the senate passed a similar measure last month. house and senate members disagree on how to make up the lost revenue. the future of the issue is uncertain. the house as a pro forma session on friday. >> with an extension in place, republican and democratic leaders work on a spending bill for the rest of the year. what's the debate on c-span's congressional chronicle. read transcripts of every session and find a full video archive of every member at c- span.org/congress. >> health and human services secretary, kathleen sebelius, on a per dept.'s 2012 budget request and the health care law. mexican president calderon

speaks at an event at the woodrow wilson center. after that, someone says congress is to blame for the 1 $0 billion in wasteful government spending highlighted in a new gao report. a couple of live events to tell you about. first, a forum on the future of fannie mae and freddie mac posted by the multi-cultural real-estate and policy conference. that group includes professional organizations for asian and hispanic realtors. our coverage on c-span3 begins at 9:00 a.m.. then on c-span at 10:00 a.m. eastern, the final hearing of the congressional oversight panel looking into tart's effect on security. members will hear from

representatives of the treasury department, the fdic, and the federal reserve. >> this weekend on a booktv, reuben carter spent time in prison. he'll discuss that and his activist work. also, scott brown on his troubled childhood and rise to public political figure. get our schedules by e-mail. sign up for our booktv alert. >> health and human services secretary kathleen sebelius testified thursday on her department pottery 2012 budget request and the health care law. the house energy and commerce

subcommittee on health is chaired by jim pitts. this is 2.5 hours. >> the chair recognizes himself for an opening statement. i would like to welcome our distinguished witnessed today, the hon. kathleen sebelius, secretary of the u.s. department of health and human services. madam secretary, thank you for your time and testimony today. the department of health and human services is a large department with broad authority

and jurisdiction. with the enactment of the patient protection and affordable care act, we have found there are several sections of this new law that require mandatory funding. hence, bypassing normal appropriations processes. this hearing will give us a chance to consider the budgetary act and make -- implications and administration of this new law. one aspect that concerns me is the office of consumer and folk and insurance oversight. less than eight months after it was passed last year, the department moved regulation of health insurance from the centers of medicare and medicaid service where they had been for years to a new office that reports directly to the secretary. in january of this year, the secretary announced it would be moving. this is interesting because

ociio diplomats many of the new health care private insurance provisions. the office has been in the news for granting over 900 waivers to a private health plans unable to meet various standards set by obama care. it is important to note that ociio was not authorized nor mentioned in obama care, yet the president's budget request a $1 billion increase for program management discretionary administration. it appears this additional $1 billion will be funding ociio. i will be interested in learning more about this new office and the role it plays. i look forward to seeing more transparency in the department's budget. i yield to ms. blackburn from tennessee. >> i will pick up with the

chairman left off with transparency. i think what this outstanding to many is the lack of transparency in this process and the difficulty with getting information. we know that our states have fought the battle. states or receiving waivers. what we see in front of us seems to be a confused process. our states are frustrated. we have heard from state legislators and from governors. they are beginning to agree with your former colleague, governor bredesen, who called this the mother of all funded mandates. there is a dissatisfaction. one of the things i will highlight with you today and question which you is my concern over lack of response. i yield back. >> thank you.

>> i want to welcome secretary sebelius. in these tough economic times, i recognize how tough budget and spending decisions are for the president and congress. i'll only hope that we create jobs and foster economic growth. i think ms. sebelius for implementing the affordable care act. i will fight against republican efforts to de-fund this landmark law. as we work our way out of recession towards a thriving economy that offers economic opportunities for all americans, we must out-innovate and help build the rest of the world. at the core of innovation is research and development. this propels the science and

business of health care. a recent report shows health care supports 211,000 jobs and $60 billion of economic activity in my state of new jersey. it requires resources. investments help research projects get off the ground and leverage resources of the private sector and academia. that is why i was very pleased to see the president's budget includes government investment in health-care research and development. it recognizes that nih and fda are employed to facilitate an environment where americans innovate. i wanted to mention my disappointment in one program, the termination of the medical education program. it has reversed and threaten the stability of the pediatric workforce and the small class of hospitals that receive this funding, which includes the children specialized hospital in my district.

it trains approximately 40% of all pediatricians. eliminating this has a major negative impact on the primary care and impacts access to specialty care for children. i am committed to reauthorize and can fund this program. really, i wanted to stress that i really think that as we move forward with the affordable care act, i know the anniversary is coming up i believe on march 23, already there are so many of my constituents and so many people i have talked to that talk about the benefits of eliminating pre- existing conditions, putting their children on their policies. what we have done with seniors in terms of cutting back and eliminating the doughnut hole, eliminating " pay four preventable care, people are aware of the benefits.

i am very much opposed to any efforts to the fund the program -- to de-fund the program. thank you. >> thank you. mr. upton? >> today's ago we heard from some of the nation's governors on the negative impact the new law will have on their states and the quality of our health care. will we have heard it is when a similar, expressing their concern the mandates and the requirements coming out of d.c. are hindering their ability to deal with the state's problems. the president offered some flexibility on monday that the states could opt out of some aspects of all a few years early as long as they met every one of the goals. i am concerned the states will only be allowed to take advantage of the so-called flexibility if the construct a program that looks almost exactly like the system that was

set up in health care law. states need flexibility without all the strings and caveat attached. the president called on the governors to come up with a bipartisan proposal on medicaid. dozens have asked for relief of the mantis of effort requirements to direct medicaid funds to those most in need. if states are instead that forced to impose steep payments to providers, they will likely drive more doctors and providers out of the medicaid program and out of the practice of medicine altogether. i believe that is detrimental to both patients and the quality of care they respect -- they expect to receive. we need to repeal the maintenance of effort as a place to start, and i hope the administration will work with this committed to expeditiously repeal those requirements. i also want to hear which programs she believes are

redundant and duplicative. the federal deficit, $1.6 trillion, we must go through the budget with a fine tooth comb. revealed,ay's report the subcommittee on oversight investigation, the federal government is risking -- is wasting billions of dollars. we cannot simply fund. because of what we have done before. every program has to be scrutinized. i look forward to working with you and i yield the balance of my time to mr. cassidy from louisiana. >> governor deval patrick testified tuesday that massachusetts is a vision of our future. i agree, but almost everything else he said was false. we were told because of this model that e.r. visits are down. they're not. we're told the private insurance

market is not affected. actually, fewer businesses are offered premiums. we were told the cost as an issue is being addressed. actually, according to the globe and national journal, people are being dis-enrolled and dental benefits are being cut. the democratic state treasurer said if the net the state implements a plan like massachusetts -- if the united states diplomats a plan like massachusetts' we will go bankrupt. i yield back. >> yields three minutes to the committee chair, mr. waxman. >> i like to commend you on the work you have done on the affordable care act. the job you were given is imposing, but you have met the leadership of steadfast

commitment. at today's hearing is meant to address the president's budget proposal for hhs for fiscal year 2012. that is very far away at this point. i am much more focused on the threats and the continuing resolution passed by the house. i believe the cuts proposed by the republican budget would be just devastating to the mission of your department. the republican proposal would cut 23% from the centers for medicare and medicaid services. this will devastate the ability of the agencies to meet its basic functions like pang medicare plans, cracking down on fraud, and funding health programs. efta would see cuts of 17%, with enforcement of the new safety law got it. the cdc would be cut by 37%, living americans more exposed to

viruses and illnesses. the community health centers program with strong bipartisan support would be cut by $1 billion, closing 127 health centers and cutting off of 11 million patients from the care they need. cuts of this magnitude are not belt-tightening or doing more with less, the go to the heart of the core missions of the agency's that comprise hhs, jeopardize access to health care, research, and the safety of food and pharmaceuticals. i agree with president obama's balance to us yesterday for the fiscal year. this agreement should be bipartisan, free of any parties social or political agenda, and should be reached without delay. thank you for being here today and i urge you to contain it to work diligently to implement the essential protections of the affordable care act, and i would be pleased to yield to any of my

colleagues on the democratic side. >> of what to second what mr. waxman has just said. when we look at the republican budget, we see things cut out that are really just unimaginable. we heard the governors, and i know madame secretary, we heard the republican governors come here and basically say that all but the health care at all, -- the health care law, the want the government out of people's lives. being 49thhappy with and 50th in education and health care, there will be happy, but some of us feel affordable health care is a right and that is what we try to do. the negativity boggles my mind. >> at this time, we will go to war with this. i will introduce the secretary of health and human services,

kathleen sebelius. she was first elected to the kansas house of representatives in 1986. in 1994, secretary sebelius was elected state insurance commissioner for the state of kansas. in 2002, she was elected to be the state's governor. madam secretary, we welcome you to the committee and look forward to your testimony. i>> thank you very much. thank you for inviting me here today to discuss the 2012 budget for the department of health and human services. in the president's state of the union address, he outlined his decision for how the u.s. could out educate, out build, and out innovate the world so we could give it every family and business the chance to thrive. i think our 2012 budget as a

blueprint for putting a portion of that inaction. that makes investments for the future so we grow our economy and create jobs, but we also recognize we cannot build lasting prosperity on a mountain of debt. years of deficits have put us in a position to make tough choices. to invest for the future, we have to live within our means. we look closely at every program and our department. when we found waste, we cut it. when programs were not working well, we redesigned them. in some cases, we cut programs we would not have cut in better fiscal times. i look forward to ensuring questions, rigid to answering questions, but i will share pilots. the past 11 months, we have worked with our partners in congress to deliver on the promise of the affordable care act. children are no longer denied coverage because of pre-existing

health conditions. families have protections and mirabeau over its " close this is get relief from soaring health-care costs, seniors have lower-cost access to prescription drugs and preventive care. this builds on the progress by supporting innovative new models of care that will improve patients' safety and quality while reducing the rising burden of health costs on families, businesses, cities and states. we make new investments in our work force. making quality affordable care available to millions more americans in creating hundreds of thousands of new jobs. at the same time that includes additional proposals that strengthen program integrity in medicare, promote lower madison cost -- lower madison cost, and reform the quality improvement organization that a provider's improve care. but also strengthens medicaid,

including funding for the transitional medical assistance program. programs which help keep health costs down for low-income individuals and help keep their vital coverage. to make sure america continues to lead the world and innovation, are budget includes funding for the national institutes for health. new frontiers of research like cell-based therapy economics have the promise to zero unlock transformative treatments and cures, from cancer to autism. the budget allows leading scientist to continue to pursue discoveries while keeping america at the forefront of research. because there is nothing more important to our future than the healthy development of our children, our budget includes significant increases in funding for child care and head start. science shows that success at

school is significantly enhanced by high-quality early learning opportunities. these investments are some of the wisest we could make in our future. our budget does more than provide additional resources. that also aims to raise the bar on quality and child care programs, supporting key reforms to transform the nation's child- care system into one that fosters help the development and its children ready for school. it proposes a new early learning challenge fund, a partnership with the department of education, which promotes state innovation and early education. these initiatives combined with the quality efforts underway in headstart are an important part of the education agenda to help every child reaches his or her academic potential and make our nation more competitive. the budget also promotes a strong family relationships. it supports child-support and fatherhood initiative that encourages fathers to take

responsibility for their children, change his policies and more of that support reaches the children, and maintains the commit to vigorous enforcement, promoting healthy relationships between fathers and their children. we also fund a new performance based incentives. such as reducing long-term foster's days and the recurrence of choked no treatment. -- of child maltreatment. we need to make every budget dollar account. that is why we provide a support for the and president bush to step out waste, fraud, and abuse. an effort that more than pays for itself, returning a record of $4 billion to taxpayers last year alone. in addition it provides a robust package of the minister of improvements to medicare and

medicaid and the proposals include prepayment scrutiny, expanded auditing, increased penalties for improper actions, and strengthening the ability to apply that corrective actions and address state activities that increase federal spending. they should deliver over $32 billion of savings in 10 years. we have made eliminating waste, fraud, and abuse a top priority. the past few months we have also gone through the budget program by program to find additional opportunities to make our resources go further. in 2009, we eliminated a program because it is duplicative. cdc funding has been helping states reduce chronic disease, but the funding was split.

one grant for heart disease, another for diabetes. and not make sense, so a lot of those conditions have a lot of the same risk factors at now states will get one comprehensive grant that allows more flexibility to address chronic disease in their home territories more effectively. the 2012 budget makes tough choices and smart targeted investments. so we have a stronger, healthier, and more competitive america tomorrow. that is what it will take to win the future and that is what we're determined to do. thank you, mr. chairman, and i look forward to answering questions. >> the chair thanks the gentle lady and recognizes himself for five minutes for questions. there was a fund created to create funding for programs authorized but the public health service act.

from fiscal year 12 to fiscal year 21, there will be $17.5 billion deposited. who has the authority to determine how these funds are spent? >> our department, in consultation with congress, presents a spending plan for the prevention fund a year at a time. >> are you authorized to spend this money without any further congressional action? >> yes, we are. >> are you authorized to add funds to the program above and beyond what congress appropriated for that program in a given year? >> yes. >> like most states nationally, by state is struggling with a major projected shortfall in the major projected shortfall in the