and the absence of final guidance, companies cannot prepare to comply with the law. cms does not seem to be taking this seriously or working to implement the law with any sense of urgency. your agency has implemented many other provisions of the health care reform law already. just think of all the ones you have already put out. the longer you delay the provision, the longer consumers will have to wait to learn about financial relationships between their doctors, drug and medical device companies. how can you wait until december 2014 to issue a final regulation when the law requires companies to begin reporting information march 2013? >> senator, i just wanted to clarify. the final rule, as you know, has been -- the rule has been finalized and is out and available. we are talking about a timetable for reporting. this is a balancing act.

again, i share your concerns that consumers have the information about relationships that may influence their providers decision. a lot of health care providers are very concerned that additional reporting requirements may indeed impede their ability to practice medicine. so we're trying to have a balance between the public right to know and the provider sensitivities. >> the final rule came out because the comment period ends friday of this week or first friday of next week. >> apologize, senator, we're talking about -- i'm thinking of the rule that may imply to nih scientists and reporters dealing with sunshine. but i will get you an updated timetable. apologize. >> but we need to have the companies know what this is a long time before march 2013. thank you, mr. chairman. >> thank you, mr. chairman. secretary, it's a pleasure to have you before our committee.

and i appreciate the way that you're moving forward to implement the affordable care act. we sometimes get inconsistent messages from my colleagues and congress. i can tell you -- >> never. >> as i travel through maryland, i run into people who are affected every day by what you did in a positive way. seniors now see a light tend of the tunnel on the coverage gap of their prescription drugs. just was a family last night that dealt with keeping their children on their policies until age 26. and i can tell you we have opened an expanded clinic in maryland that are now covering prenatal care and dental care when they did not have that coverage before the initiatives within the affordable care act. i want to start off by saying thank you. i understand there is frustration that regulations and implementations are not moving as rapidly as some members would like to see. it would be nice to see what you

need particularly to implement those programs. i'm going to work with you to achieve that. i want to at least conquer in the comments on the shortage of drugs. that is unacceptable in america that the drugs are not available. i understand your need for notification. but there are manufacturers that are not being totally forthcoming on these issues. and we have to make sure that the supplies are available. i think we have a responsibility to act. and i hope that we will find a way consistent with the philosophy of our country to make sure that those types of shortages did not exist in the united states. i want to talk about the fda budget. of course, you mentioned the fda, their budget only gets a modest increase under the president's numbers. more disturbing to me is the nih budget. national institutes of health are frozen in the budget that you have submitted. we rely on nih to give us the

answers to a lot of the medical mysteries that are out there and to provide the foundation for research that is important for innovation and job growth in america. and i've been to nih many times. and i have talked to the scientists that are working there. and i know the number of opportunities that are there that are not being moved forward because of the limited resources. so i would have hoped that we would have seen from the administration a greater priority for the nih budget. i want to give you an opportunity to respond as to the priority that nih is receiving under this administration. >> well, thank you, senator. i do share your feeling that one of the most significant areas for not only the prosperity of our nation but really the world is the on going biomedical

research going on at the nih. and i'm struck by not only how important it is in this country but around the world. what i can tell you is that nih is one of our largest agency budgets is always difficult to look at. while a number of our agencies have cuts in this year's budget, the nih budget is, as you say, kind of held harmless. having said that, dr. collins, i think, has done an extraordinary job adjusting resources so that we will continue the progress. this budget supports a 7.7% increase in new grants. so there will be 672 new research grants as part of this budget, the acceleration network and the center for translational science which are two high priorities of dr. collins which

helps again accelerate the not only stra only the strategies in government but our private partners toward cures and disease outcomes that are positive is -- have fairly significant increases in this budget. so while it is a level funding, it is focusing resources on areas with most promise. >> i look forward to working with you. i think that's a good point that we need to set priorities within nih. i agree with you. i want to make sure that senator carper has an opportunity. we have a vote on. let me raise the issue and you have a large cut in medicare in your budgets. i think 50-some billion dollars. post acute care has sustained reductions in recent efforts. there is concern against targeting against fraud and abuse and waste. i would urge us to be more surgical as we look for savings rather than using across the board issues that could jeopardize access to post acute

care. >> we would love to work with you on that issue. thank you, senator. >> thank you, mr. chairman. >> senator carper? >> mr. chairman, eh? all right. >> just a humble servant here. >> secretary, welcome. thank you for a couple things. one, accountable care organizationsment we know we have to move away from fee for service. they'll put out some draft regulations on the care. want to commend you and your team for responding to those comments and helping create an environment where we're going to see a lot of these accountable care organizations established, including, i hope, in delaware where we have john and we met with a bunch of hospital and provider folks a week or two ago and did a very nice job. but we're encouraged and excited about that. as you know, one of the things we focus on, as do you, is how

we get better results for less money or better results for same amount of money. we try to figure out how to save money everywhere in government, we can find inefficient spend wlg it's the improper payments or just fraud. we want to go after that. i'm told that y'all may have announced maybe even yesterday a record level of health care recoveries totaling over $4 billion for 2011. that's up from almost nothing from a few years ago. thank you so much for everybody that is working hard to make that happen. i worked along with some of my colleagues on many labelling to make menu labelling so that not just the item being served but the price and the calories and a lot of other information about the items being served. i understand that y'all are pretty well along the way in terms of us being able to have

that information going into restaurants. we thank you for that, too. i do have a question on this. and my question is, when -- can just take a moment and explain how some of the additional -- i want to say $1 billion in funding that the president requested for cms will be allocated within the agency to support innovative initiatives such as acos? and, for example, will cms innovation receive any additional support to expand upon the acl model and other health delivery reform? >> it's a fair question. but let me answer it kind of in two parts. the innovation center initiatives are really a separate line of funding. and as i explained to an earlier

question, we see it as our kind of r & d operation around health care innovations throughout the country. enormously enthusiastic response from providers from private payers from insurers and we have a number of programs under way. we're going to continue to find new ways to support that. billion dollar request is dedicated to setting up the infrastructure for the federal change project. a lot is one time costs for outreach efforts and id efforts and the build that will be required to have that up and running and about $200 billion is dedicated to on going enhancements of medicare and medicaid service operations. both programs, as you know, have

increasing enrollment. we want to make sure we continue to fund them w that said, senator, i know this is a concern of yours just in terms of overhead costs. i can report to you that if this request is fully funded, the cms administrative costs will still be less than 3%, even with the billion dollar increase. i think that is very comparable. >> the other thing i want to mention briefly. we had a hearing in the subcommittee chairman on federal financial management. we look into the use of the prescribing of the drugs, mind altering drugs for children. we look especially at foster care children who in the medicaid program and found there are kids under the age of 1 receiving more than one of these psychopathic drugsment we had

little boys like 12 who is one of our witnesses and he was taking five or six of these drugs. he doesn't take any merchandise now. this is something that is of great interest to us. we started looking at it. the idea of better results for less money. are we wasting money in medicaid and what we found out? we just were not using the best practices. >> senator, i have to get to a debate. i have to gavel this down. i think we should have this once every month. >> really?

>> really. you run such a huge agency. and the one thing i'd like to just say is that if you could, we've given copies of our letter and your letter which we felt was unresponsive. if you could answer that by the end of this month, we would be very appreciative and have your folks answer that. and be responsive. i'd really appreciate it. with that, is it okay if i -- >> madam secretary, i'm just going to ask, we'll submit follow up questions on writing on the issue of foster children. >> absolutely. and it's something we would love. commissioner samuels and our assistant secretary is very eager to continue pursuing this issue. >> good. thank you. >> thank you, madam secretary. >> thank you. >> thank you for being here. with that, we'll recess until further notice.

>> at 8:00 on c-span3shgs the history of u.s. space policy. president obama recently released his 2013 federal budget proposal calling for $3.8 trillion in total spending. adding about $900 billion to the deaf it? 2013. in comparison, the 2012 budget requested $3.12 trillion. can you see the entire budget online at c-span.org along with hearings and briefings.

coming up next, treasury secretary tim geithner testifies about the president's budget proposal. earlier today secretary geithner made news when he said that the current tax system is bad for business and job creation. and he supports president obama's proposal announced today to cut the current business tax from 35 to 28%. see more about that story in "politico" today. now they hear from the house treasury secretary. this was from earlier this month. this is about two hours and 40 minutes.

the hearing will come to order. welcome, everyone, to this important hearing. i want to thank secretary geithner for joining us. this is your second hearing today and fourth this week. so you're half way there. so you are a glutton, i tell that you. we know that defending this budget is no easy task. so we really do appreciate your time. >> not as hard as your job. your budget. >> it's going to be a fun day. >> you have my sympathy, you do. >> you're about to get mine but in a different way.

it's known that one of your favorite sayings is plan beats no plan. it's a phrase you use often during the financial crisis to describe the need for policymakers to plan for every contingency in order sto stay ahead of events. you're in the middle of a firestorm, the crash as a fed new york chair, you people know this. i remember your president sesor and chairman of the federal reserve coming here talking about crisis, deflation airy spirals, all about the impending collapse of the economy. it was a very, very ugly moment. and what came out of that is ugly legislation. the whole thing caught us by surprise, all of us. and the circumstances could not be more different today. it was back then we faced a crisis that most people didn't see coming. today, we're facing the most predictable crisis in our history and, yet, for a fourth

year in a row, you brought us this. this is no plan. this is no plan to restrain spending to grow the economy and most of all, it's no plan to save us from a debt fueled crisis which will be an economic disaster for all of us. if plan beats no plan, then why is the president once again deciding to duck from the drivers of our debt? why once again given us more broken promises instead of leadership? excuses instead of accountability? instead of cooperation where agreement is possible and we like to think there is some of that, why have we seen the president turn his back on the bipartisan solutions that have been percolating out there? why has he decided to base the re-election strategy on trying to divide americans for political gain? we put together a serious solution last year, the president had an opportunity to advance plans for meeting the challenges, to advance alternatives, to then compromise. and if, in fact, there is a

growing bipartisan consensus, for the reforms that are needed. there's a growing bipartisan consensus on contentious issues liken titlement spending and tax reform. reforms based on premium support which would strengthen medicare and introducing choice in competition, they have a bipartisan history. the history dates back to john breaux and bill frist and bill thomas under the clinton commission. it continues with the work done by alice rivlin and pete domenici. it includes the work that i've recently done with senator ron widen from oregon to put a bipartisan option for saving an strengthening medicare. fundamental tax reform also has a bipartisan history. in the 1986, i was in high school at the time, i read the book, we did fundamental tax reform that lowered tax rates and broadened the base. the sponsors of that bill, dick gephardt and bill bradley. i would argue this is not necessarily a left versus right issue. this is about those who are

willing to tell the people the truth about our nation's fiscal challenges and those who continue to duck from those challenges. this budget takes the latter approach. it represents a very clear threat to the health and retirement security for american seniors. it threatens our government we haver higher taxes and commits our children and grandchildren to a deminute fished future. i don't know how you conclude otherwise. second geithner, you probably be the first to acknowledge that having no plan is a plan in and of itself. it's a plan for failure. it's a plan to stay in the debt crisis. and having no plan means we're planning for decline as a nation. the point of this hearing is to find out why that kind of future for our country is apparently acceptable in this budget and to this administration. i hope your testimony can provide answers. i look forward to a great conversation.

and with that, i want to yield to the ranking member. >> thank you very much, mr. chairman. welcome, mr. secretary. i think as the secretary will testify in, fact, this budget represents a plan. represents a responsible plan, a good plan and debate we can really in this committee is not between plan and no plan. it's between two very different visions of how we move forward in this country. what this budget does is three essential things. number one, it helps to nurture and move forward our very fragile recovery. i think we all know that when president obama was sworn in, the dme was in total free fall. we now know in the last quarter 2008, we were negative 8.9% of gdp. mr. chairman, you mentioned when the previous secretary of treasury came here the economy was in crisis. that's exactly right. that's the crisis the president inherited in january when the president was sworn in, we were losing over 800,000 jobs every month.

they began to reverse it. we passed legislation and help ed rescue the auto industry and many other measures. the reality is that today for the last 23 months, we have seen over 3.5 million jobs, private sector jobs created in this country. so that's good news. is it enough? certainly not. and that's why the president's budget lays out a strategy for continuing to nurture that recovery and continuing to help businesses hire more people and grow the economy. one piece of that is something i hope will get done later today and that is to extend the payroll tax cut and ui for another ten months. very important provisions for its economy and american people. but that's not enough. the plan the president but forward in this budget is similar to the ones that he brought before the congress last september. american jobs act. also contained a number of other important provisions. you look at the unemployment

figures, you'll find that while we've seen growth in private sector jobs, you continue to see layoffs. teachers losing their jobs, firefighters, emergency responders, that's why the president's plan says we need to provide a little assistance to the states. the president's plan calls for $50 billion investment in infrastructure. absolutely necessary. we have over 13% unemployment in the construction industry. we have roads that need to be built. we need schools that need to be renovated. this is a win-win.

it's often curious to me to hear people say that building an aircraft carrier helps create jobs which it does. building roads doesn't. you know, you have to make sure that we have a defense budget and it's a job creator in an aircraft carrier. yes, it is. building a road is as well. and so why we would decide to not invest in our infrastructure which has been essential to our past economic growth and essential to our future economic growth, is a mystery. the president put together a good plan there wlachlt else does this budget do? it makes critical investments in the future. i'm sure the president is going to talk about that. look at the gi bill. that sends millions of americans to college to ged a better education. it paid after for them and the country. look at the investments they made in science and research.

research helped lead to the internet, helped the united states get a head start. we want continue to vest in this country and we can maintain a competitive edge. and finally this budget takes a balanced approach to reducing the deficit in a predictable way. it reduces the deficit as a percent of the economy to under 3%. it gets it down to 2.8% at the end of the ten-year window and does it in a balanced way. frankly, that's where our republican colleagues object to. you have a balanced plan. we are going to make tough cuts and discretionary spending. it goes down to the lowest level of percent of gdp since the eisenhower administration in this budget. they cut over $350 billion in health mandatory. they cut other mandatories as well. they also do something else. they propose tax reform not just to simplify the code which is absolutely essential, but they do it in a way that other

bipartisan commissions have done to help us reduce our deficit. the reality is that our republican friends have taken this position. i want everyone to understand. they talk about tax reform, not one penny from closing loopholes in the tax code can go to deficit reduction. not one penny. that would be a violation of the pledge taken by 98% of house republicans. and so the dilemma we have is not between no plan and plan. it's between a responsible balanced plan the president submitted and a plan that we have seen before from this committee and others which i would say is totally lopsided. you're not asking the folks who have done really well, folks at the very high end of the income scale. you're not asking them to go back to paying the same rates as they were during the clinton administration when the economy was booming.

then you got to find it somewhere else. and what that budget did is took $700 billion out of medicaid. mr. chairman, it replaces the rising cost of health care costs on seniors through a plan that ends the medicare guarantee. and it slashes important invest ams in infrastructure, education, science and research. so those are the choices we have. and, mr. secretary, i know you're going to elaborate on the plan that you have. i think it's a good plan. it's a responsible plan. and it's a balanced plan. thank you, mr. chairman. >> we're going to agree to disagree. >> chairman ryan, ranking member and members of the committee, thank you for giving me the chance to talk to you about these important questions. i'm going to talk about four things just briefly about the economy and the challenges we face there. then a bit on the near term imperatives on growths and jobs. i'll lay out the broad element of our strategy and then talk about the contrast between where we disagree. i'll give our version of where we disagree.

first on the economy. the economy today is gradually getting stronger. we have a lot of tough work still ahead of us. over the past 2 1/2 years, despite the financial headwinds from the crisis, as people bring down debt and we work through the housing construction bubble, despite the severe cut yakz by state and local governments, despite the crisis in europe, despite the rise in oil prices last spring, despite the terrible damage to confidence caused by the specter of default this summer, despite all the shocks and headwinds, the economy is growing at a rate of 2.5% since growth resumed in the summer of 2009. private employers added 3.7 million jobs over the past 23 months. private investment and equipment and software is up by more than 30%. productivity has improved. exports across the american economy from agriculture to manufacturing are expanding

rapidly. americans are saving more and bringing down their debt levels. the financial sector is much stronger shape helping to meet the growing demands for credit and capital. these improvements are signs of the underlying resilience of our economy, resourcefulness of american workers and businesses and they're signs of the importance of the swift and forceful actions we took with the fed to stabilize the financial system and pull the economy out of the worst financial situation. we face significant challenges particularly for the average working family in this country. americans are still living with the acute damage caused by the crisis, the unemployment rate is still very high. millions of americans are living in poverty, still looking for work, suffering from the fall and value of their homes, struggling to save for