change the part b payment system into phases both of which are very troubling and that is putting it kindly. these inherent concerns i would like to hear an explanation from cms as to why they believe their new payment changes will not earn medicare beneficiaries. so far what they have given us lacks any such explanation or justification and that's not all that is missing from the elements of the demonstration that has been made public. but this proposal is troubling and again i'm being kind with that description. not only for what is in it but what has been left out great for sample with the proposal cms has not indicated that conditions in which a physician has the option to prescribe a high or low cost drug that has the same patient benefits that in addition cms is not provided an analysis of how many physicians including those in small and rural practices would lose money for purchasing

needed drugs. they have not provided an analysis for how physicians would have to refer beneficiaries to more costly hospital outpatient settings. cms has not indicated how will affect the beneficiary access and quality birth -- but during the course of a formal evaluation. not surprisingly the proposed experiment has been one of the condemned by experts and stakeholders. almost immediately after his proposed demonstration was release we received a letter from times from over 300 stakeholder organizations asking for help in getting cms to withdraw the proposal. these organizations include the arthritis foundation, the caregiver action network the immune deficiency foundation, the lung cancer alliance, and the national alliance for mental illness. the organizations that have reached out with concerns about

how the proposal represents patients who suffer from the disease is treated by these drugs including cancer arthritis mental illness and hiv represent the physicians who treat the patients with these devastating conditions including oncologists, rheumatologists an ophthalmologist. we have also heard many of the same concerns for my constituents in utah. many feel the proposed demonstration would deprive them from the drugs that does treat their conditions and require them to have significant expenses to receive the needed care. obviously utah's not alone here pick patients and providers from virtually every state have weighed in on this matter which prompted all of their public and members of the finance committee to send a letter to acting cms administrator urging the withdrawal of the proposal. 14 senators from the only senate

committee with oversight jurisdiction sent a detailed thoughtful letter to cms about their proposal. how did the agency response? we have received what essentially amounts to a form letter thanking the committee members for sharing their views and noting that cms will consider all public comments that he times it could not have been more dismissive and it's turn. that's a level of attention and seriousness cms describes in the oversight from congress prayed sadly this is not an isolated incident that for seven years now the entire obama demonstrations has patronized stonewalled or flat out did nord oversight efforts on the part of finance committee republicans. there are common examples. sometimes the agency's show disregard for the law like when they refused to provide any meaningful response to numerous increase about illegal reinsurance payments issued under the so-called affordable care act.

other times they discounted oversight role entirely like when they denied staff access to last week's medicare and social security trustees report and tell the press conference putting the administration's own misleading. >> on the reports was well underway. i have on numerous occasions in writing during these hearings like this and elsewhere express my hope that the administration as a whole would change its ways and become more cooperative and transparent. i've ask out with nominees that have come before the committee to commit to being responsive to senators inquiries yet over seven years is unprecedented level of disregard has continued it in the short time left with this administration i will renew these costs in responsiveness today. i feel quite certain if there are no treatments on the immediate horizon given we have a high-ranking administrative

official before us today to help at the least we finally get straight answers to the many questions raised by cms part b proposal. another witness dr. conway stated in early may interview on the proposed demonstration that cms quote will interact with congress and take feedback and make adjustments as necessary end quote and i do hope that our conversation today will be more consistent with that sentiment than the latter shortly after the statement was made. the senators on this committee and more importantly the constituents we represent deserve at least that much. with that i will turn to senator wyden for his opening remarks times remarks. c thank you very much mr. chairman. my view chairman and colleagues what underlies this debate is we are entering an era where there

are going to be miracle treatments and there are going to be curious. there are drugs on the market and close on the horizon where science fiction not very long ago. the question for me, the foremost question for me is whether or not the american people are going to be able to afford these medicines with business as usual. too many of these treatments are going to clobber too many family budgets and threaten health programs across the country. that was one of the big takeaways colleagues are times from the 18 month investigation senator grassley and i conducted on a bipartisan basis into the rollout of one blockbuster drug. it was a drug that treats hepatitis c and had a list price

of a thousand dollars april. i think that this is going to be the pattern colleagues for years and years to come absent reform. lots of cures and a big big question mark when it comes to access and affordability. now the hepatitis c drugs that senator grassley and i did our bipartisan inquiry into are not the primary focus of today's hearing. today the committee is going to examine the demonstration are checked set to begin in medicare part b which of course as the medicare program that covers outpatient care. part b pays her a small share of the drugs many seniors prescribe and the demonstration would effect the way those trucks are. for. the demonstration has brought to the forefront additional major questions about how the country is going to afford to address

the trend of escalating pharmaceutical rises. the fact is too many seniors are getting pounded today by prescription drug bills and in my view there is an enormous amount of work that has to be done to guarantee that seniors have affordable access to the medications they need. medicare part b seniors are often hit especially hard to kiss their share of drug costs is a coinsurance instead of a co-pay. that means rather than a flat manageable fee some older people face a huge burden stuck paying a percentage of the drugs total costs. i look at that ergen the same way i look at the rising out-of-pocket costs for older people in medicare part d so for times for part b i've have proposed legislation that would establish an out-of-pocket

account to help protect older people. my view this committee ought to take a close look at ways to make sure that seniors don't get pounded under part b as well. the important question to be addressed with perspective this particular demonstration project, that's why all of the finance committee democrats and i sent a letter in april to the acting at the straygur and senators for medicare and medicaid services outlining that key components we had about the impact of the project is going to have on patients. at their core are concerns are about making sure that older people who are especially vulnerable have access to lifesaving medications. protecting access especially important in grimm america were seniors today so often face fewer choices and lower-quality of care.

it is extremely important as well that the project not result in patients being told that they have to go get treatment at the hospital for treatment is often more costly and less convenient. finally our letter said the demonstration project has to be in sync with the effort medicare is making to move towards treatment based on value rather than volume. when you focus on the value and efficiency of care there is the potential to raise the quality of care for older people while saving money at the same time. mr. chairman and colleagues at hope the committee will examine these issues carefully as it looks into medicare part b demonstration and want to thank dr. conway for joining the committee here as well. we look forward to that testimony and members having a chance to ask questions. thank you. tonight i would like to introduce today's witness. dr. patrick on my is here on behalf of the centers for medicaid, medicare medicaid services.

dr. conway holds a number of high-ranking titles that cms and responsibility for programs that provide services in over 100 million people. two of his roles overseeing the cms innovation center and serving as the agency's chief medical officer make them well-suited to testify on age and sees proposed part b drug demonstration. prior to coming to seem as dr. conway was the director of hospital and associate professor at cincinnati children's hospital. ..

physicians can often choose among several drugs and it can create disincentives for doctors to create select lower-cost drugs. even when these were as good or better based on evidence. among the approaches to be tested are the elimination of incentives that work against drugs and positive incentives for higher performing drugs including reducing or eliminating patient cost-sharing to improve patient access and use of effective drugs. in the first phase of the model, they were adjusting the fees and changing prescribing incentives and in quality and value. the second phase focuses directly on better outcomes and clinic clinical indicators to improve the value of drug

payments by utilizing value -based pricing tools currently employed by private health plans, pharmacy benefit managers , and other entities. ensuring access to high-quality care and treatment is always at the forefront of our work. under the proposed model beneficiaries would have access to the same drugs and maintain complete complete freedom of choice of doctors and hospitals and other providers and suppliers. the proposed model would not affect drug coverage or other medicare benefit. it also includes protection. it includes a new pre-appeal process. it allows the beneficiary to provide supplier to explain why medicare pricing policy is not appropriate from the value pricing. we would monitor hair pricing

and outcomes. this would ensure beneficiaries continue to have access to part b drugs under the model. millions of american rely on medication to manage product illnesses and treat acute conditions. cms is committed to ensuring beneficiaries have and maintain access to the high-quality treatment they need while pursuing better drug value. moving forward, hhs is committed to listening, working together with congress and other stakeholders to advance ideas that improve access, affordability and innovation to all americans have access to the breakthroughs ahead. there are no easy answers to these multifaceted challenges but there is a significant benefit to all of us on working together to find a solution. i appreciate the committee's interest and look forward to answering your questions. thank you for having me. >> thank you doctor.

i appreciate you appearing before the committee and perhaps you can be of great help to us today to understand some of these things. some people feel cms uses the innovation center to undermine part d prescription drug program perhaps there waving the statutory provision that keeps the government from negotiating drug prices. such an undertaking would be an overreach of the authority, however as we've seen on numerous occasions, the obama administration doesn't follow the clear amendments provided in the statute. that being the case, i think the specific speculation about part b very seriously therefore i feel compelled to ask if the innovation center is working on any project or initiative that would allow the government to renegotiate prices or on any other part d change related to drug prices and as you are the

head of the center i'd like to have a direct answer on that if i could. >> we have no part d proposals at this time. we are constantly listening and engaging with stakeholders across the healthcare system so we have payers, manufacturers, providers, others that bring ideas to us across health care including in the drug space. we view it as our role to engage with those stakeholders to listen to ideas, whether they come from congress or providers or payers or others so we engage deeply on our statutory mission which is to engage in testing, payment and service delivery models with a high likelihood of improving quality and maintaining or lessening expenditures. >> my stated position, what cms

needs to withdraw this proposed part b rule that's shared by many, once again, over 300 state older groups weighed in about the proposal upon its release. without objection, the letter i signed over with over 300 patient provider organizations will be included in this record. in addition to the stakeholders, nearly 300 members of congress urged cms to withdraw the proposal. many of the 1300 public comments that were received pointed out serious flaws. considering all of this backlash , it seems obvious that if cms meals forward it would be doing so against the interest and judgment of the vast majority of experts and policyholders in this field.

are you willing to acknowledge that this widespread opposition, that there is widespread opposition and withdraw this proposal? >> we take the input from congress and from stakeholders across the help system very seriously. that is why we proceeded through the rulemaking process which is the most public and transparent process that we can engage in. we are reviewing the comments now and plan to make adjustments in the final rule. we are deep, currently we have over 1300 public comments. we want to review those closely, carefully and thoroughly so that we can be as responsive and thoughtful as possible to the public input and input from congress.

>> it seems that they are operating under premise where situations are knowingly and purposely prescribing higher cost drugs when a lower cost equivalent drug is available. the agency view is that most positions and decisions are driven by maximizing profit and not patient welfare. this seems to me this is overly simplistic if that's what they are doing. given that you are a doctor, can you tell us the specific type of prescribing changes that physicians are expected to make under this payments scheme and provide specific instances and drugs if you could. >> i am a practicing physician and i think the vast majority of physicians make prescribing

decisions based on patient interest and i want to say clearly, i would want every physician and clinician to prescribe the medicine needed for their patient and we believe this proposal allows this to happen and we are looking closely at whether adjustments are needed because adjustments to medication as a first priority for cms and myself personally. in terms of the reason we propose this test, the current system can have disincentives that may use lower costs medication. if a physician prescribes a 10-dollar meditation, the current 6% add-on is only 60 cents and that may not fully cover the cost of acquiring and administering that medication we are proposing this test to test

the proposal that we think would remove some of the disincentives in the system to allow physicians and clinicians without regard to financial incentives and we clearly want them to prescribe the medicines they need. >> thank you mr. chairman, dr. conway, let's go right to the question of prescription drug prices because for so many older people they feel like they are getting hit by a wrecking ball. many care part b is spending double between 2005 and 2015. it 15. it increased from $9.4 billion in 2005 up to $22 billion in 2015. medicare has, as you know, begun to move toward paying for

quality and value weather than the volume of service. that's been something that has been recommended for ages and finally it is underway. so far, prescription drugs have largely been left out of that equation, that move toward paying for value rather than volume. i've been working on these issues since the days when i was codirector and i think it's appropriate to ask now if the issue of prescription drug prices isn't addressed, aren't the costs going to become increasingly unaffordable for older people and really put at risk the medicare guarantee?

because that's what it is, a guarantee. one of these costs put at risk the medicare guarantee for future generations? >> thank you senator senator wyden. you correctly note part b spending and it has been over an 8% growth year on year and i share your concern on access to medications. the current environment as you noted with coinsurance and potential for 20% coinsurance, as you can imagine 20% of a a $10000 drug or whatever the cost might be could be a substantial financial hardship and can limit access to medication. we also did propose this tax because we had not to date had a proposal directly in the drug space and paying for value. we do think paying for value is important, as you said, across the across the health system including in the drug space. we made this proposals but we do

think we are paying for value and drugs is important, similar to how it is important across our health system whether it's hospitals, physicians etc. >> does this threaten this detain ability of the program for future generations? >> so, it does have the potential, the the cost of the medicare program has a potential to threaten the program and drugs are substantial part of that cost. the reason i do this job, quite frankly, is that i care deeply about the 55+ million americans million americans in medicare including my own mother, and i want medicare to be around for my children. i think we need to make major positive changes in the delivery system reform for that to take place. >> i appreciate the agency's interest in in looking at

strategies to improve quality and value in all aspects of the health system including prescription drugs, but one of the concerns that has been brought to members, certainly members on our side is that especially in a rural area, a rural area with not exactly a large practice, physicians can be put in to a position where the cost of the drug is higher than the medicare payment and so what we are getting told on our side is that it wouldn't be possible to afford to provide the medications to the patient. i would be interested in your response to this. also in responding, if you you could tell us what happens if that's the case where the

providers sends the patient to a hospital, outpatient program which means you have higher overall cost for the older people and for medicare. tell me your response to that. i know members on our side have heard it and we've all talked about it and i assume colleagues on the other side. your reaction to that. >> thank you for the question. we propose to include providers and small practices, however we noted of concern about some of these concern about making sure that we have access to medication and treatment while we proposed these changes. we will look closely at the public comments and determine whether any adjustments have been needed for rural practices. we are doing that review now is

to maintain access to medication and we also proposed a monitoring plan, similar to what we've used in other program which can include real-time claim data monitoring. we are monitoring for access, patient outcome and we would monitor that and make adjustments and also a process where we could make adjustments down to the individual practice if needed. >> thank you. >> only have have two questions but before i ask those, dr. conway, i want to thank you for coming today. as you have heard there are many people concerned about this ill conceived plans. they have not been responsive to congressional inquiries and in addition to the letter signed by every republican signed on the committee come i sent my own letter on april 29.

i've not yet received an adequate response. in my letter i asked for clarification about the proposal and the subject research. i am submitting that for the record and i hope you would expedite an answer to that. among the many concerns i have over this proposal is a result it will have on practices that are small, particularly in in rural areas like most of my state of iowa or for those patients with rare diseases. first question, what safeguards does ms have with regard to serve smaller practices and those with rare diseases? >> i share your commitment to small and rural practices. i grew up in a small town in texas with a two-person family

practice caring for our family. we did propose to include small practices of but we also noted in the proposed rule that we were concerned and focused on the access issue and we would address access issues if needed. we sought comment about whether any adjustments or exclusions or other changes were needed for smaller rural practices that we will assess the comments and determine if adjustments are needed. >> number two, we have heard from a number of groups that many patients and providers concerns in the proposal could've been avoided if patients had been included in the design of the demo in the front-end. what plans have you put in place to include small practices, rule and rare disease in the future? >> we proposed the process for phase two that would include input at multiple points and we

are looking at the comments now to determine if enhancements are needed for that. i personally met with 20 plus patient and consumer groups and do that routinely. that was about two weeks ago. they get put on this proposal and other things across the plan. that is probably the most critical in what we get into these models. our focus needs to be on the beneficiary, on the patient and consumer at all times. >> mr. chairman, i yield back my time. thank you very much doctor connolly. >> thank you sir. >> thank you very much mr. chairman and ranking member and doctor conway. we appreciate your time and we appreciate your leadership on so many issues that affect all of us and our constituents and just

to_what has been talked about and a letter that a number of us sent to you. diane concerned that the scope of the current proposal seems broader than a typical project and just_wrote communities. i understand the proposal is to drive providers to prescribing more generic drugs for cost savings and i support that objective, but i think as we look at those, there are questions i have about what we should be focused on in order to do that. that leads me to two questions in a broader sense. first of all, the medical trustees report, i just want to

emphasize that part b premiums could be affected by dual eligible, those who qualified for medicare and medicaid, that situation and we will learn more about this as it relates to social security cost-of-living adjustments. i know we will follow this closely. i'm very concerned about seniors and unintended increases in premiums related to that. this is something we need to be very involved in. another issue raised by the report is really the big issue. it's part b which has been talked about. as you noted in your testimony, in 2015 they 15 they paid $22 billion in part d drugs and according to trustees report nearly 89.5 billion in part d.

before talking about the elephant in the room, the area the area we should be most focused is on part b in terms of the cost for seniors. spending increased 8.3 last year and the year before 8.6%. part b, which we are talking about today, 2.4%. when we%. when we are talking about three and a half times more growth, this is the area we need to be focused. dr. conway, if the the goal is to drive down prescription drug costs for seniors on medicare program in general, are we focusing on the right part when we say part b or shouldn't we be paying more attention to part d? >> so in terms of part d there are a number of proposals for congress to consider in the part

d space. we are open to ideas in part d at all times. we've had manufacturers come to us with ideas around part d and value -based arrangements in part d. similarly we had providers talk about how they want to bring in arrangements that are voluntary between the provider and part d plans. we are open to ideas from congress, from you senator, from stakeholders on what we should be doing. >> just to underscore, i've heard from three constituents in the last few months that have had hepatitis c. they weren't sick enough to get

their insurance company to get there expensive treatment covered but they had insurance so they weren't qualified for medicare. in one situation they were able to get the medication but in other two instances, that has not happened yet. it's not a good system if someone has to call the senator to intervene to get the medicine they need to be able to save their life. this is a huge issue and we will be doing a hearing on part d where the costs are in the areas in which seniors are most concerned. thank you mr. chairman. >> senator robert. >> thank you mr. chairman, i would like to ask unanimous

consent that a letter here from over 20 patient groups and many other groups to the finance committee highlighting concerns of opposition be included in the record. >> without adoption. >> when this committee was debating the affordable healthcare act, i was concerned about several positions. i believed it would increase independent choice and open the government rationing. there are poor rationing, i'm not sure what to call them, groups and you are one of them. we have before us a proposed demonstration project or test that could disrupt from some of medicare's must vulnerable projects patients.

thank you for being here today dr.. i wanted to share with you some comments and questions from a couple constituents in kansas. eileen suffers from anemia and lupus. she asked me if anyone is looking at the possible effect of such a demonstration on the people it will impact. do any of them care the good honest americans will die without access to these treatments or are they merely trying to save money by cutting costs. the proposed access will cause a degraded health outlook for many rheumatoid arthritis and other patients it will sign a death warrant for many patients like me. another constituent from wichita wrote about the cms experiment being an intrusion on the relationship our doctors have with patients and their clinical decision-making. this experiment will backfire costing patients and taxpayers even more for cancer care. now, according to the statute,

it is to test innovative payment and service of every model to reduce program expenditure while preserving or enhancing the quality of care. that's where i think we are running smack into trouble. how are you going to insure beneficiaries don't have trouble accessing the medications in the setting they prefer like a patient going to a rural oncology doctor in a rural area being sent to the hospital hundred miles away. is there anything indicating these changes will improve quality of care or patient outcomes? >> the first goal of the innovation center is to improve quality as you said or maintain quality and this is what i have been doing for 20 plus years, the paramount importance is

improving better outcomes. it also is to maintain or reduce expenditures. in this specific proposal we are proposing a value -based framework in phase two which from the private sector to private payers and providers has been demonstrated to focus on paying for value and medication. we are proposing to test that in medicare part b and we do believe it can maintain or improve quality and that is our primary focus, on the quality side of the equation. >> on that issue and pardon me for interrupting, i have very limited time, under the aca, the secretary is prohibited from using comparative research findings in determining medicare coverage. however they plan to test drugs based on how effectively it treats different conditions.

do they believe that as the authority to waive this prohibition, are you doing what you should be doing? >> so in terms of the innovation center, we are proposing to pay for value which can be things like sharing arrangements based on outcome so it is consistent with the statutory authority to test new payment and delivery models. i'll highlight on them broadly, we have thousands of providers in every state in the nation engaged in the delivery system reform. we have millions of patients that received, in many instances, demonstration and improved outcome and improve care experience and we can certainly talk about that more. >> thank you doctor. i appreciate that. you have said that the public comment concluded on may 9, they are considering all the comments on this proposal it receives throughout the comment time.

i think that was mainly about medicare pricing fax and that is in direct conflict with the letter that we have here from 32 patient groups that say there was a lack of stakeholders input in the beginning of this process and many of the problems could've been mitigated had groups been involved on the front-end. i think what we have here is a failure to communicate. i remain gravely concerned about how this demonstration are test will impact patient access to care. i would like to reaffirm my request that cms simply withdraw this proposal. >> thank you, mr. chairman. >> senator menendez is not here.

senator portman, your next. >> mr. chairman, thank you very much. i appreciate you being here doctor conway and for your service. as you know, my wife is very involved in incoming chair of one of our great hospitals. i wish i could say the same thing about this proposal about the hospital, i am am concerned about it. i'm concerned about it for reasons that have been stated already. i want to ask you about one pacific specific deep concern. it's called a demonstration but my understanding will cover about 75% of part b medications which is hardly an experiment. the control group is 25%. i was just looking through some of the information i've gotten in letters and e-mails from some of my constituents, tom clark, his wife is a cancer cancer patient and he's worried about her ability to get her cancer

treatment. barbara writes a long letter about her deficiency disease and what's going to happen to her. she is applying for disability now and is having a tough time but she faded and at home and she has to go to the doctor. if she goes to the hospital will be much more expensive and/or they won't be able to afford to provide it. just a lot of deep concerns about it. the specific concern that i'm hearing from ohio is more about these community health centers and rural health centers. we lost about 50 practices going to the big hospitals, this will continue that and accelerate it, i think this proposal which is again not a demonstration hardly, if it 75% coverage, but it's a whole scale change is going to really dislocate a lot of people i represent and cause a huge concern among some of

these smaller practices that are already having a tough time making it in the current healthcare environment. let me ask you about something that concerns me about your specific proposal that perhaps you are not aware of. i assume if you were aware you wouldn't be doing it. this is a neutral proposal and so you cut reimbursement for some of these outpatient clinics that were talking about and some of these providers who will have a tough time making it and you increase reimbursement and other areas in order to make it revenue neutral. one of the places you've increased reimbursement is with regard to prescription drugs that are used for pain management. specifically, you have a dramatic increase in reimbursement incentives for the kinds of pain medication that is addictive and causing much of

the problem we have now with this opioid epidemic that we have now in ohio and around the country. let me give you some numbers on that just in case you're not aware but on the expeed impact on pain management medication, you are seeing an increase of 46.9% versus a cut on oncology drugs by minus .6%. it's your dramatic increase and i think the whole basis of your proposal is that if the reimbursement reimbursement is cut, on the other hand you are increasing reimbursement at a time when i think there's a general sense in the administration that there is too much overprescribing of certain kinds of pain medication. it's addictive and causing so

much of the opioid crisis. the addiction recovery act deals with overprescribing issue and drug monitoring. i think there is a general view that this is a problem and we work closely with them. we are the co-authors of that legislation. this seems to run counter to that. all the concerns we hear from other colleagues about these providers is a concern of mine and the fact that there's now a demonstration. i have this bigger concern that under this proposed rule, which you say is to prescribe the most effective drugs, the reimbursement for this particular kind of opioid, this increase could have a very negative impact and increase the problem with the opioid problem. it is believed that four of five heroin addicts that are overdosing today, 129 will lose

their lives on average today, four of five of them started with prescription drug and often it was for pain medication. it was a a prescription they got because of her procedure. could you briefly respond to that? >> so three quick responses. one on the scope, we are evaluating the comments and will determine whether adjustments are needed. two, on on the practice issue, overall it is budget neutral as you describe. there is a slight impact toward the clinician space. the focus on the opioid use, for the first time we have zip codes in the u.s. for life expectancies going down and a lot of it is due to the opioid epidemic. what you have named as the fixed fee.

there is some very low cost as you where the percentage increase looked large. we'll have to look at that specifically and determine across classes of drugs if any changes are needed in the proposal. >> just one comment, if i could have an answer to this in writing, fenton all is an example, it's a big problem right now around the country. it's believed it's causing more overdoses in ohio then heroin. it's with the synthetic form of hair went. as i look at this it receives a 2000% increase in reimbursement under this model, fenton all alone. i'm very concerned that we are incentivize increase utilization rather than the opposite. >> that is from the fixed fee but we can give you a formal answer. that's from the $16.60. >> thank you, mr. chairman and thank you dr. conway for being here. as many of my colleagues have

already pointed out, the lack of consultation with stakeholders is striking and a further indication of the nature of this demonstration but i of the entity. i want to draw attention to one section of the authorizing statute that states that cmi should consult representatives and federal agencies. we know at the federal level there is a national advisory and the newly created council all related to policy. i'm also told they coordinate to ensure that healthcare providers in rural america can function to the best of their ability within the boundaries of our statutory and regulatory frameworks. the question i have is, can you inform as to whether see mmi, as

it is required to do, consult with these various entities dedicated to rule health policy to ensure that what many of us is a flawed demonstration program would not add adverse impact. >> see mmi works closely across the federal government. this proposal went through the standard clearance interaction processes and you mentioned the task force that we establish. we think that's critical for rule issues and as i noted earlier, we made a proposal in rule areas but we also noted that we were focused on access in rural areas and access to medication so we are going to review the public comments now and determine whether any adjustments are needed in rule areas. could you detail the feedback that you received from these entities that i mentioned after this hearing or provide any documents you might have?

>> yes, we can provide him put on the process. yes, it would be nice to know if in fact those entities were consulted and what their feedback consisted of. >> i understand. it's well-known that not all drugs utilized for the treatment have cheaper alternatives. the question is, how will beneficiaries who need these life-saving treatments have better access to care when their best treatment option may force their provider into a situation where he or she no longer afford to provide it. >> so, we would want, and i would want every doctor including any cancer doctor to prescribe the medicine that their patient needs. we believe this proposal maintains access through the average sales price plus the two and a half add on fee plus a

fixed fee. however, these are the type of comments that we would look closely at. if a physician or clinician could show that this is an access concern both in the comment. where we consider whether adjustments are needed, we would consider that, we also pursue proposed and exceptions process where we proposed practices or patients, if the proposal created an access issue, we could make adjustments. just to give you a long answer on this one, i was asked earlier, do i personally get e-mails all the time for medicare beneficiaries that can't access the medication. as a practicing position i care about that deeply and i want

patients to have accents to the right medicine. i want every patient to get access to the medicine they need and i want every doctor to be able to prescribe the medicine they need to their patients. those are the types of comments that we look at very closely. >> i will just add, if you have a provider that is no longer able to afford the drug and you have a senior who must afford treatment at a hospital's outpatient department as a consequence, then how is that going to increase cost sharing going to impact their ability to receive treatment? >> so i think first, we will review the comments that came in, but also, if using about a practice, i hope the people are in the practice looking at it across the board as opposed to one individual drug. of reimbursement goes up for oncology products in terms of the formula that was proposed, that's obviously revenue to practice. we are going to look at overall access to medication in the aggregate for the policy and whether adjustments are needed and also in the specifics, a medpac puts out information on

this and what different ideas they had and access numbers that they think are covered by different asp plus two and a half or three and a half patients. we will look at information from the public comments, most importantly and in the public domain. >> my time has fired thank you for joining us today. thanks for your hard work. you have a tough job. we acknowledge that and admire the energy that you bring to a very tough challenge. i've heard about the demonstration and the question is why is it so big. most the time demonstrations we work with, we tried out before we do it in the entire country, but why such a large expansive

demonstration? >> so first, it is a proposal so we will seek comments on the scope and many people have noted that. what we think about in terms of proposals is first and primarily the statutory mission which is proposed models we think have a high likelihood of improving quality and lowering cost. then on the g of traffic scope we needed think about three issues primarily. one that areas are big enough that most practices will be within an area, sort of the geographic size and two that it's evaluate a bowl. the goal is to evaluate models and determine whether they meet criteria in improving quality and lowering cost. you have to have a large sample so you can evaluate the model. three, you need to have comparison groups. geography allows you to compare to other comparable geographies but we will look at the comments and determine whether adjustments are needed i just

want to read you a short paragraph of a memo that my staff gave me. cms expects this phase one demonstration project to incentivize incentivize physicians and providers to. certain doctors who often prescribe higher cost drugs will receive lower payments while primary care positions will likely receive higher payments. is that a correct assessment? would you just talk about that. is it correct, do you want to modify it? >> that is from the impact table so it is correct, there are relatively, modest adjustments

for oncology and rheumatology. there's also adjustments in the primary care arenas. we publish an impact table because we want to be transparent about the current proposals affects and if adjustments are made, we would publish a final impact table with the effects across practice types. these are the types of issues we care deeply about and want to be transparent. >> thank you. >> last year medicare part b spent about $22 billion on prescription drugs. does that sound right. >> yes. >> several drug companies have proposed value -based payment models to ensure patients and medicare are getting the best value outcomes in return for a fair reimbursement. my question is as the proposed part b demonstration project, has it helped cms to effectively evaluate value -based payment

models for prescription drugs and the second half of that is, is the stage of demonstration necessary for advancing these for prescription drugs? >> yes, so we propose the two days approach. they are proposed as separate arms, if you will of intervention and yes, the second phase directly builds on what we've seen in the private sector about the desire to test value -based arrangements such as outcomes -based pricing and other methodologies that incentivize higher value and outcomes, hence our proposal. >> you asked a lot of questions here today. did you have a question that you wished had been asked that has not been asked?

>> my staff will probably give a better answer later and then i'll feel bad. i think one, we haven't noted the innovation specifically that congress wrote in the statute, and i will not get this language exactly right, we cannot limit any benefit to medicare beneficiaries and we are not limiting benefits to medicare beneficiaries. i said this but to reiterate it, we care deeply about access to medications, innovation and better health outcome. the question we collectively have to work on is how do we achieve those outcomes. the current system today, i literally get contacted daily from beneficiaries that don't have access to a given medication or don't have access

to care in a given area. if we think this data's quote was optimal, we are mistaken. i think we are learning path today that is much better than it was three years ago. >> thank you for joining us. just a couple questions. we are running well into the votes all go quickly. i want to go back to the scope issue because it is something that is a concern raised by many in my constituents and by my reading of the statute. it's the affordable care act that states they have the authority to test the model addressing a defined population for which there are deficits and care". this rule would change the terms of reimbursement for 75% of all

docs who administer part b drugs under the asp approach. every single drug that is subject to the asp six reimbursement, as i understand it. how could that be consistent with the congressional intent of a defined population? it just seems almost universal, which is not the same. how is it a defined population? >> so, as you noted, they are testing a new delivery model. here we defined a population based on geography. we are looking at the comments now and the scope of that geography. >> just so i understand, it's true as i understand it that they will undergo different experiments, but almost everybody is involved in this

experiment to some degree. so the current proposal has three arms and therefore does have, as you noted 75% approximately of the country in false. we will evaluate comments and determine key issues around the number of arms in the study and the geographic scope and whether adjustments are needed. i would just wrongly issued encourage you to focus on the issue. i wasn't here when the affordable care act was issued but i think a layman's reading of the population suggest something much narrower than what's defined here. something that goes to the purpose, as far as i understand the stated purpose is to make sure there's no incentive to drive positions towards a more expensive alternative than some other alternative which the current system seems to suggest. in the june report they listed

ten drugs with the highest part b expenditures. you know how many of them of generic alternatives? >> i don't want to quote a number because i'm not sure. >> the answer is zero among tent the top ten. clearly it's not the payment model that drives the dock to prescribe the ten highest expenditure drugs, it's the the fact that there's an alternative if we were to make this change, i don't know, is there concern that it could create an incentive for physicians to experience with off label use for some purposes? was that a consideration? >> so if you comments. one the proposal does not just

focus on drugs where there are interchangeable's, if you will, so for example, in her teen changeable to generic. we think the average prices the average cost of the drug +2 and half percent, plus a fixed fee a fixed fee. we will look at the public comments to determine if there are adjustments that are needed in that formula, either overall overall or in certain settings. so the goal is for both high-cost drugs and low-cost drugs that we are paying appropriately for those drugs. the current system does have a disincentive that we have heard from mid back and others on the low-cost drug where if it's a $10 drug and its $.60, 60 cents, the real question is whether that covers the cost of the physician or clinician prescribing said medication. we are trying to remove the financial incentive but still pay appropriately for the provision of drugs that you named or other drugs, once again we would want the oncologist or

other rheumatologist physician or clinician to prescribed a medicine that they need us to pay and the physician for the patient to receive the medicine they need. >> thanks. >> i think my colleague, dr. doctor conway we are at the point in the hearing where the choices either for me to filibuster into my colleagues get back or to offer a couple suggestions. i will route and ask you about how this interacts with other reform proposals. it's obvious there has been progress made to moving the health care system one that moves away from volume. you all reached the target of making 30% of medicare medicare payments through alternative payment models. that's a plus, nine months

earlier than expected and obviously what's called the legislation, the medicare access bill that has this critical program for kids has to last year to reap laces hugely flawed program with the payment system i have heard from some providers that the proposed part b drug demonstration could unintentionally discourage participation in the new payment delivery and reform models such as the oncology care model in the alternative payment models incentivized by the major medicare legislation. what would be your response to those concerns and how do you

envision making sure that this demonstration doesn't in any way discourage participation? >> thank you. we think this program aligns with those specific programs. to give you an example, the the construct of that program was to pay for value. we think they would actually work well together. we do think through different methods of evaluating where one model in another area and estimate and encourage

participation in the new payment model spirit i will not filibuster but i will, your leadership in this committees leadership on delivery system reform has been hugely important. the care choice model rise with the hospice care community. >> it would be helpful -- >> i want to thank you for that. >> i think will be helpful if you could explain something resembling english, exactly how how medicare choices worked because this was something that i had really been dreaming would be done almost since the great panther days. as i understand it, what you all are doing with medicare choices is trying to make sure that

eventually, because this is a big pilot, eventually every senior in america could have the opportunity to get hospice without giving up the prospect of care. your physician and i gathered that this also would make it easier for patients and families to time the kinds of choices that they make so that it's best for them. could you explain how that works. >> you are correct. we are pilot testing the ability for patients and families to choose concurrent hospice and pallet care. it's actually in almost 40 states and it allows for much more patient centered choices. i'll actually, if it's okay, in that panel that handle i had the pleasure of sitting between, it

was one of the biggest positive changes in hospice care in u.s. history. we will continue to modify and learn and refine based on input from congress and others but a huge positive step as a son and physician, i have have been through that with family members and patients and it enables much more patient centered choice and probably the most powerful was i sat on the other side, a gentleman whose wife passed away and said if this had been available for her they would have been able to make better choices that would have more aligned with their goals of care. at the end of the day, that's what it's about. it's about patients and families as you know and have been a leader in making choices for them. >> keep me apprised on the sprint i want to recognize senator cardin. i just want to understand that

that program, that program to provide more choices for older people, that was really born in this room because during the affordable care act, my colleagues remember this discussion, we have constantly heard this nonsense about how there were death panels. there were no death panels. now with medicare choices, it's very clear that older people are going to have a wide array of choices that allow them to choose what's best for them and aligning with their views about health and religion and morals and all of the other factors. i appreciate your take. >> thank you senator, i really want to drill down a little bit as to what your objectives are, particularly as you move toward the second phase of the demonstration. as i understand the first phase, and i was listening to senator portman's questioning, its revolution oh which means you'll have winners and losers and i

understand what you're trying to achieve in trying to do it in a way that uses current resources more effectively in dealing with the reasonable costs associated with administering these drugs. the second phase i'm not quite as clear as to your objectives. that is, is it your anticipation that it will save projected costs and if it's going to save projected cost, do you you know the range you are trying to get to in that second phase? >> yes, we believe both phases have the potential to maintain or generate savings and improve quality for patients and the second phase, as we put in the proposal, we would come forward in the future with the specifics

around drug classes in the very various tools so outcome based prices and risk sharing arrangements and indications, we would come forward with the classes and specific proposals and we would get patient input and consumer input and input from others on those proposals. to give you a tangible example that's come to us from outside these entities that want to do risk sharing arrangements where if a given drug may lower cost in the part a and b space we think about how that could have benefits across the healthcare sector. improved quality and lower cost. we have lower cost sharing for beneficiaries. they are selecting certain medications as one of the proposed tools. the goal here is to test an array of tools that have been used in the private sector to improve quality and lower cost to test them in the medicare part b program. >> we have seen in previous

efforts imposed delivery system programs that are more cost-effective and better value that the budget can prevent if it was implemented the way it was intended because you need to produce a certain amount of cost savings since everyone has to share in the reality of the budget. do build into this demonstration the confidence and credibility that you really are looking for value and not just a cut of cost issues? >> so our statutory authority calls equality expenditures expenditures but we focus on patient outcomes first. when we think about new payment model test, we lead with patient outcome. i think we take that approach here as well. our goal is to maintain access to improve outcomes for patients

and then to either maintain or lessen expenditures. the statue includes the ability of the program improved quality and maintains expenditures but that can meet criteria for expansion. >> how do you intend to engage the stakeholders as you go through into the two phases here? >> we are reviewing the comments now but i'd say the principal that we will try to put in place which is true across the innovation center is robust patient and consumer input into the model, input for provider across the health system and at the end of the day, we know that broad input and transparent processes are critical to shaping this work. i mention this earlier but we now have them in all 50 states, thousands of providers and

millions with deep engagement with the various participants. our bundle payment model, 48 states, over 15 over 15 hospitals and physician groups and others redesigning care for others and improving care and care coordination. that's the kind of engagement we want. >> does my colleague have any additional comment. >> i have a lot of comments but related to the subject, marilyn is in a unique position in one of the issues that we will need to talk about is the impact it has on each state including my own state but it's different for maryland. i assure you, my principal objective is that it's getting better value and better outcome. i think the more you can coordinate, the better off you are. i always am concerned that the pressures on the budget are used

at times to use well intended programs but just to produce savings rather than better outcome. i take you for your word when you said that's not the objective here and we obviously will be watching this pretty closely. >> let me think my collie, just one last question from me, the demonstration seeks to move into this value -based arena with steve heard that i and others is something that's had support on both sides of the aisle and we believe it is constructive moving away from clunky value driven fees, how does it coordinate with the other laudable goal of precision medicine, and all you all seek

in the days ahead to really make sure that drugs and treatments and what strikes me about this as it means what it sounds like, it's really tailored exactly to the needs of the individual recognizing this one particular drug or therapy doesn't affect george and harry in the same way and it certainly doesn't affect george and sally in the same way. tell us if we would so we have a sense of where you're going, how does phase two in particular builds on the precision medicine initiative? >> thank you for the question. we think it very much aligns with precision medicine and supports precision medicine. let me explain how. for example, if you had a new therapy that generated significantly better outcomes for patient and you're paying for outcomes and value, that

actually supports paying for that therapy and the innovation it delivers. similarly, indications pricing, you can imagine if you can really tease apart, for which patient does this therapy effective and pay appropriately for that, it really incentivizes precision medicine, better outcome for the specific patients and we think a very exciting place to work across the healthcare system, manufactures payers, providers, patient groups and paying for value and better patient outcome dr. connolly i have great admiration for the role that you play and it's got to be extremely tough for doctors.

to defend an agency who says we can determine treatment better than the attending physician, because i think that is what this does, you stated that you met regularly with patient and provider groups. have any of those groups that you've met with been supportive of this rule? >> so we continually meet with patient groups, consumer groups, provider groups. >> the questions very simple. have any of them been supportive of the role? >> yes. >> would you would you provide for this committee the list of those groups who have come in and said we are supportive of this part b roll. >> yes i believe we may have even received another letter recently but we can provide that information. >> is cms considering withdrawing this role? speak yes or no. >> we are evaluating the comments now and intend to take

those comments into account when finalizing the rule. >> are they considering withdrawing the rule? >> we attend to take the public comments into account. >> are you doing this to save money or to reach a better health outcome? >> we are doing it because we believe it can reach a better health outcome and maintain or lessen expenditures. >> does cms believe they can design a better treatment pathway than it physician can? >> as you noted i'm a practicing physician. i believe physicians care about their patients and i want physicians and clinicians to make treatment decisions based on what's right for their patients. i would like, and the agency is focused on maintaining that a

patient, a beneficiary should receive the medicine they need and they should prescribe in all instances the medicine that is best for their patient would you also agree that the location they get that is important. >> transportation is the number one issue in this country. it is in the veterans administration and medicaid. i believe it is in medicare. when you limit the rule access to these life-saving treatments, had you in fact bettered the outcome? >> we do not want to limit access including in rural areas, many of my family members are private practice physicians in independent practice. we support independent clinician practice. we are proposing a model that we think can support role and small

practices but we will review the comment. >> what about disincentives that exist in the current system. you don't consider the disincentive for a local -based delivery.when you are saying, if you go to the hospital we are going to pay you more money. >> this proposal proposed to pay the same p +2 and half percent plus a fixed fee both in the hospital out outpatient. >> our objective was to bring forth promising breakthrough therapies as fast as possible including those that would be impacted by what cms is proposing.

they sought remarkable success in bringing forward cancer patients even faster. as a result of the law, 130 drugs have been designated as breakthrough and more than 45 drugs have been approved by fda so far. i fear this demonstration project will jeopardize access to these breakthrough drugs just as they are becoming available. can you assure the committee today that your proposal will not negatively impact the success of the breakthrough therapy? we believe the proposal aligns with innovative breakthrough therapies because the proposal is about focusing on paying for drugs and therapies that generate better outcomes for patients. we have also written expressed concerns about this proposal.

physicians and caregivers are not prescribing medications to profit themselves. they are prescribing medications because they work. do you fear that providers are profiting themselves versus providing the therapies because they work? >> i would want those physicians to continue to provide the therapies that work for their patients. >> if they feel like this, in some way shape or form takes their ability away from them, then you would see a need to change this legislation. >> we want to review bears than any other comments because we want the proposal to support access to medication for beneficiary. >> last thing mr. chairman. >> the time has expired. a north carolina in is suffering from immune deficiency and he

writes members of my community on medicare and the providers who care for them already face complexities assessing accessing medical care and treatments. they should not have to face the consequences of an initiative that eliminates their treatment options. this cost-cutting measure would become a life cutting measure. i urge you to intervene to stop this proposal. >> that's a patient. i think they have probably heard from a provider that if this goes through, here's the impact on you. what do you say as a dock? >> i would say i want them to receive the medicine they need for their immune deficiency. i would say to their physician, i want them to prescribe the right medicine for their patient at all times like all physicians should. >> i urge you to look at this proposed rule. >> senator scott.

>> thank you for being here for today. certainly you're from a rule part of texas and i'm from a roll stay in south carolina. i think we both have affinity for the costs living in all areas that are absolutely severe. the thing that i have heard from my constituents consistently as it relates to this demonstration project is fear. they are scared. i know your mother is on medicare, senior citizens living in rural south carolina are scared. they are on fixed incomes and we now have a demonstration project that covers the entire nation. what they see as the results of this experiment will be higher prices. less access and perhaps, in

order to receive the life-saving treatment that they need desperately to stay alive and see their grandkids one more time is a two or three hour drive from south carolina to charleston. >>

>> around rare diseases or the impact on the folks who are socio-economic a challenged and those who are concerned belly see the governor of practicing medicine in determining value as opposed to the doctors and patients working together to figure out what is the value of proposition of their visit to the doctor and i think we can agree these concerns are valid considering the scope of the magnitude and the impact on citizens and i believe you have desires and intentions that are good looking for ways to help medicare battle before your mother who is currently receiving the

benefits, but for your for kids, i think we share the same concern perhaps with the different outcome. i hope and i would even plead with you on behalf of the citizens of south carolina better so concerned about this project with a step back from the nationwide the plantation and though certain paychecks are benefits. so to highlight a couple of various into rare disease arena sickle cell is a very powerful weapon against a nominee in my state. those who need blood transfusions are one of the only the kids. it is clear they are

excluded from phase one but it is unclear if they are excluded from phase to. can you clarify? >> you are right on blood products being excluded from phase number one. if we would never to put out a proposal with phase number two to come forward for those areas that we plan to address with both public and put impatient consumer input so our goal is to engage and with patients and consumers and as noted in a proposed rule if there are classic is or other issues to be addressed then we would look

to the public comments to consider how best to address these issues. >> everybody else has gotten an extra one so feel free. >> i appreciate the extra 10 minutes. [laughter] i didn't think that was that funny. but i appreciate the fact that concern for my constituents and now to turn they can spend on the road if you are living it just isn't day hoppes get a jump. it is a more serious proposition obamacare can provide up partnership or ride sharing service how can

we justify them to transport young adults with a program you are proposing will limit access for the most pleasurable have we figured out the transportation sharing program to help with the impact in rural areas? >> for the proposal we would want to maintain access including those smaller practices. for patients and physicians who once deliver medicine we want them to receive the medicines when and where and how they want to. we thought the proposal maintained access with improved quality. and we're looking closely at public comments including

smaller practice issues. >> / will stop for i started. >> at no doubt the sincerity or the intentions over anyone. i do want to echo my concerns for those particularly in the rural areas. and sickle cell is among them. and to be financially strapped but that means you have too much month for the money they have for those that are seriously challenged and as you have heard echoed throughout the hearing today the concerns are real because the intentions are good but the

access issue has a real concern so you may have less static number with the impact of those numbers can be quite high. >> thanks senator scott. you are a pediatrician, a career employee in this deport - - department and not a public employee you are a career employee? >> yes, sir,. on behalf of the chairman hatch in the written questions have to be submitted by july 12th. with that we are richer and.

[inaudible conversations]

the republican leader. mr. mcconnell: here's where we are, mr. president. we have a public health crisis we have a public health crisis >> mr. president. this with a public health crisis c.d.

descending on our country. we have been talking about this for three months the administration that we have to get this funding bill done before the fourth of july. before the fourth of july. this conference report that was just prevented from passing that every single democrat voted for we know that if we don't get this job done to have a vaccine within a year and a half and in the short term we're told the most single effective thing we could do is kill as many as possible so here we

are in an utterly absurd this position a plan of political games as a public health crisis mounts here in our country. pregnant women all across america are looking at this parn with utter dismay. so as we sit here with partisan gridlock manufactured by the other side with the issues that is hard for the general public to understand to refuse to pass the funds needed to the address public health concerns. veteran if that was not bad enough with the veterans administration

appropriations conference going report that is funding for construction so here we are going into the for the july we completed the passage of funding of a public health crisis.r sid and in the same vote against veterans as well. so that is where we will be. when we come back after the brief break from the fourth of july i move to reconsider , i change my vote, i move to reconsider i call a mild - - my friends across the aisle to think about this.state, and y and about this issue for the american people. this >> i have been approached in

my state with people concerned about this issue now. not in the future. so when we aback we will address this matter again and hopefully respond as the constituents are asking us. to the pending health care crisis that we all understand. is in the republican majority that we cannot pass a buyer sells here in the senate. and over the course of a few days to come back with a different attitude and to

address the crisis now.y >>. >> data on know what universe my friend lives in. does he think we are all stupid and the american people are dumb? they are not.. they understand what ison going on. we have been trying for months and then we get the money to fight zika virus. already there is $500 million given to ebola because the republicans had done nothing and he said more than four months ago we need money and the cdc needs money we have a crisis on our hands so we worked hard on top of this republicans

rejected five times the legislation that is meaningful and april 28 the senior senator from texas objected and make 18th objected to my consent all in the same day. on may 24th he objected the request again of funding zika virus and then the same day also rejected him as consent request for:he said we need to reflect. come on mr. president, listen to this. listen to this. if republicans were sitting around as i assume they were in the house as we were watching to take over the senate floor.

so i assume there were saying what can we do of we were finding zika virus? and then doing everything we can to irritate them. have this is a serious issue. so how we stop them with birth control? we just got them going to planned parenthood. danehy birth control in their situation.lly young the significant amount of was jt american women in that it

was just turned down today here restricts funding for birth control but if that were not enough with $500 million. so maybe we can do somethinggare so why do we do this? if we can control the we'll mosquitos or do anything then kill them so here is so spr we will do with the clean water act with theo ahead provisions against every fundiny environmental advice that we could get and i'll do it anyway. failed by another $107 million

after they have already failed to repeal but if that were not enough how about you this? what else could we do to stick it in there i? there is a prohibition now that says you cannot fly a confederate flag on the military cemetery. they will take that away. that g so they put that in their. so it was treated as an it here. emergency no different than a flood or fire or earthquake. the a night they were there

on the house floor it was chaos. that y and after one minute said he will pass support to fund for the zika virus. that makes it so you can go to planned parenthood for birth control were taking money for veterans or affect how you spray pesticides. t and just for good measure from obamacare we will do. later i was here a week ago 2200 a women at that time here it is one week later about 100 per women per day are affected. we don't know how many that have been infected we don't know how many will give

birth to these children that are tremendously handicapped with a shrunken brain is and as we sit here dithering with this foolishness with the clean water act and ebola funding and obamacare and the confederate flag, each day women are prevented from getting the attention and that they need for birth control is just unbelievable that somebody would have the audacity tomo come to the floor and say itdn is the democrats' fault give us money for zika virus a funding and should be offset but in the process planned

parenthood, veterans confederate flag, i can't imagine how they would haveas the audacity with that legislation. who's we know what is in the bill. but yet we have had a woman that his work so hard whenil of the free beer senators ever to serve senator any mikulski from maryland. his state has been hit harder than any other but working harder and appropriation bill we know a how much she wants it passedding with little of the awful stuff they have tried to do with veterans' funding it is hard to describe and i said this morning i have been

here a long time i don't ever remember as shameful as this legislation the last seven and a half years that this is the worst. >> the republican whip. >>. >> mr. president wasas shameful is, allowing more women of child-bearing age contract the zika virus so babies can end up looking like this. that is shameful. filib make no mistake about it. our colleagues across the

aisle have filibustered on a partisan basis a bipartisan bill funded the anti-gay zika virus efforts also including measures so we need to be absolutely clear the democratic leader basically said because his party is a sore loser in a conference report they don't love they will block funding to prevent more babies from contracting the birth defect sku micro cephalus basically a shrunken school -- skull. the prognosis is not good women are scared to death their navy will end up like this navy in their concerns are ending up on deaf ears.ore

we are getting closer to mosquitos is season and we need to get this on the president's desk as soon as possible he asked for the 1.9% billion dollars in funding calling it a public health emergency but the democratic friends blocked it because they are sore virus losers and the conference negotiation report that they g like we know this virus can effect a and entire generation this birth defect is heartbreaking and life altering. it is taken a tremendous toll in much of latin america but fortunately the only cases of of zika virus are those contracted from people who traveled to south

or central america and then come home. so far the mosquitos that carry this disease are now spreading in the united states but we know that will change soon. that is what we heard from the senator fromrmer florida, texas, and others talk about the potential impact in the united states and in particular hour former state. severe maker essentially like this, is associated with seizures, intellectual disabilities, hearing and vision problems, and developmental delays. that is assuming that this a child survives into adulthood which most unfortunately do not. how do our friends across the aisle vote against this conference report that

provides funding to help and look this mother in the eye to say we had plenty of good reasons to deny a but we know this impacts heavily children and these babies but also families. mothers and fathers are anxious about the welfare of their babies regularly going to the doctor to gauge progress. and to fine speech and occupational and physicale therapist to have them live as normal of of life as long as they can.apies to one reporter said there is no way to fix the problem just there peas to deal with the downstream consequences. once the navy contracts that zika virus there is a way to fix the problem.

we'll the defense is to prevent children like thisal from getting the virus by getting the funding that democrats just voted down so they can look for a vaccine to do mosquito eradication and other things we need to do from the public health perspective to prevent warh babies like this one from developing these devastating birth defects. or as i centcom there is no means cure once the navy has set here she has set for life.hild s and that means the family will have to leave with a great uncertainty of the health and well-being of the child as they consider thept lifelong implications of caring for a child with this type of disability.hat's by we know we don't have to except this has deal, . there is a way to fight it s by preventing a the zika

virus by a spreading in the united states but unfortunately the senate democrats just voted against that. as i said there are hundreds of travel related cases scattered throughout the country and i hope the administration does more to underscore those health threats of people travel to areas where they're at their worst that is why i joined with the house colleagues toir ask secretary of state kerry of with the cdc to where it has run rampant. with those risks associated pas with any realtime accurate information they can alter their travel plans.puerto

and they have been inching their way north and those have been reported in p.r. and throughout the caribbean. this virus is at ourex doorstep.ical i had a chance to visit with experts in my state at the university anatexis medical center and they agree it is a the health concern we have to act soon. that is why we have to prepare for the arrival of the mosquitos that carry this virus in the united states. houston and fortunately counties and cities throughout texas are working hard to counter the spread of the virus with public health official saidorts

in one of the most populous urban areas and then to take steps to make sure they are prepared as possible. >> for those mothers or fathers who could have children like this and for those to revert blood dash to combat the virus to make additional policy words recommendations to infectious diseases including zika virus. but with states like mine communities like houston are doing their part in senate

democrats are refusing to do their part. it should go without saying on the front lines of the major health concern we needam to respond at the federal level that is why it is shocking and shameful to see so many democrats oppose the of bipartisan effort particularly because they have repeatedly called for the expedited resolution of the appropriation request. over one month ago the minority leader made clear he used zika virus a major priority demanding action.lth ad that this is the democratic leader on may 23rd 2016. instead of gambling with the health and safety of millions of americans, republicans should give our nation the

money it needs to fight zika virus and do it now. not next month or in the fall. of course, he was advocating bypassing the normal legislative process and that was inappropriate for him tot wt demand 1.9% billion dollars spending appropriation that adds to the deficit without letting congress to its job. vod now the house and senate both have passed legislation agreeing to a conference report that the democrats just voted down. senator reid said for us to fail to meet the crisis would be irresponsible but he just advocated failing to meet that responsibility and trust the crisis. we cannot gamble with the health and well-being of women and children to serve partisan political needs.en and most of the needs the i

democratic leader raised are just figments of his imagination. there is no mention of planned parenthood in this conference report for cry will challenge anybody to find planned parenthood mentioned once.ligible ind and as a democratic leader servs knows they are a medicaid provider so medicaid eligible individuals can still seek whatever services they want to through planned parenthood. through medicaid. than the top ranking democrat that actually crafted the bipartisan response and then walked away and voted against it.id "fi she said on may 26, families and communities are expecting us to act. s

parents are wondering if their babies will be borne safe and healthy and we should do everything we can to tackle the virus without any further delay and i agree and frankly do not understand house-senate democrats having taken this position previously to engage in a partisan filibuster with this healthrom w crisis and then just last week the senior senator from new york said every day we wait is increasing the risk we will have problems with zika virus today we had the chance to send a bill to the president's task to meet the demands of senatorl and reid, murray, schumer, but

they blocked it for fanciful and imagined reasons for go one of the arguments that senate democrats make is that more money is neededa but this at the very levelel that they agreed athr $1.1 billion. president obama and the democratic colleagues make the argument is throwing money at the problem will fix everything but throwing no money will fix nothing which is what they voted for today less than 7% of just 40 million of the 589 million has been obligated that translates causen easily to more than $500 million to fight this cause in addition to the

1.$1 billion in this bill. and we refer from our colleagues about this great need to prepare for the coming health crisis and how essential it is to get the resources to those studying the virus and perhaps discovering a vaccine but when given the chance to doe that democrats shut it down to filibuster the bipartisan bill that they themselves her asking to do pass that is absolutely disgraceful so i hope our colleagues will reconsider their misguided efforts to follow through a with what they say we've been all along the funding to fight a real public health threats as a public health prairie that demands attention and must be

addressed now and not later.d, r mr. president wonder the senators have voted against this bill will tell the e mother of this child or perhaps another woman pregnant wondering if her child will end up with this terrible birth defect. could possibly look that woman in the eye to justify the reasons they voted against funding so other children can avoid this terrible devastating birth defect? but that none of them could famy look that prospective mother in the eye to say we voted against protecting your navy in your family for good and

sufficient reasons many of those stated by the democratic leader are of that agenda and not real. like the idea that somehow planned parenthood has been targeted that is even mentioned in the legislation. i can't imagine a more disgraceful'' that was some of our colleagues across the aisle have denied fundingder. for this and pending public health crisis.ir i hope they will reconsiderote a whole family is to worry about the health of theiry children will call the office to say why did you vote against funding the money necessary to eradicateow mosquitos why did you vote

against further scientific research why did you vote against developing a vaccine to prevent the vaccine not only here but around the world. over a cookbook that mother in the eye because what the democratic colleagues just did by voting this town was hypocritical, cynical and shameful. >> mr. president. >> mr. president with a previous comments would be more interesting if it wasn't for the fact that assad asking me and i don't

want to go into conversations on the floor but i just wonder on this if we had a real conference where things were discussed if that would be possible because of the republican leadership took the mound for a multi week vacation last week and then done their work as we have. i of course, that is their decision mr. president i find it unbelievable that to date the state senate said note to pregnant moms and veterans to deny cloture with the legislation and many have to run the risk

yourself. and then maybe not funding health care. i deeply regret the cold -- the cloture motion was denied and i hope that will be granted so we can approvee the appropriations and our response to zika virus. i will undermine called much that is i represent the cdcn in the land ted georgia. i was there two weeks ago for a meeting on zika virusth there more than 1 million cases of latin america and the caribbean and to attack the brain into of deformities. today

to stop and prevent the you cannot do it if you don't find the nation and one is the research and development that is obviously important but the other is the about education so people take yous, don't want mosquitos -- have the we don't have to think about it but they are transmitted through one of two types of mosquitos both of which are indigenous to georgia in the southeast united states and also by sexual intercourse whether in colorado or georgia is another way to transmit as well. if we don't have a good education process how they protect themselves more to this protect themselves we will be in big trouble a lot of

babies will be born with lives of tragedy because we did not do our job. table so be $10 million of the taxpayers per child. h we should come back to the table of the 1.$1 billion response to a you the education you need it we will respond and i have never understood. no >> i know with these people have done. don and to say no to the funding of the v.a. health care that is wrong. of

people volunteer for the military with 16 straight years of deployment in the middle east.e to they deserve to know when they come home there will be provided for. and to get them to join the military regardless of that condition. so as one member of theou senate i cannot say no. i don't think anybody wants to say no but i would encourage members to come back to the floor to vote for cloture and do it as soon as possible time is of the essence it is important time and there is nobody more important than the veterans of the united states of america.

>> i am peas to the senate has come to this conclusion television will undoubtedly provide citizens with greater access and exposure to the actions this will

help all americans to leave it better informed of the issues that "face the nation" on a day-by-day basis. >> during the election i had the occasion of meeting a woman who supported me in my campaign and she decided to come shake my hand and take a photograph a wonderful woman she was asking for anything and i was very grateful she took the time to come by it was an exceptional moment except the fact she was born 1894 bernie ms. marguerite louis born in louisiana born in the shadow of slavery and the time when lynchings were commonplace at african-americans could not vote. it took our country from the

time of its founding to the mid-90s of $850 billion which was the size of the stimulus package when it came over here. so we're talking about real borrowed money. >> [inaudible conversations]

[inaudible conversations] [inaudible conversations] still neck good afternoon. on november 5, a 2009, in for a good texas then army major gun down 14 innocent persons including an unborn child. while shouting species speaking arabic prior to this attack the folks in the gallery find it amusing murdering 14 edison souls.

prior to this terror attack federal officials were aware that he attempted to contact al qaeda to schaede steamers emails with a terrorist. and worried many colleagues of the promotion of an extreme radical interpretation. but they did nothing after the fact to classify these terrorist killings in january 2010 to untitled protecting the force of lessons from ft. hood. the report did not mention hassan by name or use the terms is long and i would

like nothing more than to speak to a government official about the bizarre decisions of the pattern that is characterized seven years of the obama administration. especially in light of the latest terror attack in orlando by radicalized man interviewed three times by the fbi and get it was not prevented. and they invited to such witnesses the assistant attorney general and the assistant director for the fbi national security branch both members of the administration have refused to 0p -- appear three months after ft. hood the

quadrennial homeland security made zero references but the subcommittee would have appreciated speaking with several officials about this to the british leisure. and in 2011 to send a letter to the obama administration cleaning the federal government has somehow become infected with false and highly offensive training materials and demanding that such bigoted and distorted materials be purged and i would go to that is their word, a --, not mine. and also advocating for the creation of the interagency task force to address this problem. in a lightning quick response and rather unusual

occurrence john brennan then the president to claim that the federal government had produced offensive training that urgently needed to be dealt with to reflect the vision that the president has put forward. to discuss this critical issue of national security from the obama administration should be the concern of counterterrorism or rather when they work and keep america safe? yet no one from this administration is willing to show up and defend their scrubbing of anti-terrorist

materials. let's take several more in november 2011 the department of homeland security rudy's the domestic terrorism homegrown extremism and made no reference to the islamic terrorist. despite on its face with the alleged lexical on that included anarchists -- anarchists extremist animal rights extremist and environmental extremist and racist skit head extremist but yet somehow radical islamic extremist were nowhere mentioned in the fbi suppose of lexicon similarly

to make no reference to is long or radical islam orgy hotter any other such terms. by way of comparison the 9/11 commission report mentions jihad 126 times and is long 322 times. in the even worse march 2012 under pressure from advocacy groups the fbi purged 876 documents from training materials that the best of three unidentified experts some of the purge materials were offensive. one article was purged because it was highly inflammatory and didn't

accurately argued the muslim brotherhood is a terrorist organization. it should come as no surprise that i as many others are concerned by this given i have introduced the bill of the senate's to designate the brotherhood for what it is as a terrorist organization. paul moss after all is the palestinian branch of the muslim brotherhood it as a terrorist organization that openly celebrates murdering women and children the obama administration has declined to appear and explain its policies. in 2014 the president stated that isis was not islamic and again is on a state is somehow not islamic. because according to

president obama '' no religion condones the killing of innocents. somehow no one has told that to the terrorists. also a 2014 of former white house counterterrorism strategist says they cannot directly address the interpretations of groups like isis because of the constitutional separation of church and state. u.s. officials are prohibited from engaging in debates that is more than a little troubling. our government officials in the terms of this administration prohibited from debating anything or confronting the radical theology that mandates the forcible murder or her to the infidels this committee

deserves to hear an explanation and let's finish with more recent examples this year alone the administration has purge mentions of isis and islamic terrorism from highly significant one involving a french president about the paris attacks the other 9/11 call during the of horrific orlando attacks. the administration was forced to reverse course the public outcry became too great. around the same time they were abolishing a report about countering violent extremism to reject religiously charged terminology such as jihad.

notice a trend? but to scrub any reference to pretend that the threat does not exist and tragically as a consequence over and over again we have instances where the administration has ample evidence of radical islamic terrorist whether the boston bombers or the terrorists of san bernadine no court in orlando the administration to has had ample evidence to step in to prevent these terror attacks. but the consequence of the policy now refuses to a knowledge that over and over again.

. .

i appreciate this opportunity for the first hearing of this calendar year. in my view of today's hearing, we present the american people with a false choice. it's very premises suggests that we can either keep america safe or preserve our fundamental values. i reject that promise. we can and must defeat terrorism without sacrificing our principles. to compromise these principles and blame over a billion muslims for the twisted actions of an extremist view only serves to divide america, to alienate and legitimate the load groups that falsely claim to speak for islam. this makes us less safe. to truly tackle and destroy the ideology that lead fanatics to do us harm we will be best defended by maintaining open,

tolerant us and religious freedom. we cannot fight radicalization with further radicalization. the country is still trying to make sense of a tragic attack in orlando 16 days ago. he massacred 49 innocent people, injuring 50 more, 50 more, leaving our nation and world shaken. these act of violence are sadly all too familiar and leave us asking why this congress refuses to take simple actions to prevent them. the particular form of violence of omar mateen will continue to be under scrutiny in days to come but there are a few facts i want to assert. first, as a nation we are not at war with the religion of islam. a deranged murderer invocation of islam with a hollow attempt to justify his rampage by cloaking it in the legitimacy of

religion. we know isis is trying to falsely characterize us of being at war with islam. they are trying to characterize themselves as the legitimate heir of the prophet a mohammed. isis is not islam. it is a perverted interpretation of one of the world's great religion religion. it has killed more muslims and christians and extremists that call themselves isis neither practice islam or seek it. no religion condones massacring innocent people and faithful muslims and leaders around the world have this denounced isis for the terror group that it is. as you raise the question of president obama's committed to combating isys, let, let me recount that the president has also condemned the threat of

isis, not what debate of a few words but with decisive action. we have carried over 13,000 airstrikes airstrikes and killed more than 25000 isis fighters and 120 isis leaders. over the last the last year isis has lost more than half the territory it controlled in iraq and syria. the u.s. built a 66 nation coalition to fight isis and these partners including 19 muslim majority majority states and organizations are committed to eliminating the threat posed by isis. they have contributed to wide range in the efforts to combat isis in the middle east and iraq and syria and beyond. third, there is over 1.6 billion muslims in the world including millions who are american citizens and are interwoven into the fabric of our nation. they are doctors and lawyers and scholars, service members, colleagues and friends.

i have been deeply disturbed by inflammatory rhetoric directed toward muslims and how it has infected our political discourse in the united states paired are muslim american citizens and neighbors share our stake in the nation security and our desire to be free from violence and hate. we know we can defeat isis without forgetting our value. they are able to engage and promote what are effective to be law enforcement techniques without prejudiced. i reject the notion that there is some sort of political correctness from fighting our enemy. it simply too polite to say that the brave men and women that keep yourself safe are not

fighting. place a blame on radical islam only seeks to empower isis. let me submit for the record if i could a wide range of documents, but first a statement of principles signed by dozens of foreign policy leaders including former secretaries which correctly states religious bands and tests are un-american and have no place in our refugee and immigration policy. mr. chairman i have a long list of statements i'd like to submit for the record from the ranking member senator leahy and the public affairs council, and amnesty international, the labor alliance and are new york times article and washington times article. i believe those will be smitten without ejection. >> without objection. as to the empty seats before us,

it is my understanding this hearing was scheduled with a minimum of notice and no consultation with the invited witnesses from the administration. it is my expectation they are busy keeping our country safe and as you surely appreciate from your work in the justice department, asking witnesses to speak about the ongoing investigation into the orlando incident would not have produced any testimony. i would note that the sector will be before this exact committee in two days prepared to answer questions. >> let me close i quoting what i have just omitted for the record, an article from general david pretorius. those who flirt with hate speech against muslims should realize they are playing directly into the hands of al qaeda in the islamic state. demonizing an entire religious faith and its, runs contrary to our cherished and fundamental values and it is also corrosive

to our vital national security interests and ultimately to our success in this world. i look forward to what i hope can be a productive conversation about our national security, our civil civil liberties and respect for muslim americans. >> i think my friend from delaware for his comments. i would note that they suggested it was scheduling issues that prevented them from attending. this was noticed two weeks ago and we received a letter from the department of justice that did not site scheduling conflicts, they they just said they would not attend. i would suggest that was not inadvertent. i would also suggest that senator coons followed the lead of president obama. the first when he said as we

have no war with islam. that is certainly correct. there are millions of peaceful muslims across the face of the globe and president obama and senate democrats do grave disrespect to them when they suggest some sort of equivalence between peaceful muslims and radical islamic terrorist. to suggest that confronting radical islamic terrorists is somehow hostile to peaceful muslims bears no bearing on reality. i would note as well senator coons, like president obama said this is just about creating a few words. no one has suggested radical islamic terrorism said that saying them out loud will suddenly make it go away. you cannot fight an enemy you do not acknowledge, that you pretend does not exist and that you refuse to confront. it's not simply that president

obama won't say radical islamic terrorism, it's that they have engaged in a purge to erase any focus on radical islamic terrorism. senator mentioned a minute ago that we are still trying to make sense of the terror attack in orlando. one is only still trying to make sense if one ignores the actions and words of the terrorist. a terrorist who pledged his allegiance to isis and whose pledge of allegiance was edited out of his 911 call by the obama administration, an action that would make george orwell proud. it only makes no sense if you do not listen to the promises to murder as many innocents as

possible and the purpose of this hearing is to focus on the connections between that policy of willful blindness of insisting there is no such thing as radical islamic terror and the repeated failures of this administration to prevent terrorist. when the orlando terrorist told his coworkers that he was affiliated with al qaeda and when he is interviewed three times by the fbi, when he's interviewed and has connections to an american suicide bomber, when the father is publicly proclaiming on youtube his support for the taliban, any administration focused on fighting radical islamic terrorism would have watched that individual very, very closely to make sure the terror

attack he was getting signal after signal after signal was a real risk. orlando is not the only instance. over and over and over again this administration has warning signs but because of political correctness the result is innocent americans are killed. at this point i would like to recognize mr. carlin and mr. steinbeck to provide their testimony. they have refused to attend so with that i will invite the members of the second panel to please come forward. each of you will be sworn in marmot momentarily. while you are coming forward i will begin by introducing each of the members of the second panel. the first witness is doctor m duty who is the founder and president of the form for

democracy in phoenix, arizona. a graduate for the university of wisconsin milwaukee and the medical college. he is a former commissioner of the united states commission on international religious freedom and he served as a medical officer in the united states navy. he is currently in private practice in phoenix specializing in internal medicine and nuclear cardiology. she is the president and executive director of muslim advocates in oakland california. a graduate of wellesley college in cornell law school, she is previously served as counsel to the u.s. senate judiciary committee and has worked as a litigation associate associate with several prominent washington d.c. wires. mr. philip haney is a border protection officer in the department of homeland security. officer haney completed several tours of the center in

washington d.c. and he has won numerous awards and accommodation for producing material that led to the identification of hundreds of terrorist. having retired in july 2015 he now resides in marietta georgia. mr. richard cohen is a graduate of columbia university. he is previously testified before the he is a businessman activist and national security consultant based in franklin county virginia. he has been nearly a decade researching the threat america posed by radical islamic terrorism in developing expertise on the private organizations that terror groups rely on for support.

he's a graduate of north university law school and he previously worked as a special agent of the fbi. he is taught at the national defense university, the john jay college of justice and spent several years with the civil unions office. mr. andrew mccarthy is a senior fellow at the national review in institute, a graduate of columbia and the new york law school, he served as a federal prosecutor for 18 years in the united states attorney's office for the southern district of new york. he was the lead prosecutor in the terrorism case against the blind sheikh and 11 others convicted of urban terrorism against the united states. mr. mccarthy is the author of

several books. i would ask each of you stand and raise your right hand. do you affirm the testimony you are about to give is the truth, the whole truth and nothing but the truth so help you god. >> you may be seated. you are each sworn and we will begin the testimony.

>> is your microphone turned on. >> okay or should be a red light. the microphone doesn't seem to be working if someone can try to address the technical issue. perhaps you can use the adjoining microphone if that one is working. >> thank you charming cruise for this very important hearing. i am president of the form for democracy based in furyk phoenix, arizona and i request my statements be written for the record. i'm here today taking time away from my family, work during this last week of our holiest month of ramadan, a time of fasting and deep atonement because i could not feel more strongly that our current national and direction in combating islamic

terrorism is deeply flawed and profoundly dangerous. as a devout muslim who loves my faith and loves my nation, the emphasis is the greatest obstacle to national harmony and national security. wholesale denial of the truth by many in our government is not only dishonest but it lies to the american people. there is extremism on both sides of this debate because the radical for their cauldrons of saudi arabia and iran end up speaking for islam. i'm sorry to say that linking this to islam to saudi arabia and iran and the egyptian state, to pakistan so when you speak about 1.6 billion muslims you're actually handing the narrative to the regime, not to the people

of those governments requires them to maintain their global form as the only form is islam. if we are on the side of muslim dissidents than we would be on the side of having this debate. america was formed on a debate of democracy. i think we are adult enough to have this debate and do it functionally without saying we are having a debate in which we demonize 1.6 billion 6,000,000,000-point i would tell you as a muslim in this month of ramadan that we demonize them by letting the islamic's speak for our community. they are not monolithic. they work to refuse to acknowledge the role of islam and its precursors. majority of americans are smart enough to understand to say that the house of islam has no problem is just as problematic as declaring that islam and muslims are the problem. a national security policy is

refusing to say that islam currently has a problem is dangerous. this surrender which began just after 911 has charted a course. it has hamstrung our homeland security heroes from directing the most central precursors of militant islamic. if the agency actually emphasized the role of islam and its ideologies, it would shift the entire act excess of the agency towards one of beginning to address, expose and it view the root cause of political islam which would begin to make us safer. we can't hold our homeland security accountable for precursors and then tell them they can't even engage because all they are looking at his violent extremism. the only way to write this misdirection is to shift the center back access to countering violent extremism to countering violent islam is him.

we must identify what it is. we were founded on the premise that terrorism, isis, al qaeda are all symptoms of bureaucratic bullies. we formed our organization to counter political islam just as the founding fathers did against bureaucracy. in december we convened to help launch a diverse reform movement that included over 15 organizations. it's a coalition of reformers in the u.s. that is not part of this. it includes feminist, those who believes in gay rights and all these issues of left to right but they came together to reject political islam. if everyone of them were here today, they would tell you that the refusal to identify clinical islam is the root cause and the conveyor belt is the greatest obstacle to reforming the ideas that turn out these militants. not one iota of this work would be possible an environment where

they are unwilling to understand and engage groups domestically and abroad on the diverse interpretations of these terms which i listed in my testimony. we should be able to have the maturity to engage on what these terms mean not to engage in those terms is not only dishonest but it actually marginalizes what you want and claim to respect. in fact the administration has not done so because of those who engage in their advisory circles like the council on islamic relations which is not supposed to engage the government but does because of its influence and connection to, i would say, the lobby in washington. i asked that any official use on

the following terms that i discussed be immediately lifted. any apparatus unable or unwilling to connect the dots between nine island and violent ideologies is leaving us bear and will miss the signs of radicalization. fort hood, boston marathon, san bernardino and likely orlando will show that and everyone in every one of these cases it is abundantly obvious that if they were honed in on the continuum of political islam that ultimately they would have had these individuals on their radar, but they didn't because they are waiting for that final moment when they become violent i want to end with some recommendations. we need to stop hiding behind offending the oic in their regime which put muslims like me in prison every day.

the u.s. government and public discourse must include a broad spectrum of ideologically diverse voices in the muslim community and not just one apologetic voice that doesn't see a problem and is enabling the continual radicalization of our community. it is time to stop engaging muslim brothers and media and recognize their problematic underbelly in underpinning. we must recognize they are not the only voice for american muslims that we must take women's issues and freedom of conscious a litmus test. these groups on prest will fail. it's time to start giving credence to the dictatorships over the opinion of muslim here in america that believe in our liberty and freedom. i ask that you continue in investigation into their expansive network of foundations of many of these muslim

rutherford legacy groups. i asked that you no longer fight fear, offending us by using the talk term that we use what we debate these issues within our own communities. those are pressed by islam and muslims. homeland. depends on your honesty. thank you. >> thank you. on the morning of september 11, 2001, while working for then russ feingold, my colleagues and i learned that that a plane hijacked by terrorists was heading for the capital. i still vividly recall what it was like to run out of the senate office building fearing for the safety of my friends, my colleagues and my family.

three weeks later our senate office received mail contaminated with deadly anthrax spores. my colleagues and i were put on powerful antibiotics for several months to counteract possible anthrax exposure. you see mr. chairman, i understand on a deeply personal level what it feels like to fear harm and be under attack. i resolve then to do my part to ensure that violent extremists regardless of race religion or ideology never succeed in their mission to destroy the value that make our nation great. freedom, justice and equality for all. mr. chairman members of the subcommittee, thank you so much

for inviting me to testify today on how we can do better to keep our nation safe while upholding our nations value. after 911, present president george w. bush could called on the nation to uphold the values of america. he said no one should be singled out for unfair treatment, for unkind words because of their ethnic background or religious faith. at a dark moment in our nations history president bush comforted the american people by assuring them that we are stronger together. nearly 15 years after 911 we are experiencing another dark moment candidates for president of the united states have said that law-enforcement agencies should patrol and secure muslim neighborhoods.

there should be a national registry that muslims should carry special id cards and that all muslims should be banned from entering the united states. this rhetoric makes our nation less safe. it makes us less safe because law-enforcement's job is to find the needle in haystack, a task that is made much more difficult when more stacks of hay are added to what the fbi director has called a nationwide search for the needle. we are also less safe because isis wants us to have war against muslims. think about it. do we really want to surrender our values, american values to one that has no risk whatsoever for human life and human dignity

tragically this has signaled to the public that it is okay to fear your muslim neighbor. it has lead in the last several months to a disturbing and unprecedented rise in hate crime. murders and firebombings, shootings -- in the last seven months alone there have been nearly 100 hate crimes against american muslims and those perceived to be muslim. these hate incidents are not near statistics. they affect real people and families. most importantly our children. late last year mother told the story of her daughter sophia. sophia began collecting all of her favorite things in a bag fearing that the military would come to take her family away because they are muslim as sad

as this story is the response from u.s. army veterans who have heard the story was powerful and touching. veterans posted images on social media of themselves in uniform with this message to this child. i will protect you. since the tragic events in orlando, muslim advocates along with americans from all walks of life have stood with our friends in the lgbt q community. you see, we are not willing to give up on america. the idea that a group of people diverse in every imaginable way can form a lasting bond based on the shared principle of freedom, justice, and equality for all. some would dismiss this as political correctness. to me, it is a belief in the power of what has made america great. we hope that our elected

officials are not willing to give up on america, that you will do everything in your power to uphold and defend america's defining values and principles. thank you. >> thank you. mr. haney. mr. chairman and members of the committee, thank you very much for the opportunity to testify here today. i would also like to express my appreciation for the patients and the members on the committee and senator cruise while obtaining a copy of my written testimony. i would like to start with the visual aid. this is the homeland security advisory council countering violent extremism for 2016. i colleague referred to it earlier by suggesting that we should refrain from using words like puma or jihad or others. i would like to also show you

this was published in january 2008 and it's called words that matter. i want to talk about what happens between these two documents, 2008 and 2016 because it was during that. of time that what we know now of countering violent extremism policy came to be. one of the expressions was what we heard about in the media in the few days after the orlando shootings. they were going to release the calls from 911 with all of the messages from the attacker removed. that is the exact opposite of what we need to do to protect our country from threat.

between these two times came what i call the first great courage. when i was ordered by the department of homeland security headquarters to modify a euphemism all pieces out of the law-enforcement system that had to do with muslim brotherhood network here in the united states, i was told to remove all unauthorized references to terrorism and i was no longer allowed to do what are called memorandums of information received, what we call mo irs. no more text records or research or special treatment from the agency, but during that time, hundreds of law-enforcement actions had been taken in the three year time period. period 820 records were still in the law-enforcement system. at exactly the same time a controversial inaugural meeting took place on january 27 and 28th 2010 between american

muslim leaders in the department of homeland security which was hosted by the department of homeland security civil rights and civil liberties. it was controversial because several of the individuals attended it only the conference was known affiliates of at least two of the front groups that had just been named as unindicted co-conspirators in the largest terrorism trial in the history of the united states. also, that spring at least six individuals with known affiliations to the but brotherhood group was appointed to the countering violent extremism working group which was convened under the authority of the homeland security advisory council. i would like to show you now the local of the muslim brotherhood, the moderate organization that this administration chose to ally itself with. across the middle it says the

muslim brotherhood and at the bottom, taken from carranza 860 is the word that means prepare yourself to terrify your adversaries with deeds of war or weapons of war. that is the model of it. by the spring of 2010 we come to the point that an officer was allegedly making information while the administration was bringing the very same individuals into position of influence. to help implement a our terrorism policy as evidenced in our over support of the muslim brotherhood in egypt, algeria and syria. fast-forward to a case that i worked on that was approved by the chief counsel of the department of homeland security. this is an icon of one of the

largest movements in the world outside the united states. it's called the army of darkness i began the assignment and temporary duty in november of 2011. within six months we had instituted 1200 law-enforcement actions on the case that we had started. in september 2012 what i called the second great courage when the administration removed 67 linking records out of that case that had direct ties to the san bernardino killing and the islamic center down in florida. now that we are the network that we had worked on is tied directly to the terrorist attacks that we have seen recently. at the end of my career i was relieved of my service weapon, all access to text was cut off and suspended peer my secret service manager and access was

taken away while investigations from three different ranches of the government were concluded. in july 31 of last last year i retired honorably. in conclusion, the threat of islamic terrorism does not just come from armed organizations like isis who are operating over there somewhere in the middle east. branches of the same global network had been established here in america and they are operating in plain sight, especially among those of us who have been charged with the duty of protecting our country from threats foreign and domestic. it is actually quite simple. to establish fear everywhere in the world including here in america. there is an organization in the united states that is actively doing that. it's called the assembly of muslim jurists of america. it's a benign sounding name but in arabic it means the group of

lawyers implementing law in the united states is unconstitutional. the threat that we face today, it continues growing despite those who insist otherwise are not the tactical methods of violent extremism or even operative but the strategic goal of implementing this law everywhere in the world so that no other form of government, including the united states constitution is able to oppose this influence of the lives of those who must either submit to its authority become second-class citizens or perish. thank you very much for your attention. >> thank you mr. haney. >> thank you senator cruise. it's good to see again. our country faces threats of violent extremism from many sources. the horrible massacre at the orlando gay nightclub earlier

this month by gunmen pledging allegiance to isis is the latest example. a year ago this month it was a massacre of churchgoers that the charleston manual church by a white soup's premises. two years ago it was the murder of las vegas police officers by antigovernment zealots who had been at the ranch. i would not take issue with the obama administration assessment that terrorism from those are inspired by groups like isis but i would point out that the threat of violent extremism from those blinded by racial hatred and rage of the government are serious ones as well. while i would not go so far as to say that our government has been willfully blind to these threats, i would say that the record shows that both republican and democratic administrations they have not always given these threats the attention they deserve.

the clearest example at this point comes from the history of the domestic terrorism task for that the justice department established after the oklahoma city bombing. the task force was scheduled to have one of its regular monthly meetings on 911. they didn't meet again for 13 years as the threat associated came to dominate the government's attention. during this time period, the number of hate and conspiracy minded groups skyrocketed in the level of violence increased by a factor of four. president obama has been a particularly lightning rod for the radical right. the day after he was elected, storm front, the leading neo-nazi website whose members who have committed various murders reported it was getting six times its normal traffic. there are a lot of angry white

people looking for answers. when dhs released a report in 2009 assessing the likely backlash to the election of our first black president, the reaction from groups like the american legion and members of congress was so fierce that the report was withdrawn in the dhs unit that produce the report was allowed to wither. in 2014, the justice department finally revived its task force after a white soprano missed glenn miller killed three persons in the overland park kansas that he thought were jewish. still there are indications of the threat of terrorism associated with groups like isis dominating the government thinking. the oklahoma city bombing was the first incident, the first terrorist incident that president obama mentioned in his speech at the white house summit of countering violent extremism

in 2015. it was virtually the only mention of radical right terrorism during the entire summit. two weeks after the charleston massacre the house homeland security committee released a terror threat snapshot that didn't mention the charleston killings. congress has held multiple hearings, as it should on the threat of terrorism associated with groups like al qaeda. as far as i know neither the house or the senate has held hearing on terrorism directed at law-enforcement officials in the west by government zealous such as the bundy's. members of congress have actually sympathized with the bundy's at times. again, the threat of extreme violence from individuals associated with or inspired by groups like isis is serious but it's not the only threat that we face. furthermore, as the recent study

by duke university's triangle center on terrorism and security concluded, law enforcement's virtual single focus on the threat of terrorism associated with groups like isis and its heavy-handed tactics risk fraying the bond of trust between law-enforcement and muslim communities that is so essential to effective law enforcement. president bush said it best, we are not at war with islam. muslim communities are part of the solution, not part of the problem. thank you. >> thank you senator cruise. i'm a national security consultant with a company called understanding the threat. we are the only organization in america that trains law-enforcement intelligence professionals, military leaders on the threat from the global islamic movement. the doctrine of jihad he groups and how to identify, investigate and dismantle them. we hold the firm belief that in

order to defeat the movement we must understand the enemy. u.s. military war fighting doctrine, specifically the intelligence preparation of the battlefield manual states that war planners must begin all analysis of the enemy with who the enemy says they are and why they are fighting us. that begins the basis for the trimming the enemy threat doctrine. in the case of jihad he's is sharia. universally, the enemy, whether it's al qaeda, isis, the muslim brotherhood, they all state that they are muslims awaiting jihad and the cause of the law to establish an islamic state. i will discuss one jihad group, the muslim brotherhood. based on evidence in my own experience conducting undercover

research, the council on islamic relations the holy land foundation was adjudicated in dallas texas in 2008 and identified terrorism as the muslim brotherhood palestine committee which is hamas. a designated foreign terrorist organization the u.s. government identified hamas as an outgrowth of the brotherhood. documents entered into evidence in the holy land foundation trial also revealed that it's not the islamic brotherhood of america, it is an organization that supports hamas. at the time it was indicted, the the holy land foundation was the largest islamic charity in the united states and it was convicted on 108 counts for contributing to a terrorist organization which is the palestinian branch of the brotherhood. the muslim brotherhood create

safe, allah is our goal, the cron is our constitution, jihad is our way and death to the glory of all law is our greatest ambition. the muslim brotherhood by law states that the islamic nation but be fully prepared to fight the tyrants and enemies as a prelude to establishing the islamic state. again the muslim brotherhood agenda is no different than that of al qaeda or isis. the muslim brotherhood logo has two swords cradling a cron with a reference of the first 60 of the cron that states against them make ready. this verses also referenced in the al qaeda training manual which was discovered in may 2000 by british investigators

conducting a search. during my time investing undercover research as an intern i preserve documents that covered up fraud, pleased staff and inside interns inside offices, conspired to influence congress, specifically judiciary intelligence and homeland security committees impact the congressional disc tricks and influencing legislators. ordering books on martyrdom. i worked with the muslim law enforcement officer to him

impact. [inaudible] one of the results of this situation is to order the removal of terms like jihad from our lexicon. i attended a convention in ohio in 2008 organized by muslim brotherhood group and both the department of homeland security and the department of justice fear of prison had recruitment and outreach booths. i know they are co-conspirator in the world trade center bombing it was the first to

offer. [inaudible] to congress. this means training the law-enforcement mother. they canceled training with threatenings of cries of islam a phobia and racism. documents entered into the evidence of the holy land trial and a memorandum outlined the role of muslim brotherhood in north america. quote the process of settlement is a jihad process. they must understand it is a type of grand jihad in destroying western civilization from within and sabotaging the miserable house by their hands in the hands of the believers so that it is eliminated and god's religion is made victorious over all over religions it's made up

of many other groups, hamas, hezbollah, the brotherhood, isis and many other groups and countries. they all seek to impose sharia. it is the blueprint from which they create their war fighting's strategies. from our perspective that makes the enemy threat doctrine and a direct threat to the public. until american leaders identify the threat and formulate policies and strategies that stress adherence to this ideology we will continue on our current path of defeat and lose this war here at home as we did in iraq and afghanistan. thank you. >> thank you sir. chairman cruz, ranking member, members of the subcommittee,

thank you for inviting me to testify. our counterterrorism efforts are not as effective as they need to be to reduce political violence abroad and build public resiliency at home, i disagree that the obama administration's reluctance to use the term radical islam is part of the problem. policymakers and organizations have ensured that radical islam has remained a predominant part of the discourse since the 911 attack. congress has held more than a dozen hearings from the top. biased and flawed materials produced by the fbi and the departments of justice, defense and homeland security vividly demonstrate these groups had to stand to influence on the obstruction these agencies provided over many years. the problem is not that there has been too little talk about of radical islam, but too much. i agree with resident obama that this rhetoric offends values of america and undermines the national unity and international cooperation necessary to effectively counter terrorist

violence at home and abroad. this is not political correctness, it is factual correctness. radical islam islam is no more accurate or a descriptor of that violence created by islam's than it is to promote violence done by christians in groups such as the ku klux klan. it only stokes to create fear and bigotry. the fact that the first five are locked in conflict with each other in the last wasn't even a muslim group doesn't seem to matter to those determined to see them as parts of the global conspiracy. more damaging however is when radical is used to smear muslim civil rights groups, charities

and religious institutions in the same way that the fbi did to labor organizers, civil rights and peace activists. as in the past, we error and think gang that we can improve our collective national security by undermining the security and liberty of some subset of fellow americans. the focus on terrorism committed by muslims have in fluent law-enforcement actresses and priorities which have disproportionately and indiscriminately targeted muslim communities with surveillance and infiltration to the exclusion of other violent threats. half of the violent crimes including one third of the homicides in the u.s. go unsolved even as the fbi investigates tens of thousands of false leads based on flawed radicalization theories. meanwhile, at the 2011 triple homicide in massachusetts had been solved, dzhokhar tsarnaev would not have been free to

mastermind the boston marathon bombing. inform policy the ideology is the lens through which we evaluate many civil wars. it blinds us to the true nature of these political conflicts and puts us on a path of perpetual war with predictable consequences to civil liberties, human rights and the rule of law. ideas ideas cannot be killed in ideology cannot be destroyed. though we defeated nazi germany in world war ii, my undercover work against neo-nazis in the 1990s and the political assassination in britain this month show fascism was not defeated. we respond appropriately to this threat by criminalizing the violent behavior, not by attempting to destroy in ideology. today americans know little about isis except to be deathly afraid of it which is exactly the way isis likes it. the flawed narrative that likens radical islam to isis through vulnerable american communities is generating mutual distrust

and animosity, leading to more cause for discriminatory policy and increasing anti- muslim violence. this is self-defeating as alienation and the experience of discrimination are often identified as the conditions that lead to that. it pits americans against one another and amplifies fear and it will not improve our national security. we need to provide objective information about the nature and scope of the many threats we face in the efficacy of the measures taken to address them. protect the american values and our commitment to the rule of law is what will ensure our lasting security. thank you. >> thank you sir. mr. mccarthy. - thank you chairman cruz and members of the committee and thank you for inviting me to testify today.

as my submitted testimony summarizes, i worked on terrorism investigations, trials and changes in counterterrorism law in various capacities over the years. it taught me that there are very much two sides to the story. the first muslims i met in our investigation after the 1993 world trade center bombing were not terrorists. they were muslims who had a patriotic fervor for the united states, without whom we could not have infiltrated terror cells and stop the massive murder attack, the plot on the new york city landmarks which would have killed thousands of people. in my second career as a writer in 2008, i penned an account of my experiences entitled willful blindness, the memoir of the jihad. the title is obviously a double, my principal defendant omar is a blind and will for exponent of the supremacists ideology.

our government's response to to the threat he represents has been and continues to be willfully blind to this ideology. the belief system that catalyzes against us. to grasp this dangerous phenomenon we need only consider the blind shake himself. after the world trade center bombing, our government represented to the american people, just as it does today, that the terrorist attacks executed by muslims on islamic grip sure was a wanton act. think about the blind shake. he was not nearly blind, he had several other medical handicaps. terrorism is hard work yet here was a man who was the unquestioned leader of a terror cell who seemed utterly incapable of doing anything that would be helpful to a terrorist organization. he couldn't build a bomb, he couldn't hijack a plane, he couldn't carry out an assassination, all he could do was command murder.

how could that be? the answer was straightforward though it was plainly not one that we wanted to hear and still one that we do not want to hear. the blind shake as a doctor of islamic jurisprudence graduated from al-azhar university in cairo. the seat of islamic learning for over a millennium. his area of expertise in sharia, the legal code and societal framework, the jihadists that listen to him did so because he is an internationally recognized authority in islamic scripture, specifically of the political ideology drawn from that scripture that inspires attacks against the west. the centrality of ideology tells us why terrorists obeyed the blind shake. it tells us why terrorist act, something that we must grasp if we have any hope of defending ourselves and defeating them.

we need to define a true islam in the futile hope of discrediting terrorists of purveyors of a false islam. the fact is there may not be a true islam. islam has a rich and diverse history and there are various interpretations of it, all vying for the mantle of true islam and denying it to one another. :

>> >> it is anti-western misogynist homophobic anti-semitic hand rejects the power of the people to drop their own destiny and rejects equality with no separation between spiritual life in society and to spread sharia and regards united states closely trailed by israel and europe as a principal enemies to islam that must be defeated. this is something to

highlight not avoid. this is not a partisan issue policy has been willfully blind for a quarter-century to the underpinnings of the islamic terrorist the reluctance has been rationalized and are similarly shielded from the investigation notwithstanding that is the precursors to violence and it cannot regard evidence as if it is hate speech nothing inherently wrong or much less offensive about the concept the radical religious beliefs should trigger an investigation with association of letter

radicals or mosques known to endorse jihad. it is an important principle to get right to. cannot be evidence to prove guilt somehow insulated from the suspicions of the potential terrorism offense. the goal of counterterrorism is the prevention of the jihadist attack not only is there is of living terrorists or to to be tried only after americans are murdered. in 1996 and was awarded the justice department's highest honor for of the jihadist commands the exploitation and the commission of the atrocities by young muslims. to say what the clinton

administration honored before tuesday as he is, phobic big it but the state -- mr. chairman and is no way to protect our country. thank you. >> each of the witnesses for our testimony and will begin our question and i would note that your testimony is exceptionally important and valid command members of the media and the american public to examine your testimony close because you have described a systematic policy indeed of scrubbing and sanitizing and erasing references to radical islam and you describing your oral testimony as the first great purge 376 documents were

edited by the fbi to remove references to radical islamic terrorists so and my understanding your testimony correctly that the administration has been systematically scrubbing intelligence materials to remove references to radical islam? to my guess it happened one year after the trial when it was proven the federal court that these networks were tied to financial support of tomas those records that i was ordered to modify there were virtually all linked directly to the muslim brotherhood network of individuals under condition established right here in the united states stick and i want to draw your attention to the following chart that compares the 9/11 commission report which had

126 references to jihad and 322 references to is long. no free fast forward to the counterterrorism looks upon now suddenly that has disappeared they have likewise disappeared from the national intelligence strategy and from the strategic implementation plan and finally the national intelligence strategy 2014 is this pattern of orwellian editing consisted with your experience of what you observed helping to protect this nation? >> yes. the first was in 2009 but that wasn't the last one there was another great purge when they didn't just

modify the records a completely eliminated the matter of the system which the bypasses security protocol for a department from an security and it may not have mattered except for one tragic consequence except for a the san dirty deal in fort pierce were directly related to the case of those 67 records deleted out of the system. >> could you elaborate on how potentially focusing on this threat may have helped the san bernardino terrorist attack? give it the networks are made up of individuals and organizations they don't exist without the network. you have to look at both of them that is why there is no such thing as a lone wolf terrorist because it'll function in a vacuum outside the structure of uh

community just like planets don't rotate without a gravitational force so to look at these acts as separate is a flawed because we're looking at tactics not strategy this strategy is implementation of sharia law if you militants tactics they will change constantly in we can never acquire a target if we understand his underlying strategy many in the stand by these organizations exist in the first place in the area understand why there will be affected by that gravitational force to orbit their lives around the central structure that is why the mosque is called the islamic center because it provides the center in their life. >> your organization asked the obama administration to

purge references such as this from law enforcement training materials and the administration complied air request is it your position and that the references to the commission report was somehow offensive for bigoted? >> our position is that those materials as well as products produced by the fbi are alienating the more importantly day make us less safe because the recent tragedies have shown us including orlando is we need law enforcement more than ever focusing to find the needle in the haystack and by broadly painting entire

faith community with their broad brush of suspicion we're dumping more hay on to the haystack making the job more difficult. >> so with respect answer the question is a your organization's position that the 126 references by the nine living commission was somehow offensive for bigoted? >> i want to make it clear mr. chairman our concern is not just terminology but what they are communicating not just using a word but what is communicating to agents. >> you don't think it was bigoted and it is one to understand your position whether or not it is bigoted

to use the word jihad to. >> this is what i think is problematic with public officials whether the congress or the administration who describe the problem as the problem of radical islamic terrorism. isis assisted vl maurer it is not only that but just grossly inaccurate. it is no different day and the kkk or those that attack abortion clinics with radical christianity to called the threat what it is it is the kkk and attacking clinics. >> now i have asked you

twice with those reports was bigoted your offensive than twice you have declined to answer that straightforward question. >> maybe i didn't understand your question. the use of the term in general with the 9/11 commission report i don't think is problematic itself as officials talk about the threat that is my concern. >> then why would it be purged in 126,000? >> i can't explain. and what their thinking was. >> but to deliver a request for a purge? gimmickry ask for a purge of bigoted training material.

>> on march 16 the long island press quoted though beagle director to say what are you going to do about radicalization of the muslim community? that is nonsense there is no such thing. i am curious to degree - - do you agree there is no such thing? >> this is what we do believe based on the attacks we have seen whether the orlando shooting or the attack the church in south carolina we know extremist violence takes many forms and people are motivated regardless of race or religion and what we also know there is no path away to get to that point experts

say that it is a common thread that uc for those of us seek a sense of purpose so we do not believe in this canard that somehow there is a pathway and that is what numerous studies have shown as well. >> relative you one more opportunity to answer the question so do you agree with your legal director said there is no such thing? >> there are violent individuals of all communities. >> is a connected to any of ideology? >> some people think it is said the center or even part of the causation of what

causes people to engage in violence it is unjust me but experts who say that. >> so i'll give you one more opportunity to say yes or no a there is no such thing? >> as radicalization krispy i will note for the record date is not what you to answer. >> show courtesy instead of badgering. [applause] >> to show courtesy to the victims of radical islamic terrorists, . [cheers and applause] for those that is murdering 49 people in orlando pretending it doesn't exist. >> i thank you have been very respectful the witness has not answered your

question in bidding to have a right to pursue you did it in a gentleman a professional way i am disappointed that senator driven does not understand that. >> mr. chairman i do think it is important for us to allow a broader conversation than the one question. and renewed took issue with president obama is alleged refusal to use the term by one of the questions we have what will we do to keep part interests eberhart going forward? the presumptive nominee has used the term is monism is this entire hearing dedicated to the difference and in my view it is worth considering whether those proposals made to conduct

the controls of muslim neighborhoods to require a national list to bar them from coming to this country with the first amendment religious activity. i have to ask a question for both of you with those proposals make us safer? we have a lot of testimony here today about whether or not there is willful blindness or actions taken by dedicated professionals as a result of political correctness and the pressing question for this panel is if we will address the whole problem is simply having a nominee or free address this problem by proposing and as

a matter of our own constitution. >> if i may i absolutely agree that just talking about the terminology lot like the problem away and the issue is we need to focus on the actual activity of what is causing the violence to ensure law enforcement has what they need to focus on finding a needle in a haystack. and having this disputes about the terminology is not helping law enforcement do its job. we need to focus on the real threat that what i said earlier the use of this terminology is counterproductive because it feeds into the narrative that our enemies want isis wants it to be a war against

islam and to be frank with you listening to some of the comments i was disturbed because i thought if isis is watching this now half of the journalist just gave them ammunition to go out and create recruiting videos this is what the u.s. senate is doing is giving a mouthpiece to this garbage frankly. >> senator i fully reject that moral equivalency of having this conversation to unleash hatred and bigotry with the most democratic country in the world. >> into a significant rise. >> i believe as many would tell you but denial of the

problem creates us a treatment rather than treating the disease at its core to polarized the community in this country one that says there is no problem and the other says every muslim is a possible terrorist and actually this conversation the way it has been adopted is because they love it and love the fact they want the senate not to talk about political is long because their allies it is exactly what the saudi regime desk and they say they are with us because it no one does to an appeal the opinion that the terminology that they have to go -- have to do is a disease islamism

would allow us to engage muslim reformers they don't what reformers they want us to continue to be dominated that say closure is america cannot deal with this select those theocrats dominate. >> says that the case you don't think we can? >> let me say where my colleagues is going he is trying to have an ideological debate whether in the united states to other muslim countries but i am focused on how we can keep our country safe and how can law-enforcement do

its job? i'm doing this work 15 years and in the bush administration i never once have heard a senior law-enforcement officials say it is a problem is is, where radical islam that is not an accurate description of the threat in the major country less safe if we continue and to not focus on the true threat. >> q served as the officer for 15 years to 16 years than conducting numerous investigations of radical and extremist groups barrasso those you draw a connection from perverted versions. >> and your suggestion is

removing training materials that our unfounded in fact, to make law enforcement more effective so talk about that >> those that were uncovered show that this material is not just open the biased against arabs and muslims and other groups like chinese cultural awareness training and many others that had factual laws and as the investigator trains you want to focus on what they are trying to accomplish which is a reduction of violence when i was working undercover a lot of people said a lot of things they didn't like the one i had to do working within the guidelines at the time was

objectively evaluate where there was a reasonable indication of criminal activity and by focusing on the handful of people engaging in criminal activity those that were expressing themselves in ways that i would consider hateful was a legal but i believe we are robust enough that we can leave with those expressions and what we need to do is make sure our law enforcement officials are focused on the facts on the ground rather than the theories that don't survive. >> so does the removal of the flawed counterterrorism training materials make us less safe than weaken the ability to identify those that they engage in acts of terrorism?

>> makes them more effective >> and i suggested that the shooter will be the subject of ongoing scrutiny. i meant there will be debates of though watchless loophole and others might argue we should adequately fund to insure we have more boots on the ground and that is largely the point of this hearing even if there are a few important words such you think there are stronger actions even if it is to

keep americans save? >> it with the results of lack of due process from the public just like those that were on the watch list but it is so bloated it creates so many false alarms so in fact, nobody responded to those when the system worked. and to seek clarity brought to the watch list to make it better. but if the of model they are using now and then try to whittle down who may or may not present a threat that is

with the data explosion within the fbi makes it different to focus on different threats and the money to go back to the standards that i worked under but working with a reasonable indication with illegal activity rather than a flawed theory. >> classic law enforcement work relying on the indication of substantive backs with further assaults. >> if you look at tens of thousands of investigations and with the next level investigation that is only the allegation and the inspector general report suggested the fbi and the

agents were making their own allegations. it isn't a very high standard but a tiny percentage to even make it to that level to create a lot of false alarms. >> senator sessions would be next please kindly allowed him to go ahead. >> the administration has acts of terrorism foreign and domestic with poverty and lack of educational opportunities with this approach is taken and with

the the osama bin london himself. and to have personal wealth with career opportunities that is significant or substantial. the specs person and with the neck up -- the average governments end as a muslim with the islamic extremism. have you found these sorts of material factors with educational opportunities

and wealth or poverty that these are the root causes of radicalization of the islamic population? >> i am reminded of is saying, my father and my grandfather that when you point to the moon you look at the finger. there is a lot of things to blame for those are radicalized in susceptible but to blame that syrian revolution and with those narratives to focus on their own political agenda and blame whatever fits into the block of what is happening in the muslim world. . .

to have this revolution of ideas in the house of islam we can sit back and let them do it and dominate the conversation under countering violent extremism or we can weigh in treated black adults with tough love and say