>> thank you for yielding. i appreciate the time you devote to our oversight efforts. here is the central question: how in the world can we expect people across the country in fact it was not. it is clear now that the administration knew far more about the concerns prior to the launch of healthcare.gov before october 1. uk before us on september 19 and each time you came to this committee in the past year, he promised that healthcare.gov would be functional october 1. there were no contingency plans because none were necessary. you insisted to the subcommittee members that everything was on track. i will stipulate that some parts of healthcare.gov might be working now.

they are only working now because a glitch czar had to be appointed. i do not know how you feel about that stop it upsets me. you came before the committee and told us that everything was ok. we spent hundreds of millions of dollars. we had 3.5 years to get it right and then we had to appoint a glitch czar to get it right. the enrollment numbers are meager. perhaps you have a different story. ayres, canceled plans, broken promises. that is just the start. now we know that your agency failed to heed internal warnings about the lack of readiness of the exchanges. it is my hope today that he will come to the subcommittee, prepared to answer our questions. i hope you will set the talking

points aside. you owe this to your superiors. you owe this to the secretary. you owe this to the president. you owe this to the congress. you owe it to the american people. this committee is about oversight. that requires that we look at the past. it requires that we look at the future. the problems of the past dictate to us that there will be significant problems during the first year of healthcare.gov. you need to be prepared to work with this committee to mitigate the damage that will be visited on america pass healthcare system and the american people. i yield back my time. >> good morning. mr. chairman, this is our first hearing of the year on the affordable care act. last year, in this subcommittee we held 12 hearings on the affordable care act. the hearings were frustrating

because they were not held necessarily to examine exactly what the law is doing. they were part of an effort, spread misinformation, and repeal the affordable care act. the unrelenting focus on repealing the affordable care act is one of the reasons that i believe this congress has been one of the most unproductive in the history of our country. as of today, 10 million americans have coverage because of the affordable care act. 2 million have coverage through private plans. more than 4 million have enrolled in medicaid and now have access to doctors and health services that they did

not have before. more than 3 million young adults have coverage through their parents' plans. millions more have coverage purchased directly from an insurer. as the ranking member explains the rollout of healthcare.gov is anything but smooth, and i expressed my displeasure to president obama, people were relying on us. moving forward, i know that there will be hurdles to overcome, but the law is working. members who want to repeal the act will have to explain to these 10 million americans why they should lose their coverage protection. coming from the state of florida, they will have to play to my older neighbors, our parents and grandparents, why they want to take away medicare.

the new preventative care that is available, the fact that we made medicare stronger. they will have to explain to the 129 million americans with the existing conditions why they do not deserve the same access to health coverage as everyone else. they will have to display to american women why they want to go back to a world where they cannot have the same coverage as a man. they will have to explain to people who work blue-collar jobs why they should pay higher premiums. they will have to explain to millions of americans getting covered for the first time why they would be better off uninsured. i do not think my republican colleagues can make this a. republican critics of the law were incorrect about many things. they were right about one fact. once the affordable care act went into effect, there will be no turning back. this law will continue to become

a part of the fabric of this nation. it will lift millions of american families, provide economic security. the civil rights act, the social security act, original medicare act, all of them were landmark laws that were contentious at the time. they said the new rights and protections guaranteed by the laws for our fellow americans were not important. we cannot imagine our country without a basic safety net. in the years ahead, all of the hyperventilating about the website and demographics will quickly be forgotten. we will look back and wonder how we ever had a health system that spends double than what every other nation spends per capital.

and we have rampant discrimination against people who need the coverage most. i hope that hearing will be the start of a productive session of congress. i hope we can start to work together on the aca rather than spending another year in the never-ending campaign against a law that is doing enormous good for the american people. >> i would like to introduce the witness for today's hearing. he is the deputy administrator of the center for consumer information. he has served as general counsel for the california benefits exchange. i will now swear in the witness. you are aware that the committee hearing as the practice of taking testimony under oath. do you have any objection?

you are under the rules of the house. do you desire to be advised by counsel? do you swear that the testimony you are about to give is the truth, the whole truth, and nothing but the truth. you are now under oath and subject to the penalties that forth in u.s. code. you can give a summary of your written statement. >> good morning. i appreciate the opportunity to update you on the affordable care act and the health insurance marketplace. millions of americans are now able to purchase high-quality health coverage. when i appeared before the subcommittee before the beginning of enrollment, i said that while we may encounter some bumps, we would solve them. clearly, the problems that we encountered in october were far worse than i or any of us had expected. the system did not work as well as it should have or as we expected it would.

this was not a time to get discouraged. this was not a time to give up. it was a time to roll up our sleeves and get to work to solve problems. since that time, we have fixed healthcare.gov. the tech team fixed the site software and enhance the site's hardware. by the end of november, healthcare.gov was able to support thousands of consumer visits per day with a response from of less than one second and a error rate well below 0.1%. consumers have responded overwhelmingly to the improve site. we have had a sevenfold increase over october and november combined. nearly 2.2 million people have elected plans from the state and federal marketplaces. sometimes we lose sight when we talk about numbers this big. these enrollment are more than just numbers. they are individual people, many

of whom have not been able to obtain health care or peace of mind that comes from having coverage for years. one cancer survivor from virginia now has a plan without having to worry about paying more because of his pre-existing condition. he had been paying for a plan with a $483 monthly premium and a $5,000 deductible. now he has a $111 monthly premium a $1700 deductible. one woman pick a top tier plan that will only cost her slightly over $100 per month. she will be able to get an appointment at a ob/gyn before requiring surgery. we hear stories like this every day. americans can be confident that the plans offered in the marketplace or hide all the odds affordable. the affordable care act standardizes benefits that

insurers must offer. this includes basics like hospitalization, prescription drugs, and newborn care. marketplaces are assigned best designed so consumers can compare plans and make informed decisions. insurers are prohibited from charging higher premiums to enrollees because of health problems, or from charging women more than men. cost-sharing reductions are helping consumers pay for their healthcare coverage. of the nearly 2.2 million marketplace sign-ups, many of them are receiving financial assistance. insurers can no longer refused to accept people because of pre- existing health conditions. they are required to enroll individuals regardless of health status, age, gender or other factors. finally, insurance coverages there with people most need it. and can no longer impose

lifetime all caps. americans no longer have to worry about hitting a prohibited dollar amount which could force people into bankruptcy. the health insurance market in 2014 looks dramatically different than it did in the years before the affordable care act. to ease the transition, cms is working closely with insurers, consumers, and other key stakeholders were working together to ensure that consumers have coverage. in december, cms announced that they will help consumers by requiring insurers to accept payment through december 31, 2013 for coverage beginning january 1. ensures that stepped up of many agreeing to voluntarily extend the deadline for consumers to pay their first month premium. many pharmacies have announced plans to ensure a smooth transition by providing

consumers with transitional supplies of prescriptions. i continue to believe what i said in september. the ultimate story of the affordable care act will not be what happened in the early days when the website went live. the lasting legacy will be people like nathan and emily were able to get the healthcare they need and have the security of knowing that they are able to pay for it. thank you and i welcome your questions. >> the chairman recognizes himself or fives minutes. he testified that it would be ready at october 1. why were you wrong on that? >> you referred to april and september. each time i testify, i gave you the best of the information i had. it turns out that the problem that we faced on the website

when it went live were, as i have said, just dramatically different and bigger than i think any of us had expected. as to why we did not anticipate what was going to happen when we went live, i am not sure i know all the answers. some of the people who are responsible for designing and building the website may give you better answers. i know initially, we were overwhelmed by the volume of people who came in. as time went by, that was clearly not the sole source of the problem. there were other problems as well. >> you are there for the briefings? we discussed in the subcommittee to a number of people within the administration -- you have that information. who told you otherwise that things are fine? >> may i speak for a moment to

mckinsey? there's no question that they identified a number of risks that they saw back in april as to whether we would be successful, october. at no time did the mckinsey people say that we would not make it. they identified a series of risks and some steps that they recommended we take in order to mitigate those risks and increase the likelihood that we would be successful. i think we did that. a number of the concerns that mckinsey expressed, whether the hub would be working, or whether some of the larger states like new york and california would succeed, we could very much hear what the mckinsey people recommended that we do. we proceeded forward and tried to do the best they could to maximize the likelihood that we'll be successful.

>> it was not subtle. it was strongly worded in terms of serious problems stop that same month you came before us and said that things were fine. who told you that things would be ok? who specifically informed you? >> i received regular briefings. the person i heard from the most was probably henry chao. >> despite debriefing from mckinsey, did he say that things would be ok? >> we had regular reports on the status of the bill. when i came here in september, the testimony that i gave was based on briefings that i had from mr. chao and others. >> did you discuss the contents of the briefings with him?

>> i think we discussed the issues that were raised i the briefings. when he was here and speaking under oath, he said that he did not know anything about it. >> i do not know if you saw the report himself. lexi with significant and not that the secretary said that she hired mckinsey to give them briefings and look about this analysis. significant problems are identified. they were not small. now we are not sure whether or not the key person who was advising on this was even told about this report to identify and what to do about the major problems. >> we adopted a number of the recommendations that mckinsey had for us. we put them into place, a number of the things that mckinsey recommended we do.

that is what i mean. mr. chao was aware. >> if the doctor says, do you have specific symptoms or problems? if you do not tell the doctor your symptoms, they cannot diagnose or treat. what specifically did you tell mr. chao. what did you do in response to that? >> i am not going to be able to recall or tell you exactly what we told mr. chao. there were recommendations with respect to how we should be organized as and changes that they recommended we make in terms of how the process was managed that we implemented as a result of the report. >> thank you very much. this hearing today, i noticed this after my opening statement, is called 2014, seeking answers.

i would like to ask you for questions about where we go from here. as you acknowledged in your opening statement and your written statement, the problems of healthcare.gov were far greater than what you anticipated before october 1. we are well aware of the administration's efforts to fix the problems. i was wondering if you can tell me as we sit here what problems do you see with the federal website and what steps is the administration taking to remedy that? >> thank you. we continue to address specific issues with respect to the way the site is functioning, and that effort has not flagged at all. it is ongoing. as we continue to identify any

aspects of the way the system is not performing as properly as it should, whether those be designed an architecture or software types of problems where we are not getting direct result, we continue to address a lot of those issues. the major one we are dealing with now i would say in terms of big picture has to do with the financial management, making sure that plans are getting paid, and we are using a mitigating process right now because we do not have full functionality for that process. >> we heard the administration was focusing first on getting people enrolled, and then worrying about the back end. what are you doing to remedy that? >> payments will go up next week for the first time, for the tax

credits, but we are using a process where they are providing us with the data from the issuers based on their records as opposed to being able to use the records that are generated by the ffm. that automated process will be going into place in the next month. >> is the administration working with the insurers to make that happen? >> absolutely. we have had tremendous responsiveness from insurers and they have said they are pleased with the way the process is going. it is not ideal, but it is working. >> i would be a good followup, to bring in insurers, and see if that is working. we have heard about the number of people who have signed up both on the exchanges and in states like mine that have state exchanges and healthcare.gov. what is your opinion about the number of people who are signed

up and the age groups? >> there is no question we got up to a slow start. we had tremendous response in december, and we are continuing to see good numbers as we go into january. i think in terms of the total, if we are able to maintain the pace we are at now and if we see another uptick toward the end of march, as everyone expects, because that is the deadline, we have three months ago, so we are encouraged by the enrollments we are seeing. there's tremendous demand for this product. we saw that from the beginning. >> i will say because of the glitches with the website in the early days, enrollment has been lower than the administration projected, correct? >> attitude. >> we are encouraged by the

response we have gotten from younger people. the percentage we reported of younger people this week is actually comparable to the percent of that age group in the general population. that is looking good. >> if you can briefly tell me what the administration is doing to bump those numbers back up between now and the end of march, but for the general population and also for the younger enrollees? >> absolutely. you will see a step up media campaign. obviously, we as well as the health insurance companies, helped pack at debating getting because it was not working well, but now it is, so we will see a significant increase. it will be targeted at the younger audience. we have magic johnson's ad is coming out now. we will be advertising during olympics.

we will advertise through social media as well ways that are targeted toward that younger group. >> thank you very much. >> you might want to say something to jimmy kimmel about this because he is not saying good things about this. >> also the super bowl. >> there you go. i recognize dr. burgess for five minutes. >> you said consumers will be able to go online, go into this determination of what subsidies they are eligible for, he able to look at the plans where they live. they will be able to see the premium that of subsidies they would have to pay, and they will be able to choose a plan and get enrolled in coverage giving october 1. you recall that? >> very well.

>> would you like to revise that answer? >> clearly, it was wrong, but it was what i believe and what i understood. to start, what i have been told >> [indiscernible] >> i would like to answer your question, if you would permit me. i knew i was going to be asked a question when i came here on september 19 and that it was close october 1, and i was careful to get a thorough briefing from people who were responsible for overseeing the build of the website, and the answer i gave you was exactly what our functionality i was told it would be on october 1. >> i have to tell you this. i simply do not understand why no one has been held accountable for an error that egregious. if i were you, i would fire someone under me and it would have happened in october. if i were the secretary, i would've fired you and it would've happened in october.

if i were the president, i would be so mortified and embarrassed at what has been the disaster at my signature piece of legislation signed into law, i would fire the whole lot of you. now, that was the tact -- you have to understand, why should we believe you now when nothing you said over the past year, year and a half has been accurate? >> because the site is working, congressman. because the site is working. >> i would submit to you it has not been working, because it has not been built on the back end. subsidies are coming as a result of a paper process, being entered by hand. this thing is a disaster. providers are going to be the one to take it on the chin, because we are obligated to see those patients when they show up. no one can verify benefits at 3:00 in the morning. the secretary says she will not

be responsible for paying those bills. i ask you, doctors and hospitals around this country, who is responsible for paying these bills? [indiscernible] >> the insurance company that has enrolled a person is responsible for paying those bills, and the payments of reductions will be flowing next week. they will begin next week. >> i would submit to you that website has not been built and that is a painfully slow process. i have been told numbers as low as 10% of those payments are going through. i would appreciate if you have additional information, you will make it available. i hope we have an opportunity to discuss that in future. it concerns me a lot. our providers are at risk from your mismanagement of this problem. there is something that is receiving a lot of attention, a concept of risk orders and

adjustments. are you are aware of that? >> yes. >> the risk corridor -- will you seek a change in the language? >> i will refer to omb with the spec to those issues. >> will you share with us the discussions very between you and omb on that? is there information you can make available to the committee? >> i will take that request back. >> it appears you will be needing and spending taxpayer dollars to be spent on the risk corridors. can you tell us today that this risk adjustment will be done within the balances of the affordable care act and those amounts you are collecting from insurance companies and not come from the taxpayer? >> i do not have an answer. i understand it is an issue.

we are working with omb. if you have a legal memorandum that has been prepared, will you share that with committee? >> that is not a decision i get to make, but i will take your request back. i have not seen a memorandum like that. >> you have not? >> i have not. >> this committee needs that memo and i need you to take that request back with you. we will have an opportunity to talk again, i believe. i yield back. >> i want you to give an opportunity to answer one of the questions. have those parts of the payment website been built? >> the automated process of the website is being built, and payments will be going out. >> do you anticipate a date when it will be built? >> i cannot anticipate that.

>> mr. chairman, could he supplement that when we find that out? >> yes, we need to know that. >> good morning. the headline back home in florida this week was florida enrollment surges under healthcare.gov. during october and november, we only had 18,000 floridians sign up. in december, we had 140,000 floridians sign up for coverage. florida continues to lead the nation in enrollment amongst the three dozen states that are using the federal marketplace. this is good news. on monday, in tampa -- the mayor had a great announcement, and this is something that other members can use and work on with their elected officials.

all the parts and recreation centers in cap would be available to host obligate assisters. i think this is a very creative move. secretary sebelius aid him a pat on the back. we have got to make it easier for people to set up, and one of the things that is a good problem to have, and we have such a competitive market base. we have over 100 plans that people can figure out what is asked for them. that can be difficult for folks if they just go on -- there are people that can go on the site and figure it out and analyze it and determine why it works best for them. there are many people across the country that need to sit down

2/3 of those eligible for coverage will be eligible for the tax credit. already over 80% of the people that signed up have used those tax credits. what can we do to get more help out on the ground to help people understand the options? >> thank you. it is very important as you say to get some support from state and local officials, from congressional officers, to help get the word out, to direct people, to assist them. there is a fine local help section of the site where people can get a list -- >> if people do not have a computer and do not know about that, how are you going to reach them? >> for the people who do not have a computer, the effort is

to bring them in to a location where a navigator is working or other assisters are available. the more assistance we can get from people in the community who know these folks rather than just coming from the federal government is a big help. >> our community help centers have been active. it is a community-wide effort. i appreciated it that you said, talking about the millions of folks who have signed up, these are not just numbers, but real people. one of the biggest obstacles right now for many of our neighbors to realize health care coverage is what republican governors and state legislators have done in blocking the medicaid expansion. in florida we have almost one million floridians who are being blocked to the access to the doctor's office because they will not accept the $50 billion available to the state of florida over the next 10 years.

mr. chairman, i think we need an oversight hearing on this dates that have locked medicaid expansion and what that is going to do to the health care marketplace. what is hhs' plan to continue to work with states on this issue? >> we encourage every state to take up the medicaid expansion. it is a great deal for the state and that people in the state, for providers in the state who all see a decrease in uncompensated care, a tax that falls on all us.

and we have been working as creatively as we can with different states to come up with you for ways of doing this. some states have different approaches that we have been working with on. he continued to work with all the states and hope more will pick up the expansion. >> thank you very much. >> the gentleman yields back. >> thank you, mr. chairman. you just said that your testimony to mr. burgess on september 19 was incorrect and you had based it on staff reports, am i correct? >> i said it turned out being wrong. >> if you are basing your testimony today on staff reports, how do we know that this is correct? >> i think there has been an intense focus since october -- >> have you changed your process of due diligence?

>> we are receiving more and more thorough briefings -- >> how do you know that? >> ultimately, i have to rely on the people who work under me. >> you did not fire them? >> we were having regular and detailed briefings -- >> ok. >> we also brought in a general contractor -- >> do you want to quantify those briefings for us -- why don't you let us know what briefings you're having? i want to ask you one thing. you said the website is fixed. and you define "fixed"? >> it is fixed in the sense we are no longer having problems that we had in the beginning -- >> it is not 100% operational.

it is a qualified fix? >> that is true. >> "fixed" is an amoeba, and that will change. let me move on. you had three promises in obamacare. it was going to save families $2500 a year, and the second two promises, one, if you like your plan you can keep it, and if you like your doctor you can keep it. let me ask you this -- since the president promised the average family would reap a premium decrease of $2400 a year under the law, has that happened? >> i am not sure that is what the president said. >> yes, that is. >> many people are able to obtain that are covered for lower cost -- >> mr. cohen, that is not what the president said.

>> the law permitted insurance companies to maintain grandfather plans in effect. that was their decision. whether to continue those plans >> no, sir, that was not the promise. he promised relief so these people could get -- >> i was about to say -- not all americans were able to keep the plans that the decisions the industry had made. we announced a conditional policy that enabled more of the plans -- >> how long will that transitional process last -- forever? >> for a year. >> a lot of those people could not keep their plants, and let me tell you about an emily from tennessee. emily lives in pulaski. she has coverage because emily has lupus. guess what -- under obamacare, her plan was canceled. emily does not have health insurance right now.

she is having a tough time getting it under obamacare. i am having her in for my guest as the state of the union. maybe you can help emily work this out to cause your promises that were made by you and this administration have not been kept, and then you want to give us a qualified definition of "fixed," and you are still depending on your staff. so you all are just running in circles, and you cannot give us definitive answers. let me ask you this fax emily in pulaski, she had a doctor she liked. is she going to be able to keep that doctor even though she has no insurance because of obamacare, her insurance was canceled, and she's being treated for lupus and works 40 hours a week? >> if you will get us information, it emily is willing to talk to cms, to understand

what her options are -- >> i would appreciate that -- >> we will be happy to do that. >> she is a classic victim where the government says all these plans that work for you, we are not going to let you keep them because we think we know better how emily can handle her lupus. that is what you have done to the american people and when you come in here, you give us misinformation and then when we ask you a question, you cannot be specific. mr. cohen, i agree with dr. burgess. you ought to be fired. >> the time has expired. >> thank you. mr. cohen, there are a lot of things in the affordable care act, but many of the provisions are about consumer protections

to ensure that americans have a diverse choice of health care providers. as with many new laws, there are wrinkles in the implementation and disagreement about rational intent. i want to ask you about one of those with respect to the aca. i have been hearing from some providers, and my colleagues have been hearing same concerns, about the interpretation of the provider nondiscrimination provision in section 2706 of the public health service act. what these providers are telling me is that your agency's subregulatory -- in their view, in the view of many legislators, is inconsistent with the statute and legislative intent. and the concern is this, that the guidance could lead to discrimination against some

providers by health insurers, which this provision is designed to prevent. are you aware of these concerns? my question, what are your plans to address them to ensure that the statute is implemented as intended? yes, i am aware of those concerns. i have had meetings with a number of provider groups who have expressed a concern that you raised. frankly, it has been a while since we looked at that issue. what i would ask is that we could have folks talk to you wind your staff and move forward to understanding what the concerns are and seeing whether there something we can do to clarify the guidance so we make sure there is not discrimination. >> that would be helpful, and there may he collects on the other side who are hearing these concerns. i would welcome the opportunity

to follow up with your agency and try to work this out to make sure we stay on that intent that there not be discrimination. thank you. a couple of things. one of my concerns from the very beginning is we got to get health care costs down. whether it is individual based, the cost is going up a lot faster than wages. we are not going to have an affordable system. what we're learning now is medicare spending is growing slower than the inflation rate. this is recently, and that is a welcome development. the program only spent .7 % per beneficiary in 2012 versus 2011. an overall global health care spending, the rate of increase is slow. 3.7% in 2012, less than half the

growth rate a year ago. two questions -- one, do you attribute any of this to the law, and, number two, what are the implications for the deficit over a 10-, 20-year period? >> there are a number of provisions that are attacking the health care costs. that is an issue that we need to continue to work on, and i think the law gives us tools to continue to do that. i look forward to using our process of certifying a qualified health plan going forward. we were quite liberal and took them all the first year, to get the market up and running, but going forward we can at least look at what we can do to encourage health insurance companies to work to keep costs down.

and certainly, we know that health expense is a huge part of the american economy and what the federal government spends. as we are able to attack that problem, it will have a great positive impact on spending and the deficit going forward. >> i recognize dr. gingrey for five minutes. >> i asked you the last time whether you have concerns whether young people would not sign up for obamacare and would cause an increase in cost to the rest of the risk pool in the following years. you responded that your research shows that most people want health care, and the barrier has been the costs, and that you were looking forward to people, including young people enrolling in coverage. when the latest figure that shows young people are enrolling

at much lower rates, are you worried that premiums will increase next year, that there are other concerns such as maybe these overwhelming number of mandates with which we knew 10 years ago were driving up the cost of health care insurance in the individual states, probably all 50 states, including georgia. we knew these age-banding rules that were put in obamacare rather than say 5-1 maximum premium increase for older people as compared to younger is now 3-1. community ratings -- these things are there, and i am concerned. do you continue to be concerned about that? >> we want to do everything we can to encourage all americans and in particular young

americans to get health care. it is important to keep in mind that the risk pool is not just a risk pool and the marketplaces. risk full is in the entire market. when you have 3 million young people who have been able to get health coverage on their parents' plans, those are not necessarily on the marketplace, but those are 3 million young people who now have insurance and are now part of the risk pool. i point to a study by the kaiser foundation it says the reduction of the people, young people who come into the risk pool, will have an impact on health care premiums that is pretty modest. >> that is anecdotal. i understand. let me move to my next question. i have concern. i have heard that navigators are actually going door to door. this came up last time, too.

you said that navigators would not be going door to door. they are. if you recall, during that same hearing, you told us, this subcommittee, that you would be issuing instructions to navigators that they should not be going door to door. did you issue these instructions? >> yes, we have, and if you are aware of instances where they are going to door, we want to hear about them. >> thank you. we are aware. i want to put up a video clip right now to show you that, since you asked me to show you evidence. [video clip] >> kim is a navigator hired by taxpayer dollars to help people enroll in one of the new health insurance plans. her grant came to the nonprofit southern united neighborhood in new orleans.

she canvasses neighborhoods -- >> ok, that is good. mr. cohen, what do you say to that? >> i have not seen that before. thank you for calling that to our attention. we will look into it. >> we are very strong in saying that you should be fired. my dad told me one time when i was in college and my grades came in they weren't so good, and i said dad, i'm doing the best i can. you've got a big job, you know that, we know that. and back to the drawing board. you have to do better.

>> welcome back mr. cohen, and good to see you again. i'd like to start off by getting something clarified for the record. this relates to ms. blackburn's questioning. it's my recollection that what the president said was that after the affordable care act was implemented that insurance premiums, people would save $2400 a year. opposed to what they would have been spending, compared to what they would have been spending if it weren't for passage of the affordable care act. is that your rex length of what he said? >> that's my understanding, yes. >> not that people's insurance could cost $24 less. >> that's my understanding, correct. >> in fact, has has been alluded to earlier in the various questioning, health care costs are rising at a much lower rate than they have historically.

so while the numbers may not be precise, there's evidence to suggest that the president was actually correct in that insurance would have cost more if it weren't for the affordable care act? >> i think there's no question about that, and i think it's also true that many americans are seeing actual reductions in what they are paying over what they were paying. not every american, but many americans are. >> right. let's talk about the enrollment history, because it gives me an opportunity to boast about my state, kentucky, which is widely recognized as having had one of the most successful rollouts of the affordable care act. currently the numbers are, we've had in the state of 4.4 million people, 778,000 visitors to connect our website. 123,000 plus have enrolled, in either medicaid or private plans. 559,000 kentuckians have been screened to determine whether they were eligible for medicaid or subsidies under private insurance and many of those have

not yet selected their plan even though they've been told that they qualify for private insurance. and 1283 small businesses, as of january 2, have gone and started the process to enroll their employees as well. so we're talking about already having insured about 20% or more of our entire uninsured population in just over half the, well, this would have been exact half the enrollment period. by the way, 40% of those are under 35. so in terms of kentucky's experience, i think there's reason to be, as you said, optimistic that going forward we will have adequate numbers of young people in the risk pools, and we shouldn't be too concerned yet about that. there was in one of the major national media there was a chart that actually broke down the enrollments according to three categories of states.

they had the 14 states and the district of columbia, which had both expanded medicaid and set up their own exchanges, states that have expanded medicaid but were using the federal exchange, and then states that had not expanded medicaid. while i didn't do the math, it was pretty clear that at least two-thirds and maybe 75% of all the enrollments, the 6 million or so enrollments, were in those 14 states plus the district where there was concerted government support for the program. so i'd like you to comment on that, and whether you're seeing that the degree of enrollment seems to be correlated to the degree of support at the state and local level for the program. >> i think that's absolutely right, and it's true for many reasons. kentucky is a great example where the governor has been a stalwart advocate for health care reform, and for the kentucky marketplace and getting it going. i think that contributes to the

success that those states have had in terms of developing their marketplace and their i.t. systems. if the administration in the state is solidly behind that, it helps. it helps with outreach, it helps with sending out positive messages to the community of how important this is and what a great benefit this is for people. so i think there's no question. >> we saw video there of navigators going door to door. there's another side of that coin, as well. and i know i talked to some people for instance in florida where they have been handing out flyers discouraging people from signing up. have you seen much evidence that there is a concerted effort to discourage people from exploring their options under the exchanges? >> i've heard some of that. i wouldn't be able to stay how extensive it is. obviously it's very unfortunate that anybody would try to discourage people from taking advantage of an opportunity to get health care. >> last question, is there any effort in your organization to try and find out or get evidence

as to whether that's happening or not? because i think that would be of interest to us. >> i don't know that we're investigating that, i don't know. >> thank you. i yield back. >> recognize mr. olson for five. >> i thank the chair and welcome mr. cullen, i hope you had an enjoyable holiday season like i did with my family. >> thank you. >> my first question about the exchange user fee. are you familiar with that fee, sir? >> yes. >> that's the fee that's imposed upon states or the providers that have not chosen to, that have chosen to be in a federal health care plan like my home state of texas. is that required under law, that fee? >> i think it's authorized by the law. and we set the fee. on insurance companies, based on the premium that they get in the market.

>> were priced that h.s.s. rules created that fee? >> yes, we issued a rule that created, that implemented that. >> is it 3.5%? >> yes. >> is the administration fully using that fee? do the plans and states have to cover some slack? >> i don't believe the amount of that fee will fully cover the cost of operating the federally facilitated marketplace. i don't think it's going to be enough to pay all of the costs of running the marketplace. >> so you are tapping the resources of the private sector and the states to pay the shortfall from this fee, correct? >> no, no. we're tapping resources from within our budget. but the fee is the fee. >> and the fee is authored for one year. do you expect to extend it next year? >> yes, i expect there will be a fee next year. >> my second line of questions are about the navigators. and as you know that video from my colleague mr. gingrich is

pretty damning. he remembers back home in texas that they were having registration cards going door to door. and you said, and this is a quote about the navigators, we will be issuing instructions to navigators that they should not be going door to door. end quote. my question is, this is serious, have you issued those instructions? yes or no. >> yes. >> can we get a copy of those instructions? may we get a copy so we can see them? >> sure. i can go back and tell you how we communicated that. i know we have regular communications with the navigators and we put out that information to them, that was something that they were not supposed to go door to door to enroll people. they could drop off information, but they were not supposed to go door to door to enroll people. >> and you've heard stories from new york and florida in the "new york times" that people have been coming out with these navigators what have you done to address this and make sure fraud

doesn't happen? because it's a big window of opportunity for people who want to do harm. >> any situation we've learned about that involves misconduct by a navigator, we have responded to. we, including requiring individuals that were involved to be dismissed and not, and including corrective action plans to any navigator organizations that, if we feel they're not supervising their employees adequately. >> one final line of questions about the disaster fallout of obamacare, when the problems continue. delays and misinformation are happening today all over america. for example i gotten rolled in the exchange here, the d.c. exchange, my staff as well. but when i called up last week, tried to make sure we could keep this doctor, a specialist. it took her 30 minutes to talk to somebody on the phone and she got a new card there, read it

proudly and they said we have no record of that. so she didn't get the old card, and work with this agency to confirm that yes we could keep that doctor on our plan. so my question is, given this disastrous rollout and the continued problems, have you ever been part of a conversation or debate or discussion about delaying the launch or putting a hold on it with all these problems? any discussion, ever been part of that? >> no. >> no, okay. i yield back the balance of my time. thank you. >> or comeback, mr. cohen. i was shocked to see the new support in new orleans. our navigators to not go out or to door. we do have nonprofits that are

not federally funded. i encourage them to come to our district. to let folks know they have the ability to do it. the navigators we have, they will come out to someone's house, but it will be a request. i'm glad you're going to investigate that happening. i want navigators helping people do the paperwork. as one who supported the i wouldle care act -- love our committee to be able to work on it and fix the flaws. i am pleased with the enrollment increases in the last few weeks. released him earlier this week and we know that 2.2 million have signed up for the private insurance lands as of december 28. 4 million more were signed up for medicaid and let's not

forget that 3 million adults under 26 are still able to get insurance through their parents. do these enrollment figures sound accurate to your? >> oh yes. they are as accurate as we can make them. >> they're not as much as we would like and i know the administration, that i have a memo that puts these numbers in context. enrollment in the affordable -- republicans call part d a success and now they insist the affordable care act is a failure. we have a lot more work to do in the months ahead, but there is a aret -- but no doubt people finding access to affordable quality health care. i hope my republican colleagues will sit down and work on legislation that will fix some of the problems we have. i thing congress ever passes is

perfect and we know that. particularly with this. instead of just throwing rotten apples, maybe they should look back on what happened in 2003 when we passed a prescription drug plan that i did not vote for. i was also helping my seniors sign up for it. encouraging people to do it, even though i thought the law of flawed in 2003, some which has been fixed by the affordable care act, but we want to make sure that folks get it, and that is what amazes me. would you expect enrollment numbers to look -- what would you expect enrollment numbers to look like over the coming months? >> we are encouraged by the tremendous interest that remains in the plan. clearly americans are now very much aware of united healthcare.gov. everyone expects that as

we move toward the -- we still lefttwo and a half months in the enrollment. and i think everyone expects as we get towards the end of march when it is a real deadline, we will see another real uptick in the number of people enrolling. if that happens, i think we will have some very good total enrollment numbers by the end of the. . the period. >> had paper applications in spanish and english that were used, but that is not the way we can get to the numbers we need. the website has to work. you talk about outreach

plans the administration has to ensure that as many people as possible learn about and sign up for new health coverage during the remainder of the enrollment. ? obamacare. >> another is a plan to advertise during the olympics and other events that are particularly geared toward younger people, sporting events and those kinds of things. i know social media activities are picking up and i think from what i am hearing, we will be very significant investment by the private health plans in marketing and advertising as well. a number of them held back because of the issues early on with the website. now that they see the enrollments are coming through, i think we will see significant investment outreach on their .art as well

>> in your responses to ms. blackburn, you indicated that insurance or be available to americans at lower cost. yes, i think i mentioned at least one of them in my oral testimony. >> yes, you did. i understand that. also, you would have to acknowledge undergrowth that many americans have lesser coverage at a greater cost, isn't that true? let me tell you, i received an e-mail from a constituent of mine who i know very well. his premiums in march are going to triple and just adoptable is

doubling. that is lesser coverage at a greater cost heard there is one. i would say that i have received numerous medications from members of my district, people who live in my district, along those lines. yes, there are some winners. .ut there are also many losers it shocks me that you cannot acknowledge that here today when you are testifying undergrowth in front of this committee. obamacarelosers under , aren't there? i think you need to define losers. soup alosers one in a more coverage than less.

do know of anybody in the united states in that circumstance, sir? >> i am sure there are people in that circumstance. you have also read reports in the media of people who are losers under obamacare, have you not? >> a problem i have is that i don't know what all of the options that might be available for the person. it is difficult for me to answer without knowing the full situation of what might the available for that person harriet i understand there are people who have coverage and received a notification from the insurance company that they were putting two different planet cost more. absolutely, that has happened very >> those people are paying more and receiving lesser coverage. >> i don't have details of the land -- of the plan they were being offered. was availablehat

to them that might enable them to avoid that situation. i think it is more complex than how you're presenting it to me. that is all. >> i would submit is more complex on all the situations because we have a 2000 page bill that is hard for people to get their arms around and hard for this administration to operate and run. that being said, let's talk about the shop exchanges for small businesses. that is another part of the plan that has been delayed for a year. is that correct? >> it was delayed, yes. >> many of the other delays were for a few weeks or months. why was his program delayed for a year? >> given everything we needed to do to get the system working well for people in the individual market, we made a ofision that in terms allocation of resources, we couldn't get the shop online functionality built in time for this year.

so we are relying on the s.aditional agents and broker >> maybe if you sat down and learned all the aspects you could advise kerry >> we had to make a choice. we had to decide. >> i was being sarcastic, i apologize. do you know if there were conversations before the thanksgiving announcement? how long in advance was a decision made to delay the shop line? >> i'm sure there were conversations. i wouldn't be able to tell you exactly when, but i know that into november or conversations and then when a decision was made it was then announced. >> you agree that this should

be done at some time besides a holidays when people are not paying attention? >> it is important that we put out accurate information, yes very >> you've got a big job, >> before i get to my questions, i just want to share with the and obamacare success story that i received from a constituent. brian from the city of schenectady road to me that he had been paying almost $360 per month for a plan with no dental or vision coverage. to new york state's online exchange he was able to get a

comparable medical plan and also purchase dental coverage for 290 dollars per month. as he described it this is more coverage for less money. ryan was able to complete the process in less than two hours and because he makes only $11 per hour, the difference in premiums is having a huge impact on his budget. ofan is not alone hurt as january 1, more than 241,522 new yorkers are now enrolled in quality low cost quality health insurance coverage through my stays healthy change. many young adults have health insurance to their parents planted more than 12,100 seniors in the district received the scripture and drug discounts worth $16 million. one hundred 24,000 seniors in the district are eligible for medicare services without saying any co-pays, coinsurance or deductibles. i could go on, but the point is that the affordable care act is here to stay and it is providing

an enormous benefit already to the people of the 20th congressional district of new york which i have the good fortune of representing harriet it never ceases to amaze me how hard my republican colleagues work to avoid acknowledging the benefits of a ca. i've never them admit that this law helps americans with pre- existing conditions who can no longer be discriminated against. mr. cohen, could you summarize for us some of the important new protections that are now in place under the affordable care act? >> certainly, thank you. absolutely, the issue of pre- existing conditions is a huge one. previously, people could be , notd insurance altogether because they are sick at the time of their up location but because they had some condition in the past that caused medical underwriters to say they were not a good risk. one of the impacts of that is

the fact that women were being charged substantially more than men because being a woman was considered a pre-existing condition. all of that is gone. the last one i would mention i think is very important because in the past, people would find it if they did become seriously ill, their insurance would run out because they had either an annual the mid of how much you would pay or a lifetime limit. aey might be in the middle of course of treatment that was necessary to save their lives and find that all of a sudden the insurance company had stopped paying and that they were responsible for those costs on their own. that cannot happen anymore. >> thank you. stories of people signing up for coverage would drive home how important these provisions are. i know some stores that have been posted recently. a ready story about next for miami, he is 29 and was denied coverage last year because of a pre-existing condition. he was forced to enroll in a short-term catastrophic line the --sed him -- that cost him

he now has better coverage with lower out-of-pocket costs they guarantee you will be kicked off his coverage are denied it because of the pre-existing condition. areas covered and he does not have to worry. there are more of the stories every day. albert from texas got covered for the first time in his life because of the aca. he had a plan for any $23 a month and he says it is the right thing to do. you never know what could happen to you. have you heard other stories like these? >> yes, we're hearing stories like that all the time. we are seeing them through social media herd racing people are sending us their stories on healthcare.gov very today is a place where you can provide your story and i must say they are extremely hard, neck. >> what they say to you about the importance of the affordable care act? the affordable care act is

literally going to be life- saving for many americans who without it would not have had the ability to get the health care they need. it is going to be a financial whosaver for many americans otherwise would have faced bankruptcy as a result of medical costs. we're going to see that change radically. >> i wish our colleagues would admit for even the briefest moment that this law is helping millions of people. maybe then we could move forward and have a national conversation on the affordable care act. the fact, i thank you director cohen and i thank you for appearing before our committee. thank you, mr. chairman. one person that does not think this is a lifesaving endeavor is brenda from my district. brenda has been fighting a very rare form of cancer for the last seven years.

she leaves springfield missouri to go down to little rock, arkansas to seek treatment. she's in a high risk pool. she was in a high risk pool. when she found insurance, she found a chick could no longer go to little rock, arkansas to seek treatment for this -- from this specialized doctor who has literally kept her alive for the last seven years. they gave her three months to live when she was first diagnosis. she got active. back then she was early 50s. she decided it was intended as a she wanted to get treatment for this. so she did. down in little rock, arkansas. she called me from her chemo texted me. she told me she had lost her insurance. when she found new insurance, because the high risk: away. when she found new risk

insurance, she was told she could no longer seek treatment down in little rock, arkansas, from this dr. who was one of the few in the country who doesn't. i know you say it is lifesaving, i know my friend from new york says he wants people on the set of the aisle to admit there are good cases. sure there are people who are picking up insurance. there are also people that this could very easily cost them their lives. i am concerned for people like brenda. let's talk about those high risk -- >> we certainly would like to hear from you about brenda situation. if there's anything we can do. we would be very happy to do it very >> a gated floor speech on the subject a month or so ago. she was literally in the chemo chair in little rock taking the treatment, and she said all the nurses stood up and cheered my floor speech in the rooms, but there are serious concerns for people like brenda sticking with the high risk pools for just a minute. i know that this new national high risk pool, as opposed to

the state ones that ran out the end of december or whatever, have been extended to the end of what period? >> end of march. >> end of march. how are those being paid for? where are you getting the money to pay for those? we cannot get any answers, at least my staff has not been able to, on how this is being funded. >> that's very clear, there's a $5 billion appropriation in the affordable care act and that's the entire amount of money is that 5 billion-dollar appropriation that was in the affordable care act that has paid for the pcip program. >> i hate to interrupt you, that's not my style, but the $5 billion, wasn't that for a set amount of time, we keep getting these extensions that don't seem to be paid for. >> so the statute says this we

-- says that we transition of can use that money to ease the transition of pcip enrollees into the new market, so based on the number of enrollees we had and the costs that were incurring to allow those benefits to continue through march and at the end of march, by the end of march everyone who is in that program needs to get private coverage, and that program -- >> or they won't be able to seek coverage in little rock, so that's the rub there, i think. the ranking member said earlier, and my friend from florida may -- made reference to the fact that there is all these people that have new, all these people that have enrolled in the affordable care act that didn't have coverage before. how can we drill down and figure out what that number is? because just because 146,000 in florida signed up in december,

how do we know that those people did not have insurance before? how do we know they're not like brenda that was forced off her plan and hopefully can fine -- can find another plan. is there a way to ascertain if these are true numbers, if these are people that are covered for the first time ever that never had health insurance before? >> that's a really good question, and we're working on being able to provide data as to the number who were previously uninsured versus the number who may have been insured before and are switching to new coverage, and we understand that's an important issue, we don't have that data today. >> okay, if you can work on that, because one side tells one side of the story, one side tells the other, and usually as you know the truth lies in the middle. so when i hear how many people that never had coverage before, i question if they didn't have, lost it and bought new. so thank you for your time here today. >> thank you. >> gentleman yields back.

now mr. butterfield for five minutes. >> thank you, mr. chairman and thank you, mr. cohen, for your testimony today. it want to assure you, mr. cohen, that when the history of this debate is written many years from now, i promise that you will be regarded as one of many people in this administration and across this country who were on the right side and helped millions of americans get insurance. you are doing the right thing and i want to thank you for what you do. >> thank you. >> but mr. chairman, this is getting ridiculous. my friends just won't let go, i think mr. tunko made reference to it a few minutes ago. let me try to put this in somewhat of context. yesterday's "new york times" wrote that north carolina senator hagan has faced more than 3500 negative ads about the affordable care act since june 1st. that amount of negative ads is more than three times as much as any other member of congress. five million dollars has already been spent on negative ads related to obamacare in my state of north carolina.

the fact is the affordable care act is the law of the land. it is working in my state. the brenda in my district is named carlton stevens jr. i drove up to an exxon station a few days ago, little carlton, we call him, jumped out of his car and told me how excited he was that he had signed up with the affordable care act, told me that he was paying $700 a month for he and his wife and two children, that the premium was going up to $800, that he enrolled in the affordable care act and is now paying $240 per month. the fact is and the reason, mr. cohen, i had difficulty in trying to describe winners and losers is that each case is unique. you have to compare the coverage, you have to compare the cost, you have to come mayor -- you have to compare the circumstances. so the brenda in my district is carlton stevens and he's getting insurance now for $240 per month. of all states participating in

the federal exchange, my state, miss elmer's state as well, had more than 107,000 enrollees from october to december, which constitutes the most enrollees in the federal marketplace per capita. 89% of those enrollees are low or middle income and qualify for a tax credit for their plans. north carolynians are having tremendous success with the federal marketplace and health care.gov, in fact north carolina leads all the states in health and human services region four with more than 61% of who completed applications selecting a marketplace plan. nationwide the trend is very similar. by the end of december, nearly 2.2 million had enrolled in several hundred thousand more have enrolled since then. tuesday's washington post cover story stated, quote, the data show a seven-fold, seven-fold upswing in enrollment in the

federal exchange from the first two months as the website's performance improved, end of quote. so mr. cohen, i want to ask you, can you describe for me the trend in the number of adults 18 to 34 who have selected these marketplace plans? >> i think we reported that the 18 to 34 was about 24% of the enrollments, and that that was very close to the percentage of that age group in the general population. so we were quite pleased by that and we expect to see that number increasing as we move through the rest of the open enrollment period. >> talk to me about some of the national campaigns which will help to begin to get youth enrollment up higher than even 24%. perhaps to 40%. >> so, i know that we are going to be doing a lot more paid media, specifically around the olympics, which will be starting in a couple weeks.

and around other sporting events and other activities that we would expect young people to be particularly interested in. i know we're doing, have been doing and are doing an increased amount of outreach through the social media, you know, facebook, twitter. all that sort of thing. and i know that we are all of our advertising is very targeted to try to reach the populations that we most want to get. obviously we want everyone to enroll, but we want to particularly focus on the young people, as we've talked about. >> thank you. lastly, i made reference to my home state of north carolina in my introductory statement and i'm very proud of the enrollment rates there. i have 700,000 people in my congressional district, and i tell you that 100,000 of those 700,000 is uninsured. and this is making a difference. well, what factors do you believe contribute to north carolinians choosing marketplace plans at such awe high rate

-- at such a high rate compared to the national norm? >> i have to believe that in places where the need is the most, you know, is where we're seeing the biggest response. so in places where the rate of uninsured was high, i think that's where we're seeing the biggest response. >> thank you. >> in response to his question, do you know how much you're spending on the olympics advertising? >> i don't, but i'm sure i can get that. >> would you please let us know. now i recognize the lady from north carolina, miss elmers. >> thank you, mr. chairman. to my colleague from north carolina, mr. butterfield, i'm going to kind of extend some of the questions to you, mr. cohen, where he left off. >> and adjoining districts, i might add. >> yes. my colleague pointed out that about 107,000 have enrolled in north carolina, that's the

figures that we're seeing. however, 473,000 received cancellation notices for their health care policies that they already had. so even though that 107,000 may sound impressive, we are way behind on those who have had their policies canceled. so there's a lot of making up to do. i do want to get back to some of those numbers. now, correct me if i'm wrong, how many people in america do you believe have signed up for coverage now? >> well, the most recent figures that we put out were 2.2 million. and that's just in the marketplace. obviously there are people who are -- >> so the 6 million figure that i keep hearing today, where is this 6 million figure coming from? >> that's taking the 2.2 and adding 3.9 million who enrolled in medicaid. >> okay. so when, so basically what we're doing is we're culminating. are you aware that the "washington post" gave three pinocchios to this number? are you going to keep this figure? >> i didn't see the pinocchios, i'd have to take a look at what

they called into question. >> so you agree with the 6 million figure, you believe that there have been 6 million? >> i believe that, as we reported, 2.2 million have enrolled in marketplace plans, and about 3.9 million had enrolled in medicaid. and i think the medicaid number was actually only through november. >> now, of those who signed up for medicaid, how many of them could have previously signed up for medicaid but did not before obamacare was instituted? >> i don't have that number for you. >> you don't have the number. can you get the number? >> i can certainly ask my colleagues in medicaid if they have that number. i don't run medicaid, so -- >> that doesn't fall under you? >> no. >> so, now we have a weighings where we have a number of where we have a number of -- now we have a situation medicaid signed up, wonderful, we want to make sure that people have coverage that's applicable to them. but isn't this going to play into the cost factor especially for those states, when we don't

really know where the numbers fall out as far as which, those who could have signed up before but did not? for whatever reason, and now have. >> well, the states, the states that expand the newly eligible will be paid 100%. >> right, the newly eligible. but those who could have received coverage before, the states are going to be responsible for a percentage of that, correct? >> that's right, under the usual match, yes. >> now, you said you don't have the number, you don't have the figure, when we had secretary sebelius, she see she did not -- see said she did not have that number, and i believe she actually said they could not get that number. so i would appreciate if you could get that to us in the committee. because i think the thing of it is, and i'll just quote the "washington post" fact checker, what he said is this number tells you almost nothing about how the health care law is affecting medicaid enrollment,

reporters need to stop using it, because basically, and that's a quote, because it's very misleading. now, i do want to get back, i've got a little bit more time here. we're all sharing stories about our constituents and some of the stories that we've heard have been positive. i want to hit on the issue of the change for women. because i keep hearing about the issue about, you know, bringing down costs for women. however, i have a woman who was formerly in my district, is not in my district now, from rocky mount, north carolina who reached out to my office and through personal situation lost her health care coverage, and now the plan -- she was paying d254 a month. a month. paying $254 now she's going to have to pay $610 a month.

she simply cannot afford it, she's probably going to have to choose to not take coverage. how, when we continue to claim that health care has improved for women with, you know, mammograms, when we call these things free, how did we go from $254 a month to $610 a month and we can still claim that she's getting free services? >> again, i really can't address an individual situation without knowing more of the specifics. we'd be happy to have folks talk to her, if she's interested. >> i would appreciate that. i will have my staff get that information to you, and your office, so that we can work. because if we are really going to take care of women in this country, health care issues for women, let's be straight on it. let's make sure that we are getting the points across. because women's health is very, very important. and this is very misleading. so with that i yield the remainder of my time. >> now recognize -- >> thank you, mr. chairman. i want to talk a little about constituent service when it comes to health care, because

long before the affordable care act my office spent a lot of time dealing with insurance problems. people who suddenly weren't able to get the medication that they had been getting before, really tricky issues. that sometimes we could solve and sometimes we couldn't solve. so the private insurance market as it was before was very difficult to navigate. i think that's really important to remember. but i have to tell you, mr. cohen, we have done constituent service with your office on many occasions now since the affordable care act is in place. and i'm happy that you were able to tell my friend, congressman long, that you would look at the brenda situation and work to get her the health care that she needs. i would suggest that, my experience has been that we have

been able to resolve through your office many of the problems. yes, this is a confusing time. but i guarantee you that before obamacare it was very confusing every year. and by the way, still is with medicare part d. and we really encourage all of our constituents on that program to look every single year to make sure that their medications are still on the formulary. >> if i can just say, congresswoman, we have gotten tremendous response from the insurance industry, from the pharmaceutical industry, as we've tried to resolve these problems this january. and i have talked with the issuers, i've talked with the pharmacies, the hospital association. and what i'm hearing from them is that the nature of the problems that we're seeing as we moved into january and people using their coverage are no different from what has happened every year as people get new coverage, change coverage. there are always issues in terms of people being able to verify their enrollment, being able to

see their doctor, all those kind of issues. we have caseworkers in every region of the country and we stand ready to help anybody if we possibly can. >> i know that in my state, democrats and republicans are working very hard to help their constituents and so i'm hoping that everyone on the other side of the aisle on this committee is taking advantage of the constituent service that's available from you, and then also through the insurance companies and the pharmaceutical companies. i wanted to again go over a little bit on the issue of these letters of termination. insurance companies we've talked to said they expected almost all of their current customers to stay covered. have you seen evidence of that? >> oh, absolutely. so it really is not accurate to think that because a plan was, is no longer being offered that

that means the person is not getting coverage. >> let's be clear, it's not offered because it doesn't meet the criteria of the -- >> that's right. so in every instance that i'm aware of, the carrier offered the person a new plan that and in some cases automatically enrolled them in a new plan. so there would be no gap in coverage. and then in addition to that, of course, through our transitional policy we've made it possible for people to keep their existing plan if that's what the insurance company wants to offer to them. >> my understanding of the issue of the grandfather option enables about half of those who received cancellation notices to renew their plan. has this been happening? >> that's right. and roughly half the remaining group that got cancellation letters, my understanding is are able to get actually a better

deal through the federal and state marketplaces because they are eligible for tax credits or medicaid, so they get better coverage for a lower and often much lower cost. >> so, for people who are eligible for the subsidy, absolutely. we would expect that they would pay less and they would in many cases get better benefits than what they had had. >> finally, in december the president announced that individuals who had canceled policies would be eligible for a hardship exemption so they could purchase low cost catastrophic plan. how will this change the options available to those that got cancellations? >> what that basically means is anyone who got a cancellation and feels that the plans that are available to them are not affordable can claim the hardship exemption and can enroll in the catastrophic plan which is a high deductible plan but will cover them in the case of any serious illness. and those plans are generally very afford around.

>> thank you, i yield back. >> chair recognizes mr. johnson for five minutes. >> thank you, mr. chairman. mr. cohen, i would like to thank you for being here today. we've had a long and arduous journey since this all started, and the american people came under the affordable care act last october, the website going up. and you mention in your testimony that the problems that we had, that it wasn't time to give up, it was time to roll up our sleeves and get to work. well, i respect that, but i'll submit to you that we've got a little bit of a different idea of what about what roll up your sleeves means. you see, the american people, businesses, individuals, hard working taxpayers across this country, who are increasingly burdened by the big spending, overregulating policies of this administration, not very many of

those folks get a second chance. only in washington d.c. and with this administration do we see a constant pattern of redo. at somebody else's expense, in this case it's the american people's expense. so i submit to you that what we should have done, what the administration should have done is roll up its sleeves and do this the right way in the first place. let doctors and patients manage their health care. we've got a private sector health care system that has provided the best health care in the world. it did not have to be done this way. let me get to a few specific questions. since the launch of healthcare.gov, mr. cohen,s that -- has the site been subject to

any security breaches? >> no. >> no security breaches? >> there have been no breaches in the sense of anybody attacking the site and being -- >> there have been no incidences of people attacking -- >> no, where they were successful. >> that's what you just said. >> because you interrupt me, congressman, i don't get a chance to finish. there have been no successful attempts where people have been able to attack the system and penetrate it. >> wow, that is contrary to what we heard in other testimony and what is widely known in the media. >> mr. chairman, i respectfully disagree with that. >> claiming my time, claiming my time. what is the difference, in your opinion, between a security incident and a security breach? >> you could have a security incident where because of an error or a mistake or somebody sent something to the wrong place, that was an isolated specific incident where information was transmitted in the way that was incorrect. a, when i hear breach -- >> how do you let that back to

-- how do you relate that back to the testimony we heard before the energy and congress committee that security was never even factored in and tested prior to standing up the website? can you promise the american people today right now that their personal information is secure on website.gov? >> yes. i can't promise that there won't ever be an incident. but i can promise that their information is secure -- >> that sounds like an oxymoron to me. you can't assure that there's not going to be a breach, but their information is sewer. -- but the information is secure. >> that's not what i said. >> one followup question. can you promise to this congress that if health care.gov is subject to a breach or a hack or any security failure, that you'll alert the congress as soon as you fine out about it? -- >> we follow normal find out about it? procedures and protocols for when those incidents happen. >> but the american people need

to know and this congress needs to know, so can we get your agreement that you'll notify congress if that -- >> we'll certainly work with you to make sure you get that information. >> whose job is it to inform congress and the american people when a security breach occurs? >> c.m.s. has an office of security, information security, that's responsible for that. and is today in the case of the medicare system where we have 50 million enrollees whose -- >> i got it. c.m.s. is responsible. who is responsible for the overall cyber security of the healthcare.gov site? >> i think that's the same. >> do you know how many people in c.m.s. are dedicated to protecting the security of healthcare.gov? >> i couldn't tell you a number of people. i know we have a dedicated security team. we do continuous monitoring, we actually have people watching the site 24 hours a day. >> do you know how many contractors are involved? >> i don't. >> do you know how much money is being spent to provide security? >> i would have to get that

number for you. >> does anyone report to you regarding the security of the site? >> my office is not responsible for the security of the site, but i am given reports on -- >> okay, can you give us examples of those reports so we can see what those reports include? >> i can certainly take that request back and see what we have. >> i mean, they come to you, so you ought to be able to release them, right? >> i will certainly take your request back and see what we have. >> mr. chairman, i yield back. >> chairman -- >> i was just going to say that a number of the reports on attempts to hack the system are classified, and we can make that available to all members to know that there have been multiple attempts. there's not been a breach yet. but i'm sure the attempts will continue on, but much of that is classified. >> mr. chairman, on that vein, last week democratic staff of the subcommittee and full committee prepared a memo of

information that was provided in the classified briefings which is not classified. a lot of the information, i was at the classified briefings, a lot of that information was not of a classified nature. and so what that information said is there are no successful hacks of healthcare.gov and it further said that surprisingly there have been no additional attempts on other government websites. so i would ask unanimous consent to put that memorandum which is dated january 9, 2014 into the record. >> we'll also remain vigilant because we will suspect there will continue to be attempts. >> there is some time left on the floor for votes. we can adjourn to go rote and -- to go vote and come back and complete this. >> i think we have time. >> would you like to continue? >> mr. harper, you're recognize -- you are recognized for five

minutes. >> thank you, mr. cohen. it's good to see you again. we're local done. i'd like to ask a few questions if i could. you touched on earlier in response to some questions about risk corridors. one, it's a program to offset huge cost increases being the temporary risk corridor program. where within the administration is this program housed, is it h.h.s., c.m.s. or where? >> risk corridors is under my program. >> and the individual in charge of that program would be who? >> the person who works for me who is responsible for that program's name is sharon arnold. >> so is it just that one person who would be in charge of that? >> she reports to me. so i'm responsible, but she works for me and that's her program that she's managing. with other people, with her staff. >> and there are other staff then, multiple people would help her to run that program? >> that's true. >> would you be able to provide us a complete list of the

staffers who do perform any service connected to the risk of corridor program? >> yes. >> thank you. under this program, if insurers are hit with costs greater than 103% of their premiums, the government will give them money, am i correct? >> that's right. and there are, it's a little more complicated than that, but yes. >> i've got a couple of followup questions that may allow you to answer that. how will the determination be made of what these costs are? is there a form? >> the insurance companies will have to present data to us on their health care expenditures. and then it won't be until 2015 that we actually make any payments under the program. >> so can you tell us exactly how the insurers will report this? i know it has to be, they've got to report it, but how are they going to report it? >> there will be forms or templates or whatever that

they'll have to provide to us, the accounting information that will tell us what their health care spending has been. >> and i've got a followup on some enrollment questions, if i can shift over to that. >> sure. >> the most important number as has been reported by many news outlets is whether individuals have paid. does the administration collect this information? i'm just asking, do you collect this information? >> right now we are not. but we will be. >> when? >> as soon as that functionality is built. i think i answered some questions about that earlier. not all that functionality is built yes. >> will that mean that we have to go back to all those who enrolled and find out whether they paid? we're not collecting it as it occurs? >> we ultimately will reconcile to make sure that th advanced premium tax credits, for example, are not paid with anyone who didn't pay. respect to their premium. that is a requirement. >> what department would have

this data? >> it's going to come to my office. >> who would be the individual that would be in charge of that? >> that's also sharon arnold. >> so we don't know at this point how many people have actually paid for coverage? >> that's right. >> so are you telling me that you don't have any data, you haven't received my information as to who paid or you just haven't compiled it yet? >> we've government en -- we've gotten enrollment data from the issuers with respect to the payments that we'll be making next week, but it's not an an individual basis. -- its not on an individual basis. so they've told us though, the number of people who are en -- who are enrolled who have paid, but we don't have it on the individual basis. itly we will. >> i didn't mean to cut you off. are you telling me that you'll be paying insurers without knowing whether or not the

insureds have been paid? >> no, we're going to be relying on data from them as to who has paid, but we don't vet why an automated system to get that. >> so if you're relying -- >> and we will reconcile that as soon as, make sure that those numbers are reconciled and your -- and are correct, once we capability of receiving the have the capability of receiving the additional -- >> do you know the total amount of paid from each insurer at this point? >> yes, we have information on since you're relying on that data -- what we're going to be paying to each insurer in this first group of payments that's going out next week. >> can we go ahead and get the data that you do have? >> i'm sure you can. >> all right, i believe my time is almost expired, i yield back. >> the chairman recognizes the gentleman from colorado, mr. gardner for five minutes. >> thank you, mr. chairman, thank you, mr. cohen, for your time today. i too received my insurance cancellation. have you ever met anybody who had their insurance canceled? >> you may be the first. >> that's pretty shocking, because 335,000 people in colorado alone had their insurance canceled.

the letter that i got that told me it would be canceled included this option. your option includes purchasing another individual health plan from us, purchasing a health plan from another carrier or purchasing a new plan through health connect colorado. was the presidents promise that i could keep my plan upheld, the president's promise to me, was that upheld? >> we've talked about this a lot. the law provided that insurance companies could keep the existing plans as long as they didn't make significant changes to benefits and cost sharing. insurance companies made different choices. there are still a lot of grandfathered plans out there and those maintain. but then there were other plans that did not continue into 2014. >> so -- >> in some cases those plans were canceled. >> so was the president's promise upheld to me? i don't remember the president saying there's qualifications if you like your health care plan. there is no asterisk. >> the law made it possible for

everyone who was in an existing plan as of the time it was passed for that plan to be maintained, but it didn't require insurance companies to continue offering them. so what we did in november was we offered another opportunity to say to insurance companies you can keep those plans in place even if they didn't meet the requirements of the grandfather. >> but these are big changes that you'd have to, or would a $5 change require them to discontinue the plan? >> it was a percentage change that was in the regulation as to how much, and it wasn't a change in premium, it was a change in benefits for cost sharing. >> so a copay of $5, that would require you to lose your insurance then? >> i think that was one of the requirements. >> is that a significant change to an insurance policy in are opinion? >> if a copay was 20 and it goes up $5, that's pretty significant, yeah. >> so the president's promise, so really in your mind you shouldn't have had to apologize because he didn't do anything wrong? >> i think the president said that, he recognized that what he had said did not prove to be

true for many americans. and as a result of that, we offered another transitional policy to make it be more possible for more americans. >> do you have legal opinions that give the president the authority to make these extensions and changes? could you provide me with a legal memorandum? >> i honestly don't recall whether we had a legal opinion on that provision. >> you testified in september as we've talked about, talking about everything going fine. when did you first know that it wasn't going fine? was it september 27, 28, october 1? >> october 1. >> so you had no indication prior to october 1st that things weren't going well? >> i had no indication prior to october 1st that we were going to have the major problems with the website that we ended up having. >> when did you first know that people would have their insurance canceled? >> i think we've always known that not all of the grandfather plans were going to continue. i don't think we had a necessarily a sense of how many

would and how many wouldn't. >> when do you expect small business plans to start canceling insurance? >> that will likely happen throughout the course of the year, small business plans don't tend to all come up for renewal in january. many of them were renewed early in 2013, so that they will continue -- >> how many do you anticipate being canceled? >> i don't have a number of that. we can look to see -- >> if you could provide an estimate of how many additional insured you think would be canceled, that would be great. so do we have an idea of how many signed up through the federal exchange so far? i know some of the this we've talked about before. >> we reported that through comedy people have signed up the act of>> we reported that through december 28 it was 2.2 million in the federal and the state, and of those it was something over 1.1 million were in the federal. >> so about 1.1 million in material, 1.1 million in the

-- 1.1 million in the federal, and 1.1 million in the states? >> roughly, yes. >> how many of those who signed up in exchangings were not previously insured? >> i don't have that. >> how many were previously insured but had their insurance canceled and now signed up in the federal exchange? >> i don't have that number either. >> how many saw their insurance rates go up? >> i don't have that number. >> you said that you know of a significant number of people mo saw the rates go down. >> as we've been hearing, you know -- >> you don't know for sure if their rates went down. your hearing anecdotal evidence. >> we're hearing anecdotally -- >> so we don't have any concrete numbers as to whether the rates went up or down? >> i think we know that people who were eligible for a subsidy that, for those people, it is, you know, almost certain that their costs would have gone down. >> so you have some numbers, but you don't know how many went up, okay. so of the supposed 45 million without insurance, how many people now have insurance? >> i don't think we have that

number yet, but certainly we're going to try to come up with as good data as we can. >> how do we know the law is working? working for many people and -- >> well, we know the law is >> but you don't know how many of the uninsured are now insured, you don't know how many people saw rates go up versus go down, insurance companies aren't being paid yet. let's talk about the risk corridor provisions. what is the probability of the risk corridor provision being activated? what is the probability of the risk corridor language being utilized? >> i think there will be a risk corridor program. >> but what is the provision of that language being activated and payments being made from the government to insurance companies? what's the probability of that? >> that will happen. >> so you're saying that the government will be paying private insurance companies -- >> oh, how likely is it that there will be claims on the program? >> yes.

>> i think we anticipate that there will be claims on the program, but there also may be some whose costs are lower than what they anticipated and there will be payments into the program, and i think the estimate was that it was budget neutral. >> gentleman's time is expired. do you have a followup question? >> we're interested in any legal memoranda that you've been briefed on that defines the authority under the affordability care act to delay implementation or the authority to exercise enforcement discretion over enforcement provisions. we all know this law that was signed in march of 2010 bears no resemblance to what is actually going on today, because of the variety of enforcement discretions and delays that have been implemented by the administration. we'd like to know under what legal authority you are operating or what you have seen that gives you the legal authority to do so. >> you'll provide that for the record? >> we'll take that request back and work with you.

>> i'd also like to you follow up with the other questions that members on both sides of the aisle asked. how many people of the 45 million are signed up and if it's more or less expensive for them. i ask unanimous con somebody -- unanimous consent that that the written opening statements of other members who wish will be introduced into the record, in conclusion i'd like to thank -- to thank all the witnesses, and members that appeared at today's hearing. you have 10 days to submit questions for the record. and i ask mr. cohen if he would agree to respond promptly to the questions. with that this committee hearing is adjourned. >> in 20 minutes we'll take to you lansing, michigan, >> secretary of state john kerry

holds a news conference with his canadian and mexican counterparts today. this comes as leaders meet to update the north american free trade agreement. live coverage at 9:30 a.m. eastern on c-span two. former defense secretary robert gates discusses his book "duty" live from the national constitution center in philadelphia at 6:30 p.m. eastern. also on c-span two. >> yes, internet service providers are gatekeepers and they also are two-sided networks .r to set it gatekeepers

like any gatekeepers are some on one side and the other side. the situation, then, is very similar to the credit card industry. we all have credit cards and then there are the credit card company and on the other side of that there is a restaurant. is very useful for restaurants that we all have credit cards and it is useful for us that all the restaurants will take them, but it is not so useful that the gatekeepers says some of these restaurants were not going to allow them to participate in the system. translating that to the present, if the internet service provider were to say not all the people that are putting the content on their computers, we don't want them all to be able to have access to all of the users, that is a problem with the gatekeeper behaves that way. >> this weekend on c-span, and look at the impact of the d.c. circuit court ruling on broad band and internet regulations. saturday morning at 10 a.m.. the storys book tv,

behind dr. martin luther king jr. stream. saturday 3:30, on book tv. atlanta after the civil war, sunday morning at 11. today on c-span, washington journal. at 11 a.m. eastern, we will have the justice department for president obama's speech on new nsa surveillance rules. at 2 p.m. we join the brookings institution event with reaction to the president's speech. coming up in an hour on washington journal, a discussion on net neutrality rules and what this week's court decision means for broadband companies, content providers and consumers. we hear from michael cobbs and robert dowell, former members of the fcc. at 9 a.m. eastern, a look at how americans volunteer. wendy spencer, ceo of the

corporation for national and community service, and elizabeth boris, tractor of the irving institute center on nonprofit and president obama will be speaking on surveillance or format 11:00 this morning. it will be live on c-span. westart off this morning, want to start by getting your views on surveillance and what you would like to hear the president they regarding potential reform. the numbers to dial are on your screen.