to 520,000. >> that would be the optimum army, given what we face as a nation. could you tell me the difference in terms of cost. not today, but over time. you don't have to do it today. between high risk, moderate risk and the optimum army? >> we can lay that out for you. >> and what i want the committee to look at is in terms of our budget deficit, how much, if we went to the high risk, could we remotely balance the budget. i think the amount of money involved is going to be within our power to gather if we could replace sequestration. >> now, about the a-10, the a-10 is being retired because you've got to make hard choices budget-wise. is that correct? >> that's what i believe. >> the f-35 comes online if everything goes perfectly, in 2021, i believe, is that

correct? >> around that time, sir. >> okay. so for $3.5 billion, we could keep the a-10 in the inventory for a few more years and wouldn't have a gap. >> i would just say i think it would allow us to keep the a-10 for that amount of money. it would be obviously up to them. >> do both of you still believe that military commanders should bear the responsibility for dealing with sexual harassment problems in the military? >> absolutely, senator. absolutely. >> john, do you think we're on the right track of getting a handle on this problem? >> i think as we look at the kinds of indicators that we normally used to track these reports, particularly have grown significantly. we view that as positive, as an personal to that, a good number of those reports are for years, where something happened before the soldier. usually a female. but not always. the soldier even joined the

military. that shows us they have increasing confidence. we obviously have a long ways to go. none of us are ready to declare victory. but we are doing -- the chief and i focus on this every day. we had a meeting just last week, a rally in the pentagon to kick off sexual awareness month, month of april, and everything we do and say, including our published priorities, sexual assault and harassment is my number one priority. i know that everyone in the army believes that and is working on it. >> thank you. my time's up. in ten seconds, could you tell us what happens if we get afghanistan wrong? if it falls apart? what's going to come our way? >> as i said, i mentioned earlier, ungoverned territory or instability will allow those to exploit that element such as eke and others, which would then allow portions of afghanistan

and any other area that's ungoverned and not properly secured to threaten the united states and that remains a concern. >> thank you. thank you, senator graham. senator cain. >> thank you. i'm going to ask a question about the long-term stress on the army of 13 years of war. we see these shooting incidents too at ft. hood, one at the navy yard, one in virginia recently at naval station norfolk. they posed some mental health challenges. they posed base security challenges. when we hear the testimony about sexual assault in the military, when we hear testimony about military suicides, general amos was here a couple weeks ago talking about instances where marines acted in disrespectful manners that he's having to deal with. i view all these issues as kind of connected to potentially organizational stress issues. we now have a war that's been 13 years of continuous warfare

before. talk to me about long-term stress of 13 years of war and the effect that you see in the army and what we need to be doing to deal with that, please. >> thank you, senator. in the army, you know, we've had 2.4 million deployments of -- some are multiple deployments. 2.4 million soldiers have deployed to iraq and afghanistan over the last 13 years. 500,000 of those have deployed multiple times. what that means is there is stress. stress on families. stress on individuals. and it's the first time we've done this with an all-volunteer force. we have to understand this. this is one of the things, so what are we seeing? we're seeing increased alcoholism. we're seeing -- we had initial increase in divorce rates. that's settled down. we're seeing an increase in those who have behavioral health issues that we have to help them with. that's the cost of this.

one of the things i don't talk a lot about when we talk about risk, though, is when we make it smaller, in the future, if we have to deploy these forces, it's going to put a significant risk on them because of the pure numbers. and that's one of my worries. that's one of the risk calculations i make, what's the impact this reduction has on a smaller force. and what will be the impact on our leaders and our soldiers. you know, we don't talk a lot about the impact this has on our leaders. our leaders are the ones who have multiple, multiple, multiple deployments. and have the stress of leading and they've handled it incredibly well. but they also have stress on them as well, as we move forward and we have to consider all of this in the future. we have to have programs in place to deal with it. we have to make sure we understand this as we continue to develop the army, and we have to consider that as we adjudicate risk for the future for us. >> in this time of really

unprecedented in the sense that we don't have a historical precedent of a 13-year war, unprecedented stress, we ought to be doing what we can to make it easier, but wouldn't you say sequestration, budget uncertainty. that's a pretty significant additional stressor on top of a stress that is already an unprecedented one. >> i agree, senator. >> and i just have to say i don't know exactly the context under which admiral mullen made the statement that our debt was our largest national security threat. i've just got to say, i could not disagree more. i've done an awful lot of budgets as a mayor and a governor. i understand surpluses. i understand deficits. i understand debt. i understand ratios of debt to gdp that are acceptable. we're a little on the high side. by a couple of percentage points. it's completely within our control to deal with it. the national security challenges we have that are the most serious -- debt that we can control doesn't match up to an iranian nuclear threat. debt that we can control doesn't

match up to a north korean nuclear threat. debt that we can control doesn't match up to the proliferation and mutation of al qaeda affiliates all over the world. i think we need to get out of our head that debt is our biggest national security challenge and sort of read the newspaper every morning. and it is my hope, mr. chair, that working through the budget that we'll be able to do in 16 and 4 what we did in 14 and 15. the request, if we do what has been requested, everything that's been requested, we will have lifted half of the burden of sequester, actually slightly less than half of the burden of sequester from the military. they will have absorbed more than half. i'm not sure i would have made such a reasonable request. you're trying to meet us halfway. you're asking for us to give you half relief essentially. it's my hope that we'll do that. one question only, and that is, i've been asking this in all the posture hearings.

talk to us about one year in, the integration of women fully into all mos, and give us a one-year status report. thank you. >> thank you, senator. first of all, to this point, it's going very, very well. the army has through the department of defense noticed congress of our attempt right now to open up some 33,000 positions across the army. it really does take a very broad base perspective, broad based approach to various jobs that women are interested in doing. even in our more challenging moss, our combat engineers are attended the schools. they're doing extraordinarily well. in fact, over the last three years, women have graduated at the same rate as men. a pretty remarkable statement as to the capabilities of these

soldiers, both male and female. and perhaps most important of all, we're going through a very methodical evaluation of our physical standards, and people are in some corners suggesting we're doing this to lower standards, to help women into the ranks. simply not true. what we're trying to do, and we'd be doing it even if we're an all-male military, is try to match required physical skills with those kinds of actions that you're expected to carry out in your particular job. we want every soldier to be postured for success and to have the physical as well as the mental capabilities to do the job that they're assigned to. that is a very methodical process led by our training and dongt rin command. all of us wish it would go further, but to do it right, it needs to work its way out. so we have a full report due on this at the end of the year.

from the army perspective, including our soft units, our 160th aviation is going very well. >> great. thank you, mr. chairman. >> thank you very much. senator king has graciously yielded to senator hagan. >> thank you. thank you, chairman levin and senator king. i too want to express my deep concern, my heartfelt prayers and condolences to what's taking place at ft. hood now, and particularly to all the families and all the service members, men and women and families on that base. and all of north carolina is wishing those same thoughts and prayers. i did want to make one statement on the 440th air lift wing. i am deeply concerned with an air force proposal would remove all of the c-130s stationed at pope army airfield at ft. bragg.

the airborne mission is probably the best example of the importance of joint operations, and it's critical to ensure input from all stake holders before significant decisions are made. i want you to know that i'm committed to ensuring the readiness of the 82nd airborne, which is the heart of our global response force and our special operations forces and our other units at ft. bragg, and we can chad about that later. but my first question i wanted to ask about maintaining our technological superiority. in your written testimony, you stated that if sequestration persisted in 2016 and beyond, it would not be until fiscal year 20 to 23 that the army would begin reinvesting in the modernization programs to upgrade aging fleets. i chaired the subcommittee on

emerging threats and that is a real concern. we held a classified briefing with defense secretary kendall on military technology superiority. secretary mchugh, thanks again for your service to our country. thank you. to the extent that you can speak about this in an open session, what risk will the army be assuming? if you're forced to really degrade much of your modernization programs due to this long-term sequestration that we've all been talking about this morning. >> we thank you for reading the submitted document and for focusing on a very, very important passage. this is an area that we deeply concern ourselves about. it is one of the things, the very hard things you had to do to ensure as best we can that for the threats that arise today, we're as prepared as possible to send soldiers into

harm's way to meet them. it is not the kind of cut that we would prefer to take for the simple reason that as you noted, the threats and the capabilities of our potential adversaries in the future are evolving very rapidly as well. heretofore, very basic terrorist organizations are developing key capabilities, one of the great advantages that the united states army has enjoyed particularly over the last 13 years was the best equipment, the most modern equipment. that didn't just happen. we don't just go by it at a box store. it has to be developed. own accounts have been severely hit, and under sequestration would be a mere percentage of what we view as the rational investment level. and it will have a significant impact on our snt national base. i know you're concerned about,

but also clearly on the availability of the most modern equipment in that future battlefield, not when it arises but where it arises. >> i'm also concerned about the talent that we need to have to be sure that we have the top talent, and if we put this off years down the road, we're going to lose what i think would be an institutional capability that's not going to sit around and twidle their thumbs. >> exactly. we talk about highly skilled workers. it is the same kind of challenge in our research and development snt fields. these are obviously very highly trained, very highly educated, and in our case, very high skilled individuals that will go find other things to do if we are unable to sustain them and give them work they find interesting and challenging. and work that obviously will greatly benefit men and women in uniform. >> and it really is a problem,

because if you wait years down the road, the catch-up will be way too long to be competitive. >> may be too late. yeah. >> on the front end. i know that we just had one question on the new roles for women in the military. i understand that during the last year, the army opened approximately 6,000 positions in 26 different brigade combat teams. select aviation specialties and special operations aviation and approximately 3,600 field artillery positions. i also understand the army anticipated opening an additional 33,000 previously closed positions during fiscal year 14. can you expand on that? and i know those are huge numbers. there's a big transition. with those openings, how many combat related positions are still closed to women, and how is the transition going? >> senator, thank you for the

question. we are continuing to open up positions. and as you just said, for the secretary of defense, we informed congress to open up 33,000. and those are really occupations very open to women, but they are serving at different levels. they are now serving in infantry battalions. >> and now they're getting credit for that. >> that's right. exactly. so what we're doing now, the next step is we're now looking at -- we're doing our physical demand study to move towards opening all positions to women. there's a couple things we have done. we now have our first female soldiers that's completed training in multiple launch rocket systems and they are now serving as platoon leaders. that's a new opening. we are doing our physical demand study that is looking at the rest of our artillery, army, and infantry positions that will help us as we go forward and report out in the end of '15 to

opening all of these positions as we've been requested to by the legislation. we're also conducting a significant integration study on how we would properly integrate them. so what you'll see in the next year or so is the relates starting to come out of these studies that we're doing. we just finished a fairly comprehensive test out of ft. stewart in the third infantry division in testing infantry skills and other things as we develop the standards. we had both women and men conducting in those experiments. and so i believe we have a comprehensive effort to gather the data, which will enable us to make the right decision moving forward. and we anticipate that we will begin to open up more and more and more positions to women as we move forward. >> one question that arises when you're conducting these standards. are the men already trained and the women are not? how are you looking at the actual training program? >> yes. so it's a physical demand, so it has nothing to do with training.

it has to do with physical abilities. so in other words, it doesn't count -- we're not accounting for can you do something quick or faster. it really is about testing your physical abilities to do it. so level of capability does not play into it. >> thank you, mr. chairman. >> thank you, senator hagan. senator king? >> thank you, mr. chairman. i'd like to begin by making a modest suggestion. one of the advantages of being the last person on the line is one gets to listen to all the other questions and comments. and i've been coming to these hearings now for a year, almost a year and a half, and the word that's been used more often than any other single word is "sequester." and it occurred to me as i was listening to the questions on both sides of the aisle that are deeply concerned about the impact on sequester on the army, and on the department of defense. perhaps the armed services committee could lead a

discussion to find -- to lead a bipartisan project to find a solution to our sequester and budget problem. it's a bipartisan group. well respected group. and i think most importantly, we have i think a more intimate acquaintance with the real effects of sequester than perhaps any other committee. we have three members of the budget committee on this committee, and i commend to you the idea of convening us as a group to talk about the solution to sequester, because it's would have been the frustrating things to me is that around here, we often bemoan problems like sequester, but they don't seem to get resolved. we now have a little breathing space because of the bipartisan budget agreement, but i'm just afraid if we just keep talking about it, we're not going to get

anything done. so i make that suggestion, too. >> i very much welcome that suggestion. if somebody who has spent a huge amount of my time recently the last couple years struggling with this issue and suggesting an alternative, which so far has not achieved support, because of it involves, at least in part, revenues. to address the problem. so very, very sympathetic to what you're saying. and i will talk to the ranking member, senator inhofe, about how we might see if there's enough interest on his side. already talked to one of our colleagues, republican colleague on his side. i won't identify him because he should identify himself, who raised a very, very similar suggestion, just this morning to what you have. we as a committee and we as

individual senators are in a position because we've seen the impacts, and we see the looming impacts, by the way. we've seen the '15 impacts, but also the fiscal year '16 impact where is this sequester comes back in its full bloom and its full lack of glory. so we are in a position, as senator king mentions, that perhaps except for the budget committee, no other committee -- no other single committee can see. because we have about half of sequester falls on the military. no other committee is in that position. it's the rest of us for the nondefense discretionaries divided among committee. so i'm very much welcome to the suggestion and will talk to senator inhofe and see what he thinks so we might be either formally or informally to get our committee members together and start noodling this very important issue. thank you. >> thank you, mr. chairman.

general odierno, to go from one of the broadest to one of the more narrow issues, as you know, the budget proposes a series of changes involving military pay raise, the base allowance, commissary subsidies, tri-care. the pressure here is going to be to wait. there's a commission on compensation that's supposed to report about a year from now. and i know that everybody's going to say, you know, let's put off this discussion until that commission reports. what's the downside of waiting? >> well, it's our budget figures in '15 and beyond. i mean, '15 is really -- it's the savings that we garner from those proposals immediately. it probably impacts '15 more, because we supposedly would have some output from them. so we'd have to figure out how we make up for the reductions that we booked based on our

recommendations for the changes in composition, if we have to wait. i don't have the exact number what it is in '15. so i'd have to tell you what that specific impact is. i know the number grows as it gets to the out years and becomes more significant. >> we had a personnel hearing and the number we were given was 2.1 billion for year one and almost 30 billion over five years. so i think that needs to be borne in mind that every year we put off those decisions, we have to find that money somewhere else. >> that's exactly right. the army's portion of that is around 40% because it's based on the number of personnel that you have. >> general, by my count, you've been a part of two military draw-downs. first in the '70s following vietnam and the '90s after the cold war. what lessons do you take from those experiences and different

phases of your career that can be applied to the different circumstance? >> the '70s, i was probably too young to understand what was going on and really have a grasp. but what i remember from the '70s was the hollowness of the army that i came into. the lack of training, the lack of resources, the lack of ability for us to properly train our units to meet the missions that they had at the time. that was very clear to me. we saw that change in the '80s as investment increased inside of the army and made a significant difference on morale. made a significant difference on our abilities, on our confidence. you could even argue that at some point along the way, the american people lost confidence in their military, which was rebuilt in the '80s and the '90s. what i learned in the '90s is we took our personnel out so quickly, it left significant holes in the force that took us ten to 15 years to recover from in terms of properly allocating and properly managing the

downsizing. and that was not done -- it was forced because of the amount of people to take down. but the difference between those years and now was the sheer capacity. back then we had almost a million-man active army in the '90s, which was brought down initially to 750 and 550. so what happens is now that we're getting so small, each cut has significantly more impact on the ability because we are really getting small enough now where it really means something. in the past, maybe it didn't. to me, that's the biggest difference as we look forward to this. we have to make sure we're not hollow and we have to make sure we remain at capacity so we have the ability to respond and deter. >> a couple of brief observations and questions. senator kane and i and senator levin were both in the middle

east at the same time the last six months or so. one of the things we noticed was the very high value of our training and exchange programs with officers in other countries. i think that program, it's a relatively low cost, high return because the -- i don't want to overstate it, but the respect and admiration and positive feelings of those officers for the united states after they had come here and had training here was palpable. and i think -- i'd like you to comment on the value you see of those programs. >> two things. one, it goes two ways. first is the value of us sending our officers to foreign countries to train and the influence that they have, and the influence they have to interact. it helps them tremendously when they get to hear different viewpoints and how people view us, and it helps as we look at developing capabilities.

the second piece is when they send them here and what they gain by interacting. we are expanding that program in the army. we have expanded the number of officers that come to our war college. we're expanding the number that we are sending to other countries. we've been very cognizant in that decision. for me, that's critical for us, especially as we operate in this very complex interrelated world that we have today. >> and that's a pretty low-cost program. >> it is. you get a lot for the money that you spend on it. >> just a final comment, again, based on these trips. and one i took just a week ago that was on a naval vessel. you have amazing people. when i got back from the trip with chairman levin, my wife said, what was your overall impression? and we were in some pretty interesting areas. lots of experiences. lots of inputs. but my overall impression was

the quality of people we have working for us. particularly the young people. who are working under difficult circumstances, who are -- many of them haven't had raises in a long time. they have to deal with the threats of furloughs. and i just -- and i had exactly the same experience two weeks ago on this naval vessel. it was the enlisted men, the chiefs. and the officers, of course. but the young people that we have working for us who are patriotic and idealistic are fantastic, and i often feel that we don't pay them as much respect as i think today deserve for what they're doing. >> just one quick comment, senator. that's why i still love to wear this uniform. it's because of them. and what i see every day and the sacrifice they make and how dedicated they are. i try to tell everyone that there are times when people are worried about this generation. i'm not worried about this generation. we've got great young men and

women out there that dedicate themselves to a lot of different things and that's what inspires me every day to continue to serve, sir. >> well, i have to tell you that the experience that inspired me was the interview and going through the process of the young people applying for the military academies back in maine and seeing the quality of people that want to serve our country. it's reassuring, for sure. gentlemen, thank you very much and thank you for your service. >> thank you very much. senator shaheen. >> thank you, mr. chairman. secretary mchugh, general odierno, i know you've had a very long morning, so i just have a brief question. but before i ask that, i just wanted to express my condolences to both of you, to everyone in the army over the tragedy at ft. hood. i know that we all share in mourning the victims and offering condolences to their families. i wanted to ask both of you about a hearing that i held

yesterday in the readiness committee, where assistant secretary hammock -- we were discussing the whole issue of brack. and she commented -- and i'm going to paraphrase. but we have the quote, if you would like to see it. but to paraphrase what she said is that if the army -- i assume d.o.d. -- can't get the authorization for brack in 2017, that you would go ahead -- you might go ahead and list some basis for closure in your budget request because of the concerns about because of the concerns about the ability to continue to run those bases in the way that they should be run. and while i appreciate the budget constraints that defense

has at this time because of sequestration and certainly think we should do everything possible to roll back those automatic cuts, i found it troubling that the military would go forward without working in conjunction with congress. and so i wonder if you could respond to that. >> thank you, senator. i obviously didn't get a chance to review personally secretary hammock's comments, but let me tell you the army's view. having gone through three rounds as a member of congress, i understand how difficult they are. i also understand that the way in which we need to pursue that and the way in which we realize the most savings is working with congress, particularly through a

base closure process that is endorsed in law. you have, this congress has provide ed us certain flexibilities to, short of a brack, make decisions on excess facility and excess structure shedding. and we'll certainly look at the authorities that you have provided, the congress has provided. but in terms of an actual base closure round, certainly my view, my position that will only occur should this congress give us the authority to do that. >> thank you. i very much appreciate that response, and i know we're awaiting some information about the european infrastructure and what can be done there. so i look forward to receiving that. but i very much appreciate your answer. thank you. >> thank you very much. senator shaheen, thank you for raising that subject. i had not heard of that comment until you just reported it. and i would just tell you, mr. secretary, that if our army or

any of the other services proposes something in the budget which is not compliant with the brack process, in other words, front running the brack process, it will be doubly difficult, maybe triply difficult to get a brack process going. i mean, i supported the last brack process, but i know how difficult it is to get a brack process. but it will set any possibility of such a process back many, many years if there's an effort to obviate the law, and i think that's basically what you just told senator shaheen and i very much welcome that assurance as well. you mentioned -- i only have one additional quick question of you, general odierno. you've mentioned individual rights a number of times when it comes to the mental health counselling question. and it's sensitivity which we

all would appreciate. what do you mean by that? is this the inability of a counselor, for instance, to talk to a commander about what a mental health counselor had heard from a soldier, or is it something different? >> it's partly that, but it's also, for example, if a soldier has mental health counselling at ft. bragg, north carolina, and he moved to ft. carson, colorado, sometimes we have difficulty moving that information with them. because of patient hippa, frankly. so that's the concern. we are trying to develop systems that enable us to do some of that, but it is difficult. >> isn't that a matter of mental health records being interoperable, whether it's to -- can't we shift mental health and medical records? >> the issue is the medical records would be available to

the physicians -- i'm talking about commanders' knowledge. so in other words, it's about the company commander at ft. bragg knew this. >> ah. >> but the company commander at ft. carson does not know that this soldier had previous problems. >> we had a flavor of that with major nidal hasan, and that the receiving commander was not aware of some of the disciplinary issues that he had. some of the academic issues that he had that over time added to his challenges. so part of the problem is hippa and who has access to what kind of medical records, behavioral health records. part of it is our own regulatory process, and it's the age-old culture of the military, not just the army that you're given a new start with every permanent change of station. we've made a lot of progress in making the relevant information

aware and available to receiving commanders, but we still have some challenges on what we're allowed to do legally. >> all right. let us know if there's anything we should be doing in that area legislatively. apparently we do not have any additional questions, i believe. and we thank you very, very much. >> senator, i said my respects to senator chambliss, and i want to close. we will miss you deeply. i will miss you personally. you have been an amazing and inspiring leader. the people of your great state have been blessed and we have equally been blessed and the men and women of the army have always appreciated and respected your leadership and your contributions. >> thank you, secretary mchugh. thank you, general odierno. thank you both for your very personal accolades for me. it means a great deal to me to

receive them from people of your quality and your character and your caliber and your leadership, and we will treasure those comments from both of you. i'm sorry, general? >> i just want to clarify something, senator, if i could. >> sure. >> i was asked -- >> as long as it wasn't the accolade for me. >> no. [ laughter ] i double that, sir. i was asked several questions about risk and other things. i want to be very clear as i was in the written statement that i have defined risk very clearly. at 450, i've defined the risk as significant in executing the defense strategic guides. at 420, question not implement the defense strategic guidance. i want to make sure that's on the record. by the questions i was asked, that might not have been as clear but i'm not backing away from my written statement. i wanted to clarify that for the record. >> thank you so much. there's two or things we've asked. one is -- we'll ask secretary of defense and the veterans affairs

secretary about interoperability of medical records. staff, please, if you can try to get a joint letter from myself and senator inhofe on that, it would be appreciated. in terms of the restructuring of the army aviation, you're going to get us the budget, the basis of the savings for that. so we can understand it. i think with that, we will stand adjourned with our thanks.

>> c-span is pleased to present our winning entries in this year's student cam documentary competition. it encourages middle and high school students to think critically about issues. students were asked to create their video answering the question, what is the most important issue the congress should consider in 2014? congress should consider the issue of immigration. >> inside out. the age of eight, i have been passionate about tennis. i have won a state championship. i would not be as good as i am

day without my coaches. my most recent coach is from argentina. my personal research led me to conclude the most important issue facing congress today is immigration reform. the impact of immigration on the arts, i visited the dance company, tulsa ballet. ♪ >> it is very international. from allrs are coming different countries and different nationalities. >> we might be a small ballet company in the middle of america, but we are a world-class organization. we hire choreographers and dancers from around the world.

we have 25 dancers and 16 of them are foreign. role inion plays a big our company. our spanish dancers give a different emotion onstage than the chinese dancers do. when everyone comes together, it is really beautiful. >> to look at the impact on immigration on the sciences, i visited a chemistry lab at the university of tulsa. >> the united states is number one in chemistry. lots of immigrants here working as graduate students or faculty members. most of the graduate students at any school are going to be foreigners. these students, only get them workingey contribute by in pharmaceutical companies, chemical companies.

the result in the betterment of society. >> meeting these talented people, i was astonished to learn that even they can be discriminating against because of where they are from. >> one of the most negative aspects of our current immigration system is the labeling. we talk about leading in schools and name-calling and how wrong that is. -- bullying in schools and name-calling and how wrong it is. we are the worst of the lot. bringing back the word illegal. to label a group of people it legals is very damaging. that is what nazi germany did to the jews. >> i did not know what the legal meant. meant. a legal -- illegal meant.

>> they are not criminals. they are not here to change the bloodline. they are not here to change the culture or language. >> in elementary school, alleging allegiance to the flag. not knowing that i was pledging allegiance to a flag that i was not a part of. my parents crossed illegally, i see it as something heroic. they sacrificed something to give me a better life. was thetudent valedictorian of her senior class. she came here as an outstanding student and she was taken away like a thief in the night and taken to a country she knew nothing about. that is not american. that is not what the statue of liberty says. they need to erase that from

the statue of liberty. just like they closed ellis island. you were welcoming the boats. >> mr. corker? >> aye. >> i was thrilled when the u.s. right for what was america. they passed an immigration bill. >> they came up with this 845 page bill. the senate passed it in june. >> the bad news is the bill is sitting in the house of representatives and they have not been able to move it forward. >> we have no intention of ever going into conference on the senate bill.

>>. valedictorian should be given an opportunity to go to college and as a reward for getting that education and being a productive member of this society, our society, given their papers. when that brain surgeon graduates, they can go to work and save some lives. if only the dream act was passed, heart of me would be happy and the other part of me would not be ok because my parents are not in protection. >> we have to be visionaries. this is why, i think, the current congress has failed deservedly. the people we have elected, they do not have the vision. >> they are not all valedictorians. for everyone who is a valedictorian, there is another 100 out there, they are hauling

75 towns of marijuana. >> this is not immigration, this is an invasion. >> we are shooting ourselves in the foot when we say some of the most talented people in the world, we will not that you stay here. that is the exact opposite of what we have done through most of our history. >> to watch all of the winning videos and to learn more about our competition, go to www.c-span.org. tell us what you think about the issue this student wants congress to consider. tweet us. next washington journal, former chairman of the federal election commission and

legal strategist discuss the future of campaign financing. the national center for education statistics in education week look at a recent assessment of math and reading skills in urban school districts. plus, your phone calls, facebook comments, and tweets. >> we are also seeing long lines across afghanistan of waiting, despite 22 million voter cards floating around in a country with 12 million eligible voters, there

are still long lines of men and access.o want to have of the an indication building up of enthusiasm among the population. >> we should not judge the afghan elections by the same standards that we judge our own elections. we have had 200 years of democratic evolution. this is a democracy in its infancy. if this election does produce a credible result, it will be the first handoff of power in afghanistan he. we want to be careful not to rush to judgment ahead of the afghan people. it is their judgment to make. i do not think we want to be second-guessing that issue at every step along the way. >> the absence of the international observers, a

number ofn the international observers, will have a psychological effect on the afghans. it will have an impact on how the international community views it. -- reduction in the numbers i am not trying to gloss over that fact, the truth is it is not going to make a huge difference. there are enough international observers to do their job and the real story is this is an afghan election. being undertaken pursuant to afghan institutions and afghan observers are going to be the first line of defense in ensuring a good election. >> this weekend, with the afghanistan presidential election saturday, a look at what to expect. saturday morning at 10:00. panels on gun control, the presidency, civil rights, and politics from this year's

annapolis book festival. at 11:00, talk to michael lewis, his latest looks at how wall street bankers have rigged the system in their favor. sunday at noon, u.s. military policy in the mideast. >> without objection, mr. speaker, let our people go. the speaker and this house has bent over backwards. we have passed appropriation bills. the president vetoed the first balanced budget plan in a generation.

the president has vetoed the interior bill. for the environmental protection agency, this is the do-nothing president. his people are telling the white house, do-nothing, stand in the -- blockke progress progress, fight a balanced budget at all costs. your poll points will go up. maybe they will. the fact of the matter is, we have put on the table the first balanced budget in a generation. if the president wants to continue standing in the way of that, fine. we are going to balance this budget with or without him. >> find more highlights from 35 years of house floor coverage on our facebook page.

brought to you today as a public service by your local cable or satellite provider. officials who run health six-daye exchanges for governments talked about how their programs are run and how they differ from the federally managed systems. is three hours. >> our responsibility is to hold

government accountable. we will work in partnership with citizen watchdogs to deliver the facts to the american people. this is the mission of the oversight and government reform committee. good morning, everyone. this is a conversation about the affordable care act at about the state exchanges. four years ago, the president health care law was passed. he promised the people they would be able to keep the .overage .eality is setting in americans have received cancellation notices from their insurance companies. family coverage have increased in many areas of the country. the bureau of economic analysis reported that health care spending hits a 10 year high. obamacare would be good for the nation's economy, we were told.

in order to minimize the negative exposure, employers were forced to lay off some workers and reduce some full-time workers to part-time. the cbo estimated that obamacare would've -- would reduce -- would reduce employment by 2.5%. it increases federal spending when the federal government continues to run a massive deficit. taxes and20 new significant cuts to the medicare advantage program. 80% of the people who were uninsured are still uninsured today. the ministration hasn't lamented extra -- the administration has and lamented changes. anger, the to public administration allowed insurers to renew non-grandfathered policies for an additional year.

the administration set a dangerous precedent i going around congress to rewrite parts of the law. the obama administration's rewriting of the law has introduced greater uncertainty in the market and may lead to higher premiums in 2015 and beyond. one of the largest insurance participating in the exchanges predicted double-digit rhenium exchange -- increases in 2015. analysis predicted that premiums will continue to increase. there are many issues we can and will explore in the days ahead, the topics of today's hearing our state exchanges. representatives from those

states are here today. they were forced to use an error ridden website. state residents are working for the same issues that on the federal side. states have worked incredibly hard and we are grateful to your service, you are struggling with some of the federal regulations and some of the delays that are coming down as well. problems with the website raised several questions. after it possible spending hundreds of millions of dollars that somebody different exchanges have difficult time putting together a website? what was the effect in delaying guidance on the construction of the state exchanges? where was federal oversight of the projects?

how could so many state exchanges have such a difficulty all of the same time? how many more taxpayer dollars ?ill be requested congress has an important oversight role. i appreciate you coming in being a part of this conversation. >> thanks to all of the witnesses who have traveled long distances to be with us today. now we have surpassed the goal for enrollment with more than 7 million americans enrolled, republicans are is determined today as ever to try and rip it apart. 7 million americans must be wrong.

the latest enrollment numbers prove that there is a genuine demand amongst the american people for affordable health care. the 7 million does not include enrollment searches that took place in the 15th states including california running their own exchanges. republicans will not be focusing on these successes or conceding that their predictions thus far have been as reliable as a fortune teller at a carnival. many republicans have voiced their certainty that the aca would fail. the 7 million goal was impossible. today, it is the committee's 26th hearing on the aca. this week on the floor we voted for the 52nd time to repeal it. like all historic and

transformative pieces of legislation, the rollout has been challenging and far from smooth. republicans have contended from the beginning that there is no meaningful role for the federal government in health care. let's remember how the market has handled health care in the past. the market allowed insurers to recent your coverage if you got sick and and i you coverage if you had a pre-existing -- deny you coverage if you had an existing condition. let's remember how the market determined premiums. he for the aca, with the exception of the recession, premiums grew by double digits year after year. since the law has gone into effect, we have seen dramatic and premiums. i ask you to look at this chart.

i agree with my colleagues on the other side that the aca should be the subject of >> the consistently partisan approach has been all about tearing the program down, not fixing it. the preparation for this hearing provided the latest example how this committee seeks to undermine the administration's efforts to implement the law. executive director of the massachusetts health insurance says, massachusetts has experienced its own website issues. upon hearing about the change in witnesses, the chairman of the committee threatened to issue a

subpoena. i would like to apologize on behalf of this committee to ms. yang for the efforts to bully you into testifying today. bet this committee should focusing on is what we should do in the future to contain costs. a truly balanced hearing would've looked at more than just one story of state east exchange success. if someone from kentucky's exchange had been invited to testify, i'm sure they would've wanted to tell the committee that her limoneira analyses found that approximately 75% of the enrollees were previously uninsured before signing up through the exchange, and that 49% of their enrollees are under by the of 35, or that end of the enrollment. , over 370,000 kentucky citizens

now have health insurance that did not have it before. to haveend, i am glad peter lee, the executive director of the california exchange am a cover california, here to testify as minority witness and to bring some good news and balance to this discussion. at the end of march 31, over 1.2 million californians have signed up for health insurance through the exchange. this number greatly surpassed california baseline projections of 580,000. the enhanced projection was 830,000 for the entire open enrollment. . a foreign is medicaid program, medi-cal, and rolled approximately 1.9 3 million and an additional 800,000 were found likely eligible. the springs a total of all californians and rolled through medi-cal and the exchange to almost 4 million people. inurance companies california are reporting that 85% of the enrollees have paid their first months premium.

california has refused to accept the exchanges current success are now continually updating policy such as efforts to increase enrollment in the latino community. we look forward to hearing more from you today about the improvements of california plans to make and how you can help other states. mr. chairman, i value our relationship. we have common interests that we have discussed many times. i know we can put our heads together and come up with new topics that conduct real oversight. i sent a letter to chairman i said yesterday to hold a hearing perpetrateded fraud by health management associates, a for-profit hospital chain that allegedly ripped off taxpayers for more than $600 million. that should be the work of this committee. i look forward to hearing the testimony of all witnesses present today and thank you for being here. >> i would like to recommend --

recognize the chairman for his opening statement. i would like my opening remarks to be put in the record. faults --mber, all all the false claims of been made about the aca, it is good to go back and put context on this. if you like your plan you can keep it, false. if you like your doctor you can keep them, false. premiums will go down, false. premiums will go down an average of $2500, the it ministration said. false. the website will work, false. the website is secure, false. we've had countless hearings to spell all these claims made by the administration. now we will hear about the dismal performance of the state exchanges. again, underscoring how poorly this law has operated, how bad it is and why we need to change

fori just want to thank you putting this hearing together. i look forward to hearing from our witnesses. more important, i look forward to asking questions of our witnesses from the six state exchanges and the overall impact this law has had on the american people. mr. that i yield back. >> cartwright, for an opening statement. >> thank you chairman langford and chairman jordan. this marks the 26th hearing this committee has held on the aca. of 25 hearings, you'd think every member on this committee on both sides of the aisle would have and working tirelessly to guarantee that each and every one of their tostituents had access affordable health care. you'd also think that these hearings would have consisted of a bipartisan effort to find ways to fix healthcare.gov, and that actual oversight would eventually take place.

this is the oversight committee. say that in 25o hearings none of this actually happened. i'm afraid that today will not be any different. this committee and throughout this congress, health care has become a divisive, partisan issue, instead of offering solutions to ensure the constituents have access, this house has instead held 54 votes to repeal the affordable care act. some of my colleagues have also run misleading and often times sut right false advertisement designed to frighten their constituents instead of educating them on the realities of the apa. i'm glad that democrats have held over 400 events in the district at home in order to educate the constituency on the aca. i have had five of them myself in my district. i would also like to commend my fellow democrats, ensuring that

their constituents are afforded the same kind of information. this hearing has been called in order to examine the state health insurance exchanges under the aca. california has one of the most successful state exchanges with more than one million individuals having signed up for private health insurance plans through its exchange. other states such as new york, rhode island and connecticut have also experienced success with implementing their state exchanges. i'm grateful that mr. peter lee to speakith us today regarding california's state exchange and provide much-needed balance to this hearing today. i do wish that new york, rhode island and connecticut were also included today, so we could hear about their best practices. i also wish that pennsylvania had its own state exchange so that my constituents could have had the same tailored access that the states have.

why was the governor of pennsylvania had originally accepted the administration's generous offer for medicaid expansion, it is my hope that the two sides can still agree on a plan and expand medicaid for the more than 520,000 pennsylvanians that would benefit from that kind of expansion. the high demand for the quality affordable health care available under the affordable care act is real. it is evident by the recently released enrollment figures haveng 7.1 million people signed up for the private health insurance plans easing both the federal and state exchanges, beating both administrations own .oal and popular expectations if the market demand isn't enough, the health-care bill is more popular than ever. about half of all americans now support the law, despite the misinformation being disseminated over the last four years. i want to say, i'm glad that

many many more people in places like oregon, maryland, california, massachusetts come hawaii and minnesota have health tourance than they did prior october 1, 2013. i am interested in hearing how the states did this despite glitches with the rollout in each of those states. i look forward to hearing about the best practices from the state of california, from which i think we can all learn a lot. i welcome our witnesses and thank them for taking the time to be with us today. i yield back, mr. chairman. recognize the chairman of the full committee, mr. issa. >> i want to thank you for the work you've done, mr. langford, the details of these laws in healthcare.gov and in the overall legislation. that myanimous consent entire opening statement be placed in the record.

>> it is important as a californian to have california representative here. the best and the worst will be seen in looking at the largest eight in the union. often turn divisive, partisan legislation into divisive, partisan oversight. mr. spear havet, made that clear by talking about republicans this and republicans that. i called, or authorize many of those hearings they alluded to. i am probably did it and i'm only sorry we didn't do more and sooner. half ofly, about america's federal spending will be related to health care, , medicaid toicaid eligibles for our seniors and obviously the growth related to subsidizing the affordable care

act. they represent the largest single bulk of the budget today, and that over than $1 trillion is an area over we have no real control over the rise of those costs unless we implement changes that drive the cost of delivery down. president obama became a senator, we had problems with health care. i think republicans and democrats need to recognize that medicare and medicaid have been part of the problem, not just part of the solution. just a few days ago by voice vote, almost a cowardly act in many ways, we did what was called the doc fix. of oldased on a decade mandates that somehow we were going to lower costs through some congressional magic and fiat. every year we recognize that it

does not work, and that if we don't suddenly come up with billions of dollars of new money , our doctors will be underpaid by about 25% of what apparently we believe is fair. the user is an example of a clinton era, republican house and senate attempt to regulate health care. this committee has a solid responsibility to do in real facts and real costs and real savings. that is not been the case for people on both sides of the aisle for decades. the affordable care act is well intended, i believe. but it has had many flaws. is that we will see today fairly straightforward. instead of doing a single website in which everyone fed in , spending $700 million, $800 million, one alien dollars, $2

billion, some enormous amount of money to create a network, what we did is issue out large grants . in the case of california, the number i have in front of me is -- is $1.6 billion. let's understand something here today, whether you voted for the four noble character you didn't, redundant programs throughout most of 50 states that issued hundreds of millions of dollars per state to do the same thing sometimes with, success, or the case of maryland, i believe today, some would say failure on the website. that alone was billions of dollars of unreasonable, unrest -- unnecessary, redundant in the planning. for the states all come together and use a common platform, a common software, was common

sense. into contracts into which each state may or may not have chosen the same good vendor , or in some cases the same bad vendor that the affordable care act federally used, is self evident today. arguingt past the petty about who voted for it or against it, whether we voted to repeal it or change it. publicans and democratic members are in fact today regularly talking about necessary change. i know the 7 million figure is big as of yesterday. i know as a republican i'm told to say that very clearly that figure represents a great many people who lost a plan and in fact simply picked up and got the 7 million. mr. lee will undoubtedly, quite frankly, have to tell us that because california mandated to get onto the exchange, that you get off of programs that was

necessary and delivered cancellation of all kinds of programs in california, because vendors had to choose whether to keep their old program or participate in the exchange. i'm not holding anyone accountable. it probably seemed like a good idea at the time. but the fact is, we have not driven down the cost of health care to the individual, except when the taxpayer picks up the tab. all of us today should begin looking not just at mistakes like 30 some different websites all paid for with federal dollars, all essentially asking many of the same vendors to simply duplicate the software, but bill is twice, three times, four times, for reinventing it. we also should look at the question of since we have not succeeded in the past and driving down the cost of health efforts,ugh cms's

rather repeatedly have simply said we will pay less and cost shift as the ford will care act is implemented and more and more people are under a federally subsidized program, where do we cost shift to? we are running out of people we can cost shift to, which means by definition, everything we do will be something we have to pay for. mr. chairman, this is long, and i apologize for going over. but i, like you, am passionate about efficiency. not just affordable care act, but all the federal spending has .o really be looked at i have taken note of the fact that corruption by vendors using federal dollars is rampant. i believe that we do need to go after it. i look forward to holding a hearing in which we look at both sides. offenders who socked to enrich themselves by getting more than they deserved and government oversight agencies that let it

happen until it child up to hundreds of millions of dollars. mr. cartwright, i want to thank you for something you did that you may have forgotten. basisted for a bipartisan for a major change in how we procure i.t.. , senator becomes past udall has a companion bill, and we willmes passed, become more efficient on a bipartisan basis in this committee. i know we started off on a partisan basis. hopefully we can switch the tone to realizing that we are all living with increasing health care costs. whether we voted for affordable care or not, we have a major role to try to drive down the future increases in health care if we are going to be competitive around the world in commerce. i thank you, mr. chairman for your indulgence. i yield back.

>> i recognize mr. cummings for his opening statement. you just move make clear across the country. >> i apologize. thank you very much, mr. chairman. third, justil the three days after the deadline for americans to sign up for health insurance under the affordable care act. a lot has happened in the past six months since the federal and state exchanges opened for business. pretty,ot always been but we should take a moment to reflect on what we have accomplished. more than 7 million residents of our states have signed up for affordable health care. millions of people who could not afford health insurance and were one accident or illness away

from financial ruin, now have health insurance. this is very significant. this is something that we all should be proud of that is not all. we hear talk about what it didn't do. the affordable care act, insurance companies are no longer allowed to discriminate against people with cancer, diabetes, or other pre-existing conditions. there are no longer allowed to discriminate against women. that is happening now. millions of our residents receive free repetitive care so they can stay well. we all know it is cheaper to keep somebody well and to treat them when they are sick. about want to talk driving down the cost of health care. millions of kids can stay on their parents plan until they

are 26. billions of dollars of rebate checks have been sent to consumers across the country. that has happened and is happening now. laserjet omen, put simply, the ,ffordable care act saves lives and it prevents people from going through pain. it allows people to live longer, like the gentleman who is probably watching us now with colon cancer, knowing that he has a way to be treated. he will be able to walk his daughter down the aisle. person who wants to survive long enough to see their child graduate from high school. that is what the affordable care act is all about. sometimes i think we get so caught up in the things that we are going through, that we forget the big picture. emerson said it best, he said do

not be pushed around by your fears and your problems, be led by your hopes and dreams. that is what this is all about, hopes and dreams. today,the witnesses here and to the state and federal employees are working tirelessly to implement the law, i want to say thank you. at dr. sharp steen of maryland, the head of our health department. this is a man who has given his blood, sweat and his tears trying to make life better for people when he was a commissioner in baltimore and now for our state. i can probably save as i knew all of the people there, i know that you are all doing the same thing. you don't do this for the money, you do it because it feeds your souls. you do it because you want to make a difference heard you do it because you want to affect

generations yet unborn. that is what we are all about, we should be about, making a difference so that people can live the best lives that they can't. the road we took together today for the federal government. it has been challenging for some states including my home state of maryland. i cannot fully express how frustrated i was with the troubled rollout of the maryland health connection. in my state as in many, people have a desperate need for quality affordable health care. we needed the system to work. let me say it again -- we needed the system to work. lives depended upon it. when it did not, unnecessary obstacles were put in the way, which is completely unacceptable. let me say this, sometimes you have contractors that advertise more than they can produce.

so they sell you a bill of goods. maybe those are the folks that we need to be looking at. let's be clear, this is not just .bout a website this is about making a difference for people so that they can be the best they can be and be all that god meant for them to be. the answer to the problem is not to decimate the affordable care act. solution is not to eliminate health care for millions of , to cut the funding for the aca, or to return to the days when insurance companies could discriminate against us based on our medical conditions. and i will it before say it again, we are better than that. to let insurance companies to that to us.

the remedy certainly is not to try to scare people away from enrolling in health care they have a right to under the law. when you scare them away from enrolling, you have scared them away from having health care. insurance, for being able to take care of their child when the child gets sick, or prevent the child from getting sick. we are better than that. unfortunately, our republican friends have voted more than 50 fund -- repeal the and stoppedned, affordable care act. i asked chairman ison that we move to -- german issa that we move to higher ground. issa that we move to

higher ground. written, whens that man is able to walk down the aisle with his daughter, when that mother is able to see her child graduate from college, one that person lives long enough to see their first grandchild born, they will not be worried about whether a website failed. they're not going to be talking about that. they may not even know that it was the affordable care act that saved them and give them a life. all that will matter to them is they had an opportunity to live in dignity and have a moment of happiness. and as we move forward, since this is the law, by the way, that we move forward to make a lot better and not try to destroy it.

only reason i mention his past efforts with regard to numerous hearings is that i have not seen in these hearings one notrt to improve the law, one. if we could move to that, then we could move to higher ground. with that i yield back. i would like to recognize the panel. please introduce your guests from maryland as well. >> this is the head of our health department in maryland. a staff member on this committee, mr. chairman. some years back, he came to baltimore and he was a commissioner of health there. he brought all kinds of innovative project to baltimore,

now he's ahead of health department for maryland. >> i'm delighted to introduce mr. peter lee, who is the executive director of cover california, who has had a storied career in health care, both in the private and public sector. he was formerly the deputy director for the center for medicare and medicaid innovation at c m s, among many other places. we are very glad you're here. >> you definitely have the longest time zone change of mr. gene yang is the executive director of the massachusetts health insurance exchange. 's interim chief executive officer of the minnesota health exchange. all witnesses are sworn in before they testify. can you please stand and raise

your right hand? >> do solemnly swear or affirm that your testimony will be the truth, so help you god? i ask you to limit your testimony to five minutes. you'll be a part of the permanent record. mr. matsuda, you are batting off at the beginning. a little spring baseball conversation. push to talk at in and we will receive your testimony for five minutes. >> thank you, chairman, ranking members, and numbers of the subcommittee. my name is tom matsuda, interim executive director of the whole i health connector, speaking on behalf of the connector and its board of directors. hawaii has long been a leader to ensure that our residents have access to quality affordable health insurance. in 1974, hawaii enacted a groundbreaking state law, the

hawaii prepaid health care act. this law requires that most employers in hawaii provide health-care coverage to employees who work more than 20 hours per week for at least four consecutive weeks. hawaii's prepaid health care act requirements are generally stricter than those of the .ederal affordable care act as a result, hawaii has a low uninsured rate estimated at or 100 thousand individuals. because the state's law is so strongly supported by the people of hawaii, below low estate authorized the establishment of a state based marketplace to harmonize the aca with the hawaii prepaid health care act. my written testimony provides detail about the connector and i would like to focus on some specific issues. first of all, enrollment. a march 31, 2014, we have 7005 hundred 96 individuals enrolled in commercial plans to the individual marketplace.

through thenrolled shop small implement marketplace , and 24,006 and 41 completed applications in our system. the connector does not handle medicaid eligibility or enrollment for the medicaid population. that is handled through the department of human services, or dhs. 28,000 enrollments from last october through february this year for a total of over 36,000 enrollments across the entire hawaii marketplace. we launched our online marketplace on october 15 and accepted the initial application forms between october 1 and 15th. the system has been operating since then. it was very difficult to use at first. as of now, we have made significant improvements. the system is better today than it was back in october. our system is working from end to end, but more improvements

can be made. sustainability. as a state based marketplace, we must be self-sustaining but january 31st, 20 15. last year, the connector board approved a premium assessment, a two percent premium assessment for plants sold on the connector. our board is now engaged in a sustainability planning process. the key is to reduce operating expenses while supplement enrollment, especially in the shop exchange. federal and state decisions to give small employers the option to remain with their plans has reduced the volume of participants in shock. hawaii has received for federal grant awards. while hawaii is a small state, we are subject to the same federal requirements as all other states to establish the infrastructure on the state based marketplace is.

our small population and low uninsured rate mean that hawaii has a smaller market to support our operating costs. as of december 31, 2013, the connector has spent about $57 million of the total 204 million dollars in federal grant money is awarded to us, and we have an operating system. for our priorities going forward, we have roughly 11,000 in completed applications. --se individual enrollments the individual enrollment is not a compete. we have increased staff to complete this process. we are also working on extending our outreach into the communities that are underserved to help educate these populations about the services available to them. connector, ithe appreciate the opportunity to

issues with you today. we believe an issue of the connector and are fully ready to contribute our part in hawaii's long history of dividing access to affordable quality health care coverage to our residents, thank you. you members of the committee. i appreciate the opportunity to testify today. be onerue that i used to of the people sitting alongside the back wall. i think -- i could say that every staffer wonders what it would be like to sit on the of the- on the side microphone. after the hearing i will be able to tell them. i as has been widely reported, marilyn has faced -- maryland has faced significant issues. on september 1 the system barely worked at all. we struggled with hardware and software problems, but we did

not give up. we now expect to hit our enrollment goal, in fact we expect exceeded by 10% or more. we expect the number of enrollments and qualified health-care plans to come within 10% of what was predicted by independent experts and to exceed our expectations for medicaid enrollment. by the time the dust settles we could see enrollment of more than 300 thousand in maryland. maryland's story includes decisions we could -- we wish we could make again, failures by multiple members and to many i.t. frustrations to count varied but maryland's story is also about an exchange that is a lot more than a website very it is about a state that is battling back and is looking towards the future. i have submitted detailed written testimony, soil make some key points. first, the exchange is lot more than a website. it includes our art in a ship with more than 2000 brokers, it includes a competitive market with four carriers offering many plans. it includes dental plans.

that has aebsite physician network for each carrier and a navigator program that includes more than 30 grassroots organizations. second, we did face serious website problems. we made a major misjudgment in retrospect-ish and it -- initially in trying to buy commercial off-the-shelf software that could be configured for the purpose of the affordable care act instead of building something specifically for this purpose. the products that were advertised as being ready actual effective and efficient. this caused immense frustration for consumers. at certain points it made us wonder whether anyone would be able to enroll. than give up in the face of these i.t. challenges, maryland tackled the problem head-on. ,hanges included new leadership including when the governor asked the secretary to step aside from her job and be the

single leader for all i.t. development. contractor toal help fix the system, implement hundreds of critical i.t. fixes, collaborating closely with carriers to allow for special types of enrollment for people that had trouble on the website. manual workarounds which allowed process applications by hand. the incredible tough work of hundreds of consumer assistance. finally a strong finish with as much enrollment in the last two days as in the first 10 weeks or so. as a result, we expect not only to meet, but to exceed our enrollment goals. quality and affordable health coverage is providing peace of mind and access to families across maryland. it is also going to reduce the hidden tax that all of us pay for poorly managed and uncompensated care. under our unique system in

maryland of rate setting for speaksls, which not only to chairman isis point, is going to reduce the cost of care within that system, but also we -- to address affordable cost of health care. in me finally say that -- addition to the significant work in the significant work in hundreds of fixes that it took to get us to the point where we could exceed all enrollment goals, the secretary of information technology have led a process of figuring out the future for the website. analysis, thesive board this week voted to leverage the connecticut i.t. solution in order to upgrade our website. this is a model that has proven

very effective and allows us to use something that works very well in time for the second open enrollment. here it is the chair of the board of the maryland health benefit exchange, i deeply regret the frustration that many marylanders have experienced. i am also proud of the efforts of so many who have worked tirelessly to overcome i.t. challenges and help their friends, neighbors and fellow citizens gain access to affordable and quality health coverage. thank you for the opportunity to testify. i look forward to your questions. >> thank you, mr. chairman. jordan, chairman langford, ranking member cart right, ranking members. and members of the subcommittee, good morning. thank you for the opportunity to testify about our experience implementing the affordable care act in massachusetts. as you know, massachusetts is very familiar with the framework of the aca. in 2006, former governor mitt romney worked to fashion an x

health care. once he took office, the governor worked to bring the statutory framework to life in close collaboration with our state's legislature, our health care providers, our business and labor leaders, our insurers, our consumer advocates and callous others. we are extraordinarily proud of the results we have achieved together over the past eight years. virtually all of the commonwealth residents are now insured, at 97% varied 91% of our residents report having access to a primary care physician, and 80% having seen the physician in the previous 12 months. on a whole host of measures, we are healthier. at the same time, more employers are offering coverage, and our states budgets have been consistently balanced. are most important lessons we have learned in the years since

2007 was that health-care care reform takes time. we refine our plan is to learn new lessons in collaboration with our partners, including the bush and obama administrations. it has not always been easy, but we kept our eye on the goal of getting people adequately covered. as governor patrick has remarked, we learned early that .ealth care is not a website we support the affordable care act because it embodies the principles of our massachusetts reforms and because it gives our state new tools to sustain and expand on our success. we know that it is already helping to put affordable care -- affordable coverage and care in the hands of americans across the country. massachusetts itself, since eac took full effect, over 200,000 more people have signed up for subsidized coverage. almost 30,000 people have purchased unsubsidized aca compliant plans through our

health connector. the health connector is also offering dental policies for the first time with over 2300 plans purchased to date by individual shoppers. you and so, while implementing the aca, we have experienced website challenges. these are mainly due to failures of our system integrator. with our new team in place, we are on a path to go live with the functional and reliable exchange website for the next open enrollment. challenges impeded our progress in achieving our full vision for the website by october 1 of last year. on that account, we decided to deploy only parts of the new system on that date. given these constraints, and with many people encountering errors and wait times, even with the parts that were deployed, we have developed alternative pathways to support enrollment. have enabled us to protect and expand coverage

with strong cooperation from our health insurers, providers, and consumer advocates. many residents of the commonwealth of experience difficulties with some of these processes, and we fully share their frustration. we have not allowed website problems to prevent us from meeting the ultimate goal of the aca, getting people covered so that they can enjoy health and economic security. though the website challenges are mainly the result of an underperforming i.t. vendor, we are holding ourselves accountable for fixing them, and we are making progress. system,stabilized our eliminating a backlog of paper, and stanched -- and substantially reduced cost and away times. we continue to maintain strong data security protocol that meets federal standards, and has cap personal information safe from data breaches. we have a detailed plan to open up new parts of the website only when we know they are ready for

users. in the meantime, through the creativity and flexibility of our team, people are getting covered. we have an unwavering commitment to ensuring quality, affordable health care for the people of massachusetts. it is a commitment that kept us moving forward through both the peaks and valleys of state reforms. it is a commitment to keeps us moving forward today as we strive to realize the aca's full potential for improving care and improving lives. thanks for your time. i look forward to your questions. >> thank you, ms. yang. mr. lee. >> good morning. , and you to chairman issa ranking members spear, cartwright and cummings. i'm glad to share with you our early implementation lessons in california in launching the

verbal care act. think it is important that we acrossited in california a whole range of constituents whether they be health care providers, workers, and a range of political positions. we are seeing the fruits of that effort today. california is one of 15 state-based exchanges third when we started, we looked at the data and said somewhere around 4 million californians could benefit from federal support, or fromxtended medi-cal cover california. any very few short years we have gone from being a 10 person organization to one of over 1000 people. we are a very very fast startup that is working to change history. how is it going so far? you have heard some of the numbers. 1.2 million californians now have coverage rectally through

cover california. million have coverage through medi-cal. this is close to 4 million californians. every single one of them went through cover -- covered ca.com. many of them work processed by humans. i can't stress enough, exchanges are about more than websites. i want to talk a little more about what they are about. but it also want to underscore that when we think about state-based exchanges, there are five exchanges out there that as of a month ago had already covered more than 30% of those eligible. those states include california, rhode island, vermont, washington and connecticut. other states did a very good job as well. kentucky, new york. as of three days ago, california had brought coverage to more than 50% of those eligible in the exchange. that is a remarkable number when

you think about what it takes to grow a brand-new, start program. tummy tuck briefly about what it takes to make a state-based exchange work. i would note that when we say work, we do not mean perfect. it is been rocky, it has been bumpy, and it will continue to be rocky and bumpy. this is historic. this is a very big change to the health-care system. overall, we feel good about the progress we're making. it takes three things foreign exchange to work. affordable plans delivering health care. marketing and outreach and effective enrollment. the area of affordable care, cover california has been an active purchaser. 33 health plans expressed interest in our marketplace. we selected 11. cover california specifically went through a process of standardizing our benefits to give consumers the tools to make choices and understand what they were choosing between other plans. we ended up getting very

competitive rates and are optimistic those rates will stay competitive and affordable. right out of the gate, we gave him -- we give consumers information to choose. second element of success is effective marketing and outreach. cover california has been reaching out to californians across demographic sections through tv and radio and newspapers. overimportantly, through 250 groups anchored in local communities doing outreach to inform people about the importance of enrolling in cover california. finally, effective enrollment. than an i.t. system. it is a complex i.t. system. has toent system we have connect with more than 11 different major databases, including the federal government , but also the state system. we ever system up and running.

it has served more than 12 million unique visitors. it is working well, but more importantly, the over 25,000 californians, these are county workers, these a licensed insurance agents, these are certified enrollment counselors heard every community of the state has been helping literally millions of californians get enrolled. that is why we think it is largely working in california because californians have stepped up. they stepped up to talk to the neighbors, members of the churches, members of the schools, to get them covered. would you have lessons learned we can share their dozer in my written testimony and i look forward to responding to questions from the committee. >> mr. leitz. >> chairman jordan, trevor lankford, chairman issa. ranking members and members of the oversight and reform committee. good morning. thank you for inviting me to come here today to talk about

minnesota's expenses in establishing our online health exchange. i want to stop it telling you about two people who live in minneapolis. cory is a teacher. for years the family had health insurance through his job. but over time, the families out-of-pocket costs grew. after welcoming their third son irving into the family, they had to choose between paying the mortgage or paying their health bills. whenminnsure opened, the boys qualified with no deductible. she was able to call phifer plan for less than $200. she was thrilled. say the am proud to company -- the system is secure and successful. because of our efforts, his thely are just a few of hundred 70,000 people in minnesota who have access to affordable coverage because of

e. overre -- minnsur 88,000 have enrolled in medicaid , over 34,000 have enrolled in minnesota care. in other states these individuals are enrollees would be in private plans are tax credits. the remaining four 7000 have enrolled in private, qualified health care plans. it is also worth noting that in minnesota, 95% of people enrolled in health coverage have paid for it. as we continue to process applications, we expect our numbers to grow even higher. it isn't news to this committee that the rollout was rocky. our initial launch in october was plagued by software errors and technical glitches. i was appointed interim chief executive officer on december 18 after the resignation of the first executive director. in recognition that more must be

done to ensure minnesotans have access to a functioning website and comprehensive affordable health coverage, i took immediate action. in january, i commissioned an interview of our exchange by active health. they recommended we make a number of enhancements to customer experience to help boost enrollment and to improve customer satisfaction. working in close partnership with our vendors, we were able to stabilize our system. our eligibility software is now operating within over 99% success rate compared to 70% in mid-december. our online marketplace has been stable now to process more than 2000 enrollments today. december software problems caused are call-center wait times to collect to over an hour, and up to 70% of consumers were simply giving up before they could be helped. we resolve this issue by more than doubling the size of our call-center and bringing stability to our software system . average wait times for the month of march were genetically less. moving forward, we are planning our budgets for 2015.

i am happy to say that next year's calendar your budget is balanced and does not seek additional state or federal and to operatem minnsure. a longer term, we are in the process of selecting a lead vendor. make theis to not just 2015 open and roman. a better experience for consumers, but have a conference of roadmap for continuous and enhancing the exchange for consumers in the open enrollment periods to come. i had the opportunity to meet kate needleman and her son irving recently. she told me that having affordable insurance has opened the doors for her family. health reform is indeed more than a website. it is about getting real people and families into afforded -- into affordable health coverage. thank you for the opportunity to testify and i look forward to your questions. >> thank you, mr. leitz.

>> thank you very much. mr. chairman, ranking members and other members of the and government reform committee. thank you for allowing me to speak about organs efforts. i recently retired as chief executive officer of providence health and service in the oregon region. throughout my career i have had direct experience with the challenges of expanding access to quality health care while managing costs. last year, the governor asked me to step in to help navigate the challenges around the launch of the state's health care exchange. currently i service the president of the oregon health leadership council and fallen cherry adviser to the governor and dr. bruce goldberg, acting director of cover oregon for whom i am appearing today because he recently suffered a broken leg. inle the launch of the aca oregon has been different than we hoped, over 300,000 individuals have enrolled in health insurance plans since october 1.

governor kitzhaber for released an independent assessment of cover oregon produced by the company's first data. requestrt, which i also to be included in today's record, was based on 67 interviews with stakeholders in cover oregon governor -- and health employees and legislators from both sides of the aisle. a review of more than 3200 documents. it assesses the technical problem -- problems with the enrollment and rollout of our health exchange website. members of the committee, what you to know that in response to first data signings, the governor announced numerous steps he is taken or will take to improve performance, accountability, and oversight. these steps are detailed in my written testimony, which also has been shared with you. we do know that some things have worked very well. we have used our technology investment to enroll more than 300,000 oregonians in health care coverage since october thanks to cover oregon and the oregon health authority. we continue to be proud of the

work we have done to improve oregonians's lives and we know that that will endure. i welcome your questions and the opportunity to discuss with you oregon's ongoing health-care transformation work, as well as the progress to secure public trust and make good on cover oregon's promise to enroll more oregonians in affordable, high-quality health insurance. thank you very much. >> thank you mr. van pelt. we will now turn to questioning. let's start with a gentleman, vice chair committee, the gel men from arizona. >> mr. leitz, i want to start off with you. we talked about the rocky start for your exchange, earlier. my first question is, and the three months leading up to the botched website rollout, ebbers of the websites receive bonuses for the work they did on the exchange, is that accurate? it is. >> why would the state pay people a total of $27,000 for a botched website?

usually bonuses go to exceptional work. botched doesn't seem to mean exceptional. >> congressman, those bonuses were approved in the previous executive director. >> i'm glad you said that. have you done anything to call back those bonuses? >> congressman, not today, no. >> interesting. in january, united health optimum division released a report stating that the exchanges current program management structure and process is nonexistent. management and leadership decision-making is in crisis mode. that report also concluded that the exchange might be so badly need to be it might scrapped. you're quoted as saying we do intend to take action, in fact i thought i heard you speak about this in your comments. a result ofon as the report. have you fired anyone in the botchedvernment for the

launch and the massive loss of tax-free dollars? have you fired anybody? actions have been taken. >> purses have been fired? persons have been fired? >> you did make some changes? >> yes, congressman. >> last week, the los angeles times wrote about how the exchange was referred to as a blackhole. he was referencing consumer applications that were frozen or vanished. did you ever find with is that -- was vanished applications when? >> congressman, yes we did. >> your total accounting? >> yes, were able to identify any applications at a previous the been the system that we were not able to track during the fall rollout or a >> we provide that to the committee?

>> out to folks back in minnesota don't know that story. >> congressman, we will be happy to provide an accounting of those individuals very >> thank you very much. >> will try to go fairly quickly. how may people did you have to hard to process paper applications because of the problems with your exchange website? will start with you, dr. matsuda. >> recently, we increased staffing to handle the backlog that are mentioned in my by total of 80 people. >> how much of the cost? >> i will have to supplement that for the record. >> we like to know how that was paid for, too. >> about 200 more people to the car center -- through the call center. >> house paid for? >> through our grants under the usual rules. >> to the federal government? >> federal and state governments. >> ms. yang? >> we have leveraged a workforce

of about 300 individuals through an intensive work. in the past four weeks. we are happy to report that the paper application backlog has been eliminated. >> how much to the cost? >> i do not know the precise number. we can get back to on that. >> hausa paid for, mr. lee? >> we have a customer service staff that we expanded by about 250 people that do both phone and mailable. a preprocessing work with county partners throughout the state of california. additionally did some extra contracting with vendors to get through the paper backlog. i'm not sure the number, i will happily follow up with you in a number. it was actually paid for out of our federal establishment grants. >> mr. leitz? 50 individualsy were added. we paid for that of the establishment grant. -- out of the establishment

grant. >> oregon leveraged a workforce from state agencies. we will have to get back to on the precise number and payment source. >> i will come back to you quickly, mr. van pelt. when did the state first alert cms at the exchange was not going to be operational? you are all in the first data assessment. i would have to refer back to that report. >> you can address? >> i was called in shortly after this wasnor determined not working or going to work, and that being the case, my time up the papertting application process and steps going forward. they had very poor oversight. her predecessors were talking with regards to the lackluster questions and how they were unimpressive answers.