moment to making the world a better place. with his wife by his side, he tackled his education. he became a counselor serving the department of defense. he became involved in veteran service organizations and rose to the ranks to become a national commander of the disabled american veterans. i have a purpose in life that's been develop other military families through some of what i had to go through, bobby words -- bobbies were to tell many generations. if i could do myself nor to help others, i'm okay with that. these walls represent veterans of multiple areas and conflict. those are represented give voice to the many are part of a nationwide community of both intergenerational euros. they include men like army sergeant jason pepper, deployed

to iraq, his last memories as he dove onto of his soldiers to cover them from a rocket propelled grenade was that you would never see his wife or his child again. while he would survive, his last words proved to be prophetic. the blast cost him his site. but despite his injuries has pursued his education and is planning to start a new business. though he may never actually see his firstborn daughter, he and his wife, heather, have added two more children to their growing family. in a sense, veterans like sergeant pepper and many others have sacrifice one life to the country and service. in an instant, their hopes and dreams for the future were shattered. but with a love of their countrymen and the support of the family and their community, they rediscover their purpose in life to learn to accept or

overcome the obstacles their injuries have imposed. these walls remind us that a sacrifice might only have of our nation is most often shared with a loved one who cares for our injured heroes. every individual dream change by disability reverberates for families, survivors and communities upon whom are wounded rely upon for support, care and advocacy. we are at this point in time disentangling ourselves for more than a dozen years of war. in that time we have sent our sons and daughters into the battlefield with no fronts an intimate dangers. these may be the first wars on record where our society has not fully experience the mobilization of an era. our nation has become so great, so prosperous, that we can send our armies to fight two wars

with any type of rationing or demand to change the lifestyle of the general public. we have created the best military in the history of the world. we've given our fighting men and women the best arms, and our utmost to ensure that every soldier -- through the capability of our forces, which are great, and their valor is unquestioned, the toll the war has taken on their bodies and hearts and their minds, is a timeless reminder of the need for this memorial. for as long as a nation that we have come as long as we send our young to fight it, we have entered into the promise with them as we drafted and enlisted them into our military, we made a sacred promise. this is our greatest social contract, to the men and women we've sent in harm's way will be made whole should they become ill or injured in service, that they should enjoy the dream they

fought to defend, that their survivors should see the future that remembers a fallen. without this agreement it would be inconceivable to ask our young to be willing to fight and die for our country. and without their doing so, our ideals as a nation, our freedoms and our prosperity would not exist. this obligation attached here in stone is to recall the deepest sentiments of our founding father george washington is what brings us here together today. to be all those have shed their blood or lost their limbs in service of their country. this obligation for our injured servicemen and women first proclaimed by general washington in 1783 is perhaps the highest form of public justice. as we stand here inside of our nation's capital, the centerpiece of our democracy, we must fervently pray that the

price paid by our nation's heroes will be remembered by those who we have elected to represent us. we must pray that our obligation to veterans remain a commitment that goes above partisanship and that they remember those for whom the battle continues. we must ask the heavens as those representatives ascend to the halls of power and walk those grand steps, but they look to this sacred ground and remember the promise that we have made for those who have served. thank you so much. [applause] ♪ ♪ ♪

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♪ ♪ [applause] >> ladies and judgment please welcome ms. lois pope, mr. arthur wilson, mr. robert fogel and the honorable sally

jewell. [applause] ladies and gentlemen, the president of the united states, barack obama. ♪ [applause] ♪ ♪ ♪ >> ladies and gentlemen, on

behalf of the disabled veterans' life memorial foundation, it is our honor to present to america's citizens the american veterans disabled for life memorial. [applause] ladies and gentle it is my distinct pleasure and honor to introduce to you the president of the united states, barack obama. [applause] >> thank you so much. good afternoon. please be seated. to all our disabled veterans, our extraordinary wounded

warriors, we gather here today, on this gorgeous autumn day in america, because each of you endured a moment that shaped the arc of your lives and that speaks to our debt as a nation. maybe it was there on the battlefield, as the bullets and shrapnel rained down around you. maybe it was as you lay there, the medics tending to your wounds. perhaps it was days or months later, in that hospital room, when you finally came to. perhaps it was years later, as you went about your day, or in the midnight hour, when the memories came rushing back like a flood. wherever you were, whatever your story, it was the moment that

binds each of you forever, that moment of realization that life would not be the same. your foot. your hand. your arm. your leg -- maybe both. your sight. your peace of mind. a part of you was gone. speaking to his fellow veterans of the civil war, the great oliver wendell holmes, jr. once said, as i look into your eyes i feel that a great trial in your youth made you different. different from what we could have been without it. and he said, we learned a lesson early which has given a different feeling to life, a sense of duty that burns like a fire in the heart.

to lois pope, art wilson and everyone at the memorial foundation and our incredible veterans service organizations who devoted so many years of effort, especially our friends at the disabled american veterans, to all the architects and craftspeople who lent your talents to bring this memorial to life, members of congress, secretaries jewell and mcdonald, distinguished guests, and most of all, to our veterans who have come to know a different feeling to life, and to your families, it's a great honor to be with you here today. for more than two centuries, americans have left everything they have known and loved, their families and their friends, and stepped forward to serve. to win our independence, to

preserve our union, to defend our democracy, to keep safe this country that we love. and when the guns fall silent, our veterans return home, ready to play their part in the next chapter of our american story. as a nation, we have not always fulfilled our obligations to those who served in our name. this is a painful truth. and few have known this better than our veterans wounded in war. in the first years after our revolution, when our young nation still resisted the idea of a standing army, veterans of the continental army returned to towns that could be indifferent to their service. one veteran, his hand mangled by a british musket ball, was deemed, like many veterans, as unfit for labor. and frustrated by his inability

to secure a disability pension, he wrote that many of those who aided in conquering the enemy are suffering under the most distressing poverty. after the civil war, and again after the first world war, our disabled veterans had to organize and march for the benefits they had earned. down the decades, our nation has worked to do better, to do right by these patriots. because in the united states of america, those who have fought for our freedom should never be shunned and should never be forgotten. so, today, we take another step forward. with this memorial we commemorate, for the first time, the two battles our disabled veterans have fought, the battle over there, and the battle here at home, your battle to recover,

which at times can be even harder, and certainly as longer. you walk these quiet grounds, pause by the pictures of these men and women, you look into their eyes, read their words, and we're somehow able to join them on a journey that speaks to the endurance of the american spirit. and to you, our veterans and wounded warriors, we thank you for sharing your journey with us. here we feel your fears, the shock of that first moment when you realized something was different, the confusion about what would come next, the frustrations and the worries, as one veteran said, that maybe i wouldn't be quite the same. and then here we see your resolve, your refusal, in the face of overwhelming odds, to

give in to despair or to cynicism, your decision, your choice, to overcome. like the veteran who said, it's possible for a man to lose half his physical being and still become whole. it is here we can see your perseverance, your unyielding faith that tomorrow can be better, your relentless determination, often through years of hard recovery and surgeries and rehab, learning the simple things all over again. how to button a shirt, or how to write your name. in some cases, how to talk or how to walk. and how, when you've stumbled, when you've fallen, you've picked yourself up, you've carried on, you've never given up. here we get a glimpse of the

wounds within, the veteran who says, i relive the war every day. because no matter what war you served in, and whether they called it shell shock or battle fatigue, or the 1,000-yard stare or post-traumatic stress, you know that the unseen wounds of war are just as real as any other, and they can hurt just as much, if not more. here we're reminded that none of you have made this journey alone. beside each of you is a wife or a husband, mothers and fathers, brothers and sisters, sons and daughters, and neighbors and friends, who day after day, year after year, have been there, lifting you up, pushing you further, rooting you on.

like the caregiver who said, i loved him for who he was in his heart. and he still had that. today we salute all your families, and the love that never quits. and, finally, here we see that our wounded veterans are defined not by what you can't do, but by what you can do. just ask captain dawn halfaker. in iraq, her humvee was hit by an rpg. she suffered burns and broken bones, lost her right arm. she struggled physically and emotionally. but with the help of her fellow wounded warriors she came to focus, she said, not on what i had lost, but on what i still had. and today what she has is the respect of her fellow veterans that she mentors, a business of her own, one that hires

veterans, and a beautiful 6-month-old son. dawn's picture, this member of the 9/11 generation, now graces this memorial, and we are honored that she is here today. and, dawn, please stand up. [applause] i've seen dawn's story over and over and over again, in all the wounded warriors and veterans that i have the honor to meet, from walter reed to bethesda to bagram. i know in dawn's life, many of you see your own. today, i want every american to see it. after everything you endured, after all the loss, you summoned the best in yourself and found your strength again. how many of you learned to walk again and stand again and run again.

how you've competed in races and marathons and the paralympics, on team usa. how you found joy and love, getting married, raising children. how you found new ways to serve, returning to your units or starting new businesses, or teaching our children, or serving your fellow veterans, or leading in your communities. america, if you want to know what real strength is, if you want to see the character of our country, a country that never quits, look at these men and women. and i'd ask all of our disabled veterans here today, if you can stand, please stand. if not, please raise your hand so that our nation can pay tribute to your service. we thank you. we thank you.

we're inspired by you. and we honor you. [applause] from this day forward, americans will come to this place and ponder the immense sacrifice made on their behalf. the heavy burden borne by a few so that we might live in freedom and peace. of course, our reflection is not enough. our expressions of gratitude are not enough. here, in the heart of our nation's capital, this memorial is a challenge to all of us, a reminder of the obligations this country is under. and if we are to truly honor these veterans, we must heed the voices that speak to us here.

let's never rush into war, because it is america's sons and daughters who bear the scars of war for the rest of their lives [applause] let us only send them into harm's way when it's absolutely necessary. and if we do, let's always give them the strategy, the mission, and the support that they need to get the job done. when the mission is over, and as our war in afghanistan comes to a responsible end in two months, let us stand united as americans and welcome our veterans home with the thanks and respect they deserve. [applause] and if they come home having left a part of themselves on the battlefield, on our behalf, this memorial tells us what we must do. when our wounded veterans set

out on that long road of recovery, we need to move heaven and earth to make sure they get every single benefit, every single bit of care that they have earned, that they deserve. [applause] if they're hurting and don't know if they can go on, we need to say loud and clear, as family and friends, as neighbors and coworkers, as fellow citizens, and as a nation, you are not alone, it's all right to ask for help, and we're here to help you be strong again. because our wounded warriors may have a different feeling to life, but when we are truly there for them, when we give them every opportunity to succeed and continue their enormous contributions to our country, then our whole nation is stronger, all our lives are richer.

so if you're an american, and you see a veteran, maybe with a prosthetic arm or leg, maybe burns on their face, don't ever look away. do not turn away. you go up and you reach out, and you shake their hand, and you look them in the eye and you say those words every veteran should hear all the time, welcome home, thank you. we need you more than ever. [applause] you help us stay strong, you help us stay free. to every wounded warrior, to every disabled veteran, thank you. god bless you. god bless these united states of america. [applause]

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♪ god bless america ♪ my home sweet home ♪ god bless america, land that i love ♪ >> we will leave the president here and go live to health and human secretaries sylvia burwell. best wishes and shouldn't reporters questions on health care policy. this is just getting underway. >> good morning. welcome to the latest in our series of joint kaiser health news, health policy news breakfast. my name is alan, i'm editor-in-chief of health affairs, leading journal at the intersection of health care and policy. running the show today will be julie robben, dissing which fell at kaiser health news. you all know her from her 16 years at health policy correspondent for national public radio. the star of her show today, the reason you hear is sylvia burwell who is the nation's 22nd secretary of the department of health and human

services. as you know she can get hhs after serving as director of the office of management and budget with previous stint at quite a few places but mostly so as president of the wal-mart foundation and present of the global development program and coo of the bill and melinda gates foundation. we are pleased to cosponsor this event and i were now headed over to julie to get the program going. >> good morning. thanks ago for being here. thank you, madam secretary, for being here. i'm going to ask moderators open question and i'll open it up to the audience. we do have tv cameras here so please wait for a microphone to get to before you speak and please identify yourself and your news outlet when you ask a question. madam secretary, i think pretty much anybody in this room still as ptsd from lester's open enrollment period what could you say to reassure us that we will be having a groundhog day when november 15 rolls around? >> well, in terms of that i will also remind everyone that a year

ago on this date i was doing a government shutdown in terms of these questions have ptsd. with regard to open enrollment, i might start with a broader lens and come to that issue specifically are in first of course want to thank kaiser, thank you, julie, for moderating today. as i also should mention ebola. i think for me to be her i'm sure we will have some questions about that issue. it is one that we are working on deep at the department, and have been for many months actually in terms of the issue working across the department from the office of global affairs where we of someone actually embedded at w.h.o. from the hhs team to make sure -- all the work you're also very with the cdc is doing, there preparedness at home and attacking the epidemic at its center in west africa. ..

>> found erskine and said, erskine, don't you think sylvia's a little young for this job? and erskine looked at helen thomas and said, helen, in this place a year is a dog year. and i'm sure you all realize i'm reminded of that story not because i'm young anymore, in terms of my first 100 days. but with regard to the affordable care act and how we are thinking about that and being ready for that, it's obviously one of the top

priorities. when i think about the affordable care act, i think in terms of three measures; quality, affordability and access. and this particular question about healthcare.gov and the marketplace is deeply focused on access. i think it's important to recognize when we talk about access that the most important measure there is the reduction in the uninsured. with regards to the access question, that's why the legislation was passed. when we think about what is the measure by which we should judge ourselves, it's the question in the reduction of the uninsured. the marketplace is a very important means by which we get there, so is medicaid, so is employer-based coverage. so with regard to the marketplace as we go into it, i think there was a conversation even here yesterday about these issues. there were a lot of lessons learned. and those lessons were both positive and negative. in terms of some of the positive things, we learned a lot about how the consumer behaves and reacts in terms of the consumer works up against deadline. we learned a lot about the

importance of sound technology. and from those lessons have put together a plan that we are working on every single day and have been since the day i arrived before i arrived. as part of that plan, there have been a number of pieces. one, prioritization in terms of deadlines we're meeting on a day-to-day basis. second, i think i many of you know that we have focused on management as a part of that going forward. many of you, i think, yesterday had an opportunity to spend time with andy slavitt and roy lotus -- loy lotus. those are new additions to an already-strong team k and finally we are, obviously, deeply focused on technology. so continue to make progress every day and are looking forward to continuing to do that day by day. we're deeply focused in quite a bit of detail. >> well, before i get to the audience, i have my own question which was that last month the gao put out a report that

suggested that plans were not necessarily doing a good job letting people know when there was elective abortion covered. this was, obviously, one of the last issues settled when the law was enacted. there's supposed to be one plan that doesn't have abortion coverage, one plan that does. apparently, that's not necessarily happening. what is the department doing to make sure that all gets straightened out? >> so, first, i think it's important to reflect that with regard to the federal law and the issue of federal funds, there are no federal funds being used for abortions except in the cases as the law states, rape, incest and questions of life of the mother. and i think that's an important part in this context. with regard to the issue that's been raised, it's one where we believe we need to insure the law is being enforced, and right now cms is working only the ways we're -- on the ways we're going to communicate with states and insurers. >> will this be straightened out for open enrollment? >> working true, you know, the

plans are in place, you know, for the most part we're finalizing those plans. so in terms of how the communication is going to work, we'll have to see how quickly we can get the communication out and where we are, because i think the gao report was actually based on a previous year's plans, not this year's plans. >> okay. let's go to the audience. or right here. no, wait for the microphone. >> maureen -- [inaudible] with the indianapolis star. there are still disagreements after that meeting, what are the disagreements and how confident are you that you're going to be able to reach a deal with indiana to expand medicaid? >> >> with regard to the issue of medicaid and medicaid expansion more broadly, i think everyone knows there are 27 states plus d.c. that have done the medicaid expansion. we're in conversations with a number of states has has been purr purported, and each of the stated as we think about this issue and are working with each state individually, there are

really two things that are the guiding principles of these conversations. the first one is that it is important to listen hear the needs on a state-by-state basis and the needs of indiana and how that governor is approaching it are actually different than tennessee which has also been reported and utah which has also been reported in terms of my conversations with those golfs. -- governors. the second issue, so we have to think about what flexibility they need and what they think is the best approach for their state. the second thing is that there are some core parameters that are both statutory and policy in terms of what medicaid needs to provide. that's where we're having the space of the conversation. we're continuing the conversation. the governor and his team and our team have been working on, in a year, over a period of a year in good faith on this effort. i think everyone is coming to the table with a real desire to make progress, and we're going to continue to work on that. >> wait for the microphone. >> thank you.

dena jones from cnn. it's a compound question. you touched on ebola, so just is on health care sign-ups, do you have a goal that you can share for this year in terms of number of sign-ups, and i guess i'll turn to the number of reductions in the uninsured, is there a target goal in and on ebola, we all know this temperature screening at some of the major airports in america going to start, but what do you say to people who argue this is in some cases all sort of for show, to calm the public's fears since many, many people could still make it through given the 21-day incubation period? >> so with regard to the first question about our goal, our goal is for the consumer to have a quality experience in our open enrollment period, and we will continue to try to move those uninsured numbers and to maximize our ability to do that. with regard to the question of a specific goal and the numeric goal, one of the things -- and there is a cbo number that exists, a 13 million number -- that is based on a trajectory

that eventually gets to 25. and i think one of the things that is different from when that number was originally put out is now we actually have information about what happened in the first open enrollment. so how one thinks about the slope of that line over a period of time is something we are analyzing and working on, and working on from this perspective. a top-down number is how you get to reaching a specific number out there, but now we have data and information, and we want to try and wild that number -- build that number bottom up. based on what we know both on those that did enroll and information we learn from that. so that's something we're continuing to work on with regard to that specific question. in terms of the issue of ebola and how we are thinking about the issue of homeland preparedness and making sure that we are ready as a nation, as i think has been made clear by director fauci or, tony fauci or dr. frieden, the important and most important place with regard to taking care of

screening is actually at the point of departure. and that's been in place for many months. and as we know, we have a case, you know, and that case, sadlyy is deceased. but for many months did not have a case that entered the country. and we know that screening has worked in the sense of 80 people have been pulled from the lines and stopped in the home country. that's the most important place for us to do that. the next step with regard to preparedness as we've discussed is having a system that can handle any case that we have, and we have had one case. and i think there may be other cases. and i think we have to recognize that as a nation. and that's why the preparedness of our health care system and whether that's the fact that 8,000 health care providers have been on cdc webinars or the fact that literally hundreds of thousands of health care workers have been communicated through our health alert network and the seven separate directional

documents. those are the most important steps. at the same time, we continue to evaluate and add steps that we think are helpful both to fight in west africa and to care for our people. the question of the screening we'll be doing at this period in time, there are a couple of things that we know and believe, and that is it's the importance of asking the question how a person may answer a question at the point of departure versus the point of entrance may differ. the second thing is the true, it is a period of time of travel. there is, there isn't -- and i don't think we're making a claim that anything is 100 percent secure, but what's most important is we know, we know how to contain, and that is detect, contact tracing, isolation and treatment. and that was what was implemented, and we've seen implemented in dallas in terms of the tracking of the folks. so we will continue. and, yes, confidence is an important thing, but there is

also what will happen in that period in terms of the questioning and what will happen in terms of that period of time when a fever could occur. oh, sorry. >> back over here. >> hi, thank you. chuck ross from the post dispatch in st. louis. another open enrollment question. as you know, there are, there were three facilities around the country that were processing paper applications during open enrollment, and one of them was in suburban st. louis, and there were allegations there that there was little work being done there. i'm wondering if you can talk a little bit about, have those situations been cleared up, have they been fixed, and have you gotten a better sense of paper versus online applications as you go forward in the new open enrollment period? >> i think what we are hopeful is that we want things to happen and occur online as much as possible. in terms of -- but one of the things we're focused on deeply is the consumer and the consumer

experience and want to make sure that we have alternatives and places for the consumer to go. and whether that's consumers' ability to work with navigators, some people want to work with a person to do this in terms of this is new and they need help, other people want to go directly on. for example, yesterday we previewed 2.0 which is, actually, out and in the space right now. in terms of the special enrollment period. and we think that tools like that will help people who want to do it online do that more. so we would like to see more people online. we will continue to work to insure that consumers -- and consumers have different needs. there are consumers, you know, why it's on a mobile app is because we know that many of those young people that are in that gap use mobile applications. that's why we've tried to move that to a mobile device. we also know that in terms of the latino population, that actually there's deep penetration of smartphones, deeper than the penetration for the nation as a whole. so what we're trying to do with regard to the question of open enrollment is make sure that

we're serving the consumer the best that we can in two forms. one, operational technology being sound, and that gets to questions that were discussed, i think, yesterday about testing. and the other is as much consumer ease as we can. will there be imperfections? yes. things will not be perfect. but i think what we do know is that we are aiming for a strong consumer experience, and it will be better. >> over here, in the back. >> nancy metcalf from consumer reports. we saw in the first open enrollment period a lot of people signing up who really had low health insurance literacy. and a couple of problems i saw crop up, one was people who would have been eligible for reduced cost-sharing silver plans never knew it because they never got past the full screen of bronze plans and ended up with plans with much higher deductibles than they were

really entitled to. and the second is the inability of people to really -- and this is not a surprise, i mean, it's been talked about before -- really figure out who's in their networks. and i just wonder if you have made or are contemplating making any improvements to those features of the user experience. >> so with regard to we are working across the board in terms of that user experience and making sure that people are educated about how to go on and how to shop. i mean, one of the things is this is a complex space to begin with, and you mentioned that many of these people have not been in the market. i think if i went person by person and said what is your premium, what is your deductible, what is your monthly premium, what is your deductible, the people in this room are the single most educated people in the nation with regard to health care. period. you know, you all are the people that write about this every day, you think about this every day. and for me to even, you know, go through and tell me your co-pay,

for every single individual, i think we might have some gaps in terms of each of you. and so i think we have to put this knowledge question in the context of where we are as a nation. i think we believe that the marketplace is going to, hopefully, move those individuals you're talking about, but i think this question of us as a nation and how educated we are which takes us to an important issue which is the issue of making sure that we have high quality care and affordable care. some people call that delivery system reform. but, so we are working to do that. in terms of the ways that we're working to do that, our stakeholders are an important part of that education process. having met with them myself several times whether that's enroll america or the groups of stakeholders, that as we talk about and as they are doing outreach with regard to enrollment, there are two additional pieces of outreach they need to do, enrollment and reenrollment, but they need to do use and shopping, education, and the other thing -- and

that's on the web site for the marketplace. but the other piece that is an important thing that's the next step is making sure people know how to use the care. and i think that's another part of what we're doing. with regard to this question of access to providers, we are working with the insurers to make sure that when you click through in a plan, that there is a place where you can click to get to that provider list, to try and create some ease. i think this is a place where we are all going to make steps, we're trying to make steps step by step as we go, but i think your point, actually, is about the marketplace, but it is a broader point. >> [inaudible] >> sara -- [inaudible] with bloomberg bna. are you tracking the number of policies that are being canceled because they're not compliant with obamacare, and or what are your expectations for getting a more normal risk pool this year? >> with regard to the issue of

cancellations, that's an issue i think you probably know that last year we put in place a policy that would leave both states and insurers with the choice of extending til 2016 as a transition period to try and create a place of transition to get through issues that were raised last year. at this point a couple of things. one, we obviously think the number is going to be much smaller number than last year. i think we need to recognize that the issue of cancellations, again, in the marketplace before the affordable care act there are policies being canceled in employer-based care. insurers do that. and so there's the question of what's happening in the regular marketplace and then those plans that need to come into compliance with quality health plans. we believe, we put in place an alternative for transition. we are working with insurers so where there are those situations, do they have another plan that is an alternative plan, and are they communicating that clearly. so working through the issue, i

think that there will be a smaller number this year. >> the issue of -- [inaudible] >> with regard to the question of the risk pool, i think when one sees that we have a large increase, 25% increase in the number of plans and insurers coming in to system this year as we announced recently, i think that is a reflection of the question that the risk pool is something that, obviously, the insurers believe is a risk pool that works for them economically, or they wouldn't be entering and putting plans in the marketplace. >> in the back. >> i'm jim landers with "dallas morning news". i had a question about the transparency initiatives of the department. you've just put out an open payment system for the links between doctors and pharmaceuticals and medical device companies. you've had on the weapon for

some time now medicare in-patient and physician charges. there have been problems with the open payment system on the drugs and pharmaceutical -- device links in the last week, but as far as the other ones go, the hospital systems say that charge masters really aren't relevant to anything that's actually paid in the hospital system, so it's not really a good indication of what those prices are. what are you doing to strengthen the transparency that cms is providing the public about these things? >> so continue to work and respond to comments. as you mentioned, when we put the first set of information out, one of the things we heard was making sure that the information has context. so when we did the most recent release, tried to provide more context both in terms of the release and anything about that. i think the issue of transparency, when we think about where we were four years ago with regard to the question of transparency -- and it goes

back to our consumer report question a little bit -- the issue of what kind of transparency people have even about benefits in their plans and the transparency that people have now that they know what a qualified health plan is and what those benefits are and those being clearly stated. across the board in the health care space -- and whether it's around the provider information, around the consumer information, we are trying to move on all fronts. it's also related to electronic medical records in terms of the transparency that an individual can actually have about their own health care. and so with regard to what are we doing, we're working, actually, on all fronts in terms of trying to move the information forward so that both consumers and providers have information that they can make decisions about and that we create a transparent marketplace where decisions are made. can we improve it, should we improve it? yes. when we hear the feedback on this most recent elements of open enrollment, we want to do

that. one of the decisions that we had to make and i had to make the decision is the information wasn't perfect. in the most recent rollout. there was data that was not as clean, and so we had to present some of the information, couldn't present exactly all. but made a decision that it was better to get out a large portion of the information so that we can continue on this path on transparency. the transparency path, because it's new to everyone, it's going to take us time to get there. we need to continue to evolve. but i think we think it's an essential part coming back to a point i just raised which is the importance of information to decision making to getting to a place where quality and affordability we drive towards that. and that is about delivery system reform. >> be. [inaudible] right here. >> hi. this is -- [inaudible] from the washington examiner. i have a question related to the

risk corridors which is that a few months ago you had issued guidance on the risk corridors saying that if the -- in-payments weren't enough to cover the out payments, that the hhs would find other sources of funding subject to appropriation. and as you know, the gao just released a legal opinion recently saying that, basically, that depending on which language congress adopts that hhs won't be able to make payments unless, essentially, the appropriations language allows for it. and so i just wanted to get your understanding of whether or not hhs will be in a position to make payments in fiscal year 2015 if congress doesn't put in language allowing it. >> i think that there is a distinction between what happens at the end of the program and the current approach we have to the fee-based structure that the

gao was talking about. and so with regard to we don't have concerns in the upcoming year, and as we've said and said in what you're reflecting earlier, we will work with the congress if there are needs in terms of this question of appropriation. so don't think it's a question that will need to be faced right here in '15. if it ever does become a question, i think we've been clear we'll work with the congress on any additional language that we need. >> back over here. maggie? >> maggie fox with nbc. your style and the style of your predecessor has been very different in terms of handling crises than the previous administration. you've had to deal with the crisis of the rollout of obamacare and now the crisis of ebola. i remember during the bush administration hhs was very much in front. you're taking a backseat this time. are you happy with that strategy, and will it continue?

>> i guess i would start by saying i would like to understand definition of a backseat. i have an ebola meeting every single day since july 28th. i usually have three a day. >> can you tell us about that? because the face to the public has been tom frieden who people know and trust and tony fauci who people know and trust. we haven't seen secretary burwell. >> so with regard to the issue of ebola, i think everyone knows the nation is frightened, and people are frightened of this disease. they're frightened because it has a very high mortality rate, they're frightened because they need to learn to understand what the facts are about that disease. and thinking about people and trust and who you want to hear that information from, tony a few has been working on this issue -- fauci as he said on friday, i think he said 38 years in terms of his work on this space. dr. tom frieden has been, whether it's his work in new york or his work at cdc.

and when one has such high quality, experienced physicians and infectious disease experts, you know, dr. frieden also has an mph, a master's in public health as well. for me, i -- that's why i questioned what you meant. i think what you're suggesting is who is on camera often versus the question of deep work on the issue is something that i consider my responsibility and do. and whether that's on a day-to-day basis making sure that our teams are working on this issue internationally or working on the domestic preparedness, that is something that i consider my responsibility. with regard to the voices and the voices on a day-to-day basis, i think it is important to have the experts that we have and we're lucky to have in our federal government working and speaking about the issues. >> back over here.

>> jay hancock, kaiser health news. we've written a couple stories about hhs' minimum value calculator which, as you know, is certifying as minimum value plans for large employers which do not include hospital benefits while at the same time foreclosing the employees who were offered these plans from getting subsidies in the exchanges. and a lot of people are wondering if this is something that the administration intended. and so far we've had no answer. can you talk about that? >> this is an issue i'm going to be honest and say not familiar with this one in terms of the minimum value calculator and that. i think the one thing i would say is i think you know the issue that the administration is deeply focused on is making sure that people have access and the issue of affordable and quality access. so within that context -- >> well, these folks don't, they

don't have access. these plans don't have hospital coverage. can i get back to you, to somebody in your office -- >> welcome to. we're happy to follow up. >> and who should i be in touch with? >> think right now -- i think right now ben will follow up with you. >> okay, great. thank you. >> uh-huh. >> over here. rebecca? >> hi, i'm rebecca adams with cq roll call. i have an ebola question and a medicaid question, actually. i wondered since you are so deeply involved in the ebola issue, can you give us an update on the work that's going on at nih or whether there'll be additional deployment for public health workers overseas, and what do you anticipate in terms of needed funding that you may need to ask congress for after the cr expires? and then my medicaid question is about backlog which we've seen in applications, states such as california still have an enormous backlog, and i wondered

if you could address that. >> i'll do reverse order. with regard to the medicaid backlog, that is something that each state and the regions in each state are different, and so that is something that we actually -- it is retail. and so we work state by state by state and are working through that on a state-by-state basis, continuing to work with the states on their plans and how they're going to do that. i think many people know we sent certain types of letters to different -- if you follow the issue, you probably know we sent those letters. and in terms of sending clear signals about the level of import. and we continue to follow up. as i said, it is retail. because each state actually varies as to why there are issues in the backlog, and we are working on literally a state-by-state basis to clear it. with regard to ebola and where we are, i think i welcome that someone has brought up the fight in west africa. because that is where this has to be taken care of. that is what we need to do, and

that is where there isn't the public health system in place to implement the things that we know can contain ebola. with regard to the progress that's being made, i'd also reflect that when you look at nigeria and what nigeria was able to do in terms of their capability to contain, that is a place where we have seen it work, and we've seen it work in a developing world system. certainly, nigeria had a also the advantage of there was a lot of polio infrastructure that was transferred to be used in terms of the contact tracing. and some of those efforts and had experience in terms of emergency operation centers and those kinds of functions, and we see that. with regard to progress on the ground, i think as you know the u.s. military that started with the largest deployment for cdc, we also are the large d.a.r.t. which is the disaster and response teams that we usually use that are led by usaid and now have brought in, you know, the command and control that comes and the logistical

capability that comes with the united states military. they are on the ground. progress is being made in terms of the construction of ebola treatment units, in terms of the construction of the 25-bed medical unit which is an important part of attracting health care workers from around the world to be willing to come and serve there, continuing to get the training up and working which dod is doing, and dod has also already deployed labs. several of the labs for the testing, and that's an important part of the detection. so continuing on that line. at the same time, we are also working with the countries and who on doing community-based care. it's not a full ebola treatment unit, but during this interim period while we are getting those up and running and for people who may not have access, making sure that there is community isolation. and so that is the other piece

that's being worked on. there has been progress on burial, and i think as everyone is sadly focusing on here in the united states today, the issue of ebola spreading even through a deceased's body is an important one. that is being clearly taken care of here in the united states. but with regard to making progress there, that's a place where we're making progress. and that is, has to be a behavioral change because for in the burial process, which is a cultural issue of how you treat your deceased, generally involves touching. and that's something that we've had to work through. but there is being progress, progress being made. the numbers are going to increase before we can get to a leveling-off point. but right now what is most important is that every day those on-the-ground efforts that there is urgency. it is about days. every day makes a difference in terms of the number of cases that are contracted. and so there's great urgency on

the ground. at the same time, i think we're all very focused on the urgency here at home. and yesterday, i think you all know, president did a call -- i was on the call -- with governors and elected officials across the country. dr. frieden did another one with statehouse officials. the urgency on both fronts, make sure the country is prepared, but we have to work every day to make sure that we are standing up the capability for these three countries to handle this. >> good morning. alex -- [inaudible] bloomberg news. i wanted to ask about the other plague that's in the news right now, and i think the one that's a little scarier to parents in the united states particularly, edge row virus. what does your -- enterovirus. what does your department know about how this outbreak began, and what is your department doing to develop either treatments or understand any linkages to paralysis or other serious outcomes?

>> so cdc is doing its traditional tracking and working with health departments across the country to understand when there are cases and make sure that the appropriate testing to understand, you know, when there are likely cases whether it is that virus or not. and so that's step one. and we are doing the tracking that we do in terms of the numbers and the numbers by state and the numbers by locality so that we have an understanding of that. the other thing that cdc is doing is communicating clearly about the things that we believe are most important, and i would just encourage everyone in this room to step up your hand washing, and if you have children, to make sure that you are encouraging that kind of hand washing. that's one of the basic things, but it's something, you know, before the meals, before everything, making sure we're doing that. cdc's communicating that. the last part, and i think it gets to the core of your question, cdc is working with the individual health departments to do the investigatory work to understand in these cases are, you know, whether it's the question of paralysis or the question of

death, is it directly related to the virus or something else. and so we are part of that investigate process to term -- investive process to determine those things. so cdc is doing its traditional work that we do with public health while as you're appropriately reflecting there's much focus on the ebola issue, our teams are deeply engaged in this issue. >> [inaudible] determine the origin of the outbreak at all? >> that's a question i would defer to dr. frieden. >> over here. mary ann. >> i'm mary agnes kerry with kaiser health news. just a couple questions about healthcare.gov. you talked about how consumers' public response to deadlines, what are you doing to make sure you don't have problems at the beginning and end of enrollment, and could you talk about the building of the back end? that has been a problem before. >> so with regard to the question of load, that's something that i think was spoken to a little bit yesterday

by andy which is we're doing a lot of different kinds of testing, end-to-end testing which is something i think most people focus on. but one of the types of testing we are doing is load testing, and that is about trying to test the system with different amounts of volume to try and address the issue that you are raising and to make sure that we're appropriately prepared for surges that would occur. with regard to the issue of back end, as we work through -- there were a number of things the back end, you know, parts of the back end worked in terms of -- that were happening last year, and there were other parts of the back end i think you're probably referring to maybe payment issues or those kinds of issues, and we are continuing to work on those. some of the back end issues are around the irs issues that we'll be doing, continuing to make progress on even of these -- each of those issues in a sequenced fashion. as i mentioned before in the beginning, we are prioritizing as we go through, but continuing

to make progress on these back-end functions and whether that's the database lining which some folks here have asked me questions about before, we coronet to work with insurers -- we continue to work with insurers and our own ms. >> if i could follow up before we go to the next question. can you give can us an update on the people who still need to get in documentation as of the end of last month? how many people have actually been cut off and how many people are going to have their subsidies changed? >> two different categories. one is the documentation realitied to that, and we are -- related to that, and we are continuing to process that information because i'm sure you can imagine that more paper to the deadline point that was just raised, more paper has come in. same thing with the income. when we send out the letters that say things will change, that's when we start to get the documents. we're in the middle of processing those, want to get all of that processed as much as possible before we get to open enrollment. so we'll have final numbers, but

the numbers continue to go down from the numbers we made public. what we tried to do, and this is to the transparency point earlier, is put out the numbers. the numbers, you know, 115,000 letters were sent on the immigration front. that number will come down. similarly, you know, the number of the starting point, it was 1.2 million households that had income issues. well over 800,000 of those were resolved, and then we sent out letters to that block, and we're processing what we've gotten in. >> have you actually cut anybody off or changed their subsidies? >> with regard to the question of subsidy change in the cutoff, i think in terms of how that will be implemented, it is over a month-to-month period over their cycle, so i think that also has to do with insurers and when they would do that. >> [inaudible] >> hi, ricardo sal v.a -- sal very with ap. the focus is on people signing up for the first time next year,

there's a lot of focus on that. but i wanted to ask you, what are your goals for retention for the people who are already in the system? what are your goals for a satisfying consumer experience for those people, particularly since for many of them automatic enrollment may not be a good option since costs of their plan, the premium and their subsidies are going to change? so can you lay out for us your objectives for retention both on the consumer experience and the kind of percentage share of retention that you want to see. >> reenrollment, i think it's important to raise because i think as we think about the system and going through the process, i think people think we -- this is year two. it's not year two because of the point you just raised. this is the first year that we will have reenrollment and enrollment. so it is the first year through the cycle. and to be honest, when we get to april, it's the first year of the reconciliation cycle. so this is the first full year.

and i think the focus on reenrollment is something thatter equally focused on. as -- that we are e rally focused on. as i said earlier on the question of the analytics, when i think about the 13 number or whatever number we think is the right number, we have to derive this number too. so right now we are working both with the insurers and their analytics on this as well as our own analytics on what percentage retention we think will be there. that's going to be a part of this overall of what we think our final numbers will be. so don't have a specific number on that. continuing to work through to try and get to the right place, and that right place is based on this is in awe product, this is a -- this is a new product, this is a product as some have reflected hasn't been used and trying to get to that right number. with regard to the deep focus on making sure that two things happen, that people who want to do autoto-enrollment are able to do that in the easiest way possible and that for those we want to encourage those to go in and shop because that's a part of what the marketplace is.

our communications are targeted toward exactly what you just suggested which is making sure that people know the importance of going in and shopping. and i think it was outlined yesterday, and i think we're going to spend time and come back and probably, i think, ann drink slavitt and kevin will both be talking further about the specifics of the reenrollment process, but let me say a few general things which are our communications are going to be targeted on encouraging people to come in, because i think we believe it is best if they can go in and make sure they shop. that is the idea of a marketplace, to make sure you get the best keel. i think kevin mentioned we want to make this as simple as possible, and doing simplified instructions that are easy, usable and very simple are an important part of this process. the other thing that i think is an important part of what we are going to do to make sure that the consumer has an experience and makes it easier for them with the question of reenrollment is making sure that they have alternatives.

different people will want to do this different ways. some people are going to want to put in their plan and go shop. some people are going to want to auto-enroll in their own plan. some people are going to want to use help and guy dance, so making sure -- guidance, so making sure we have different avenues because one of the things that gets reflected as we get into these questions of how people go in and what they do, different people have different needs, and we're trying to meet as many of those consumer needs as we can. >> are you going to prominently tell people who are being reenrolled that their subsidies might change, they might get a better deal if they shopped? >> yes. yes. that will be a part of the communication pattern that we will do. and the communication will start with marketplace communication and insurer communication as open enrollment starts and then will go through that period in terms of making sure that people know and understand that. and people who are auto-enrolled will also get communication so that they know that they still have an ability to go in and

change even after that point while we're still in an open enrollment period. >> diane. >> i wanted the to know what you're doing -- i wanted to know -- i'm sorry, dye grab weber -- diane weber, kaiser health news. we saw a big difference in states that had an insurer who sort of actively did a marketing plan like in florida, healthcare.gov states that had an active insurer on the ground versus states like iowa or south dakota where the biggest insurers sat out of year one. what do you know about insurers' marketing plans to try to reach these customers, and, you know, what can you tell us about them? are they, are they stepping up and planning to put the information out there too? >> so with regard to ininsurers, i think it is, you know, the reflection that for those insurers who aggressively

pursued market share, one saw the impact and results of what they did. and i think that is something that, you know, it is at least our understanding from our conversations with insurers that they are thinking about. and i think different insurers are thinking about different ways to go about that both in terms of the issue that was mentioned in terms of reenrollment as well as the issue of additional open enrollment. and i think they are, as they would do as they each have their own marketing plans in terms of how they're going to go about doing it because it is about competition in term of how they market. so it is our sense in conversations with the insurers that this is something that they are each individually thinking about how they maximize. >> are you pulling some progressive ones in? [inaudible] >> you know, we are encouraging whether it is our stakeholder partners or our insurer partners to be partners with us as we go into open enrollment. and that has to do both with

reenrollment and how we communicate. what we're trying to do as much as possible is communicate with the insurers in this case on what we are communicating on. our communication materials in terms of what they will contain so that they know what we're doing, same thing with the shareholders so that their earths can be complementary -- efforts can be complementary in terms of giving people good information about reenrollment which is a challenge for people who are not part of an insured population as well as those new people to the marketplace. so thing that we're trying to do most is make sure we have clear communication. >> [inaudible] >> joyce frieden, med peach today. one of the things that's come up with the plans on health care dot governor has been the issue of -- healthcare.gov has been the issue of narrow networks, some plans offering only one hospital or very limited choice of doctors. i know some states are developing or the naic is developing a model standard for

what constitutes a network, but i wondered if hhs was thinking about putting in any more standards for that. >> i think as you appropriately reflected, the role of the state insurance commissioners in the regulating of the networks is the place where there is the core fulcrum of the point. we want continue to listen and understand how the marketplace working. with 25% increase in the number of plans that are coming in, we're hopeful that's going to increase more competition and diversity of the type of plans that will be in place. it's something we want to continue to listen and understand in terms of how people are behaving in the marketplace as well as in -- we continue to look at what people are doing in the private marketplace, too, the employer-based marketplace so that we understand exactly how consumers are participating. we're continuing to do that but also providing any support we can to efforts of state insurance commissioners if they have questions or need help as

they're thinking through how to work on this issue. >> hi, dan can be. [inaudible] from cnbc.com. where do things stand on the issue of web brokers like e-health insurance, being able to enroll subsidy-qualified individuals directly without having to go through health care.com, that interface? that was supposed to happen last year, it didn't. heard multiple promises during the year that it was going to happen. as far as i know, it's not happening on any meaningful scale. >> in terms of the exact specifics of where they go through, that's a question oom going to defer to andy to make sure exactly what they are able to do in terms of the click-through and whether or not they actually can do it individually themselves, because there are -- i want to make sure we get that right. but with regard to the welcoming of the issue of the brokers and intermediaries as a part of it, this is part of the system, and

we think it's an important part of the system. i think kevin mentioned yesterday that we think it is something that we welcome. i think with regard to our ability to make progress on as many fronts as possible in terms of integrating from a systemic perspective, how we think about what we can and can't do, there is a balance on consumer friendliness and making sure that the functionality is there with regard to making sure that we have the testing space. and so as we've made decisions about what we can accomplish in this year, it is that balance of those two things. >> hi, tom howell from the washington times. just want to know if you can give us a status update on some of the states that ran their own exchanges and had kind of a shaky time during the first round. as far as states transitioning to the federal web platform, states that are trying to salvage their own technology, where do you see things out? is it going to stabilize in this next go around? >> so there are states, as

you're reflecting n a number of different statuses. in terms of what nevada's doing is different from maryland and massachusetts. each of the states on a state-by-state basis, again, this one is another one that' retail -- that's retail because of the difference in each of the states. so we're continuing to work on a state-by-state basis and whether that's making sure the folks in nevada have an opportunity on how they're going to reenroll as we work with them or in the states of massachusetts and maryland and making sure that their systems are ready to function. so we are working on a state-by-state basis to provide the southern, and the support is different in each of these states. and so what we do is continue to track it and work with each of them directly. and, again, this issue of communication and clarity is one that i think is a tool that we're trying to use from a management perspective in terms of being clear about what our expectations are and making sure

we're communicating with them about what their expectations are of us where we have what you're reflecting, i think, is that point where we have crossover with these states that have had challenges. >> are you confident that the states that had challenges are all going to work starting november 15th? >> we are doing everything we can to insure and have asked the questions. we work with them on a day by day basis in terms of the different types of progress. for different states there were different issues, and we continue to work with them on a day-by-day basis. >> [inaudible] >> wait for the -- >> arthur allen for politico. i wanted to ask a slightly more obscure area of policy, but on health i.t. there's been a lot of dissatisfaction expressed by some provider groups, the ama about the meaningful use program, and there's also on the other side a lot of concern that

these health systems and computers and hospitals aren't talking to each other as well as we'd like yet. and i'm just wondering whether things have reached a point that you've considered any sort of -- in talks with the onc or cms changing the focus or altering the meaningful use program, incentive program at all. >> i think that steps have been taken in terms of some of the issues that were raised in terms of the timetable and trajectory and slope of the line with regard to the issue of meaningful use, because we have heard some of that feedback. so that, i think, is a step that has been taken. i think what's a challenge here, and it gets to the core of the issue, what we need to get to is interoperability in order that we can get to the point of, you know, when i first came to hhs and everyone was meaningful use, you know, those words -- the idea that once we can get these systems interoperable, that's when you get the real value. you get the real value as a practicing physician, you get the real value as a consumer.

and that's the next step. at the same time, as we're trying to move forward, we're receiving comments and pressure to slow the implementation. and so this is a push-pull as we're going through change. and so what we're trying hard to do with the office of the national coordinator for technology -- i don't know the onc doesn't seem to be very meaningful, don't follow this as closely as it sounds like you do -- but what we're trying to do is get that balance of hearing the input that we're hearing about slow a little but at the same time move as quickly as we can to getting over the hump. because that's when -- we're starting to see some of the value of electronic medical records, but the real value comes at that point in time. and that's also the point in time which we're going to see the changes in, that will help with reforming the way we deliver quality in the system. and so this is an important part of it. a couple of weeks ago i spoke

and spoke with the brt and did several things around the issue of delivery system reform, and this is one of information and what you have raised has to be one of the fundamental anchors of that change. so right now what we're trying to balance is that pushback on speed, at the same time continue moving forward. >> [inaudible] >> thank you. steve -- [inaudible] cleveland plain deal canner. on the subject of provider networks, it can be quite a task for the consumer to go on healthcare.gov and figure out who's in the network, who's not in the network. in fact, you won't figure that out on healthcare.gov, you've got to contact the insurers. not all insurers are equally transparent about that, so it becomes quite a process. you're looking at price, okay, these plans might be equal, but is my doctor in there, is the hospital i wish to go to if i need to go to a hospital in there. has there been any consideration

of requiring the insurers to be much more transparent about that, to post on their web sites, for for instance, here ae our networks? >> right now, actually, we do ask the providers to list that on their networks. and because these issues are updated and it is the providers that provide this information, what we do is link to that. that's how we are getting that information, trying to get access to that information for the consumer. >> but, again, not all are equally transparent, i'm finding. >> continue to work with the insurers on their levels of transparent city. i would say this issue -- transparency. i would say this is an employer-based issue in terms of the entire market and gets to this broader issue of transparency in the entire health care space. and i think as we look because we are driving and the marketplace has so many questions, we are driving and pushing this. but i think the issue you're raising is an issue, that lack of transparency, if there is lack of transparency or varying levels i think as you described

it, is something that is an issue across the board. we're trying to encourage, and because we are doing the links, we're hopeful that that is going to encourage the providers to provide the information for the consumers that they need for decision making. >> right here. >> hi, jayne o'donnell with "usa today." doctors and hospitals say that with the increase in high deductible plans that they're seeing people wait longer and longer to get treatment, and they're seeing an uptick in things like later-stage cancers. do you think the middle class is actually worse off while the poor are better off with their plans, and what do you think that's going to portend for the nation's health? >> with regard to the evidence of that, that's something that, of course, we will want to see if there is evidence of what you just described. i think what we do know with regard to the question of the broad middle class -- and this is an important part of what the affordable care act did -- is in terms of prevention and

screenings and the things that actually are very important to preventing some of the conditions you manage, that because of the affordable care act people will have access to those and access to those in a number of cases without payment. without co-pays, without any kind of thing. so when i spoke earlier about the importance of making sure that people understand how to use their health care, that was a comment that was actually not just about those who are newly entered into the marketplace and newly insured, it's about everyone here. again, the most educated group, i'm in a room with the most educateed, and if i asked everyone to write down the top six things that you can get to do because of the change in the affordable care act, i think it's a reflection of we do need the education to make sure people know and are taking advantage of that for their own health care. so with regard to the increased access, the other thing is for many women the issues of plans that could charge more more women because of their different health care, that's no longer there, and i think that's an

important middle class issue. for middle class people, if any of you made a decision to change your employer right now and there is anyone in your family that has a pre-existing condition, you can now do that without fear that you won't be covered. and so the questions of the benefits with regard to the middle class and even those who are in employer-based systems are something that i think we need to spend time focusing on both in terms of educating people about a what it is that are the benefits of the affordable care act. >> [inaudible] >> i'd also like to ask about the consumer experience. >> introduce yourself. introduce yourself. >> i was about to, sorry. i'm jeff young with the huffington post. a little over a year ago the president, your predecessor, everybody down the line talked about how wonderful the shopping experience was going to be and how great the web site was and how the call centers were all staffed up and people were ready, and that turned out, to put it briefly, to not be the

case. so, i mean, what can you say to assure the public that this time what we're hearing now about how the web site's better and the call centers are ready is going to be true? >> so i want to be clear, i think that what we have said is that the experience will be better. we have said that it will not be perfect. we mow that, and we know that there -- we know that, and we know there will be issues that will be raised as we go along through the process. in terms of the question of the evidence and where we are, i think what we can say is yesterday you saw an application that is up and running that was tested since july that reduces the number of screens from 76 to 16 in terms of an application that while not everyone can use -- and it is for those who are newly enrolling -- that we see that we have that and have that in place. the second thing with regard to the experience, because i think there are two elements to the experience as i said, one is the actual functionality which you

were reflecting was problematic as well as the consumer experience. and that's an example on the consumer experience side. on the question of the functionality, i think we've outlined in detail and spoke to this yesterday, i think andy spoke to it yesterday with regard to the testing that we are doing to insure that the functionality has that capability and whether that's the end-to-end testing, the alpha testing, the functional testing, the load testing. and those are the pieces of evidence that i think we reflect. i think yesterday what andy said is very true, what we want to work on is not talking about expectations, but about results. and that's what we're focused on as we work through this time in this process. >> so as secretary, you're confident at this point you have a firm grasp of exactly where things stand, because a part of the issue last year is it seemed like the people at the top of the chain didn't know that the web site wasn't going to work.

>> what i have said and will continue to say is that every day we are working through the deadlines that we have internally to get us to what we have said which is a good consumer experience for open enrollment. and each day we do that, we work through them on the technological side, we work through them on the consumer experience side. >> we have time for one more question here in the back. >> hi. susan jaffe, kaiser health news contributor. if consumers really do the homework and track down which providers are in which plans, providers and do drop out -- can and do drop out during the plan year. other than requiring advance notice -- and i'm talking about marketplace plans as well as medicare advantage plans -- other than requiring some advance warning, what can hhs do to address this problem, especially since so many plans have, you know, very limited provider networks, so if your doctor leaves your plan, you may

not have a whole lot of options in the middle of the year. >> this is an issue that works across the entire employer-based system, and so it is an issue for the entire system. it is not simply a marketplace issue. and that is a decision that providers make. and so our ability to control, you know, the insurer and the provider, what we want to do is create a marketplace and that the competition in the marketplace will drive consumers to make choice and decision. one of the things that we saw last year in terms of what consumers, many consumers make their decisions on -- and you see it in the private employer place -- is actually they do make that decision often based on price. and so as we continue to move forward, we're going to learn, and we want to continue to learn what the consumers are making choices on and have that income how we try and shape and influence. but much of this is -- it is a marketplace. it is an open market, and that is a part of the system that we have and that we support and work within. ..

[inaudible conversations]. [inaudible conversations].

>> this weekend on the c-span networks, friday night at 9:00 p.m. eastern on c-span a memorial service for president reagan's press secretary james brady. on saturday night at 9:00 p.m. eastern, former secretary of state colin powell talks about world affairs. and sunday evening at 8:00 on "q&a," author robert timberg talks about how as a marine in vietnam a landmine explosion nearly killed him and changed his life. friday night at 8:00 on c-span2, author, activists ralph nader calls for alliance from the two

parties to take on issues affecting america. and sunday, just after 7:00, syndicated columnist naomi klein on free-market capitalism and its impact on climate change. friday at 8:00, on american history tv, on c-span3, curator and director of the cia museum in virginia, tony highly, explains the museum's mission of preserving and presenting the agency's history. saturday at 8:00 p.m. eastern, king george's war of the 1740s. how it helped american colonists establish regional identities and gain valuable fighting experience for their own revolution. sunday night at 8:00 p.m., president ford's congressional testimony on the nixon pardon. find the television schedule at c-span.org. let us know what you think about the programs you're watching. call us. email us at comments @c-span.org or send us a

tweet@c-span #comments. join the c-span conversation. like us on facebook. follow us on twitter. during this campaign 2014 season the c-span networks will be bringing you 100 debates from across the country. and we continue tonight with the illinois u.s. house debate between democratic incumbent, sherri abuse toes, and bobby shilling. that is 7:30 eastern on c-span. after that debate, c-span will take you live to the illinois governor's debate between incumbent democrat pat quinn and his republican challenger bruce rounder. "real clear politics" rates this race a toss up. rasmussen pole at end of the september shows governor quinn ahead while a we ask america poll shows mr. rauner in the lead. pennsylvania governor tom corbett and challenger tom wolf differed on voter i.d. as you.

a judge struck down the voters have to be produce an i.d. at the polls. we'll start with mr. wolf and followed bid mr. corbett. this debate was produced in pittsburgh. >> looking at preferred public policies. it is also about democracy. we're running democratic tradition. we should be doing everything in our power not only to make pennsylvania better and stronger, making our democracy stronger and better. voter i.d., one more way of limiting franchise, one way of keeping people from vote something absolutely wrong. it is anti-democratic. >> >> moderator: governor corbett. corbett: i disagree it is not anti-democratic. makes sure one person has one vote. makes sure accuracy in that vote. i signed the bill and fought to defend it in the courts. the courts overturned it based

on procedures that were put into place. if that bill were to come back before me with the procedures changed according to what the court saw and see it in other states i believe, then i would say, yes, we need to sign it because i want to make sure, particularly in areas where there is just primaries, where the primary winner will probably be the winner, that's where we particularly need to make sure one person is voting only one time. >> i have a follow-up question for both of you. there are some states that feel that we are past the point historically where certain groups are in danger of losing their voting rights. do you feel this country is in that position, mr. wolf? wolf: not sure which groups you're talking about. >> moderator: any groups disenfranchised in the past. wolf: we still have a long way to go before i think lots of people feel they're enfranchised. look out turnout in primary election we went through. pennsylvania was far lower than it was in india voted at same time we voted.

we need to work on ways to make our democracy more relevant to the people. disenfranchising people really doesn't work. the reason, i think governor, ought to be honest here, the reason the republican party was trying to push this because it would disenfranchise democrats, democratic voters. that is anti-democratic. not only anti-democratic with a capital d but anti-democratic with a small. did we. we should not engage in that behavior. >> moderator: governor korb better. >> mr. wolf, you can try to determine the intention of republican party is. my is citizens in pittsburgh, eerie, pennsylvania, suburbs are doing exactly what they're supposed to do, one vote for one person. disenfranchise mane is very interesting question the way you put it that way. i think what we see is lack of interest. i did see that the democrat primary, had 18% turnout for four different candidates. obviously the party, the electorate wasn't too interested in number of the four

candidates. what i see is we need to educate more, we need to do better education of participating, particularly in grade school and high school. even in the work place, encouraging people to go vote. but whether people are discouraging them to go vote i don't think that is taking place as it did 30, 40, 50 years ago. >> and "the cook political report" lists this race as leans democrat. "real clear politics" has averaged recent polls in the place, find mr. wolf ahead by more than 15 percentage points. see the entire debate on website, c-span.org as we work our way toward bringing you 100 debates during 2014. discussion whether women and people of are underrepresented in american politics. this is about an hour 1/2.

>> hello. everyone, thank you for joining us today. i'm the executive vice president of external affairs here at center for american progress. i'm so pleased you're here with us today. women of all races make up 18 point 5% of united states congress and women of color make up an abysmal 4.5% of the congress. these exist in direct contradiction with women make up half of the population and more likely to vote than their male counterparts. this afternoon we'll hear about the reflective democracy campaign new research which shows that this persistent, underrepresentation of women anl

women of color exists throughout the country at all levels of government. over the summer the reflectivelo democracy campaign finished an unprecedented new database of more than 42,000 elected officials throughout the country their survey showed the great disparity in gender, race, and ethnicity between our electedea lawmakers and those who they represent. i would like to thank donnatw hall, president of the women donor network of which the reflective democracy campaign is a part and brenda carter, director of the reflective democracy campaign for bringing their new research to share with us today. thank you so very much. at the center -- [applause] at the center for american progress we believe our growing diversity is an asset and that our democracy is strengthened when election officials reflect

the constituencies they serve. evidence suggests that there is much to be gained from encouraging a greater number of women and people of color to run for office as well. studies including the one we will discuss today, continue tof suggest that places with more reflective lawmakers, produce more progressive policy outcomes. this data from the reflective democracy campaign is a new starting point for a necessary discussion as we look ahead, not just to november's midterm elections but more importantly, to 2016 and beyond. how can we understand, address, and ultimately reverse thebu chronic underrepresentation of women and people of color in politics. here to address these issues is our speaker, our keynote speaker, representative donna edwards. she represents maryland's fourth district comprising portions of

prince georges county and anna rundle counties. she was sworn in june of 2008, becoming the first african-american woman to i represent maryland in congress. i find that stunning and startling, repeating it, the first african-american woman to represent maryland in congress. congresswoman edwards has enjoyed a diverse career as a non-profit executive director of the national network to endodomestic violence. she led the effort to pass the violence against women act that was signed into law by president clinton. since being sworn in, congresswoman edwards has secured a number of legislative accomplishments to improve the lives of working families in her congressional district and around the country. her first act as a medicaller about congress was to add maryland to the after-schoolun suppers program, insuring access to nutritional suppers to after school and youth development programs in schools located in low-income areas. during the health care debate

congresswoman edwards secured a provision that holds insurance companies accountable for unjustifiable rate increases. congresswoman edwards also introduced legislation to expand research and development, domestic manufacturing, and infrastructure spending, to create jobs and grow our economy. she was also the first member the house to introduce and champion a constitutional amendment to overturn the supreme court's citizens united decision. cap could not be more honored to have congresswoman edwards today to share her perspective on thi critical issue. please join me in welcoming congresswoman donna edwards. [applause] >> well, thank you very much and good afternoon to everyone. i am just so delighted both to be here at one of my favorite organizations now, institutions here at cap.wa i can not tell you what it means to have cap at the table making sure that those of us who are

policymakers really have the tel right stuff in front of us in order to do that job. so thank you very much. and i can't say enough about women donors network. i first came to know wdn many years ago in my time in philanthropy. more than that i've come to know the women of wdn, including its leader, my other donna, donna hall. because we have been able to work together on a number of issues over the years and i just appreciate your leadership. and what a better time could we find to discuss leadership, leadership development, and reflective democracy? because in fact they're the same thing. when i think about, as i was listening, as i do sometimes when i don't zone out to my own biography, in fact, my story is a story of what it means to have reflective democracy.in and i was stunned as well when i

won election in 2008 and people said to h me, you know, you're e first african-american woman to represent maryland in congress and i denied it. i said that can not possibly be true. how can w it be true in a state that was the home and theno centerpiece for harriet tub man and sojourner truth and frederick douglass, how could it be possible i'm the first the first african to represent maryland in congress? yet that is the question as we look across the united states that we have to ask ourselves, really particularly because increasingly around the world we're coming in on the low end when it comes to leadership than really reflects our population. and i want to talk about what that means for women. i am on the political side the recruitment chair, i was thisn past cycle, for the democratic congressional campaign committee. during this cycle we recruited

of our top tier candidates, a majority of them were women. i don't think it is an accident when you have women around thend table helping the conversation about identifying candidates, talking to people, that you will come out with an awful lot more women. so i'm proud of that. but it is frankly not enough. and although it is true that in this congress we have a majority of democrats in the house of representatives now, that it is perhaps more representative than it has ever been. if you take, look together at the aggregate of african-americans in the congress, of women in theo congress, of lgbt members in the congress, that we are more a majority, minority, minority majority, whatever you want to call it congress than we have house of representatives on the democratic side than we have ever been. but that is not the whole

congress and it is not at large. the difference when you have a, have representatives at any level of government that better reflect the population and the communities we serve, the better public policy will be, it should not be an accident or a surprise either, that my first act of congress was to add maryland to the after school suppers program. while part of that is because of my experience as a mom, as a experience of a single mom, struggling mom, to put food on the table to make sure when my son went to school that he had enough to eat. t thinking on that experience, alongwith marrying that to the experience of so many people in my congressional district, that led me to do that. that is reflective democracy. it should not be a surprise that, the priorities for me as the chair of the democratic

women in the house and the co-chair of the bipartisan women's caucus, that i put at the front and center equal pay for equal work. raising the minimum wage. making sure that we have at least one day of paid sick leave. focusing on things like child care and providing access to quality, affordable child care. i want to talk about that for one minute. because we know that 2/3 of america's workers who work for the minimum wage are women. and awful lot of those women are women of color. so it makes a difference when you're at the policy table whether that becomes a priority or not. that is reflective democracy. when you think about, things like, equal pay for equal work, i was with a group of senior women, just yesterday about, over 100 of them, largely african-american women in my community. and i started talking about equal pay for equal work. now the overwhelming majority of

those women are not working anymore and they're retired. p and most of them are either living on a small pension ifng they were fortunate enough to receive one, or almost living exclusively on social security. what does it mean for those women the fact that we haven't made sure we have equal pay fora equal work and that is not front and center of our policy agenda? what that means for them is that they enter their retirement years having lost thousands and hundreds of thousands of dollars in income, unable to contribute to their own retirement security, just because they didn't make the same amount asth the man who was next to them who had the same education and same experience. we need leaders at the table who reflect those persons and are able to contribute to the policy discussion to make certain that those policies become reality. i had an experience when i was raising my son and, i was really struggling around issues of

child care and paying for the mortgage and all of those things and talking about those things. i remember when i ran for congress, there were some people who said to me, mostly male people, said, oh, you shouldn't talk about those things. people don't want to hear about that. it will make you seem too softsu and no one will want to vote for you. nothing could be farther from the truth. that in fact my ability to speak about my experiences as a single mom and as a worker, really contributed to the conversation about why it is that i should be elected. those are the conversations that can come to the table when we have democratic representation that really reflects ourme communities. why do i think that child care is important? because i was one of those moms who was paying a dollar a minute for every minute that i was late, picking my son up from child care on a fixed income, where i couldn't afford that extra dollar a minute. of course in the washington area it was more like $18 a day, if

you're stuck in traffic. why was it that i was concerned about child care, when i had to in fact get, what i already knew as a mom to be substandard child care for my son and ended up with meningitis and i almost lost him? talking about these issues that ground why it is that we work and engage on public policy is exactly what the idea of reflective democracy is all about and frankly we can't have the kind of democracy that all of us, really aspire to and want if all of our voices are not at the table. and that means that 18 1/2% is not enough in the congress of the united states to reflect a population of a majority of women who need to be serving in elective office in the united states. it is just not enough. it is not enough that we've gone through what, 23years, if i'm doing my math right -- 238 years.

and not had a woman at the highest level of the united states and commander-in-chief. so maybe been 238 years too long for that. maybe 238 years too long for the fact that we only have a verys small percentage in the congress of the united states. so we have to do better. when i think about my african-american sisters in the congress, we're a small cohort as you heard but we sure bring an awful lot of different conversations, even to our table among the our african male colleagues. so it isn't just enough for us to say that we can elect people of color into the congress. it is time for us to really elect women into congress. and so finally i would like to close by sharing with you this story. it is a story of a little girl who was, you know, in her preteen years with glasses and the braces and the, you know, no

one wants to take out those pictures of any of us in middle school. but i had one of those pictures and, and i looked at the leaders around us. i began to at leaders like shirley chisholm and like barbara jordan. i thought, my gosh, i want to be like them. i looked at my mom who worked so hard all of her life taking care of six children and trying to grow them into responsible human beings. i marvel at that frankly. i had enough of a child just t trying to grow one child into ab responsible human being. i think about my grandmother who struggled when she was farming with my grandfather and really struggled to put food on the table. when the farm wasn't working, she would go and clean houses and she never had more than a high school education but she was one of the most brilliant, smart, women that you would ever meet. we have these legacies in our

country. and it is about time that our political leadership actually reflected the kind of legacies we have in every single family and every single household all across the country. so, thank you very much for having me here today. i hope i'm able to sit in on just a little bit of the panel discussion. and thank you to the women donors network for the research that you've done, that can really inform the direction that we take. and i would like to say that going into, you know we're about to finish kind of one election season. and going into another election season, wherever it is that we g find ourselves, it is time that we stopped just asking women to run. it is time that we really support and get behind them when they do. and then more than that, to stand behind them when they lead. thank you very much. [applause]

>> good afternoon, everybody. as the other donna said, i'm the other donna. my name is donna hall and i have the privilege of serving as the president and ceo of the women donors network. it is really wonderful to have you here today because for us to have donna here with us is a bit of a celebration. takes me back to the time we first met. we were invited to be a small delegation going to the country of chile, when michelle bachele elected the first time. the first woman elected president in south america. a group of 15 of us traveled there. as some of you might remember she made eight campaign promise half of her cabinet would be women. when we went to see her inaugurated and asked her cabinet to stand up, it was a remarkable thing for all of us from the united states to see 10 of 20 leaders stand up who were women.

so it is wonderful to have you here today because this is a really a follow-on to one of those questions which is, how do we, how do we really get women and people of color into office? as i mentioned before, i'm the president and ceo of the women donorsea network. and we're a national network of 200f members anfid we really strife o make structural and through convenings, through catalytic and collaborative funding and working in partnership. that is what brings us here today. who leads us? this is really our topic today. america was founded on the ideal that all people are created equal and have a stake in how our nation is governed. while we may not always succeed, ours is a history of pursuingw this vision.n is not enough that women and citizens of all races have the right to vote. i every american must have equal

access to lead as well. today we're here to confirm with hard data the extent of a very serious problem. the problem that our elected officials do not truly represent the populations that they serve. in fact, our research reveals what we all intuit, that white americans, and particularly white men, maintain a powerful hold on the political representation at all levels in our country. we at wdn have long been concerned women and people of color do not have a real voice at then tables of power. we learned this over and over again as we apply intersectional lens to all the work we engage in, a lens that overlaps race, gender and class as it applies to the problems of our times. this concern is not limited to election officeholders but also extend to the halls of business, to the arts, and to many of the

large and powerful non-profits and foundations. i think we would all agree there is a growing awareness of this reality and a lot more discourse today than there used to be about these persistent patterns in our society but for us at wdn we decided to start with a narrow focus on elected officeholders as a strategy to reflective democracy. today we're here to describe for the first time that we now havee an open source database that has compiled demographic data including race and gender for the first time on over 42,000 elected officials in the united states, from the federal, to the state, to the county, to down large to cities of 300,000 population. what you will hear and see shortly tells a very stark story, one that will surprise you even more i think than you think. it suggests that in order to have the real democracy that we all cherish, we must workde

purposely to remove structural barriers that are preventing more women and people of color from leading in america. wdn got this work started but we can't do it alone. we invite you to partner with us as we this work forward. in the next two weeks, we'll be releasing more data, as well asn an interactive tool that will allow anyone to see how their state stacks up, when it comes to representation of women and people of color. we'll also issue a tool kit for taking action. and in 2015, we'll focus on working with partners to develop pilot projects that can test different solutions for tackling structural barriers that would result in more reflective democracy. before i introduce brenda, i just want to take a couple of seconds to acknowledge people here today who really helped us with this work in getting us to the stage where we are. first of all i want to thank, winnie and nira and people at

cap hosting us today. cindy who i see in the back and pillar weiss, is she here? hi. there sheca is. they worked with us throughout 2013, helping us to distill our focus and to provide the overall structure for this reflective 2 democracy work. we couldn't have done a data project you will be hearing about momentarily had it not been for great folks at noi and rutgers university center for american women in politics. and of course our opinion research firms, lake research and david binder research and our communications consultant they have been with us and partnered to do a lot of work in a short period of time. and finally i would like to acknowledge jennifer ancona, who is the senior director of membership and communications and really managing this largeee initiative in-house for us at wdn. let's get to the meat of our conversation, i would like to bring up brenda carter who is our campaign