minnesota was the state said they were implementing the program. you're cannot illustrate the basic health program january 2016. new york estimated $2.5 billion

billion. how is this possible since the money has never been appropriated? in other words what extraconstitutional authority are you invoking that allows you to spend money that is not an appropriated. >> with regard to the issue of the teen 11 aware that is 1311 is about states that want to choose what ways and see flexibility and that is what we do is work with states than they do that appeared with regard to the car sharing and the issue of 1311 the budget appendix at 1046 and 1047 believes the law. >> there's been no appropriation. you acknowledge that, won't you? >> we believe the authorities or the authorities -- >> but you are conflating two concepts. you are conflating authorization and appropriation. there is an authorization that

there's been no appropriation. at the appropriate money that hasn't been appropriate? >> for programs that are tax credit for programs that are part of the discretionary budget every year. in terms of discretionary programs the earned income tax credit i'm not a part of the discussion. >> just a follow-up. would you give a briefing to me and also to chairman tim murphy who chairs the oversight subcommittee on energy and commerce to clear up these things with more time together? >> it would look forward to these issues. >> you mentioned $22 billion in fraud savings which is okay, not great. mr. lewis and i found this out with numbers of our subcommittee. by medicare's own admission his waist and a billion dollars a

week every single week in fraudulent and erroneous payment. $22 billion is okay. but it's like turning it off halfway through the year and let a 9.5 years ago and do nothing. we really need to up the game. i healed back. >> thank you mr. chairman. thank you for california california constituents in their health care. madam secretary, thank you for coming out. i want to say i hear a lot for my constituents as well about the aca. i hear from people who are pleased that preexisting condition is no longer an issue but the 26 euros stay on the policy. they have access to quality preventive care which i know for a fact will save us all many in the long run. but i also hear them say they

recognize problems with the aca and they want us to work together to fix those problems. so i don't know how it could be a lot different in other parts of the country. my experience has been that folks want access to quality affordable health care and we do have a responsibility to figure out how to make that happen. i appreciate your effort in that regard. i am all for fixing, make in tweaks and adjustments. congress member black and i will introduce legislation today that falls into the category of making mistakes. we are going to introduce a bill that would use reporting requirements for employers operating coverage for their employees. it would require the exchange has used the most recent tax data to ensure individuals or

families will not have the large tax bills at the end of the year. as i am sure you know, california, my home state of california requires the most recent tax data has worked well and it has been beneficial. i am wondering if you have any thought on the more recent tax data to determine eligibility for subsidies especially auto renewals and make it not apply to all the exchanges. >> it is in our interests and we want to get the most up-to-date information we can have which is why we encourage people to come in and updated throughout the year to do that. we have to look at the legislation. i'm not sure if this is a treasury rs but we work together to understand. what we want is to have the most up-to-date information. that information for some people is an evolving and changing

piece of information. self-employed incomes change throughout the year. we have means they can update it and we encourage them to do that. the most up-to-date information is something we support. with regard to specific set the legislation would like the opportunity to look at it and understand where we could be. >> thank you that i also have questions regarding the feel process that i understand from your staff is how we will work together outside of the committee hearing to deal with that. i appreciate that commitment. >> it is. i would use this as an opportunity to mention the piece of legislation bipartisan senate finance just passed this past week on the issue in terms of the strategic approach to help us get to a place where we can reduce the backlog of appeals. there are administrative things we can do but we need statutory health. senator hatch and mr. white has

led him outside and we hope we can help as well. >> we are working together on the legislation and i hope we can have the help of your agency making sure that this is the best legislation possible. >> thank you here was over quickly. >> i healed that. >> thank you, mr. chairman. madam secretary, with respect to many of us here and across the land believe the principle you've outlined in all of us hold dear are all being harmed by the current path we are on. i want to highlight some of the problems that are weaselly of are weaselly primate patience industry in destroying the ability of those working as hard as they can to care for those patients. one is the electronic health record meaningfully you start dictating what must be documented and how they must be documented. without regard what is truly important and necessary to take care of patients wasting money

wasting time wasting resources in the expertise that physicians. many of the thin crack this in fact a note to individuals who said this is the last straw and a quake in an age they could practice for years and years. there are solutions if we allow for those providing care. another example of cms making it more difficult for physicians to care for patients in some cases small rural practices we discuss will drive physicians out of business so access is destroyed. the u.s. inappropriately confuses clinical data happening medically with the patient with billing data under the guise of wanting more information and save everybody else in the world is doing it. the fact is the u.s. will be the only country to use all 87 codes. the only country to use it in the billing process, the only

country to put the cost on the shoulders of the positions in those providing care happens on october 1. it passes the prologue sadly it holds real potential to the significant disaster further harming patients. i urge cms to delay any penalty for coding errors for at least two years. it is only reasonable given the magnitude of change coming. durable medical equipment oftentimes the only thing that stands between the quality of life in hospitalization or even death in the instance of the provision is a caring provider. cms has put in place a system of competitive bidding that doesn't work. it is harming patients in driving folks who have been wonderfully providing care in the states and communities across the nation out of the further harming the patients. i am pleased to allow a private demonstration to show much

better way to save money and provide services to patients. sadly the president continues to shamelessly can then attack those standing up for patient centered health care. as recently as yesterday he ignored reality and cynically mock those striving for positive solutions. we know he has a pen and a phone. but he doesn't have is the knowledge or humility or concern or desire to work together on behalf of those struggling to provide care and those receiving the care. none of secretary i urge you and your team to join with us in an open-minded way to end the oppression of meaningful use and provide flexibility so they are not destroyed and demonstrate competitive knitting has a much better way to give physicians the freedom to care for patients. if you are sincere in your desire for accessibility and

affordability and quality, that would lead to your action working with us and i look forward to that and move in a positive direction. >> thank you, mr. chairman. thank you, madam secretary for your service. from the great state of connecticut we are so proud of the affordable care act and it's great to have a governor that is hands-on in this implementation and all the progress that we know that has been made and will continue to be made under this act. mr. chairman, i would like to submit for the record the 28 page report in the language of health care 2009. is there objection? >> no objection.

>> i have a great deal of respect for mr. wants as well. he instead revert also another pollster and someone who spends time on the science of language looking in detail what people should say around subject matter areas. now this is particularly of interest to me because in the past this was recommended in 2009 and basically describes the 10 rules to take over. it is informative even in this debate today. for example the argument suggested democratic health care plan must center on politicians, bureaucrats in june. not free markets, tax incentives or competition. we will hear a lot of that. it also goes on to -underscore

you simply must be vocal and passionate on this side of the reform. the status quo is no longer acceptable. if the dynamic becomes president obama is on the side of reform and republicans are against it then the battle is lost and every word of the 30 page document is useless. he goes on to say this and this is the whole point. it is not enough just to say what you're against. you have to tell them what you are for. it is okay and even necessary for your camp pain to center around by the health care plan is for america. but if you offer no vision for what is better for america, you will be relegated to insignificant that vast and labeled obstructionist

outbursts. what americans are looking for in health care is what your solution is, what it will provide words have more access, more treatments and more doctors are sure winners. i agree they are and that is that the subject should be about, for as providing more access. madam secretary, may i ask you are you aware of any republican legislative proposals to reduce the number of uninsured in this country by more than 60 million make sure we continue to provide all the benefits of addressing preexisting condition, keeping your children on the plan in making sure we focus on prevention. >> i have not seen a proposal that does that. >> i thank you, madam secretary.

but back on the submitting the full report for the record i think it is worth everybody's reading and we have to get back to what the committee should be doing and that is to put americans first and put americans on the road to having the best access, more access more accessibility and more availability to help. thank you. >> we are now going to enter in the two to one phase to keep a peak world. mr. buchanan. >> thank you, mr. chairman. thank you, madam secretary. i appreciate you taking the time to speak. my biggest concern. at the top of the list is chairman of the florida chamber. we have 137,000 businesses. most of them were 50 employees or less. a lot of small business. the biggest issue before the aca to rack 15 years of affordability and there is some

expect patient our hope that we could have occurred on affordability. there's no question people get the subsidies. they have over a million in florida. just about that poverty line they don't get the subsidies and i want to talk on to basis first. small business, their cost to provide health care has gone up 20% to 30% the last three or four years. we talked to another person the other day. throughout florida, throughout our region, we are not seeing any reduction or anything in terms of affordability from the standpoint and many times last week we had a town hall. one woman a couple weeks ago said $2000 a month to get health care. she can get it for a laugh and she has to pay and send $10,000 health care if she has a claim.

what is your thought on the affordability and where we are right if they relates to people who don't use subsidies. >> when we think about affordability, we think some progress has been made. we were seeing deductibles and growth and we have seen a slow premium. the things we have seen lowdown is a solid premium growth across a number of categories. we've also seen medicare savings, over 300 million in terms of where we are and medicare pricing. the other thing that is indicative as we have seen the per capita health care grow as a nation because we had so many people retiring. the overall cost of health care will go up because we have more relay. >> we are short on time. we are not seeing the discounts per se to come to florida and talk to small business people. most of it is 20% to 30% increase in the last couple

years. unfortunately a lot of the cost gets pushed to the employee. so many employees or maybe picking up a couple hundred bucks a month are now paying $500 to $600 out of their pocket. if they don't give a city many are guided. we like to talk about the middle class. a lot of this is between the middle class at risk in terms of health care and what are your thoughts on that. >> this is why one of the things we need to focus on is the delivery system reform. that is the idea of better, smarter, healthier. we have to be careful when we talk about this topic because people hear it and we need to make sure we reserve quality and improve quality. why do we have the lowest level of quality offerings for health care. right now one of the things we did in january, we committed the federal government for medicare

payments, 30% by 2016 50% by 2018 will be based on value instead of volume as a part of working on the overall issue. you want to hear what you are hearing about is to us. >> i may just close with the idea because we have a few seconds. i hope we can focus more on affordability all of us because that is bankrupted a lot of people that don't get subsidies. that is the reality of florida for small business and individuals. the focus needs to be on affordability, finding the ways to bend the curb on health care costs. >> we look forward to the opportunity to work on this delivery system reform issues. >> thank you, mr. chairman. thank you madam secretary for being here today. as you know and as we spoke earlier about the consumer operated and oriented plan programs which were the alternative to the public option, i would argue perhaps these are somewhat caused by

public options. you intend to be low cost government subsidized health care plans and today hhs has awarded $2 billion in federal funds to establish the plans that as you know served over 100,000 people in nebraska and iowa and was pleased at the state of iowa and a sense been liquidated. folks on the plane have the musketeers, less frustrated and began looking for other plans. i sent a letter january 23rd asking specific questions. did the receiver responds. i would like to request unanimous consent to submit to both of these letters for the record. quickly some questions. the opportunity received approximately $146 million on federal loans. will any dollars be paid back to federal government? >> with regard to that that is a question i'll follow up on. >> appreciate that.

my understanding of iowa and nebraska were told they could not suspend enrollment in a whopper contract opportunity and have it remain a health plan yet tennessee was later allowed to do so. do you know why the policy changed russian art >> for a conversation i did follow up with cms and we didn't have record of that solar love for a team to follow up and understand that there was miscommunication. based on your comment something was concerning to me when you mentioned and i went and followed up. if we can work with staff to understand what your staff understand happened, that would be helpful >> recent reports claim one hour didn't have operating loss in 2014. is that accurate? >> i would have to follow it. >> are there concerns >> are their concerns and possible liquidation of other plans in the future? >> with regard to the co-ops because they are one of businesses, startups like we

were just talking about before. we are going to have failures in terms of the co-op system. that is a part of what the congress gave that to request further means went to 1 billion. there will be a co-op that will have challenges and issues. the to make sure we get in front of them into the kinds of things we have to do a situation which was to make sure as much as possible we would engage in supporting communication and offering a special enrollment period and working with state insurers to use authorities they have to make sure consumers are taking care of. >> okay. and if the consumers on the failed co-op be penalized by the agreement? >> i do not know how many are not still in the system that will check in follow up on that. yeah yeah but i want to confirm

the report. >> i have introduced h.r. 954 would tempt anyone who is last hope and sharon from the failed co-op's on the individual mandate. could the administration support that approach in legislation? >> about the opportunity to see if that is something that has happened or not review the bill. >> in the bigger picture above is a large sums of money being offered to the consumer operated and oriented programs what is the likelihood of those dollars being paid to? >> with regard to the laws that have gone up? that will happen in terms of a successful co-ops and is gaining traction and working. there are maybe some that are not and we would get back on the specific question. >> seems to me also to various phases rather than today's issue might have a different approach

for paying on the claims that were submitted. how on top of this are we? in nebraska there is fall back and yet it hurts my people. i apologize. my time has expired. >> the state insurance law as he knows a part of how that is determined. we try to support the states of different options. >> mr. blumenauer. >> thank you, mr. chairman. madam secretary, i appreciate your reluctance to deal with hypothetical legislation that hasn't yet been returned to deal with a legal decision that hasn't yet been rendered. i think it is prudent. but if this current takes place by the court it seems to me it would not be rocket science as some of my colleagues have mentioned to make relatively minor changes to conform

statutes to the intent and text of the bill and move forward. i think the committee could take one weekend and fix it and move on. i would like to shift gears slightly. we have had an ongoing series of conversations. it has been six years since a provision i offered was approved approved unanimously by this committee dealing with end-of-life care. that provision despite a kerfuffle and certain rhetorical flourishes remain in the legislation. unfortunately, it felt that into the reconciliation process and six years later we are trying to achieve those subject is. although the world has moved on

a best-selling book by a too local one day, billy graham, all agree it's necessary. you recently received a letter from 65 notable national organizations calling on you to have medicarereimbursement for advance care planning. as you know the ama did the coding. it's all ready to go. fox is going to be there and get it lingers. published peer reviews and research shows that dance care planning leads to better care, better patient and family outcome, fewer unwanted hospitalizations. the list as you personally know it is compelling for the service. if the administration prepared to finally move forward and authorized that? >> with regard as i think you

mentioned the ama has given the guidance encoding and we are in the process of reviewing that. as we indicated in a recent rulemaking that is something we are working on in reviewing the current coding. >> it has been six years since congress embraced it and this committee approved it unanimously. we have had the research clear, the il-1 dying in america. i'm trying to understand, what is it that is so hard to figure out whether or not this is part of the legacy of the obama illustration which has got some good things with health care. this seems to be a terrific thing that is really simple to make a huge difference in peoples lives, private insurance. what is it that is hanging this up? why can we get to yes? >> as we have said in our conversations with you this is

an issue will work on because if we do make the process we anticipate. >> i find it mystifying. this is one of the few things the committee agreed to unanimously and we see the difference it makes in human life and the administration continues -- [inaudible] i hope this could be part of the legacy and part of the 2016 reimbursement. i find it frustrating beyond my ability to express. i have walked the plank for this administration on things before and this is really troubling. >> the time of the gentleman has expired. >> thank you, mr. chairman. thank you madam secretary for being here today. i want to add that the comments of chairman brian and others on the committee regarding the

supreme court decision later this month on the constitutionality of the president's health care law. kansans are poised to lose their subsidies, which is the only thing that makes their insurance somewhat affordable. many constituents will be facing increases over 30% next year which in addition to the loss of subsidies will make their insurance unaffordable. i am extremely frustrated because i had an exchange with your predecessor secretary sebelius three years ago. february 28 to 2012 and a witness before the committee. on that day i expressed my concern that i did not see anything in the health care law that would allow federal subsidies through non-faith-based exchanges. the administration didn't have the word hate to go through saturday facilitated exchanges even though the irs was telling

congress it didn't matter. and the law there is no mention of the term fairly facilitated changes. even though secretary sebelius with the detailed writing for the interpretation of the law should never did. now the supreme court will finally weigh in on it. i am equally concerned when you sit just the business before the supreme court is just about the subsidies because we have research which talks about all of the positive outcomes from the decision by the supreme court against the administration over another million individuals freed from the mandate. over 260,000 businesses freed from the employer mandate.

hundreds of thousands of new jobs. 1.2 million workers added to the labor force. with limited time, what i would like to do is turn my attention to a different topic. i have introduced legislation in the past three years alone with my colleague, representative kind, to repeal a provision that allows folks to go to their doctor to get a note in order to purchase over-the-counter medicines with their hsa or fsa. this prevents patients with government red tape they must navigate to purchase over-the-counter medicine. you save the health care system money. additionally present positions with the bizarre scenario of unnecessarily seen patients in order to prescribe over-the-counter pain relievers or allergy medicine. this provision makes care less

affordable more confusing. cause doctors offices and makes patients less likely to use over-the-counter medicine. madam secretary i was just wondering if you think this is good policy and if you would support sn repealing this provision. >> so as i have articulated, one thing we are focused on is the idea of how we can improve quality and move towards affordability. this piece of legislation i am not familiar with in terms of the issue you are trying to resolve. this is one i would understand. i also want to return to where you began. >> in theory, would you support this simply commends the chairman to mark up the bill over to the senate? >> that is already passed with a partisan support out of the

committee and out of the house before. >> congresswoman, i want to look at the substance of the issue. it is not one i'm familiar with. >> already. >> thank you so much. mr. paul said. >> thank you, mr. chairman. secretary, thank you for being here. i want to address a couple of things. in minnesota unlike many states we have pretty low uninsured rate prior to the president's health care law kicking into effect and we have a high risk tool for people that have preexisting conditions since 1976 and it wasn't perfect but it works pretty well. the high-risk pool is closed away from the new exchange program said. a lot of the headlines would've heard from colleagues concerns about premiums rising. headlines over the last few weeks in minnesota should be experienced under the new exchange of the president health care law law has been affecting

pocketbooks. eight minnesota health care plans proposed premium hikes of 11% to 74%. another story here, blue cross blue shield of minnesota the largest in the individual market and now proposed average increases of 54%. certainly this is a pocketbook issue for families individuals, small business alike and my hope regardless of the court decision and how that goes that we will work with the administration on addressing the affordability costs. when you talk about premiums this goes to the heart of affordability as opposed to talking about per capita health care costs and other areas like that. i hope the cooperation will be coming forward. we need a host of issues if we solve the challenges rather than digging in and protecting every provision of the law right now.

my interest with medical devices and medical technology which we talked about last week is important in my state. america has been a leader in developing technologies incurious and innovation at a rapid pace. it does not keep pace and i don't think it's acceptable that american-made technologies available to citizens and technologies and not available to patients at home. the number one concern right now put doctors and investors isn't the fda the biggest hurdle they now face a cms and the lack of certainty surrounding coverage encoding and reimbursement. these decisions can take two or three years after the devices have been approved they've already been approved. this creates a lot of uncertainty for manufacturers and others who want to utilize technology for their patient. my question is what can hhs do to oversee cms under your

authority to make sure we bring certain people from coverage decoding the quite honestly can be a whole host of area of money. it is definitely an impediment right now. >> on the issue at the dma and cms, we would like to work. what we are trying to do is get the balance between making sure we've all talked about health care costs and growing health care costs and make sure the evidence-based decision saying they will pay for it. fda in terms of safety and cms determined that we will pay the benefits such that they should be part of the payment piece and will continue to move through quickly, but also find ways to balance it. if you have ideas that is something we would welcome in terms of what you hear from the companies. the other thing important to touch on the premium issue. what is in the news recently as

a part of the aca after to make sure we have transparency and downward pressure on premiums. what's been in the news recently as any premium increase about 10% has to be reviewed by state insurers. what you see in the space right now in many articles i'm not sure about the headlines divide, but they are about the fact you are now the first submission. we saw this come down because the review process works because they are conversations in public that creates downward pressure in the premium increases. it is a part of the process in a semi-flat oval base. most insurers say the majority of the people they think they will roll in 2016 went premium increase. we agree with you on the importance of the downward pressure. >> thank you. mr. kind. >> and secretary, thank you for being here.

obviously there's a lot of tension and focus on where the court ultimately comes down. in your opinion, how quickly or easily could the congress if it wanted to enact legislation that which should fix that if it is in the first decision of the supreme court. >> i think i wouldn't be -- i would hesitate to say how quickly. i think the question of the issue if it is ruled as about the subsidy but that is a relatively simple solution that one can do legislatively with regard to subsidies for those in the federal marketplace. >> i come from the state wisconsin, i'm very proud of. i've never seen a greater act of fiscal malpractice on what is perpetrating the last two years and denial of the medicaid expansion money from the budget proposing $300 million in cuts in the university system. if you take the medicaid expansion fund that would bring

it to the state $350 million over the next 20 years. it seems to be basic math and his denial of god is not only denying people who are tough to cover to be get rid but also giving the money in the state were conducive to it in wisconsin. you especially and hhs have been working closely with other republican governors throughout the nation to figure out a path forward on waivers and modification and i would encourage you to continue those lines of communication because we need help in the scott them. he also rejected the ability to form the exchange. we could have done at the wisconsin way. he chose not to. we do the math first decision. 166,000 could lose the premium tax credits. my guess is that insurance would be rendered unaffordable to them. there is a lot riding on the decision and hopefully they will continue to work with the state to do the right thing and

wisconsin where we need help. i also appreciate your sustained focus not only on delivery system reform but payment reform. i agree with my colleague, mr. buchanan that more needs to be paid to cost containment. you set up the new network on quality collaboration from the land of integration and coordination, quality measurements best practices. in your estimation how quickly can we exhibit the quality based reimbursement system? >> when one considers medicare dollars are large portion, we believe we can do to 50% by 2018. the goal for 2016 b. and 30% because obviously i won't be here and we need to set a goal and achievement. we think you can get 50% of medicare. the point at which 50% of medicare is based on value and

which i do make a pass by the network. i am meeting with the insurance ceos as well as ceos of companies because those are the other payers. in new york state, medicaid has committed the same thing we are. i think the path we have medicare on is close to the trajectory for the nation in terms of moving towards more value. >> why do you think more states are taking up the challenge in converting medicaid to that type of payment system? >> more states are interested in our conversation. a number of states not wanted to have the public commitment. a number of states are part of the network and across all state that could look around and talk to governors from a number of states that are willing and thinking about this because they believe the value-based payments and medicaid is a very important thing. there are more states interested that are not in the point of public admin.

>> thank you, mr. chairman. >> thank you here we are now going to three minutes per person to fit in as many people as possible. >> thank you, mr. chairman. secretary burwell, in the period of time the affordable care act has been a top bid probably the most unpopular aspect and most debated in my district where the ipp panels. many names were given to those panels. last week i think i was able to cast a vote publicly that would abolish the panel. yet there is talk about strengthening the panel. there is talk about expanding the panel. could you give us an explanation of what this talk is all about?

>> with regard to the changes in our budget it is to strengthen and increase medicare savings. as we have all discussed, health care cost in the issue of health care cost and medicare being a core element of that is an import one. we are hopeful in the budget of $423 million in medicare savings in specific ways we can all have a discussion about those who disagree with us about the balance we have a provider in beneficiary purchase getting the money. what we believe is the ipaq is a tool that the congress would still engage with because you would improve anything that wasn't suggested. the congress would have the opportunity to give it a thumbs up or thumbs down is an important tool to keep the pressure on all of us. i think we all know medicare expenditure is a tough issue for

everyone in terms of the issues we talk about a man's for dna or other things. we believe it is a tool in the toolbox. we and our own budget are depending on specific issues that congress could review. right now would not kick him in the president's budget would be 2019 if you don't do any changes we would do it would be 2022 and that is obviously another administration. >> so why has the president not said to the panel? >> with the issue panel members, it is something we believe we should do in consultation with the congress. that has been in place and you are expressing making sure to name the panel that there is appropriate congressional and put it. the other thing is at this point now that we see the numbers and we have made improvement in terms of the trust funds by

ability by many years, it would be in another administration. the question of the panel now. >> the president will not name the panel. >> we have not yet done it. >> ms. black. >> thank you, mr. chairman. thank you for being here come the secretary burwell. from the treasure inspector for the tax administration. the affordable care act requires exchanges to determine if applicants were offered health insurance by their employers as they were offered the affordable coverage, does individuals are not eligible for the premium tax credits. they treasure recently reported neither the federal estate exchanges were able to verify that they were not offered health insurance by their

employer. this is happening despite the fact the burden on the costly reporting requirements have been placed upon their employers. what is it that hhs is doing to insure people who receive credit legally are eligible? >> this is the ap tcu are referring to. with regard to that we have the data matching process we are doing and it checks immigration status as well as income status and that is one of the processes we are doing to make sure we released numbers were over 100,000 people came off the rolls because we weren't able to verify the information. it is a process last year that took a long period of time and now we've improved to a 90 day period of time. >> when they go to the other part of this. in their application for this

coverage, individuals asked their employer offer them health insurance and the exchanges are required to provide their response to those questions along with the information related to the irs and the monthly data report. this report again found neither the cms by many state exchanges were able to submit information until well after 2015 when filing season with complete. two of those state exchanges has still not provided the required information. this is one example of the numerous delays from cms when it comes to obamacare. health care.gov alone took over a billion dollars to build and it's apparent the systems are still not fully functioning. the cms undertook this project without effectively planning with the development or oversight.

these are taxpayer dollars being wasted. my question is can you i'll let the oversight conducted to ensure the requirements set up for a fact and the system to protect our taxpayer dollars. >> i want to check because as you all know there have been over 50 odd it at the affordable care act. i want to make sure you focus on the right one. we have a place where the information is going from the federal marketplace to the irs on a monthly basis. with the artists we received from ig is in the gao, we continue to work through suggestions. we will follow-up that it is not the case we are now -- >> i would appreciate are following up. >> thank you mr. chairman. thank you madam secretary.

i am pleased during the conversation progress he suggested the safety of medical devices. a few of us have brought that up. by incorporating the fda unique device identifier, udi. the system of health insurance claims. myself and chairman brady top about this. i am asking you today, despite the widespread support that some in cnn's i'm putting it mildly, have resisted the safety affair. so we need the tools. would you commit to work with the committee this summer to improve the policy forward? we have made progress working together on something that will actually be more implementable. we are working on it and it is something your comment and the chairman's comments and others

are something i recognized came in. we look forward to working with you. >> thank you. let me shift gears here. my colleagues on the other side combo together all the time is spent trying to undermine the aca they would have been able to come up with an alternative to this law. they can't find anything good to say about anything. so in this committee along with this committee along with had over a dozen hearings on issues related to the individual and employer mandates. members in good faith of what it is today. not to mention 64 of those to repeal or undermined the aca. make no mistake about it. that is what this is about. how many have we had on the elusive republican alternative i keep hearing about? zero. the reality is the act is

working. medicare problems, medicaid has problems. this is a very imperfect world, madam secretary. more than 10 million americans have helped the market places. 80% receive tax credit with coverage. i am interested in one question. as the aca enacted employer or sponsor rate than does the aca's big game for the financial incentives for employers to cover? that is my question. >> this past week we've seen a piece of work or the urban institute with regard to the number of employer bases. the statistics we have come a certainly cbs changes to its most recent changes to the aca members have to do with the fact they now have lowered the number

of people a thankless veteran employer-based market to the marketplace and the urban institute numbers that came out this week said an percentage has been a very slight, basically the same. a slight tip up but not numerically significant. the actual maintenance of those in employer-based market. so there's not been an increase. >> thank you. mr. young. >> madam secretary, thank you for being here today. the president of the g-7 summit this week said the affordable care act is working. part of what is bizarre about the whole thing is we haven't had a lot of conversation about the horrors of obamacare because none of them come to pass. he continues somewhat oblivious to things i hear in my own district saying it hasn't had an adverse effect on people who already have health insurance. i am frustrated and i know many

hoosiers are frustrated by the adverse impacts of experience from diminished coverage option to the lack of accessibility in their own communities for care. a lot of people are squeezed and they go into the exchanges with the price increases on premiums. and then there are the penalties of coors. the taxes that existed they can afford to buy health insurance. so i just want to humanize this a little bit for you because i know you are quite conversant in the statistics and the goings-on of much of the health care law. my district in jefferson her premium went up $135 a month. she no longer has access to the family physician who has cared for her for over 25 years. brandon from greenville sign up for health care his family can't use because of damage deductibles are too high and

they make just enough they don't qualify for assistance. jason from georgetown indiana had to pay the individual mandate tax because he couldn't afford to pay the increased premiums on the exchange and didn't qualify for an exemption. deborah from new albany skyrocketed to $800 a month, more than her mortgage payment. these are just illustrative of what our larger problem in every state across the country, every congressional district had you know, and the residents own words, the source of a cat is past. they asked you to pass. they are an existing right now she is should know what to leave i can tell my constituents who are trying to come by with this law. are they merely collateral damage? >> with regard to the examples of the story they are important

combined with the numbers in terms of what we know the 16.4 million people in our country are no longer uninsured. i hear those stories and respect those stories have been trout 22000 months later the text is up to you how to treat ms peer through the emergency room in the treat you. >> in the near term, what do we do? what do we do for the hoosiers who don't qualify? >> first of all we need to make sure have exhausted the remedies. >> i've made sure they have. >> there is the issue of coverage to care and help people to understand how to select the right plan. the plants on the marketplace are various. but in terms of the questions of deductibility. >> thank you. >> thank you, mr. chairman.

thank you and secretary for being here. early on the administration is looking for improvements to the aca to run a couple of them. it is disingenuous if you don't help make some of those fixes. one of them deals for seasonal employees, the definition between seasonal workers and seasonal employees. not sure if you are aware of the conflict with the definition in the difficult path and people in my districts across the country. the other is the revision program. this program is aimed at reducing unnecessary hot liberated nation called the reduction program. the goal was really something i would support and probably many of my colleagues supported. it's estimated 18 billion for years wasted unavoidable reimbursements. the implementation of the program has been problematic for those hospitals serving low in a population. evidence suggests eligible

proposed medicare and medicaid are much more likely to be rid of it in 30 days regardless of position suffers to educate them on proper discharge care. do you believe the program can be approved by adding clear just days for dual eligible status as well as other plan readmissions such as those internal? >> it is difficult to think that can cause. we had a proposed rulemaking and suggestion of how it makes the kinds of changes. the remarks were received back were issues not the right way to go about it. the commerce bank lay has given how we can work to the issue. we look forward to working with you on how to correct the proposal and we believe it is an issue. i understand how we can account for that. at the same time, we know we have morbid-ish and then we should in terms of quality in getting to that is something we

like to do. we clearly didn't get there. >> incher and beneficial act would be his appeal and introduced. i would hope the administration would consider and support off the unseasonal employees h.r. 863 to clarify the definitions between seasonal workers and seasonal employees causing compliance problems for employers and individuals. interactions between seasonality come employer mandate an individual mandate create opportunities for accidental noncompliance resulting in significant tax penalties for workers and businesses alike. that is another issue i would hope we could work on. these issues clarify and fixes you said fixing or improving the current law. i yelled back at >> gentlelady goes back.

i understand the hard stuff. i regret the fact that not every member will be able to ask questions at this moment. i'd like to invite any member, particularly those who did not have the opportunity to give us the committee their questions in writing. we will submit them to the witness massive secretary to respond in a timely manner to these questions from the remaining none are as. with that -- >> i think a number of you have my numbers. >> with that to honor your time your deadline, the hearing stands adjourned. [inaudible conversations] [inaudible conversations]

.. [inaudible conversations] >> we are live this morning for a forum on the american criminal justice system. kicking things off will be new york congressman hakeem jeffries with a keynote speech followed his remarks will hear from a panel of local and federal political officials, law

enforcement representatives and lawyers on how race placed into policing across the country. the american constitution society is the host of this discussion also this afternoon we will pick up a pair from the same forum on structural changes recommended for the supreme court. that will get underway at 4 p.m. eastern and we will have a 41 c-span2. this discussion on the criminal justice system running just a little bit late we understand we will have that for you when it gets under way. in the meantime here's a senate not in session today but the house is. members gavel in just a couple moments ago and to continue work on international trade legislation. this morning and throughout the day. a house democratic aide is reporting that the president will attend a caucus meeting with the democrats at 9:30 a.m. ahead of the critical vote. the trade votes happening today on capitol hill.

also jake sherman is confirming he is with political confirming the president will try to save his trade agenda by coming to capitol hill to meet with house democrats. a huge moment for the party. we will get more on those treadmills and what's happened and the house today. we spoke with the capitol hill reporter. >> it looks like they will vote on three bills today but she really huge we are looking at. the first on trade adjustment assistance which is a democratic priority but democrats started to revolt on that yesterday. they just were not happy with kind of what was going on and they are seeing it as a way to potentially stop the trade promotion authority bill which would by be the second vote of the day. if they pass taa they can move onto tpa but if either one of

those build fails it will pretty much for right now stop all the trade bills. >> host: in the hill this morning you have a webcam and you go to all the members of congress and list how they are voting. what currently is your account? >> caller: well, i think we are still about three dozen or so democrats were and decided and right now we're really looking at those democrats. were expecting everybody can i think what we've been calling it a niagara falls of votes. were just starting to see everyone come out either in support or opposition. there is going to be a group of democrats who will probably wait until there on the floor and watching those vote counts to actually cast their vote and maybe a handful the weight and decide on the floor. piercing these pile up, how they will vote. it's going to be close.

i've heard some reports that there could be up to 30 democrats are actually support trade promotion authority, but with any of these votes, usually tight ones especially on trade it's almost as anything kind of goes day. >> host: what is the reason that members, that the public hasn't been able to see the trans-pacific partnership agreement as written, and that members have to go into a secret room and take no notes or cell phones that's the only place they can see that? >> caller: sure. trade deals, i mean there's a 12 nations, including the united states involved in this agreement. they kind of understand, or explanation out of the white house and even from the other trading partners which includes japan, australia new zealand, is that they prefer a certain level of confidentiality. so they can put forward their

offers and what they want to see in the trade agreement. it's kind of a living document that is costly change and they're always trying to nail down chapter by chapter but they think if congress does pass trade promotion authority, the expected shouldn't at least has been said that nations, especially nations like canada would actually put down their best deals. so basically they just want some sort of -- [inaudible] they can negotiate and kind of continually changing their offers. that's just what they have asked for. it would be available to the public if this trade promotion authority bill passes for 60 days before the president signs it that most democrats who are opposed argued it would be too late, that they can make any changes to it.

but that's what the explanation of the white house and the trading partner. >> host: what's been the role of nancy pelosi? >> caller: the minority leader in the house has basically made sure that the white house and our member's have an open channel with each other. and i believe most of the house leadership that they talk to the white house a lot of officials have come up to capitol hill yesterday. it was a big flurry of activity with jack lew on the hill and chief of staff of the president. they basically said you guys can come up sal the trade deal and let democrats decide based on merit how they will vote down the road. basically left the door open and

said you guys can come up here and talk to everyone and i'm going to let the members decided she has not taken any position yet. so they just sort of let members go through the process and make up their own minds. >> host: john boehner to has been whipping the republicans have been whipping their members to vote for this? >> caller: yes. in fact, ways and means chairman paul ryan was one of the co-authors on the tpa bill with orrin hatch who's the finance chairman in the senate and the top democrat on that committee ron wyden to this bill. so ryan has been a very aggressive role along with several of his ways and means -- most of his ways it -- ways and means committee has really helped are they got lots of trade meetings lately with republicans to answer questions, and a very good number of

republicans have shown up including the ones who are skeptical, to who have been traded -- mode for trade and it has been they have taken an aggressive stance and an aggressive stance of a major members are educated understand what's in tpa, what's in the trans-pacific partnership commenters would answer any overall, overarching trade questions. members have been very confident of those efforts in setting its help them review what's in all of these bills. trade is a very complex and so it's been a very open process on that site is a. >> host: finally, vicki needham the hill first vote this morecambe what should we watch for? >> caller: that's a great question. it has to be trade adjustment assistance or ugly that's the building will do first. that bill needs to pass in order for trade promotion authority to come up. there are a lot of democrats including sandy levin who was

top democrat on ways and means who said he's going to oppose it. a lot of liberal democrats who have come out against fast-track trade promotion authority to see that as stopping taa which is a top priority for them. it helps focus of lost their jobs because of trade and has been included in the package you know it's not working as well as getting democrat votes but has been used in the past for that. but to move it along and it has to move along with the tpa. we are really going to be watching how many democrats vote for than it and against it. we been hearing the difference principle to vote for taa, not vote for tpa. it would be an interesting mix. likely to see a slow boat like yesterday. potentially with a certain democrats coming and helping out. it was a little more optimism on the side of folks who wanted to

see taa passed the republicans don't like it but they may need to throw a few more votes that weight in order to ensure that tpa gets a vote today. >> host: vicki needham is with the hill newspaper. thank you for your time this morning. >> live now to the forum on the american criminal justice system. we should be heading for some congressmen hakeem jeffries who is being introduced right now. this is live on c-span2. >> people who work in law firms and corporations. and that is incredibly valuable. you can see it now but wait until you see what happens in the next five, 10 20 years. this is such an important organization for the lawyers in this country. today i had the pleasure of introducing our featured speaker this morning congressman hakeem jeffries. a fellow new yorker, a very proud graduate of nyu law school. he's worked assessment of young

lawyers here in houston is also worked in firms like his passion carried into public service. he served in the state assembly for six years before being elected as the united states congressional representative of the eighth district of new york. his history with acs extends back to the time when he was in -- he was an assembly mr. geesman secret to the new york chapter. he's been active and events that acs has had on immigration reform redistricting state legislature reform and has been one of the congress was most outspoken voices on the subject of police brutality or in april in memory of eric garner, congressman jeffries introduced the excessive use of force prevention act of 2015 what could make the deployment of a chokehold unlawful under federal civil rights law. so what i'd like to do know without any further a do is have tried to come up and speak to us

come and then we will start the convention first plenary panel on "beyond ferguson: a nation's struggle with race and criminal justice." congressman jeffries? [applause] >> well, good morning, everyone and first let me thank mark for his leadership, for his tremendous involvement with acs and for the very generous introduction. it's an honor and privilege to be here at this wonderful conference this gathering of such brilliant and thoughtful and caring jurists and attorneys and law students and professors and people who are involved in the public square trying to make america the best that it can be. now it's my understanding, and i'm here to give opening remarks in advance of what will be a

phenomenal panel moderated by chris. and so much of it is just to set the table i think and then get out of the way. and so i say to you what the iconic elizabeth taylor said to each other eight husbands. [laughter] i won't keep you long. [laughter] but i did want to just share a few thoughts on phenomenon of over -- overly aggressive policing at our criminal justice system and how we might move forward. i've had the honor as mark mentioned, of serving in the united states congress for the last few years after spending six years in the new york state assembly. justice brandeis of course described state governments as laboratories of democracy. and i've been able to transition

now from the laboratory of democracy to the house of representatives, which i think is the lions den of democracy. but there's a wonderful opportunity i still believe here in this institution notwithstanding the lineup in terms of who's in the majority right now to deal with some of these are important issues in america. i was struck when i first got to congress, sworn in in january january 2013 and, of course, it was at the same moment when barack obama was being sworn in that same month for the second time as president of the united states of america. and so as a new member of congress, all of us we had a very robust freshman class. we were invited to be present on the capitol steps to participate in this wonderful american democratic moment but since we were all freshman, of course we

were there on the capitol steps that we were seated way up top. and i quickly realized that wonderful thing about sitting on top is that you can see everything that was happening in front of you. and, of course there was the president of the united states, the first family was right there with him out in front of us more than a million americans from different regions different religions, different races all their participate in this democratic moment. but what struck me the most was that in close proximity to barack obama he that arch conservative supreme court justice antonin scalia. and right next to scalia you had house speaker john boehner. and right next to boehner you

had former republican presidential, vice presidential nominee and current ways and means chairman paul ryan. and right next to those three jay-z and beyoncé. [laughter] what a great country, only in america. but what it seemed for me captured come is that we have this gorgeous all across this country of diverse people who can come together as part of this grand american experiment. abraham lincoln once publicly pondered the question a little more than 150 years ago. how do we create a more perfect union? he asked the question of course in the context of the civil war that was raging at the time threatening to tear this country

apart. and we know that year after year, decade after decade, century after century since that moment we've made tremendous progress in america. yet the death of michael brown n. ferguson the death of eric garner in staten island, the death of tamir rice in cleveland, the death of walter scott in north charleston from the death of freddie gray in baltimore should make clear for everyone that we've still got a long way to go. the principle that was unleashed on this country by supreme court in plessy v. ferguson of separate and functionally unequal has been abandoned as a result of the brown v. board

of education decision. yet we know that from the department of justices report ironically in ferguson, missouri, we still have a criminal justice system that for many people in america in many communities it's separate and unequal. and i think there's no more of an area where this is the case than in the context of how american communities are policed. and i would just suggest there are three things that got to think about if we are going to strike the appropriate balance between effective law enforcement on the one hand and a healthy respect for the constitution, for civil rights and for civil liberties on the

other. the first is that we've got a problem with overly aggressive policing tactics like stop and frisk and broken windows that are unleashed in a disproportionately higher fashion on communities of color. for more than a decade in new york city we were saddled with a stop-and-frisk program that was out of control. at its height, more than 650000 top, questioned and frisked encounters in a given year. the overwhelming majority of folks of course who were stopped, questioned frist, embarrassed, humiliated, in some cases physically roughed up with people of color. what should be equally troubling is the fact that according to the new york police department own statistics during that stop

and frisk era, approximate 90% of the people who were stopped questioned and frisked did nothing wrong. no gun no drugs, no weapon, no contraband no offense. nothing at all. clearly notwithstanding what kerry first ohio said there was no reasonable suspicion but the overwhelming majority of these individuals had engaged in a criminal act or about to do so. yet somehow integrate cosmopolitan city of new york there were many who thought this was justified by some vague notion of criminality in communities of color. but thankfully we've got a constitution and thankfully we

had a brave federal court judge who believe in those principles. i'm proud of the fact that this judge is here today and she presided over the dismantling of a stop and frisk era in the city related to be an unconstitutional invasion. and we are thankful. [applause] we've got a problem but we've got a constitution. and that of course is why we are all here. but then you take stop and frisk and its declared unconstitutional. it's dismantled after the direction of federal court order, and then we moved to its close cousin, broken windows policing. and the problem that i've got with a broken windows that i think we should work through come and begin i grew up in europe said in the 1980s came

of age at a time when there were over 2000 homicides per year. i've represented communities that want safety, that embrace safety. but we also want constitutional policing. we also want to make sure that the principle of equal protection under the law applies to everybody. so the problem i've got with things like broken windows policing is that there's really no law enforcement justification for many of the activities that are unleashed in communities of color, like going after folks for riding a bicycle on the sidewalk, taking up two seats in a subway car having an open container of alcohol on your front porch. and we know of course that things like broken windows policing, or what has been referred to in places like

ferguson as taxation via citation your disproportionately targets many of colors -- color and many municipalities are balancing the budget on the backs of otherwise hard-working individuals who are been channeled into the criminal justice system. and for many of them their life will spiral out of control unable to thereafter robustly pursue the american dream. and, of course, it was a broken windows policing that led to the encounter ultimately resulting in the death of eric garner. he was targeted for allegedly selling loose cigarettes. at worst that's an administrative offense for which he received the death penalty. this brings me to my second point that i think we've got to address, which is in the

excessive use of force are too often directed at a farm african-american men are now again, police officers, the overwhelming majority of them i believe, are a hard-working individuals who are there to protect and to serve. but no one can reasonably look at the events of the last year which just represent what has been taking place in many communities across america for decades but have brought to life in a vivid fashion now because of the miracle of modern technology. no one can look at the events of the last year and concluded that we don't have an issue with the excessive use of police force. as we saw in that videotape.

when eric garner cried out 11 different times, i can't breathe. and on 11 different locations a police officer failed to respond. medical examiner says he died as result of sexy asphyxiation. a chokehold had been applied that had been banned by the police department for more than 20 years yet something that the police officer to conclude that eric garner was a threat to his life. no evidence on that videotape that he had resisted arrest. there's something deeper that appears to be taking place as to why some police officers feel the need to use that level of

force, particularly when the subject is of a certain race and a certain gender. and if we're going to try to solve this problem we've got to confront it in an open ended evidence-based real way. and the last thing that i would suggest we've got to deal with is the fact that when a police officer crosses the line far to often the criminal justice system fails to hold them accountable. and we've got some actors in the criminal justice system perhaps because of the close relationship between the prosecutor and law enforcement who seem unable to fairly and comprehensively present a case before a grand jury that could

allow justice to be done. we saw that down in ferguson where it appeared to me that the prosecutor acted more like a defense attorney for officer darren wilson. seemed uninterested in allowing the facts, whatever they may be, to come out. same thing of course happened apparently in the grand jury that presided over the officer handling of killing of eric garner. but this is nothing new. one of the solutions of course that has been presented is to figure out a way independently for prosecutors and the police involved killing particularly within an arm civilian to

present a case either before grand jury or a judge so that justice can be done. because if there's no accountability the belief in the system breaks down. it's inherent credibility which is necessary to hold it together the roads. in one of the great pillars -- the roads. one of our great pillars of democracy is shaken. now there are some who say well does america have the capacity to address these profound problems? and certainly there's a reason for all of us to be skeptical in this climate, in the city where democrats and republicans, progressives and conservatives seem so bitterly divided, where people can see the same thing

unfold on videotape and come to two different conclusions. we've obviously got some tough challenges that we've got to work out in america but i still think that we can make it to the other side. as i take my seat i'm reminded of the time when a few young man were gathered at an estate of one of the wealthiest people in the world. and they were gathered at this state, and they were on one side of a big lake and in this lake there were crocodiles and alligators. and one small turtle. and at the other side of the lake the estate owner shows up. he looks over nbc's these young men -- and he cries out if any of you are willing to jump in

this lake, rescue the turtle, and make it to the other side, we will give you anything that you want in this world. about five minutes went by and nobody responded. and so the owner of the estate turned around and began to walk away. and then all of a sudden he heard a big splash. turned back around and sees one young man frantically trying to make it to the other side. he gets to the middle of the lake, scoops up the turtle. he dodges the crocodiles, dodges the alligators. somehow makes to the other side gets out dries himself off, and over the turtle. the owner of the estate posits for a moment and says i don't know how you did it but

congratulations. so now you made it to the other side. now you can have anything that you want in this world. the young man paused for a moment and said, well i just want to know who pushed me in the lake? [laughter] what am i trying to say? sometimes you find yourself unexpectedly in a tough spot. and when you're in that moment you've only got two options. you can either sink or you can swim. and if you look at the history of this great country, whenever we found ourselves in a tough spot in the aftermath of the civil war, a nation divided, but we came up with the 13th 14th and the 15th amendment. whenever we found ourselves in a tough spot alessi versus

ferguson unleashes jim crow segregation on the deep south -- plessy v. ferguson. when they come up with a 64 civil rights act and the 65 voter rights act. whenever we find ourselves in a tough spot. the presidency of george w. bush -- [laughter] america comes together in a multiracial coalition and since barack obama right down the street shattering the ultimate racial class this evening. whenever we find ourselves in a tough spot because people like those in this room thinkers lawyers and jurists and activist we find a way to make it to the other side and continue our long necessary but majestic march toward a more perfect union. have a great conference. [applause]

>> thank you congressman, for those beautiful remarks. okay everybody, let's go swimming. i'm going to introduce to you the moderator of our next panel, chris hayes, a lot of you should know him. he hosts the msnbc all in with chris hayes and the city editor at large for the nation to ladies and gentlemen, please meet chris hayes. [applause] all right. let's welcome them with a good introduction at once. body mic score an amazing thing.

[background sounds] all right. i'm going to introduce this incredible band and get ready to. i'm going to keep these introductions brief because you guys have an extended lunch because you're all distinguished individuals, which you can read about it. i'll start to my left honorable judge shevlin united states district judge for the southern district of nixon's 1994 as congressman jeffries was noticing she oversaw the landmark litigation accounts of the city practices of stop and

frisk and issued a tremendous opinion probably i would say the single most important for my amateur perspective as a nonlawyer in this landscape released in the last five, 10 years possibly ever in terms of this era. dick most is to my left altman from west baltimore represents the neighborhood in which freddie gray lived and he is married to marilyn mosby and women you may have heard of who is the prosecutor for the city of baltimore. [applause] >> a professor at rutgers law school where she teaches constitutional civil rights state and local government law by decisions of the litigation at the naacp's legal defense fund. sergeant burton chairman of the washington, d.c. police union represents 3600 officers detected and sergeants. you spend a distinguished member of the department for 21 years.

and walter mack, a department -- he served as deputy police commissioner. all right. nick i want to start with you, councilman. baltimore just had its most violent month since 1972. if i'm not mistaken 42 homicides. there is also during the same period of time a massive plummeting and arrests. i wish i had a draft but it is extremely striking if you look at the data. what is going on in baltimore right now? >> multiple things. you know, first thing i will say this when you look at a place like baltimore, specifically

west and east baltimore you see a lot of urban decay. urban decay is as american as apple pie. we can continue to look at the criminality of the byproducts of it and we can continue to focus on the what do we really need to talk about ally. and i say this decades old socioeconomic issues that play out in places like baltimore and being a representative, being a person who's grown up in baltimore known folks who understand the plight of urban american audience we understand that the incident we see this spike of increase before every summer. memorial day weekend is always historically a place where you see unfortunately a lot of violence. that was played out in a much real fashion this time. like you said over for homicides in one particular month in the city of baltimore. i say that because i think it's

several variables to this complex equation. is it a culmination of things that festered out of the civil unrest? yes. is it the time of the year associated with all we see in the spike in crime? yes. is it the interaction or lack thereof between police department and the citizens? yes. is that a segment of a force that has potential, particularly issues but sosa with the current state of the freddie gray case? probably yes, but it is hard to paint a silver bullet. but when you look at the drop and arrests, that's been happening for quite some time. so then we also bring in the morale of the police force but i think it's hard to quantify specific variables to type into. however, it's a major problem. the one thing i was a assessors on the city go up in flames and as we saw the looting and the writing and with all the cameras and all the coverage right now

we have any major american city unprecedented amount of violence in 2015, yet we're not getting the same level of attention or curiosity associate with this area. and i think that's more of a public aspect of it. at the end of the day no matter if the individuals are part of an illegal element no matter if the individuals are putting themselves amongst harm's way and being murdered or been shot, at the end of the day us as americans, we need to understand and know that it's critically important that we develop ways into these folks. i sit on that because just wrap it up to see we can continue to talk about policing. we can continue to talk about community policing and interaction of community that we have to start talking about the socioeconomic divide and talk about the root of the issue. that's developing a way where we provide opportunities for these young men prior to getting into

the criminal justice system but how can we get to them before? >> i want to ask you about jumping off that introductory because i think there are two things that strike me about this. if you go back and read -- and 65, 67 -- [inaudible] it lays out his very standard kind of view of a connection. despair, hopelessness, racial segregation post-world war ii and the fact that inevitably this will produce environments in which people have the opportunities, produces crime unrest et cetera. is an amazing thing happened in which, as the basic standard. that's what i think. and then nothing better and crime went down. crime goes up in 93 and until 2015 this historically unprecedented drop in crime happens that things don't get

bad and was baltimore. they don't get any better unless the chicago. didn't get any better in north st. louis. what does change the is the policing mechanism, right? answer my question is how do you understand why not? like why do we wake up and his work in which what happened to freddie gray if it happened in 2012 and effort in 1998 it will. >> i think cell phones. we have the confirmation of the brutality of some police officers against marginalized black and brown people. i'm glad you mentioned the commission report. the cover commission was convened by president johnson in 1968 to study the source of racial unrest during the summer of 1967 because of racial unrest across the country. one of the findings of this

report was that the priest abuse, police brutality was a number one grievance among residents who were studied in users communities. ahead of unemployment, ahead of inadequate housing. but what's important understand in your question raises it is that there is a social context that councilman mosby has spoken to. in which we have profound segregation confront racialized disadvantage and these interactions between the police and the committee becomes highly racialized and the police become a symbol of white power, white repression. what's interesting about the current commission report is that dr. kenneth clark who is a psychologist testified before the kerner commission back in the 1960s and he said, you know, your findings reminded of the findings that were made after the chicago on rest in 1915, the harlem arrest in

1935-1943. the point being that nothing is new and nothing has changed. and you are, it's 2015. window in the last 16 years or so we have seen over 70 unarmed men and women who have been killed by the police or so here we are again it's déjà vu and to councilman mosby's point, we have these underlying social issues the profound agony and misery in many of these urban communities. and just to add to this and that we can get into this a little bit later we have a constitutional infrastructure that is largely blind to the racialized conditions on the ground. [inaudible] spirit is slightly off point i do nothing to do with policing but it has to do with what we talked about the social environment. i've been a federal district judge for more than 20 years so i've done 2000 sentences.

let me tell you that every sentence report reads the same. a young man grew up without a father. the mother was a drug addict the kids dropped out of school in the night or 10th or 11th grade that you began using drugs at 13 to 14. ticket has no employment history. i have read 2000 report and i'm telling you 90% read the same. so there's a huge problem. that's one judge, 2000 census 20 years. of course, in a major city talking about new york city but something is wrong when so many people in the community have the exact same description i know walter is a different word he knows what those reports read like, and then you send them to chill. what does that give? gives them a felony conviction and then they can't get employment, not to mention they can't vote but they can't get employment and they can't vote. habit disenfranchised group of

people without hope. so we need to talk about that and i'm glad you started it. >> unfortnuately, the answer to that scenario has been more police. so you look at our major american cities. you continue to see an increase of judgment in emphasis and the resources that been place on policing in these communities. yet you see a continued decline or drop or stagnant approach associate with budgets around parks, education getting her children before they get to the criminal justice -- >> but, you know the budget -- there is no jobs. >> there's a couple of things here that we are not talking about. i'm glad professor doctor that the historical perspective and the fact that what we're seeing now in terms of race and racial disparity is that you're right it's not new because when the country was founded it was founded with racial disparity.

those things have continued until now but the big issue that i want to bring to everybody's attention, racism is an american problem. we act as if it's only the police but racism is an american problem. in terms of unarmed people killed by the police or the were killed come we don't know what issuesthe issues were surrounded those 70 that you mentioned during the significant period of time by the murders in baltimore in a month our extra significant in that we can't just make that attributable to the fact that the weather is changing and crime spikes during a certain kind of you i think all the things that councilman talked about our reasons for it. in terms of how we got there the last 19 years or so in criminal justice let's go back to the '80s to late '80s, early '90s your and what did our country demand from its legislatures, governors and the president?

we had crime problems and we demanded that something be done. what was the solution parks mandatory minimum sentences. we increased our police department to deal with of violence. and as a result we put a lot of people in prison based on what was requested from the communities through legislation through all of our elected officials. that's what we're seeing now. entrance of the history in baltimore and the things that the judge and accountability talked about, those socioeconomic issues are not the police come that's not something the police cancel. that is outside of our area of expertise. and until we deal with those issues the old adage is true an ounce of prevention prevention is worth about a group of what we spent to incarcerate some is much better spent to make sure they get through school and all those things before we get them in a system. that is right. >> let me follow up on one thing. there is a young man who shot and killed in atlanta. he was a veteran and he was struggling with mental illness.

he was running around a housing complex naked, and he was clearly acting out of control. it's a horrible tragedy and the thing i kept thinking about was someone called the police to deal with individual. we america the citizens of the letter, the citizens of america said the police to do with this this individual. difficult as an issues that some 28 year-old who shows up, he's not trained to deal with someone who is schizophrenic and having i mean come it seems to me that we asked the police to essentially interact or maintain order in situations that's run the gamut from outright criminality to profound mental illness to speak chris it is budgetary priority to in washington, d.c. for example every department of mental health and we deal with individuals that have mental illnesses all that done. the department of mental health

does not have transport capabilities so they call the police to do with the transport when they want to move someone from, let's say a community mental health facility to inpatient hospital. so when they called the police and we had a tragic incident with someone who is suffering from mental illness. he stabbed a police officer. the crisis a team from the department of mental health, they could not assist that person did so when you put a police officer in a situation to deal with some is going to essentially what is an emotional break and particularly if the person has no clothes on you can't control them. which they had a cage or something else they could just i don't know the facts of the case but it's difficult. >> i think look, it's tremendously important to acknowledge that policing is a really, really difficult and challenging job and i completely understand that. we also have to understand the social context, the difficult

and crime in which we see it takes place because also very important to make sure that we talk about accountability of the police. i mean the police are vested with authority by the state to go first people come to arrest people in some instances to use deadly force. i want to make sure that is front and center in the conversation because it's not to discount the difficulty of the job. but at the same time went to talk about, we've got a problem. the congressman just discussed at length. we've got the statistics. we got the individual stories. we have a profound problem. the approach that we take has to be about institutional reform. it has to be about working within the culture of the police department to institute mechanisms of accountability. we need to change our law probably. it's a constitutional doctrine. but i want to make sure --

>> i'd like to get your thoughts on accountability. >> i want to say that obvious all problems cannot be solved by the police department alone and certainly every city and new york have made the issues with other providers who are were not available at the time when it was necessary. but a young 28 year-old police officer arriving on the scene should not be the first time that the issue at least has been brought to his attention what do i do under the circumstances? and in this day and age there are tremendous providers of best policing practices that are available for training. and in many times basically many of those trained, many of whom i know their first reaction is force is your last. if you arrive on the scene were there is a naked person you have to see that there is nobody about the heart and whatever but

the first thing you do in lesser qualified is ask for help, is ask for a response from within the department. most police officers certainly in new york do not go there going to get support from anybody in the civilian population that they are isolated, that the only folks are going to respond to help them under those circumstances our fellow officers. and, therefore a lot of this is training. solution is not solely within the department. but do our best practices that are available. there's a learning curve and basically a force solution should be the last solution that our officers go to. >> we go back to budgetary priorities. whenever the budget gets tight the very first thing that gets cut is training, the training budget. in 2010 the metropolitan police department at its academy staff by one-third. when economic downturn hit we stop hiring. police stopped training. that is bad for a police agency

because you're not only training your new people you of ongoing trinket another example. hand to hand and defensive tactics training. it is a skill that if you do not practice, you will lose and you will lose the other note of any police department that has ongoing and service hand to hand defensive tactics training. we do firearms training they would go back into reverse on the love this is a function of the can budget. it's a priority and this is a political leadership question. are you going to put the resources to the kind of thing that everybody believes police officers should have come at the end of the day to the people with the decision-making. >> just real quick. when you look at the budget for police departments throughout this entire country over the past couple of decades exponentially have grown. again we see of the types of city services have been cut or kind of just flat lined out for two to three decades. i think you're right when you

talk about budgetary priorities but it's budgetary priorities inside the police department. this year alone baltimore city's police department got $22 million more than they had last year. the last fiscal budget. but where is that money going? is that going to the training? is about the core competence of where we're trying to drive the experience and the know-how? or is it going to other equipment and other intelligence and other technology to kind of over police communities? >> i think it's the same for most government agencies and most businesses, personnel costs are personnel costs drive our budget that i'm aware of and what's left over after the personnel costs is for discretionary expenditures. >> i want to bring in judge scheindlin. there's two things here, right? there's a sort of set of letters in this problem, if you're going to call it a problem.

there's how police act in a situation, right? whether people should call the police in certain situations. that's an interesting question. i think there's a question surrounding the mechanical part. like should anyone have called the cops on a bunch of teenagers acting reckless and a police party a there's how the police are trained. bears what we as a society want the police to do. and then there's the law the constitution, which is older than the binding constraint with the amount the police matter. functionally it occurs to me that most of the time the constitution is essentially relevant. like sure police are trained in it and like everybody knows they get this sort of problem this dynamic, miranda, et cetera. but really the law and the street interaction between a police officer and someone, it might exist later. it might exist in your courtroom

when it gets dragged before it does it actually exist? does the constitution in any real meaningful when exit in in the moment between a police officer on the street and a citizen? >> that is a really short question and i appreciate how short it was. how to begin to answer that i can only answer i think in the context of the stop and frisk case. the problem with stop and frisk is a became devout in new york, it was 4.4 million stops coming half of those were of african-americans. that means 2.2 million people were stopped. they're supposed to be stopped on reasonable suspicion. you're right nobody was interested in that because the policy was, and there was evidence, the mayor said the purpose of this is to instill fear, instill fear in everybody if they go out carrying a gun it will be stopped the so it's going to be a deterrent. by the constitution says we don't have things like we can't

like everybody who might commit a crime tomorrow. we can't go waltzing and don't because there might be guns in those homes. there are things we can do. they may be effective in stopping crime that's not the standard. this notion you can stop 2.2 many people to instill fear was one of the problems. the other one was his message went out to every precinct. we need to target the right people. this is a quote. we've got to target young black males between 14-21 because they are committing the crimes. the problem with all those 2.2 million people stopping, 90% absolutely innocent and even of the 6% that were summons and arrested. those are all dismissed. you have all those people wrongfully stopped. again i'm not against good police work. i want good practically sport but it's got to be within constitutional limits. in utah but recent suspicion you've got to talk about what is reasonable.

what is reasonable to stop somebody. here's some of the funny stuff that can affect you should stop somebody if they want to test. you should walk somebody -- stop somebody if they want to slow. you should stop somebody if they are looking around for down. really. this is true. this is what they would write a. this person made a gesture i suspect my gesture is different from your gesture. it's all in the perception of person who is deciding that she made that movement. we have a problem with the standard maybe. how is the cops supposed to really discern and again the answer is training. wolter said i told agree. training training, training. >> in the context of discussing policing we have a number of american policing is not homogeneous. we do not have a national police force so you don't have a standard across 18,000 police departments that we have in this country. most of which are less than 50 police officers. what to do things that i'm troubled by is out of the stop

and frisk case the term has become demonized and it's not supposed to be demonized to the way it was deployed in a new police department made incorrect a stop and frisk is a judgment tool when done properly. and we have recent suspicion. i suspect that if you look at all the other police departments and all of them are getting additional scrutiny, that you will find another one that employed the stop and frisk in the way the nypd did. we have stop and frisk in -- mike strength is in washington, d.c. i consider a separate aggressive police department because we police department because we police department because we did things come for the stop and frisk. we have a written directive on stop and frisk in 1972. and essentially that order hasn't changed because the guiding principle that governs it has not changed. >> but i don't want to lose the point that judge scheindlin is making which is that the standard of reasonableness and with the stop and frisk

contacts the concept of excessive use of force but the question of what constitutes a reasonable seizure under the fourth and it is essentially the court has said it's a very factor down in greater where you have speeded stop anyone for anything. >> walking fast, walking slow come into work we have a wandering come you can stop people for wandering. ..