of political turmoil. it's not a geopolitical positive issue. i would note that as i think through the market consequences of what's unfolding just on the oil market with ripple effects on the gas market, this is going to be a significantly more volatile price environment rather than a less volatile price environment and the winners and losers of that are the same. a commodity producer in a volatile price environment in which you are struggling to keep market share and revenue, it's not a pretty picture. >> robin? >> i would take it differently. i think a potential big loser on this is environmental movement and green concerns. i think that could be a big mistake. i come back to my point earlier that this is not the end of history. this is not a static situation in both technology and politics

will continue to drive a lot of changes. it ain't over. i would urge people to keep pushing it. >> winner, i would say consumers around the world. not just in the united states at a time where you could have lower energy prices and a different set of energy choices depending on how you value the environment, climate change and so on. you have a different menu of options than you previously thought you had. hugo chavez is someone who hasn't been called upon yet as a loser out of this. i agree with ed obviously whenever i can. and it's absolutely the prudent thing to do. and for those same single commodity economies, it could

also become a winning situation for them in the long run in the sense that a very high energy prices have enabled an awful lot of bad economic policies in those countries and the lower price of oil in particular may allow room for a different kind of economic thinking and reform that's very necessary for those countries so maybe in the long run they are winners too. >> john? >> the winner i think will be north americans if we get this right from a government policy standpoint. i think north americans broadly will win the most. i think we'll start a multidecade new generation of prosperity in this part of the world. the big loser, i think, will be opec with the exception of saudi arabia, which i think has actually more enlightened global thinking than any of the other opec nations. they'll find their way. i think opec will descend into

chaos as an organization and will have -- they don't know now how much they are hated by the entire world but they will find out as things unfold. >> thank you so much. i am sure -- i'm not sure it's an upbeat note to end on but certainly a provocative one. what a terrific discussion. thank you to the new america foundation and steve for hosting us and to all of you for coming today. thank you. [ applause ]

coming up later today on c-span3, president obama has nominated steven crawford to serve on the postal board of governors. he's a public policy professor at george washington university. that hearing gets under way at 2:30 p.m. eastern and it's live here on c-span3. this weekend on booktv, growing up in the shadows and secrets of the rocky flats nuclear weapon facility. kristen iverson looks at the effect on the environment and

the people. and sunday on after words -- >> carter in her opinion was governed with a magnolia accent and she saw the dominos start to fall during this time and by 1979 she was in full-fledged option opposition and carterism and that appeasement and particularly crucial in this respect in 1979 she saw the fall in nicaragua as lacerating experiences for her and people like her. >> the political woman behind the reagan cold war doctrine sunday night at 9:00. and at 10:00, marine sniper anthony swofford on life since leaving the military. hotels, hospitals and jails all part of booktv this weekend on c-span2. health and human services

secretary kathleen sebelius spoke in washington yesterday about the next steps for implementing the president's health care law. she spoke at george washington university school of public health for about 20 minutes. >> please join me in welcoming secretary sebelius. [ applause ] >> good afternoon, everybody. i am delighted to be back at george washington. i was telling dean goldman that i have had the pleasure of being here at the school of public health a number of times and announcing a number of important new initiatives here in this auditorium and i think it's a perfect venue to discuss the affordable care act and importance of the supreme court decision. i want to recognize president

steve knapp and thank him for his hospitality. certainly dean goldman for her not only warm welcome but her leadership here at the school. you're going to have a great treat. some colleagues who i worked with for a long time are members of the panel that you're going to hear from and certainly the other keynote spoeakers. i'll tell you something that may not be immediately obvious. we all have kansas connections. i am a former governor, former insurance commissioner. lived in kansas. my husband is a federal judge still in kansas. tom daschle had the good sense to do what i did and marry a kansan and sheila burke, longtime aide and assistant to senator bob dole, the senate majority leader from kansas. you might have thought we were here for our health care

expertise but it's really our kansas connections. you know, over the last couple of weeks, there has been a lot of commentary about what the supreme court decision on the affordable care act means for politicians in washington. we've heard speculation about who is a winner and who's a loser and who's up and who's down and what it means for november. with congressional republicans, today holding their 31st vote to repeal the affordable care act, it's clear that some want the political discussion and political battle to keep going. but i'm really glad to have a chance to be with you today to talk about what the health care law means for those outside of washington. the hard working families that the law was really designed to help. but to do that we need to set the stage a little and remember where this country was when this law was passed two years ago.

so back in 2010, the urgency around health care challenges was growing related both to the health care of our nation and also the economy of the country. despite spending more than any nation on earth, we were moving toward 50 million uninsured citizens and really mediocre health results. our health expenditures were consuming a greater share of our gdp threatening our global competitiveness. families, businesses and governments were all struggling under the burden of rising costs. and between 2000 and 2009, the decade before the health bill was passed, insurance premiums doubled. the share of small business owners offering employee coverage dropped from 70%, where it was in 2002, to under 60% leaving more and more of those

employees uninsured. and medicare costs continued to rise putting the trust fund on pace to be insolvent by 2016. one small business owner who wrote to me early in my term summed up the frustration that so many americans were feeling when he wrote to me, "i'm near the breaking point. eventually we'll go out of business or be forced to cancel our employees' insurance. either way, it's a lousy set of options." at the same time, the private health market was becoming more consolidated and less competitive. now, some americans had dependable access to coverage in public plans. more children, the seniors, disabled, veterans. even the poorest adults and pregnant women through medicaid. employees of the largest

companies usually fared pretty well. but that still left a lot of hard working families in a broken market where insurance companies made a lot of the rules. totally legally insurers could cap your coverage, raise your rates or cancel the coverage with very little accountability particularly if you were in the small group or individual market. and if you were one of the 129 million americans with a pre-existing condition like cancer or even asthma, you could be locked out or priced out of the market all-together. now, that was a fairly successful business model for many insurance companies. in fact, in 2009, the five largest insurers made $12 billion in profit. but that didn't work very well for a lot of the people who were left on the sidelines. so the health care law was passed in large part to address the issues of cost and coverage. that's exactly what has begun to

happen over the last two years. so the law's first principle is simple. if you have coverage, you can keep it. for the 250 million americans with insurance today, the main change in a lot of those policies is that they'll get some more security. the law puts in place new insurance rules and many of those are already in place prohibiting insurers from capping the coverage or cancelling it without cause if someone gets sick. preventive care is now free for 54 million americans with private plans. and there are new limits on how much of your premium insurance companies can spend on overhead costs like ceo bonuses and marketing ads. and as a result starting this summer about 13 million americans will get rebates from their insurance companies. you heard me correctly. insurance companies are actually sending money back to their

customers thanks to the ad-20 rule. despite what some have claimed, the affordable care act does not cut medicare benefits. in fact, the program is more robust than ever. new benefits have been added for seniors. the law has begun to close the insurance gap in medicare prescription drug plans, the so-called doughnut hole, saving over 5 million beneficiaries with the highest medication costs. about $600 a piece. we have brand new efforts and new surveillance tools in fraud and abuse areas and we've already returned in the last two years about $5.4 billion to the trust fund and that doesn't include the new $3 billion settlement that was just announced last week. yesterday our department announced that so far in 2012, more than 16 million seniors and

persons with disability on medicare have already taken advantage this year of at least one free preventive service like wellness visit or a cancer screening. now, what we know also is that small business owners were often at a very difficult place in the market. they are beginning to see some relief thanks to the new tax credit that covers up to about a third of their insurance bills for employees and all americans with insurance will benefit from no longer having to pay the extra thousand dollar per family that's estimated to cover the cost of uncompensated care for americans with no coverage. the law is beginning to provide some better coverage choices for middle class families. we have about 3.1 million young adults, some of them might be here at gw, who were previously uninsured prior to 2010 and now have coverage on their parents'

plans. we got 70,000 americans all around the country who are taking part in the new high-risk pools that were previously locked totally out of the insurance market because of their pre-existing health conditions. at the same time, the affordable care act has begun breaking the stalemate in washington on addressing health care costs. now, there was a lot of agreement for decades that our health care costs were too high and that they were continuing to rise in an unabated fashion. while there was a lot of agreement that we had to do something about high costs, there wasn't a lot of action in congress certainly much action prior to the law passing. in the ideas put forward by those who favor repeal, would limit government health spending, lower government health costs simply by shifting costs to seniors and patients. there's an alternative vision of

how to lower costs that's part of the construct of the affordable care act that captures doing on a national scale whiat some of the best health systems have begun to do around the country and that's bringing down costs by actually improving care. so prior to the passage of the affordable care act, many of the financial incentives in our two large public programs and medicare and medicaid right now include about a third of the country. almost 100 million people are participants in one of those two programs or sometimes in both. but the financial incentives were often in the wrong place. they actually many times penalized care improvements the way we paid providers and hospitals. over the last two years we've really begun to change the incentives in the health care system to reward providers for improving care and we've had an enormously enthusiastic response

from doctors and hospitals across the country. for example, just on monday, we announced that a total of 154 health organizations serving 2.5 million americans have already signed up under the law to form the so-called accountable care organizations. these are structures where providers share savings when patients stay healthy. it's a huge first step in a voluntary program around new delivery care strategies. there are many more of those strategies under way. lowering hospital based infections, looking at ways we can improve protocol, medical health homes, bundling care, all designed to really keep people healthy in the first place and keep them out of the hospital and lower the opportunities for return. all of that progress has been going on in the last two years so when we have as we have again today people talking about repealing the law, i think it's

important to remember what's really at stake. this has nothing to do with the fortunes of elected politicians around washington, all of whom, by the way, already have excellent health care. it's the health and economic security of middle class families around america that are really at stake. so repeal actually could subject those families once again to some of the worst insurance abuses. we know it would automatically raise the price of seniors' medication and add financial barriers to their preventive care. it would end the tax credits that are currently helping small business cover their employees and force millions of young adults to once again begin their careers without the security of health coverage and it would mean that too often the best quality of care would continue to be out of reach for most americans. what we know is that there were

four justices who actually voted to strike down the entire law. it would have accomplished those goals. but the majority of justices has allowed us to move ahead on full implementation of the act and with the slight change in medicaid, which now makes the program a voluntary program and removes the penalty phase of medicaid so that the department of health and human services could not take all of the underlying medicaid funding away from a state who chose not to participate, medicaid funding will operate like the chip has funded over the last number years where states voluntarily come into the program and we think that given the very generous framework of state/federal participation and the opportunity to ensure the

largest number of lower income adults in that program that states will indeed decide to insure their populations. two major parts of the program don't take effect until 2014. the new marketplaces will be set up in every state where families and small business owners actually get to make for the first time ever an apples to apples comparison of health plans and choose the one that's right for them. there will be new rules for insurance companies. no one could be discriminated against because of a pre-existing health condition. and you can't be charged more because of your gender in an insurance plan. now farm families, small business owners, entrepreneurs and others who can't afford coverage can qualify for a tax credit averaging about $4,000 per family. and members of congress and

their families will get coverage through the same exchanges alongside their constituents. so over the past two years we've been working on implementation because setting up these new markets can't happen overnight. we've partnered closely with states to set up the new consumer friendly marketplaces. and far from what's reported as a federal takeover, the law really gives states maximum flexibility in shaping their own markets. states can decide for instance to fully operate their marketplace, to partner with hhs to run pieces of the exchange or to have us do it all. in fact, the law contains a provision that if states come up with their own way of covering the same number of people with the same kind of quality and now cost increase, they can present a plan and take over the whole system. the president has actually asked congress to move up that

provision from 2017, the way it's written in the law to 2014, so states could have the flexibility in year one. and yesterday i received letters from 12 governors that say they are already fully engaged in planning to establish their own marketplaces. we anticipate more to be fully ready as we move through 2012. in the months to come, we'll keep working with states to meet them where they need it's appropriate and have all of the exchanges running in every state by 2014. another key change that is coming in 2014 is that states will begin receiving a very generous federal match to expand medicaid coverage to uninsured adults at 133% of poverty. now, those who don't walk around with poverty tables in your head, that means that for an individual you make less than $15,000 a year and for a family of four, the income is less than

$31,000 a year. so we're really talking about some of the poorest working families in this country. now, here's what states are being offered. for the first three years, 14, 15 and 16, the federal government pays 100% of the newly insured enrollees as well as paying health care providers who serve medicare patients at a higher rate. after 2017, the federal government's share is reduced but never less than 90%. the lowest it gets at the end of ten years is a 90/10 share. a much more generous match than the current 57% that the federal government pays for medicaid programs today. the states also have flexibility in setting the benefits for the newly covered folks. and their expenditures will be offset by reduced spending on

uncompensated care for other savings in the law. this has unprecedented federal support, access to affordable coverage for low income residents and steep reductions in cost for the state, the citizens and the health care provider. we think at the end of the day, this is a deal that states won't want to turn down. as i said earlier, we've been through this before with the chip program. when congress expanded coverage for kids in 1997 and offered to pay 70% of the costs, not 100% of the costs, states were initially skeptical. only eight states began covering eligible children in the first year. but within 2 1/2 years, all 50 states had decided that the benefits far outweighed the costs and committed to participating. the 2014 medicaid expansion offered states an even better deal. and we're hopeful that states will take advantage of it to

cover their neediest working families and ensure that their doctors and hospitals actually get paid. so earlier today i sent a letter to all governors, many of them my former colleagues laying out this information. we're going to keep working closely with states to make sure that the hard working families who are looking forward to this new day have access to affordable coverage. now that the supreme court has issued their decision, i'm hopeful we can stop refighting the old political battles in trying to take away benefits that millions of americans are already enjoying. instead to move forward with implementing and improving the law to provide more security to americans who have insurance, more choices for those who don't, and lower costs for everyone. thank you all very much. i'm going to turn the podium back over to dean goldman. [ applause ]

>> and a live picture now from capitol hill that is the house radio and tv studio. we expect in just a moment or two, speaker john boehner to come out for his weekly news briefing. you can see the reporters are there and as we speak, there comes the speaker. live coverage now on c-span3. >> good morning, everyone. in the last weeks, job report was just another reminder that president obama's policies haven't just failed, they've actually made things worse. 12.7 million americans are on the unemployment rolls. many more have thrown in the towel and have given up looking for work all together. more women are unemployed today than when the president was inaugurated. and young americans are desperate for a full-time job. the unemployment rate has been stuck at higher than 8% for 41 consecutive months. this is the longest streak since the great depression.

remember, the president's stimulus spending binge was supposed to have us well below 6% unemployment by this point. instead, "the wall street journal" and other media reports say the obama administration outsourced stimulus dollars to foreign companies and workers. now, americans not only ask the question where are the jobs, i think they have a right to know, where the hell the obama administration shipped their tax dollars overseas during a recession here at home. i think the president owes every american an explanation. president obama and democrats here in congress have shown us what doesn't work. more government, more spending, more taxes don't create more jobs. now that's why the house has been focused on removing government barriers and getting washington out of the way. we've passed more than 30 jobs bills including bipartisan bills

expanding energy production and projects like the keystone pipeline. we voted to repeal the president's health care law which is driving up the cost of health care and making it harder for small employers to hire new workers and we'll vote later this month to stop the federal government from imposing new regulations on the private sector. and at the end of the month, we'll vote to stop the largest tax hike in history that's due to hit the american people and small businesses on january 1st. we'll also dellay the groundwor for tax reform that closes loopholes and lowers rates for all. fixing the tax code will boost economic growth and create jobs by lowering taxes on companies so that they can be more competitive with foreign competition. this will keep more jobs here in america and actually bring jobs that have gone overseas and bring them back home. unfortunately president obama and senate democrats aren't focused on jobs. the president is out there

campaigning for a tax hike on 900,000 small businesses that his own party won't even support. in fact, senate democrats were given a chance by senator mcconnell to vote on the president's tax hike and they rejected it. the american people are tired of the games. they want washington to focus on jobs. republicans are listening and colleagues across the aisle unfortunately aren't. jake? [ inaudible question ] >> i think chairman lucas and the committee have done a lot of good work. no decisions about it coming to the floor at this point. >> could it come in july? do you expect it this month? >> no decision has been made at this point. >> thank you, mr. speaker. house republicans on health care ve