three times as many applicants, that is medical institutions that are applying for the slots in order to conduct this experiment. and i would just like to draw to your attention the fact that the va has already had a wildly successful program that handled 11,000 people in that reduced hospital stays by 60% and nursing care days by 80%. and so i appreciate all of your efforts in this area, but i think it could help to telescope the time frame it's going to take us to put together a program in order to keep people at home, share wit the institutions that are working hard in partnership to keep them at home, making the patients and their families better able to deal with the disease. so i'm just looking for a little wisdom for you in terms of what

the -- what your agency is doing and how much of an imperative you see this for our country. >> well, first of all, mr. markey, i want to thank you for your tenacious leadership on the alzheimer's issue and continuing to raise it and make sure it's an issue that is focused on. as you know, not is there 80 million in the research budget, it's about a 25% increase in alzheimer's research. we also have proposed a portion of those funds, additional funds, not those funds, for care giving and at-home care. because we know family care providers are the largest number of providers for family members.

but i would share your interest. and we look forward to working with you on what is the long-term strategy, how fast we can get there. as you know, some timetables were set for the first time in the national alzheimer's plan. there is a lot of agreement that we probably need to move ahead of that pace. but at least we have a pace and a measurable pace outlined. and so we would look forward to working on getting the resources, getting the research, getting the care-giving strategies in place. >> a fully implemented independence at home project could save billions of year if we get to the point where we verify what the va has already determined. >> that's a great point. and we will definitely work with our partners at the va. >> thank you for your great work. recognize burgess for five years. >> thank you. this is one of the rare instances of bipartisanship in the affordable care act where we

work with your office on getting the independence at home language refined and included. so perhaps there is hope down the road. but actually, going back to state exchanges for a moment, some states are concerned that without the final rules on the exchanges, they're bumping up against a deadline that is going to be pretty tough for them to meet. i mean, they need these rules probably within the next couple months if they're able to be able to finalize their issues to meet the deadlines. >> and they will have them shortly. we have the interim final roll-out. and we intend to finalize the rule in the very near future. >> so we can look future that by -- >> yes. >> by what? the ides of march? april fool's day? tax day? what day can we look -- >> shortly. they need them in the next couple of months. they will definitely have them in the next couple of months. >> and the essential health benefits rule also will be coming out in that very short time span? >> the essential health benefits rule has not yet been proposed as an interim rule.

i'm talk about finalizing the exchange rule. that will happen in the very near future. they'll have the exchange rule. they'll have the medicaid expansion rule. that's been out. the essential benefits rule will be promulgated in the near future. but there is detailed guidance right now that states are working on. >> i'll just make a prediction. that won't happen until after election day november, but that's just me being cynical. for a state like -- let's say for example there is a state out there that worries what is happening under the affordable care act and really thinks the federal government is going to a little too far on this. so they're reticent to set up a state exchange. i mean i can think of states that might fall into that category. i may be going there this afternoon. so you're preparing a national exchange for those states that will not either because they haven't had time or because they did not have the inclination will not have an operational state? >> it will be a federal facilitated exchange. in some cases operating fully the exchange for states.

>> so part will step in and provide that operational control, that right? >> pardon me? >> the federal government will step in and provide that? >> yes, sir. >> now will, that be administered through your office or through the office of personnel management? >> it will be administered through the cms, through -- we will be operating at hhs the federally funded exchange. >> my understanding is there will be both the for profit and not for profit offered under the language of the law? is that correct? will there be a not for profit federal exchange? >> no, there will not, no. >> i thought the language of the law said there had to be -- >> no, i think you're talking about the co-op situation which is totally different. >> no, i'm talking about the ex-changes or the federal exchange. >> not for profit, no. there will not be a not for profit. states have that option. that is not at the federal level, sir. >> let me ask you this. a lot of talk about the contraception issue and the essential benefits.

when will we see -- are you proposing that an institution that refuses to comply with your contraceptive mandate, what is going to happen to them? >> sir, i'm hopeful that the rule that we intend to promulgate in the very near future, which will be informed by conversations with nononly religious employers, but labor leaders, women's groups, and others, and actually greatly informed by the 28 states which have a framework like we're talking about already in place will indeed satisfy the religious liberty issues and make sure these preventative health benefits are provided. risks the noncompliers going to be fined? >> sir, we'll get -- as you know, this is a discussion where -- >> well, let me just share with you something. it bothers me that for the first

time in this country, regardless of what the issue is, and i personally support the issue of contraception. but at the same time, it bothers me that there might be a fine for faith. i don't think that has ever happened before in this country. and i am concerned -- >> no one will be fined for faith. this is an issue dealing with -- >> well, why did you propose a two-tier system where some churches might be exempt, but a catholic hospital might not? i mean, that sounds like that's the direction that you're going. >> the exemption, which is in the original rule finalized in january -- i'm sorry, in february, is the language used in the majority of state laws which have some religious exemption. that's where we got that language. it is a definition that is in the irs code. it's not something that we invented. it is a definition of churches and church-affiliated association. >> if is state-required

sterilization is required for citizenship works you be required to do at this at a federal level? >> sir, i'm not going to answer thatank you. mr. whitfield had a number of observations that he wanted entered inttoo record, and i would ask to enter those now under unanimous consent. >> reserving the right to object. i know you handed that to us, but we haven't had time to really look at it. so if we could take a look ate before we agree to unanimous consent. >> all right. we'll wait until you take a look at that. and recognize the ranking member for five minutes questions follow-up. >> thank you. madam secretary, i just want to give you an opportunity to address somewhat of a others have said. clearly the matter of insurance coverage for fda-approved contraceptives under the aca has become controversial. unfortunately, what i think has been lost in the debate is an

understanding of how hhs arrived at the decision it's made. and i just ask you to take a few moments. you know, i've got four minutes or so, to provide the broader picture, to tell us about the aca's provisions on preventative health services and women's preventative health services, the role of study on preventative women's health services and the processes in developing these regulations that are now under attack. i know you started to get into that with dr. burgess. but take the four minutes to maybe explain it a little more. >> well, mr. pallone, the affordable care act had a provision that as part of a definition of essential health benefits, various populations should be looked at. the recndor children around immigrations would be included. the strategies for preventative health that are recommended by the united states preventative

health services task force would be included. and recognizing that too many insurance plans often did not include benefits that were specifically recommended for women's health, we were asked to develop a set of preventative health services for women. we turned to the independent scientifically driven institute of medicine and asked them to make recommendations to us. they came back with eight various health benefits, domestic violence screening, mental health benefits, well women visits, and the full range of scientifically recommended contraception services. we promulgated their rules as part of the strategy for women's health as an interim rule and added a religious exemption. and to be informed by what language should be used in that religious exemption, we looked at the 28 states which have some

kind of contraceptive mandate in place right now, often for a decade or more operationally right now. and we included language that was used by the states in the majority of cases that have an exemption. many states don't have an exemption at all. that language was put out. it was finalized in february. and to -- and an additional accommodation was made. we announced that we would have an additional year for religious-based organizations who had a religious exemption -- objection to the provision of contraceptives so that their implementation date would be deferred until august of 2013. and that we would promulgate additional rules around their ability to both uphold their religious freedoms, not refer, not pay for, not provide

contraceptive coverage, and yet make sure that women who were janitors, teacher, nurses, employees, the spouses of employees, the daughters of employees would have access to this very critical health benefit. and so we will be promulgating a rule around the implementation strategy for preventative health services, which will be a huge step forward for american women, knowing that contraception is the most frequently taken prescription drug from women 14 to 44. 99% of women of all religions use continue contraceptives at some point in their health lives, and that often if you purchase contraception out of your own pocket, it can be an expensive strategy if it is provided within an insurance pool it not only is no cost, but often reduces the cost of the pool. >> thank you very much. i appreciate it. thank you, mr. chairman.

>> the chair thanks the gentleman. i think that concludes all of our questioning. thank you, secretary sebelius for, again, taking time to be with us today and for all of your answers. i ask unanimous consent that all members' opening statements be made part of the record. the objection so ordered. have you seen the request, the set requests? i think burgess needs more time. they're going to need some time. >> i remind members that they have ten business days to submit questions for the record. and i ask the secretary to respond to the questions promptly. members should submit their questions by the close of business on thursday, march 15th. without objection, the subcommittee is adjourned.

next, a senate committee hears from interior secretary ken salazar on the president's 2013 budget requests. after that a discussion on how states can encourage small businesses and economic growth. and then a forum examines the impact of voter id laws. if you lad said in 2006 that the world would be begging for the united states to use force again in the middle east within three and a half years, everybody would have said you were crazy. >> brookings institution fellow robert kagan is not only an adviser to the romney campaign, but also serves on secretary of state clinton's foreign policy advisory board. >> what i've been writing for years actually is that there is a lot of continuity in american foreign policy, more than we expect. a lot of consent, a lot of broad consensus. and i think what you're seeing here is the kind of consensus that exists in the foreign policy community, and probably

there is a lot of overlap between the two parties. >> more with robert kagan on foreign policy and his latest, the world america made, sunday night at 8:00 eastern on c-span's q&a. interior secretary ken salazar discussed the department's 2013 budget requests before the senate energy and natural resources committee tuesday. president obama has requested $11.4 billion for the department. salazar says it's a gad budget, but it also requires the agency to do more with less given the tough fiscal times. this is just under two hours. >> okay. why don't we get started. this morning the committee's reviewing the president's proposed budget for the department of interior for face zal year 2013. we're very pleased to have secretary salazar back with us in his old committee room.

the department's proposed budget of $11.7 billion in appropriated funds represents a slight increase over current funding levels. in my view, it's a reasonable proposal. it reflects the difficult choices the president is required to make given the current fiscal environment. there are a number of programs such as the land and water conservation fund that i wish were funded at higher levels, but i understand the budgetary constraints the administration is facing. i want to take a minute to just express my support for the secretary's determination to adequately fund and carry out the interior department's responsibilities for safe and environmentally sound oil and gas production in federal lands and particularly in the outer continental shelf. we were commenting in the hall before coming in here that at least it's not two years ago

when we had the bp oil spill as a very real issue before our committee. i believe especially given the challenges of the deepwater horizon disaster, the department has act properly in continuing to focus on safety issues. obviously there is a lot of concern about gas prices abroad in the land. i do believe that domestic production is important. robust domestic production is important. it needs to be pursued in a responsible way. that clearly is happening. the domestic production of both oil and natural gas are up. since 2008 they're projected to continue increasing over the next ten years to nearly historic levels. our oil imports continue to decline. and they were down to 49% of

consumption in 2010, which is an impressive improvement over where we were even four or five years ago. i'm pleased that the budget includes increased funding for renewable energy development on public lands as part of the department's new energy frontier initiative. i understand the department has approved 29 commercial scale renewable energy projects and associated transmissions since 2009. i believe these efforts hold great promise, and the renewable projects can yield important energy for our economy in an environmentally responsible way. i'm also glad to see that the budget proposes enactment of a hard rock abandoned mine land fund pour the reclamation of mine sites that threaten human health and safety and cause environmental degradation. i'm particularly concerned with the legacy of unreclaimed

uranium mine sites on indian lands in states such as mine in new mexico. secretary, i hope you can work with me and others here on the committee to seek funding to address this very serious issue. finally, i'm pleased to see that the department's budget request demonstrates a strong commitment to implementing the indian water rights settlemenro country, including funding for a number of settlements in my state of new mexico. with that, let me defer to senator murkowski for her opening statement. >> thank you, mr. chairman. mr. secretary, good morning, good to see you. mr. hayes, welcome to you as well. thank you for the work that you have been doing on behalf of so many. well, these are areas that are contentious most certainly. and with the budget it even makes them more contentious. i was raised to recognize those that have tried to work with us and make good things happen, even if it's not as much as i

would like. so i start off my comments this morning by thank you, mr. secretary, for your personal involvement in trying to advance some issues that are critically important to my state, and i think to the country when it comes to domestic oil and gas production. the last time we were all together, was when you came up to the state to visit, to look at some of the issues that we had before us, specifically cd-5 at this time stalled out because we couldn't get a bridge, permit for a bridge across the area. i had also an opportunity to look at the ocs projects and what shell is pursuing. mr. hayes, i truly appreciate that you have committed as much of your time to help address not only these issues, but some of the other alaska-specific issues. we have made some progress, and i think it is important to recognize that. but i also appreciate, as you do, that we've got a ways to go. we will continue to work with

you. but i appreciate that you are working with us. and i thank you for that. i would like to address just a couple very alaska-specific issues, and mr. secretary, you and i have had a chance to discuss them. i'm more than a little bit disappointed within the budget on the alaska conveyance program. there is an enormous reduction to that program. and as you know, we've been working for well over 40 years to try to get the conveyances to our alaska natives to try to try to get the land conveyance that are made upon statehood which is now 53 years ago. we're continuing with that, but we can't make these conveyances unless we have that budget. i addressed our state legislature last week, and one of the early questions that came up was the issue of the federal government's rule with regards to our legacy wells. the 137 wells that were drilled by the federal government

decades ago and sit without attention, literally falling into the landscape. it an environmental scar. and we in alaska kind of feel that this is a double standard. the private sector is held to the highest environmental standard, and yet the government is -- is saying well, we can maybe get to one or two of them a year. and i understand that these are budget priority issues. but i think we need to figure out how we make them a priority. one of your priorities is full funding for the land and water conservation fund. the chairman has indicated his support of that. but it's difficult for me to say well, we need to -- we need to work to expand and bring even more federal lands under the federal purview when we're not taking care of the commitments and the responsibilities, the promises that have been made with other lands. so we need to resolve that. i also want to bring up the very

strange relationship that many alaskans feel with the federal land management agencies and the perceived overreach of the federal government into their lives. whether it's the ran cher activity on the yukon river or the lack of cooperation and coordination by refuge managers, i think these are legitimate grievances. we need to work with you on this. so i hope that you'll make it a priority to improve that relationship. next is an issue that affects not only alaska, but many others. and these are the new and the higher fees and royalties from interior within this budget. i know that the philosophy is that the federalr th many state rates. but you've got to admit that this isn't exactly a one-sided bargain. those states easily trump the federal government in terms of regulatory stability. so when we ask them to pay more while providing less, it really doesn't work. i note that the chairman has mentioned the statistics that the president also has repeated,

that oil and gas production is up. that is true. but when you look to the oil and gas production on federal lands, we've actually seen 11% decrease on federal -- on the federal side. so i think it's important to put that into context. i am hoping that we will get a little clarity about the disclosure requirements that the department is working on for hydraulic fracking. the question that i would have is whether it is just that. whether it's a disclosure requirement, as many of the states have advanced, or actually a new set of regulations. i think all of us are looking very critically at this. we want to make sure that this boom that we are seeing across the country when it relates to our opportunities for hydraulic fracking combined with horizontal drilling, we recognize that it is vastly increased our natural gas supply, and it's reviving communities, bringing about jobs. but those could all be lost if the federal government decides to place owner redundant on the

technology. again, i appreciate your efforts in a very difficult area. the folks become home in alaska are talking about nothing but energy right now. and it's not just the price at the pump, but it's all energy. so you are here at a particularly opportune time for us. i thank you and look forward to questions. >> ms. secretary, why don't you take whatever time you need to describe the administration's proposed budget, and then we will obviously have questions. thank you for being here. >> thank you very much, chairman bingaman and ranking member murkowski. thank you senator wyden and senator barrasso, senator lee and senator shaheen and senator franken for all the issues that we work on. on many we agree on. sometimes we disagree. but i do think that we're making progress on the whole host of fronts on the energy agenda for the united states.

let me also say at the table with me today is deputy secretary david hayes. and as senator murkowski pointed out, he has done a herculean effort in terms of moving forward on alaska issues, including the coordination of permitting issues in alaska. and pam hayes who has been the budget director for the department of interior many years now. and i also wanted to say thank you to the staff on both sides, democrat and republicans on this committee that work with us on so many issues. let me start out by just characterizing the way that i see this budget. senator bingaman and distinguished senators, i see it as a squeeze budget with some tough choices and some very painful cuts. it's a budget that cuts government and requires government to do more with less. it supports job creation. job creation i know was a focus of this committee, a focus of the president. it's a job creation and energy

both in the conventional energy as well as renewable energy. it supports job creation through conservation and tourism. it supports job creation through the water supplies that we manage on behalf of the people of this country. and lastly, it honors our important responsibilities to the 566 tribes and alaska natives of the united states of america. overall this budget is 3% below the budget which was enacted by this congress in 2011. that's 3% below 2011, and it's about even with the budget that was enacted in 2012. let me review each of these pieces in a little more detail. first in terms of cuts in efficiencies and government, which i know many of you have been focused on, wanting to make sure that the government is run more efficiently. it's a high priority for the president. it's been a high priority for us at the department of the interior. this budget foresees that there will be a downsizing of

additional 591 fte within the department of the interior. so we are asking our employees to do a lot more. this is, in fact, even in the climate where we have asked them to take pay freezes for many years at this point in time. but we're continuing to figure out a way of doing more with less. we also have a number of program terminations that are set forth in this budget in downsizing, $517 million of downsizing and reorganization that is included in this budget. some of these are painful cuts. the national heritage area programs which many of you on this committee have supported, those are cut so many million dollars. that's a painful cut. some of the central utah project which i know senator lee and the utah delegation have been very interested in, which we have supported and continue to work on, we have a cut in there of $18 million for the central utah project. not cuts that i would like to

see, frankly. but given the tough budget times, these are things that we've had to do. administrative efficiencies, which include revisions to how we take a look at procurement and information technology and a whole host of other administrative functions with the department. this budget for 2013 forecasts that we will be able to save $207 million just from administrative efficiencies. 10 we're doing everything we can, given the fiscal times that we face here in this country. i want to spend a few minutes speaking about jobs and energy and the other components of the budget that i made some comments at the beginning about. first, with respect to energy, you will note in the budget there are $662 million for conventional energy. there is $86 million for renewable energy. this is all part of the president's program to move with the all of the above energy strategy. and so when we look at the