what are the pluses and minuses of prime minister cameron's proesal that passports be taken away from people of, in particular countries, that travel to syria. in our case, americans traveling to syria, what are your thought from the fbi perspective of taking away the passports. >> that is a question bet are answered by secretary johnson. but quickly, it is of interest to us. i met with home secretary as i know secretary johnson did from the uk this week to try and understand better how that is working for them. among the concerns i would have, is what is the due process i would have in the united states. how i do protect sources and methods. how do we use, if at all, classified information to make the showing that would be necessary. i'm interested in any tool that might help us identify and incapacitate these people. but i want to understand the details better. >> also, if i could ask, what are the advantages of allowing them back in the country and

monitoring them to see what they are in contact with? or is that too risky? >> no, a case by case basis. and sometimes it makes sense under limited circumstances. let somebody back in, cover them very closely to see who they connect with. sometimes it makes sense to have them come back in the country and lock them up right away. so it is hard to say in the abstract. >> okay. >> secretary? >> i agree with the fbi director that suspension of passports should be considered on a case by case basis. the state department has the authority to suspend passports. i also know suspension of passports can be done when the situation warrants in a matter of hours or days. it does not necessarily need to be a lengthy process. and i agree given the current environment that we need to

seriously consider limiting certain individuals to travel. either go from one foreign country another. or from our country another country. >> director olsen? >> i think this was touched on by the chairman. how concerned are you with al qaeda, isis, as far as getting themselves back in the headlines to reestablish themselves as the number one terrorist force that they would -- to increase chances of an attack upon the homela >> i'm very concerned about that. these groups are in attention for fund-raising, for recruitment. one way to compete is to show you're the biggest and baddest

group out there. i think that the environment we're in right now shows challenges. i agree with the premise of your question. >> secretary olsen? >> i agree. i think there is a competition among the groups. one particular example of this would be the reisn't announcement of al qaeda core. that was announced on social media on says third and it could be viewed as effort by core al qaeda to reassertity supremacy in this global movement. so those sorts of -- those sorts of efforts can be viewed in the context of what might be an emerging competition among groups. >> director comey? >> mr. king, the logic of it is compelling. you're not going to be the leader the "globe"in th global striking attention.

>> thank you. i yield back. thank you mr. chairman. >> chair recognizes ms. jackson lee. >> i too would like to thank the ranking member for this hearing and i would also like to thanks each of the presenters, members of the panel for your service to this nation. having served on this committee from the beginnings of the recovery period, of 9/11 when the select committee on homeland security was first formed, to create this department, i know how important the issues that all of you gentlemen are speaking of are to the nation and to the security of america. i think it is important even in this meeting to hold up the constitution, to tell all of those who would have a malicious intent toward the united states is that we will not sacrifice our values, our liberty, our commitment to equality and justice for their terroristic ways.

and i thank all of you for recognizing as my ranking member indicated, that we are not here to label a faith, islam. or the muslim people. we are here to ensure the security and safety of the united states of america. i want to first of all say that as i was looking over materials that i think are relevant, i think it is important to note from an article, and i ask for unanimous concept to put into the record an article by william mccan't, who indicated that the issue or idea of isil began in 2006, long before president obama or secretary johnson or anyone was in the positions they are in today, and before the american withdraw. and had at that time popular backing. >> so let me be very clear.

i believe our president has been very effective in trying to both down size and bring down the war in iraq and as well address the national security of the american people. >> i will not vote for an authorization for war. but we cannot talk about isil without doing something. so i will vote today for ensuring that other fighters in this instance, the free sir yn army is well trained to do the job. that means that we, here in the united states, must be very sure of what we're doing to protect the homeland. mr. johnson, i would ask, mr. secretary johnson, i would ask a follow-up question on my colleague, mr. thompson. coming from texas, do you feel that you have sufficient federal resources on the border to, if there was such an intrusion, that your staffing between ice,

on the inner side between the border patrol, intelligence, working with your colleagues, do you believe you have the right and necessary resources? >> we have more resources today than we have at any time previously. over the last several years we put at the border, particularly southwest border unprecedented level of resources in terms of people, technology, vehicles and other equipment. as you know, i'm sure congresswoman, app remengs over the last 14 years, have gone down. they've gone up there year because of the spike in the rio grande valley secretary poppo s. but we can use more. the bill passed at the senate last year at 7-4-4. >> thank you. >> toward border security.

>> thank you. >> i wanted to be clear, if i could, because my time is running, that you do have, i do support that legislation and i would rather have the federal resources than unpaid national guard that has been put down by the government of the state of texas. let me quickly ask the question to all of you, we know that we've been hacked. all of us have been hacked. but the question is, are you able to discern the distinct between the identity thief hackers and that of the state hackers coming in as terrorists on the cybersecurity grid? can you all answer that question? and my last question, so i get it in, so you can answer if if you might, the women of this nation are seemingly targets of recruitment for isil. women coming from western nations, poor, maybe uneducated, are we having a special target to recognize the concern for those women? and how we would stop that, if all three of you can answer that, i'd appreciate it.

>> congressman, let me begin with the question on cyber. as director comey suggested, we have a range of different types of actors and we do a pretty good job of detecting the nature and type of actor for each specific attack. but it is a range from private individuals to others. and i refer to my colleagues. >> i agree with secretary johnson. those attribution gets increasingly difficult as the private, the thieves, get increasingly sophisticated and some of their techniques rifle those of nation states. but we do a good job of sorting them out. with respect to recruitment of women, you're absolutely right. there is a targeted effort by isil to atrkt fighters and spois

spouses of fighters. they are trying to attract them to come to their so-called calafade, to start families in their warped world. >> mr. olsen? >> i would only today what director comey said about the recruitment of women. one of the most barbaric thing they have done is the enslavement of young women and girls. it is a huge concern to us. if i may add ms. jackson lee, you held up the constitution and today is constitution day. >> yes, it is. >> director of national intelligence jim clapper yesterday held a swearing in for those of us to reaform our commitment to the constitution with the work force and i think that reflects the commitment within nctc and broader intelligence committee to our fidelity to the constitution. >> and mr. chairman, thank mr. olsen for his service and i believe i asked for unanimous consent for this. but i also ask for unanimous

consent, which i like to refer to the chairman's review, hr-54488, which i would like to put into the record, can which is legislation that is called no fly for foreign fighters. it doesn't tie your hands but it refines the watch lists to make sure that everyone that should be on it, is on it. particularly since the foreign fighter concept. is continuing to grow. i ask unanimous consent to introduce that into the record and look forward to discussing that with you gentlemen. thank you very much. i yield back. >> dr. brown from georgia. >> thank you. mr. olsen mentioned that roughly a hundred americans have joined isil. do we know how many americans have actually joined isil as well as other terrorist organizations around the world? >> any of you can give me a number? >> i want to be clear about the numbers, if i may, congressman.

we estimate over a hundred americans have travelled to syria. to join with extremist groups in syria. >> so you don't know a number of who actually joined, is that correct? >> once in syria, it is difficult to discern what happens there. >> do you know who they are that have joined or have travelled to syria or traveled to pakistan or other places around the world? do we know who those people actually are? >> with varying degrees, we have specific information about who they are, whether they have travelled to sir whiy they are, whether they have travelled to sir whiria or othe locations. >> we go back and forth to what peter king was asking about passports. the state department recently said that they are not going to revoke passports on americans, they fly to syria or fly to different places. if we know who those people are, i think it is an outright security threat not to revoke their passports. certainly i believe in due

process, i think we can do this. and it is a huge security threat to this country, if we don't revoke their passports. we already know that tsa is allowed known terrorist -- they are on the no fly list. that present a huge security threat to america. next yes, if all three of you, is that we've got cities and now state of california that have declared themselves as being sanctuaries for illegal entrance into the country. do you all see this kind of6ñañ philosophy of cities or state being a security risk to our nation? >> secretary? >> i guess i would answer it this way. we have a pretty good ability through law enforcement, intelligence homeland security,

means to identify individuals, including undocumented, who are people of suspicion, suspected terrorists, and the fbi proves that time and again. i do think that in any time or situation there are a large people who are undocumented, that there is a risk, it hinders our ability to track those individuals. which is why, from my homeland security perspective, i'd want to see those people come forward and get on the books so i know who they are. so if with what you're suggesting is that the risk to homeland security grows when there are a larger numbers of undocumented people, in any one place, in any crowded area, i can't disagree with that.:r) >> we know that we've got porous

border, particularly on the southwest. and as secretary describes there, we have others other than mexicans crossing the border that we have apprehended. we don't know how many people have not been app remended. would you agree with that statement? yes or no? >> we generally believe that -- we have an ability to calculate totality of crossing the border. it is between 70 and 90%. we have a sense for who we didn't get who crossed the border. >> i apologize for interrupting you. do we know how many syrians or pakistanians or iranians or somalians or others have crossed the border? ? >> in a broad sense. there is obviously legal people who travel from those countries for legitimate means,

lawful means. so i think we have a pretty good sense both through legal minority and apprehensions. >> i think this increases our security threat too because of the terrorists flying into this country with -- on the visa waiver program. i think we need to look at that. one final thing, some say that with isil and what is going on in syria and iraq are just involved in a local civil war. what would you say to them that this threat poses to our own interest here in this country. if i could get all three of you to respond to that. >> i'll start. congressman, i think that isil represents a huge threat to our interest. represent a potential threat to our homeland security.

it represent a threat to the stability in the region and represent a threat to the americans in the region and they demonstrate the willingness to kill americans because they are americans. and as the chairman and others have pointed out, they acquired territory. we have to be very concerned any time any terrorist organization acquires territory for training, for launching attacks. we are determined to take the fight to this group. >> director comey, would you comment, please? >> i agree with what secretary johnson said. i wish it wore the case that it were something in a box half way around the world, but it's not. >> okay. director olsen? >> i agree. secretary johnson would add that understanding within our departments and agencies or within the intelligence committee, the nature of the threat the group poses. >> thank you. mr. chairman, my time is expired. given the amount of time we have witnesses, i will hold members

strictly to the five minutes rule. next we have mr. barber, who is not here. so mr. payne. who is also -- where is mr. payne? right next to me. you changed seats with ranking member. thank you, mr. chairman. >> mr. secretary, you know, recently there have been news reports that have claim ed thousands of foreign students overstayed their visas and disappeared. however, homeland security is doing a great job in their own data appears to show that while cases are initially flagged for review, the location of'.[y the students was in fact known by dhs field offices. now it is my understanding that

there are many reasons why a record might be flagged as potential overstay. none of which are reasons to expect dangerous activity. for example, dhs's own press office state that many cases are closed due to a variety of legal reasons, including student receipt of a green card or departure from the united states. you know, for generations, american foreign policy leaders have agreed to educational exchanges are one of the most successful foreign policy tools. l peace prize winners since 1987 have been student educated in the united states. and america needs friends and understanding around the world more than ever. and educating young people here gives us a great opportunity to develop those ties for future

world leaders. therefore, we need to understand how the department manages the student veisa pr program. can you discuss what dshs uses to because we want to discern from the real threats by mischaracterizing students. >> we have to depend on t.o. a very large degree on what universities tell us about whether the individual is still a student. still seeking an education in this country. as you reference, there have been a number of individuals who have overstayed their student visas. this is something i've looked into, taken a special interest in. i believe there are a number of

vulnerabilities in our abiggs to track these individuals that are being addressed. a number of gaps are closed. we looked into the number of those reportedly overstaying visas. we have found a very large fraction have neither been arrest ordered returned to their countries or getting their green cards. there are still open investigations. but i don't have the exact numbers offhand but a very, very large number of those who were initially individuals of concern, we found either -- or now in compliance or have ret n returned but they are still open investigation on some. i think we are doing a bet are job of tracking individuals and i totally agree with what you said about the importance of student visas and importance of receiving an education. >> thank you.

>> i saw a report where they used a number of 60,000 which was absolutely ridiculous and absurd. and you know, it appears that numberer's closer to maybe 6,000.ztp÷ but isis is on top of closing. and narrowing that number consistn'tly, is that correct? >> that is correct. of the 6,000 you referred to, we have found that a large number are either in compliance or have returned or opinion arrested. there is still a number, i don't have the number offhand, but there is still a number offhand that is a fraction of that that are under investigation. but i believe most of them are either in compliance or have been arrested or returned. >> thank you. i will yield back. >> gentleman from pennsylvania. >> thank you, mr. claireman. director comey, i appreciate your focus on the interest of technology. i enjoyed your anecdote of the fact that your sneakers may tell

your refrigerator that you went for a run. i know you appreciate your same sneakers could tell your wife you went to the refrigerator. but i do appreciate your leadership on the on the technology front. i'm struck by your concept, your observation after ten years, you are seeing the dramatic change and metastasize you see in the cyber domain and we see the fifth dimension of warfare in the cyber capacity. one of our former colleagues, lee hamilton, who observed the same phenomenon from our time together in 2001, came back and testified earlier in the week that he sees the cyber threat as even greater than the collective threat currently coming from isil. so you know, we know about the use of radicalization and recruitment done. we have seen more sophisticated attackes from iranians, tied to denial of service from our banks. criminal gangs use the internet

for creation of ways in which they can do things like extortion and raise revenues. i'm also genuinely concerned about the ability to purchase expertise out there in the worldwide domain from people that may not be directly associate but can be hired to conduct activities. and of course, some concerns that even a certain point the kind of islamic jihad could be tied back to terrorists, transport systems, banks, things of that nature. looking at specifically at isil, what do you think the cyber dimension is, the cyber threat that isil creates? >> thank you. i remember fondly our time working together. thank you for caring so much about these issues. but i think it trance forms all of the things we are responsible for. i see isil focus on the internet

cyber space to recruit. sort of peer to peer communication to lure people to come and fight for them but also as the chair said, through their very slick propaganda efforts. to energy tize and train would- fighters. i know this is something nctc has thought a lot about as well. >> have you seen something with regard to the activity that leads to you believe there is growing competency that may have a threat from isil on the cyber domain? >> it is something we are concerned about. but at this upon the i would characterize it as basically just aspirational in terms of any capability of isil or similar groups to carry out cyber attacks. i think as director comey said, primary concern is the use of the internet to recruit and track followers.

>> director johnson, or secretary johnson, you may fell comfortable in commenting on that but i want to take my remaining minute to thank you for your leadership and close cooperation with this committee as we have worked to structure new legislation that would enhance the ability for the agencies across the board. to better prepare to be responsive to the growing technological threat. can you tell me, not just -- i know you support it, but can you tell me why you believe this legislation is critical to the enhancement of your mission and why it is so critical that we act in a timely fashion on this? >> congressman, thank you for your leadership in this area. i think it is critical. there are several reasons why i believe legislation in this area is important. one, to codify the authority of

dhs to act in the dot gov world. there is legal uncertainty about our ability to protect the dot gov world. there are statutes that some would interpret to inhibit our ability to protect the dotgov world. so the existing statutory landscape needs clarity in order for us to do our job. we know also in the private sector, there are those concerned about legal authority to share information with the government and about their civil liability, if they share information with the government if they act in response to the government. and we're also looking to enhance to hire cyber talent. but one of my immediate concerns, which i know you're focused on is clarity in terms of helping us police the dotgot

gov world. this is something we have do on a dailydvw basis. we face attacks on a taly basis. opinion just a cybersecurity threat any more. >> thank you again for your leadership. and the kind of junction through with which a lot of the activity can take place and how vital it is. thank you for your leadership. and i yield back. >> thank you for your leadership on cyber. secretary, you're in strong support and administration's support for passage in the senate. we all appreciate that as well. chair recognizes mr. higgins. >> thank you. firstly on the isil numbers, about five weeks ago, a published reports, estimated to be between 7 and 11,000 isis fighters. the most recent cia report puts that estimate at 31,000. and i'm just wondering if that's -- that distinction is a result of bad numbers analysis

or rapid recruitment, success, on the part of isa? >> yes, congressman. so the current assessment is that the strength is anywhere between 20,000 and approximately 31,000, 31,500. that obviously demonstrates what we are talking about is an approximation with a wide range. we have limited intelligence on this question. that's by virtue of the fact that our ability to collect on this question is limited in syria and in iraq. but the increase in that number does also reflect some of the recent gains that the group made through battlefield success and recruitment efforts particularly in iraq. so it is both, the change reflects our limited intelligence collection but also the gain the groups made more recently.

>> since commencement of air strikes, have the numbers dropped? have the increases been reduced? because i think part of the military strategy there, is to stop the isis momentum. because that, more than anything else, is probably the most potent recruitment advantage that isis has. >> what we've seen certainly is that air strikes have had an impact on the military momentum of isil. so it had an impact on the battlefield. i think it is too soon to tell how those strikes will affect the overall numbers of isil fighters or their ability to attract people to join the ranks. >> so estimate of future recruitment is open-ended and unknown? >> that's right. how it will look in a year or more from now is, at this point,

a question that we don't -- >> let me talk about that question. it is hard know where this is going because nobody saw it coming. if we saw it coming, we potentially could have acted earlier to hold its progress. and we know that 15,000 foreign fighters traveling to syria, 2,000 of which are from europe and the united states, begins to bring this closer to home. you know, isa is younger than al qaeda. more aggressive. more brute ylal. better at raising money. more technologically sophisticat sophisticated. my district alone, last year there was a terror plot toborough up a passenger train that was thwarted, that was going through niagara falls. two individuals were indicted and thought to have al qaeda

affiliation. in 2006, six homegrown terrorists were convicted of providing material support to al qaeda after having travelled to afghanistan and participated in al qaeda training camps. and just yesterday, in rochester, new york, about 50 miles from my district, a man was indicted for attempting to provide material support to isa. attempting to kill u.s. soldiers and for women of firearms and silencers. i think it's -- people shouldn't be alarmed, but i think that the growth of isa, our inability to come up -- we have a strategy that is not foolproof. it depend on people who, we have not demonstrated any confidence on before the free syrian army, and all of the thousands of militias that make that up, this

is a major concern. and i saw it in the secretaries statement, you know, five things that the department of homeland security is doing including aviation safety and a number of other things pap and that's fine. but i think that threat of isa to the american homeland is much more existential that we are willing to acknowledge. the idea is not to alarm anybody but to prepare for what is a very, very serious situation that is metastasizing in that part of the world. they won't stop in east rn sir why or northwest iraq. they have a goal and it is very specifically defined. the borders in that part of the world, these people have no appreciation for historically, because they had nothing do with it. they looking to up-end the entire middle eastern region. and wanting to claim it for themselves. i yield back. >> gentleman's time is expired.

mr. duncan is recognized. >> thank you mr. chairman. i want to thank the gentleman, mr. higgins, for his comments as well. thank you, gentlemen, for your service tower nation. have you an immense challenge ahead of you. we all recognize that and support it where we can. having a dialogue about the global threats about safety and security is very important, not just for lawmakers and policy makers, but also for the american people. i want fto comment, secretary johnson, that you use a broad spectrum and whether it is broad flo idea who is in our country or what their intent is. one side of a political spectrum want to paint a rosey picture that we have a secure border. but the fact is, americans realize that we don't. and we also, i think americans

are counting on us in this arena to transcend politics and work to keep the bad out of our country and to work to keep another 9/11 from happening. they expect you guys to transcend politics and focus on keeping us safe. i grew up in the cold war. at that time we were, as a nation, tracking troop movement of soviets, surface and sub surface ships and where they may be across the country, across the globe. now we are tracking individuals. foreign fighters who may have left our country to syria to fight jihad who may be radicalized and may have the ability to come here. in june, i was in brussells. before we got brussells, a foreign fighter traveled to

syria, was radicalized. made his way through turkey and germany. germany knew about this individual. failed to let the belgiums know. he went into brussells and shot up a museum. at least three maybe four individuals lost their lives. he was caught at a bus stop with the very7gq weapons he used to commit the crime. germany knew but failed to share that information. that information. we rely on information sharing a wz he try to track individuals. as they travel around the globe, an immense challenge. we talked earlier or heard earlier about the hundred or so americans that have gone to fight with isis. but we all have somali-americanes who travelled

to fight with al shabaab. this is unclassified now, internal memo from fbi. on june 13, a violent criminal threat section sent out a request for mission creep by other federal law enforcement and the traditional fbi lanes. and goes on to talk about homeland security investigations is an issue and an alarming number of field offices. i appreciate the director of fbi saying that that's really not an issue. but what i want to point out is, dhs is stood up in 2003 to recognize, or after recognizing the stove pipe of information. the walls are barriers of sharing information between agencies, that possibly could have thwarted the 9/11 hijackings. earlier about germany letting

belgium know about a traveler through their country that killed folks at a jewish museum. we cannot afford to have these type of turf wars between agencies charged with keeping us safe. so how, director, how do you combat that? how do you keep that mission creep issue from becoming an issue? and i would love to hear from secretary johnson on how he feels about that. >> thank you, mr. duncan. but talking about it constantly, that report made my head explode so i shared that head explosion with every leader in the fbi to let them know how i think about it. which is that fbi does nothing alone. to be effective in protecting the american people across all of our responsibilities we need the partnerships you see visually represented by the two of us sitting together. there is no other way do it. the american taxpayers should have no patience for turf battles. i got none. >> i appreciate your communication. i'm concerned about communication where the rubber

meets the road and that's where the communication needs to happen. if you have turf wars going on, i'm afraid information may not be shared appropriately. >> that's what i meant by talking about it. >> good afternoon.

i am delighted to welcome you to the brookings's decision -- brookings institution. i am even more delighted to welcome sylvia burwell, burwell, tolvia

this event at brookings. i have known sylvia a long time. over 20 years. sylviafirst encountered in the clinton administration, i thought of her as that friendly, competent young woman who worked for bob rubin at the national economic council. i learned that sylvia was the go to person and a can-do person. that was a useful person to have around. i also learned that she liked to keep in touch with real people out around america, not just in washington. and that she grew up in west virginia. one day, i found myself in a hard hat, deep underground in west virginia in a coal mine with sylvia, barbara ven and rich trumka.

i was not the only one who noticed that sylvia was competent and levelheaded hearing the president notice to that, president clinton. by the end of the administration, she was the director of -- she's had a distinguished career. president obama had the good sense to bring her back to washington to be director of omb. i was delighted. affection forg the office of management and budget and i always feel better when i know the agency is in a strong, confident hand. a deep respect for the difficulties of that job because it is the toughest job i ever did. but apparently, it was not tough enough for sylvia.

talked her president into an even tougher one. the department of health and human services is a vital agency of government that literally affects every single american at sometime in their lives, often many times area at any time in history, running hhs effectively is a huge strategic and managerial challenge. but this may be the most challenging time of all. it includes implementing the affordable care act. is a far-reaching, much-needed piece of legislation that has -- that is already providing millions of people with affordable health insurance and will impact the way americans interact with their health care system for decades to come. it is complex. we don't things simply in the united states. it gives states a lot of flex ability. it will play out differently in different parts of the country.

it will change as we gain experience with what works and what needs to sing. -- needs fixing. people in the academic world and at ring tanks like this one often imagine that the hard job in government is making policy. no, it is not. after the political battles are fought, and the compromises are made, after the bills are passed and signed, the really hard job is to implement the policy on the ground. and that is city of -- that is sylvia burwell's job right now, to make the affordable care act work and she is here to give us a progress report. sylvia. [applause] >> thank you very much, alice. it is an honor to be introduced by someone that i have known and

followed for so long. i am sure most of you all know that alice was the original director of the congressional budget office as well as the first woman to head the office of management and budget. to follow in alice's footsteps, she was someone who has climbed many mountains, both literally and figuratively, for those who know her, and for whatever reason, in trying to aspire to do that, when i left the clinton administration, i decided to climb mount kilimanjaro. aookings is a place that has special place in the burwell household. we like to read to her children. our children are sex and four. it is a morning ritual over breakfast. sometimes we read the magic treehouse and sometimes we read brookings institution reports. [applause] when my six-year-old daughter found out that i was coming today, i don't seem all dervish,

but i do have a message firm -- from my six-year-old. on the whole aggregate gdp eating a less good measure of economic progress, she does not agree. while i am not going to get in the middle of my daughter and a brookings scholar and academic leader, i do just want to skip to the fact that i have great respect for brookings as an institution and the work they do. examining all issues, they take both the long and the short term view. they think about and analyze trends over time, conduct smart, systemic, empirical research. and focus on three words in the motto. quality, independence, and impact. as a former omb director, those words are music to my ears. i want to take this opportunity to apply that analytical

framework to the issue of health care. as we think about the question of how is the affordable care act working. then i would like to share with you a little bit about how i am thinking of the steps as we go forward here i. i have come to believe strongly in the importance of measurable impact. when it comes to the affordable care act, i think there are three basic measures. access, affordability, and quality. our more people getting covered? access and affordability. are middle-class families shielded from suffocating melba -- medical those? affordability -- medical bills? affordability. when you consider the law through affordability, access and quality, the affordable care act is working.

and families, businesses and taxpayers are better off as a result. four years after president obama signed a law, middle-class families have more security and many who already had insurance have better coverage. if -- fewer americans are insured and come at the same time, we are spending our health care dollars more wisely and we are starting to receive higher-quality care. as we walk through the evidence, it might be helpful to add a little historical context. as a country, we have been wrestling with these questions of how to cover the insured for as long as the brookings institution has been here. as a matter fact, even longer. in 1912, teddy roosevelt's progressive party platform called for universal health care along with priorities like women's suffrage and a national highway system. in the 19 20's, women got the right to vote during in the 1950's, president eisenhower

delivered this nation a highway system. franklinago, president delano roosevelt succeeded increasing social security but was unable to make roberts on the issue of a national healthcare system. 625 is ago, president truman asked congress for a fair deal, a deal that included things like equal rights for all, an increase in the minimum wage, and universal health air. congress passed the minimum wage. 50 years, president johnson signed medicare and medicaid into law. but a few years later, another president told the congress, "copperheads of health insurance is an idea whose time has come in america. there has long been a need to access tory american health care." that president was richard nixon. heftyuntry has paid a

price for inaction on health care even though president ford come up harder, bush, and clinton made this issue a priority. cost spiraled out of control and health care became unaffordable for millions of families and businesses alike. taxpayers felt the effect as well. priced outo weren't of the health-care market, many were locked out because of pre-existing conditions. and many who were fortunate enough to have insurance did not receive a very high quality of care. by the time president obama took the oath of office, our system had broken down to such a degree that we were spending far more as an economy on health care in both gross and per capita terms that all the other developed countries. in 2009, we were spending $2 trillion a year on health care. it was almost 50% more per

person than the next most costly nation. these rising costs took their toll on family budgets. study led byrvard a certain professor with a very bright future, elizabeth warren, found that 62% of personal bankruptcies were due to medical problems. what were we getting for the higher health care costs that we shouldered? fund10, the commonwealth benchmark our health care system against six advanced industrialized nations. in that the quality, access, efficiency, equity and healthy lives. we were dead last. while we were not scoring well in these benchmarks, we are doing a lot better on some measures of quality. by the time the affordable care act was passed, tens of millions of americans were injured. -- were insured.

everyone felt the impact. too many americans relied on the emergency room for the most basic medical care. uninsured children statistically were more likely to have fewer immunizations and go without prescriptions. uninsured adults were more likely to have chronic health conditions, many of which went undiagnosed. the system was not working either for millions of americans who had insurance. went bankruptwho due to medical bills actually had health insurance. just because you happen to have an insurance card, your carrot was not necessarily affordable. if you got charged several thousand dollars for an ambulance ride that was not covered. notng an insurance card did guarantee that you had access to the services you needed. having an insurance card did not mean your doctors were effectively coordinating so that

you wouldn't end up taking tests twice or getting procedures that you may not even need. thanks to the affordable care act, things are changing for the better. let's consider for a moment the evidence on the uninsured where we are making historic progress. the affordable care act addresses affordable, quality, and access. coversat barriers to like pre-existing conditions as well as annual and lifetime caps . it allows young adults to stay on their parents' policy until they were age 26. it created the health insurance marketplace. insurance companies now can provide affordable coverage to consumers through that marketplace. during the last open enrollment, consumers chose from an average of nearly he plans. i have some news for you when it comes to choice and competition. today, we are able to announce aat in 2015, there has been

25% increase in the total number of issuers selling insurance in the marketplace. there is already real evidence these plans are affordable. just last week, the commonwealth fund released a study showing that 70% of americans with marketplace insurance plans feel they can now afford their care. and a majority say their premiums are affordable. it is no surprise therefore that, when folks evaluate the success of the law, the marketplace receives much of that attention. reportsmarch, news suggested it would take something close to a miracle to reach 6 million people. last week, we announced the that 7.3 million people signed up for marketplace plans, paid their premiums, and have access to affordable care. borrow aon people, to

phrase from the vice president, is a big deal. but i am here to tell you i don't think that is the number we should focus on very yesterday, we released another number, a significant number, and that is that 8 million people enrolled in medicaid or chips since the enrollment date, an increase of nearly 14% in terms of the monthly increases before that time. that is a significant number. but again, i don't think that is the most important number we should focus on. the number that is even more important is that, in just one year, we reduce the number of uninsured, adults that are uninsured, by 26%. 2013,nslate that, since 10.3 million adults are no longer uninsured. i firmly believe this is the key measure. we should look at it because it

represents historic progress on something that has eluded our country for over a century. there isn't a business in america that wouldn't be ecstatic with that kind of growth. ultimately, every number tells a story. i want to share with you the story of robert mailer junior, a floridian who was uninsured. roberts coverage, he signed up for the marketplace and it took in effect on january 1. on january 2, robert went to see a growth he had on his tonsils and i'm afraid the diagnosis was bad. it was late stage cancer. after prayer, perseverance, ration and chemotherapy, robert is now cancer free. without health insurance, those treatments that saved his life would be $200,000. under the affordable care act for robert, what we saw is he paid a $2000 deductible, $1500 in co-pays, and what was roberts

monthly premium? $118. i want to read some words to you from robert directly. "i was not in favor of obamacare," he said. tost year, i was not going pay for health insurance and i was quick to take the penalty. i am one of the luckiest people in the world. i'm going to live and work and be productive. so i would submit that roberts story is not a story of the left or the right. it is the story of affordability, access and quality. who it comes to americans already had insurance, i will be straightforward with you. those of us who support the affordable care act haven't done a good job at making the case that this was something that helped those people. if you think about a mom or a dad sitting at the kitchen table working out a family budget, it is a big deal that they are saving money, still getting

better coverage, and have financial security. many middle-class americans have more money in their budgets because their insurance company is now required to spend at least 80% of their premium on their health care. families have saved an average of $80 that they can live on their electric bill or back in their grocery budget. meanwhile, millions of seniors are saving billions of dollars on their prescriptions as we phased out the donut hole. more than a .2 million seniors have saved -- 8.2 million seniors have saved $5 billion. middle-class families are benefiting from the real security that comes from knowing your health care coverage will be there when you need it. to worryno longer have about losing their homes or having their hard-earned savings or anaway by an accident unexpected diagnosis.

there is security in knowing that, if you lose your job, you can purchase market place coverage, even if you have a pre-existing condition and you won't lose your insurance just because you get sick or get caught off or if you need chemotherapy or some life-saving operation. a healthier and more financially secure middle-class is good for business who benefit from a healthy workforce and consumers with more disposable income. the bipartisan policy center reported last week that businesses lose $576 billion each year because of an unhealthy population. as the new law makes our population healthier, we should be able to ring this number down. some of the biggest and most positive impacts that businesses and taxpayers feel from the law are in the area costs. since president obama signed the affordable care act, there is evidence that we have been to the cost ahe