>> and later a look at afghanistan's economic future. just a few minutes ahead of retireme retirement, congressman john dingell spoke at the national press club on friday. he is one of two world war

veterans serving in the house of representatives. this is an hour. >> good afternoon. and welcome. my name is byron and i am an adj adjunct professor and the 170ing president of the national press club. he are commit today our professions future through programming with events such as this while fostering a free press world wide. for more information about the pres club visit our website at press.org. i would like to welcome our speaker and those attending the event. guest of our speaker are at the head table and working journalist who are club members. if you hear applause, generals

of the member public are attending so it isn't lack of journalistic activity. i would like to welcome c-span and others. you can follow us on twitter. we will have a question and answer period after the guest concludes and i will ask as many questions as time permits. i would like each of the guest to stand as your name is announced. erin kessler, marisa shultz, christina marcos, pope barrel former head of the house of legislative consult and guest of the speaker. kevin mareda, managing editor of the "washington post." richard francis and skipping

over the speaker jerry, the washington chairman of the buffalo news. angela kings. a bloomberg news whitehouse correspondant and a 2013 president and the member who organized this. consula washington who handled fcc and financial matter. david shepherd. laura wittin and lauren, heard on the hill columnist.

[ applause ] >> when our guest today took his seat representing michigan in the u.s. house it was the same year the first mcdonald open and coca-cola was sold in cans, gas was 23 cents a gallon and you could buy a car for $1900. john dingell took office in 1955 and served alongside 11 presidents and is not only the longest serving member of the house, he is the longest serving member ever. he announced he is going to retire at the end of his 29th full-term. dingell at 29 succeeded his father in the congressional district. his district is the heart of the big three auto countries. he is hoping that the dingell

dynasty continues with his wife debby being elected in november to succeed him. dingell spent a decade and a half with the house chairman committee and was there until 2008. he is known for his quick temper and questions that people magazine called intimidating. the committee has wide ranging jurisdiction he has has authored laws on clean air, endangered species and health care acts. inspite of that, dingell has a reputation as an ally of the auto industry.

he watched congress since he was a child. at his father's knee and serving as a house page in the 1940's. we invited him to give a farewell speech but mr. dingell said he is not done working or governing yet. so he is here to talk about to about when congress worked. please give a warm national press club welcome to congressman john dingell for his 7th appearance at a luncheon since march 7th, 1975. [ applause ]

>> well, thank you for your gracious welcome and thank you all of my dear friends for kindness and such a gracious and gentlemen welcome. [ applause ] stand up, jim, we are proud of you. [ applause ] it has been a particular honor and privilege to serve with you. he has been a role model for any

and all. i also want to welcome and to recognize so many of my dear friends and former members of my staff who are here today. and i ask that all of you whoever worked on behalf of the people of southeast michigan or with me on the energy and commerce committee will you please stand and be recognized. [ applause ] >> there is a strange thing about my association with my staff. i picked the most extraordinary able and the finest and loyal people who ever drew a breath.

i am proud of you and grateful you would be here today and grateful you would be my friends. it is true i have served in the house for nearly 60 years and i have seen many things good, bad and much change. and i have had the privilege of watching washington change from a little town in the woods to an institution rather to a major city of international proportions and i have had the privilege of serving with, not under or for, 11 presidents from eisenhower to obama and where would observe that sam rayburn used to get much touched off when people would have how many presidents he had served under. and i have had the privilege of

casting 25,000 votes. i have served alongside more than 2400 colleagues and i have sat in the chamber of the house of representatives to witness 51 state of the union speeches from all of the 11 presidents when whom i have served. in my office i have been able to author -- service -- and pass landmark legislation that helped protect the environment, ensure civil rights for all and help our middle class to grow and prosper. and i am proud of what i have been able to do. i was thinking as i made my mind up when i was going to run as to rather i should stay and serve and when the lovely debra and i talked about these we looked and saw we completed the things my dad set out to do when he was

here and been able to move forward to complete all of the goals which i had when i started out here. i want to make it clear this is not to brag about my accomplishments. it is simply to show there was a time when congress could and did work. and when congress passed major legislation and earned bipartisan support to move the nation forward. business was done with hard fighting but also with good will and mutual respect. i want to make it clear i didn't do these things my byself. no man or woman could. we did them with colleagues who were more interested in seeing the nation grow than falter. people who are willing and able to put partisan labels on the

shelf and instead work for greater and common good were the hallmarks of those congress. in these days, i remind colleagues of the very definition of the word congress. it means coming together. it means a body which has come to together. and it is a part of the historic understandings this country had when he had a congress which worked. sadly, however, it hasn't been doing much together lately and i imagine that you have observed this also. this is not a congress that is working but it could be and frankly it should be.

last year we saw 57 bills signed into law by the president. that is 57 total. we created as many laws as there are varieties of a famous product. perhaps that is the way we should name that congress. but don't get me wrong. getting things done does take time. i remember years ago, i brought up a set of bipartisan clean air amendments that passed the house with a vote of 401-21. 13 hours of work was what it took the house to complete the effort. folks came up afterwards and said dingell, how in the name of common since did you manage to

pass that bill in 13 hours? i looked at them and said it took me 13 hours to get a bill that both sides agreed to on the floor but it took me 13 years to do the work that made that possible. that tells you how hard legislation is to do. and my former staff here most of you news men and women and my good friend jim moran can testify to the difficulty of the process of compromise of getting legislation with good will. one of it interesting things about the congress is the change. it has become in too many instances a money chase. it has become in too many instances an instance where it is the goal of members to have

the name of a committee on their letterhead which draws and attracts attention and support politically. it is unfortunate this is so because the congress is an important national trust. it is something where we have a duty to the people to do what is necessary in the broad public interest and regrettable it is the case we don't see that occurring on many instances in the congress. the committees are too large and should be shrunk. the subcommittees are too large. i served on one committee where i found that the number of members in the subcommittees exceeded the number of members

on the full committee when i went on there. and it could go on and on as to how it has gotten so big as to be uncapable of carrying out responsibilities. other forces are making things go badly. the supreme court decision in the citizen's united case has allowed unlimited anonymous or dark money to flow into the our political system. we have a court that is taken the most literal approach to so many of these important decisions that the consequences are beginning to have a very serious effect on not only democracy but the trust of people in their government. and i regret to note that there are still more god awful cases

rattling around over there at the supreme court that are almost certain to do more harm. any layman reading the citizen's united decision will assume this was in no way written by a group of intelligent individuals. [laughter] >> or people even remotely aware of what is going on in the current political structure. the decision flies in the face of so much of what our representative government was founded upon. allowing people and corporate interest groups and others to spin an unlimited amount of unidentified money has enabled certain individuals to swing any

and all elections whether they are congressional, federal, local, state or whether they are votes about the creation of some kind of local entity or resolution of local question. and that is why we have seen the rise of the super pacs and people are now dipping their hot hands into every kind of election and state ballot initiatives and anything under the sun that will help them to get what it is they want. unfortunately, and rarely are these peopleaving goals which are in line with those of the

general public. history shows that there is a very selfish game that is going on and that our government has largely been put up for sale. we also had many in congress that wish to do nothing more than shrink the size and scope of the federal government. and this without taking into account the families, the veterans, and active duty military and the countless others who rely on this government and on our nation and these people forget that they are even more than 300 million americans and that those 300 million americans and more are living in one of the most dangerous times in american history. many of my republican colleagues now find they must sign a grover

pledge when they run for congress saying they will carry out the goal to shrink government down to the size where it can be drowned in the bathtub. these are his words, not my words. so with this pledge and similar litmus test, these quandaries are only made worse by redistricting where a similar event has occurred before to enable legislators to be owned by these same special interests. we see state legislators draw and state legislators draw our congressional lines with little interest in fair representation, with small concern about protecting regional boundaries, or about any blink of

consideration for any part of the voting rights act which is again under attack. this is for achieving one particular set of views. michigan creates more and more safe seats, we see members focused only on winning primaries. not about the public interest and not about the real discussions of the concerns that members have or that citizens have. the pledges are signed. and they attempt to become the ideological image of what their

primary electric sees what their primary product is or should be with a work prodoth that equals their goals and facilitates t r their wishes. there is no incentive to stick your note out and be compromised. it should be noted that boat sides run on the narrow partisan privileges. a simple analysis will tell us that this does not help our democracy. i have said before that i would be scared to bring up the ten commandments for a vote in the congress because i am not sure they would pass. and i am almost certain they would have a vast number of amendments laid upon them. unfortunately, i still compelled

to stand on that. we have a congress that has decided to begun running policy and legislative qualities from the speakerser -- speaker's office. the congress was built by seeing goals and seeing to it that every member and everybody in the chamber and everybody outside represented by people in the chamber would have a right to be heard and the right to be able to see to it that the congress functioned in a way that heard and attended to the fears and hopes and dreams and the concerns of every american. and so beginning back with

gingrich and the delay -- that is a funny word. we came out with the idea that we would facilitate it by allowing one man or one entity to run the congress of the united states. and so now we have seen a clear effort by both republicans and by their democratic successors and now the republicans again to ultimately resurp the committee process. when i started, there were only a handful of members on each committee. and 3-9 members on each subcommittee. 3-9! the interesting thing was some of the most complex and difficult questions would be

dealt with in the committee where members would come together, they would first hear the testimony, run everybody out of the room, remove their coats, and one of my colleagues used to say fight like hell for however long it took. the result was that we had committees that knew and understood legislation and they could explain it and defend it and they had the trust of their colleagues. today their committees with nearly hundred members on them. if each member gets five minutes, multiply that out and see how much opportunity there is for real decisions of the important issues of the day. anytime there is an important meeting each member then gets

only minutes and maybe seconds to address their interest or ask their questions. i repeat, what do you think the chances for for intelligent debate of important national concerns. we see new members who come in and they head right to the floor to make some of those great big wonderful speeches before they even know where the restrooms are. [laughter] >> they land in washington on a monday or maybe a tuesday and their first question is what time is the first plane on which they can return home? again, how is this going to facilitate a significant

national debate or intelligent discussion of the legislative business? we hear from the members i am against this and i am against that. do we ever hear much about what they are for? more importantly the question is what are they willing to make a compromise on? comprimise is an honorable word and i am going to try to continue pushing that view during my remaining time in the congress. and so we ought to ask these new members what are you for? what are you going to compromise on? and what are you going achieve? to see if we can come up with a resolution to the difficult

controversy and difficulty questions of the day. i am sad to leave the congress. i love the congress. and i am delighted the lovely debra my wife is running for the congress because i think she is smarter, decent and much prettier than i am. i will observe that my sadness is relieved by the poisonous atmosphere we see in the politics today. so while i am troubled, in refocusing efforts on the important matters at hand, i am comforted to know they can only improve. so when the dictionary defined the word congress as the word coming together it also defines the very way we can emerge from this current mess. first, and foremost, it will take a congress willing to put aside petty differences and live

up to the definition. compromise isn't a dirty word and it isn't evil. cooperation isn't a bad act. the sooner congress realizes this and american citizens realize this and they began impressing this view on their candidates the better the situation is going to get. so, then the congress can begin to focus its work more on the public interest but it also is going to take an american people who are willing to and interested in seeing to it that the congress works. it also is going to begin to require a control on expenditures of money.

first race i ran, i spent $19,000 and i thought good god what an awful number. i later had the fight of what up to that time was my life. $35,000. more recently i had a serious fight with an incumbant colleague and i had to spend $3 million. he spent $6 million. there are needed changes where people understand that their congress is not something that should be traded or should not be traded on the commodity exchanges. the congress is something that belongs to us all and it is something that is achieved only at great blood shed, loss of life, great suffering, huge hard work, and the wisdom of men and

women far smarter than any that we see running around now. and interestingly enough those men and women were not people who had preeducation but they were people that understood by hard study of the wisdoms of persons earlier in the history of this world. so what we need to do is to have the american people dictate that which must be done. i am proud that i have been able to be a part of the body and truly a child of the institution. i intend to keep this nation and all of my colleagues in my thoughts and prayers. and i have to say more often in my prayers than in my thoughts.

in any event, thank you for what you do. thank you for the great power which you wield with your pen and your typewriter and your ability to communicate thoughts including the wonderful computers. and thank you for your leadership in what you are doing because we desperately need good thinking people. and people who are determined to see to it that this oldest institution of its kind in the world continues to be the greatest gift of all. you know, when i go to bed at night, and when i get up in the morning, i thank the good lord for the gift which he has given to me. making me a citizen of the

united states some 87 or shortly 88 years. and the opportunity to be an american having more real good things and more money but more freedom, independence and opportunity than any person in the world before. so thank you. and god bless us all. more importantly, god bless the united states of america. thank you. [ applause ]

>> thank you, again, congressman dingell for being with us today and for delivering your speech and for following tradition of a question and answer session. the first question is what has changed in congress the most since you first visit capital hill while your father was a member of the house from 1933-1955? >> well, obviously the quote reforms which opened the place up. and in point of fact which have denied us the ability to really talk about the concerns which we have. second of all, the size of the committee. third of all, the unworkability. forth of all, the lack of capacity of the members to carry

out their functions because of the size of the committees and size of the subcommittees and the harsh fath that no body trust the committee. we used to have an entity that was called the tuesday-thursday club. and this was the crowd which showed up on tuesday and got the hell out of washington on thursday. that is not the way the government should run. government should be a full-time business where we seek to serve the nation and see to it its business is well-conducted. this is not washington and the congress is not a place where everybody comes to have a good time. this is a place where the most important of the nation's business is supposed to be addressed. there are other things that i

can mention to you which i am sure you all would recognize and which any or all of you could for forward with your own wise and necessary additions to my comments. >> do you ever see congress returning to the more bipartisan ways of days gone by? what would make that happen? >> well, two things: one, some kind of a national event which forced the members and leadership to do that. roosevelt, war -- something like that. but beyond that, there are other things that could do that. one would be some kind of national calmity or something

else that would be almost unique and that would be wiping out of almost the entire membership by seeing to it that the voters through us all the hell out of washington and installed their own people in our place. there are other things but that would be a fair summary of some of the things that might be helpful. >> do democrats deserve any of it blame for the bipartisan divide in congress? >> of course. everybody deserves it. democrats and republicans deserve it. but if you look around, you will find that the news media, the public at large, the citizenry in general all have their faults in this and their reason for feeling guilty about this.

look and see what the listener ship of the president's state of the union message is on tv and you will observe one thing. that it is usually timed to fall after and instead of super bowl or something of that kind. i am not going to tell you the super bowl is not important and not good to watch or listen to or not exciting but i am going to tell you that from the standpoint of the nation's well-being it is not important. and so what we have to do is to get the american people to say, you know, we want you to do something and when you have a town meeting and have them get up and they say what are you

going to do about compromising this into where the citizenry accepts it. one strength i had as committee chairman was i would see to it that i got the left and right to compromise together on legislation. the end result was we passed enormiously huge legislation after huge fights but we passed it -- enormously -- that is still doable but it requires leadership and it requires people be elected to lead in the congress. >> you had les than kind things to say about the supreme court. >> i thought they were quite kind as a matter of fact.

[laughter] >> i thought they were deserved, right and truthfully if they have listened perhaps maybe would have been helpful. >> and following on, what do you think motivated their citizen united decision? >> money. and the fact that almost the entire court was selected on the bases of idealogy and not training. i should not say anything more probably. so far i have been overly kind. the supreme court is probably staying in that mode today. >> what has been the lowest point in your congressional career?

>> oh, boy. um, i saw my world come down around my ears when i had to get a divorce, get the custody of the kids, and raise four kids alone. and thank god i was able to do it with the help of a sister who is going to find the lord waiting for her waiting in heaven. and i was able to do that in a way which made by kids solid, successful citizens. it was tough. and at that time, we were having a huge battle over energy and energy prices, something we regularly do on the hill. but something which were the

administration was putting out a publication entitled quote shove to it dingell. and so i was in the midst of this dog fight about whether they were going to shove it to dingell or i was going to surprise and by a narrow margin i did. some of the people in this room were there to help me through those difficult days. >> carrying on, what has been the biggest highlight of your time in congress? >> you know, i would answer this way. every day is a blessing. and when i get up in the morning, i always look down and

see there is a little grown underfoot and i say thank you lord. but, more importantly the highlights, the single one i am was obamacare or the wonderful bill that we got through that took care of health care for all of our people. that was something my dad wants and something we did and a lot of others we did, too, that were important. and a legislative standpoint that i think was probably the one thing that was most important. >> why does congress need members like you who stay for many years as part of the institution? >> you learn the business. a lot of people think you walk through the door and you are an expert. you are not. there were a lot of people that

never learned where the hell their office was or anything. and you had a lot of people who frankly never learned how to get along or don't know the names of their colleagues or are not able to compromise because congress is essentially and necessarily compromise. it is getting along with your colleagues and knowing what it is they need and what they want and what they have to have. years ago, i got a little guy by the name of gross from iowa and everybody said that is awful, dingell. and i had no, gross is a good and decent man and if i could get a reasonable relationship with him, and reasonable

friendship, we will run the committee and we will run it well. and we ran a subcommittee but we wrote more conservation legislation there than we ever did sense. it was a tremendous period. i got another guy, and god rest his soul he is gone but i think warmly of him. bud brown of ohio was another one. a lot of people said bud had a terrible acid sense of humor and he did. but he was a wonderful guy and if you got underneath that you would find a wonderful fellow. and brown reported to me, dingell, my wife is filing for divorce, and she is going to name you as a correspondant.

we are spending more time together, you and i, than we he was with his wife. i would have a few crack pots and we had to get along with them and get things done and we contrived to do it. and we did it because we had trust. and we had friendship. and i solved a bunch of rail strikes because i had trust in friendship and got the secretary and transportation and said you don't know and i don't know you but i said we have to work together and our words have to be good and we have to trust each other. and we did.

one of these strikes we solved in 48 hours and the other in 18 hours. probably the worst mistake i made as a chairman because damned if they didn't take jurisdiction of railroads against the commerce committee because no one knew we did anything. but to know how important the human relationship is between members in the congress. if you have that, you have almost everything. if you don't, you have got nothing. >> one of the criticism of politics in the united states is it is corrupted by money. you have emassed a network of

2.8 and 7.6 million dollars making you the 71st richest member in the chamber. how do you account for that wealth and did a lifetime in washington help you get rich? >> first of all, i am not rich. second of all, i live very frugally. third of all, i am very careful about how i spend money, as is debra. we have lived in the same house in virginia for better than 30 years almost 40 years. we have made money trading houses and the average american

if he uses good sense can do something like that, too. >> how have relations between the press, and the members of congress changed over the past 58 years? >> they are about the same. [laughter] >> it is kind of interesting now. it used to be a guy on the committee, i could always tell when the media was going to be there because he would show up. and that was always a tip that things were pretty important that day. the business of the house has been a little bit corrupted, not a lot, but a little, because it

is interesting to note -- it is interesting to note that that money, or rather that relationship with the media, is one which generally scares the members of the house. it also is a situation where if you watch the members and do this on c-span or something like that. watch the members. he is not talking to his colleagues. he has his eye on that television up there. and if you look you will find that instead of an intelligent debate, all of a sudden, you have a guy who is making a big

speech to the television which is quite different than it would be were he to make his speech to somebody with whom he was having a real discussion with of important issues. just to return to one point, i have done pretty well because i learned something, and that is how one can take and use the compound interest rule to benefit himself. and one of the reasons you know that is that i have to report it. so you can be pretty sure that it is fairly truthful and it

does very frankly keep me and the system sort of massed. >> now on to questions about the issues. at the start of every congress you always announced a bill establishing a national health care system. we don't have that. but we have obamacare. how is obamacare working in your estimation? that is a little bit like asking how is this child going to do in his presidential race as that child, boy or girl, does in his or her race for the presidency. i happen to think very well. this is the biggest single

undertaking of this kind ever done boy this nation. social security was something like maybe $50 million. this is more like $350 million. and it is not done by people who are working with their government. it is done by people who are working with insurance companies. so all of these things have got to be done by everybody pitching in and cooperating. we didn't get a nickels worth of help from the republicans. they sulked. and so their complaint is they were not heard. but we would invite them but

they would not come. so i don't have any questions about the fact it is doing about as well, given the circumstances, as it could. but going further than that, if you look, almost every american is covered. second of all, the long standing complaints of the american citizens about how they were treated have been largely addressed. citizens are able, now, to know that they are not going to cancel their policy when they go into the operating room on the gurney. they are going to know that all is not going to be any pre-existing conditions. the numbers of recipients and benefits is almost a 100%. someone is paying $360 something

in the office in insurance and guess what? he went out in the market and they said you can not have this. it isn't going to do the good for you that he wants. we will give you the same policy for $160. >> he said wow. so then, he went into the market and they looked at him and they said this is costing you too much for your wage and we are going to credit you. he winds up paying $68 a month. same policy. haven't heard a squawk from him. but you hear it from the republicans yelling it ain't working. and insurance companies, if they are not satisfied they are all of a sudden finding that they have to pay if they exceed the

cap of 80-85 percent depending on the size of the facility. you always hear the republicans complaining about that. i guess they are busy with other more important things. >> well, speaking of republicans, republicans point to the irs scandal, the va scandal and iraq and say president obama is not competent but how do you think he compares with other presidents? >> he didn't get us into the iraq war and he wasn't involved in watergate and he has run a pretty honest administration. so let's take first the va. one of the reasons the va is a

problem is that he has got to take care of 100 million vets and he has to see to it that he not only takes care of them but that he sees to it that they get care they are supposed to. and that is against the skin fled congress that had a cut of $10 million or 10% that the republicans were prepared to give. so i don't have any real problems with that. a lot of these people are getting -- in the va, a lot of the people are getting their benefits and a fair number of these guys are waiting because they are not qualified to go in. these are non-service

connecting. the service connected are for the most part not involved. >> watt what was the other one? >> i think we covered everything. >> i don't want to run out of here but i want to address what these no-good republicans say because every once in a while they say the truth and i would like to praise you if you can find me an instance. >> the question was the republicans point to the irs scandal and the va and iraq. >> oh, the isrs. we are giving amounts of money under citizen united to fat cats trying to buy the government and the irs is looking at them. i say hurray.

the guys doing this are crowd that very frankly would steal a red hot stove and then go back and get the smoke. >> we are almost out of town time i would like to remind you about the upcoming speakers. on july 17th, anthony fox, se secretary of the deparliament of transportation. and july 27th the director of the centers for disease control. july 21, the president of nid r nidper -- nigeria and then the president of congo will be here.

next i would like to present congressman dingell with the traditional press club mug, i don't know if you have a set of half a dozen, but here is another one we are honored to give to you. and our traditional last question. given your reputation as the toughest questioner in congress, what advice do you have to reporters asking? >> know the answer before you ask the question. [ applause ] >> thank you congressman dingell, thank you for coming and the national press club staff including the broadcast center for organizing the event. we are ajourned.

>> hope i didn't disappoint you. >> on the next washington journal, a look at the major cases before the supreme court this term. and brian brown, president of the national organization for marriage and the human rights campaign will debate the rules on marriage. and we will talk about the auto industry record-number of recalls this year. washington journals begin lives at 7 a.m. eastern on c-span. on this weekend's news makers south dakota john thune is our guest. he talks about the 2014 mid-term

elections, the country's transportation needs and the ongoing irs investigation. here is a portion. >> we are all very concerned when we hear the irs in addition to targeting conservative political groups maybe targeting conservative senators who have been critics of the irs. senator grassley's integrity is impeccable so the suggestions of auditing or examining him is another example of an agency with a bunch of people that have an agenda that has run amuck. is there a discussion on it? yes, based on the revelations that came out and it has generated a good amount of discussion. with respect to the finance committee, we were trying to get

this concluded and this investigation that bipartisan investigation by the finance committee but we cannot get answers from the irs. like everything else. they are evasive and misleading and not providing answers in a timely way. there is no accountability there. ...

you can see more of that interview sunday at 10:00 a.m. and 6:00 p.m. eastern on c-span. >> author on the rise of political power and their 2-decade battle over their father's empire. >> this lawsuit that played out between the brothers. this culminates in a boardroom showdown. bill frederick and a couple company shareholders worry essentially trying to expand the size of the board. as the chairman, and it would have taken a greater role in the direction of the company. the end result, he is out of the

company by his brothers a few years later. they're is a really dramatic moment in the book where, you know, the board has to sit down and decide those days. >> daniel showmen sunday night at 8:00 eastern on c-span q&a. >> next, a discussion on health insurance rates following the health care laws implementation and what can be expected in 2015. among the speakers is an adviser to the massachusetts and federal health care plans. this was hosted by the alliance for health reform. it is an hour-and-a-half. >> those of you are still looking for seats, look for a staff member to help guide you toward the ones that are still open. good afternoon. my name is ed howard with the alliance for health reform.

let me get away from the microphone. and i want to welcome you on behalf of senator blonde, rockefeller, our board of directors to this program on health insurance rates, including the market forces and regulatory structures that affect them. every few days it seems we read about insurance rates for 2015 being proposed in one state or another. even though it seems that we just got through the open enrollment a few weeks ago, insurers are already piling their proposed rates fell mostly with the state insurance departments for the coming year. we will try to do today with the help of a group of panelists with deep experience and big analytical file a proxy fight firepower is to help explain what those numbers mean, what factors affect them and what importance we should place on

them. one fact that i would like you to keep in mind what you're listening is that most of the right numbers you will be hearing. and in the year 2012 to about 19 million people were covered in that market out of the 267 non elderly americans who had coverage from all sources. as interesting and useful as this discussion will be, remember that that applies to about 7 percent of americans with coverage. we are pleased to have as a part of the commonwealth fund, a century old flat to be fund established to promote the common weal, commonwealth, common good. we are doubly pleased stabbed as cold moderator the commonwealth

vice-president for federal and state health policy, someone with a lot of policy experience herself, including stints on the staff of a couple of u.s. senators. rachael will start us off with a bit of a complex of this topic of health insurance rates for 2015 and how they're shaped. >> thank you so much. welcome to everyone. we are thrilled that this is sell your choosing this it been your friday afternoon with us. thank you for joining is. i will wait for the slides to come up. as ed said, this topic is a really critical topic of the moment. in the briefing to debris represent an important part of the work that the commonwealth fund is doing to really track and measure how the affordable care act is being implemented. you know that a vast majority of folks who are enrolling in health plans to the marketplace is this year will be eligible

for premiums subsidy and therefore know that the cost to consumers and the federal government alike. understanding what goes into the rate setting process is critical and one of the things we wanted to do today. the factors. and i think it is important to keep in mind that there is never the systematic effort. we will talk about why and some of the policies that are new. in order to understand the impact of the changes that have been made to the private insurance landscape we really have to start by orienting ourselves to the wave line, we are measuring progress against. part of what you will hear today is some of the work supported by the fund that doctor gruber will discuss to provide a benchmark to discuss future trends and to

help determine that the law as achieving one of its major goals from providing comprehensive health insurance to nearly all americans were buying coverage. just a recap, most of us understand what some of the shortcomings or in the individual market prior to the dca, but to level that, prior their rates in the individual market were unstable and highly variable. there was also an immense amount of variation across the country in terms of how states regulated plans to which you can see in this slide. for example, not every state conducted rate review. some did it for in formation of purposes. even states with prior approval processes, many at that time that meant that the rates insurers were proposing went into effect and let the state take action. public access to rate and review data was limited. only 13 states have access.

there is much variation in taos states made their rate review information public. what that means is that prior to they see a they are limited in their ability to look for cross plans across base, and across the country to make conclusions about those adequacies as well as the affordability. so as we all saw no regulation of health insurance and health insurance market has historically fallen. the affordable care act to provide new rules for the federal government to contribute to this process. in major way that the affordable attracted inserted was providing grant funds to states to assess the in this new authority. by requiring that plans and insurers structure. you see some of the highlights and milestones that plans had to meet in the of 40 character, and

2010 about $250 million was made available the states used over five years to assist them in the rate review process they decided that as part of those new resources that would focus on making that information publicly available on the internet and in consumer friendly format. and 2010 the medical loss ratio provisions went into affect, which determines that insurers needed to spend 80 or 85% on some -- of the premiums on medical claims and a quality improvement. that resulted in about a billion dollars in rebates being paid out. we are starting to see actual outcomes from these early provisions. what this comes down to is the affordable care act aims to bring down premiums by increase transparency regarding premium increases. that think it is important to keep in mind that it does not

include a formal approval process of the federal level. health and human services is tasked with working with states to develop a process for annual review of rates. they do not have the ability to deny proposed rate increases. the opening up to transparency will help enable consumer jurist and strong competition in the market. due to the changes made consumers them to have more complete access to systematic information about the benefits covered and the prices of those plans regardless of the state of the 11. importantly for this group researchers and policy makers have the ability to make informed decisions based upon standardize data to be able to look across time and talk about and think or what has been happening in that space. so why are we focusing on this now? what does this mean?

as you may have noticed, every week it feels like a few more states are coming out with proposed rates. it is really important, the average premium rate across all the plans. keep in mind, these are also the proposed rates. the final premium rate changes could increase or decrease. the main reason we wanted to focus on this today, the majority will be releasing rates this summer leading up to the fall. releasing their 2015 rates in the fall as well. we will talk more about the regulation process as well.

as ed mentioned, we have the team to panel of experts. what it means for 2015. my first panelists, discuss the findings from the latest report which said an important context through the race that will continue to be released. the american company of actuaries, describing the factors that go into the rate setting process with the major drivers as a cross increases in 2015. on my right the georgetown center providing more details about states' regulatory processes as well as the variation across the country. finally, the vice-president of federal affairs, no stranger to capitol hill, providing in on the ground perspective as a nationwide insurer and some insight. you can find biographies along with complex information for

these and other experts. with that i will turn to doctor gruber. >> if i may, can i do a little housekeeping? want to make sure people know that if you want to engage in or engage the twitter sphere, you can dudack. -jack is raised 2015. the lower right of the slide that is on the screen now. we have got a new feature if you want to use a device for which you need wi-fi access. we actually have arranged for wi-fi access from you. there are instructions on each of your tables. the user name and password. they are on there. there we go.

okay. there will be a video recording of this briefing in a few days on our website and a transcript a couple of days after that. call your attention to two pieces of paper in your packets, blue and green. i card that you could use to ask a question when we get to that part of the program. very important. we can improve these programs as we go along. you're watching you can find all of these background materials that we have distributed to the people in the room on line and at the same website. you can follow along, including with the slides. thank you for -- >> thank you. thanks.

the title says it all, context. we think about things in life in context. if it is 85 degrees today, is that hot or not? that depends upon the historical pattern of weather and will we expect. the redskins win 12 games that's pretty good given how bad they were last year. patriots fans, 12 games are what you expect. everything is about context. somehow we forget i human basic instincts. of $500 billion deficit, that is actually historic rio carry. health insurance rates and no exception. people want to evaluate them. it is not relevant. we should compare them to what scientists would call a car

factual. that is really the goal of my report. to do so of going to rely on data collected by someone else to monday it was collected by jon gabel. this is important to it because it is the first systematic data ever collected. there is some survey data, put out reports with averages, but there has never been a comprehensive evaluation of what the far rate increase requests have been och. they had a sample that grew over time. it reported overall national data as well as the specific data only reporter for states

where they had only 50 percent of the individual market enrollment. they went on the web, collected all the information they could on the five largest insurers in the state. they then took a sample of the remaining smaller insurers and developed a set of weights based on market share to get awaited representation as simple xbox stuff, and then a weighted average. this is not perfect data. i want to be very clear on that. this data is for an incomplete sample of states and insurers, but it is the best data out there and the most comprehensive data collected today before 2011. actually, that should say it was collected starting in 2008, not 2010. the reason that matters is

because the hca, although the exciting aspects kayten in january, there were important aspects which matters starting in 2011. federal rave review of all insurance rates that -- proposed insurance rate increases of more than 10%. as well as a minimum loss ratio regulation. if you want to think of of what three obamacare individual market you have to focus on 32011. respect the effect of obamacare. this is the best that we have to look at that market. i will focus on the 2008-2010 timeframe. just a summary of what we find, summary of what we find. in 2008-2010, high in variable premium growth. overall premium growth averaged more than 10% to year.

in the growth rates or highly variable. some states premiums rose as lastly%. within states there was even more variability. huge variability in rates. the bottom line is that premium rates were both rapidly rising and very variable while we start by looking through the data. highly technical graph shows the average rate of premium increase to market across time. increasing. this was sort of the state of the world and the individual market. this is a market with consistent double-digit premium increases. be clear on what that means. the same product over time. if you look at what people paid

three people were buying less and less general policies to compensate. if he looked at what people paid it might have gone up less than the deductible. if you look for the same policy as well was charged, premium increases will double digit. that is the first consistent finding your. now, as i mentioned, data are not perfect. let's play with the data little bit, cut it to for ways to see how robust the conclusion. the first column is will we showed you. what if i only consider states where the data included more than 60 percent of the individual insurance market. the third column says order finally include states for the data included more than 80%? more than 60 percent of the market in every single year,

tried to restrict the data act, if the results suffer. the ever -- the answer is no. you get the same bottom-line results no matter how you cut the state which is sort of low double digit rate increases in the pre a ca. that is our baseline, our baseline temperature, number of wins, we should be thinking about what we see the data coming out. basically single-digit increases means that gone up less. that's the context in which we want to put these increases. that's the first point. the second point is about variability. this shows the state rate of increase, this is the state rate of increase. the only important to take away,

these numbers are all over the map in 2010 you had kentucky with the five and a half and nebraska with a 21%. the point is, these numbers are all highly variable. what that means is we cannot draw conclusions about the overall impact of obamacare on this market. these states will be very variable demand we cannot react. even further, go to the next table where show autograph of the percentile of change. i take all the data, every observation and graft the distribution of the changes. if you look of 50% and focus of

the 50th percentile was 11%, with typical firm increase the premiums. but for 1% of firms, from premiums actually fell by nine and half percent to 1% or more premiums rose by 28%. this is just showing you have variable premiums chased across the firm. the blue line is weighted. the red line is what the newspapers are reporting. this is look at the data, ignore the big insurer and ask what happened to premium increases. you had some furniture for a 50% more. it turns out to prepare a small. but the important point, there was a lot of variability in the reported rates over time and

said he could not learn anything from anyone degrees certainly not if you don't wait it. with the previous sale will saying it was hard ameritech's a large sample of states to get a picture of what's happening. so what are want to do is just, what are what you take away from misses to conclusions, in some sense of the start with the second point. we cannot draw a conclusion from any one story. we have to wait and see the broad picture. it will be hard to really know what has happened until we get a final set of rates. conclusion to, they're right context in which we interpret is

the double-digit increases. the key. >> things go on john. i too will be providing some context. my role will be to provide a brief overview of some of the premium components and talk about some of the major drivers of changes for 2015 premiums. in terms of premium components the major factors are who is in short and whether their health costs. terms of who is covered from other demographic and health status and from that their health spending. of the premier and components include administrative costs, taxes and profits, and laws and regulations can affect in nerol. be talking about three major

drivers. the first this changes in expectations. when insurers are developing their 2014 rates and to make a lot of assumptions. there was a lot of uncertainty. in tennis will we know i'm a we do have information. but in as limited envy. uncertainty moving forward to the public changes in those

assumptions could be affecting premiums. also have to keep in mind that insurers need to make assumptions amelie well and some other enrollee population in terms of retrospective, but also looking forward where reeve going to get an increase in enrollment because of the increase in the individual mandate penalty? another couple of things that we need to think a is the single risk pool requirement. that means when developing premiums insurers have to incorporate and woman and claims not only in size but also outside. lot of the data really focuses on exchange keep time.

that policy was implemented late last year and allows the states to allow insurers to renew who the hon ac he complied plans. insurers said larry finalized premiums when that policy was implemented. they could not incorporate the changes to the risk profile that would result from that policy. what could happen is on the the transition policy people who were lower cost by the end up staying with or keeping than non hca compliant coverage whereas higher cost people could move to new coverage. insurers did not incorporate that the one.

there will be able to incorporate that. you may see higher premium increases in states that a osha transition. the second major drivers the insurance program fond. 10 billion will be used to reimburse high cost claims. that amount will decline and 2015. reinsurance programs of such claims. by doing that and can lower

premiums. a reduction would result of lower offset. as something that happens every year. the big question is, will this recent slowdown continue. insurers have to make assumptions about the. those are the major drivers believe there were several other us including since and provider

networks, broad verses narrow, changes and provide a payment. and have it start rookies in more detail. >> thank you. >> thank heehaw the new review

requirements, and the who labored you when scared and the interplay between the department of insurance and the state and federal marketplaces and. state rate filing requirements generally fallen to one of two categories. in the prior approval issuers misheard submit rate filings. issuers must submit rate filings to the department of insurance but can't begin charging them without approval from the department of insurance. based on research conducted by the kaiser family foundation to weigh in the individual market impartially 30 states and the district of columbia require prior approval. seventeen states require race to be filed but not approved, and

three have not. for example, a state with an authority to disapprove or prove may appear to have more leverage there are a will to use the authority to engage in discussions. even absent authority they were able to engage carriers. the rate review process included minimal transparency. rates generally were not privileged and the information included is often considered to be a trade secret. the resultant is often a new

mechanism. half before will care act, in an effort to create consistency and transparency. hhs will review rate increases and less of as the servant of state -- to assure consistency they consider file and use face a beacon for -- effective. with that said based on research conducted in 2204 in the individual market for the 17th and one with no filing requirement pass legislation to

obtain prior approval authority. it is important to point out of the federal rate review program and provide 250 million grant funding. what is an effective program? to be an effective review statements received sufficient information, consider at least 15 rating factors identified by regulation, make a determination of their reasonableness and make the filing information available to the public and provide a mechanism for receiving public comment on proposed increases which allows the public to have them put and also must report the results to hhs and. so what has the impact of the federal rate review program ben? of of 43 straight -- state to

the district of columbia receive federal grants. in mexico provides a nuys snapshot of how the process is continuing to improve as the mexicos initiatives are similar to those in other states. to the approximately seven and a half million which allowed them to pass legislation. in mexico posted the rate filings on line and the state now conduct public hearings and plans to recycle three grant to pursue more in-depth analysis and analyzed and published person did and coordination with premium andre filing information . >> the difference between the rate and price in. >> it's a great question.

the information that the carrier files to justify the office of representative permian. if you pay 500 a month in premiums, the rate filing is all of the data that supports how they get to that price. in terms of the interplay of the departments of insurance are solely responsible for reviewing and improving rates to lead except in those five states said hhs is determined to not have an effective rate review program. when you go online the premiums received for the qualified health plans offered reflect the underlying rate approved by the province of insurance. while the exchanges of the marketplace is to not have direct input and review or approval authority, the marketplace does create parian

transparency with stern's competition and of town or pressure at just want to thank everyone for letting me be your and join the panel and in the discussion for insurer perspective on what is going on to my how we set our rates to mile market has of marking. and let me start by talking about who will point is. era of large national insurer. we do business in many of our states command you will see on this map the states in which we do business. we generally are known as and the blue cross and blue shield. new york as empire blue cross. it is through those subsidiaries

we're participating. there are also our nation's largest medicaid managed-care company. anything in the house insurance here we are to submit an. well for medicare coverage, advantage. we have a lot of experience across a number of markets, we of the largest individual and small group market insurer. when you think about the hca, this is an overlay. halases and harlan viejo ca impact to say is that a dramatic expansion. where we're participating right now, we are actively participating in two of the demonstrations and also working

with the states of texas and new york. we're in six states that are expanding medicaid and participating in 14 exchanges. it's a little bit messy, but a few spend more time studying it is pretty straightforward. we are in six state-based exchanges, california, car wrong , new york, kentucky, conn., and nevada. the awesome and nine panera facilitated marketplaces or partnership arrangements. that is maine, new hampshire, georgia, missouri, ohio, wisconsin, indiana, virginia tech. that's a long way of saying we have a lot of experience of the lot of different regulatory schemes will a lot of experiences with the lot of different rules.

very indifferent to a graphics. i was asked to participate because we got the breadth of experience and one of the things that is clear is the context of support. one. are with like to make is ask the look at 2015 rates we can't forgive or ruin. going into the market we were looking and a very different regulatory structure than those individual insurers experienced previously. we were allowed the rate based on health status, age, gender to and we used those mechanisms and tools to try to price our products and encourage people to come and our plans. wheeler also looking and our risk profile and how we maintain affordability.

coming in the 2014 that had changed significantly. we could not rate or price products based on health status, gender. a limit of three to one. a very different environment. that was just one major factor. the second is essentially to five covering the essential health benefits. a third factor that i mention this who the uninsured were and how they act. we had a good sense but did not. slow our anthem company started pressing products. we started with doing research elite field. we drove down in the three states to in which we did

business but had experience and. we're in new york and maine. her also in kentucky which had and that in place, repeal that and has it back in place. we looked at all the experience. the third thing we did, and the belief -- we have not talked about what they did, we went out and did a simulator experience with about 60,000 uninsured. was a web based experience. we want them to run number of questions asking them what would motivate them to purchase insurance, what was important to them looking at network, formulary and tried to better understand how there were going to purchase nba ventured marketplace we did not have

subsidies in the marketplace. trying to understand how they make decisions. but we took all that and factored it into our 2014 rates. one of the things we found is we thought that the individual market under these market rules with subsidies was going to behave much more like a traditional smart group market would look. we actually started our rate process based on small group operates in the best and tried to look at those and modify from there. really what you end up with is i guess, an educatedh? guess. retread to make it as well educated as they could, but it is a guess. then you fast forward to today, and we are looking at and filing a 2015 rates and you have to ask yourself what additional information you have since. a great job of you have information about medical trend. you also now have some

demographic data. we know who are in our plans. geography, where they live in each individual state. that really is the most concrete additional information that we have. as she mentioned, we have some medical claims data and some pharmacy data, and i want to caution everyone that it is difficult to draw broad conclusions based upon the data. medical claims stated generally has some of to the three month run out which means that it can actually takeoff up to three months from the date the you are provided a service by a provider before your insurer gets the blame. often does not take that long, but it can take up to that long. if you think about the open enrollment and how far we are after, many people actually did not start having effective coverage of the applied to the april 15th deadline until may may 1st. we don't have a lot of medical

claims data, and what we have is going to tend to be heavy on those who utilize services right away. those who have a pent-up demand but if needed services were not hard to get with. we do have more up-to-date pharmacy data. a little bit more real time. again, it is sergeant from broad conclusions about how the entire enrollee population will behave to the end of the year because it is early data. we are analyzing that. we will not really fully use that experience state debt and to we prize for 2016. other point i would like to make is, this really is the transition. looking at context, one year or two years, you have to think about this as potentially three or four years until we get full clay is stated, so long story

short, it is difficult to draw broad conclusions about pricing. every company had different information, making their best educated guess. similarly for 2015 they tried to enhance that, but it is still very much an estimate. you also cannot generalize the averages over in individuals experience. at risk and contradicting myself one resource of want to point you all to as you look to materials coming out coming it is on their website which is on the slide and it was available to anyone in the public. the summary from a couple of days ago. states make information available and are putting it up on their website. what you can see is that there is a great deal of variety in

the experience across the board. again, don't draw individual conclusions about us take a person, but it does point out a few individual things. you have additional players coming into the marketplace. they talk about carrier participation. there were 55 carriers coming back into the markets from a total of 56. an additional 18 are coming into the market. the yen, while we start out from the beginning because we want to go where our customers were and try to limit disruption as the largest individual market insurer, there are additional folks who did not get into the market right away. and that will impact pricing. similarly, there are additional products. we learn to bought them, if they like them, introducing new ones, different ones. they're is a change in the

number of products available. when you looked at the premiums across all ten states, it is up and down side. the lowest and second lowest, there are no changes downward and changes up or. people make educated guesses. they're no adjusting based upon additional information lot to do it again next year. what is interesting, really that the premium alone in a market that is 80 to 85% subsidized is not enough to look at. you also -- if you're trying to understand the impact on the individual consumer. a totally different element into the marketplace. it is interesting. 78 percent of the consumers,

175% of the federal poverty level. so again, it depends on your background and your age. 78 percent of people will see their rates go up and 20 percent will see it cut down. you have a decrease in rate that still has an increase since the amount of premium that the subsidize individual will pay. similarly states where you see increases in premiums overall but a reduction in the premium that is subsidized. we are still growing. it is something we are proud to

be supported. an sense of this, when typically in the various states that will point operates in, the 2015 raids thus far in the states we have had to file. in one case we file first with the exchange before we file with the insurance regulator. in that case we have filed with the stains the night at the insurance regulator. the state of california, an active negotiation. none of them have made public yet. if the thing i would point out is that the of the piece to keep in mind, we often have to provide a certain amount of notice to our existing customers about the impact on their

individual rate. at various state by state. in the state of new york, no matter when we file as to what that file a request is. governments, once approved we have to provide summer between 60 and 90 days' notice. >> very few data on which to base this on. >> thank you. >> i have gone us going. we are now at the point where you are able to join this conversation. excuse me. we have microphones that you can use to ask questions orally in which case i would ask that you keep it brief, identify yourself and your institutional affiliation if you had one. as i have mentioned, there is a green card in each of your packets you can use to write a question do you have any questions?

>> i've got one. thanks to the panel for laying the foundation for really great discussion. several of you talked about variations. also how states regulate and how they operate their private insurance market. there is also quite a bit of variation within states. reports suggest that maybe variation within states may be increasing. i was wondering if you could take a few minutes and explain what you think is going on and. what contributes to a variation within states. asking themselves when they see one published rate for a state to have a better sense of what that represents. >> start things off.

one thing to keep in mind when looking at how rates may change her for a particular insurer in a state and out things very is where were they in 2014 and then where are they in 2015 because you might see some convergence. i know i saw somewhere that there is actually a divergence in some states. some new players coming in. that can affect some of the rates, but there are some insurers' suit really are expecting a very unhealthy population in 2014 and now they're seeing something. well, maybe we overstated that and will come down a little. every insurer started off at a different place. and it should not be surprising that the rate change is a different because there were starting off at different places

>> also add that all lot of health care is still very local. lacrosse to shield, we serve everyone within the entirety of our service area. most of the state's we do business in, we are in the exchange. amongst all the insurers, many of them, the same number best heat but not the same number of geographic rainy areas. different dynamics. an air tran area. georgia, a state that has gotten some attention, an urban area like atlanta, you have a lot of different providers, lot of different providers competing, a lot of choice and variations of very competitive marketplace is. for providers as well as for plans. in other parts of the state we may be only insurer and then maybe the only hospital network. and so a lot of the variation for ross has to do with the

provider network, the formularies, really with the underlying cost of care which gets automatically reflected in the rate. we cannot lose sight of the fact that ultimately on the cost of care. >> i would add to the point that from a rating perspective carriers of the flexibility to include the geographic rating factor. you may be across a different area and end up with variability because carriers can price based upon geography. >> if i could add three quick things. the first is it is important to emphasize that we have to look at aggregate's instead of anecdotes. there will always be some folks that go up plot and some folks that go down along. ..