and first lady betty ford. host: welcome back. -- a couple of live events to tell you about tomorrow here on c-span. -- general ray odierno speaks about the future of the army. that is at 1 p.m. eastern. at 2 p.m. eastern, the senate subcommittee on civil and human rights looks at refugees from the civil war in syria. it includes representatives from the state and homeland security departments. now i discussion of what happened during the first days of coverage under the affordable care act. "washington journal," this is 40 minutes. host: welcome back. our next guest is elise viebeck, she covers health care. guest: thank you for having me. host: walk us through how this

has been going on for the congress has said. guest: sure. obviously the botched rollout of healthcare.gov did not help anything, but people have been having mixed experiences. some are going to the doctors office and they are fine, they are using their new coverage without issue, others are encountering problems when they call their insurance companies. i think it will take several months for all of this to shake out and for people to understand how their plans work, first and foremost. there are different providers within the system who can adjust. there is a lot of shake up right now and no one really expected it to go perfectly in the first few weeks. host: what about the administration's response to those mixed results? guest: first, they are saying to call the insurance companies. in fact, many new people who have voted in the obamacare

-- who have enrolled in the obamacare plan, they may have gotten a packet in the last few weeks from their insurance company that contains a lot of information. health insurance is complicated, so there are people who are having to go to these companies with these providers to make sure they understand what is going on. the administration also set up a toll-free number to help people navigate those problems and they have caseworkers to help people with personal issues. -- persistent issues. host: tell us what you will be watching in january. guest: people do not need to have paid for their coverage to begin. some people are using coverage that they still have not paid for. we will be watching that. many opponents of the affordable care act believe that we should not be counting the 2.1 million people on private plans as currently enrolled, because not many of them have paid their first premiums yet. we will be looking at that. down the line we have the march 31 deadline that ends the

initial enrollment. that will be the deadline for the obama administration. we will be watching how many people enrolled in those private plans or medicaid, how stable are those distressed pools going forward? host: we are talking about health care this morning from -- with elise viebeck, from "the hill." our numbers this morning -- host: talk us through what you are hearing from members of congress, particularly from republicans, who are obviously very focused on this law. guest: the house gop is already planning another obamacare related vote this week. they will be bringing up the latest security concerns that somehow healthcare.gov requires the administration to notify anyone who has personal data that is compromised because of

the healthcare.gov security issues. we don't know that has happened yet. the administration has strongly rebutted any assumption or allegation that healthcare.gov is making people's personal information vulnerable, but the republicans are going to try to draw attention to that this week and undercut the law as we start the election season. republicans are working to make this law their main issue in order to protect their seats in the senate. host: one piece from "the hill," talking about aca insurance spiking right now. guest: it is interesting, people were not able to use these claims until january 1 at the earliest. people often do not use health insurance on day one. you may not need to go to the doctor. health-care care providers told us on the hill that they expect things to begin starting this week.

obviously there is a holiday lag that has gone away. people are back to work, back in their normal lives, getting their needs met at the beginning of the year. host: our first call comes from new jersey. henry is on the line for democrats. henry, are you with us? caller: yes, i am there. host: go ahead, you are on with elise viebeck, of "the hill." caller: good morning, how are you? yes, i am. host: turn on your television, -- turn down your tv. we will be happy to chat with you. -- turn down your television, we will be happy to chat with you. caller: let me tell you how happy i am to be part of obamacare. my wife and i were both laid off from a job the downsizes. she did not have no insurance for a while. i did not have none. cobra costs weighed $800 apiece. on october 1 we signed up and

kept on every day with every hour our calls. i did not have much problem, ok? i wish people would go into the system and see how it works, ok? i am living proof of how well the obamacare works. my wife got sick a couple of days ago. we were praying a few days ago that we did not get more from the regarded insurance. she got the payment slip, we did not have the card yet. everything was in the computer. at the drugstore they picked up the medicine. it costs seven dollars for the medicine. my wife and i, we are very happy with the health care. i wish that everyone would look into it and give it a fair shake. the way these people are talking about it is not fair. thank you. guest: henry certainly has a

success story. he and his wife are the kind of people that the administration was hoping to help. it is possible that that family is receiving a tax credit in order to make their coverage more affordable. in the state of new jersey we have seen a lot of people reporting positive experiences. it is important for viewers to remember that this law affects every american in a completely different way. one of the reasons that the backlash has been so negative is that any negative story, it is presumed the administration is going to have to immediately fight back like it is an attack on the law. there are people like henry, who are having success. host: west virginia, george, democratic line. caller: thank for c-span, we can get the news and the truth out. i do not think that this young lady is telling the real truth about obamacare.

do you belong in obamacare? guest: in obamacare? caller: do you belong to obamacare? guest: i have employer-based health care. i know a lot about obamacare. do you have a question? caller: people cannot even get a telephone call in west virginia to get the ok to get the treatment in the hospital or from the doctor. not only that, you are not going to get the 7 million people needed to make this thing work, for one thing. and then the emergency room is quadruple already with people going to the emergency room, using this here what you call it because they cannot it into obamacare, you put them into the medicare what you call it. it has almost tripled the people going to the emergency room. where are you saving money? you date -- spending more money because of these people that did not want to buy insurance. you people are now giving it to them for practically nothing.

that is why they are happy for it. i have always had good insurance that i have paid for out of my pocket. not only that, i am also a veteran. as far as that goes. but this obamacare is going to self-destruct. the republicans do not have to do one thing to get rid of it, it will self-destruct itself, mark my words. within the next year. guest: obviously, there have been many, many problems with obama care for people across the country. peoples experience tends to be based on who they receive insurance, and what state they live in. for people in the state of west virginia they would have many problems, which does not surprise anyone in washington. host: that number that the administration was hoping for by the end of march, do you have any idea how on pace they are? guest: we know the 2.1 million people signed up for rival plans

under obamacare under federal -- private plans under obamacare on both federal and state exchanges. certainly, that was a major expansion based on what we saw in october and november, two very troubled months at the beginning of the enrollment. i still think the administration has a lot of catching up to do to reach that benchmark. in fact, we know that, the white house has since pushed back and said that 7 million was not their goal, even though we know it was their goal in some places, but it does not mean that the law cannot survive with fewer enrollees, but it will be a major reach for them to get there by the end of march. host: fairfax, virginia, on the line for democrats. caller: i just wanted to say, obviously, there are a lot of problems with obamacare. she is right about that. everyone knew that that would happen. health care is very complicated. unfortunately, the insurance

companies are alternately still -- ultimately still really in power, although there are some steps, like pre-existing conditions, things like that, but what we need is single- payer. i am so tired of the republicans who, first of all, they do not even want to take a step away from the broken system that we had before. you know, they just want to keep things the same. we have to move in some direction. i had a young son who, when he was under two years old, had what was called baby asthma. it was very common and it usually just kind of goes away, but after he was diagnosed with that the insurance company sent me a letter saying they would no longer cover anything having to do with his entire respiratory system from that point on. that is the kind of crap that has been going on out here. we have got to understand that

the health of human beings should not be a basis for someone to make a profit on. guest: for many progressive democrats, the law did not go far enough. we have to remember that these marketplaces are all about connecting uninsured americans with private health insurance. not government run, but heavily regulated and it still remains in the hands of private insurers. there are many families out there today who are thankful for the affordable care act a cousin -- because it banned discrimination based on pre- existing conditions. for his son it was something as minor as baby asthma, and for others it could have been acne, sleep apnea. many people think that those issue should not have been discriminated on and the affordable care act no longer allows that to happen. host: delays have been announced for various portions of the law. do you expect more of that? guest: yes.

perhaps before the end of march as the administration seeks to reach as many potential enrollees as possible, the entire six-month enrollment. it could be slightly delayed, that march 31 deadline could be pushed back. we will see larger adjustments to the law as well. insurance companies will be receiving -- receiving more money to shore up the risk pool, and it is possible that people may see relief under the individual mandate because of problems with healthcare.gov and for people who would have otherwise qualified for medicaid expansion but lived in states that were not supported. host: how is healthcare.gov working now? guest: it is working better, in fact. they performed the tech surge, the white house called it. i remember being here at c-span to talk about it, i had gone on that morning and it was clearly not working well that morning and it turned into an enormous

firestorm for the white house. now it has turned the corner. a former microsoft executive is now heading up healthcare.gov. i think that the administration is very focused on making sure the website irks going forward, -- works going forward because , it was such a disaster. host: port st. lucie, florida, frank is on the line for republicans. caller: how are you? guest: good. caller: i was wondering, this is a tax that people have to pay to stay in the country, now. it used to be that you did not have to buy insurance to stay in the country, but now this is a tax that you have to pay to stay in this country or you will get fined. you do not have to pay health insurance -- you do not have to have insurance, but now you are forced to buy in.

and it is not affordable. if they will not correct the problem, i think they should start with the hospitals, doctors, and insurance companies to charge too much. $45 for an aspirin to go to the hospital? i went for a toothache and they said they could not help me, that they were not equipped. they charged me $4700 and said they could not help me. guest: the caller brings up an important point. anyone participating in the american health care system knows about this, it is price inflation. anything at the hospital, the inflation, it will cost more than what it would at the local drugstore. hospitals are seen as charging enormously huge prices between them. if you compare hospitals in your hometown with other places, a procedure may cost more at one place compared to three miles down the road. there is certainly a lot of support within the public to get

more transparency about these prices so that people can make choices that are better for them. often when we need our health care needs met, we are not thinking about the price and many people wish that those prices were out there in the public. host: ohio, darlene is on the line for independents. caller: good morning, ladies. guest: hi. caller: a couple of questions. they are easy. are we headed for universal health care? second of all, why was the various state insurance departments not involved in the process prior to the affordable health care? my third question is -- do you know anything about ohio's magi? i may be saying that wrong, so i will spell it. m a g i. also, is there a possibility that our politicians could be

regulating hospital billing practices and letting us know how much we are charged for various services? take you so much. -- thank you so much. guest: some people believe that obama care represents universal health care because, as the previous caller noted, everyone is now required to pay insurance or face fines. there are a variety of extremes in getting that coverage, you might get it through medicaid or private insurance tax credits. it depends on how you define universal health care, but certainly it is a law that help -- attempts to achieve that in several ways. second, state insurance departments are heavily involved in regulating the insurance. and they were before the passage of the affordable care act. some of them are working heavily with the federal government to implement this law. others have not been as involved. the magi issue in ohio is not one i am particularly aware of

because i cover the federal government, but i would encourage her to reach out in ohio, they should be able to answer her question. these billing practices are the ones i was talking about earlier, desiring transparency, the obama administration has sought to increase that by publishing reports from data on those prices. host: we are speaking to elise viebeck, from "the hill." let's go to our democratic line. caller: over three years ago i was involved in a car accident. i thought i was set with my health care through work. before that i injured in a car accident has been injured again. health care in 2012, we put out almost $20,000 in health care between the co-pay and paying the insurance direct.

i put out somewhere, not sure exactly, between 17,000 and $18,000. on the limited income that we got, that was 67% of our income. we have paid our savings out of the ira to supplement this year. my wife is not -- in the process of getting on obamacare. insurance has changed drastically, slow down, stop. this could happen to anybody. you could be hit head-on with a car. life changes in a fraction of a second. you do not know what is going to happen tomorrow. thank you for your time. guest: any american, any person can run into an unexpected health crisis, as the caller said, which is why many people

feel that health insurance is so important, it prevents the kind of medical threat, but even if you have health insurance you are sometimes overloaded with terribly onerous out-of-pocket costs. that should improve for some people under the affordable care act, but not necessarily everyone. host: you recently wrote a post called "top five obamacare stories to watch." what are you watching now? guest: we are watching enrollment numbers very carefully. they are going to suggest how successful it is likely to be in the future. we know the 2.1 million people signed up for health insurance plans through healthcare.gov in december. obviously the administration wants that number to be much higher by the end of march. we will be watching that. but what we really want to know is the age of the people signing up for the health-care exchanges, which the administration has not said they will not publish the data, but they certainly have not put it

out yet. we want to know whether the risk pools will be balanced. this is a concept of insurance that if you have enough young people do not subsidize the cost of your sick or patients, it will move altogether. if you do not have that, if it is only 60 people signing up, -- if it is mostly sick people signing up, the administration could be in trouble, so we will be watching it. there are many strategies in the pools that are not in good shape. it is not that all is lost if it is older or sicker people enrolled, but we will be watching as it will be a problem for the white house of that is the case. host: scarborough, maine, republican line. caller: good morning. guest: hi. caller: do you suspect, now, that everyone going to the hospital and to the doctor has insurance? i know that in the past people would go to the emergency room because that was their only

outlet. that was our most expensive place for them to go. now that everyone has health insurance, instead of the hospital billing out 69 dollars for a band aid, it is now $.69. that may be the wrong number, but i think that got paid out to insurance companies who wound up paying to the hospital that amount of money. someone had that much money. do you suspect that now all of that is going to drop? and the immigrants that are not documented people, they are going to end up in the emergency room. who pays that bill? thank you. guest: these are great questions for emergency rooms and health care for the uninsured. they are the most expensive venue by far, barring certain surgical operations, emergency room's are very expensive.

the caller is right, they looked at uncompensated care for the uninsured, particularly low income americans in underserved communities, there are billions of dollars effectively donated to charity in the form of care for the uninsured. it is likely that health care prices in some areas could go down as a result, people having insurance, it could be better for everyone overall. it is an interesting question, going forward. host: baltimore, maryland, michael is on the independent line. caller: thank you for taking my call. i was just wondering, with the affordable care act, what about the new taxes that will be implemented along with it? who, primarily, will be affected? thank you. guest: these are great questions. the affordable care act pays for itself with new taxes on health

care industry. new taxes on providers. very few americans will be seeing these taxes, although there are a few that will hit people. many people point out that the individual mandate to buy insurance or pay a fine, if it is upheld as a tax, but primarily the law pays for itself through a variety of taxes on the health-insurance industry, like medical device manufacturers. host: what is happening with the birth control mandate? guest: from the beginning that has been one of the most controversial portions, offering a range within health insurance plans. for celtic -- secular employer, that is not a big deal, many of them were already offering birth-control ranges. but for secular companies with religious owners, this has become highly controversial.

there are certainly states that preach against this control, particularly the morning-after pill, which some people consider equal to abortion. picking up the mandate in the coming years, recently sony a soda mayor issued an injunction -- supreme court justice sonia sotomayor issued an injunction for a group of catholic nuns in denver, which made major news, as it had not been done before. even under the accommodation proposed by the white house, it was deemed that their religious liberty was still being infringed. no one is quite sure how it will come down, but we are watching. host: from twitter this morning -- explain why it is so expensive. guest: so expensive? oh, boy. obviously provides a variety of tax credits to americans, expands medicaid, pays for major expansion of health care in the united states through taxes on

the insurance industry. it is one of the largest federal reform laws of its kind we have seen in decades. that may be why it is so expensive. host: independent line, raleigh, north carolina. caller: yes. my question is -- the administration has said that it is on the younger generation to sign up and pay for the healthier. if the healthier are allowed to stay on to their parents insurance until they are 26, it cuts them short, they will not be paying for it until after they get off their parents insurance. how is the affordable care act supposed to be paid for? thank you. guest: when you talk about younger, healthier people signing up for obamacare, we are not just talking about teenagers, we are talking about people in their late 20s, early 30s, into their 20's on the affordable care act.

many people out there, those are the people the administration hopes to sign up for the new exchanges. host: gary is on the line for democrats. caller: why is it, if you had a doctor, the wonder -- the one doing the service, and then you had the insurance company, the one handling the money and the paperwork, and the government involved, why do you need all of these people involved? especially the insurance companies. people went up three percent to five percent. plus, the irs is going to collect the money for the insurance companies and handle it.

it seems to me like this is a fallback so that if the federal reserve bails, then they have another income on the people that saves income tax. -- that is the same as the income tax. it is a monopoly. thank you. guest: interesting point. the affordable care act does reregulate much of the health insurance industry. but it was a law that was negotiated here in washington both in congress and within the health care industry, whose players knew that as a result, they would receive many more customers in exchange for being taxed. --host: do you expect to see more movement on the measure? we have requirements

notifying us if data has been breached. of healthcare.gov has been a major issue for republicans in congress, particularly the house oversight committee chairman, darrell issa. i think americans are very concerned about the security of their data online at any retailer, including a place like healthcare.gov, which we know had trouble to begin with. snapridges at skype and chat and barclays, and all these different places, we can expect to see more of that. host: what about further guest: votes to repeal the health care law? guest:we could see those the next few months, certainly before the election. the house republicans will be

focused as much as possible on the health care law. they're hoping it is an issue that will take their candidates to victory in 2014, and certainly to gain seats in the senate based on the argument that perhaps democrats overreached with this law. that is what republicans will be arguing, and certainly we can expect more votes on this issue. host: don in michigan is on the line for republicans. caller: good morning. you mentioned about taxes. i own a health-insurance agency here in michigan. you said that there were no taxes in the rate of the affordable care act. this is the biggest tax hike of the middle-class in this country's history. let me give you an example. just a family of four with a silver plan, average age for monthody, about $118.84 a just in taxes. can you explain to the audience on how you just said there is no taxes in the price of obamacare?

mistaken. color is i did not say there were no taxes in obamacare and i did not even say there were no taxes on individuals. there are taxes on individuals, but primarily the lot -- the law pays for them through the insurance industry. that is where the major funding comes from. some will see their costs rise and others will see them fall. there is no way to argue that there are no taxes in this law. from martinsburg, west virginia, on the line for democrats. commenti was calling to on another caller's comment from west virginia. i just wanted to say that i had a 23-year-old son who went into the hospital. we are in a more populated area. in.as able to get he signed up for the obamacare at the hospital. process andy nice

there were not too many problems. no matter what people say about obamacare, it has been actually factual. we had an experience were there were not any problems for my son to sign up as a 23-year-old. are having people positive experiences and are signing up in their communities, at hospitals, mayoral offices, public agencies, and having a fine time. it's kind of depends on which state you live in and which insurance you are signing up for. it sounds like this woman's son had a good experience. host: another question from twitter. mark stone writes -- a veryyes, that is interesting question, very collocated for people whose income tends to vary. seasonal workers, part-time workers, and people like that will find it difficult, frankly, to navigate the issue. what happens is, the government will pay the full subsidy to the insurance company on your behalf

if you -- your current income makes you qualified for it. and then in the next tax year, you will have to adjust and perhaps repay some of that subsidy. it will be very complicated and that will be an issue that we will have next year when the first tax filing season happened after obamacare is implemented. in ohio, chris is on the line for independence. -- independents. i was diagnosed 18 months ago with: cancer. i'm 55 years old and i did not have insurance. by the end of last year, i probably racked up almost $500,000 in medical bills. i have to have chemo every two weeks in order to stay alive. with this new effect of this new affordable care act, it has been a blessing to me and my family. -- she may have already answered this a long time ago, but nationwide health

insurance. it just seems like it will eventually have to go that way. it is just so expensive to try to cover it on an individual basis. the you have any comment? guest: it is something that progressive democrats are hoping for, that as a result of the formal care act we will move more toward a single-payer system, a medicare for all system perhaps. but it seems like the american public is wary of this so far, certainly after the problems with the affordable care act rollout. the law remains very controversial, and in fact, the majority have reported that they are still having bad experiences. it seems unlikely the public will tolerate a major overhaul of the health care system in that way within years. it could take decades and maybe we will move in that direction, but the republican party is not likely to let that happen. they are still intent on repealing this law. all total about cancellation notices, do you

expect to see more of those? and if so, what does that mean? noticesancellation created a political firestorm for the white house the last seven months -- several months. many plans had to be careful. they did not qualify for grandfather status under the law. issuelations became an for republicans to hammer obamacare and the white house, saying that, again, president obama promised several times that people could keep their coverage if they liked it and that turned out not to be true. we will hear that echoed over the next year as midterm elections go forward. go forward,le as we some employers will begin shifting some to employees. it is possible we will not to that movement for a couple of years, if not decades. but there are cancellation notices in some peoples's future. many people who support the affordable care act say that is one reason we are happy, that people are happy that the market places exist. host: alabama on the line for

republicans. caller: i am a word person and i've heard so many reporters and thatrious networks report the pay for the affordable care act will come from government subsidies. the health-care care industry will pay extra taxes. the single papers and is me and you -- the single-payer person is me and you, the taxpayer. you would do us a service if you spearheaded the idea of, look, taxpayers pay all the bills. the government doesn't have any money except what they take for us. -- from us. when you say the government will pay subsidy, you are leaving out the fact that we are assessing -- that we assessed the money that the government only administers. the health-care industry does not print money. they only take money from fees and services. it is the taxpayers who are

paying for the whole thing. no government agency, no industry except they get it from us. i wish that all the networks and all the reporters and all the papers would tell the truth like it is. some people who are ill-informed will paint -- oh, the government is paying, oh, yeah. that leaves us out. no, we are the government. we have to remember that, of course, individuals are taxed , and that create revenue for the government to do what it wants to do, including and lamenting laws like the informal care act. but taxes on the individual are not dealing kind of taxes on american society. industries are taxed. companies are taxed. and those are major revenue streams for the affordable care act. the colors correct in some sense, that some will see higher taxes under the affordable care act, or at least higher prices. many of the taxes are taxes on companies.

perhaps he would want to argue that the taxes on those companies are then raising prices for consumers, which could be the case in some areas of the medical industry. but it is incorrect to say that it is merely tax on individuals paying for the informal care act. host: another question from twitter. guest: that is not a practice in american medicine. people are very upset about this because consumers desired transparency when they use medical services. they prefer to know about the cost. it in one way or another, serves the industry to keep it less public. the obama administration has been forming a variety of initiatives that will allow the consumers to understand the pricing of their health care. in fact, last year they probably -- they published a report about the cost of medicare.

based on your geographic area, you could be paying four times more, or quite a bit less, for a sustained vertical service. this will be a major issue going forward. perhaps congress will get involved. we will have to keep our eye on that. host: rose in illinois on the line for democrats. nurse. i am a retired i was elected formerly to be president of the chicago nurses association and work for 10 with the visitor nurses association. i'm very aware of the problems with the health-care care industry. i believe it is imperative that we have reform, so that more people have greater access to health care. if we look at some of our vital statistics in our health care system, we are not the leaders of the world. wet is unforgivable, because use our technology for unrelated matters.

100% time president obama and michelle obama for their health care system. the glitch that happened with obama's proposal is not entirely accidental. the republicans are thinly disguised greedy people her. point caller raises the that the health care outcomes in this country are not as good as other company -- countries. , your united states health care outcomes are not likely to be as good as they are in other countries, despite the fact that we spend much more on health care. we are paying more for worst outcomes. it is not fair for people to