on their medicaid e jiligible. on the medicaid side, you will see over the long terp. although medicaid numbers are going down, medicare numbers are growing. in part because the medicare reform assumes responsibility for the population. so while we have the e apriu lo given to the medicaid eligibility. >> do you have a definition about that. i read that is, the assumption. we have only sort of hurd it verbally. could you provide us with greater information. the assumptions you are making how that would be handled. because that is actually something fairly new for us. >> we can provide additional information. really there are some questions we will follow up later on. assumption you are making whether the states would have adequate resources to be able to

do what they're doing now. for frail, elderly in our nursing homes under medicaid given reductions that are being made in this budge. i yield back. >> let me interject. this is a budget resolution. it is not the final legislation. that's what authorizing committees are in charge. it contains, block grants. the such, like. and it assumes in its assumptions, medicaid money goes to the population. governor can't take it and use it for roads. that level of specificity rests with the commerce committee. so you know in a budget resolution you don't have that level of detail. >> the category between, it's women and children.category. seniors. they can appropriate vied a variety of services. no way of knowing, how this money might be used and affect

our frailest and sickest seniors. >> the assumption it must go for its intended population. >> may i comment as well. is that possible? >> yeah. >> i just want to upon the out that, that the medicaid system right now is, is makes it such that -- we spend a lot of money that is wasted. on folks who are by and large healthy. right now in the state of 2/3 of the folks on the medicaid rolls, sorry, was that -- >> yeah, we will do this. i think there is medicaid, medicare amendments coming up. why don't we g i lk through. and, stick within the lanes of the procedure. otherwise we will have a real long day. >> all right. i thank you, mr. chairman. let t 500. where it is cut. by

$166 billion below the base line over the ten year period. how much of that is from the student aid ra >> we have assumptions in terms of whatappens on these progr programs, determined by authorizing committees. with respect to mandatory programs. there were expansions done in a -- some bills,ne a reconciliation bill for incom repayment program. we assume that that was, would be reversed. there are other asumgsumptions make. >> any assumptions regarding pell grants. >> on pell grants. we assume. we do not assume a increase in the war. we assume the current award level. the president's budget has the a hype ear ward leve-- higher awa.

only funds it for two years. our assumption on pell grants. fund it within the discretionary amount. pell grants is a program. a portion of it funded with mandatory fund and part of it is discretionary fund. we assume it is funded with discretionary resources. and that the maximum award is maintained. >> yes, significant portion of 166. the shift from mandatory to discretionary. >> do you assume thedo lower in coming out.ith respect to the assumption in the base line. under current law. >> let me turn to function 920, allowances. your budget shows for each of the functions, sort of

spending, and targets. for the different areas, defense, international affairs. education. thou -- billion. in your allowances function. could you explain what that represents? going on. first. cbo with respect to the sequester savings, puts the savings in function 920. in adishgs when we focus on discretionary programs we really focus on the bt year 2013 in terms of what is going on in specific functions. we carry some assumptions into the out years. something revisited through the appropriations process. we didn't spend a great dealhfu individually what are the specific assauumptions over the next ten years and programs. ultimately

appropriations committee. the other thing when you look at the president's budget. he carries -- all of his out year savings. all in, in, in -- in an allowance. unspecified allowance. we have gone through and specified a fair amount of savings in the discretionary area. we hav't listed them -- them all. some within 920. within 920 we have proposals that cut across the government. a couple examples are in attrition. in the federal work force. we have savings. the boe has -- has -- disaster funding that was -- that was, you know, enacted last a couple other areas, >> those $900 billion in cuts which is an unusual amount of money in the category. so thepppriators could cut

defense by thatai that's what they decided or any amount up to that. >> our overall discretionary levels in the budget control acts levels. under the, the, after the joint committee. beyond 2013. we assume total discretionary spending at those levels. our defense spending is frozen at this year's level. higher than the ppt's budget this year. and then we have a real growth in the defense budget. we do not assume any budget in t years. we understand those savings are achieved in nondefense programs. clarification here. you are showing in your function tables as you go out years. 050 for defense. showing a certain level of spending. functions. also showing level right? >> yes, sir. >> you have an allowance, $900 io that

says, defense spending would remain in the samethose years. any more than any other function. >> ibaseuline. it has very, very large savings already. that was our starting point in thte budget. i think additional savings in order of $200 billion. we did assume specific savings that, that are difficult to distribute. in the individual functions from, from attrition. in theork force. i believe the pay freeze, we have -- those savings in function 2920 because they're difficult to distribute across the functions. yes there are unspecified savings. they're not as large as the $900 billion thatcite. >> right. i gather that -- that the appropriators are free to distrub to tdi distribute $900 billioinare alw that. we can't bind how the

appropriation committee appropriates funds. >> we can create a fire wall. you did not do that? >> we do note wall. >> my last set of questions. >> last one. last one. >> then with your, indulgence. we have minor ones we think, hopefully the staff, could answer there. there in more detail. just with respect to -- the overall discretionary cap. for this year in your budget. which there has been much discussion about. as you know, mr. chairman, we believe that there was -- a level set in place. in fact it was put in place and signed by the president. one of our -- one of our budget reform processes was to do that so that it would be predictable. apparently that's, that's not predictable. in this case. but i want to know is -- what exactly is -- the, the

discretionary spending tag. in this -- in this proposed budget. >> just i think it might be useful to start and describe how the budget control act works. the cap, you are correct, the cap year 2013 was $1.4 trillion. the joint select committee on deficit reduction was assigned to achieve savings. if the committee did not achieve its savings, it did not, that cap is reduced to $950 billion ton, on january 2nd, 2013. so there are really two caps in the budget control act, there is 1047, to answer your question, our assumed level, level we would set for the appropriations committee in this resolution, $1.28 trillion. >> thank you, mr. chairman. >> all right. now it is -- 1:45. we have a half-hour before the vote series i believe.

so, let's proceed to amendments. yes? >> may i make one reap quest. may i make one request. >> without objection, included in the record. >> yep, yep. sound good. pceed with consideration of fiscal year 2013 concurrent resolution. the staff will give an overview. under a ruling. sorry on the wrong page. under committee rule 9 the committee will consider the budget rag gaaggregates, amendm may be offered off to the document subject to this agreement between the majority/minority. after the document is approved it will be in the text tough the resolution for the final vote and whether to report the measure to the house. the committee will now proceed with consideration of the budget aggregates functional categories and other matters. the ranking member and i agreed

to limit time for consideration of each amendment. now we proceed to the amendment process. the committee, ranking member and i have agreed, to limitimco time.ach amendment. a list of amendments have been distributed. organized in three tiers. should be familiar. each tear one, 20 mints tier minutes.inutes. debate time divided by the sponsor and member opposed. the proponent of the amendment will have one minute reserve to close. nine, ten, back to one. for example in tier one. the document will be and open to amendment at any point. >> since we may haveconsent. >> the gentleman asksr.

>> uchl consent unanimous conse. are than >> ms. schwartz. you are first up. >> i do have an amendment. >> the clerk will designate the amendment. ment offered by ms. schwartz. an amend r >> ms. schwartz. >> yes, i think i would be more explicit and say it is an amendment that would prevent this budget to end we know it. and i would want to just, begin a couple others want to speak to it. for decades medicare has been a life line for older americans. providing quality and affordable health coverage for all seniors in our country. the creation of medicare in 1965 addressed the challenge of insuring seniors as incomes decline. prior to medicare, little over a

half of, of those over 65 had insurance. and private insurers were terminating coverage to greatest need of care. medicare is a prop is to our seniors they will not be left alone to manage the burd in of health care costs in the most vulnerable years. house republicans are now again proposing to break that promise. the republican medicare voucher plan ends medicare a specific set of health benefits to our seniors. it end the wide array of choices, currently available, under medicare. from traditional fee for service in which 97% of physicians participate, providers, to medica innovative delivery models. the voucher offered by republicans, not only is limited in a amount, there by limiting choices, that seniors will have depending on their ability to pay. but will also make -- no guarantee that they can keep their current benefits, or their

own doctor. this year's republican plan just like last year's proposal not only eliminates guaranteed benefits and shifts cost to beneficiaries, does nothing to address the underlying causes of rise, it's seniors costs. alone who will bear the financial burden in the future. as we have heard in some of the clear. the last year's republican budget would have increased health care costs, typical 65-year-old, by more than $6,000. in 2022. and yet, knowing e -- they're proposing th bter way. for seniors and all americans. thanks to the law we put in place, and the repeal, under this budget, we are moving from a highly fragmented health services to

innovative payment models. with pnt centered medical homes. bundled payments. fewer readmissions to hospitals. be care, and improved care coordination for those with chronic diseases. ll seniors and for taxpayers. the affordable care act.are savn protects access to care and reduces our nation's deficit. their budget weakens medicare and reap verses transformation of health care service delivery and reduces cost for seniors. this republican budget walks away, primary care, prescription drug coverage. adding cost for current seniors as well as future sten yerz. this budget walks away from the seniors, nursing homes, every day, 48 million elderly and

disabled americans, across the country, count on medicare for their life saving medications, doctor visits and hospital care. denying this guarantee of health care by privatizing medicare is not responsible budgeting it's a betrayal of the nation's seniors and democrats and this administration will not let it happen. i would look to with that, yield to my good friend and ranking member. >> thank you, ms. schwartz. thank you for offering this amendment. as this committee knows, very well, the increase in costs for beneficiary in the private market have been going up at least as fast, and in most years, faster than the i the m. we also know by looking at medicare advantage itself. until passage of the affordable care act. we were paying 140% in many cases of fee-for-service.

we were providing the private w. paid not only by taxpayers. by every medicare program. so to suggest this is a solution is counter to facts. now, the other -- and it's pretty clear from the structure of this proposal, that in the end of the day you realize we can't rely on the market. because unlike the federal employee health benefit plan, unlike medicare partprcription republicans say is the model. in this case, in this case, you are capping the amount of the voucher, premium support. whatever you want to call it. regardless of the health care costs. and when you do that. when you do that you are risks arising -- of rising health care costs to the seniors. who ar

lot more. that's why cbo did its analysis last year. based on the other assumptions. th parameters here, again, the consequences are -- are -- the same. and as, as mr. response to the questions -- the reality is if the costs rise at a rate that is faster than gdp pl .5, seniors are going to be left holding the bag with respect to -- to the amount they get with the voucher. and you know what? a plan with current benefits , with that voucher, they will have to take less benbenefits. or if they find a plan with benefits. it may cost a whole lis, in our that is a violation of, of the medicare guarantee. because everybody should always be able to be assured of theut g

to pay a whole lot more. more. so with that, thank youopportun. >> this amendment is pretty straight forward. it does protect guaranteed benefits and avoids a cost shift to seniors in this country. it's something that has worked for a long time. right way and ain the growth protect our seniors. i would like to reserve the balance of my time to close. justneminute. >> you can do it now but you'll have one at the end. >> you saved one for me already. >> yeah. >> then i would be happy to just add one other comment, if i may, arp has just sent us all a letter that does talk to the fact that -- >> no, no, i'm sorry. was my mike on? i'm sorry. please continue. i apologize. >> thank you.

>> i would like to quote the house republican budget proposal -- well, lacks balance economic security of older americans and puts at risk the bipartisan agreement on discretionary spen i think that is medicare is something that is important to our seniors and the fact that this budget puts a great risk. we should be working together to make sure that we save mopey in the right way and not jeopardize our seniors or, in fact, some of our healthy seniors as well. any senior can be bankrupt by its -- by the cost of health coverage. i want to yield one minute if i may. >> 37 seconds. >> i'm sorry. i didn't see you get here. >> we had substantial progress

in trying to address the problems with medicare and rising health care costs last year when we -- the year before last, dded 12 years to the solvency of medicare through the affordable health care act. it is a real mistake to am a way that asks more from those who have the least when the same budget simply hshe most. and i believe that the approach the gentlewoman takes is the right one. >> the gentleman's time hasu se ten minutes for ourprobm. i will promise i'm not going to claim time on every one of these amendments but on this one i'm i'd like to debunk the tired political attacks on the republican effort on medicare. first, we keep

voucher and premium support asi word. i understand it quite well. that's what i'm told. a vucher is like going to the mailbox in the mail and doing something with it, buying insurance, school tuition for your kids or something like that. that's not what premium support is. actually all of us should know s beuse it's what we have as federal employees. premium support is you get a list of guaranteed coverage options that are preselected -- in this case by medicare, in the medicare exchange. in this case you can't be denied care based on your health status. you can't -- you're guaranteed issue with community rating. you pick that plan and then medicare subsidizes your premium. you don't get a check in the mail. you don't get a voucher. they subsidize based on who you are. less if you're a wealthy person. more coverage as you get sicker. now let's review a stunning

chart on medicare -- no, i'm not going to yield, no, no. let's review a chart on medicare's future under the president's approach in the house republican approach. let's start with the republican budget. let's look at how this budget puts medicare spending on a sustainable path. my battery is working now. this shows you the growth rate of medicare under the republican budget over the long term. this shows you how we can do a plan where there are no changes for people in retirement. and how we have more choices for people in the future, 54-year-olds and below. this year's budget, it's a fact people don't like to hear on the other side but it also guarantees the traditional fee for service plan exists forever. these are guaranteed coverage options. now the gentleman talks about a

cap. the cbo themselves tell us they don't know how to measure, therefore, a cap is necessary. we have been told it works. let me compare this to the president's proposal to use ipad, the unelected, unaccountable bureaucrat board apppolitical . here is the president's budget and what he is proposing. this is law, by the way. this is the law that is -- here is what it proposes for medicare's growth rate. let me do that again. this is the republican budget, what it proposes to throw medicare at, here is what the affordable care act and current see much difference there? yet my friends on the other side seem to complain this is draconian cuts to seniors. how can that be if if our trajectories are the same?

let's talk about the main difference between our approach and the affordable care act, the president's new health care law. it's not the proposed spending. as you can see they're the same. the difference is who is in control? 15 bureaucrats or 50 million empowered seniors? that's the difference. now look at ipad doesn't work because unlike cms, cbo thinks fail by 2021 because the actuaries tell us 40% of medicare providers under the of rdable care act are going to business. they're telling us the providers will get paid 80 cents on the dollar and they will just go bankrupt or stop taking medicare patients. that doesn't provide much access or affordability. here is what happens if if wert the current law. medicare grows at the unsustainable rates that

jeopardizes this program not just for future seniors but for current now if ipap ends up failing, if price controls which lead to denied care end up failing, then we go to that red line. here is what that red line does to our budget deficit, more importantly to our debt. this is the debt over the last 40 years. this is the debt into the future. this is what cbo is estimating our debt becomes in the primary major driving of our debt is medicare. and if ipab fails, if all those providers go bankrupt, if the price controls don't work and we relapse back to the status quo, we have a debt crisis on our hands. here is what our plan proposes. the next click, we pay this debt that is the proposal. let me go back to this one more time.

we're proposing you grow at this rate. the affordable care act grows at this rate. and if we go up there, sorry, i'm doing it the wrong way. if we go up to the top, we bankrupt the country. we bankrupt medicare. so at the end of the day the difference is this. medicare -n to save m medicare, in order to keep its guarantee for current and future seniors, in order to prevent a debt crisis from ruininury angi di which does reform medicare. it says 15 political appointees will decide how that line is going to meet. ey cut medicare to providers which will lead to denied access for seniors. we are saying let the seniors make choices. more to the point, force the insurers to compete each other for her business as a beneficiary and also give her

the choice of the traditional medicare system if she so wants to choose tor more rational, far more humane and, more importantly, we do not want to subject her medicare benefitf 15 political appointees. we want to put her in power. more to the point, we think it's this. wealthy people, because they're wealthy, can afford more out of pocket. can't. so we distinguish. we say cover that low income person without pockets. give people more money the less they have. give people more support if they get sicker and require higher income individuals to pay more out of pocket because they cans medicare. with that i'll yield to my gentleman, the georgia, mr. price. >> i want to say to my colleagues on the other side who have dubbed this