promptly. for the more, on november 6, 2013, the chairman sent a letter to the new york fed requesting information regarding contingency planning related to u.s. debt limit. the new york fed wanted the finger at treasury department claiming they needed treasury's permission. although we have rejected the fed's claim that it needs treasury permission, i ask that you commit to resolving this issue and insuring that the committee receives the requested documents by the date of december 18. you can respond in writing. we will move forward. additionally, this question of prioritization of debt. you have mentioned in the past that you are unsure of your department, whether or not it has the legal authority to prioritize debt payments in the event of a failure to raise the debt ceiling. i voted to raise the debt

ceiling. i think we have an obligation to pay our obligations. have you requested from the office of legal counsel of the department of justice, an answer to this question? >> congressman, on the question of responsiveness to oversight i very much except -- >> i just asked for you to respond in writing to that. have you asked or your department asked whether or not you can prioritize debt? >> the question of prioritization is fundamentally a policy question. as your comments reflected, i do not believe nor does any president nor treasury secretary >> let me ask you to answer my question. >> i have one minute 54 seconds left. have you asked the department of justice's office of legal counsel whether or not you have the authority in the event of

not raising the debt ceiling to prioritize debt payments? >> the issue of whether or not that decision is made is fundamentally a presidential decision. >> have you as treasury secretary, your department, requested from the office of legal counsel? >> it would fundamentally be a question between the white house and the justice department. >> ok, let me point you to the fact that a huffington post article from last week says the obama administration took the platinum coin option more seriously than a lead on. this idea that you have a $1 trillion coin minted and deposited at the fed and draw upon that, it is according to the huffington post, the administration did ask the office of legal counsel for this absurd idea to actually be judged whether or not it is legal. at the same time, you will not

say that you have asked whether or not you can prioritize payments. that is deeply concerning. >> i am prepared to discuss the policy on both of those issues. i don't disagree with you that the platinum coin is not an option. >> at me ask one final question on volcker. who is the primary enforcer of the rule? >> if i could just go back, on the question of the debt limit, the real issue is we must keep all of our obligations -- >> i agree. who is the primary enforcer of volcker? >> the volcker rule came out of five different agencies. there are different aspects depending on what kind of a financial institution you are. >> can you submit in writing your view of this as chairman? >> i am happy to respond to your question. >> the time of the gentleman has expired. as previously announced, the

chair now declare the committee in a brief recess. brief is going to be defined as approximately less than five minutes. then the senators john mccain and chris murphy are in the you joining a the ukraine rally. according to the associated 200 thousand antigovernment protesters are in the central square around ukraine's capital today. senator mccain appeared on cbs this morning from ukraine to talk about why he was there. there is no doubt about the andtegic and geographic every other aspect of ukraine. it is a large country, it is a cold should country, it is the beginning of russia.

happening here is not only our desire to be part of the european union, which makes them look to the west, and to not be coerced into the customs union that the russians and putin are trying to push them into. they are tired of corruption, there tired of the bad economy, and they really want to change. >> are you concerned that this could make tensions worse between putin and the united states? >> i think it may. of the a long tradition full that of peacefully demonstrating they have been peaceful. they were attacked by the police, which did not succeed. i think the other aspect of this is this is a country that is in really bad economic shape.

we need an imf loan and they need assistance. russia -- i back to think the consequences they believe would happen would be rather serious. there are several hundred thousand people. i have heard between 200000 and half a million in the background here. i'm telling you it is cold here. them on capitol hill the senate was in for a brief session to move forward on defense programs for 2014 and the budget agreement, setting the stage for the working week ahead. senators gavel back in tomorrow at 3:00 eastern time. it will be considering to executive nominations. votes are scheduled for 5:30 p.m. live coverage over on c- span2.

corrects france ferdinand and his wife were in syria a vote, the capital of bosnia, which was at that time part of austria- hungary. nationalbig serbian holiday which was celebrated every year. serbia, the neighboring country was furious that austria-hungary took over bosnia. it was seen as a provocation by forces who had been plotting for a greater serbia. they decided to kill him and they did. it was very sloppy police work. one of the conspirators shot his wife and him point blank and they both died. >> the events leading up to world war i, margaret macmillan on the war that ended peace tonight at eight clock -- at span's q&a.

>> lawmakers for testimony dealing with the health care law and insurance coverage for small businesses. held by thewas house small business community. it is around will -- around an hour and a half. >> small business programs -- our marketplace created by the program -- printed by the president to shop for, compare, and enroll in health insurance plans for their employees. the obama administration established high expectations for the exchanges. both all-out media blitz before and after the enactment by the administration, they promised options for small businesses that would increase small business or to sing power to lower costs and give consumers, not insurance companies, control over their health care. unfortunately, like too many of his other promises regarding the

health care law, the reality experienced by small businesses is different. take for instance the promise that shops would expand their options for small business. the administration announced only one option would be available in the exchanges. since enrollment in the exchanges began, many of americans and thousands of small businesses have received cancellation revocations from their insurers. on november 27, a day before thanksgiving, the it ministration announced online and romans would be delayed until next year. that online enrollment would be delayed until next year. it ministration anticipated the health law and the shop exchanges would lower health insurance costs for small businesses. instead small businesses are reporting significant increases in the cost of health insurance. a committee described a 44% increase.

axes acrossds, multiple majors, established by the administration, have failed to expand health insurance options for small businesses and they have failed to reduce the cost of health insurance and fail to give consumers more control and choice over their care. i want to thank you very much for appearing before us today. >> thank you, mr. chairman. every employer and employee knows there a few issues of greater important than access to health care get the affordable cap -- before the affordable limited,re act was a health care was decided by small firms is one of their biggest worries. lack of choice and skyrocketing costs. reportedhhs recently

that in 11 states premiums were an average of 18% lower than the amount small firms paid prior to the law's enactment. aroundcus has revolved the individual marketplace that can help uninsured individuals purchase qualified health plans. unfortunately tend -- unfortunately less attention has been paid to the small business. this marketplace was designed to provide an array of affordable high quality health insurance plans for small lawyers in that small employers and employees feel small businesses demanded more options and the health insurance marketplace. it is essential that competition remains vibrant in the health insurance marketplace because

when it declines premium costs generally go up. addresses this issue by encouraging competition and also guaranteeing high- quality health insurance. exchange marketplace provides benefits to employers and employees alike. and even take advantage of tax credit. employers have more control over the coverage they offer and how much they contribute to employee premiums. they receive the benefit of new market reforms like preventive care and not being excluded because of pre-existing conditions. that employees -- including getting one bill, writing one monthly insurance

check, and easily comparing plans. still the implementation has not been without its problems. several delays with employee choice and the website have let -- have led to some frustration for all parties involved. there have been bumps in the road and optimism remains high. today's hearing will give us a chance to hear about how this marketplace is helping small firms and their continued the limitation. we have seen health care spending at its lowest rate on record for any three-year. bank -- any three-year. bank -- three-year period. this finding demonstrates how critical it is to keep an open -- for the sake of small firms and entire health care markets.

us witness today will help understand how shops are working for small firms and how we can continue to move forward with many solutions. i would like to recommend that i would like to welcome director: for taking time out of his business schedule to join us. provide use will with insight. gary:,y's witness is director for the center of consumer information and center of oversight for medicare and medicaid services. he is responsible for overseeing the health, insurance -- health insurance exchanges and other aspects of the law. mr. cohan we a great -- to cohan we appreciate you coming in. cohen, we appreciate

you coming in. shape the opportunity to discuss the many benefits of the to smalle care act businesses and their employees. act isthe care transforming the insurance market, making it easier for them to find and him -- and purchase employee health plans. it is important to remember that the reforms that are in the affordable care act, some of which have you gone into effect and the remainder go into effect in the years beginning january 2014, are not limited to the shop. we have transformed the entire small-group market, whether the products are purchased inside the shop or outside the shop. i think there are sometimes some confusion that in order to benefit from the reforms, you have to buy a product through you do have to purchased through the shop to be

eligible in 2014 for the tax credit. other than that, the same reforms apply whether talking about products inside or outside. historically small businesses have been charged 10% to 18% more compared to large employers can small businesses are employing women or workers with high chronic illnesses and have faced higher insurance rates in most states. eco-small firms have fewer employees to pool, then premiums can to radically vary from year to year. when we hear about employers who are concerned because they're looking at premium increases, one thing they need to bear in mind is although their premiums may be affordable this year, if one employee gets sick and has a serious illness, there is nothing before before the care insurers fromnted to radically raising rates based

on experience and a small pool of employees. one employee getting sick could cause the rates to increase radically. anymore underppen the affordable care act because health status is not allowed to be taken into consideration when determining rates. the that makes rates much marketable and stable than they have been in the past. the a book air act created the tax credit to help small up lawyers of workers get a contribution to help them pay for workers premiums. a worker may qualify if it has 25 full-time employees, who make an average of less than $50,000 per year. in the mouth of this 35% of the employer cogitation, it goes up

to 50% for policy years beginning in 2014. since the tax credit became available in 2010, it has provided hundreds of thousands of small businesses more than $1 billion in total tax credits. turning to the shop, because the shop is the place where the have to gomployers to the eligible for the tax credit. there are a total, in the phyllisstates where the -- for the federally facilitated market place is operating, 66 plans operating, 1900 planned options and six qualified dental insurers offering options. in the state-based shops, as ricky member velazquez mentioned, most of the state- based shops are giving employers the option to offer more than one carrier to their employees

and letting their employees choose from a number of plans. we have announced that although we have not provided the option for 2014, in 2015 the federally facilitated marketplaces will provide that option as well. getting in august we launched a dedicated call center for players to learn more about the shop and get answers to some of their basic questions on the affordable care act. since the call center launched we received more than 22,000 calls from employers and others interested. we recently -- we have gotten a .alls -- gotten a lot of calls that shop has people who are specifically trained to help agents and brokers with their questions and enable them to assist their clients.

one of the most important tasks we have is to ensure small businesses understand the new options available to them so we work very closely with the small business administration, which is leading the outreach to small businesses and with the departments of labor and treasury. we provide detailed asked the nations of the shop marketplace and answer new questions on the shop, that is part of weekly national will -- weekly national webinars the sta conducts. we have been providing information on these weekly webinars since they began in july of this year. in addition a lot of our outreach on the ground is done through the cmf for best cms regional option -- cms regional offices. just since september 1, regional ops is -- regional offices are

participating in 20 events throughout the country to provide information about the shop and the small business market. recently we announced changes to ensure that small businesses where the facilitated market place is working to take it vantage of shop coverage and the health care tax credit. we have said we want to take it vantage of the sales and dissipation channels that artie exists in the market. small business owners work through aim agent or a broker to obtain coverage for their employees and to find out what sort of plan is going to be the best for them. thanpleased to say more 70,000 agents have been trained to assist those in the federal marketplace. point, as we have

announced that the online capability to shop and get enrolled for small businesses is of available until the fall 2014 for the 2015 policy. doesn't mean there aren't resources available to small that smallowners business owners. employers can go to healthcare.gov and there is a greatly improved and expanded ability to see what plans are available in the shop, to get a premium estimate raised on the specific number of employees who work for the employer, and to get links to the issuers. they get a premium estimate, they can see the cost-sharing. deductible, co-

pay, etc. peter they can then get links to the website to see more specific information, provided directory, the drug koran, etc.. -- the drug corn, etc. they get enrolled with coverage either turkey through an issue or through the use of an agent or broker. we haven't updated the materials we have available and the materials we distribute through webinars we have and so on and so forth, to announce those changes. ,e have been contacting directly by telephone and e- mail, each and every small business that cemented an application to us those contacts have been bullet -- have been order to get enrolled through the shop and particularly if they're eligible for the tax credits.

small business owners have struggled to keep up with the ever rising costs of health insurance for their employees. the ford will care act made it easier for businesses to find better coverage options and build on the current employer paste -- employer-based insurance market. tax credits give employers new options to provide their employees with high quality affordable health coverage crude a look forward to continuing to work with you. i will be happy to answer your questions. >> thank you, mr. chairman. i appreciate you joining us today. it must be a tough job for an answer these questions as i understand that these gotchas. as i have them for me you have to -- these questions. haveunderstand, you

testified -- it's only why they didn't know and why the show that's why the shop has been -- from entire year. >> it has been extremely well- publicized on october 1 came, we ran into a number of difficulties and problems that were unanticipated. at the time i gave that testimony i was providing the best information i had based on -- >> i appreciate that. what is confusing to me, mr. deputy administrator, is that when i listen to secretary sebelius, she blamed it on the contractors. somehow she was shielded from being able to make those decisions. were you involved are silly in making those decisions? i'm tried to figure out where the mess of this so we can get

this shop online instead of waiting another year. this,t i would say is societal is what i would characterize the business owner of the marketplaces, including the shop. have been instrumental, obviously, in providing the regulations and the guidance and setting forth the rules of how the exchanges are to operate and the shop is to operate. i hope you will take this as trying to duck the question, the people who built the website do not report to me. >> who do they report to? obviously we had contracts, supervised by people in cms and the office of information services. thee people report up to chief operating officer of cms and ultimately to the administrator. they are outside my organization. >> hominy deputy administrators

>> i want to go say six or seven. >> ago starkly up to administrator? >> yes. >> when did the folks in your line find out about the shops and the fact that they were not going to make it by the deadline? >> i wasn't involved in conversations as far as what the functionality of the website was going to be into september. we were pushing hard to get as much of the functionality to be available for october 1. that was obviously the target and the deadline. it was sometime time into december that a decision was made that it wasn't going to be ready. thatnounced at that time it was not going to be ready for october 1 and we were hoping to get it implemented in november at that point. >> how many small businesses do now project will oversee the tax

credits for 2014? ani actually do not have estimate of that's number. >> does anybody over at cms? >> i'm not certain. i can look to see whether we've come up with that estimate. i'm actually not aware that we have at this point. >> we hear a lot of discussion about how helpful those credits will be. i'm trying to get a sense of how --y might even call it they might even qualify for that. this hopefully was going to provide an opportunity for comparison shopping, more access for the small businesses. as no idea, given the failure to meet the deadlines, of how many will be taking advantage of this. -- it would be a difficult number to come up with. how manynow myself

employers would actually even be eligible for it, having 25 or fewer employees per wage. sums then --ke then you make assumptions for how money please want to offer health care at all because many don't. and it wastand that difficult for the administration to predict that. everything changed with the failure to meet the deadlines. i'm just trying to get a sense of those numbers should have changed as well. >> retried recognizing that we were not able to provide the online experience. we try to do everything we can to make sure that employers will have access to those tax credits. is good thing about it unlike on the individual side with an advance payment on the tax credit for employers, it is

a tax credit the claim at the end of their tax year. so you are left with submitting a paper application? >> that is correct. >> thank you, mr. chairman, i yield back. >> ranking member velazquez. >> thank you, mr. chairman. , the online experience is lacking. we know that. this survey --at i don't know if you are aware -- this survey found 80% use a 25 to 50 agent when employees are more likely to use 1:00 p.m. the fact we do not have the website does not mean it will hinder the ability of small businesses to get into the health care marketplace. >> i agree, that is right. >> last week we had a hearing here with a panel of small businesses.

claim that their rates were going up dramatically. i would like to get your sense as to why these increases are happening. would it be because they are receiving better coverage than they used to or do you have any other explanation? >> i would just point out a couple of things about what happened to rates. i think it is important to keep in mind that since the affordable care act has been in effect, premium rates for health insurance have been rising at the slowest rate literally in decades. that is true for a number of reasons. one reason is increased focus on great review. done a lot to give grants to states to enhance andr rate review programs

also to provide any rate would have over 10% to be justified by the insurance company. based on our report that we put for 2012, the average premium increase for small business in 2012 was only 4.7%. up at ae been going rate of 18% per year or more. addition, that seven percent was almost anti-percent lower than what the insurance company asked for. that shows that the focus on rate review has had a direct impact on the extent to which rates are going up. if employers are facing increases, it is from a lower place than they would have been

without that. i'm sure you're familiar with the medical loss ratio provision of the law. it is called the 80-20 rule. that says insurers had to spend $.80 of every premium dollar a small business pays on actual health care and only 20% on others.rative costs and that provision has resulted in substantial rebates to small businesses across the country that, in effect, reduces their premium. they may be paying a higher premium but they get a refund because the insurer did not meet that standard. --king at the change from and then the national survey of employer health plans done by mercer every year since the growth and total health benefit cost was only 2.1% in 2013. we are seeing very dramatic reductions across the board in the great -- in the rate of

growth in the market in general and in particular for small businesses. looking at the increases that some employers are reporting the are seeing as a result of the change of 2013 to 2014, i would make a couple of comments on that. as everyone knows the president announced recently a policy that says that issuers could continue to offer the 2013 plans for and a number of states have adopted that program , a number of issuers have. employers expecting to see a change from the noncompliant plans to the plans that will comply with the aca will have the opportunity to keep their existing plan. and then i think to some degree it is changing benefits, although i would point out that the essential health benefits that are required in the small group market were based on the

most prevalent benefits that as ofd in the market 2013. there is not a dramatic shift in the benefits available. it is a front for the individual really where people have skinny plans that do not provide a live coverage. a b-day covered hospitals or that sort of thing. in small groups the benefits haven't changed that much. we have made some changes that will result in reader stability over time. it is going to be somewhat misleading to look at just 2013 to 2014. i think you need to look at the trend of what is going to happen going forward because rather than an employer facing large increases, just because one employee gets sick, that isn't going to happen anymore. what i hear from many small businesses is what we need is

predict ability and stability. it will provide predict ability and stability over time without these jumps that have been experienced in the past. >> thank you very much. we have seen the enrollment numbers regarding individual marketplaces. we saw the amount of people enrolling. haven't heard much about the enrollment seniors. do have any access to the state data? because we haven't been taking enrollment online, we don't have those figures in the small-business market the way we do on the individual side where we know because the enrollments are coming through us. we are going to be receiving enrollment data from the insurance companies.

weon't have that today but will be getting in rome its data from the insurance companies and we will be able to report that out. marketplaces -- some of them have been reporting small group enrollments. that information should be available. >> when you anticipate having this data reported to you -- when do you anticipate having this data reported to you? clefs -- >> on a regular basis as their signing people up and then we will have to group that together. we will do that. >> thank you, mr. chairman. -- mr.:. mr. cohen. >> thank you, mr. chairman.

i think we keep experiencing from this administration debate and switch. you just made the comments that atare seeing rates rising slower levels than they have over previous decades. didn't the president promised us that we were going to have lower rates, not lower rates of increase? time, ink that, over expect that will happen. i don't think it is reasonable or necessary -- i think over time as more competition -- again, it is important to recognize that the health insurance market in many states has been extremely concentrated and there has been one dominant carrier in some states. we are just beginning to see -- this is not even the first year. i think we are beginning to see

fines in some places where haseased competition resulted in decreases in rates. to ultimatelying lower rates for americans, we would like to be able to hold you to that. really this is about fairness. isn't that what you are trying to say? we want to have it fair for the american people, fair for small business, is that right? >> yes. >> it is. then perhaps you could explain live inf you happen to rural colorado versus urban colorado, you are paying a premium under the president's so-called "affordable care act." explain to me how that is fair. >> congressman, i think you'll find -- no, no, i think you'll --d rates in urban areas are that is not new.

>> people who live in rural america, and their rates are lower were axis is lower, the administration is comfortable with that? >> of knots -- i'm saying it's not because of the affordable care i am saying it is because of a number of other factors, including but -- including the cost of providing medicare -- >> you could be paying anywhere from 65 to 100% premium just because you live in a rural area. that is where a lot of small businesses in my area come from. how is the administration helping them with this policy think with increased competition, we are hoping there will be more issuers offering health coverage in both rural and urban areas, and what we have seen is you look at states with more competition, rates are lower. in states where there are not a lot of competition, rates are higher. that was true before the

affordable care act and is something we expect to change over time, but the discrepancy between medical costs in rural and urban areas is not new or something caused by the eighth the eighth. class that is not what the president, thus when we were talking about introducing this now law on the american people. they were going to lower our costs. we are seeing world america suffer, small businesses are seeing cost go up. tell you this is disturbing coming from a moral area with data -- a lot of small businesses. the lack of compassion this administration is showing for these small businesses, how many have canceled those ologies now that the resident unilaterally made the decision to extend it, not giving it to individuals, but small businesses favored to big business early on. how many cancel policies? do you know? class i do not know.

it is important in reference to the you just said, requirement that employers offer coverage does not extend to small businesses in the affordable care act. only large employers fear there is no connection between those two things. it is always small employers choice whether to offer coverage to issue employees. class we are short on time but -- keep inserting the world the words, we hope we will be able to lower cost. it does not give a lot of comfort to many of us. you keep pointing to the credits. who pays to death for the credits issued by the overnment? five these are tax credits alternately paid by the treasury. >> the american people -- actually, there is no real net savings. sooner or later, someone pays the bill. is that accurate? >> i think, as

with many things taxpayers before, there will be a benefit to society as a whole for making it possible for small businesses to provide health care to its employees. we all benefit when people are healthy and have good access to health care. class the federal government mandates, small business suffers, and i feel my time has expired. mr. chairman. >> thank you. >> thank you. i appreciate the opportunity. thank you for being here. welcome. is it a requirement for any small business under 50 employees to provide health care to employees? >> there is not. how many small businesses in america would you estimate are small businesses with under 58 employees? >> i do not have that figure. i am sure it is available, but i do not have it. class it is well over 95%. mrs., whethers the website is not working or

not, they are totally unaffected by this website not working there it i would ask you personally, and allegorical question. how many times has your computer works perfectly in every new up >> i think wetly? are all quite familiar with circumstances where we go on a site and it does not work. class i appreciate that. is there anything that prevents small businesses from getting health care because of the aca? can they still shop for a healthy care through an asian? how many small businesses do you thek the ranking member -- ranking member alluded to this, but how many spent a lot of time thinking about health care plans and which ones to get for themselves and employees and they are trying to sell and a bestseller a product and move the economy. how many really do it by themselves, call you up or call and say, i want to get this

plan? >> my impression is that while small businesses are very concerned about the cost of health care and they want to provide it to their employees, historically, they rely on brokers. class that is the intelligent thing to do. i urge all of my businessmen and women to use my agents on a regular basis. can you emphasize the 2012 80 -- figure for us and how much less than it was going to be? >> so, in terms of rates, the average premium increase for small business in 2012 was only or .7%, whereas before the aca, byes have been increasing 18% and more. >> that is substantial. i had a veterinary practice and had a lot of different health care providers. my agent shopped around for me to find me the best deal at any given time. if i found a plan that did not go up in double digits, i jumped

on it. that was exciting to me. you testified already we will see more of this going forward where premiums are up a little bit. i will be honest, i concur in one aspect with my good friend and colleague in colorado. i do not think we will see rates go down a whole heck of a lot. i am a realist. i just want the race to go up minimally. i cannot buy my house for the same price in the year. everything goes up over time. right now, health care costs prior have gone up to double- digit breaks and breaking the back of small men and women. to reduceame in town health care costs is the aca. the pooling referred to is critical. while i have a lot of rural folks in my area, i choose to live in world. i have a farm myself and do not expect to get the same rate as my colleagues. i know with a pooling, my rate

will be a muriel rated going forward. any comment? >> no. thank you. you remind me i should always stress when we talk about what is happening with rates. i think we all understand the predominant factor that causes health insurance rates to go up is the cost of delivering health care. that is the main factor that causes it to go up very we need theork together to bend cost curve down to improve access to health care, to eliminate uncompensated care, a tax on every single american, because we all end up paying when people show up at the emergency room and do not have insurance. we all end up ain't. that goes into the hospital and doctors charges and gets puts that -- the fact in the race the insurance companies charge to us. it is not free. on what we to focus can do to in desk to attack the increasing cost of health care

delivery. we need to bear in mind those costs go up year over year and bye continued to go up significantly lower amounts since the affordable care act was passed. rateshen we talk about being lower, we have to be somewhat realistic that there are certain costs baked into health insurance rates that are due to what it costs to provide the actual underlying health care. >> in my state, the rates are much less than a lot of people thought. i yield back. so, deputy administrator, has the rhetoric changed now? now you are talking about, we keep hearing all this talk about race not increasing as much as they were. theyhe president not say would go up as much as they go down? >> in some places, we have seen rates go down. in new york, they went down rather dramatically.

and, it varies a lot from state to state, depending on the laws that were in set on that state prior to the affordable care variesry desk it considerably on state to state. and how competitive it is. it is hard to make a general statement about what it is like i everywhere for everyone. believe thate to as this law becomes fully implemented over time, and as we see greater competition, that will has an effect on reducing rates overall, bearing in mind there are certain factors that will always be a -- a part of the cost of health care and salaries to insurance company employees, etc. >> i find it fascinating the rhetoric has changed. you are hoping for that now. we heard all this talk about how

rates were going to go down first businesses, but now we are talking about rates not increasing as much. aca was bringing predictability and stability. your words, to small business. when you talk about predictability and stability, how do you get predictability and stability when you continue to cut these deadlines off gas so administrator tavener stated october 29 in a hearing that the online enrollment for the federal shots was going to occur , going to occur, as the end of november, and that things were moving along nice the end would be ready to go in life than a month. how do you go from that too, we need to delay it for one year, and how does that bring any stability and started to go into these small businesses out there trying to make decisions? >> i would just say again, i do not

believe the lack of availability of the website and the ability to access the application, etc., online, is affecting the rate people are paying. the rates have already been filed. >> i am talking about predictability and stability. was my comment. was that there would be more creditability and goalie for small business owners in terms of the rates they will pay to provide insurance for their own employees because they will not be subject to dramatic changes in the event an employee is diagnosed with a serious illness and then they are faced with a situation, and i have heard this directly, i either have to let the person go or i have to stop offering health care, because i cannot afford the premium for the one person who has gone the diagnosis of cancer or some other terrible disease that will dramatically raise the cost to that employer. pre-k's there is no predictability or stability in

this whole process. of trying to even find out what your rates will be were getting that process. it is very frustrating. we hear from malt businesses over time about uncertainties. we used that word around here all the time. has been the enemy of uncertainty, to say the least. class thank you for being here. as we know, there is a lot of misinformation circulating, much of it person -- purposeful, that is leading to a lot of confusion. district ina large queens, new york city, that has many small business owners and is beingeurs -- what done to reduce a lot of the misinformation and get the truth of the law out there yet health out there? -

quests we provide information about the affordable care act and about the small business exchange. e-mailedon, we have her desk e-mail list serves that we put information out so any small business owner who comes and wethcare.gov sign up have been putting out information through that channel. we have been doing public service announcements as well on the radio to help provide additional information. outave a significant effort in the states through the regional offices that have been holding a large number of educational and otherwise

informative events for small business, and then, we have a dedicated shops, small employer available to any small business person who just wants to call and get information about the aca in general or more specifically about the options available to him and her. call center, when you call in, there is a prompt on the line. if you're an agent or broker, you can get directed to someone specifically trained to help answer questions, to help them with their small employer clients. specificeen doing webinars again directed at ,gents and brokers to help them and finally, i would say, particularly over the last several weeks, given the

notsion we made about having online capability available, we have been working very closely with the broker the ciasociations, with be, and others, and i have met staff,em myself, with my to make sure they can push out to their members information about how to assess coverage using the traditional channel of going through an agent or broker. we have done quite a lot. we want always do more. to make sure everyone we have beenas talking about, that there is nothing about the fact that this online shopping experience is not available that is preventing any small employer from getting a tax credit if they are eligible. >> thank you. we saw in massachusetts that many people did not get coverage until closer to the deadline.

do you anticipate the same to be true this time around, and how will your long and moment anefit the small firms? >> great point. i think it is important to recognize that first of all, there is no open enrollment time for businesses. businesses can actually sign up throughout the year at any point in time. my understanding is in fact small business policies do run at any point throughout the year for a year. while there may be a somewhat larger number coming in january, throughout the year, there is no particular magic as far as getting coverage for a small business, and no particular magic to march 31, which there is in the individual market. small business owners can apply for and get coverage throughout the year. in the individual market, everyone is expecting that we inl see a spike here

december for january 1, and we are to see another spike in march as we approach the end of open enrollment. for small businesses, because current policies will be ending at various points in time throughout the year, it seems likely we might see more of a than in the individual market. >> thank you, i yield back. you said in new york, insurance premiums for small business are going down here at i think you even said dramatically down. i am not misquoting you? >> so, the question i was asked, i am not sure was specific to small business. i am familiar with information

that the new york state insurance commissioner has put werence the plants announced in the rates were announced for the new york. in fairness -- -- >> >> just to clarify, the small businesses you are talking about, i believe there were 100,000 individuals out of 20 million where the rates went down and the insurance commissioner quoted the statistics for those 100,000 individuals. yorkers00 other new that statistic did not apply to. i would suggest you check your data. as a small-business owner in the mists of insurance or numeral right now, the increases are staggering and they are of theing because affordable care act. because of obamacare. have lessght if you than 50 employers offering health insurance is not mandatory.

youorld says, and i hope agree, if a company offers insurance, that is a good thing. >> yes. >> it should not be one-size- fits-all. with 12 -- weny had someone in here testifying, and do not laugh but the name of the company was "college town moving junk." these were young and healthy adult males. i asked the question, do your employees need maternity coverage. after a few snickers, the answer was no. do they not have to provide that now? they cannot have a plan that does not have it. >> i do not know whether new york state already required the coverage. many states did. i can sell you essential health benefits were based on what was the most prevalent small group than in the market. >> one-size-fits-all. if i were an employer and i had a good plan my employees like

and it did not have maternity care, i cannot offer that plan. it does not meet the essential benefits. class under the policy the president announced a few weeks ago, you could still sign up for the plan. but you're right. >> you are incorrect. in new york, it did not offer that option. i am from new york. >> you are correct we do not have that option. we had 20nt is if employees and they are healthy and they did not want to pay for , and employeesug were satisfied with that college, a lot of drugs or generic, then a company did not have to provide coverage and did provided and provided at an affordable rate, and they all of a sudden cannot offer that coverage anymore. in some cases, prescription drugs can be 40% of health insurance. employees do not need it. now the government is saying in these cases, the company may not offer it. so they had a good plan, work for the company and employees,

they cannot offer the plan, and now they get no plan. how is that good for the family? >> the law provides that if people have health insurance, it should be health insurance that will actually pay for the needs and they have. >> prescription drugs. you do not need them. they were young. >> they may need prescription drug coverage. >> washington knows best, but i do not believe washington does. iother thing you said, and just take issue perhaps with some of your statements, are you telling me, that if i had six employees, i have an experience rated land, and if one employee get sick, then my premiums could i have sixif employees, i am in a computer the -- community rated clan and not in experience rated plan.

>> maybe that is true in new york, but not every state. >> again, a blanket statement, but in new york, i am in a community rated plan. less than 50 employees, i ensure you that i assure you i am in an employee rated plan. hundreds of thousands of dollars of expenses, a serious illness, my premiums do not go. statement that made it sound like the aca was andend-all for employees companies that offer insurance care less talk about new york. that is not a true statement at all. >> we are trying to provide that exact same benefit which you are saying is a good thing to people across the country. employers across the country should also be free from having skyrocketing health plans. states vary and there is no question. we are providing a level of security -- >> my time is expired.

i would like to point out to clarify, new york, you cannot keep your health plan. in new york, if you are under 50 employees, there is nothing in the aca that is helping us -- helping that employee, which you used as a very stark example. i can assure you a lot of theoyers and employees like health care they had and they cannot keep it anymore and there are things that are considered essential and they did not think are essential and now they will not have insurance and they will go home and asked lane to the wife and kids why they do not have insurance because the government told their employer what they have to offer and now they cannot afford it your that was not a good day at the dinner table for that family in new york. thank you. >> thank you for making the time to be here. a small business with a partner from 1990 72 2003. we face increasing health care costs year after year.

double-digit increases, having to make hard choices about how much we could provide for our employees and what would be the best to serve them. it is a challenge we face for a long time. a challenge our health care system, a challenge that if we do not address it for the long term, it will affect decisions we make. in businesses and government, for a long time. on yourouch base comments and you talked about business owners struggling to keep up like i did with my partner a decade ago, what do you see as the most important aspects? how do we make more people aware of the advantages or opportunities they will have once we get through the to use thepresently affordable care act to better provide health care for their employees? >> what i have heard from a number of small business owners and stakeholders and associations is one of the is thethey point to

employee choice model, which is available now in the state-based marketplaces and will be available in the federal marketplace for next year. that provides something not available to most employees in the past, where an employer could offer a number of different options, maybe an hmo from a different company and the provider plan from another. employees can make a decision based on individual needs, what sorts of coverage are best for them. >> as companies try to weigh choices, we are seeing in different states that some states are ahead of others. many small businesses are trying to compete on a national scale. what will you say to companies who do not have the options today. what should they be doing to make sure they are continuing to provide employees health insurance cap go -- insurance?

class going through an agent or employersntion again, can go on healthcare.gov now on the land side, not the application side, and see all of the plans available to them through the marketplace. as with anything, it is a complicated subject but the more employers can educate themselves and learn what options are available to them, and then if and are a smaller employer else before tax credit, that is something they should pursue. 50% of the pay employer contribution. manyeaking on behalf of so small employers, it is critical we continue to get information out, that we understand that going forward, the steps to

take, adapt and understand their needs and give them the options they need. with that, i yield back my time. >> thank you. mr. cohen, a couple of things just sort of helped me dig in to some of the information. i know some of the frustration you will hear from us as members was based in information coming to us that there were problems with the website and the mechanics and. we've got a lot of happy talk thrown our direction. you always wonder how much of that is professional staff hiding behind politically so often,staff, and our relationship with the administration seems to be political and not necessarily factual. i want to back up to where we were before. talk to me about some of the data you believe you have models

. obviously, with an organization like yours and what you do, you would be modeling it. on first, adoption. what are the models you build for under 50 employee through thes going aca or other mechanics, to expand health coverage e have you built those models? >> you know, i will have to go back and look to see what we have. i would be happy to get you that information. i just do not have that. >> something that would be incredibly important for your organization, is also, would you have paid attention to the cases of subsidies? >> i think i know on the individual side, there have been -- we have looked at enrollment and cbo published figures for what they expected enrollment to be and what the costs would be. i am not able to call to mind what that was on the small business side.

if we have the information, i am happy. for that, ask you because as we are now seeing much of the data coming out as, the dramatic skewing into the individual's side into medicaid plans, instead of individual purpose it -- purchases. maybe that changes. just trying to get our head around what is the budgetary impact for all of us that have to do policy making into the future? are we about to wake up one day futurehave just loan up entitlement spending and other spending in this law? so the unintended consequences of something, it'll bunch of mechanical issues. >> are you familiar with the discussions that have been around the biggest -- business aggregation rules? of? >> in terms of what actually makes up 50 employees. >> how you count?

o add up to 50? >> yes. >> yes. i am familiar with the impression but that is a treasury rule. >> a treasury rule, but do you of the up having part administration and part of the modeling for what that actually brings in or does not into articipation? >> on the question of what modeling we have done, i would need to go back and see what we have for you on that. click ok. leslie, we had fascinating testimony here of some gentleman sitting at that same table, saying, we have a small business and we offer health insurance on our little business, but i am an investor in this one and i participate in this one, and i do this one, and oh my heaven, everything else i am touching will get pulled in under this business aggregation rule. inm better off not investing

my son and my brother-in-law and my daughter's businesses because i create a cascade effect and force everyone under the 50 employee will air this is not sort of hitting your radar on what this does both in membership enrollments, future subsidies, and actually, the obvious economic impact? >> no. i have not seen anything on that myself. >> ok. we make sure we reach out to mr. cohen and ask them for their data sets of what they modeled in expectation of participation, and the subsidies that were modeled to go along with that? i yield back. >> would you provide us with that information? >> i would take whatever questions you have and work with you to get you the information. >> we will make the request formally.

>> a lot of my questions were asked. job, as usual. i was looking to try to figure out what the amount of the subsidy would be on the government per year for small business grows but you asked that question and i thank you for it. a quick question here with -- most of the other administrative offices throughout the government have gotten some sort of complaint bureau. one forr office have the small businesses to lodge complaints? you said something about them being able to go there for information. withf there is a complaint a policy in regards to a company providing coverage or just the participation, is their way to lodge a complaint? >> we do. we do have a part of our office that receives complaints from the public.

complaintsthey are about what we're doing and sometimes they are complaints about what they have experienced , they have had a problem with a health insurer or something like that. >> if i am insured and i have a problem with the company, who do i contact? >> we have a phone line of people on our website. >> the number is on the website? identifies it as a claims complaint line? is that right? >> yes. there is healthcare.gov call center, the focus now for most of the questions coming in. >> healthcare.gov, isn't that where everybody goes to sign up that is not operating? >> the call center is not operating. literally thousands of people answering phone calls every day from the public. >> you are incorporated with that line? >> yes. a dedicated small-

business call center as well. >> ok. >> that small businesses can .all to ask questions >> that is troubling. i am concerned. we discussed this around a little bit with regards to increases in coverage and cost of coverage. got a little bit of an insurance background. that people, such as long as the price is affordable and they do not have problems, they will continue to take it and when it becomes unaffordable, they will drop it or, if they have a situation where they cannot get coverage and have an illness that now has a pre-existing condition, for instance, and cannot get covered someplace else, then they will keep it. you wind up with adverse selection, which means people who have the most to gain are the ones who stay in the program

and the ones who have most to lose will get out. as a result, premiums will go up accordingly. willo not think that happen? that is the assumption i get from the discussion you have had though far. class is the question whether that will happen in the small group market specifically? >> why would it not occur? >> there has been a lot written about what will happen to offer rates when employers are offering to their employees and the employer sponsor market altogether and the small group market in particular and a lot of productions about what will happen. been pointed out today, most employers offer coverage to employees because they think it is the right thing to do and they think it helps recruit better employees. >> is this a likely scenario?

you have got 12 employees. one of them gets a serious illness. wreck your rate, the person drops out and now has to go on their individual plan, which because there is no pre- existing condition with the new president posses health care law, they will not be a will to get coverage. then, you have adverse selection because all the people who been have problems will be in the pool. >> the person getting sick, that is the point i am trying to make. the person getting sick cannot wreck your rate anymore under the affordable care act because rates cannot be based on health status, but only age within certain boundaries and location and, not on health status. so, this will make it easier for coverage to maintain for their employees because they will not have to worry about rates goading -- going up. >> of that individual will be

retained in the health care the abilitycause of to continue to provide care for that person, it will be more costly. sick, theyple get have more health care costs. what happens under the affordable care act now is we are creating a single risk pool so any particular insured -- insurers, all of their employees , all of their small group insurance are in one risk pool. we have made the small group market look a lot more like the large group market or the large group market, health insurance has been less costly and more stable than in the small group market. we are creating a larger risk the to spread the risk so burden of the employee getting sick does not fall just on that spread acrosss the entire risk pool.

>> my time is up. thank you, mr. chairman. >> i have a note here i just received a couple of days ago from an employer in my district who has 93 employees. he said his 2013 health care contract cost us $558,000. 625 thousand dollars, 19.1%. generated from obamacare was an additional $44,341. is looking at an increase of about 30%. .hen you factor everything in and i do not know if he has factored in individual taxes on top of that. quite significant. i ran a law firm for 25 years

before i ran for congress. we always carries major medical on employees because we did not want to be bankrupt by catastrophic health event. insurance fored .ental or vision on minors never needed it in our whole 25 years. the care plan the law firm was on has been canceled because of obamacare. are looking for another plan they can buy that does not have those coverages. can you lead me to one? >> that does not have -- those coverages. they want a plain major medical policy. it is what they need for employees. where can they buy one that does not cover substance abuse, assuming their>>

,olicy will not be extended substance abuse coverage, mental health coverage, are part of the essential health benefits acquired --what is required by the affordable care act. i would say again the benefits which were determined on a state-by-state basis, not determined nationally, everybody had to have the same. they were determined on a state- by-state business. in most states, they chose to thethe benefits afforded by most use small group plan. in general, the benefits required for small group plans going forward are very similar to benefits employers were choosing to buy up until now. >> i did not choose to buy it.

you said it was gone on a state- by-state basis. some of those states do not have to carry these outlying coverages. .> they have to >> so it is national, not state- by-state. >> but how the benefits will be offered and what had to be in each plan within the essential health benefits, was done on a state-by-state races. but you are right the categories are mandatory. >> so some states do not have to have certain kinds of mental health coverage and certain do? >> in this particular benefits offered very. yes. [laughter] , 15s so my whole law firm employees, they will not be able to find a plan offered because these are required federal

benefits. >> mental health and substance abuse are required. class and dental and vision and maternity. so, my 60-year-old law partner in his life will have to carry maternity coverage. cost ofe spreading the providing maternity coverage to women across the entire pool of people buying coverage. that is insurance. that is how insurance works. insurance does not work where you just pay for what you need. it works so we spread the cost .cross everyone >> you are wrong. insurance is where you choose to go by the coverage you need and you spread the risk among all the other people who knew that coverage. here, you are forcing people to buy things they do not need that they clearly do not need and do not want. is that not right? >> of we

discussed, maternity and substance abuse and mental health coverage are among the essential health benefits, yes. why would you for somebody to buy things they do not need and do not want. explain that to me. what is the purpose of requiring a 70-year-old woman to buy this? purpose is to make sure all americans have access to the health or they need and to spread that cost. class so you are saying a 70- year-old needs maternity coverage. >> no. spread the cost among americans. class if they do not, why do they have to bite? -- >> if they do not, why do they have to buy it? [laughter] >> they have no way of knowing whether they will need mental health coverage or not. >> i can promise you a 70-year- old woman whenever need maternity. class i understand that.

class i am over my time. thank you very much. >> mr. king? >> thank you, mr. chairman. i am glad i am not sitting in that seat. the unpopularity of this atrocious law has to reflect itself in this discussion we're having here. i think the chairman for holding this hearing. think about some of the promises that have been made and i wonder if there is not a committee in the white house to make sure they are all broken. own policy, at my and i had not given it any thought until about october. i spent the previous four years fighting on behalf of the american people against this had so then, when i finally really no choice except to be -- to subject myself to this law, i began to read through the policies available and it was awfully hard to get my hands on any policy. the most information i could find was from verbally over the telephone.

i remind you 25% of the people in this country profess to be catholic and i am among them. the teachings of the catholic church are this. the catholic church opposes contraceptives in these forms, birth control pills in that form, and sterilizations, abortion causing pills, and abortion. with the legislation that requires that at least a policy be offered for purchase the dash, so everyone in the country has an opportunity to purchase a policy that does not fund abortion. i find it is almost impossible to find out whether that actually is the case or not, and of those offered to members of according to representative chris smith, whom i trust, is that there are 112 policies offered to members of nine of and of those, them do not cover abortion. ,f those, eight our regional

and there is only one available that does not fund abortion. that was my choice. i wondered if there were only one woman in the world, if i would marry her sight unseen, but that is essentially what happens on the lse. only one available to me. then i look at it and i see, it really is not spreading the cost across the broader universe here. of --e, in the mandate mandated contraceptives listed in this policy, there is no deductible. that means anything you can get a doctor to prescribe will be no out-of-pocket costs to the person utilizing that. i am confident the gentleman's reference to a maternity coverage does not apply to a 70- year-old woman. how do you reply that we have mandated contraceptives here, three of them on this list directly violate the principle

of the catholic church. it appears to me it is impossible for a faithful catholic to buy a policy that does not violate their conviction. >> you have asked me a number of different questions. ofh respect to the provision contraception without cost- sharing, there is a part of the affordable care act that ofuired a study to be done particularly preventative services for women, and an independent study was done that found providing contraception to women without cost-sharing had significant health benefits for women and pursuant to that study and the provisions of the law, there are a number of different preventative services. mammograms, -- >> i did not see that on here. >> there are a number and not just to women, because there are

other things that have to be provided without cost-sharing, because there is a very robust literature which shows -- >> let me -- instead of leaving , let'swallow in that just take this to the question. how does a faithful catholic comply to this law and not violate convictions? >> i really cannot speak to the convictions of a catholic. and what causes them to violate or not. qwest they oppose contraceptives and the sterilizations and the abortions. the law says a policy shall be offered to anyone, at least one that does not fund abortion. how do i know that? >> i cannot answer the question of how people are able to find out the answer. a fair question. >> we have a mandate we will buy the policy or have the irs come with a taxnished us and not a penalty.

how does a person comply with the law when the federal government is not complying with the law and if they are not, they have been obligated under obamacare to make sure there is at least one policy available that does not fund abortion. i think it is important to the people on this panel and those who might listen to this committee to know there are three other basic principles here that are mandated violated by this legislation. that is the contraceptives and the sterilizations. they are mandated to be paid for by everybody, even the people mr. rice is talking about, without a deductible, even though almost all of the other services have a deductible. it looks to me like this is a direct assault on people who are pro-life, especially catholics. fda has concluded those drugs do not cause abortion. they prevent pregnancy, but they do not cause abortion. we can debate that, but i'm not

a scientist. i know that is the conclusion the fda has reached. we would deal with that. lex the contraceptive pills, there may be an argument there. even if we are talking about that. , i doe balance of these not agree. the vernacular used by the fda to try to get around this sounds like a bunch i have seen from this it ministration. a any case, the point is made person is no longer free in this country. i will yield in a moment. you cannot be free in this country to follow your conscience or your religious convictions because this law as enforced by the administration violates the deepest convictions of at least 55% of the people in this country and i yield back area >> time expired. let me see if i can get back on track. i lost what this hearing is all about.

it is about exchanges. you, ifjust like to ask viagra is prescribed, by a doctor, is that covered? >> it depends on what the particular insurance policy, whether it is included in the drugs covered by the policy or not. that is an insurance company's decision. viagra is not a preventative service mandated. >> glad to hear it. this are:, let's talk about the states that have chosen to run their own exchanges. others have declined. we are seeing great results in the state based marketplaces, especially in new york. in fact, numbers were given here. i know the only numbers coming out from new york is the one we are provided by the insurance

commissioner from the state of new york, who said, they have approval rates for 2014 that are at least 50% lower, on average, than those currently available. we do have some numbers coming out of some states that are related to small businesses. that has madetes information available in the small group market, premiums are estimated to be an average 18% lower than the premium a small employer will pay for summer -- similar coverage without the affordable care act. would you say this is the type of trend we will see coming out of other states? >> yes. i agree with that. again, i think it is important to bear in mind insurance markets vary dramatically from one state to the next. we cannot generalize from new

york's experience to where there is a very competitive market and a lot of carriers offering coverage to other states, where there is maybe only one or two does. over time, i think -- i would of states example that have established their own marketplaces and have been successful, will encourage and inspire other states to do the same and what they will find is that the affordable care act and it,way we have implemented gives states a tremendous amount of flexibility to operate the marketplace in the way that is best for the residents of their state and give them the opportunity to retain control of regulation of the insurance market, which traditionally has been a state function. >> what role can you play to replicate the success we are seeing in new york, where nearly 300,000 have completed

applications on almost 100,000 have already enrolled? >> a great question. we actually work with all of the to help them if they are interested in moving towards becoming either a state partnership marketplace where they operate some of the functions, including the alpha reach and review of plans to be .ffered on the marketplace we receive and review and issue the states to help them establish state-based marketplaces and then we work with them all to the process of developing the marketplace. mississippi,, in the state decided to operate the small business. closely with an

insurance commissioner in mississippi to help that happen. >> here in this committee, we always talk about the important of having certainty for small businesses. when they put together a business plan, they need to know what they are confronting and what types of resources they will have available. my question to you is, what had inthe threat of cuts the implementation of the provision of the affordable care act by your agency? >> you know, well, i would say, as with any government agency, we do the best we can with what we have. while it would always be helpful

to have more resources, and i think, particularly, the secretary has spoken very about the benefit of having additional resources to do more outreach, to be able to do more education, to be able to make sure every single person in the country and certainly every small-business business owner in what benefitsnows the law can provide of -- to them and what they can take advantage of. that has been difficult, given the funding levels we have. >> thank you, very much. thank you, mr. chairman. >> last chair -- last question. documents you all knew as far back as july 26 that the federal shops were not going to function, or at least, the website was not going to function. it will have to be delayed. we had a study requested that determined there were significant challenges. cms continued to promise the

public and congress time and time again that the exchanges would be ready to go, or at least the shots would be ready to go, for that first launch. it wasd you find out nowhere near operational? >> so, sometime well into september. the shopnew that functionality would not be available for october 1. i would just say, congressman, i mean, you know, none of us had way thepy with the website rolled out. the president said he is not happy, the secretary is not happy, i was not happy. to geted really hard everything ready and up and running for october 1. some pointlear at well into september with respect to the shop, that we were just not going to make it. that is what we announced. informed? cap nor

>> when you say "informed," it was a process of pushing and trying to see what we could get done and then there came a point in time when a decision had been made. will we be able to do this or not? that was sometime well into september when that decision was made. >> but you do not know when the administrator was informed or knew for a fact this was not going to happen? >> i do not have a specific age but i know it was, at some point, into the month of september. >> the frustrating part is, and it goes back to the with smallity, businesses, it is frustrating and administration that wants to talk about how small business is so important, why they waited until the day before onlineiving to announce enrollment. >> i am sorry, to interrupt you,

there were two issues. what i talked about in september be it announced it would not ready until october. we announced later it would not be ready at all this year. that decision was not made until very close to the time it was announced area we continued to push and hope we could get that ready and be able to roll it out by the end of the month. a year in time to when we announced it, we realized, given the work that needed to be done to make sure the website was functioning effectively for people in the individual market, that we just had to make a choice and that is what we did. >> that makes my statement better than i could have. i want to thank you for coming in today and for testifying before our committee and making yourself available for questions. of thethe limitation health care a lot has been problematic is an absolute understatement. that is unfortunate. they were exposed to simplify

and provide affordable insurance options for all small businesses. instead, the implementation has become a game of hide and seek and nobody has one with that -- won with th at. with that, i would ask unanimous consent for the members to submit statements for the record. without objection is so ordered and this hearing is adjourned. on monday, former u.s. trade representatives from the george h.w. bush and clinton administrations will address the 20th anniversary of the north american free trade agreement. you can watch that at 9:30 a.m. eastern. ceo on monday, chairman and dan ackerson will speak at the national press club about their progress at the company. he led the gm initial public

offering in 2010, 1 of the largest and u.s. history. you can watch his remarks beginning at 1:00 p.m. eastern. >> fcc was the first -- provided the first country in the world to provide allocated sector. this allows vital signs without having intrusive marketers. we are a remote wireless monitoring solution. we are able to monitor and keep them well. typically, a patient would have to go to the doctor maybe once a week to get a blood reading.

and then the data goes into this device and that can go to our service center or our nursing center. --y can alert the nations the patient's cardiologist. on providing a model notice for health apps. for example, when you go to buy a can of soup, you know how there is a consistent fda label that led to look for the things you're interested in? some people care about sodium or sugar or fat. similarly, we are developing a tool. we have done this for personal health records and now we are expanding it. this can help you say, ok. these folks do not resell my information. again, a consumer can help to growing ands exploding field. -- governments's

role of technology on monday night on the communicators on c- span2. -- c-span 2. the aiken -- a hearing on the conditions in afghanistan. witnesses includes state department special representatives or afghanistan and pakistan. from the foreign affairs committee, this is just under two hours. >> this hearing will come to order. task all the members to take their seats. i have been focused on afghanistan since before 9/11. today, the committee recognizes the tremendous sacrifices made by our troops, by their families, so that america is safe from the type of attack that osama bin laden launched from afghanistan.

next year, the administration plans to transition from combat operations to and advise and assist role. we need a workable and realistic transition plan in place. last month, a delegation led by adam kissinger and joined by scott perry and juan vargas, traveled to afghanistan and pakistan and they collected information useful to this committee. i thank them for their oversight work. i also want to recognize the committee's military advisor, colonel andrea thompson. she has served towards in afghanistan and organize the trip. i am concerned administration has not defined a mission in afghanistan. u.s. troop strength will drop 34,000 in two months in pending a bilateral security agreement,

these numbers will drop lower. the remaining troops will have a limited role as they should. what will be our objective? what constitutes success? insufficient planning for this transition could put american lives at risk. it is questionable whether our diplomatic facilities are equipped, physically and staffing wise, to protect u.s. personnel. this danger will increase as troops withdrawal and transition planners better best figure out how to protect our personnel during this transition. unfortunately, corruption in afghanistan places our aid programs at constant risk of waste, fraud, abuse, and despite years of rule of law training, the afghan government has few workable safeguards in place to prevent the misuse of u.s. aid money.