that authorizes defense programs and policy. a vote though to vaps a cyber security amendment bill failed to get the 60 votes required to move forward. the senate live on our companion network c-span 2. the sub-committee will resume the hearing and mr. parmar sorry for cutting you off mid sentence but i had to make the floor vote. so thank you. >> i will probably take no more than two more minutes. the issue of domicile and jurisdiction post the greatest risks for american children and families who have made conscious decision to permanently settle in the united states and yet

find themselves being dragged into indian courts due to issues described about. in my own case we are hindu americans permanently residing in the united states and re sans was born in new jersey. my ex-wife and i are both u.s. citizens and i've lived in the country for 21 years. re ang lived here until he was wrongly removed and left to india india. she absconded from new jersey. and it is evident to any reasonable person that neither i nor my ex-wife were domicile in india and therefore hindu would not apply to us and yet three courts reached a complete opposite decision. i urge this committee to take special note of the broad and

subjective interpretation and application of family law which is being applied in extra territorial manner by indian courts to foreign nationals and knob residents as cause of concern as rights and protection of the constitution of the united states are being impinged upon. the hague convention has been in place for 30 years. how much more years will it take before we see american children being returned from countries like brazil india and japan, who have failed to recognize parental child abduction as a crime or disregarded international law and their own treaty obligations. we are not demanding special favors from our government but when parents are being left behind twice, once by their abductor and then by our own government, to fight a state machinery in another country without drukt and sustained u.s.

government intervention it is nocoence dense that for every sean goldman there are hundreds reage parmar. the courage across our government to address this human tragedy is baffling. it is troubling to see the same state actor repeat their bad behavior continue because we are too who begs the question who will be the beneficiaries if our children don't return. in conclusion -- sorry before that, i have a few recommendations that i have submitted in exhibits e. and f. and i would like this committee to kindly consider those. i will not go into the details right now. but in conclusion, on a positive note earlier this month the

u.s. attorney for northern district of illinois indicted a father for international parental kidnapping of three children traveling with them to turkey on route to pakistan without their mother's consent permission or knowledge. he left on may 2nd and was arrested on may 6th at o'hare airport on arrival as a result of swift and coordinated actions on part of the turkish airports and law enforcement agency. all three children are now safely in the united states. we urge our government to deliver the same kind of justice for our children who are victims of this terrible crime including albert, alfred,ar chard, kif car re ang, nicki abdullah, sean trisha, and dozens if not hundreds of other american children currently in india. will conclude with what david goldman stated in his testimony

before this committee in may 2013. these cases typically drag on for months which soon turn into years as the abductor creates a home feel advantage with tactics in the home kurn's legal system. this is the norm, not the exemption. these are abduction cases and laws have been broken. these cases are not custody disputes. and let's not forget that some believe we are asking for our government to intervene in custody disputes. we are not. all we are asking is that when our children are kidnapped to thwart a proper resolution of custody, law governing their return to our country is upheld. when it comes to international law that deals with children abducted from the united states and other lands, there is no rule of law and the broken lives and spirits of left behind patients across america whom we

represent here today stand as a living rebuke to that failure to enforce the rule of law. the plain fact is that a nations refuse to return american children pay to price for defying the law and unless we arm the state department with the tools they need to do their job and unless nations who break the law flagrantly and repeatedly suffer real consequences nothing will change. nothing will change. after over two years, those words still hold true the department of state now has the tools in the goldman act to use them urgently and effectively to bring our children back. we are asking for action, we are asking that you bring our kids home. thank you chairman smith. >> thank you so much for your testimony and very extensive list of recommendations including for aiders and abetters of child abduction. i think all of your testimony is brilliant and i think you for those specific recommendations. mr. findlay.

>> thank you chairman smith and distinguish members of the sub-committee. i'm pleased to be here on behalf of the missing and exploited children. i would like to thank you mr. chairman and other members on behalf of the families impacted by the terrible crime of international abduction. the act provided family and supporters with additional tools to bring their children home and i'm sure it will be implemented in the planner in which congress intended. as you are aware for years nick machas focused on international child abduction. working with the state department and law enforcement agencies to assist the impacted parents and families. today in our distinct role as a nonprofit nongovernmental organization we continue to work with families as we have with each of the parents even today to apply our experience networks and resources to help them locate and recover their children. you've heard today clearly that significant challenges remain. there are still several

countries including japan india and tunisia among others in which there are delays and a lack of any real progress toward u.s. children. for one example, india represents the individual nonhague country with the highest number of nick mac's own statistics and reflect the same reality facing the individual parents who have shared their powerful stories today. nick macis assisting families in 53 total child abduction cases and of those cases, 51 have been open for longer than one year and in nearly half of those cases the parent has been seeking the return of their child for more than five years. when that much time has passed that a child is separated from their parent, no terms are adequate to describe that situation. it is much more appropriate to describe it as heartbreaking.

this is not comfort blg information. but every single statement we have heard today demonstrates that information is important. the annual compliance report has long served as the only comprehensive source of information to evaluate the person formance of countries in the metric how many and how often are abducting u.s. children reporting. the compliance report is a tool. it is a tool that nick mac and i utilize every day to educate professionals. for those that are concerned an abduction might occur it is utilized to associate the risk and directly relied upon by families attorneys, courts, law enforcement agencies and others to support their ep efforts in implementing safeguards to make shire a child is not wrong my removed from the united states in the first place. the question that is always posed by each interested party is what can i expect and the

compliance report helps to fill in that answer. for those families that have already experienced a tragedy the report is a tool to inform parents of the challenges they might be facing and what realistic avenues are available for recovering their child. among the common questions asked by parents is what can i do and again the compliance report has helped in some small part to fill in that answer. as you've heard there are numerous concerns about the breath of information contained in the state department's first compliance report issued under the requirements of the goldman act and whether or not it contained sufficient details to continue serving as a useful tool for the answers of parents. because it is a information clearing house we uniquely appreciate the importance of details when a child has been lost. mr. chairman and other members i thank you with the chance to share with you to ensure the most useful and complete information is always available and most importantly to help you

implement better solutions. my hope and anticipation is that each compliance report continues to expand on existing knowledge and use as a more useful tool than the last report. i'm happy to answer any questions about nick mac's programs or role and any information similar to the statistics to the sub-committee and anything i can answer to assist with your work and i thank each parent and i tib with your on going support for these families to continue to bring their children home. >> thank you mr. findlay. and i want to thank you and the national children for missing and exploited children. the senate finally had the bill on the floor which i introduced five years ago and on the fifth anniversary of the introduction of the bill into the house that they finally got to vote on it. but nick mcwas very involved and your letters of support and endorsement were key because many members were unaware and

there were balls in the air and people are multi-tasking every day of the week here and it helped to pierce through and say oh, they are there for this and what does the bill do and so thank you for that very, very important and pivotal support that you provided as well as the work that you do on behalf of the families and the families on behalf of themselves and for each of those who have testified, what you do for all of the others. i've been so encouraged and deeply impressed and -- how you never just fight for your own child, you reach out -- or children and try to help others who are similarly hurt by the abduction or by abduction so thank you for that leadership as well. and i hope the american public we are grateful that c-span decided -- because they get to pick, they have editorial judgment merit their coverage and they decided to come and hear you and the administration speak to this issue so we are

grateful they are now able to take that message throughout the entire country so that people will know the agony that you face and the frustrations that you face as well. let me just ask mrs. barbirou and i know you support others that are left behind could you tell the sub-committee, with some detail, if you would, what it is like to wake up every morning knowing that your child has been abducted not knowing what is happening during the course of the day? all of you might want to speak to that. as a father of four and grandfather of four children i can't begin to sense how traumatizing that has to be on a daily basis year and year out. and the commander is here his daughter abducted when he was deployed to yokohama and his wife has passed -- or the mother

of his child and he can't even get his own child back. as you mentioned, dr. savoie, in your testimony, his case. the agony. if you could speak to the pain it imposes upon you, it would be helpful for the sub-committee to get that sense. >> thank you, chairman. i don't know that you can verbalize the pain. i can say that it is something you have to work through. it is devastating every day to -- as you said, you can't imagine it. and even if it is happening to you, you can't imagine it. it is a nightmare that continues to go on. for me, i'm grateful that i do have my daughter with me and through her i am able to witness a piece of my son on a daily basis. and that is a tremendous blessing that i am firmly aware that so many other parents do

not have the gift of. and for them, i can -- i is say for each of us our cases are different, our circumstances differ, but we can feel each other's pain and feel each other's tragedy. i sat here and spoke with mr. savoie and i want to cry for him. and it is not something that i feel i can personally put into words but just ask you to try to imagine. and knowing that you can't ever get to the point of understanding that depth of devastation, realize that it is equally difficult to put into words. >> all i can do is really echo those same statements that there are really no words for this kind of pain this kind of trauma. daily, hourly. every time you see a child in a supermarket, it reminds you.

and i'm also a stepfather as well. and i have step children. and every time i go to a sporting event or hug my step children, i'm reminded that i'm not able to give that same love and care to my own biological children. and i think all of us feel that way. we're constantly reminded that we're parents. you don't lose that. it is a lie dodge cal imperative. it is part of our fabric. part of the fabric of our being. and that love is being denied. and then you start feeling the empathetic pain for the child. that is the other thing. as a parent you don't think i'm being denied something, and that is true, we are. we are victims. we are crime victims. but our children had no choice in this matter whatsoever. and you empathize with them. all of the hugs they are missing and the sports events they could have and the opportunity to speak your native language with

them. all of that gone. and it would be great if at some point we could find a justice system that would give us back that time. but the truth is congress cannot give us back that time the u.s. government cannot give us back that time god himself cannot give us back time with our children. it is gone forever. and so we're left with the -- the pain and the suffering and the parents here and many of these parents have chosen maybe as a bit of therapy to give back and help prevent these things from happening to other people and to work together to help return these children in some measure and not lose more time. >> chairman, i 100% agree with what was just said. again, i'm just reminding, this is a human problem. this is lives that we're talking about. if we just focus on that, and

try to decouple it with law and diplomacy and everything else, the geopolitical power games and everything else then we can solve it, as long as this stuff is out there in terms of democratic stuff, then we are really missing the point. >> mr. findlay, in the testimony just a few moments ago, miss christensen said the new law is ebb couraging more countries to consider -- to become part of the convention if they are already not part of the copvention. is the law making a difference, in your opinion. and i say this as a source of encouragement. and if we get the report right and if we get it right on japan. it is egregious it is a

whitewash and i can't think of words to describe it and if you recall that from our friends from the administration, i did ask that they go look at it and reissue portions of where they got it wrong and there is nothing wrong with the definition of unresolved abduction case and which is why i read the definition from the text to make it clear and they have misread that clearly somehow and as i said earlier and before you answer i am concerned again at a previous hearing when ambassador jacobs said i don't think we're going to sanction japan or threaten them with sanctions because you think that would be detrimental to our bilateral relationship. a relationship needs to be based on trust, based on honesty, clarity and not putting uncomfortable truths under the table this -- this egregious wound that it does to your

children as well as to left-behind parents of parental child abduction. so shame on us if we do not look them straight in the eye -- this has to improve and this is a very serious issue between our two countries because we care about the kids, the abducted children and we care about the left behind parents. so mr. findlay. >> thank you chairman smith. i think as you've stated and i've reiterated several times in my testimony, i saw the sean and david goldman act as a tool of recovery and also of prevention and some of the promising differences i've seen since the time it has been enacted are slow steps toward improving our nation's response to preventing an abduction occurring in the first place. i've indicated that the information the national center submitted in our written statement regarding the active

cases to japan where 50 out of 54 active cases have been ongoing for longer than a year. 20 out of 22 active cases to brazil have been going on longer nan a year. 51 out of 53 to india have been going on longer than a year and all six cases in the country of tunisia have been active for longer than one year. that is not comforting information. we're happy and pleased with the opportunity to present that kind of information and to give that picture to other patients and to the committee to try to get a perspective on whether or not the countries are complying. but that remains a depressing picture and that remains a depressing picture in the months since the goldman act has been passed and so i'm hopeful and optimistic but the active cases remain the way they are. >> as you all know, the next shoe to drop will be on the

sanctions portion, vis-a-vis the 22 nations, which ought to be 23, japan has to be on that list and there are serious repercussions which i hope the administration will use as that tool box and we will hopefully hear from ambassador jacobs in july as ho how -- to how that is going so we don't get a designation without commensurate sanctions so the countries know we mean business. there are two areas i worked on closely and trafficking and international religious freedom and we've seen a lack of enforcement of sanctions when it comes to other human rights abuses so this is hopefully an opening for the administration to say if you use the tool box right and say we mean business, sanctions will be deployed and the quickest way to get those lifted is to obviously resolve

the cases in a way and return is the ultimate resolution of the case. let me just ask you, finally to what extent any of you might want to speak to you do you believe that corruption abroad, mr. findlay you might want to speak to this in terms of judicial system and judges and a foreign ministry that might be susceptible to corruption and we know it is a huge problem in many countries and even here in the united states. what would you say to that? has that caused some of this? >> i will, to some extent, i'll try to answer your question. i would defer on the realities that individual parents have faced in some cases to the parents that have lived it and i wouldn't presume to speak to each individual situation. i will say as to it relates to this hearing, each information contained in each report has

been detailed descriptions of the perform abc results that are in concern for noncompliance when there was concerned about judicial performance there was significant detail provided for a country that has not been spoken about today, but such as costa rica where there were in past compliance reports of detailed descriptions of the problems that the united states noticed in the application of the treaty principals in their courts when considering hague convention cases. they remain noted i believe in the current report as do numerous other countries however to some except the detail and the level of depth as to what led to the designations was not in the report. and as i look at this tool to make everyone aware of existing problems and it is important to make sure the level of depth and detail remains. >> i think your point is

extremely well taken. on page 30 of the report it has countries demonstrating patterns of noncooperation and there is an a.b.c.d.e. and with judicial performance, law enforcement performance and persistent failure of conconvention countries to work with the united states, and reduction cases and then you turn to the next page where it has the 22 countries it has brazil a.c.d. india e. and so that level of reporting needs to be -- is a point very well taken and break out so that they know and so there is real transparency as to what is the depth of the problem. more is more here and we need more. you have to keep referring back to say what is e. it shouldn't be that way. thank you for that. that is a good insight. would any of you like -- yes.

>> i think in japan, i would not describe it as corruption, i would just say that there is -- the fix is in. the law just doesn't allow for this to happen. and the courts aren't changing it. there is a problem with following rule of law even with japan itself. >> and even with the chief justice of the supreme court in japan, we need to become a tail wind behind the reformers in japan so -- >> absolutely. >> so if we put a zero for unresolved cases, who are we really helping there. one, it is inaccurate and second it is not helping the reformers. >> and we are taking the wind out of their sails. and when the chief justice was saying that, he was talking to his judges and say you have to get with it and follow the laws. there are laws that can be used on the books and the lawmakers have put things in there like

article 756 and to help the situations and the patient rights thing haven't changed but the courts themselves are not cooperating and when you have this intrinsic assy and this is not technically corruption but it is an official problem that we have. and by calling out japan with its problems for what it is and saying to our friend our friends ore there, look you have a problem with your system, it is violating human rights let's do that. i don't think we're hurting japan, we're helping japan. and we're helping japanese children who deserve those same rights. >> thank you for the question. and i think i would echo that statement that i'm not sure it would be corruption as the descriptive word i would use. but there is certainly an issue

in tunisia with the rule of law. where you have a tunisia president visiting with u.s. senators and declaring to them that there is no final judgment in an abduction case where the supreme court of tunisia has made a ruling declaring that the home of residence is the united states and the best interest is served there and through repeatedly members of the administration and up to the newly elected president, to respond to any request by our government officials to say there isn't a final judgment, it is absurd. what is your rule of law? you've just instilled a new constitution that directly upholds your supreme court and it's -- and its rulings and you turn around in the face of those and say, well we don't have a ruling, we don't have a final

judgment. well if your supreme court is not the final judgment then what is? and i do applaud the tunisia judiciary for following the international law and upholding its legal obligations in the face of what is very obviously an interest of society to protect its citizen because they see my children as tunisia and not as vids and they do not see them as children who deserve the familihood of both a mother and a father they see them as symbols of their national -- of -- as national symbols. my children are tunisia and american as well and the home is the united states and the tunisia courts have rules and the american courts have ruled and it is simply time that those judgments be enforced. and i don't know if you call

that corruption, i certainly call it a problem. >> gentlemen i think there is a lot of commonalities that it is hard for us to define whether we face corruption or not. but for example, laws that have no clear guidelines so that from one judge to the next, under the same set of circumstances, you'll get different rulings. the fact that even after for example, in india, there is a progressive thought in the law commission in 2006, one of the reports said they should succeed to hague so that joint custody is allowed. fortunately on the latter there has been some movement within the indian parliament and they have placed a rule change and it

will take some years to implement. but the main challenge we face is both cultural and attitude approach to that. i think -- so it might not be an overt sort of decision to harm somebody, but it is the lack of or the ignorance in the issue is probably what is hurting us. >> let me -- if you have anything else you would like to say, i would like to give you the last word or we'll just conclude. but the trafficking victim act report requires this mammoth study country by country, mr. findlay, which you know which breaks out protecting sex and trafficking and every country has a monologue and a box of recommendations and then there is a tier system one, two, three and watch list and if you are a tier three country you are an egregious violator in human

trafficking and you get sanctioned. this didn't start out as this thick book and it quickly became that and data calls out to the embassies and the goldman act and we want somebody in every embassy working this and a seriousness of implementation for you and your kids and my hope is that again correcting the deficiencies currently and right now and we'll appear to secretary kerry who i think is a reasonable man and he'll hear that appeal and hopefully take it to heart and make sure in japan and india where there are no unresolved case and according to this we have two, from both of those countries sitting right here, we'll look to fix it and to get it right for accuracy. and again for the courts, and mr. findlay, you might want to speak to this and how important

it is before judges that this report be correct so that they make informed decisions about the vulnerabilities of someone perhaps going abroad with their kid, with their child. >> i'm happy to speak to that mr. chairman. just yesterday wednesday of this week i was on the phone and speaking to a family court in the state of washington and to the litigants and the attorneys involved in that case and describing and answering questions related to the risks of abduction to a particular country, not one spoken about or represented today but the resource aside from the information, the limited information that our center obtains from cases reported only to us, but aside from the information we have firsthand, the next and the most important and most comprehensive source i have to point to is the information that comes from the u.s. state department and i value that information and i value the completeness of that information and i do know there are 14 states plus the district of columbia that have adopted

uniform child abduction prevention laws in the family law systems that encourage or require family judges to receive information about whether or not a country is a signatory and more importantly whether or not they are living up to the treaty and whether or not what it means to live up to that treaty and to address living and safeguards and our center knows firsthand there are interested parties and government entities and parents and attorneys and advocates and agencies who are desperate for this information and would love as much information as can be provided. we do our best to provide what limited info we can and share that with the sub-committee but that is where i'll leave it is that information is important. whether or not it is comforting and paints a happy picture it is still important.

>> actually yesterday i had an individual contact me about the report and knew that i was testifying here today and he wanted me to mention his case which is very much on point. he -- prior to japan signing the hague had been granted sole custody of his children with supervised visitation because there was a threat of an abduction and now that japan has signed the hague the other side is now petitioning to have that supervised visitation removed in court. under the premise that japan is now a hague country and is complaint and therefore we don't have to worry about this any more. and very much to that point, if this report is not accurate and says zero, zero, zero, no problem, those children may well be abducted. they may well be abducted and may well be abducted with the judge's permission, because he or she will rely on this report

saying that zero, there is no problem. and 90 days is actually not enough time to correct that for this individual. the other side can present this report as evidence with an expert witness in that court and put it on the record and now claim that japan has a flawless record in this area when we all know that is not the case. so it is a very real concern and created a very real concern for this particular individual in texas right now who is worried that this report may have given the other side, who may have nefarious intentions, the ability now to legally abduct these kids right out from under us. >> that is already the case in the report from tunisia where there is zero abduction -- unresolved cases. did you want to speak to that? >> i just -- you offered to have a closing statement so i'm going

to take you up on that offer chairman, and thank you for that opportunity. i just wanted to reiterate that miss christensen in her testimony asserted that the mission of oci is to assist children and families involved in ip caw and to prevent its occurrence. that does not mention recovery. but my assumption is the assistance to children and families involved in i pc a means they are offering the assistance for recovery and yet all i heard in their testimony and all that i see through the compliance report is an interest in prevention. and i stated in my testimony but want to restate that the convention is a powerful tool but it is not a tool that will result in the return of our already abducted children. and while i advocate strongly for the use in future cases, i wish for it to be made crist

clear in the record that i pc a is a fair and powerful law with strong remedy if applies will result in the return of our illegally abducted children abroad. and as a request to this committee would ask that in the future you ensure that ip acara was implemented in the spirit with which it was created and if necessary it be updated with an explicit requirement of accountability for the total existing cases by country including newly reported cases and the total number of children involved in each case represented in feature states by congress because our children count and they must be counted. it is so important that state understands they represent individuals and they must count.

thank you. >> just i will end on a couple of items from the recommendations that i had. i think forward, while we're talking about the report, since 30 years, hague convention has been in place but we haven't had a consolidation of data sources. so department of state should enhance the tracking of government cases by leveraging sources such as the u.s. family courts police department reports, the amce kref and the fbi and other sources to have a more consolidated sources instead of waiting for the parent to report the case. one of the other recommendations i would like to highlight is in returning the children especially to the top destinations, department of state should consider deploying a permanent attach a at the u.s.

mission who will be -- who will ensure that the pending cases are being worked on in a fair and quick manner. so the children actually come home, that is the bottom line. and the third request i have is with you and the rest of congress, is to really take the leadership on this and make it a win-win situation for both the u.s. and india and engage with them on this issue just like you would engage with them on any other strategic and economic issue. if you make it important i'm sure it will be important for them as well. >> if i would just put on the congressional record one last request just to be able to say that i love my children isaac and rebecca and i will never stop fighting for the ability to be involved in their lives.

and i look forward to the day that all of us can be reunited with them, with our children. and i thank you for all of your support if trying to make that happen. >> thank you dr. savoie and thank you all for your extraordinarily expelling testimony. and i can assure you that this sub-committee will be -- and my efforts. and as you know i learned the sufficiently and the gaps in what you face on a day to day basis through david goldman's case, very good welfare whereabouts but not much when it came to policy and trying to effectuate the return of sean, his son. and from that ordeal i learned through him and through his son and now through all of you just how agonizing it is and that is why we wrote the law and be tenacious in making sure it is

faithfully implemented. you are heroes and i thank you for your leadership and mr. findlay thank you for the work you do. it is irreplaceable. the hearing is adjourned.

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>> if you missed any of today's house hearing on international child abduction, it will be available in our video library. you can find that at c-span.org. also today a senate hearing on federal whistle-blowers. customs and border protection officer told the story at that hearing of his son threatening to jump off the roof of his high school. he called it the most costly and emotionally devastating thing he has had to deal with as a result of wanting to do the right thing. he also said he spent some $41,000 in lawyers fees healthcheck was responding to a question from senate homeland security committee about the costs of whistle blowing. here is his statement. >> me the biggest cost has been watching my son trying to jump out of his high school roof because he saw his father lost his uniform, his weapon. he has always been very proud of

my career and the way i perform my duties, not only at work but off-duty. i have raise lead excellent children. but it was the most costing and emotionally devastating thing that i had to do. receive that phone call that no father wants to receive that your son is in the roof of his high school, getting ready to jump because his father is going through a whistle-blower retaliation action. luckily, i was there. i got in time. the police was there. and the fire department was there with the jumping blanket. he finally jump and he was hold by a county police and he wouldn't let nobody arrest him. he has to be arrested by his

father. and with great pain, i picked my son, who is autistic to come down to the office, put the handcuffs on him and took him to the patrol and then i follow on my vehicle and spent two days in the hospital talking to him. that my problem was going to be resolved eventually. that patience will pay off. financially, it has cost me over $41,000 in lawyers fees just to keep my job. i am in debt up to my neck but as a responsible citizen i pay out of hand and am waiting one day i can be compensated for all the troubles i have financially put myself into because i did the right thing. >> you see that entire senate hearing on federal whistle-blowers tonight at 9:00

eastern on c-span, or any time on our website at c-span.org. a look at what the house and senate have been doing today. the house passed the 2016 defense spending bill on a 278-149 vote this afternoon. the sixth of 12 appropriation bills to make it through the house. house members now in the first of a couple of days working on trade promotion authority. a vote expected on two trade bills tomorrow on the floor of the house including the trade promotion authority for the president. watch that house coverage live of course, on c-span. meanwhile, the senate continuing work today on a bill authorizing $612 billion for defense programs and weapons. today a vote to advance a cybersecurity amendment to that bill failed to get the 60 votes required. the senate is live on our companion network c-span2. the road to the white house to be get more crowded. hillary clinton will officially kick off her campaign this

saturday in new york city. you can see that live at 11:00 a.m. eastern time on c-span. on monday, another hat to be tossed into the republican presidential ring when former florida governor jeb bush officially announces his entry into the race. we'll have that live at 3 eastern time on c-span3. and tuesday it's donald trump's turn. he'll announce his plans tuesday at 11:00 a.m. in new york city. you can see that live at c-span.org. mary todd lincoln was known to be well educated and bright. she spoke several languages fluently and had a strong interest in politics and took an active role in her husband's career. she suffered a series of emotional challenges. three of her four children died before they reached adulthood and her husband wassis a natd while sitting next to her at the theater. mary todd lincoln, first ladies,

examining the public and private lives of the women who filled the position of the first lady and their influence on the presidency. from martha washington to michelle obama sundays at 8:00 p.m. eastern on american history tv on c-span3. health and human service secretary sylvia burwell testified yesterday about the king vverwell case challenging subsidies in federal run marketplace. she appeared before the house ways and means committee. this runs about two hours.

>> committee will come to order. we know that the secretary is on a tight timeline today with a hard deadline at noon. that's why the ranking member and i just discussed that we will limit questions' members to four minutes so as to accommodate as many members as possible in the questioning. but first, let me start off by thanking our witness, secretary burwell. i understand that you've got to get going. so we're going to move this as quickly as we can. but we were supposed to have this hearing earlier in the year, but events overtook us. so here we are today. i understand that the majority of your remarks are going to be about the budget. that's all well and good. but it shouldn't surprise you, secretary burwell, but that we're a little more interested in talking about obamacare. especially given the president's remarks this week.

i hope he gives you a medal for this job. because defending this health care law is no easy task. i think any objective observer would say that this slaw on the fritz. by the law's own standards the whole point of obamacare was to make health care more affordable. premiums aren't going down, they're going up. way up. all over the country. and insurers are proposing double-digit premium increases. in maryland, it's close to 30%. tennessee, 36%. south dakota, 42%. tax season was like a bad dream before. now it's a total nightmare. people could never afford these plans on their own. so the law gave them subsidies, to some people. well, now two-thirds of the people who got them had to pay

the irs back. on average over $700. that's not the kind of money that people just have laying around. and for all of this hassle, for all of this, what are we getting for it? the argument was that if people had insurance they'd go to the doctor instead of the emergency room. but now even more people are going to the emergency room. so whatever the supreme court decides later this month, i think the lesson is absolutely clear. obama care is just flat busted. it just doesn't work. and no fix can change that fact we're not talking about a ding or a dent or a fender-bender or a flat tire. the whole law is a lemon. it's very linchpin. its central principle is government control. that means higher prices, fewer choices, and lower quality. so the answer isn't just to

tighten a few screws and everything will be fine. the answer to tweak it here and tweak there it and we'll all be okay, the answer is to repeal and replace this law with patient-centered reforms. the truth is i don't have to convince this administration that the law is broken. i know that you know that it's broken because you keep trying to fix it. for several years now, hhs has delayed parts of the law, and sometimes, in some cases, they have rewritten it on the fly. we know the most egregious example, the subsidies. the law says that people who buy plans on the state exchanges can get subsidies. it doesn't say anything about federal ex-changes. and yet hhs has sent millions of subsidies out the door, putting millions of people at risk. more and more it seems the administration isn't so much as implementing the law as they're improvising it. we have already seen the evidence of the administration using one account to pay for multiple programs. programs that congress never

funded. that's one of the main reasons that we are holding this hearing today. it is congress that wields the power of the purse. and more and more, the administration is acting like a purse snatcher. so, again, my kudos to you, secretary burwell on a very difficult assignment. but the american people, they deserve better. they deserve a health care system that puts the patient first. they deserve lower prices. they deserve more choices. they deserve higher quality. and the committee is going to do all it can to make those things happen. and with that, i'd like to yield to the ranking member. >> welcome. you know i'm glad we're having this hearing. obviously, the republicans want to focus on aca. and i think that's a good idea. because what's busted is not aca, but your attacks on it. endless attacks. never coming up with a single

comprehensive alternative. all these years. so you sit as armchair critics while millions of people have insurance who never had it before. millions of kids have insurance who would not otherwise have had it. people who have preexisting conditions no longer are canceled or can't even get insurance. the donut hole is gone. millions of people in lower income categories are now ensured through medicare. millions and millions and millions. cost containment is beginning to work. it's beginning to work. the increase in costs, that rate is going down.

and so you're livid because it's getting better. that's why you're livid. and i'm not surprised at your fervor. we'll be glad to take it on. we'll be glad to take it on. and i think you just need to understand what this experiment is all about. it was combining increased access to medicare, to medicaid with an increased reliance on the private insurance sector. that's really what this is all about. an experiment. and you talk about government control. more and more people are getting insurance through the private

sector. and the states that are denying their citizens further coverage under medicaid are essentially telling people well get lost when it comes to health coverage. get lost. and you have a governor mr. chairman, who is running around this country, talking about the evils of health care when millions of people are benefitting from what happened. so you decided to turn this from budget to aca? welcome. welcome. your frustration is millions and millions and millions of people are benefitting, have health care when they did not before. so madam secretary, i think they have thrown down the gauntlet.

i don't feel sorry for you. i think you love this job and you like being the person who is administering this experiment in greater health coverage after 70, 80 years of nothing being done in this town or throughout this country. so i happily welcome you because i think you're a very happy warrior. i yield back. >> i'd like to recognize the happy warrior now for your opening statements. the floor is yours, secretary burwell. >> thank you. chairman ryan ranking member levin and members of the committee, thank you for the opportunity to discuss the president's budget for the department of health and human services. i believe firmly that we all share common interests, and therefore we have a number of opportunities to find common ground. and we saw the power of common ground in the recent bipartisan

sgr fix. and i appreciate all of your all's efforts to get that work done. the president's budget proposes to end sequestration fully reversing it for domestic priorities in 2016 matched by equal dollar increases for defense funding. without further congressional action the sequestration will return in full in 2016, bringing discretionary funding to its lowest level in a decade, adjusted for inflation. we need a whole of government solution, and i hope both parties can work together to achieve a balanced and common sense agreement. the budget before you makes critical investments in health care, science, innovation, and human services. it maintains our responsible stewardship of the taxpayers' dollar. it strengthens our work together with congress to prepare our nation for key challenges both at home and abroad. for hhs, the budget proposes

$83.8 billion in discretionary budget authority. this is a $4.8 billion increase which will allow our department to deliver impact today and lay a strong foundation for tomorrow. it is fiscally responsible, which in tandem with accompanying legislative proposals would save taxpayers a net $250 billion over ten years. in addition, it is projected to continue slowing the growth of medicare by securing -- in savings as we build a better smarter, healthier delivery system. in terms of all americans with access to quality affordable health care, it builds upon our historic progress in reducing the number of uninsured and improving coverage for families who already had insurance. a recent example of this progress is the 10.2 million americans who are currently enrolled in health insurance through the marketplaces in

2015. the budget covers newly eligible adults in 28 states plus d.c. where expanded medicaid and it improves access to health care for native americans. to support communities throughout the country the budget makes critical investments in health centers and our nation's health workforce, particularly in high-need areas. to advance our common interest in building a smarter better healthier delivery system it supports improvements to the way care is delivered, providers are paid, and information is used. to advance our shared vision for leading the world in science and innovation, the budget increase funding for nih for $1 billion to advance biomedical and behavioral research among other priorities. it invests $215 million for the precision medicine initiative, which will focus on developing treatments diagnostics and prevention strategies tailored to the individual genetic characteristics of individual patients.

to further our common interests in providing americans with the building blocks of healthy and productive lives this budget outlines an ambitious plan to make affordable quality child care available for working families. to keep americans healthy, the budget strengthens our public health infrastructure with $975 million for domestic and international preparedness, including critical funds to implement the global health security agenda. it also invests in behavioral health services, including more than $99 million in new funding to combat prescription opioid and heroin abuse dependence and overdose. finally, as we look to leave our department stronger, the budget invests in our shared priorities of addressing waste, fraud, and abuse. initiatives that are projected to yield $22 billion in gross savings for medicare over the next decade. we're also addressing our medicare appeals backlog with a

coordinated approach. we are pleased that the senate finance committee last week passed bipartisan legislation and we look forward to working with this committee on it. i also want to assure you i'm personally committed to responding promptly and thoroughly to the concerns of members of the committee. i want to close by taking a moment to say how proud i am of the hhs employees from their work combatting ebola to assisting unaccompanied children at the border. the commitment that they show day to day, day in and day out as they work to help their fellow americans have those building blocks of healthy and productive lives. i look forward to working closely with you to advance our common interests on behalf of the american people. thank you. >> thank you. let me first start by saying where we agree with the administration, we work with the administration. this week's action on trade is a perfect example. but on this health care law we could not be more opposed to what the administration is

doing. we really think this is doing a great harm to the health care system and to the people we all represent. so let me start by just addressing the big elephant in the room. any day now, the supreme court, as you well know, because your name is burwell, in king versus burwell is about to rule. and if the court rules against the administration, then millions of people will be stuck with a government-designed health insurance that they cannot afford. so, i mean the big question is then what? what about the people who are going to lose their subsidies and possibly their coverage? is the president going to dictate to us how to fix this flawed law, or is the president, is the administration going to be willing to work with us to give families greater freedom in choosing the health care that works best for them? >> so with regard to the question of the courts i think you know we believe that we are implementing the law as it was written, as the statute was

written, as it was intended as cbo has scored it for all these year as recent articles have reflected those who were part of writing the law indicated it ought to be. citizens should receive subsidies that contribute to and citizens in the state of texas is not is not what we think the law intended. >> i understand your opinion on what the court ought to do. but there stands a reason there is a pretty good chance it may not go your way. so the question then is then what? >> the court does decide and if the court would decide for the plaintiffs in the idea that the court would say that subsidies in the federal marketplace are not eligible, those states that are part of the federal marketplace, that those citizens can't have those subsidies, if the court makes that decision, we're going to do everything we can, and we're working to make sure we are ready to communicate, to work with state

ss to have authority, the critical decisions will sit with the congress and states and governors to determine if those subsidies are available. >> so here is the question i'm trying to get. the president going to stand up and wavy a one-page bill, i have a one-sentence fix. take it my way or the highway? is that going to be the administration's position? or is the administration going to be willing to work with congress to find way to give people more health care freedom? that's the question i'm trying to get at. >> with regard to the question of health care freedom, i think it is important to reflect the market someplace a market. it uses private insurers. people that sign up in the marketplace are not on. so they have many choices. as a matter of fact, in the marketplace this year, there were 25% more plans. that's more choice. that's more competition. that is why we intend -- >> let me ask because i want to be kind to everybody's time.

let me ask it this way. if the plaintiffs prevail, if the king side wins and then the exchanges are deemed unconstitutional, not legal in the federal exchange states then the individual mandate is effectively struck down for the taxpayers in those states. the president going to say reinstate? i've got to tell you it's not real popular. and we here, at least on this side of the aisle aren't eager to reinstate the original mandate. we would like to free people from some of these mandates. i would say the administration has kind of been a little two sided on this issue mandates. so is the administration going to take the position congress must just reinstate this thing in all these 37 states reinstate the individual mandate, reinstate the original employer mandate, my way or the highway, sore the president going to be willing and flexible to work with congress to fix this mess and negotiate with congress? that's what i'm trying to get

at. >> i think it's very important, though, with regard to the decision before the court, the decision before the court is who receives subsidies and whether or not those subsidies can be given in states that have a federal marketplace versus a state marketplace. >> yes, we understand that that. >> is the decision. and that is the only decision before the court right now. so with regard to what happens if that decision occurs. >> yes? >> three things occur. the first thing that occurs is for the people -- >> secretary burwell, we know what will occur. well already know this. the question is what will the administration do? will they stand up with one piece of paper and say my way or the highway, or will they work with congress to address the situation? >> so the problem that occurs if the court decides against us if s that they have made a decision that the subsidy -- >> you're not going to answer the question, are you? >> no the answer is the problem that gets created is subsidies aren't available. they aren't available for millions of americans. they lose their insurance.

it drives up costs in the individual market. to solve that problem, the critical decisions are going to sit with the congress or states. >> right. so for a bill to become a law, house, senate, then the person at the end of pennsylvania avenue, the president signs that law. is the president going to come out and say only my way or the highway, one sentence, one-page fix, or is that president of the united states going to be thinking less about digging in and defending his law as exactly written, or is he going to be willing to actually deal with the issue which is affordable health care for millions of people who are losing their health insurance. is he going to work with congress to address this situation or is he going to put concrete around his ankles and say it's my law or nothing? that's the question i'm trying to got at. >> the president and we have said -- the administration has said all along, with regard to improvements, and we believe that there are improvements that can be made. we look at affordability, access, quality, and the issue

of how it affects the deficit and our economy. we will look at anything and have that conversation. with regard to the specific that you raised i do think it is important. the issue of the individual mandate, that is related to a very fundamental part of the system, which is preexisting conditions. and it is our experience, at least in my conversations across the country that most americans believe that you shouldn't be kept out of insurance or banned. if i have a child that has a condition that is born with a particular condition, that i shouldn't spend my time worrying that that child will never get insurance once they go off mine. >> you're kind of going off topic. i'm going cut you off there. we both know that there are ways of dealing with those problems without having to impose an individual mandate. let me leave it at there in the interest of everybody's time. mr. levin? >> well, i'm not surprised at

the tone but i really think it is so counterproductive. chairman, you talk about two-sidedness. the two sides when you say you worry about the millions who will lose their insurance when it's your allies who brought the suit that would deprive them of insurance. you talk about concrete, having feet in concrete. that's exactly where you have been in terms of aca. your feet have been in concrete while you have brought up bill after bill to try to destroy aca. and when you say will the president be my way or the highway, that's precisely what has been your approach to aca.

precisely. you've never sat down with us to say how could we make some changes. instead, you have been out to destroy aca and you say where's the president's plan when the president believes the court will and should uphold the law. all you've done is issue op-eds. and bills, contrary, contradictory bills. so you don't have any plan. like you haven't had a plan for 60 years. so you can keep going after the secretary, and she will keep trying to spell out. i'll ask you when i finish how

many people have been receiving subsidies, madam secretary? >> so 7.3 million people have received subsidies through -- that are in the marketplace right now. >> so when you shed tears about 7.3 million remember, or about the law it's 7.3 million. what has been the average subsidy? >> $272 per month is the average subsidy. and in terms of those that are in the marketplace that are subsidized. that's the 7.3. so 10.2 million people are currently in the marketplace overall. about 85% of those receive subsidies. the average subsidy is $272 per month, which is what results in the affordability. >> and just quickly tell us how many people have received additional care through expansion of medicaid. >> the question of the total number, because there are people

in terms of the expansion itself, about 10 million people are the estimates in terms of those states that have expanded. >> so add those two together and we're talking about individuals with families and the republicans come here and castigate you and this president. the shoe should really be on the other foot. i yield back. >> mr. johnson? >> thank you, mr. chairman. i hardly know how to follow that. i guess i'm supposed to thank you for being here. but i have to tell you, i'm not in agreement with much of what you're saying.

let me just ask you, you know we're trying to get the health care back in shape. and it sounds like to me that you want to go your way and not try to work with us. and let me just ask you if there are any proposals that hhs supports that will reduce costs for consumers without setting price controls or imposing other restrictions that will reduce access to care. >> yes. in terms there are a number of things that are a part of our budget and that we're currently implementing that are reducing costs. we know that since the passage of the act the trajectory of medicare -- >> but it looks to me like everything is going up. >> medicare spending, if we look at what it was projected to be in terms of the previous ten

years up to 2008 to where it has been through '09 through '14, we saved $300 billion. with regard to per capita health care costs in the country in 2011 '12, and '13 the cost growth is the lowest it has been in 40 years. that's taxpayer savings. >> insurance rates are going up not down. and everybody is paying more for it. >> so insurance rates before the affordable care act were going up, often in the individual market well above double-digit numbers. so what we have seen since the implementation is while those rates are still continuing to go up, they're going up at a much lower rate. >> okay. let me just change subjects for a second. ask you about an effort that my colleague lloyd doggett and i have been after for a number of years. and that's ending the use of social security numbers on medicare card. as you know, that finally became law earlier this year as part of the medicare access and chip

reauthorization act. so let me ask you. is hhs already implementing that, and how fast do you think you'll be able to issue cards without social security numbers on them? >> first, let me say thank you. having put this in the budget when i first arrived at omv i thought as i told you it would take years. so thank you for your leadership and effort on this. we were pleased, and i personally was very excited. so right now we are putting together the work plans to do that. we haven't established the exact timetable. but as soon as it was passed the next day have asked the team for the work plans. we want to do it as quickly as possible in ways that will serve the consumer. as you know, there are a lot of medicare consumers. we want to make sure that we're not disrupting them or their service. but we very quickly want to do it. because like you, we believe this is an important part of privacy and security. >> well, i thank lloyd doggett for helping me with that. how easy do you think you can make it for seniors to get a new card? >> i think that's the part in terms of understanding the

timing, because we want it to be easy for seniors, and we want to make sure they understand. one of the things we don't want to do by making this improvement is create confusion. so figuring out the way that we can enter the new people coming in very quickly with their cards, but those with the existing cards because we don't want to have a confusing situation. so that's what we're working to do and look forward to staying in touch with you and your office about how we do that. >> thank you, ma'am. thank you, mr. chairman. >> thank you. mr. ingle? >> thank you, mr. chairman. i want to thank my colleague mr. johnson for not drinking all of that kool aid you had in the back against obamacare and bringing forward something constructive that the people would know outside we tried to provide health care. it's very healthy. and i can't try that kool aid. i was a former altar boy. i went to school. i learned all of the religious. i just thought that the right thing for americans to do is to believe that health care was

part of the pursuit of happiness. it doesn't even seem like a political thing if a kid is sick and someone says that you can't have health care it should paint us as human beings. if a person goes to a doctor and finds out that the child an illness but he can't get insurance, if we find the good samaritan on the side of the road. and we know that most people middle class people have insurance, but their poverty sometimes restricts people from getting this. it just it seems to me that instead of tearing down a system where you know in your hearts people are getting health care, that you would say i don't like the way you've done it mr. president. i don't like the way you democrats have done it. let us help you to do it better. but to take some sense of pride that the supreme court will just strike down the opportunity for people to get just basic health

care, to me it's not just mean-spirited -- >> will the gentleman yield? >> i don't think so, mr. chairman, because you're on a roll now. and i don't want to have you become a nice guy at this point in time. because i'm glad that you have rehearsed the attack that you intend to do. and i don't care who the secretary is. if you're on the side of giving assistance to people that can now go see a doctor, that can now prevent going to intensive care because they've had preventative care, they can now get insurance that they couldn't have insurance, from a political point of view, i wouldn't want to be in your shoes explaining it. of course, those that already are covered, it's no problem there. i've got mine, jack. you get the best that you can. but i don't care what religion you believe in and even if you don't believe in any, it seems like compassion should override partisanship. and if we don't like what is before us, we should work hard to repair and fix it and to

improve it. and so you know, at 85 years old, if i have to decide on what moral side i'm going to be raising issues on, i can't find a better one than this. and, you know it goes without saying. if you are crippled, if you are blind, if you are disabled if you want help, and if money and insurance is what is keeping you from getting it you could not give a better political home run to the american people to decide a basic question, which side are you on. so i'm glad that politically my party would never put me in this position. and i -- the only position i would rather be in is where you are sitting madam secretary. to be able to see that you are on the right side of the issue you can see that people don't really want to discuss the millions of people that are

being helped. and we're not talking about -- we're talking about life and death in the true sense of the word. and if someone had a conscience that what a doctor said i wish you had seen me earlier, and they said i wish i could, but i didn't have insurance to do it doctor. well how many cases we have in intensive care saying this woman, this man should never have to have been here if it was detected earlier. and we have a mechanism for all of this. do we have to -- >> time for the gentleman is expired. >> well, thank you, mr. chairman. >> i understand the gentleman -- >> i'll give back the balance of my time. >> was another minute there. but you cut that off. >> we're doing four minutes so we can get to members of the other here. i would ask members if you do have a question, ask it earlier on so that the secretary has a chance to respond. gentleman from texas is recognized. >> thank you mr. chairman and madam secretary. health care is about patience, not politics. i was really pleased to hear you

answer mr. ryan that if the court rules against irs in this case that the administration will do everything we can. can you give us some guidance here? will the president sign legislation other than merely extending the subsidies to federal exchanges? >> with regard to the question of legislation and the affordable care act, we've had -- that has ban question and a comment. and where we've been is when there is repeal of fundamental elements -- >> but on going forward. i appreciate looking backwards. but going forward, if the court rules for the plaintiffs will the president sign legislation other than extending subsidies to the federal exchange? >> so the president has, and i think will continue to sign legislation that we believe improves affordability, quality access and takes care -- >> so the answer is, and thank you for what i hear you say the president will sign legislation other than simply extending the

subsidies to the federal exchange? you're saying that's correct? >> the sgr bill that we just recently signed includes very important provisions that actually extend the affordable care act's effort to do delivery system reform. >> as you know, that's not a supreme court case. specific to that, asking your guidance. the president will sign legislation? >> specific to the supreme court case. >> other than merely extending subsidies. >> specific to the supreme court case, if the question is the supreme court case, i want to return to what the supreme court case is about. >> no, i'm really looking -- we're looking for your guidance in a bipartisan way. so your answer is yes, the president will sign legislation other than extending the subsidies to the federal exchanges? >> with regard to the question of the supreme court case, that is an issue about subsidy. >> right. >> that is all that is about. if your question is are we willing to consider things that would improve or enhance

affordability, quality and access, we are open to those things. >> so yes? >> with regard to the supreme court case, though i think it's very important or the me to be clear that is about one item. that is about one item. >> i just want to make sure again, as we look to work together to put patients ahead of politics, you're saying yes, the president would definitely sign legislation other than exchanging -- extending the subsidies of the federal exchange. the answer is clearly yes? >> i want to distinguish between the question of how one resolves the problem that gets created. that is -- that doesn't have anything to do with any other parts of the affordable care act. >> no, no, no. this is such an easy question. it can be yes the president will sign other legislation or no, he will sign only that legislation. >> congressman i think it's very hard for me to answer a question about hypothetical legislation. >> no, it's actually not hypothetical. as we know, the court is going to be ruling not hypothetical.

if a rule for the plaintiffs guiding us you're saying the president would sign other legislation? he will not, as mr. ryan said, he will not say my way or the highway? >> with regard to fixing improving the affordable care act, these are two different issues. >> no, no. madam secretary, i don't mean to interrupt. i'm really seeking your guidance. so the answer, though, to finalize it is yes? >> my answer, congressman is we will review any legislation we get. that has to do with the affordable care act based on -- >> but i'm talking about timing. so the answer is no? >> with regard to legislation that we sign we'll look at any piece of legislation and we'll judge it by four things. access -- >> let me ask this again. will the president sign legislation to extend those subsidies temporarily while republicans and democrats and the president work toward a long-term solution? >> with regard to the subsidies, as i have said, the critical

decision is with congress. if the congress writes legislation that makes sure that those subsidies are available that is something that -- >> the sans yes? yes, you would sign legislation other? >> time extended. >> correct? >> congressman i apologize. but when you say other, i want to make sure. >> time for the gentleman has expired. mr. mcdermott? >> mr. chairman, thank you. ms. burwell, it's really nice out in seattle. i'm not sure you made the right choice coming back here to work. >> time in the wrong washington. is that what you're telling me? >> i listen to this and we're all talking about if the president does this and whatever. but let's talk a specific. because i think that we haven't heard a specific come out of the republicans in -- since the bill was passed. they have never put anything on the table. now we have a bill 1016 put in by senator johnson from wisconsin. and his -- it's his solution if

the bill fails and as i read it quickly, it repeals the individual mandate. it repeals the employer mandate and it says that the states can continue the funding down, and the standard of benefits that people get are not the national standards, but whatever the state of mississippi or alabama or georgia or texas or one of these states that has not had an exchange, whatever they set as a benefit, we know it will be lower, because it already. they won't cover people in medicaid. so they clearly don't care about the level of health care. but explain to me how you would -- >> will the gentleman yield? >> to 1016. >> no i'm not going to yield. >> you take back the disparagement of the state of georgia. >> to explain. >> time. >> she has the right to explain what the president would think of a particular piece of legislation that has been put

forward as a serious thing by a senator in the united states senate. >> so with regard to the johnson piece of legislation, that piece of legislation is from our perspective is repealed. because it gets rid of preexisting conditions. it stops the funding for preventative services. it undoes that people up to 26 would be covered. and it actually takes away subsidies from all over time. and so with regard to that particular piece of legislation, that is a bill that from our perspective is repealed. and we have spoken to the issue of something that repeals the affordable care act is something that the president will not sign. >> so in answer to mr. brady's question, will the president sign a bill that we pass, if we pass this bill will the president sign that? >> as i have said, this bill in its current form is repeal and the president has said he will not sign something that repeals the act.

>> is there any place that you see that there is a proposal on the table by any member of the house or senate that makes -- that looks at this point as though it deals with protecting the aca in general and fix the one specific problem? >> we have not seen anything. >> and you've looked at all the legislation and read all the press releases and everything else? >> at this point we have not seen something that addresses the specific issue of the question. although i think there is also the issue i think we're all very focused on the loss scenario. at some point i think it is important to focus on the win as well in terms of how we all go forward if there is a win. >> tell us about the costs of health care. we hear the chairman says the president promised that there would be a reduction in premiums.

now, would you explain why that's a little bit misleading in that certainly everything is going up in the society but they're not going as much as was predicted, i think is what you would -- i'd like you to talk than. >> that's correct. and as we have seen, the premium increases that occurred in the individual market and even in the employer-based market we are seeing smaller increases in those premiums than we saw before. and so while there are increases, the increases that we were historically seeing that were driving costs for individuals for employers, and in terms of medicare and the costs to the government that is what we have seen shrink and slow. >> thank you. mr. teaberry. >> thank you, mr. chairman, thank you ms. burwell. the recent reform that passed a few months ago included a bipartisan bill that i sponsored to require binding bids from suppliers participating in the competitive bidding program.

the provision supported by my democratic colleagues removes bad actors from the program, something i know i don't have to go over with you and ensures seniors get quality medical equipment. in a compromise with the administration, the law requires that cms implement the provision not earlier than january 1 of 2017 but not later than january 1 of 2019. i think that the 2019 is a very generous timeline. to implement the bill. and would hope with your leadership that we could move it closer to the january 1, 2017 timeline. because at the end of the day as you know, again, there is bipartisan support for this concept. my good friend bill pascrell is all over this issue as well. we think that this will ultimately help separate the good from the bad and ultimately help our seniors. so your leadership would be

critically important to moving that closer to the beginning than the end. >> so it is related to mr. johnson's question too. as soon as the bill passed which was such a very important bill, i don't think i need to articulate to this committee all the important things, have worked to put together the work plan so that we are specific and we do try to meet and where we can beat deadlines. we've been able to do that on some bipartisan legislation in behavioral health that was supported both in the house and the senate in terms of meeting deadlines we were given. and where we can, we're going to try to. thank you for your support and help in doing that. if we need further support and help, he will come and ask. >> thank you. >> but it is something that is a priority. >> thank you. the other issue secretary, is intellectual property rights. >> uh-huh. >> and the creation of innovative new medicines that improve people's lives in supporting good u.s. jobs. we're talk about trade this week. i want to ask you specifically about india. over the past couple of years india's intellectual property climate is unfortunately deteriorated pretty

significantly. and the u.s. ip intensive industries have suffered, including pharmaceuticals. and they have expressed significant issues with respect to the indian market. most notably courts in india have issued compulsory license as well as denied or revoked several patents for popular medicines held by u.s. companies siting an indian law that many believe diverges from india's international legal international trade commitments. have the compulsory license denial been part of any hhs discussions with its indian counterparts? and i know this is kind of a question that might have come out of left field based upon what you prepared today. but would you agree it would be ill advised for any u.s. government employee to undermine the policy of the u.s. to promote strong international property rights in foreign markets? and if you aren't prepared to answer that, would you mind looking into it and getting back to us as we have this trade debate this week?

>> yes, i'm happy to get back. ustr would probably lead in any of those conversations that were in that space. so i think what i will do is coordinate with ustr, see that we get back to you together. because i think you probably know, those conversations with the governments are being led by ustr. we give our policy and programic input to them and they lead. we will make sure that one of the two, either hhs or ustr get back. >> thank you so much. i appreciate your leadership. i yield back. >> thank you. mr. neal? >> thank you, mr. chairman. madam secretary, the opioid addiction issue is pronounced now across my congressional district. and there are all sorts of stories about that indicate a nationwide trend. and curious about the response of your department, the agencies that you oversee and also to ask specifically about prescription drug misuse. >> yes. >> the evidence that you're

coming across on that basis? >> so with regard to the issue that you have raised thank you for raising, in our budget there is $99 million additional dollars to implement an evidence-based strategy on the problem. let's just quickly touch on the problem. when we think about the problem as you articulated in your district across the country opioid and overdose deaths have exceeded the number of deaths from car accidents or any other accidental death. in the year 2012, there were 259 million prescriptions. for opioids. that's more than one for every adult in the country. >> would you say that again? >> over 250 million prescriptions in 2012 for opioids. so that's how many prescriptions there were. so that's more than the number of adults in our country. so that was one prescription for every adult in the country in terms of where we are and the magnitude of the problem. let's go to the solution space we have worked and worked with states and worked with the congress. there are a number of bills here

up on the hill right now. three basic areas we need to focus. one is prescribing. a big part of the problem, as you can see from that number is prescribing. what we need to do there is we need to provide new prescribing guidelines for pain and pain medication that will help the problem. but also in the prescribing space, states need to do what are called prescription drug monitoring plans. they're almost in all 50 states, and they're the means by which a physician has the opportunity to look up and see that a controlled substance was already given to you, and control it that way. same thing with pharmacist. so prescribing is number one. number two is the use of noloxone that actually stops death, and making sure first responders have access. number three is the issue of medicated assisted treatment

combined with behavioral issue, and making sure that we do treatment for those who are addicted. those are the three things. the $99 million additional funding in our budget cuts across cdc and samsa. as we do this, we're doing this in conjunction with states. i've been in massachusetts with your governor and done a joint event with your governor. this is a bipartisan bicameral and state issue. whether it's both sides of the legislative body and both sides of the aisle. and certainly your colleague from kentucky is leading in this effort on the house. so that's our plan. that's what we're trying to do. >> it's noted that in some places in new england, heroin is selling for $3.50 a bag on the streets of some of our old industrial cities. and i have house bill 1821 that i would invite members to take a hard look at. senator markee has a companion bill in the senate.

what action should congress be taking along the lines of this issue, noting that you have there are now more deaths from overdose from automobiles. >> so on the heroin point, we know that the second two elements, the nonprescribing elements of the strategy will work on it. with regard to the places we believe we need help from congress to implement that strategy, one is in the area of uprinorthine that helps and the question of prescribing. the second place is making sure people are trained with the guidelines. >> thank you. mr. busteni. >> thank you. welcome, secretary burwell. last fall they proposed the child enforcement rule. and dave camp along with senator hatch sent a letter expressing concern about this. and the issues that were raised were that the administration in this area was usurping the

authority of congress to write law and was in effect writing law. this has been a repetitive theme. i think chairman ryan raised this issue regard to certain issues relating to obamacare. but we've seen this with immigration, obamacare, other issues of telephone law, tariff measures. this committee in a bipartisan way has been willing to work with the administration on these child support policies. why does the administration choose to trample on the constitution and article i powers in an area where we want to work together? i just don't get it. i understand there is always tension where we disagree. i get it. and that's a fight we're seeing play out in the courts. but why in an instance where we do have willingness to work and cooperate on this important issue area. >> we would look forward to the opportunity to work in this space. in terms of that particular rule, there were some very important things that i know you were familiar with and the fact that some of these things were done in the 1990s. so people have to do paper

applications with regard to child support. so a lot of the rule was about things like improving ability to use technology and other things. and improvements and simplifications to the rule. if there are specific policy areas that are of concern we are listening to those comments that have come in. i think you know we have not finalized the rule. and we'd welcome the opportunity to work on the issues and the substantive areas. some of the things that have been mentioned in the release that happened yesterday are in areas where the states advised us, in the state of texas in terms of we are following what the states have asked us to do in terms of things like using money for people to do job training, which is an issue that is important in a number of the states. >> chairman ryan and i introduced legislation yesterday dealing with this. in order to protect our constitutional right to write law, i know this companion legislation and senate by senator hatch and senator cornyn. but we want to put the administration on notice that

this body the legislative branch writes law, and that the executive branch executes. and we're getting tired of it, especially in an area where we have some agreement. just be put on notice that we're going to assert our constitutional prerogative. on a different issue, the employer mandate has not been implemented. a lot of complications with it. we know how complicated it is. we have heard testimony in the past on this. and i know it does not apply to small businesses 50 or fewer full-time equivalents. but those individuals would still be subject to the individual mandate. why is it has the administration been reluctant to assist these kinds of small businesses? i questioned secretary liu when he was before this committee earlier this year with regard to health reimbursement accounts. and there was a move i think for a six-month reprieve on really

onerous penalties for small businesses. but six months. i just don't get it. have i legislation that would actually make it more effective for small businesses to use these health reimbursement accounts which are completely legal under under aca, but yet for some reason your agency and the administration has decided to close the door on these. i don't get it. shouldn't we be helping small business s businesses and their employees in a troubled time? >> we agree with you and want to do more. in the budget proposal that's before the congress for fy '16 we've proposed expanding the tax credits available for those up to 25 employees. we want to move it up to 50 to expand the access to tax credits they can get. >> health reimbursement accounts are very effective. >> time. >> thank you. >> the time of the gentleman has

expired. >> mr. doggett, are you ready? >> thank you for being here. it seems to me that the focus of this hearing and all of our work should be on how we could make this health care system work better and deliver services and insure more families instead of speculating about some court decision. as you know, madam secretary, i have a number of concerns about the way this law has been implemented, particularly in texas, and the fact that two out of three of our texans who are market eligible for these marketplaces are not yet enrolled. and i think there are things that your office can do for more effective implementation. i would encourage you strongly to do the same kind of cost benefit analysis like you did at omb. look at the contractors and see if they are delivering on their services. i have a number of queries to you about those. i hope to focus on how we can make it better and make the

implementation better. when i hear you accused of being a purse snatcher, it does get my attention. the easiest thing for the court to do and i think the right thing is to not ignore the other 900 pages of the law and focus solely on four words, and if it's necessary to have a legislative fix deleting four words solves the entire problem and allows this law to work the way congress intended for it to work. there are many other ways to address this problem and some states are looking at the possibility that the best way to fix the law, should the court render the wrong decision, is to simply create their own exchange. it's also extremely impressive to me that of all the proposals that have come in at the last minute of republicans to deal with the possibility of an adverse court decision, how many of those proposals attempt to

include as much of the hated obama care as possible, preserving the right of young people up to age 26 to participate in their family's health insurance program attempting to maintain exchanges. if today we're asking you about how to make improvements to reach more people in our laws that would be a reasonable thing instead of the polemics that are going on here. i think, i think it is probably historic. i could not find another circumstance in which members of the house and senate ask a court to deny thousands indeed across the country millions of people an opportunity to get a federal tax credit to say please deny in texas our two senators please deny our constituents $600 million every month in federal tax relief. but let them keep paying taxes to finance the same kind of tax

credits for people in california. or someone from wisconsin, since chairman ryan joined the same brief in the court who says, please have my constituents continue to pay taxes to fund tax credits in connecticut but deny thousands in wisconsin. it's an unusual situation to say the least that that kind of approach would be taken. i believe we need to look for improvements in the law, to strengthen the law, but the idea of denying relief to people who are receiving it right now is to take away from them federal tax assistance and to take away from them the opportunity to get the insurance that is working for their family. to say it's a lemon to provide families the relief with insurance for pre-existing conditions that they never had before, something that is life-saving in many cases, is

truly a misstatement about the work of this legislation. >> thank you. time for the gentleman has expired. mr. roskam is recognized. >> thanks for your time today. there's two issues that i'd like to use our couple of minutes on. first, they're related. it's the discussion around cost sharing reduction payments and then also the basic health program. so just to set the table, the cost sharing reduction payments the issue is whether the administration has the authority to spend out of an account that hasn't been appropriated. as you know, chairman ryan and chairman upton wrote to you and secretary liu on february 3rd. your response back at a staff level -- look i mean, it was sort of predictable. it restates the obvious in terms of the number of truisms about the affordable care act. and then it says go talk to the lawyers at the department of justice because there's pending litigation. little bit of a cute response in

my view, but it's your play. now, where there is no litigation pending and the issue is exactly the same is on the issue of basic health programs. so it wouldn't be satisfactory to say, you got to check with justice, because they're not involved in any litigation because there is no litigation between us at this point in time. so here's my question. the law's really clear that you can't spend money that hasn't been appropriated. there's no ambiguity about that. the constitution's clear, the gao states this many many different entities say that money cannot be spent absent an appropriation. and yet there are a number of states that are announcing that, you know minnesota was a state that says they're going to be implementing the program, new york has announced that they'll operate the basic health program starting in january of 2016. new york has estimated that they'll receive $2.5 billion

"b," billion. how is this possible since the money has never been appropriated? in other words, what extra constitutional authority are you invoking that allows you to spend money that's not been appropriated? >> with regard to the issue of 1311 and where that is, i think 131 1 is about states that want to choose and try to do what thins and ways that seek flexibility. and that's what we do is try to work with states when they do that. with regard to the authority both for the cost sharing issue in 1311, in the budget appendix, it's the place where we believe the authorities lie. >> but there's been no appropriation. you'll acknowledge that, won't you? >> with regard to the authorities there, what we believe is the authorities for the aptc are the authorities because that is what the money -- >> but you're conflating two concepts. you're conflating authorization, which i'm not arguing with and appropriation.

there's been authorization, but there's been no appropriation. how do you appropriate money that hasn't been appropriated? >> but for programs that are tax credits for programs, those aren't part of our discretionary budget every year. in terms of discretionary programs, the earned income tax credit, other tax programs and tax credits are not a part of the discretionary process. >> so just to follow up, would you be willing to come in and give a briefing to me and also to chairman tim murphy who chairs the oversight subcommittee at energy and commerce to clear up these things when we have more time together. >> congressman, we'd look forward to the opportunity to try to clear this up and have the right people come and discuss these issues. >> thanks very much. one other quick point. you mentioned in your opening statement that there was $22 billion in fraud savings, which is okay, not great. the problem is -- and mr. lewis and i found this out together along with all the members of our subcommittee, by medicare's

own admission, medicare is wasting a billion dollars a week. every single week in fraudulent and erroneous payments. so $22 billion over the decade is okay, but it's like turning it off halfway through the year and then letting 9 1/2 years go and do nothing. so i think really need to up the game. i yield back. >> thank you. mr. thompson. >> thank you, mr. chairman. thank you for having the hearing and helping to subsidize my california constituents and their health care. appreciate that. madam secretary thank you for coming out. i hear a lot from my constituents as well about the aca. i hear from people who are pleased that the pre-existing conditions is no longer an issue for them. that their 26-year-old can stay on their policy. that they have access to quality preventive care, which i know for a fact will save us all money in the long run. but i also hear them say that

they recognize their problems with the aca, and they want us to work together to fix those problems. so i don't know how it could be a lot different than other parts of the country. my experience has been that folks want access to quality, affordable health care. and we do have a responsibility to figure out how to make that happen, and i appreciate your effort in that regard. so i'm all for fixing making tweaks making adjustments. congress member black and i are going to introduce legislation today, as a matter of fact, that falls into that category of making a tweak, making a fix. we're going to introduce a bill that would ease the reporting requirements for employers offering coverage to their employees, and it would require that the exchanges use the most recent tax data