by a line of questioning asking about the individual marketplace. how volatile was the individual marketplace before the affordable care act became law? >> i would say it wasn't a mark marketplace at all. it was unprotected, unregulated, and people were really on their own. >> madam secretary, the kaiser family foundation reports have over 50% turnout of individuals that have coverage and individual market churn out coverage every year. they either lose coverage, priced out or drop it s that consistent with what you're aware snf. >> that's an accurate snapshot. about a third of the people are in for about six months. and over half are in for a year or less. >> so individuals that were in the individual marketplace before the passage of the affordable care act did not have the same protections as those in group coverage? >> that's true. >> and 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. >> so these were typically one-year contracts. if they use the plan because they got sick nor a car descent or a victim of domestic violence, sometimes they would be thrown off the plans or rates would go up? >> yes. >> i think that's important to note, madam secretary. and i'm intrigued as well that my understanding is that last month hhs conducted an analysis that found that nearly six out of tun uninhere issed americans will pay $100 a month. >> they'll have a plan if that is their choice. >> and that number would be even ier, would be better if more states chose the option of using federal funds to expand medicaid to cover the low income population? >> that's just a marketplace snapshot. those are people that will be in the marketplace. >> madam secretary, i don't think i 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 and fixing this problem? i hope that we all agree we want this website fixed. i would yield to anyone that would disagree. seeing 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 cyou can do. maybe we have some 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 policy. they don't have to be insured by their company at a higher price. >> i appreciate that. 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 after they submitted a claim for going to the hospital or becoming sick? >> no, sir. >> madam secretary, one last note here. it seems that we received some horrible news that there are bad actors already taking place of fraudulent web sites that imitate the health care xlafrpg or misleading seniors into disclosing personal information. i signed on to a letter to you led by my colleague representative out of california to request that you prioritize fraud prevention efforts. what has the administration done to prevent the fraudulent acts? >> i can tell you, congressman, the president felt very strongly that that needed to be part of our outreach effort which is it 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 commission 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 the policies any longer. that's a red flag. we want to make sure that people turn over potential fraudulent acts. we have put training in place for navigateors. we have our law enforcement -- >> the gentleman's time has expired. i would just note that we -- with the indulgence of the secretary, we're hoping that we can have all members ask some questions but we also know that with four minutes we're going to have a little trouble. i'm going to ask unanimous consent that we try to limit our questions and answers to no more than two minutes. and i talked to mr. waxman. is that okay? because otherwise we will -- there will be a lot of folks who will not be able to ask a question at all. >> three of us. >> mr. chairman, i would submit

that if the questions get submitted we would be happy to provide timely answers also. >> so can i do that? so with that we'll try two minutes. mr. lance? >> i guess i won the lottery on the two minutes, madam secretary. >> 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 y in your opinion was there not more than two weeks? >> again, we have products, the insurance policies themselves by companies. we're loaded into the system. so we could test up until then but it wasn't until september, mid-september that that was done. again, the contractors said we would have loved more testing time but we think we're ready to

go ahead. >> i believe that will ultimately be a dispute between cms and hhs and the contractors and if there is anything question do regarding that because, obviously that, didn't work. and i had thought given this as the signature issue with the president that the website would be ready. number two, in my judgment the president's statementes were overstatemen overstatements. there's a report in the new jersey newspaper this is 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 grandfathered. yet regulations issued by hhs say that grandfathered status would not be a continued for so much as a $5 change in a co-pay.

is that accurate? do you believe that 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 outfacing issues that were more rigid than that. but i would say that in terms of having companies being able to collect a profit margin, that was certainly built into the grandfather status. >> i think that's too little a change. >> the gentleman's time has expired. >> thank you, mr. chairman. welcome, honorable secretary. thank you for fielding our questions and for responding when you were extended the kurt stoi off -- courtesy to offer a

response. as a strong supporter of the aca, i'm frustrated and it's fair to say the american people are frustrated as well. i heard you hear many times this morning say you're frustrated. i think by and large people want this law to work. when i talked to folks back home in the capital region of new york that i represent, even people who oppose the law initially aren't rooting for the failure of the affordable care act. instead, 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 determination 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 the initial website issues, has hhs looked at what the state web sites are doing as it searches for solutions to fix health care? >> absolutely. and we shared a lot of the

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 is fully functional. and that's good news for new york and california and other who's are running their own state web sites. but we are learning from them. we've shared information with them and we are eager for all the help and assistance moving forward. >> thank you. similarly, some states made the choice of rejecting medicaid expansion that would help some of the poorest citizens get access to the health care situation. this is despite the fact that medicaid expansion is entirely financed by federal dollars. can you comment on hhs' plan in the future to encourage more states to run their own marketplaces and expand medicaid so 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 and 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 gentleman's time expired. dr. 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 amount, even by a dollar according to your regulations, that would not qualify as a grandfathered clause. just to add that out there for the record. i gather even by a dollar. that said, i get a letter from someone in my district, adrian.

she says that -- she lost her coverage. she lost her coverage because spousal coverage is gone. she's gone on the exchange. she doesn't qualify for subsidy. but that her premium and out of pocket costs under any plan is $10,000 a year. she feels she -- she writes this. she feels betrayed by her government. she has to sit there asking herself is this fair? if you were she, do you think that 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. >> that's for the co-pay, not the co-insurance. for the co-insurance, it's any amount. i have limited time. do you think -- if you were she, if you were adrian, do you think is fair? losing her spousal coverage and now $10,000, no subsidies? >> sir, i don't have any idea what she's looking at. i can tell you that, again, based on what we've seen in the market and what we've seen in the plans, people will be getting full insurance for the first time at a better rate.

>> again this is what she reports. do you think it's fair -- if what she reports is true, do you think it's fair? >> i can't answer fair or not fair. i don't know what she was paying or what she is paying now. did she have full insurance? >> richard writes that his daughter received a note that his premium is going up because she's being lumped with older, costlier patients. now it's possible that the only people that sign up will be those would are more costly. does hhs have plans on what to do if only those who are more costly sign up and premiums rise for snerve. >> everybody? >> sir, that's what we're trying to do to make sure -- >> but if only the costly sign up, do you have plans? >> that's the importance of the individual mandate you just outlined. getting rid of pre-existing conditions, making sure that people -- >> do you have backup plans? >> we will encourage others to sign up. it's why there is a penalty in place. >> is there to assume there are no backup plans? >> the gentleman's time has expired. >> thank you, mr. chairman.

madam secretary, nice to see you. come to this hearing with a little different perspective. kentucky's 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 just in the last week. and i think very importantly, more than 400 businesses have begun applying for their employees as well. so, yeah, the idea this is going to be bad for businesses is not borne out in kentucky. would it be safe to say that if 36 states have done what kentucky and new york and california have done instead of 14 that the rollout would have been much smoother and the website would have been much easier to construct? >> i don't think there's any question that, you know, in january of 2013 we knew how many states were not running their own website and i think

mid-february we learned about partnerships. so it was not until that point that we learned that 36 states would actually be coming throughout website. having said that, we should have anticipated. we should have planned better. we should have tested betterment we clearly are running very different vehicle for enrollment than we thought we were going to run in march of 2010. >> right. >> on the 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 -- >> the federal government can't require insurance companies to sell insurance? >> yes, sir. >> in fact, insurance companies all over the country are making very difficult decisions now about where they want to participate and where they don't. in some markets they're actually trying to get out of the market cancelling people because they want to play in other markets and so forth. they're all making the 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. they're business decisions being made? >> in cancellation policies that one-year contract notice is a routine in the individual market. it has been in place for years. and for a lot of people, they are being canceled because they're being notified you can no longer be medically underwritten. we won't ever have the kind of limitation on what your policy can pay out or charge you out of pocket rates. those policies will cease to be offered in the marketplace. >> the gentleman's time has expired. mr. guthrie? >> thank you, madam, secretary, for being here. last week we had a guess and the president talked about the alternatives to the website. his phone calling or using paper

applications. what he said, i think you said it with the phone, they take the paper applications but they enter them in the same web portal. i know you get the issue of being logged on and off:but there rish u there a -- but there are still issues. it is six to eight weeks to be processed. so if this will be ready in november 30th, you're getting close to january 1st if it's eight weeks and somebody does lose their insurance so they're signing up for this. even though you have a march 31st open enrollment, what happens to these? is there a contingency plan for the people to continue their insurance? >> 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. >> they said just processing the paper, actually. >> i understand.

but it is the site for -- they put the application into the site and get a determination. that's part of what the process is. so the site is part of the portal all the way through. there is an integrated insurance vehicle. and so that will improve. and we, again, with four months of continuous service which is far longer than most people had, some of these cancellation numbers, again this was pointed out from florida blue cross, it's true of everyone else, these are not january 1st numbers. they are year long numbers. so over the course of 2014 when an individual's policy is due to expire, that individual -- >> but it could expire january 1st and not be able to get coverage if the website -- and the vendor said they needed months to test. they would have liked to have months to test. that's what they said f we're going to get to -- even if it works november 30th. >> we're testing as we go. there is beta testing going on now.

that's how we are fixing and identify to identify things. people are getting through every day and we know more -- >> with the paper process, if it does take four weeks, november 30th and people's cancel january 1st, there needs to be contingency for that person. >> typical insurance is 2 to 4 weeks of signup. they will have two full months of signup. >> 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 preexisting condition. women can no longer be charged more than a man for same coverage and have access to comprehensive benefits like prescription drugs and preventive screenings and free contraceptive coverage and maternity care which is often left out of coverage.

the days of complicated pregnancy or domestic violence being a preexisting conditions, those days are over. i want to say to my colleagues after a three and a half year campaign to repeal, to discredit, to even shutdown the government over obama care, i want to say, get over it. we all agree, that there are problems but these are problems that 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. so if you could just briefly say how are the navigators -- how important are they in making

this system work for the american people? >> well, what we know, congresswoman, 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, don't trust a computer. they need a live human being to ask questions and get questions answered and talk about the plan and talk about insurance. so the navigators play a hugely important role. we have 2500 trained navigators on the ground right now. we have thousands more community assisters are trained and ready to go. 45,000 agents and brokers have gone through specific affordable care act training. but those individuals working with their clients, customers and in the case of gafnavigator the public at large, they are not paid by a company and want to help people get coverage, they are hugely important. >> gentlelady's time -- mr. olson. >> i thank the chair and welcome

madam secretary. >> thank you. >> i would like to open with a quote from american icon, i'll hold up a poster. it says, if the user is having a problem, it's our problem. i'm glad to hear you raised this philosophy during your testimony today, ma'am. obama care was signed into law 1,256 days ago. and since then, there's been user problem after user problem after user problem. regarding healthcare.gov, your dputty administrator for consumer information, gary cohen, testified one month ago, where we are sitting, that cms has worked hard to test the infrastructure that will allow americans to enroll in coverage confidently and simply and securely, end quote. and yet according to forbes, and

the wall street journal, you told them that you need five years of construction and one year of testing. the program crashed and burned at least three times and the user is still having problems. it's been down the whole time you've been testifying. the system is down at this moment. my question, ma'am is very simple. when did you know these changes were going down? a month, a day, a quarter? and did you tell the president what you knew? >> sir, i was informed that we were ready to launch on october 1st and the contractors who we had as our private partners told us and told this committee that they had never suggested the delay and that is accurate. our cms team felt we were ready

to go. i told the president that we were ready to go. clearly i was wrong. we were wrong. i knew that in any big new complicated system, there would be problems, no one ever imagined the volume of issues and problems that we've had. and we must fix it. >> yes, ma'am. but credible journalists said you knew you needed six years -- >> that quote has 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 the quote comes from but that is not from me. >> gentleman's time is expired. >> thanks for attending, i suspect deep down most support the concept of reforming insurance market so people have better access to coverage. we have disagreements by the means to get those in. it seems that every day we're hearing something new going wrong. i'm concerned the short term

enrollment problems could become long-term insurance market problems. my constituents already losing confidence the federal government is ready to pull this off and in order to restore the trust, to delay the individual mandate penalties until we're sure the system is going to work. not fair to penalize consumers when it is not their fault and make sure additional fits and starts won't cause larger problems. right now less concern about who's to blame and how to fix it and to ensure it doesn't happen again. all of our constituents want and need health insurance. it would be a huge mistake if we're blinded by our love or hatred that we miss opportunities to address its flaws. to the subject of technical problems becoming market problems. can problems of folks getting into the system snowball into risk pool problems where those who choose not to enroll affect the costs of those who do enroll? >> certainly a risk pool needs a balanced market. 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 will we see a problem having the risk pool if the tech problems cause -- effect entering? what are we going to look for and use to decide something needs to be done? >> again, sir, we will be monitoring 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 and 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 the next month, at what point do we think about further delays in posing penalties? >> i think that having a defined open enrollment period is one of the ways that you then make an assessment if you have a pool that works or not. you cannot have an unlimited open enrollment period with any insurance company because that really doesn't work. >> thank you.

>> mr. mckinley. >> thank you, mr. chairman. >> last week -- last week the cji representative at campbell said she met her contract obligations and met specifications and said the only problem she had was with pace. but the pace wasn't part of the specification. do you -- and we asked her, you would testify to, did -- she said you would testify that she did complete her contract in accordance with the specifications. would you? >> sir, i don't think it's how the product is working that it's supposed to work that anybody finished their job. >> they shortened our time with it. >> so, if she hasn't met their specifications and yet we're still using her, is the american taxpayer still paying money to fix the problems that she didn't do -- her company didn't do in the first --

>> none of our contractors have been paid of the amount -- >> will she be paid for this work into the future? >> we will make that determination as the work goes forwards. as we learned what needs to be fixed -- we'll know about -- >> i'm sorry the time frame, cut it down. >> who owns the software, now that this has been developed with taxpayer money to develop the software to do this -- >> it is owned by the centers for medicaid and medicare services. >> will they be able to use it by license with other clients? >> not to my knowledge. i think it is specifically designed for the marketplace with these products in minds. >> the last question to try -- >> the clients are the american public. >> under iv and v, she testified that she thought that was something we should have done. under hhs, you recommend or the hhs recommends that for software development, they should have a

independent verification and validation program. can you share with us in the time that's gone why we didn't use iv and v -- >> i don't think that's accurate. at every point there is independent testing. >> independent. >> yes and outside -- >> you recommended verification and validation not someone within your staff? >> pardon me? there is a level of self-attested testing and cms testing and independent test on each piece of the contracting. >> not cns. >> that's what -- >> gentleman's time -- >> it needs to be done independently, people who do not have -- >> is expired. >> i'll get you the information. there are three levels of testing, one is independent for every piece of this contracting, yes. >> mrs. caster. >> good morning, when open enrollment began a few weeks ago the people back home in florida

helping neighbors sort through the new options for coverage, the navigators, were taken aback by how grateful people are to have new pathway to the doctor's office and the care they need. affordable options. the -- there are no longer being discriminated against because they had cancer. and diabetes or asthma. they are very grateful. they said, they said to me directly, it's like they found water in the desert. right now they are surprisingly -- they said it's taking time because people want to sort through all of these options. before they finally sign up at the end of the 26-week enrollment period. we must fix the marketplace to meet their expectations and we have high expectations for you and the administration. i think it's important to point

out it's more than just a website. it -- despite the obstruction by republicans in my home state of florida, nationally, even going so far as to shut down the government, millions of americans are already benefitting and there are benefits that are not tied to healthcare.gov. some madam secretary, let's clarify what's working. is it correct to say many of the improvements that the aca makes to employer coverage and medicare were the vast majority of americans receive their coverage are not dependent on healthcare.gov. >> that's correct. >> so the delays and problems with healthcare.gov do not affect the millions of individuals thanks to the aca who no longer have to worry about lifetime monetary caps on their coverage that previously sent them to bankruptcy? >> that's absolutely true. i think the quote that the president was quoted recently saying if you have health care, you can -- you don't have to sign up for the new marketplace was referring to the large

portion, the 95% of insured americans who plans are solid and stay in place and move forward. >> i understand the frustration with the website. i don't know why people are not similarly outraged by the lack of medicaid coverage in many of our states. do you find that hip critical? >> i think it's very troubling that millions of low income working americans will still have no affordable option if states don't take advantage of the expansion program leaving states bearing the cost of uncompensated care and families and workers not able to go to work and people still accessing care through emergency room doors. the most expensive, least effective kind of care they did g . >> mr. gardner? >> thank you for being here. here's my letter. this is the letter my family got canceling our insurance.

we chose to have our own private policy back in colorado so we could be in the same boat as everyone of my constituents. and yet my insurance policy has been canceled. the white house website says if you like your health plan you have, you can keep it. did i hear it wrong? >> again, sir, i don't know how long you've had your policy -- >> why aren't you losing your insurance? >> pardon me. >> why aren't you losing your health insurance? >> because i'm part of the federal employees -- >> you're in charge of this law, correct, why aren't you in the exchange? >> because i'm part of the federal employee health benefit plan. >> why won't you go into the exchange? you're a part of this law, literally in charge of this law. should you be any different than the americans out there losing their health insurance? >> i'm part of the 95% with affordable eligible health care coverage. >> most americans aren't available to them. why will you not agree -- >> i'm not eligible for the exchange because i have coverage in -- >> you can decide to drop your

coverage of your employer. you have the choice to decide not to choose -- >> that the not true, sir. >> members of congress are now part of the exchange thanks to an amendment that was added by congress but i'm not eligible. >> with all due respect. >> if i have affordable coverage in my workplace, i'm not eligible to go into the marketplace, that's part of the law. >> madam secretary, i would encourage you to be just like the american people and enter the exchange and agree to find a way -- >> it's illegal. i would like to show you an advertisement going on in colorado right now. this is an advertisement that a board member of the colorado exchange put forward, do you agree with this kind of advertising for obama care? >> i can't see it. >> it's a college student doing a keg stand. >> if the colorado exchange did that -- >> do you approve of this kind of advertising? >> i don't see it, don't know what it is and i did not approve it. this is a state based -- >> that's a pretty big picture

of a keg and you can't see it? >> do i approve of it? >> you have athe built to opt out and you could take the insurance. >> if i have available employer based coverage -- >> i would like to submit a waiver from my district from obama care and hope you consider waiving it for the fourth congressional district. >> gentleman's time is expired. >> does your policy covered? >> mr. mathison. >> thank you, mr. chairman, madam secretary, thanks for your time. i want to ask on the issue of the fixes to healthcare.gov, we've had a lot of conversation about that today and talked about confidence levels for being ready by a certain time. i think one question that a lot of us have is, can you define what the magnitude of the problem is? is there a scale or metric by which we can understand how bad this is today and how we're going to get to where we go to have it fixed? >> well, again, sir, i've been

informed that the problems are in -- the reports i've seen are really in two areas, they are in the performance area, which is speed and reliability. it's too slow and doesn't have reliable transfers and in functionality, there are parts of the system that don't make accurate transfers. so we have done an extensive assessment. they are prioritized. one of the priorities is the enrollment features which pass individual information to the companies where they want to enroll. that is not reliable at this point. the companies are not getting accurate data. so an example of the kind of thing we know we need to fix. >> is there a way to -- if you set up metrics figure out if we're making progress in terms of fixing those issues with speed and performance and functionality. >> with the team and jeff zienst

at the head of it, there are comprehensive set of issues that will be measured and accelerated. >> do you have target dates along the way if you want to meet the november 30th time, assume it's functional of what you want, do you have target or metrics along the way to make sure you're on the path? >> my understanding is there are sort of groups of targets that fixes that can be loaded together. it isn't one at a time. they don't take days but they are try being to determine with a specific path, one of the charges that qssi has, really looking at the umbrella of what needs to be fixed, prioritizing them, figuring out what destabilizes if something else is fixed and how they can be grouped together. and that report will be in later next week. >> gentleman's time is expired. >> thank you. i would like to talk about kansas a little bit today.

much like with some of my colleagues have made references to the wizard of oz, i don't think anybody not from kansas should do. they worked awfully hard to go down the yellow brick road. when they pulled back the curtain, they found there was nothing they didn't already have. and as we pull back the curtain, people are finding it's not exactly what they have worked so hard to find their way too as well. two stories, there's this commitment, if you like your plan you can keep it. i have a letter from mr. breeto in kansas, saw him in benton, he got the letter that says because your current plan does not offer the benefits standard qualified you'll be discontinued -- says good news, then there's a group of folks, pizza hut from kansas, franchisees, lots of folks have taken employees and families working there, gone from having full-time jobs to part-time

jobs. they aren't able to keep the health care plan they had either and the one they wanted. what do you tell -- why were the plans these folks had good enough when you were the insurance commissioner in kansas and when you were kansas' governor but the plans today aren't good enough for those hard working kansas families? >> sir, i would tell you in the roles i had the honor of serving in in kansas, i worked every day to try to eliminate the discriminatory features of the insurance industry that finally with the affordable care act are gone. my successor and elected insurance republican commissioner sandy kraeger and i worked on a whole series of plans to expand coverage. i did work on these issues and we were not necessary -- >> you say these were lousy plans and miss tavenner said no true insurance. do you think the plans weren't

true insurance? >> in the individual market, the insurance commissioner in kansas and virtually every place in the country -- >> it's a yes -- >> it's a yes or no question. were they true insurance plans? >> a lot of them are not true insurance plans, no. >> i yield back. >> gentleman from vermont. >> i'm going to summarize what i've been hearing. number one, the website must be fixed. you've been very forthright and you're going to fix it. number two, we've had a real battle about health care, had a battle in this congress. it was passed and the president signed it and the supreme court affirmed it, a brutal battle. there was an election people where the american people affirmed it and then the shut down in the threat of deabt default. all of us represent people who are going to win or lose depending on how effectively this is rolled out. there's significant question about existing insurance policies what the president said

and so on. let's acknowledge something. a lot of insurance companies were ripping off innocent american people by promising them insurance until they got sick and then it got canceled because they had a preexisting condition that wasn't disclosed. that's got to end. the challenge for us going forward is to make health care affordable. madam secretary, my question is, is there any indication that there's been a slowing of premium increases as a result of the affordable care act because, unless we can keep those premium increases down, they can't rise faster than the rate of inflation, all of us are going to lose. >> i would say the trends in the private market over the last three and a half years are that cost increases have slowed down. are rising at a lower rate than the decades before. in fact, in this individual

market, the old individual market, the typical increase was 16% year in and year out rate increase. often that came with additional medical underwriting. it gives a sense of how the costs were. we know that medicare costs are down and medicaid costs had a decrease per capita last year, not an increase per capita and underlying health care costs are down. these rates in the new marketplace have come in about 16% lower on average than was projected. not by us by by the congressional budget office. and we know that in many of these markets, they are much more competitive. i believe in market competitiveness. that drives down rates. the states where the most companies are participating, have the lowest rates. and new companies have come in, significantly below the old monopoly companies that dominated this individual marketplace. we're on a pathway. are we there?

no. affordable coverage at the end of the day for everybody is the goal. >> i yield back. thank you, madam secretary. >> i'm trying to make sure you're out of here by 12:30 before we start the second round of questions. >> mr. kissinger. >> that was a joke, right? >> i see sheer panic. >> thank you for being here. you stated earlier to mr. har better, you give the president regular updates and the president said he knew nothing about the status and functionality of the marketplace. how often and what were the subject of those updates? >> i think there were a series of regular meetings with the president with some of our federal partners with offices of the white house from the omb to others on a monthly basis, giving reports on policy and where we were going, none of those i would say involve

detailed operational discussions. that wasn't the level. it was are we coming together? do we have companies and plans. >> i understand that. obviously when it comes to the president of the united states, certain level of details you have to see kind of 10,000, 20,000 foot overview. in terms of functionality, he was legitimately caught off guard on -- >> i assured him and -- that we were ready to go. everyone knew with the big plan that there were likely to be problems. no one anticipated this level of problems. >> just a quick question. where is hhs getting the money to pay for fixes? is it coming from other hhs accounts? have you used your transfer authority to move money from nonaca programs to pay for the cost of implementing the president's health care program? if so, from which have you drawn money to help with the fix that's not aca related? >> as you know, congressman, it's been two years since we've had a budget at hhs.

we also have not had at the president's requested implementation budget, authorized by the congress, each of those years we have used not only resources internally but i do have legal transfer authority that i've used and a nonrecurring expense fund. we'll get you the details of that. >> the answer is yes, there are non-aca money being used for the implementation -- >> there is money that is specifically designed for either outreach and education, so health centers hired education and outreach people as part of their outreach for health personnel. i would say it's definitely related cause to get expanded health care. >> thank you, mr. chairman. >> thank you, mr. chairman, thank you madam secretary for being here. my understanding is that a lot of the companies insurers that have been offering plans in the

individual market, the ones sending out these notices, are actually repositioning themselves in the health insurance exchange to offer alternative plans. is that -- >> yes. >> and in addition to those insurers who have been in the individual market, you have a lot of other companies and insurers providing plans in health insurance market? >> that is true. >> so the way i look at this. i went to buy oriole tickets when the season was underway. they closed the window. i didn't have to go home because they opened another window a few feet away. so essentially what's happening is people are coming up on the renewal period and getting up to the window, the individual market and being told that window is closed but if you go right down the line here there's another window that's open. by the way, when you get there,

you'll get better coverage, potentially at reduced premiums. if you go down to window 3, these subsidies that may also be available to you. this notion that people are being turned away from an affordable product, that provides good quality care, is prepostero preposterous, they are being steered to a place where they can get good quality coverage, in many instances much better than the coverage that they had before, at an affordable rate that is supported by the subsidies that can be available to many, many people. this is what is so promising about the affordable care act. so i think it's important for people to understand that that window is not being shut. they are being steered someplace elsewhere they can get a good opportunity. >> i think the first option for those companies is to say we'd like to keep you here and here are the plans we're offering.

but to be fair, customers will now have an opportunity to look across a landscape, which they couldn't before. they will have entry into those other windows, which many of them didn't have before with a preexisting condition. as you say, 50% of the market will have financial help in purchasing health insurance which none of them had before. >> gentleman's time expired. mr. griffith. >> earlier in your testimony here today you said a couple of times, plans we enjoy but then as you noticed with mr. gardner's eloquent testimony, we're not going to be in the same plan you're in. i was one of those that thought it was a good idea as part of a proposal floating around the halls here in congress, that the president and cabinet secretaries ought to also be in the marketplace and not have a special federal plan that is you will have after january 1 and we will not. the president while that was being discussed issued a veto threat. did you discuss the veto threat with the president before he

made it and have you discussed it with him since then? >> no. >> and then i will ask you relating back to the contractors involved in this. cgi told us that the spanish website was ready to go. that they thought everything was ready just as they did with the regular site. that didn't prove out. but that they were told not to implement it. likewise the shop and browse section was ready to go. do you think they were misleading this committee when they made comments? >> i think what they believed is that that product independent of the entire operational site was ready and tested. what a determination was made -- i was involved with the spanish website and medicaid transfers to say let's minimize the risk for the whole site -- >> that raises the next question up, because one of the other contractors qssi, i believe, indicated that part of the problem because once you took

away the opportunity to browse, every had to set up an account and cms stopped one of the browsing options as well and that contributed to the log jam and contributed to the problems. isn't it -- is he correct on that, that not allowing people to look without having to sign up, wouldn't that have made it easier for the american people? >> in hindsight, that probably would have been advantageous, i can tell you the decision made going forward was to minimize risk, that didn't work so well. adding additional features that didn't involve people wanting to get to what they would independently pay and what they would qualify for and what the plans were seemed to be things that could be added down the road. it was wrong. >> gentleman's time is expired. >> i appreciate it very much, mr. chairman and thank you, madam secretary, for testifying today. over the week in "the new york times" wrote the following, project managers at the department of health and human

services assure the white house that any remaining problems could be worked out once the website went live. other senior officials predict a serious trouble and advise delaying the rollout. can you confirm this is true? did any senior official predict serious problems and did any senior department officials advise delaying the rollout of the exchanges or parts of the exchanges on october 1st? >> i can tell you that no senior official reporting to me ever advised me that we should delay. you heard from the contractors on the 24th that none of them advised a delay. we have testing that did not advise a delay. so not to my knowledge. >> did they indicate to you there were serious problems? >> they indicated to me we would always have risk because this system is brand-new and no one has operated the system like this before to any degree. so we always knew there would be the possibility that some things

would go wrong. no one indicated this could possibly go this wrong. >> can you name some of the officials that gave you the advice, that there were serious problems? >> again, we had series of meetings with teams from cms. i was always advised that there is always a risk with a new product and new site. but never suggested that we delay the launch of october 1st, nor did our contracting partners ever suggest that to us. >> thank you, madam secretary. >> thank you, mr. chairman, yield back. >> mr. johnson. >> madam secretary, thank you for being with us here today. cms was the integrating prior to the rollout, correct? >> that's correct. >> you testified you hired an outside company to serve -- >> one of the contractors -- >> who is is that? >> qssi, who built the hub. >> the same company that told our committee last week they were not only the developer of the hub and pipe line but also

an independent tester of the system. >> you've acknowledged in your testimony today that inadequate testing played a significant role in this failed launch, aren't you concerned qssi has lost its ability to be an objective independent arbitrator in addressing the problems that plague the system now? they are part of the tester and part of the developer and part of the problem. >> i haven't lost confidence in them. the testing they did is valid ating the pieces of the equipment, what we said, since the launch is we did not do adequate end to end testing, that was not the qssi responsibility. >> in this new roll as integrater, are are you going to be paying them more than they were paid under the original contract? i would expect -- >> that discussion is under way in terms of what the role will entail and outlines are, yes,sir. >> hard working american taxpayers have already paid for this implementation once.

do you think it's fair to ask taxpayers to pay more so qssi can attempt to do something that administrator tavenner and her team were unable to do right the first time. >> the american taxpayers expect us to get the site up and running. >> any expected it the first time. >> i understand and so did i. we have not expended the funds that have been encumbered forred contracts. we'll monitor every dime we spend and reaudit things that are going forward. >> with that, mr. chairman, i yield back. >> gentleman yields back. mr. long. >> thank you, mr. chairman and mr. secretary for being here today. given your testimony, earlier today you said that i'm responsible for the implementation of the affordable care act. i've heard you referred to and maybe yourself as the point person for the rollout, the

architect of implementing affordable care act. so you are kind of the president's point person, are you not, for this rollout? >> yes, sir. >> i earlier you were asked -- there's a lot of things striking about the rollout of this and about affordable care act all together, but the thing most striking to me, is when we had the point person for the rollout here, and you're not going into the exchange. i've heard you say, that -- and you got advice from the foekds behind you, but i'm asking you today, can you tell the american public if your advisers behind you, if they happen to have given you wrong information, if it is possible for you to go into the exchange, like all of these millions of americans going into the exchanges, will you admit to forego your insurance plan you're on now and join us in the pool. water is fine. all of the congressman and staff have to go into the exchanges. we have to go into the d.c.

exchanges. i will say i tried to get on the website. was successful during the hearing earlier and got to the d.c. exchange where i have to buy from. i got part way through and when i got to part to enter my social security, i could not bring myself people to do that when i heard from folks about the security. if your advisers are wrong and it is possible for you -- i'm not saying it is, if it's possible for you to forgo your government plan, will you tell the american public, i'll go into the exchanges next year like everyone else? >> the way the law is written -- >> it's a yes or no. >> let's say you're wrong on that. if you're wrong -- >> i don't want to give misinformation to the american public -- >> what? >> i don't want to give misinformation who have affordable coverage -- >> women you go into the exchanges? >> if you can, will you? that's a yes or no. >> i will take a look at it. i don't have any -- >> that's not a yes or no.

>> gentleman's time is expired. >> you're the architect of the whole program and you won't go into it -- >> i did say not say it. it's illegal. >> if it's not illegal -- >> will you go in? >> affordable coverage -- >> the water is fine. >> gentleman's time is expired. >> i have a unanimous consent request, i'd like madam secretary, i'd like you to answer for the record if you were able to do what the gentleman just suggested or follow the recommendation of cory gardner, our colleague from colorado and went into the -- to buy an individual policy, would you be able to find one that would protect you from cheap shots or do you think it has to be mandated for coverage? i leave it -- the record open for your response. >> we'll wait for that response to come back. >> gladly go in the exchange if i didn't have affordable coverage in my workplace.

i would gladly join it. and the d.c. market is an independent state based market even though d.c. is not a state. we do not run the d.c. market in the federal marketplace. >> gentlelady from north carolina, miss elmerz. >> i have a couple of questions, thank you for being with us today, madam secretary. i would like to go to the issue raised by my colleagues here about accurate information. number one, i've heard the issue of medicaid part d brought up, many, many times, although my colleagues all voted no against it initially, now they are stoeing the virtues of medicare part d. is it a mandate or is it voluntary? >> it is a voluntary program. that's the first piece of accurate information i would like to get. we're asking or we're actually forcing millions of americans to go to find a health care premium in some way, whether it's to go

to the exchange or whether they are to be insured, many of my constituents are being -- are reaching out to me those with individual policies and they are saying to me that my rates are going up 400%, my rates are going up 127%, these are my constituents. now, we're talking about open enrollment, but it's forcing the issue, is it not, that if an american does not have health care coverage, they are essentially breaking the law? is that not correct? >> if someone can afford coverage and has that option and chooses not to buy coverage, they will pay a fee on their -- >> and it is a law so there are they are -- >> you also brought up the issue quh you were in kansas that you fought against discriminatory issues. as far as the essential health benefits, correct me if i'm

wrong, do men not have to buy maternim maternity coverage? >> policies will cover maternity coverage for young and healthy. >> including men. >> under 30-year-olds will have a choice also of a catastrophic plan which has no maternity coverage? >> catastrophic. but the men are required to purchase -- >> an insurance policy has a series of benefits, whether you use them or not. one of the benefits -- >> that's why the health care premiums are increasing, we're forcing them to buy things they will never need. thank you, madam chairman. >> the individual policies cover families, men offer ten do need maternity coverage for their spouses and for their families, yes. >> single male age 32 does not need maternity coverage to the best of your knowledge has a man ever delivered a baby? >> gentlelady's time -- >> i don't think so.

>> -- has expired. gentlelady, cathy morris rogers. >> thank you, mr. chairman. although we were told repeatedly that if you liked your health insurance plan you would be able to keep it, we're now being told by the government that they have determined many existing plans to be lousy, subpar. in reality, this law is becoming quickly less about helping americans purchase affordable coverage and more about compelling millions of americans into a struggling medicaid program. in my home state of washington, 90% of enroll ees will be in medicaid. 16,000 of them coming into a program they were already eligible for. colorado, 89%, kentucky, two thirds, maryland, 97%. this is -- these are states already struggling with budgets, wondering how they are going to cover medicaid, which is as we all know for the most vulnerable population. isn't it true, that in states

like washington, they are going to have new unexpected costs associated with a dramatic influx into medicaid? >> congresswoman, the medicaid expansion provision of the affordable care act is -- >> are states going to face new costs? >> federal government pays 100% of the cost of newly insured for the first three years -- >> these are existing -- people already eligible and we know that two out of three doctors don't accept new medicaid patients and we know current provider rates are going to drop at the end of 2014. isn't it true existing medicaid enroll lees will further compete for scarce resources in these states? >> if the citizens of washington who are signing up are eligible for medicaid, they certainly will be enroll in medicaid now -- >> i'm concerned that the most

vulnerable in this country are going to lack access to the care they think they are going to receive. >> i think that's absolutely true. in states choosing not to expand medicaid, it's particularly dire -- >> it's existing medicaid. >> finally, i wanted to inform the secretary, you told us several hours ago when the hearing started that the website was down. if you look at the screen, several hours later, healthcare.gov is still down. you promised the system would be ready on october 1st. you're clearly wrong. so before i leave you today, i would impress upon you this is more than a broken website. this is a broken law, millions of americans are getting notices their plans are being canceled. >> gentlelady's time is expired. i just -- i would do a couple of things here. first, i'm going to ask unanimous consent that the written opening statements for any member on the committee be

interest dugsed into the record and without objection, the documents will be there. consent to put the document binder and other documents presented to the secretary during questioning into the record without objection. so ordered. let me say in conclusion, we do look forward to having you back in december to get an update on where we are. we'll work with your schedule to find a right time and date early that week. i want you to know we're going to want real numbers. you'll have them by then, is that right, in terms of signup? >> we'll have them by mid november. >> we look forward to getting those done. we appreciate -- we really do appreciate your time this morning to take questions and i apologize to all of members who we had to shorten the time but those things happen when you have this much interest.

we look forward to continuing to get an update and look for your continued work. >> mr. chairman, from our side of the aisle, we want to work with you. and i hope on the other side of the aisle, they would take the same approach. let's do something constructive, not just negative attacks against the bill that i think

...

>> the government shut down has hurt our economy and slowed economic growth. congressman van hollen mentioned a couple of the headlines. the one that is particularly painful to me is entitled "consumer confidence collapsed this month -- thanks congress." grow wages, create good jobs, and help our people. we want to make sure that the middle class can stay on the rungs of the middle-class aonomic ladder and we want policy to help those who are to there, get their -- there. i want to give three points. taxes