losers under obamacare. >> if not allowed to answer. >> the answer is either yes you know there are or no you don't. it yes or no, sir. >> will the gentleman yield. >> i will not yield. >> i think you need to define loser. losers led him to pay more for coverage. i just gave him an example that he bought a knowledge that he knows of anyone in the united states in that circumstance. >> i'm sure there is someone in the united states in that circumstance. >> if have you read the reports of other people who have had successes are wears under this coming year have also read reports in the media of people who are losers, have you not? >> the problem that i have is that i don't know what all of the options that might be available for that person. it is difficult for me to answer without knowing the full situation know what might be available to that person. anniston that there are people who have coverage and received a notification from their

insurance company that there were being put to a different plan. absolutely that has happened. >> you have reason to believe those people up paying more. >> i don't know the details of what the plan is that they were en, the details of the plan is that they were being offered, and i don't know the details of what other plans might be available to them that might enable them to avoid a situation. i think it is a little bit more complex than you are presenting it to be. that is all. >> i would submit that it is more complex and all of these situations because we have 2,000 some page bill that is hard for people to get there arms around this talk about the sharp exchanges. >> the online capability is delayed for one year. yes. >> many of the other delays for a few weeks and months.

why was this program delayed for one year? >> given everything that we needed to do to get the system working well for people on the individual market we made a decision that in terms of allocation of resources we could not get the shop online functionality built in time for this year. so we are relying on the traditional agents and brokers who historically have always been the way -- >> a complicated situation that you had your hard time getting your arms around and maybe if he sat down and learn all the aspects of the you can advise. >> we had to make a choice. >> i was being sarcastic. i apologize. the delay was announced the day before thanksgiving. >> i believe. >> do you know if there were conversations before mr. how

long in advance the decision was made? >> i'm sure that there were conversations. i would not be able to tell you exactly when, but i know that into november there were conversations. decision was made and then it was announced. >> there is a great concern for a lot of us that a lot of these announcements come. even made comments of the hearings. first to you agree that is not an appropriate to run the operation known as pay attention. accurate information so that people can understand what is happening. >> i now recognize mr. tantillo for five minutes. >> thank you, mr. chair. thank you, director : for your testimony once again before this subcommittee. i believe that we should have civil discourse with you.

will try to conduct myself accordingly. before i get to my questions are just wanted to share with the committee in obamacare success story i recently received. brian from the city of schenectady road to me that he had been paying a must be entered $60 per month for a plan with the dental or vision coverage. new york state on-line exchange able to get a better -- medical plan and purchased until coverage for $290 per month as he described to me, more coverage for less money. able to complete the process in less than two hours. because he makes only $11 per hour the difference in premiums is having a huge impact on his budget. he is not alone. as of january 1 with an 2,415,202 new yorkers were heralding quality low-cost health insurance coverage to my house exchange. more than 6500 dagen notes in my district now have health insurance to their parents' plan

in more than 12,001 of the seniors the district receive prescription drug discounts worth $60 million. 124,000 seniors and now losel for medicare preventative services without paying any copays chemical insurance, or deductibles. i could go on and on, but the affordable care act is here to stay. it never ceases to amaze me how hard our republican colleagues work to avoid a knowledge in the benefits. i've never heard them admit that this law help the millions of americans of pre-existing conditions within the longer be this tremendous against. can you summarize for russell of the important new protections that are now in place under the affordable carry? >> certainly thank you. the issue of pre-existing conditions is a huge one. previously people could be denied insurance altogether, not

even because at the time that there are playing with that they had some commission in the past notwithstanding whenever that could be, they could be charged significantly more as a result of that. women were being charge substantially more than men. being a woman was deemed to be a pre-existing condition. all of that is gone. the last one is very important. in the past people could find that if they did become seriously ill the insurance would run out because they had either an annual limit of how much it would pay or a lifetime limit treatment that was necessary. all of a sudden the insurance company stopped paying and that they were responsible for the costs on the road. that cannot happen anymore.

>> thank you. drive home how important these new provisions are. and as some stories have recently been posted. twenty-nine and denied coverage last year because of a pre-existing condition. forced to enroll in the short term catastrophic plan the constant to under $80 per month and that determination date. because of the hca he now has better coverage with lower out-of-pocket costs and will not be kicked off this coverage. war stories each and every day. cover for the first time in his leg because of the hca. never know what could happen. have you heard other stories accused iraq. >> we are seeing them through

social media to lessen the misters stories on health care. there's a place where you can provide your story. i must say they're extremely heartening. >> and, you know, what did they say to you about the importance of the affordable character back >> the affordable characters literally life-saving for many, many, many americans to without it would not have the ability to get the health care that they need, and it's going to be a financial lifesaver for many americans who otherwise would have faced bankruptcy as a result of medical costs which was the leading cause of bankruptcy in the country parts of the hca and woman see that changed dramatically. >> i just wish our colleagues would admit free to this law is helping millions of people and we could move forward and have a national co rescission.

>> the gentleman yields back. >> thank you, mr. chairman. one person that does not think this is the less savory never is brenda from my district. brandes been fighting a very rare for a cancer the last seven years she is in the high-risk group. when she found insurance she found out she could no longer go to lower raw carcass sought to seek treatment from the specialized doctor that is literally capture a lot less seven years. they gave for three months to live when first diagnosed. she got active comment she's mid to late 50's. back then she was the early 50's, 50 years old. she decided it was not time to die.

down in little rock, arkansas. she called me from her keynote chair, texas mecham e-mail me telling me that she lost her insurance. when she fell new insurance because of the high risk pools, she found new insurance commissioner was told that she could no longer seek treatment down in little rock, ark., from this doctor who is one of the few in the country that does it. and that you say. there are good cases. there are people that are picking up insurance. there are also people that this could very easily cost them their life. i am concerned for people like brenda. >> we certainly would like to keep -- hear from you about the situation. >> and i appreciate that. >> very happy to do that. >> i gave a speech on the

subject a month or so ago whenever she first e-mail me. she was literally in the kaynine chair taking the treatment. she said all the nurses set up and cheered. there are serious, serious concerns for people sticking with the high risk pools. i know that this new national high risk pool as opposed to the state ones that ran and at the end of december have been extended until the end of that. >> the end of march. >> the end of march. how are those being paid for? where are you getting the money to pay for those? we cannot give any answers, at least my staff cannot. >> that -- $5 billion appropriation. that is the entire amount of money, the appropriation that is paid for the program.

we head -- >> i hate to interrupt you. it is not my style. the $5 billion, wasn't that for a set amount of time? we keep getting these extensions that don't seem to be paid for. >> instead she says that we can use that money to easily transition into the new market. what we found was we had enough funding based on the number of enrollees we and the costs that we were occurring to allow the benefits to continue through march. at the end of march, by the end of march everyone in that program needs to get to you know, private coverage. >> are there will be able to see coverage that's the rub. the ranking member said earlier

and my friend from floridian made reference to the fact that there are all these people that have -- all these people that have enrolled in the affordable care act but did not have coverage of four. how can we drill down and figure out what that number is? just because 146,000 signed up in december, how do we know that those people did not have insurance and how do we know they are not like brenda, for stuffer plan and complete can find another plan. is there a way to ascertain if these kutcher numbers to really people covered for the first time ever and now have health insurance but never had before? >> it's a really good question, and we are working on being able to provide data as to the number who were previously uninsured verses the number may have been injured before and the switching to new coverage. rio vista and that is an important issue.

>> if you can work on that. you know, one side tells one side of the story. one side tells the other. usually the truth lies in the middle. when i hear how many people never had covered before lost it thank you for your time. >> thank you. >> the gentleman yields back. >> thank you. they've you for your testimony today. i promise that you will be regarded as one of many people in this administration and across this country who were on the right side and helped millions of americans get insurance. you're doing the right thing and i wanted thank you for what she do is. mr. chairman, this is getting ridiculous. my friends just won't let go. made reference to it a few minutes ago. let me try to put this in somewhat of a context. yesterday new york times wrote

but carolina senator kay hagen more than 3500-that's about the affordable care act since june june 1st. that amount, negative ads, more than three times as much as any other member of congress. $5 million have already been spent on negative ads related to obamacare in my state of north carolina sen. the fact is, mr. chairman, the affordable care act is the law of the land. it is working in my state. the brand in my district is named carl stevens jr. i drove up to an exxon station a few days ago in tell me how excited he was that he had signed up with the affordable character with told me that he was paying $700 a month for he and his wife, the premium was going up to $800. he enrolled in the affordable care act and is now paying $240

per month. the fact is commander reason mr. cohen had difficulty in trying to describe winners and losers is that each case is unique. you have to compare the coverage , the cost, the circumstance. and so the brand in my district is carlton stevenson mantillas getting insurance for to under $40 per month. of all states participating in the federal exchange for my state had more than 107,000 enrollees from october to december which constitutes the most enrollees in the federal marketplace per capita. 89 percent of those enrollees are lower federal income and qualify for a tax credit for their plan. but carol indians are having tremendous success with the federal marketplace. in fact, north carolina leads of the states in health and human services region four with more

than 61 percent of individuals a completed application selecting a marketplace plan. nationwide that trend is very similar. by the end of december nearly 2 million had enrolled in several hundred thousand more have enrolled since then. tuesday's washington post cover story stated that dated shows a sevenfold upswing in enrollment in the federal exchanges from the first two months of the web site's performance improved. in so, i want to ask you, can you describe for me the trend and the number of adults 18-34 who have selected these marketplace plans? >> i think we reported an 18- 18-345, 24% of the enrollments and that that was very close to the percentage of that age group in the general population. so we were quite pleased by that