operate as as mr. hoyer said yesterday, not precise enough. it seems like millions of individuals who listen to your speeches now find themselves without coverage and are now scrambling to find coverage in a marketplace that offers more expensive plans with fewer options. in response to my constituents' calls for help, i created a portal on my website, no patches or fixes needed, that allows those who have experienced problems to reach out and tell me about their personal experiences. in the just the last few days, my office received dozens of complaints regarding increases in their monthly premiums. i received one such notice from a mother in her early 50's to just received a notice that not only will her insurance premiums double, but she will also have to switch insurance -- insurers to keep their doctors due to the affordable care act. can you imagine receiving notices like this?

i can tell you that just in my district, the 11th of georgia, many more are experiencing this situation. . this is like telling them their premiums will double. i know neither you nor the administration would never advocate for such a policy, yet here you are subjecting those currently in the individual market to such government intervention. and i would hope that you would agree with me and recognize that these increases are a heavy hardship on my constituents, on all of our constituents, republicans or democrat. now i get to my questions. you know the health care law included a hardship exemption from the individual mandate. yet the administration has failed to finalize the application form for their hardship exemption, 3 1/2 years after we passed this law. as of today, can an individual

apply for a hardship exemption from the individual mandate on healthcare.gov. yes or no? >> i don't know. >> i do, it's no. on october 15, politico reported that if the online system for getting into obamacare coverage is rickety, the system for getting out of the mandate doesn't even exist yet. h.h.s. says it will take another month at least for the administration to finalize the forms for the hardship exemption from the individual mandate. why has it taken 3 1/2 years to finalize a simple application form for an exemption from an individual mandate? >> as you know the individual mandate is not in place until next year. we have made it very clear that if somebody is medicaid eligible in a state that doesn't choose -- >> my last question, an estimated 16 million people in the individual market have or

will receive cancellation notices stating their health insurance coverage does not meet minimum coverage requirements of the affordable care act. the bill specifically grants you, madam secretary, the power to determine the criteria for hardship exemption. will you provide all of these individuals a hardship exemption since the affordable care act is taken away their plan. will you do that? >> no, sir. i think those numbers are far from accurate. 95% of americans who have health insurance will be in a continuous plan, medicare, medicaid, employer-based v.a. 95%. 5% who are in the individual market, a portion of those 5%, a portion of them, about 12 million people, a fraction of those 12 million, will have a plan that doesn't meet the criteria and has not been grand fathered in. they are indeed receiving notices. many of those individuals, half of them, will be eligible for

financial help get agnew plan, and they have many more choices in the marketplace. we will not have a blanket exemption. >> sounds like a hardship to me. >> the gentleman's time has expired. mrs. christensen. >> thank you, mr. chairman. thank you, madam secretary, for being here and thank you for all that you and your staff at h.h.s. has done in implementing the affordable care act to ensure it would provide the many benefits to children, to women, to medicare beneficiaries, and to ensure security to those who already have insurance, as well as lower costs. the biggest complaint has been about the application and the enrollment website, but we have heard over and over from you that those are being addressed. you will recall, and i know my colleagues will recall, that congressman rush and i have always been concerned about those who do not have internet access, those who are uncomfortable using the internet

and would not ruse it -- use it. i would want to remind everyone that there are other avenues for enrolling, either by telephone or by paper. either alone or with the help of a certified application assistant. but my question goes to one of the rumors that has been circulating. there are many rumors about how the affordable care act has affected part-time workers. some of my colleagues on the other side claim that the companies are moving workers to part-time jobs because of the health care reform law and that low-wage workers are being detrimentally affected. i understand why these claims are being made. that's just another part of the ongoing efforts to undermine the law. would you take a few minutes to just set the record straight on the part-time issue. >> certainly. 95% of businesses in this country are small businesses.

under 50 full-time employees, and there is no responsibility that any of those employers have to provide health coverage for their employees. on the other hand, there are now tax credits available for some of the smaller employees -- employers who want to cover coverage to actually come into the marketplace. for the other businesses, the businesses hiring 50 or more, there is a standard that says an employee is considered full-time if he or she works 30 hours a week. and that really came from a market snapshot, with help from the small business administration, of where employee benefits were in the private market based on hours of work. what was a part-time or full-time employee. what we know about the economic data is the high point of part-time workers was in 2008

and 2009, at the height of the last recession, it has been decreasing each and every year. there is no data to support the fact that there is an uptick based on the impending affordable care act. i am sure that there may be some individual employers making some business decisions about how many workers they want full-time and how many part-time. but i can tell you there is no economic data or employment data that supports the notion that this is an effect of the law. >> it's my understanding that part-time workers, the lowest percentage of workers in many, many years right now. >> for the first time as you know, congresswoman, part-time workers will have options for affordable health insurance. they never had that before. they have never had options in the marketplace. they have never had some health purchasing coverage for themselves and their families.

their full-time colleagues have, but they have not. they will have options. >> just to be clear, i had another really long querks the last part of it, it would be fair to say at every point along the way you expected this website to work based on everything you had been told by the contractors up until that point? >> i expected it to work and i desperately want to get it working. >> more than anyone else i am sure. >> we are committed to fixing it. the only thing that i think build back the confidence of the public is fixing it. >> thank you. >> the gentlelady's time has expired. mr. scalise. >> thank you, mr. chairman, for holding the hearing. thank you secretary sebelius, for being with us. last week when the contractors were here, i asked them under oath if they had actually delivered the system they were contracted to build. all four answered yes. i want to ask you, did the contractors deliver the system that you contracted them to build? >> i don't think i can accurately answer that question.

what we know we have a system that doesn't function properly. >> definitely know that. >> as we fix things we'll know more about what is broken along the way and i'll be able -- >> someone in your office -- somebody in your office oversaw the implementation and received the product. they either said this is the product we contracted and paid hundreds of millions of dollars to build or wasn't. does somebody in your office -- >> i think we can say that the products tested individually, verified individually -- >> clearly it was an integrated system. i used to write programs for a living. i developed software products for laving. if you're developing an integrated system, it's irrelevant if one isolated component works by itself, when you but when you plug it in together it doesn't work, that's a system that doesn't work. one of the questions i had and others, somebody in your agency made a decision, weeks, literally weeks before the deployment torques change the system. instead of going from a browser

ability where somebody like die kieyack or amazon.com, could shop for products, look at prices before they purchase, which is how consumers are used to doing it, made a decision to change it around and gather the information first before you could let them see prices. was that you who made the decision? >> no, sir. >> was that miss tavener. >> it was. and a team who look -- >> did that team make the decision because they knew once people saw the prices -- we are getting reports from all our constituents of dramatically higher prices than what they were expecting -- did you make the decision because knew that when they saw the prices they might not want to buy the product so you wanted to gather the information first? >> sir, first i did not make the decision. i was informed about the decision. clearly they can see the products. there is no requirement -- >> over two hours trying to get into the system. i never once got to a point where i do see a price.

i did get kicked out and got the blank screens. i do want to share stories with you from some of my constituents. we started a page on faith-based -- facebook and twitter. people are sharing stories. we are getting lots. randell said, my health care premium went up 30%, $350 a month increase. michelle, our insurance premiums are going up $400 a month and our deductible has increased. then sean from covington who said, my current plan through united health care is no longer being offered in 2014 due to obamacare. i received a letter stating that the new health care law was indeed the reason for the removal of my current health care plan. madam secretary, what would you tell sean who liked his plan and now has lost it? he was promised by you and the president he would be able to keep that plan. what would you tell sean now that he's lost his plan? >> i would tell sean to shop in

the marketplace and out of the if united chose not to keep sean's plan in effect for sean -- >> because of the law. >> sir, the law said, if you keep sean's plan in place, if he liked his plan, if you -- >> sean likes his plan. >> then the plan is still there. >> you and i may disagree who you work for. i work for sean. you work for sean, madam secretary. sean lost his plan that he liked. there are thousands and millions of shauns throughout this country that lost the plan they liked because some bureaucrat in washington said we think your plan's not good enough. even though you like it. even though you were promised could you keep it. you are now not able to keep that plan. you deserve to give sean a better answer than you have to shop for something else. >> the gentleman's time has expired. mr. mcnerney. >> thank you, mr. chairman. thank you, madam secretary, for coming today. i'm going to foum on mr. doyle's

line of questioning. one concern i have with the fallout from the website is that many users who tried to sign up and were discouraged because of problems will now be too discouraged to come back once the site is fixed. what do you plan to do to get those folks to come back? >> sir, we intend to invite them back. formally by email, by message, but we don't want to do that until we are confident they'll have a different experience. fixing the site is step one. and then inviting people back to the site to make it clear that when our timetable is fulfilled they have four months to shop for affordable health coverage on a fully functioning site. we know we are going to have to spend is special time and attention on young and healthy americans who don't start out thinking they need health insurance, aren't away of the law, certainly don't want to use a failed or flawed site. so we are going to have to spend

some particular attention on them. >> thank you. have the software specifications for the website and related software element including the testing specifications has that changed since the initial rollout? >> i know that there certainly are some changes because -- since october 1? >> since the rollout. >> the specifications haven't changed. we are certainly fixing as i say speed and reliance is one of the issues we are taking a look at. that's the performance side. there also are functionality sides that things do not work as they can including the enrollment passed on to insurers. we are fixing functionality and i don't think that's a change in the special. i think it is actually making the system work the way it should. >> are you -- is the department doing prioritization on the

problems? >> yes. >> could you describe that a little bit? jeff f last week when joined us for this short-term project, we asked him to lead a sort of management team. we have pulled in all of our contractors, as well as additional talent that they may have available, -- available. we have talked to tech folks in and out of the private sector, and insurance, some of their tech experts, to get all eyes and ears, made a full assessment, developed a plan for fixes along the way, have a punch list for going after those fixes, and we are doing a daily tech-free thing and blog to tell people what we have done, what we have fixed, what's coming next, what the functionality is. and we intend to do that until it's fully functional. >> thank you. madam secretary, looking past

the initial problems with the rollout, do you think that the affordable care act will be successful in bending the health care cost curve and reducing the fraction of our national economy that goes for health care? >> well, i think that we have lready had some success. the goal is to continue to achieve that, fully insured population, arguably, with preventive care, with an opportunity to see a primary care doctor and not go through the emergency room will in and of itself reduce cost. having people identified earlier who may have serious problems and managing those problems will reduce health costs. i think the delivery system also needs some considerable help in paying for a number of procedures, number of tests, number of prescriptions, but paying for health outcomes. >> thank you. >> mr. latta. >> thank you very much, mr.

chairman. madam secretary, thank you for being with us today. appreciate your testimony so far today. there are some questions we have received from our constituents back home, specifically about what's going on with the website and for them. and so what i'll do i'd like to get those to you, but there are a lot of questions here and a lot of thoughts going into a lot of these questions. if i could start with last week's testimony when the four contractors were here. and in one of the questions that i had posed to ms. campbell from c.g.i., in her testimony she stated that they delivered the medicare.gov and also federalreporting.gov. and i asked at that time were these sites more or molest complicated than the site we are talking here today. she said of site today was more complicated. and in the questioning, in terms

of her testimony, we have been hearing about this end-to-end testing that wasn't happening. that we had individuals out there saying that two weeks had been done. but ask her about was there sufficient enough time when they did the medicare.gov. the response she gave me back was on medicare.gov, which was a less complicated site. she stated we had sufficient time to test the system before it went live. i asked her in a follow-up, then what, was that sufficient time? she said we had a number of months before the system went live at that time. i just want to make sure because again sometimes things don't get reported accurately. in the "u.s. news and world report" there was a report on october 18 of this year and some questions going back and forth, i want to make sure you record it properly. after two weeks of review the h.h.s. secretary concluded we

didn't have enough testing specifically for high volumes for a very complicated project. the online insurance marketplace needed five years construction a. year of testing, she said. we had two years and almost no testing. is that correct? >> i don't know the quote. i never suggested that we needed five years. i don't know what that's from. >> that's one of the things i want to check. >> we clearly did not ever have five years. the law was signed in 2010. >> last week when you were down in texas you were being asked by a reporter about the system and the launch. one of the parts of the question was that at what point did you realize the system wasn't going to be working the way you envisioned before the launch and why didn't we stop it before the launch? and again this is what was reported, we knew we had another six months we would probably test further, but i don't think anyone fully realized both the

volume cause such problems, but also exposed some of the problems we had. going back to ms. campbell's statement that they tested more extensively on a system that was not as complicated but h.h.s., c.m.s. decided to go forward with only a very short period of testing. do you think that was acceptable? >> clearly looking back it would have been ideal to do it differently. we had a product, that frankly, people had been waiting decades to have access to affordable health care. medicare existed well before the website. medicare is a program that started 50 years ago. the website was an additional feature for consumer ease and comfort. so they were not launching medicare. they were not delivering health benefits to seniors. they were putting together an additional way to enroll in

medicare. i would suggest, sir, that we had deadlines in the law that people had benefits starting january 1. we wanted an extensive open enrollment period so that a lot of people who were not familiar with insurance didn't know how to choose a doctor or choose a plan. had never been in this marketplace or people who needed to understand fully what the law offered, had ample time to do that. so the date that i was, again, required to select for open enrollment, that's again part of the statute, how long would open enrollment be, we picked that date, all the contractors that began early in this process in the fall of 2010 when we issued -- i'm sorry, 2011 when we issued the initial contract to c.g.i. and to s.s.i. knew the october 1 date. that was not changed. it wasn't added to. as we got closer to the system,

one of the reasons, again, that we peared down what needed to launch on october 1 was an attempt to minimize the risk to the system to get people to their ability to see clearly what they were entitled to, what the plans were, and if they chose to to enroll. clearly the testing should have been longer, should have been more sufficient. >> the gentleman's time has expired. mr. braley. >> thank you, mr. chairman. madam secretary, people who are watching this hearing might be under the assumption there is some kind of political debate going on over the affordable care act. people in iowa don't care anything about who is winning the political debate. they want these problems fixed and they want them fixed now. i think that's the responsibility of everyone in this room to make sure that that happens. i tried to go into the marketplace on october 7, and i encountered problems immediately dealing with the security code

questions which required you to select dates. one of them was type a significant date in your life. today is my birthday, so i put that in. i tried three different ways of entering that date, and got a message each time, important, this is not a valid answer. same thing for the third date entry. and a lot of times when you're registered online for anything, and you have to put a date in, there will be a little prompt there that tells you what the format is you're required to enter. do you know have we solved this problem in the security code area? >> yes, sir. one of the initial issues was just getting people into the site. and the i.d. proofing, which is a two-step process, one is you give some preliminary information and you set up a password, but the secretary to ensure that your personal data can't be hacked, can't be interfered with is the second

step where some personalized questions, which only can be verified by you, are indeed part of that. again that was an initial hold up in the system. we focused a lot of attention on that and the first several days it was fixed. only to then discover there were system problems throughout the application. and that piece has been fixed, but i would suggest it also was a function of trying to make sure we had the highest security standards. that we were not cavalier leer about someone -- cavalier about someone's personal information being able to be addressed and attached. and it was a functionality that didn't perform properly but does now. >> one of the things that keeps coming up in this hearing because you are from kansas, references to the "wizard of oz." people went to see the wizard because of the wonderful things he did. the affordable care act is doing a lot of great things in iowa. the des moines register wrote

that iowans buying health insurance on the government's new online marketplace will face some of the lowest premiums in the country. it's increasing competition in our state. iowa consumers are able to shooze from 40 health plans in the marketplace. you mentioned the growth of health care spending is at the slowest rate in 50 years. 50,000 iowa seniors have received prescription drug rebates. bans on pre-existing conditions are allowing people to get coverage and switch carriers. and now insurance premium increases are subject to review and can be rejected by the people reviewing those plans. all of these goods things -- good things don't mean anything unless we solve these problems. what i need to know is how confident are you that the problems will be fixed by december 1? again, congressman, i have committed to that date because that is the assessment of both

inside and outside experts have analyzed and i think they kicked all the tires and looked at all the system. i know that there is no confidence in that date until we deliver on the date. i am well aware of that. that's on me. >> since americans were supposed to have six months to sign up, would you support ensuring they still have six months by extending the open enrollment period for two more months? >> at this point, congressman, they will have a fully four months -- fully functional all ways to sign up. again there are alternate ways and the website right now that people are getting through. the open enrollment period is extraordinarily long. it's about six times as long as a typical generous open enrollment period. and it's important for the insurance partners to know who is in their pool so again they can stay in the market next year and know who they are insuring.

we think that the timetable will allow people four months' time to fully use the website. they can use it right now. they can use the call center. they can go to navigators. they can enroll. >> the gentleman's time has expired. mr. harper. >> thank you, mr. chairman. thank you, madam secretary, for being here today. i'm sure there are other things you would rather be doing but we welcome the opportunity to have this conversation. i'm going to ask the clerk to bring you a document for you to look at so i can ask you a couple of questions. if you can go to page 8 on that, i have highlighted an item there. but this is a copy of a c.g.i. slide show from october 11 discussing technical issues that must be addressed within the website. on page 8 of what i handed you, c.g.i. recommended that c.g.i. and c.m.s. have a review board to agree on which issues can technically be solved and which

hould politically be solved. would such a review board convene? >> i can't tell you. i have never seen this document and am not aware of this recommendation. >> c.g.i. is responsible for the website, correct? >> c.g.i. is responsible for the application. >> for the application. does it surprise you that in the slide show that they gave on october 11, they acknowledge political reasons for -- >> sir, again. i have never seen this document. i have no idea what that means. did you ask c.g.i. when they came? >> can you find out for us if such a review board was done and any decisions were made on political reasons or other reasons and find that out for us? >> sure. that question needs to go to c.g.i., but i can ask them to report to you. >> if you do that. >> this is their document if i understand it. this is not our document. >> would you turn to page 9 of that document, please. it states challenges on page 9

in this presentation by c.g.i. it says under challenges, unable to determine at this time whether low enrollment counts are attributable to system issues or due to users choosing not to select or enroll in a plan. so those are two completely different issues, obviously. if it is a system issue that's something you have confidence at some point will be resolved, correct? >> yes, sir. >> if it's a user selection issues, that's an entirely different story, is it not? >> yes, sir. >> when you use the phrase earlier about a punch list, that's like having somebody move into a house. someone's buying a new house and they go through and they have been told this house is going to be ready for you to move in on october 1. they load up the van, they come in, and they get in and it's not finished. part of the plumbing's not right, the wiring's wrong. they go in. this creates the situation where

health care shouldn't be a zero sum game. we want to be fair to everyone. we want to help people who are vulnerable. but at the same time we shouldn't have to hurt folks. we've got people in my district, in my state, who are getting notices of cancellation. they are being hold of higher premiums they are having. these are great concerns that we have. how do we work through that? i want to say i appreciate you accepting responsibility for these initial rollout failures that we have had. but who is ultimately responsible? it is the president, correct? >> for the website? >> the president is ultimately responsible for the rollout. ultimately. >> no, sir is. we are responsible for the rollout. >> who do you answer to? >> i answer to the president. >> so is the president not ultimately responsible like a company c.e.o. would be? >> sir, he's the president of the united states.

i have given him regular reports and those -- i am responsible for the implementation of the affordable care act. that's what he asked me to do. >> so you're saying the president is not responsible for h.h.s.? >> sir, i didn't say that. >> ok. so the president ultimately is responsible. i think it's great you're a team player and taking responsibility, it is the president's ultimate responsibility, correct? >> you clearly -- whatever. yes, he is the president. he is responsible for government programs. >> my time has expired. >> the gentleman's time has expired. mr. lujan. >> mr. chairman, thank you very much. before i begin i'd like to ask unanimous consent to submit into the record some articles from new mexico publications, albuquerque journal, albuquerque business journal, the first entitled small business owner, health exchange will save me $1,000 a month. >> without objection. >> i see my time did begin there. ail try to get through this, mr.

chairman. addam secretary, i was intrigued by line of questioning by congressman green asking questions about the individual marketplace. how volatile was the individual marketplace before the affordable care act became law? >> i would say it wasn't a marketplace at all. it was unprotected, unregulated, and people were really on their own. >> madam secretary, the keyser family foundation reports that over 50% of individuals that have coverage in the individual market, churn out coverage every year, they are priced out or drop it. is that consistent with what you are aware of? >> that's an accurate snapshot. about a third of the people are in for six months. and over half are in for a year or less. >> individuals that were in the individual marketplace before the passage of the affordable care act did not have the same protections in group coverage? >> that's true. >> would those individuals in the individual marketplace sometimes have higher co-pays?

>> higher co-pays, unlimited out-of-pocket costs for often coverage that was medically underwritten or excluded whatever medical condition they had in the first place. >> these are typically one-year contracts. if they use the plan because they got sick or a car accident or victim of domestic violence, sometimes they would be thrown off their plans or rates would go up. >> yes. >> i think that's important to note, madam secretary. i'm intrigued as well that my understanding is last month h.h.s. conducted an analysis that found that nearly six out of 10 uninsured americans getting coverage through the miles per hour will pay $100 per month s. that correct? >> a plan available for less than $100 if that's their choice. >> that number would be even higher, would be better, if more states chose the option of using federal funds to cover their low-income population? >> definitely. that's just a marketplace snapshot. those are people who will be in the marketplace. >> mad yucca mountain secretary,

i -- madam secretary, i don't think i have heard anyone from the other side of the aisle today, my republican colleagues, ask you how can congress work with you and support you in fixing this website, fixing this problem? i hope that we all agree we want this website fixed. i would yield to anyone that would disagree. see no one accepting that. i'm glad to hear that we agree with this. now, madam secretary, what can congress do to work with you to fix this website? >> well, i'm not sure that there is hands on work that you can o. maybe we have technical expertise. but i would say getting accurate information to constituents is helpful. letting people know that they can check out the facts in the law. that they may be entitled to some financial support. that cancellation of policies means that the policy that they had may not exist but they have a lot of choices of new policies and a law that now says they must be insured in a new polcy. they don't have to be insured by

their company at a higher price. >> i appreciate that, madam secretary. going back to the individual marketplace, madam secretary, did this congress in previous years before the affordable care act make it illegal for health insurance companies to raise rates on someone half they submit add claim for going to the hospital or becoming sick or getting rid of pre-existing conditions? >> no, sir. >> madam secretary, once last note here. it seems we received some horrible news that there are bad actors already taking place of fraudulent websites to imitate the health care exchange or misleading seniors into disclosing their personal information. i signed on to a letter to you led by my colleague, representative raul luis, out of california, to request you prioritize fraud prevention efforts. what the administration does to prevent these fraudulent acts. >> i can tell you, congressman, the president felt very strongly that needed to be part of our outreach effort which is why the attorney general and i convened representatives of state

attorneys general, insurance commissioners, the u.s. attorneys, and the justice department and the federal trade mission which has jurisdiction to make sure that we first got out ahead of some of this developing consumer outreach, no one should ever give personal health information, because personal health information is not needed for these policies any longer. that's a red flag. we want to make sure people turn over potential fraudulent acts. we have put training in place for navigators. we have our law enforcement -- >> the gentleman's time has expired. i would just note that we -- with the indulgence of the secretary, we are hoping that we can have all members ask some questions, we also know that with four minutes we are going to have a little trouble. i am ' going to ask unanimous consent that we try to limit our questions and answers to no more than two minutes. is that ok?

otherwise we'll -- there will be a lot of folks who will not ask a question at all. >> mr. chairman, i would submit to, if the questions get submitted, we would be happy to provide timely answers. >> can i do that? with that we'll try two minutes. mr. lance. >> i guess i won the lottery on the two minutes. madam secretary -- >> the gentleman's time has expired. >> 20 seconds, mr. chairman. on the website, madam secretary, the contractors testified last week that they needed more than two weeks for end-to-end testing. why in your opinion was there not more than two weeks? >> again, we had products -- the insurance policies themselves by companies were loaded into the system. so we could test up until then, but it wasn't until september,

mid september that was done. again the contractors said we would have loved more testing time but we think we are ready to go ahead. >> i believe that will ultimately be a dispute between c.m.s. and h.h.s. and the contractors. if there's anything we can do regarding that because obviously that didn't work. i had thought given the signature issue of the president, the website would be redy. number two, in my judgment, the president's statement were overstatements. the four pinocchios is an indication of that. there is a report in the new jersey newspapers this morning that 800,000 people in new jersey who purchased their policies in individual or small employer markets will be affected by this. mr. walden in a previous question mentioned the fact that in an individual market you would be able to keep your policy, grand fathered, yet regulations issued by h.h.s. say that grand fathered status was

not -- would not be a continued for so much as a $5 change in a co-pay. is that accurate? do you believe that is a significant change? >> sir, we gave i think in the grandfather regulations a guide for how pricing could change, medical inflation, and i think it was in most cases plus 15%. there were some individual consumer p out facing issues that were more rigid than that. but i would say that in terms of having companies being able to select a profit margin, that was certainly built into the grandfather -- >> that's too little a change. >> the gentleman's time has expired. mr. tonko. >> thank you, mr. chair. welcome, honorable secretary. thank you for fielding our questions and for responding

when you were extend the courtesyle to offer a response. as a strong supporter of the affordable care act, i'm frustrated and i think it's fair to say that the american people are frustrated as well. i heard you here many times this morning say you're frustrated. i think by and large people want this law to work. when i talk to folks back home in the region of new york that i represent, even people who opposed the law initially aren't rooting for the failure of the affordable care act. they want congress to come together to fix these problems so that we can move on to real issues that matter like creating jobs and growing the economy. my home state of new york, which also experienced website problems at the outset, has now completed enrollment determinations on over 150,000 new yorkers. with more than 31,000 having already signed up for quality low-cost health insurance. given that many states have had success in overcoming these initial website issues, has h.h.s. looked at what these state websites are doing as it searches for solutions to fix

healthcare.gov? >> absolutely. we shared a lot of information going in. i think that the hub feature that we have in our website that all states are using, including the state of new york s. fully functional. that's good news for new york and california and others who are running their own state websites. but we are learning from them we shared information with them, and we are eager for all the health and assistance moving forward. >> many states made the illogical choice of rejecting medicaid expansion contained in the a.c.a. that would help some of their poorest citizens get access. this is despite the fact that medicaid expansion is almost entirely financed by federal dollars. can you comment broadly on h.h.s.'s plan in the future to encourage more states to run their own marketplaces and expand medicaid so that the law can function as designed? >> absolutely. most recently last week the state of ohio did move into the

medicaid market and we now have 30 governors, i think 27 states have fully completed the process, another three are in the process. republicans and democrats. who -- some of whom sued us about the constitutionality of the act who are now deciding that for the citizens of their state they want to be part of the expanded medicaid. we'll continue to have those conversations. it's not just about the marketplace. it's also about medicaid. >> thank you. the speaker pro tempore: the gentleman's time has expired. mr. cassidy. >> you said that only if -- an individual policy is only canceled if it changes significantly, but to be clear, after may, 2010, if co-insurance went up by any amendment, even by $1 according to your regular laces -- regulations, that would not qualify as a grandfather clause, just to have that out

there for the record. i gather even by a doll amplet that said i get a letter from someone in my district, adrian, she lost her coverage. she lost her coverage because the coverage is gone. she's gone on the exchange. she doesn't qualify for a subsidy. but that her premium and out-of-pocket costs under any plan is $10,000 a year. she feels betrayed by her government. she has to sit there asking herself is this fair. if you were she, do you think this would be fair? >> dr. cassidy, i want to start by the amount that you gave is not accurate. i was told $5 not $1. >> for the co-insurance it's any amount. but i have limited time. do you think -- if were you she, if you were adrian, do you think this is fair? loses her spousal coverage. no subsidies? >> i don't have any idea what she's looking at. can i tell you, again, based on

what we have seen in the market, what we have seen in the plans, people will be getting full insurance for the first time. >> again, this is what she reports. do you think it's fair? >> i can't answer fair or not fair. i don't know what she was paying. >> move on. >> did she have full insurance? >> richard writes that his daughter received a note that his premium's going up because she's being lumped with older costlyier patients. it's possible that the only people that sign up will be those who are more costly. does h.h.s. have plans on what to do if only those who are more costly sign up and premiums rise for everybody? >> i think, sir, that's what we are trying to do to make sure that -- >> do you have plans -- >> the importance of the individual mandate that you just outlined. getting rid of pre-existing conditions. >> but if only the -- do you have back up plans? >> we'll encourage others to sign up. it's why there is a penalty in

place. >> is it true there are no backup plans? >> the gentleman's time has expired. mr. yarmuth. >> thank you, mr. chairman. madam secretary, nice to see you. come to this hearing with a little different perspective. kentucky is doing a great job with our exchange. as of this morning we had 350,000 people who explored the website. 59,000 started applications. 31,000 are now fully enrolled. and new coverage, and 5,000 in the last week. i think very importantly more than 400 businesses have begun applying for their employees as ell. would it be safe to say that if 36 states have done what kentucky, new york, and california have done instead of 14 that the rollout would have been much smoother and the website would have been easier to construct? >> i don't think there is any question that the -- in january of 2013 we knew how many states

were not running their own website. in i think mid february we learned about partnership. so it was not until that point that we learned that 36 states would actually be coming -- having said that, we should have anticipated, we should have planned better wee, should have tested better. i don't think that's any excuse. but we are clearly running a very different vehicle for enrollment than we thought we were going to run in march of 2010. >> on this subject of cancellation of policies, isn't it true that first of all the federal government can't require insurance companies to sell insurance? >> that they can't? >> can't require insurance companies to sell insurance? >> that's correct. >> inshurens companies all over the country are making very difficult decisions now about where they want to participate and where they don't. and in some markets they are actually trying to get out of the market, canceling people, because they want to play in other markets. they are making those decisions now. >> we know we have more

insurers, 25% more insurers in the individual market than we did prior to the law being passed. >> a lot of dynamics going on here that are not necessarily an indication that the president misled anybody. business decisions being made all over. >> cancellation of molcies -- policies again, that one-year contract notice s. routine in the individual market. it has been in place for years. and for a lot of people they are -- there are pomcies now, they are being canceled because they are being notified you can no longer be medically underwritten. we can't charge you more because you are a woman. we won't ever have the kind of limitation on what your policy can pay out. or charge you exorbitant out of pocket rates. those policies will cease to be offered in the market. >> the gentleman's time has expired. mr. guthrie. >> thank you, madam secretary, for being here. last week mr. lau was here.

i know the president talked about the alternatives to the website. is phone or calling or using paper applications. what he said, i think he said it with the phone, they take the paper applications but enter them into a web portal. i know you get around the issue of getting on and logged off. there is still issues with data within the web port a you can't get reliable data signed up. he also said because of the surge in paper applications it's like six to eight weeks to process. if november 30 when this will be ready to use, even if you do it now, eight weeks are getting close to january 1, if somebody does loose their insurance, and they get to january 1, even though you have a march 31 open enrollment, what happens to these? is there a contingency plan? sir, i think that we have improvements every day on the speed of the site. circo was giving you early snapshots of difficulty of

accessing the site. i think that's greatly improved. >> processing the paper. >> i understand, but it is the site. they put the application into the site and get a determination. that's part of what the process is. the site is part of the portal all wait through. this is an integrated insurance vehicle. so that will improve and we again with four months of continuous service, which is far longer than most people have -- some these cancellation numbers, mr. garret, again pointed this out from florida blue cross, but it's true of everyone else, these are not january 1 numbers. they are year-long numbers. over the course of 2014 when an individual's policy is due to expire, that individual -- >> it could expire january 1 and not get coverage if the website -- and the vendor said they needed months to test. they would have liked to have had months and months to test. if we are going --

>> i would say we are testing as we go. this is beta testing going on right now. that's why we are fixing and how we can identify things. people are getting through every day. and we now know a lot more -- >> the paper process f. it doesn't take four weeks, then it's november 30 and people are canceled january 1. there needs to be a contingency for that person. >> typical insurance is two to four weeks of sign up. they will have two full months of sign up. >> the gentleman's time has expired. ms. schakowsky. >> thank you, madam secretary, for bringing to millions of americans access to affordable, comprehensive health care coverage that's going to be there when they need it. i want to thank you especially as a woman. women can no longer -- being a woman can no longer be considered a pre-existing conditions. member can no longer be charged more than a man for the same coverage. women have access to comprehensive benefits like prescription drugs, free preventive screenings, and free

contraceptive coverage and maternity care which is often left out of coverage. the days of complicated pregnancy or diabetes or domestic violence being a pre-existing condition. those days are over. i want to say to my colleagues, after a 3 1/2 year campaign to repeal, to discredit, to even shut down the government, over obamacare, i want to say, get over it. we all agree that there are problems, but these are problems hat i see being fixed. i want to say that what we did under medicare part d can be an example of how we can work together. and in fact chairman upton and i both sent a letter asking for more money for community-based groups to help implement the program and make it work. we can work together.

if you could just briefly say how are the navigators, how important are they, in making this system work for the american people? >> what we know, congresswoman, is that a lot of people are not web savvy. and are not frustrated by the website because they don't have a computer, they don't want to use a computer, they don't trust the computer, they need a live human being to ask questions, get questions answered, talk about the plan, talk about insurance. so the navigators play a hugely important role. we have about 2,500 trained navigators on the ground right now. we have thousands more community assisters who are trained and ready to go. about 45,000 agents and brokers have gone through specific affordable care act training. those individuals working with their clients, customers, and in the case of navigators and community assisters, just the public at large e. they are not paid by a krnings they are not collecting a fee, they just want to help people get coverage. they are hugely important.

>> mr. olson. >> i thank the chair and welcome, madam secretary. i'd like to open with a quote from american icon. hold up a poster. it says, if it's having a problem, it's our problem. i'm glad to hear you embrace this philosophy in your testimony today here ma'am. obamacare was signed into law 1,256 days ago. since then there's been user problems after user problems after user problem. regarding health care.gov, your help duty administrator for consumer information, gary cohen, testified one month ago, right where you're sitting, that, this is a quote, c.m.s. has worked hard to test the infrastructure that will allow americans to enroll in coverage

confidently, simply, and securely. end quote. t according to forbes in the "wall street journal," you told them that you needed five years of construction and one year of testing. the system has crashed earn burned at least three times. the use certificate still having roblems. it's been down the whole time you have been testifying. the system is down at this moment my question is very simple. when did you know it was going down, a month, day, quarter? did you tell the president when you knew? -- what you knew? >> sir, i was informed that we were ready to launch on october 1. the contractors who we had as our private partners told us and told this committee that they

had never suggested delay, and that is accurate. our c.m.s. team felt we were ready to go. i told the president that we were ready to go. clearly i was wrong. we were wrong. we knew that in any big new complicated system there would be problems. no one ever imagined the volume of issues and problems that we have had. and we must fix it. >> yes, ma'am. you needed -- >> that's been repeated. i can guarantee you i would have never stated that because the law was passed in march of 2010. i chose the open enrollment date. i don't know where that quote comes from. but that is not from me. >> the gentleman's time has expired. million barrow. -- mr. barrow: thank you, mr. chairman. i suspect deep down most people on this committee support the concept of performing insurance market so more people have better access to insurance coverage. we have disagreements about the means used to get to those ends

which sp why i voted against the affordable care act. every day we hear something new going wrong. i'm concerned these short-term enrollment problems could become long-term insurance problems. my constituents are losing confidence about the government to pull this off. i think we should delay the penalties until we are sure the system works. it's not fair to fine them if it's not their fault. what went wrong and how to fix it and ensure it won't happen again. nearly all of our constituents want and need health insurance. it would be a huge mistake we are so blinded by our love or hatred for obamacare missed opportunities to address its flaws. the subject of technical problems becoming market problems. can problems of both getting into the system snowball into risk pool problems where those who choose not to enroll can affect the cost of those who do

choose to enroll? >> certainly. a risk pool needs a balanced market so you need people who are older and sicker to be balanced with people who are younger and healthier. that's how a pool works. >> at what point are we going to see a problem vggetrisk pool if the tech problems cause effect folks -- what are you going to look for? what are you going to use to decide something needs to be done? >> again, sir, we'll be hon torg during the six months of open enrollment, as will our insurance partners, who is coming into the pool. that's why we want to give this committee and others reliable, informed data about not only who it is but what the demographics are and where they live. >> if things aren't better by the end of this next month, at what point are we going to start thinking about further delays and imposing penalties? >> i think that having a designed open enrollment period is one of the ways that you then make an assessment if you have a pool that works or not. can you not have an unlimited open enrollment period were any

insurance company because that really doesn't work. >> mr. mckinley. >> thank you, mr. chairman. c.g.i. the representative campbell said that she had met her contract obligations and met the specifications. and she said the only problem she had was with pace. pace wasn't part of the specification. what you wouldr, testify to, she said you would testify that she did complete her contract in accordance with the specifications. would you? >> sir, i don't think until the product is working the way it's designed to work that anybody has finished their job. that's my -- >> they have shortened our time. so if she hasn't met the specifications, yet we are still using her.

is the american taxpayer still paying the money to fix the problems she didn't do -- her company didn't do? >> none of our contractors have been paid the amount -- >> paid for this work into the fuhr as we go to correct this problem? >> we'll make that determination as the work goes forward. i will tell you, sir, that as we learn what needs to be fixed how long it takes we'll know more about -- >> who owns the software now? now that we -- this has been developed with taxpayer money, developed the software to do this -- >> owned by the serntsd for medicare and medicaid services. >> owned by us. will they be able to use it by a license for other clients? >> not to my knowledge. i think it's specifically designed for the marketplace with these products in mind. >> last question-did >> the clients are the american public. >> under i b&b, she testified that was something we should have done. under h.h.s. you recommend,ing

-- >> we'll leave this hearing at this point as the u.s. house is about to gavel back in for legislative business this afternoon. the health care hearing will continue on our companion network c-span3 and online at c-span.org. live now the house is set to consider a bill dealing with bank regulations and a final passage vote on a resolution disapproving the debt limit increase passed by congress on october 16. the speaker pro tempore: the house will be in order. the prayer will be offered by our chaplain, father conroy. chaplain conroy: let us pray. eternal god we give you thanks for giving us another day. once again we come to ask wisdom, patience, and peace and understanding from the members of this people's house. on this day, we ask your blessing on the men andom