screeria -- nigeria. - and later

the house budget committee works on its 2016 federal budget proposal. president obama signed an executive order that sets a goal to cut the carbon emissions by 40% over the next ten years. white house senior adviser brian dee briefed reporters on the executive action today. later press secretary josh ernest addressed events in the middle east including recent comments from israeli prime minister benjamin netanyahu on a palestinian state. this portion of the briefing

runs about 25 minutes. >> thanks. i'll just be brief about the announcement that the president made today and then happy to take questions, if you've got them. we just returned from the department of energy. the president signed an executive order, which sets a new goal for the federal government to reduce our greenhouse gas emissions by 40% over the next decade. that's in comparison to 2008 levels. the executive order also commits the government to increasing the share of electricity that the federal government consumes from renewable sources by 30%. the commitments today build on goals that this administration set in 2009 around greenhouse gas reduction. those goals are ones that we are well on our way to meeting and the progress that we have made over the last several years gives us confidence that we can

up our ambition and set these new goals today. indeed last jeer the federal government used less energy than we have in the past in any given year over the past four decades. the reason why this is a big deal is the federal government is the single largest consumer of energy in the united states. so our actions have an outside impact. in terms of making this a little more concrete, this is really a triple win for the environment for the economy and for the american taxpayer. just to put it in concrete perspective, the announcement that we made today and commitments made today will reduce gas emissions by 26 million metric tons between now and 2025. that's the equivalent of taking 5.5 million cars off the road.

that also happens to be more cars that are registered in the state of massachusetts, which is my home state. the actions will also save up to $18 billion in taxpayer resources because our agencies will consume less energy or consume it more efficiently. those are resources that can be better deployed for the objectives that the agencies have set out to tackle. and importantly, this is good for the broader economy because the actions that we take encourage the businesses that do business with the federal government as well as their suppliers and others to be more energy efficient and use more clean energy as well. one of the things most interesting about and promising about this announcement was the president after touring the roof at the department of energy and seeing some of the solar panels that are up there joined a roundtable of companies including who's who of the

fortune 100 including ge ibm, all of whom came today to make their own commitments on reducing their own carbon pollution in the coming years. and what they told the president and the conversation that we had was really around the ways in which when the federal government acts as a catalyst for technology or as a catalyst for investment, it enables these companies to push the envelope themselves and to push their supplier networks. we heard a lot about the impact particularly on smaller businesses that are in the supply chains to these companies. and so overall, sitting around the table, we had businesses that represent $45 billion in contracting with the federal government and they explained the leveraging impact of these commitments. this is just another example from our perspective of reenforcing that we don't need to choose between encouraging strong economic growth that's

consistent with middle class economics in which helps create good jobs here in the united states and actions to protect our planet for our kids. it's another example of the president staying on offense, taking actions that he can to try to help encourage this process forward. and this is a signal to the internal community as well that in a year when we are working toward a global agreement on climate change that we're going to continue to do our part and encourage other countries to do so as well. so it was a good announce m, an opportunity here from the private sector for the president to get out and get a little bit of sun on the department of energy roof and with that i'm happy to take any questions you guys have. >> since we have you, i wanted to ask about keystone, which i

know is another area that's now in your portfolio. two questions, the first we heard a more pessimistic tact from the president as he's described the project. is that an indication that he's kind of the date for having to make a decision nears that he's more pessimistic about the project? the second part that i had is a question about the extent to which you see keystone as a possible negotiating chip with congress on a broader climate deal or other countries as you try to broker that. >> so as you know and as you have heard josh say many times, this is an issue that's in the process in the state department and that process is where it is. so i don't have any news on that. i think that the president has

spoken to this issue, but has also been clear as he's doing that that the state department process is moving forward and will conclude. i will say that one of the things that i think the president has reenforced and you've heard in the president's comments on this issue is his view that we all should be setting our sights substantially higher than the debate around this one pipeline and that there is a lot of opportunity to improve the country's infrastructure and help encourage this move toward a clean energy economy if we could engage in that debate. our hope is that we'll be able to do so. >> does that mean that the president would be willing to include keystone as part of a broader infrastructure package. is that kind of -- we hear that

phrase from you guys a lot. is that what it's intended to mean? >> what it means is that there's a process that's gone ongoing and it's going to resolve itself around keystone that we are not getting into or commenting on. and it means that separate from that process, the president thinks it's very important that we have not only a discussion about doing something more aggressive on infrastructure, but congress actually starts moving and showing a commitment to do so. >> can you -- first on your initial announcement. do you know the percentage that the government represents in terms of emissions in the u.s.? and just sort to put that into the context of industry and otherwise? and as a follow-up to keystone, your predecessor chose to recuse himself from advising the president because he has strong view views on the project. do you have strong views on the

project and how are you advising the president? >> to the first question the federal government is a single largest consumer the department of defense is responsible for the nonoperational portion of the department of defense and is responsible for half of the energy consumption. so our capacity to both directly reduce energy use and reduce greenhouse gas emissions is significant, but also as the largest consumer in a market you have market power to help drive innovation and drive change outside of the federal footprint. so i think that the potential for this announcement is best

understood in that context and that's what was striking about having these private sector at the table today was we heard from them loud and clear that if the administration and the federal government sets standards and focuses incentives on certain innovative technologies, it really drives a lot of investment and a lot of change not only in their companies but throughout their supply chains. and with respect to the second part of your question i'm not going to speak to john. from my perspective, this is an issue that's in a separate process and we are focused on that process running its course. >> the length of time that it's been in the state department looking at this has surprised a lot of people.

does the president expect to get the recommendations in this calendar year? >> i have nothing for you on timing. >> so this maybe wouldn't even reach his desk for decision at the end of his term? >> i have nothing f on timing. >> the 40% reduction target is for direct greenhouse gas emissions. does this apply to suppliers and venders and contractors? >> the answer to 40% is it is direct in terms offed consumption of energy by the government. the way in which the government consumes energy is often associated with contract activity because we have contractors who are running a federal facility or in other cases

cases improvements and being paid back through a stream of the energy savings. so the work of the businesses who contract through the federal government is very integral to achieving this goal. there's been a separate issue, which is those companyies that are those contractors making commitments about their own activities and that's what was exciting and new about today's a announcement was that this was ibm and ge coming to the table not only committing as a contractor to help the federal government achieve the 40% goal, but to make commitments within their own corporations to reduce greenhouse gas emissions so you have a company like ibm saying they are going to reduce their own greenhouse gas emissions by 35% by 2025.

part of why they are able to do that is because the innovation and investment that the federal government is driving helps them achieve that objective as well. >> major? >> specifically as you can, can you tell us what's allowed the federal government to get to where it's gotten and what kind of innovative things or lessons you have learned from those successes will drive you to this 40% goal? >> sure, so i think it's a couple things and we have seen these play out over the last several years. the first is we have seen a substantial reduction in the cost of deploying clean energy and some of these energy efficiency technologies. so the department of defense, for example, is moving out and deploying solar on military installations, and they are meeting and exceeding their targets and objectives in part

because of solar has come down more quickly than anticipated. and that has both a cost opportunity for them but also mission oriented opportunities because of the reliability of not having to rely on the electricity grid. it is solar flare season. the second thing is that the data analytics have improved substantially, which matters a lot for energy efficiency. one of the things that the companies talked about today was that by having much more data about how their businesses operate and being able to aggregate that up, they are able to identify where there are gaps in their efficiency chain, why a certain plan is operating much less efficiently than another. see whether there are valves to tighten. the president referred o to this as a fitbit for business, and i

think that aptly characterized it in some of the progress we have made on the data side has allowed us to do that. and then i think the third is innovations in the way we contract. as i was just mentioning, one of the things we're doing now is we set a goal of $4 billion in energy performance contracting, which is the idea that rather than the federal government having to put taxpayer dollars down to upgrade a building we contract with an outside provider who pays the up front cost and then gets repaid out of a stream of the savings that come from reducing the electricity costs. and because the investments here are well proven, that's become ing a model that's working both to encourage more activity, but also bring the private sector in an innovative way. >> paul, i'll give you the last one. >> i've been reading a lot about the military use of biofuels

like algae to power everything from aircraft to this green fleet that the navy keeps talking about. bring us up to date on that and how close are those things to becoming operational? >> so that's a place where i think the armed services and particular the navy see substantial promise. a lot of the work that is going into that area right now is in the r&d space, and so both in the services and the defense department but also at usda and d.o.e. investing in applied research to better understand the potential and also the mission impacts of relying on these types of fuels. so i think our view on that is that there's real promise and real opportunity. it's going to require us to maintain a consistent program of r&d investment, but i think that

we still see it as an area of real promise going forward. >> when will the navy and air force be able to wean themselves off these conventional fossil fuels that we've been hearing about for quite some time. >> i can't tell you with precision, but. i can tell you that the -- that the opportunities are increasingly becoming cost effective and that as you think about where the military is deployed around the world and the circumstances that they are put in the ability to have alternative sources both of electricity where you're not reliant on the grid but also fuels is increasingly important from a mission standpoint as well as a cost standpoint. so we're quite optimistic that we're going to be able to push the envelope in those spaces then that's part of the furry behind the case that we're making today. >> thank you brian.

>> thanks, guys. >> now back to our regularly scheduled programming. i know there's a full at 2:00 in the oval so if there are some of you that have responsibilities, i won't be offended if you sneak out the back. >> the islamic state claimed responsibility for yesterday's attacks in tunisia. has the u.s. been able to verify those claims? >> let me start by saying we extend our deepest sympathies in toou nearby ya and condemn in the strongest terms this terrorist attack, which tooked lives of innocent tunisiaens and tourists visiting from other countries. the president's adviser today spoke to her counterpart who is the minister of interior. she made that call to express condolences for yesterday's attack, to offer u.s. support and assistance and pledge solidarity with tunisia in the

face of terrorist violence. the united states is justifiably proud of the robust cooperation that we have with tunisia on counterterrorism and continue to stand with our partners against terrorist violence. we have seen reports that isil has claimed responsibility for these attacks. the tactics that we saw at the museum would be entirely consistent with tactics that isil has previously used that show a blatant disregard and even a brutality for innocent civilians. >> tunisia has been held up as a country that perhaps came out of the arab spring as more of a success than some of the other country countries in the region. if this is the islamic state launching this kind of attack, what does that say about tunisia's stability, its ability to fend off islamic extremism. >> i'll say a couple things.

the first is we know there is a long border that tunisia has with libya which is a rather unable place right now. and that is why the security cooperation that i referred to earlier that exists between tunisia and the united states is so important. that was the substance of the call today and i'm confident that we'll continue to be in touch with the tunisiaens in the weeks and months ahead as we talk about efforts that we can make to supplement their efforts to provide for security in their country. they obviously live in a volatile and even dangerous part of the world right now and we certainly are interested in doing what we can to try to support their government and people as they confront this threat. >> prime minister benjamin netanyahu seems to be backing away from his comments during his campaign about not allowing a palestinian state while he's in charge. he says now that he would allow that if the circumstances

change. yesterday officials here and at the state department were saying you took him at his word that there would be policy ramifications for what he said. based on what he said today, do you think those comments were just a campaign pledge that he always intended to backtrack on? do you take him at his word today that he would allow for palestinian statehood? >> i did have an opportunity to read quickly a transcript of the interview he did with nbc today. what is apparent is that in the con context of the campaign and while he was the sitting prime minister of israel, he walked back from commitments that israel had previously made to a two-state solution. now to be clear the united states for more than a decade under both democratic and republican presidents has strongly supported this approach to try to address the conflict between the palestinian people and our allies in israel.

and it's worth pointing out that this is a policy that was supported and in place under both democratic and republican presidents. it is also a policy that was and has on more than one occasion been unanimously supported by democrats and republicans in congress congress. as recently as december of last year, the united states house of representatives on a voice vote passed the strategic partnership act, in which the pursuit of a two-state solution was identified as our goal to resolve this conflict. so it is as we mentioned yesterday, cause for the united states to evaluate what our path is forward given the prime minister's comments. so we'll have to sort of see

what sort of policy and priorities the prime minister chooses, but we certainly are in a position to evaluate our approach to these issues given that the prime minister essentially backed away from commitments that israel has previously made to this effort. >> you standby the need to reevaluate, to look at the options despite what he said today? you don't think based on his flip back that what he said previously was a campaign promise to get votes? >> i mean, the motivation of the prime minister and the comments that he made even just earlier this week is something that you'll have to take up with him. what is clear is the united states has been clear about our policy for some time. it also merits pointing out that we pursue this policy not just because it's convenient. in fact, it's not convenient it's rather difficult as been chronicled by all of you in this

room. but we have been in pursuit of this goal because we believe it's clearly in the best interests of our closest ally in the region. we believe it's in the interest of israel to establish a jewish and democratic state of israel living side by side in peace and security with a sovereign palestinian state. that's a way for us to diffuse tensions in the region. it would reduce tensions in the region. it would serve the national security interests of the united states, but it's the best way for us to provide and protect the israeli people. again, it doesn't remove all threats, but it certainly is a way for us to resolve what is a prominent point of contention in this region of the world. and the comments from prime minister benjamin netanyahu to walk away from that commitment just this week has prompt eded the united states to evaluate our position on these matters going forward. >> jeff?

>> can you put some flesh on the bone on what that means when you say you're evaluating the position? what does that mean exactly? >> well, i would start by saying that this commitment to a two-state solution has been the bedrock of a lot of u.s. policy toward this region of the world. in terms of making decisions at the united nations and in other multilateral forum, the united states has repeatedly intervened in some of those debates at the u.n. and other places by saying, the best way for us to solve this problem is for us to get the two parties to sit down at the negotiating table, resolve their differences so this two-state solution can be realized. so that principle is one that we have applied in a variety of

settings to serve as the basis for decisions that have benefitted israel and that have protected israel from isolation in the international community. but now the prime minister of israel says earlier this weekdays before an election that this is a principle that he no longer subscribes to and that his nation no longer subscribes to. that means the united states needs to rethink our approach. that steps that this principle has been the foundation of a number of policy decisions that have been made here. now that that foundation has been eroded it means that our policy decisions need to be reconsidered. that's what we will do. >> that sounds like a statement that israel should no longer expect u.s. protection in the u.n.? in the u.n. which is what you specifically mentioned. >> that's one example in which this policy decision has served

as the basis for a substantial number of policy decisions. i'm not suggesting that any policy decisions have been made at this point. i don't want to leave you with that impression. in fact, what i have tried to say is that understandably it has promised us to reevaluate the strategy we'll put in place to make those decisions. that will be something that we will do moving forward. also at the white house today, president obama met with prince charles who's in town with camilla for a four-day good will tour. here's a look. >> it's always nice coming back. everybody is always so friend lily. >> i think it's fair to say the american people are quite fond of the royal family. they like them much. better than their own politics. >> i'll tell you what was nice.

i was there 45 years ago. it was fantastic. it's very special. >> it's beautiful. thank you, everybody. thank you, everybody. >> thank you. >> thank you, everybody. on the next washington journal, "the wall street journal" discusses wednesday's news conference at the federal reserve and what could happen if interest rates rise. after that ron kessler talks about his book and current reform proposals for the secret service. plus we'll be taking your phone calls, facebook comments and tweets all on washington journal, live at 7:00 a.m. eastern on c-span.

our road to the white house coverage continues friday in iowa with remarks from potential presidential candidate former governor martin o'malley. live coverage at 9:00 eastern on c-span. this weekend the c-span cities tour has partnered with media come to learn about the history life of columbus, georgia. >> right here inside the museum is remains of a confederate ironclad the css jackson. this was built here in columbus during the war. those oval shapes that you see are actually the gun ports of the jackson. and the jackson is armed with six rifles. the particular brook rifle that we're firing today is one of the guns built specifically for the

jackson. it was cast at the selma naval works in selma, alabama and completed in january of 1865. the real claim to fame is directly connected to the fact that there are only four ironclads from the civil war that we can study right now. and the jackson is right here and this is why this facility is here. it's first and foremost to tell the story of this particular ironclad and to show people that there are more than just one or two ironclads, there were many. >> watch all of our events from columbus saturday at noon eastern on c-span 2's book tv and sunday afternoon on "american history tv" on c-span 3. today mark ss the 36th anniversary of the u.s. house of representatives first being televised. c-span was there when then representative al gore made that

first speech. you can see his comments online at c-span.org. c-span, created by the cable tv industry, brought to you as a public service by your local cable or satellite provider. the house budget committee passed its 2016 budget proposal on a party line vote of 22-13. the approval followed yesterday's day-long markup session where republican members couldn't come to an agreement on a defense spending amendment. the budget proposal by committee chair tom price would cut $5.5 trillion in projected spending over the next decade and balance the budget. the house republican budget is expected to come to the house floor for debate next week. we'll show you now part of yesterday's markup session leading up to the recess. this runs about five hours.

>> this markup will resume. next on the list of amendments we have amendment number four from the gentle lady and the staff will distribute. and the clerk will designate it and the staff will distribute. >> relating to medicare. >> recognized for six minutes. >> thank you, mr. chairman. the population of the united states continues to be on the

verge of dramatic demographic shifts. since 2002 the number of americans age 65 and older has increased by 21% and the ageing of the baby boom generation will only accelerate this growth. only 15 years older americans will account for 20% of the u.s. population up from 13% today. by 2050 the population of older americans is expected to double by over 80 million people. by 2050 the population of americans age 85 and over is estimated to more than triple from 5.5 million in 2010 to 19 million in 2050. about 71% of these adults have a disability or will need assistance with at least one activity of daily living. so they can't feed themselves, dress themselves, or bathe themselves. as a former secretary of the new mexico department of ageing and long-term services, i understand the difficulties that older

americans face. they often face a unique set of risks and challenges, including affordable housing access to social services and transportation. but chronic health issues and health care costs may be the biggest threats to the economic security of older americans. and poverty aggravates everything because the poorer you are, the sicker you are. over the last 50 years, medicare has helped countless americans and their families be independent and financially secure including an estimated 55 million americans who are receive receiving benefits today. in fact, since medicare was signed into law poverty among older americans has dropped from 35% the year i was born in 1959 to 9% today. however, medicare is not perfect. although medicare covers nearly all adults age 65 and older, premiums deductibles, co-pays and significant holes in benefits have left many

americans with higher expenses. between 2010 and 2040 annual out of pocket health costs for 65 and older will more than double in inflation adjusted dollars. but medicare reforms under the affordable care act have helped control costs increase benefits and extend medicare solvency. since the aca was enacted, premiums for medicare have largely unchanged since 2010. seniors have saved more than $15 billion on their u prescription drugs and the life of the medicare trust fund has been extended by 13 years. our path forward should build upon these successes and we should strengthen medicare, improve essential benefits and contain costs. but this republican budget moves us back ward. it turns medicare into a voucher program and puts insurance companies ahead of seniors. it shifts more costs to beneficiaries, it does nothing

to contain health care spending and it forces seniors to either pay more or skimp out on necessary medical care. based on what we know from nonpartisan congressional budget office analysis, there's no evidence that a voucher plan will reduce medicare spending without significantly increasing costs for beneficiaries. my amendment would preserve the medicare guarantee and it protects benefits for over 55 million americans. it may be convenient and frankly easy to shift costs on to seniors on a piece of paper. the hard thing to do is to strengthen medicare to improve its essential benefits and to help older americans live with the economic security and dignity that they deserve. this is what we should be doing. mr. chairman, i yield back the balance of my time. >> i now recognize for seven minutes the gentle lady from tennessee in opposition. >> thank you mr. chairman.

i want to just set some things straight here to make sure that we have the actual facts on the table. so first of all let's take a look at what the cvo has told us about the medicare program. they tell us in their reports that it will be bankrupt by 2030 unless there are significant reforms that are made to the program. second, let's also take a look at a failing trust fund and look at what the affordable care act and the president's rating of medicare to $700 billion out of a fund that was already failing that is only worsened the problem of a fund that is not sustainable. in addition to that, as a proponent of this amendment has alluded to, there are 10,000 baby boomers retiring every day that are going to be coming into this program. so we see that a fund that is already failing is going to have a significant number of new

folks coming into it. so let's take a look at what the republicans propose. first of all, i don't understand why my colleagues on the other side of the aisle continue to call this a voucher program. a voucher program is where you give someone money, and they take the money and purchase the product. this is not a voucher program. this is a premium support program much like what we had in the workforce for those employers who provide insurance. so our plan would allow the recipients choice, which is a really good thing to allow them to be able to choose a program that best suits their need. it then the government is a guaranteed program would then take that subsidy, that payment and give it to the plan. it's very much like medicare part d, which is working. so we know that there is a

program out there that already is similar to what we're proposing and it has worked and that tells us that this program would also work. i also want to correct something to say we're going to lose medicare as we know it. our plan actually provides for traditional fee for service and remains an option forever. and i don't know about you, but seniors i talk to don't want us to tell them what's best for them. they want to choose so they will have the choice between a premium support program or stay in fee for service they make that decision. we know that this plan has been scored and it does show the latest report from cbo shows that premium support can actually produce savings to the seniors and also to the federal government. so we're talking about a plan that goes defunct in 2030 and we're looking at real reform we know by the congressional budget office scoring this that this is

a program that actually can work. it does slow the medicare spending and it transitions to a new medicare program for future generations. so those that are currently in and those who come to the future have that choice. we also on our program make sure that those who need the most help get that help. so those that are at the lower income will get more support with their premium assistance and those at a higher income will get less at a significantly higher income may get nothing at all to help them because they can afford that themselves. again, it gives our seniors more freedom, it allows competition to come into the market and any time there's competition, it drives down the cost. that's something that occurs in other programs and it will work in this program as well. the real threat, the real threat to medicare is to guarantee the

status quo. we know that by all of the reports that are done by not doing anything, that is really the largest threat. and doing nothing or worse trying to ration the care represents the greatest threat to our seniors' health security. so i would urge my colleagues to look at the true facts of this and urge them to vote no on this amendment amendment. mr. chairman, i yield back. >> gentle lady yields back. the gentleman from arkansas wish to speak on this amendment? >> thank you mr. chairman. i'd like to compliment the gentle lady from tennessee for such an excellent job she did explaining what is actually in our budget proposal for medicare and how we are very much concerned about the future of medicare. my parents are on medicare we all know people that use medicare. we want to preserve it.

as was just stated it was due to go bankrupt in o 2030. we have to implement changes now or this is going to get worse as we move down the road. i will also reiterate it's not a voucher program. if people choose to stay on the fee for service program, by all means they can stay on the fee for service program. why are we afraid to give them the choice and the option to choose something different. something that's proven to work, something that's projected to save money something that will provide more options for seniors, which means more market competition, which means lower prices and better quality. this is a great opportunity that we have to implement the ideas that are in this budget proposal and i do hope that everyone will give this a lot of consideration, a lot of positive consideration that we will adopt this. thank you, mr. chairman, i yield

back my time. >> recognized for one minute to close. >> thank you, mr. chairman. i want to clarify a couple things. one, as we talk about what cbo scoring is and isn't i think we have a tendency to mix apples and oranges. cbo is also quite clearly scored that in the voucher program which is defined as a premium assistance, that's a voucher, and if you look at that definition, you'll see that clearly defined that they will rise by 100% in 2020. you can stay in the fee for service program but you pay more. what this is now is not a guarantee of a medicare program it's a guarantee for insurance companies who will continue to ration care and what happens to this population if they don't have access to the health care services and their families that they need, not only does it effect their economic security and their poverty rates will go

up, but in fact, it will cause health care cost shifts in emergency rooms and hospitals to go up. so this isn't a cost savings at all in the health care system. the reality is that the $700 billion we referred to in the affordable care act took administrative costs and gave it back to beneficiaries. those are the reforms we should be talking about. >> time has expired. all in favor will say aye. the noes have it. >> recorded vote is requested. the clerk will call the role. >> mr. garrett. mr. cole no. mr. mcclin tok, no. ms. black no.

ms. woodall. mr. rice, no. mr. sanford no. mr. brat, no. mr. blum, no. mr. palmer, no. mr. westerman no. mr. buchanan no. mr. van hollen, aye. mr. pascrell?

mr. ryan aye. ms. moore, aye. ms. caster, aye. ms. lee, >> aye. >> miss grisham? >> aye. >> miss single? >> aye. >> mr. lou? >> aye. >> mr. norcross? >> aye. >> mr. molten? mr. molten? mr. garrett? >> no. >> mr. woodall? >> no. >> mr. susman? mr. susman? mr. mooney? mr. mooney? mr. passquell mr. mcdermott? mr. chairman? >> no. >> mr. chairman, no.

>> all members voted? any member wish to change their vote? if not, the clerk will report the tally. >> mr. chairman on that vote, the ayes are 11 and nos are 20. >> the nos have it. and the amendment is not agreed to. the next amendment is amendment number 5. the clerk will designate the amendment and the staff will distribute the copies of the amendment. >> amendment number 5 offered by miss engel related to medicaid. >> the gentle lady is recognized for six minutes. >> thank you, mr. chairman. i am offering a simple amendment that would reject the $913 billion in custom medicaid contained in the budget resolution we're considering today. my amendment will ensure that seniors, persons with disabilities u and working families do not lose access to

critical health care and long-term care services by reversing the cuts to the base medicaid program contained in this resolution. medicaid is the work horse of our health care system. it's a critical part of the safety net that provides essential health care and long-term care services to 69 million americans. it is not the most glamorous program, but it has been very successful in supporting the most vulnerable among us. medicaid beneficiaries include poor children and their families, someone with cerebral palsy or multiple sclerosis or autism, or a senior who needs help getting dressed in the morning and feeding themselves. further, the medicaid program provides health insurance for one in three children in america. these are exactly the people that would be damaged by these drastic cuts to the medicaid program. turning medicaid into a block

grant as this budget proposes is not the answer. it does nothing to reduce health care costs but would inevitably shift burdens to the states, and would lead to a dramatic cut in health care support for the 69 million americans who depend on medicaid. imposing a serious financial hardship on them and their families. in fact, the cbo analyzed a similar proposal from then chairman ryan's budget and they concluded that states would likely have to make significant cuts to their programs as adopted. and i quote cutbacks might involve reduced eligibility for medicaid and c.h.i.p., coverage of fewer services, lower payments to providers, or increased costs by beneficiary. all of which would reduce access to care. is this really what the american people are asking for?

cbo has also estimated of turning medicaid into a block grant would result in states dropping between 14 million and 20 million people from medicaid by the tenth year. this is right when we've seen the -- is this right when we've seen the uninsured rate drop since the implementation of the affordable care act? we cannot afford to take a step backward right when we're beginning to make so much progress. we cannot forget the impact the medicaid cuts will have on seniors. seniors and persons with disabilities make up almost one-quarter of the medicaid population, and accounts for two-thirds of the spending. medicaid is the largest payer for long-term care services and support in the united states which most americans will need at some point in their lives. medicaid pays for nearly half of all long-term care in this

country. when this program was absolutely not designed for that purpose and that's a different issue we need to talk about, but here let's protect those that it's protecting right now. we need a real long-term care system in this country, and you'll hear more from them later. but in the meantime we should not be cutting medicaid which provides such essential services to so many who need it. >> i'm pleased to have the gentle lady from tennessee be recognized for seven minutes. miss blackburn. >> >>. >> my mistake i recognize the gentleman from indiana in opposition. ten minutes in opposition. >> thank you. i hope i'm not doing the vice chairman's job, too. or maybe i do.

ive appreciate the chairman recognizing me. and i appreciate again this issue of being brought to the forefront. i want to address some of the things that have been said so far far, and make sure everyone understands that what our budget does, what the flexibility in it does for medicaid is strengthen and preserve it for the future. to make sure that those who really and truly need the care can get it. because right now, that's not the case. as the gentle woman alluded to. the current system, the current program is broken. and that's an understatement. i want to be clear that this budget that we're proposing intends to spend $3.33 trillion over the next decade on medicaid and other health programs. medicaid spending increases over the ten-year window that this

budget assumes. according to cbo, current medicaid program the gentle lady is talking about is growing at an annual average rate of 5% to 6% while the economy only grows at 2.3%. this budget proposes simply to slow the growth in spending and gives states the flexibility so that regardless of the slow growth in spending they can still meet the needs of those citizens, those constituents who truly need the care. spending growth at the rate that i just described is simply unsustainable. if it's unsustainable, by definition it's ultimately not going to be available to anyone. but the problem with medicaid just isn't that it spends too much it's not giving patients the access to the health care that they need. it was mentioned repeatedly of access that people need. time and again we hear reports of medicaid patients unable to find a doctor who will see them.

patients on medicaid often have worse health outcomes than those who have no insurance shall at all. and the doctors nurses and hospitals who wanted to treat these patients simply cannot afford medicaid's below-cost reimbursement rates, which can be 70% of what private insurance would pay. for states and taxpayers, the current medicaid system means massive spending and an ever-larger deficit. states are now spending more on this program than they are on education. something has to be done. when something is this broke, the wrong answer is to throw -- is to throw more money at it, expecting a different result. that's analogous to insanity. medicaid has one of the highest estimated improper payment rates than any program. the total spending on medicaid, the state and federal shares is expected to total $578 billion. over the next ten years cbo

expects total federal spending on medicaid to $4.6 trillion. the medicaid program is not expansions, like obamacare in fact proposes. the answer instead is to put states back in charge of their own medicaid programs to fit the unique needs of their population. there are numerous examples already across the nation where states have used existing albeit limited flexibility found in the current medicaid program's waiver program that allowed them to achieve the results without increasing their budgets for their outlays for the program. look at rhode island. hardly a conservative state. our plan gives the flexibility needed for states so that they can do, frankly, what this federal government has failed to do. chiefly among them three things. let the government closest to the people determine who actually needs the help that

medicaid provides. let's let the states determine what that kind of help looks like. and finally, how that help is disbursed and received. i trust the states. i trust our local officials and our local community leaders to come up with a system that they know is best for their community. with that, i'm pleased to yield two minutes to the gentleman from michigan, mr. molenar. >> thank you very much. and i also want to speak to the issue of flexibility. because as a former state legislator, one of the things we observed in our state was the opportunity to innovate. when the medicaid expansion went into effect in michigan, there was a tremendous opportunity to improve the lifestyles choices, and incentivize healthy behaviors. now, the state had to go to the federal government for a waiver

on that. what we're doing here is we're saying let's give states the ultimate flexibility and to innovate according to our -- to their unique characteristics. in michigan, in the year 2000, we had between 1 and 8 and 1 in 9 michigan residents on medicaid. now we have 1 in 4 on medicaid. as we notice across the country, over 30% of physicians are not even accepting new medicaid patients. and this is at the same time when federal reimbursement rates for medicaid are being cut across the country. so it is not a sustainable program. i think what this does is puts us in a far better path to innovate and to encourage healthy behaviors, and get on a more sustainable path for the future. and i yield back. >> i thank the gentleman. i yield the remainder of the

time, mr. westmoreland. mr. westerman, excuse me. >> thank you. i will be brief. and just reiterate some of the things that have already said. in my state, not only do we -- we have not a fourth of the population getting medicaid services, but a third of the population getting medicaid services. and 20% of them are able-bodied working age adults. in my state medicaid not only is more than k-12 education it's more than k-12 education higher education, and corrections combined. it is the single largest expenditure in our state by far. i was told when i got to washington, d.c., that 3% or 4% growth is considered a cut. now i realize that that's the way things are perceived up here. this budget actually makes medicaid sustainable over the future. i yield back. >> time has expired.

miss engel is recognized for one minute to close. >> thank you, mr. chairman. i would actually -- i have great respect for all of the gentlemen, especially the gentleman from michigan. we worked together on many things. i tilly would say that the flexibility he talked about is exactly what does exist in this program. and you're all talking about the great amount of money being spent. it is because there is so much need out there. and we have a real crisis in this country. the fact of the matter is that every state in the nation has at least one medicaid waiver. and there are over 350 waivers nationwide. states can already decide who they cover, what benefits they provide, and how they deliver health care services. if states want to experiment with different models, they've got the ability to do it. you all say that people can't have good access to doctors. but through it people don't want to take them. but numerous studies have shown medicaid has improved access to primary care and preventive

services. the landmark medicaid study in oregon found that people with medicaid were 40% likely to have suffered a decline in their -- >> the lady's time has expired. the question is on agreeing to the amendment by miss engel. the nos have it. >> i would ask for a roll call vote. >> the clerk will call the roll. >> mr. akita? >> no. >> mr. garrett? mr. garrett? mr. cole? >> no. >> mr. mcclintock? >> no. >> miss black? >> no. >> mr. woodall? mr. woodall? miss blackburn? miss blackburn? >> no. >> miss hartsler? >> no. >> mr. rice? >> no.

>> mr. susman? mr. susman? mr. stanford? >> no. >> mr. womack? >> no. >> mr. brattt? >> no. >> mr. blunt? >> no. >> mr. mooney? mr. mooney? mr. grossman? >> no. >> mr. palmer? >> no. >> mr. mullnar? >> no. >> mr. westerman? >> no. >> mr. van hollen? >> aye. >> mr. yarman? >> aye. >> mr. passquell? >> aye. >> mr. ryan? >> aye. >> miss moore? >> aye. >> miss caster?

>> aye. >> mr. mcdermott? mr. mcdermott? miss lee? >> aye. >> mr. pockan? >> aye. >> miss lou hanger sham? >> aye. >> mr. lou? >> aye. >> mr. norcross. >> aye. >> mr. molten? mr. molten? mr. garrett? >> no. >> mr. hughes? >> no. >> mr. woodall? >> no. >> mr. buchanan? >> no. >> mr. chairman? >> no. >> have all members voted?

any member wish to change their vote? if not the clerk will report the tally. >> mr. chairman, on that vote, the ayes are 12 and nos are 20. >> nos have it. the amendment is not agreed to. the chair will make a few announcement. now, the chair intends to continue through the remainder of the markup without stopping. we will have a bipartisan meal in the lunch -- well, it will be supper in the room. and we ask members to partake during the time when they're not participating in debate but to be present for all votes. and i apologize for the break that we had before but i think we can finish in good season if we keep rolling through this. at this point we have amendment number 6 up. the staff will distribute copies. >> amendment number 6 offered by mr. passquell relating to health care coverage.

>> mr. passquell is recognized for six minutes. >> a moment? a minute? well, i want to thank the gentleman from new jersey for offering this important amendment to protect tax credits to keep health coverage affordable for american families. you're always looking out for hard working families mr. pass carell, so thank you. the offeredable care act is working. it's working for americans, and now republicans want to throw another wrench into the mix, and eliminate tax credits for families that have been able to buy health coverage in the exchanges. this caught my eye, especially because florida families will be the most impacted if the tax credits go away. despite the political opposition, at home in the state of florida, we have 1.6 million floridians sign up in the exchange. they took the personal responsibility and signed up. and many with the help of the tax credits are finding it very

affordable. the average premium with tax credits is $82 per month premium. meaning life-and-death, means better quality of life for their families. now i really oppose what the republicans are doing in their budget, and that is to attempt to pull the rug out from under them again by saying, we're going to repeal the affordable care act. and in doing so eliminate their tax credit. let me say something about nicole peterson a single mother in my district who got divorced in the past year. you're going to hurt her, and her family. she was able to get a plan for herself and her three daughters. her monthly premium was $468. she received a credit of $150. what she said is it's phenomenal for our family. it enables me not only to afford the policy it helps me stay healthy, not to have the fear of anytime i get sick do i go to the doctor or buy groceries this week. i yield back. >> thank you. from the day the affordable care

act became law my friends on the other side of the aisle have done everything in their power to repeal it. this is very unlike what happens when we passed plan b, the prescription drug plan. we lost you guys won that vote. we went back to our districts and made it work. and then we made a commitment. if we ever become a majority, we would fill in the doughnut hole. that is you don't pay premiums, you get no benefits between $2,300 and $5,200. we were very different, mr. chairman, than you were. i mean, yes. the house has already voted to repeal the aca. we shouldn't be surprised that your budget once again assumes the aca is appealed. however, today's markup gives another opportunity to put into real terms exactly what the repeal means. mr. chairman, my amendment would restore the aca's premium tax

credits which help millions of americans offset the cost of their health care premiums. why are we against this credit when we want to talk about and defend the credit for the 1% to those corporations in this country. i want you to be arguing on behalf of the american people. this year 8 million people received premium tax credit. next year, 15 million will receive these tax credits, according to the congressional budget office. my home state of new jersey 254,316 people receive a tax credit worth an average of $306 per month. the budget is a tax hike on every single one of them. repealing the aca taking away these tax credits for millions of middle class americans will only reverse the progress that this law has made in affordable health insurance. i want you to stand in front of the people in your state and say you no longer have that tax credit, and we're going to raise

your tax beside. and i hope you'll vote for me. the united states uninsured rate has continued to decline, reaching a low of 12.#9%. the uninsured working age adults has dropped from 20.3% to 13.2 % since october of 2013. i think that's progress. now, maybe you don't consider that progress. i consider that progress. when the aca marketplaces opened their business, a 35% drop in the uninsured rate. without the aca, there would be a 17 million more uninsured people this year and 23 more uninsured people next year. and what is your plan to help those people? tell me. america's waiting to hear this. we're waiting. we're waiting. i said this afternoon, the curtain's coming down after two days. this curtain doesn't even go up, for crying out loud. you don't have a plan.

many were paying for plans that didn't provide them for coverage they needed. americans were denied coverage for preexisting conditions. and insurance companies arbitrarily increased their premiums to the point they couldn't afford insurance. people were charged more because insurance companies decided they were too old too sick, or even the wrong gender. wow. what do you know about that. you just discovered that? yet, what was my republican friends' answer? repeal, repeal, repeal. drill, drill, drill. repeal, repeal, repeal. you think that if any republican colleagues cobbled together all of the time they spent trying to undermine the aca, they should have been able to come up with an alternative for this law. they can't find anything good to say about it. but again the budget provides no alternative.

we'll get to that. >> the gentleman's time is expired. >> i happily yield back to you. >> i appreciate that. now i think i'm correct that the gentle lady from tennessee, miss blackburn, is recognized for seven minutes. >> mr. chairman, i appreciate that. and to my friend across the way there, i hope that mr. passkarel would come to me to tennessee. i would love to have him out to hear of the real-life stories of how this is adversely impacting people, individuals. there is a lady down in my district, an accountant. she was in a plan that was deemed unacceptable by obamacare. you know what her insurance cost went up per month? 700%. now, she has been adversely

impacted. you could also go with me to wayne county. and you could talk to employers who will tell you that the impacts of obamacare are very, very real to them. they see them every single day and they want this off the books. you ask what is our plan? let me tell you something. last year the energy and commerce, we had 162 different bills. we had 162 different -- no sir i will not yield to you. no, sir, i will not. we had 162 different bills that were there as replacement bills for obamacare. some great examples across state line purchase of insurance to open up the market to get costs down. guess what happened? cbo said 13 million people would be in there because costs are lower. when it comes to this issue of subsidies, and i will say this, i have to say i'm glad you're

looking at what will happen after king versus burwell, and that decision in the courts. because you know that day is coming. and you know that you are going to see a ruling that will probably not be in your favor. so i give you credit for coming to the table with something. because we've got 36 states that didn't set up their own state-run exchanges. and, you know, you've got to look at what's going to happen. now, when you talk about the subsidies, let me tell you, this is a letter that i got from secretary burwell. and i think this is why insurance is too expensive to afford, and why we do need to get this off the books. while we are confident in our position, a decision against the administration in the king case would cause massive damage. first, millions of people would lose their health insurance subsidies, and therefore, would no longer be able to afford health insurance.

we've got a product too expensive to afford. this is why we need to work together to get the costs of not only health insurance but the delivery of health care, get the cost down and improve the access. that should be a goal that we share. second, without tax subsidies healthy individuals would be far less likely to purchase health insurance, leaving a disproportionate number of sick individuals in the individual insurance marketplace. now, this is from the secretary talking about the plan, and you've got to have the subsidies, because the product is too expensive to afford. so, therefore, i think it behooves us to realize that what we've got here is the president's law made health insurance more costly by requiring plans to include washington, d.c. determined

benefits in levels of coverage, the health insurance exchange subsidies are going to cost taxpayers $1.1 trillion over the next ten years. it is going to adversely impact the taxpayer. because they're paying more. and the subsidies cost a lot more than that however, because americans lose their freedom of choice in the health coverage that they want to purchase. i at this time want to yield to miss blackburn from tennessee for her comments. >> i thank my colleague for yielding. i want to talk about what i'm hearing back in my district. this past saturday, i had a birthday party for my grandmother. one of the grandmothers were there. and she came up to me and said you know this really hasn't helped me at all. because even though my premiums are partially paid for me and she is one of those lower income

single ladies that's working hard, in a factory, where they don't provide insurance, but she said this is what's happening for me. the premiums are high, but i do get some assistance with that. but here's the real problem my co-pays are so high that i can't afford to pay my co-pays in order to be able to get the services that i need. she has high blood pressure and she has diabetes. she cannot afford her medications because the co-pays are so high on getting her medications. also, what i'm hearing throughout my district consistently, consistently, is the fact that i cast use the same doctor that i used to use the hospital that i used to go to does not accept this form of insurance, even though it's blue cross and blue shield. i thought i was getting into a really good program. and then there are other providers, such as maybe their physical therapist they can no longer use that they have that relationship with. i'd like to be able to say that this was the answer.

but it's not the answer. the answer is actually having a more patient-centered program where it's not a washington down program, but a program that comes from the communities and up. where there is affordability, and accessibility and quality and innovation and choice. right now, there's not choice. there's a limited number of programs in each one of these states that people can even choose from. their doctor is not on there their hospital is not on there. what good is it to have insurance that you're paying out of pocket but the insurance is not providing you what you need. you can't get your medicines, you can't use your doctor, you can't use the hospital you're accustomed to. despite all this the reports are saying even though we do have maybe 8 million people 16 million in another report, but that's adding in folks that already, like the students who are in school that are on their parents' plan, so the number is

a little foggy, but despite that the reports are saying we're still going to have 30 million people that are uninsured. we can do better. we can do better by allowing this not to be a washington down program. but being one where we put the patients and their families and their doctors in charge. mr. chairman, i yield back. >> gentle lady yields back. the gentleman from new jersey is recognized for one minute to close. >> thank you. i'm waiting anxiously to hear the great plan in the sky. i'm waiting for what the alternative is. my colleagues for their remarks and recognition, the vast importance of the affordable care act and the premium tax credits that the law provides. the reality is mr. chairman that the republican budget would take away affordable health insurance for millions of americans, and drastically increase the number of people without health insurance. and there is no plan to fix this. you cite sir, several cases. i'm talking about the millions and millions who have insurance now that didn't have it before.

everybody's important. don't get me wrong. this is not a perfect thing. we never said aca was the perfect plan. like you said plan "b" was a perfect plan. of course, now it's closer to perfection because we changed it. until last year, republican efforts to repeal the aca were in many respects impactful only in the abstract. today, the major coverage expansion provision have gone into effect. meaning that -- >> the gentleman's time has -- >> can i finish the sentence please? >> how many clauses? >> only 20 more words. thank you, mr. chairman. you've been most gracious. now have health insurance because of this law. and many of them have premium tax credits that help them afford their insurance. i hope you'll vote for this amendment. it makes sense. >> the gentleman's time has expired. i hope that my charity is not a

bad omen for the future for activity. the gentleman's time has expired. the question is on the amendment offered. aye? those opposed no? the nos have it. the clerk will call the roll. >> mr. akita? mr. akita? mr. garrett? mr. garrett? >> no. >> gentleman needs to be present. >> i'm right here. >> mr. garrett? >> no. >> mr. dolart? >> no. >> mr. cole? >> no. >> mr. mcclintock? >> no. >> miss black? >> no. >> mr. woodall? >> no. >> miss blackburn?

>> no. >> miss hartsler? >> no. >> mr. rice? >> no. >> mr. stutzman? mr. stutzman? mr. sanford? >> no. >> mr. womack? >> no. >> mr. bratt? >> no. >> mr. blum? >> no. >> mr. mooney? >> no. >> mr. grossman? >> no. >> mr. palmer? >> no. >> mr. mullnar? >> no. >> mr. westerman? >> no. >> mr. buchanan? >> no. >> mr. van hollen? >> aye. >> mr. yarman?

>> aye. >> mr. passkarel? >> aye. >> mr. ryan? >> aye. >> miss moore? >> aye. >> miss caster? >> aye. >> mr. mcdermott? mr. mcdermott? miss lee? >> aye. >> mr. pockan? >> aye. >> miss lou han grisham? >> aye. >> miss engel? >> aye. >> mr. lou? >> aye. >> mr. norcross? >> aye. >> mr. molten? >> aye. >> mr. akilta? >> no. >> mr. stutzman? >> no. >> mr. chairman? >> no. >> mr. chairman, no.

>> have all members voted? any member wish to change their vote? the clerk will report the tally. >> mr. chairman, on that vote, the ayes are 13 and the nos are 22. >> the nos have it. the amendment is not agreed to. the next amendment is number 7, and the clerk will designate the amendment, and the staff will distribute copies. >> amendment number 7 offered by miss moore to the settlement al nutritional assistance program. >> miss moore is recognized for seven minutes. >> thank you so much, mr. chairman. i would yield time -- >> excuse me. i apologize. six minutes and one minute to close. >> thank you. i would yield two minutes each to representative barbara lee, representative ryan, and representative louhan respectively in that order. >> if i may note that the gentle lady controls all the time. >> and i will claim the time for the rebuttal.

the one minute. >> the chair will not stop people after their two minutes. you have to do that. >> can you wind that clock back to six minutes? okay. so in that order, representative lee, ryan, louhan. and i will stop you. [ laughter ] >> i know you will. let me thank you, congresswoman, moore, for once again offering this amendment to protect nutrition assistance. you know from personal experience, i know from personal experience, many know that the majority of people don't want to be on food stamps on or s.n.a.p. they want a job they want to be able to take care of their families and live the american dream. s.n.a.p. helps lift 5 million people out of poverty in 2013 alone, including 2.1 million children. in fact more than 70% of s.n.a.p. participants are families with children. people in every state and in every congressional district experience food hardship.

yet this republican budget continues the trend of decimating food assistance in the long-term, and tinkering with block grants which are really schemes that could endanger food assistance delivery. what's worse and let me just mention the cbo report our democratic seniority and myself requested a cbo request on s.n.a.p. assessments on low-income households. it found cuts would drive the poorest families deeper into poverty. in this report the cbo analyzed three different proposals to reduce aggregate s.n.a.p. spending by 15%. cbo found with each proposal, families earning the least amount of income saw vastly disproportionately negative impacts. under at least one proposal, a family of three with an income below $15,000 per year would see a $600 cut.

this report also discusses how proposals to turn s.n.a.p. into a block grant program, which republicans have put forward in previous budget drafts, could allow for federal s.n.a.p. funding to be diverted to other programs and create the potential for even worse economic conditions for low income families. we know this would only increase hunger in our communities. we cannot allow this vital nutrition lifeline, which is what it is for our most vulnerable to happen. >> thank you miss lee. i yield two minutes to mr. ryan. >> i thank the gentle lady. we've heard the word certainty. i want to make a quick point that we ask how the transportation funding is going to come for the transportation, highway trust fund. we'll figure that out later. how about the health care piece. we'll figure that one out later. how about the tax rate. we'll figure that one out later.

this budget is anything but certain. for anybody. and to speak of uncertainty, we saw the statistics. the top 1% gets 17% of the tax expenditures. the average ceo is making $296 for every $1 that the worker makes. and here we're offering an amendment to make sure that the least among us can have some food. and we're going to get resistance. these deep cuts to the s.n.a.p. program aren't compassionate. they're irresponsible. and quite frankly, they're bad economics. they're bad economics. if we want to start growing the economy, we've got to make sure that the average person has some money in their pocket. i want to make one last point before i know i'll get cut off. the issue of nutrition. this -- earlier amendments were talking about medicaid.