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.

i would like a report on that. to do that.e happy >> the gentlelady is recognized. >> thank you, and thank you for your outstanding testimony. i would like to start by quoting the speaker when he referenced the rollout as her rent is in the launch was anything but smooth. representative -- the rollout her rent this -- horren dous and the launch was anything but smooth. of medicare part d, which is seen as full of

problem's, it was all about fixing it because it was in president bush's administration. i would like to see the same frank lists -- frankness or willingness to fix the problem now that it is in president obama's administration and we are undertaking a much larger effort. good is that you have fixed the problem. i have trouble figuring out whether or not you have met your or will meet your goals. >> we are going to meet our goals. our goal for the short-term is to improve our functionality and

the usability of our system. >> they have exceeded enrollment. >> as you have heard in my testimony, we are proud of the fact we are achieving the fundamental goal to expand on top of a solid ground. our work is not done, but we are on the solid path. >> we have never had specific goals. are unsure. we still have work to do. >> minnesota is solidly on track, and we feel good about the future of what's ahead of us. oregon is on its way to achieving its enrollment goal and feels confident in the steps we have taken to improve our technology. >> california is a great sunshine story, and we are proud of that.

would you tell us what some of the reason for the success was? >> i would be happy to. some of these are highlighted in my testimony. i would highlight briefly five things. one, leadership focused on consumers. we put politics aside and said let this work for consumers. we have very effective collaboration between state agencies, the medi-cal agency which i partner with but also ,ith the regulatory agencies the department of insurance. this has changed the entire insurance market. it's not just about exchanges. .t's about changing this has worked on the ground. the partnership collaboration has been vital. we have had bumps along the way.

we have adjusted our course and will continue to do that. this is the beginning of a long road. we look forward to learning as we move forward. implement going to the connecticut i.t. solution. i don't know how other states are, but they seem to have made it work very well. what do you think the key is to the connecticut system? >> there are several things very attractive about the connecticut solution. first it's a very elegant design for consumers and consumer assistance workers. it also has good functionality for insurance workers. it uses some of the software pieces we already have licenses to and runs on the same

computers we have already purchased. there is a lot of overlap that allows us to reuse some of the initial investments. those are some of the reasons. we were able to demonstrate it recently. >> we go to the gentleman from michigan. >> thank you for holding this hearing to look at a program being panned as an exceptional opportunity to carry on an approach that takes freedom and opportunity, and i think a great health care continuation for our because we weren't able to deal with the cost. let me ask a question. july 2013 auditor's report

called the cover california plan andnew high-risk entity, that was the auditor's statement. the report stated that under all enrollment scenarios cover california will not have sufficient revenue to cover operating costs in fiscal year 2015-2016. specifically it said it would be losing $73 million. used old -- you told state in septemberials that the long-term stability of the organization is its greatest weakness. what did you mean by that? a couple things. we are very appreciative to receive federal funding to get .oing we will be running 100% on our own steam. we cannot go to the state of california for general funds, so making sure we are well managed

is a critical, important factor for being an ongoing organization. ,he auditor's report also noted and are budgeting has plan to have a couple years of deficit spending. >> you still believe you will be? >> absolutely. we are in the process of doing our revised budget. able to adjust every year our operations on the beenue and expense side to fiscally well-managed for california. >> let me follow up. the state auditor's report noted generally would provide the revenue required exchange, but you shut down the market earlier this year.

we didn't. >> you didn't shut it down? >> we have over 600 businesses. we turned off the online enrollment functionality, which is generally not used, but that's generally not how small businesses and role anyway. anyway.l >> you don't plan a taxpayer bailout in the future. >> state law in california ought to be clear. we cannot be dependent on general fund money. >> federal taxpayer bailout as well? expect any more federal support or a bailout? i will hold you to that. i hope that's the case. >> we both do. let me ask several questions.

let me start with dr. sharp steam. how much has been paid to develop an operating exchange. your microphone please. far our exchange has spent about 120 $9 million. that is what has been paid in total? grants in total are about $180 million. let me get the exact number. >> you can be prepared for the question. >> it's about $180 million in grants. that.en't spent all >> that is what has been paid to you thus far? >> those are the federal grants we have been awarded.

>> what are the contractors, and how long have they been paid? but there is a long list. >> where they bid competitively or full source? fax we did competitive procurement. >> any other contracts. or squat in a >> there were a couple. -- or sole source? >> there were a couple. >> how would you rate them? we let go our contractor. we were disappointed with some of the software work i mentioned before. it was sold to us that out-of-the-box it would be able to do things it could not do out-of-the-box. theound out with some of same problems minnesota has. >> for the record if i could get that would to us clearly state whether you would seek further federal funds to fix your mistakes.

with that my time has expired. >> thank you, and thank you to the witnesses. for your tireless efforts to get people to sign up for affordable health care. i come from a state that did not start its own exchange -- , which i think the failure to do that in pennsylvania was in abdication of responsibility of the governor on behalf of the citizens. seen 12 hospitals close. i have seen enrollment as a way to strengthen our hospital system, and that includes pennsylvania. governor corbett decision to decline to establish an exchange is in a peculiar way.

it was first celebrated by .mericans for prosperity 20 minutes later the commonwealth of pennsylvania itself made the same announcement in a press release. the timing of that announcement raised questions as to how the koch brothers influenced the decision in the first phase. place.t even more disappointing was the decision to expand medicaid for more than 520,000 pennsylvanians who could be covered. the federal government would have eight 100% of those cost for the first rigorous, facing it down by 2020. it down by 2020. someone confided to me that if pennsylvania does not accept medicaid expansion, he is going to have to close one of his two hospitals.

that is how important this is. pennsylvaniaett in submitted a waiver proposal that premiums and limits to medicaid recipients. ofs will be hundreds thousands of low income residents without health care coverage in 2014 in pennsylvania. unconscionable to me. it's time to quit playing politics with people's lives, with people's health. urge governor corbett to reconsider. the citizens we represent are citizens all of your

have made the decision to accept medicaid expansion. california has enrolled more than 1.5 million new applicants and to medicaid since october 1. am i correct? >> that's correct. >> can you tell the committee what the expansion means for those california residents and for the state as a whole? >> i appreciate the question. we have been in close partnership. people don't know what they are eligible for. we have had thousands of people when they in tears have affordable coverage provided to them. i have talked to many of them myself, and the people on the front lines relate these stories constantly. >> what about you? can you describe the impact of

medicaid expansion on your ts in your state? >> we know about 60% of our populationopular -- is eligible, so we know we are reaching the uninsured by enrolling them in medicaid. what that has allowed them to do is access services, often for the first time, to get preventive screenings, to care for issues they might have had not cared for in the past. it has been an important thing as well as for the caregivers. >> thank you. what about you, same question? >> the medicaid expansion is extremely important in maryland. we have done an analysis there are well over $150 million in uncompensated care reductions as a result of the expansion, and it matters a great deal. i met one mom who says her aughter got -- was telling me

story about a sick baby who needed a heart surgery that medicaid paid for, and out came the daughter to give me a hug. they are real people in maryland. i see the medicaid expansion changes lives. >> the gentleman from florida is >> you have been called worse. chairman.to the i appreciate this hearing. causingear this law is premiums to decline sharply for americans, i don't know what to after having dealt with so many disappointed constituents in my district. the question is who are you going to believe, those who are defending this law or your own eyes?

willnk the american people make their own determination. has ledhearing this to the expansion of coverage for 3 million adults, but people have debunked that and said it is probably less than one million. some of the numbers back and forth are fine, but the central ifmise for this law was that you like your arrangements, this law would not negatively affect you, and it would benefit you at lower cost. central promise has been broken. if people like their plan they may not be able to keep it. i don't have any constituent who .as come to me we don't talk about the increase in deductibles. people are paying higher premiums and seeing their

deductibles, up. people are paying way more on premiums than they used to. you have all of those things which we were told were not going to happen, but then we see a lot of people have seen their existing arrangement undermined or changed in a way they would not have chosen to do it. we have constantly said everyone now has health insurance, but if you look, when the law initially passed, they said it would be 37% of americans who are uninsured would be covered. then they said it is going to be closer to 40% of the uninsured by this point in 2014 and the actual number is 12.5%, and that is not just including these exchanges. that's including dedicated expansion and the age 26 rule. 12.5% of the uninsured that have at a great cost.

we are seeing the amount of money that has gone into creating these exchanges. seeing people on medicare advantage. it hasn't even produced what they said in terms of expanding coverage. i think that is something that has made a lot of folks frustrated when they see numbers like that. i have a couple of quick questions. where a news report couple had signed up for a plan, and then they got a voter registration card sent to them that had the party already checked. are you familiar with that report? >> i am. >> how did it come or there would be something that would be pre-checked. is that something you have control over, or is the election office sending this separately from cover california? >> every voter registration form

at cover california has been designated a national voter registration agency, so it's a requirement under law that we send these out in california. every voter registration form is provided by the secretary of state's office. this is something we report, and it's being investigated. >> thank you. i also read another report about whether they are advertising to people in the country unlawfully. i don't believe they are lawfully allowed to get obamacare subsidies. how are you approaching that? get folks who to don't have legal status to get signed up on cover california? >> absolutely not. we are trying to communicate clearly how a family who has mixed status -- there are many who might have one member of the family who is not a documented resident and another family member who is. we want to make sure those who are eligible for coverage get coverage. it clearly indicates the rules on how a family should come

forward. we greatly appreciate of the guidance from the federal government to make it clear that the guidance provided is only used not to discourage individuals as families coming forward to get coverage if they would we -- they would be used.d that would be >> if someone could not get status that would mean -- >> absolutely not. fax any cancellations has oregon had on the individual market -- >> how many cancellations has oregon had on an individual market? >> i don't know. >>, and people have enrolled via the individual market in oregon as of april 1? approximately 65,000, and another 140,000 in medicaid or oregon health plan. >> of the 140,000 medicaid, do you know how many would be

eligible for medicaid anyway? >> approximately 100,000. >> it seems to me there were more canceled and have signed up in the individual market, and if you were going to control the medicaid numbers a lot of states have seen increases in states that didn't even expand medicaid. i think it's important we are able to determine those. i am out of time, so i will ield back. >> the ranking member of the full committee, the gentleman from maryland. i believe the gentlelady from new mexico is recognized. >> thank you, and i also andeciate the panel today spent some time working with our state legislature and our to enactovernor

legislation that got passed by .ur legislature we had to pass it three years, three times in order for new mexico to get started, so you are pointing out trials and tribulations. one thing we haven't discussed is that many state waited until the last minute, and that exacerbated the issues you have identified today. i am interested in some of the education and outreach efforts and would love to have each of you talk to me a little bit going forward, targeting those folks that are still uninsured, really clarifying these numbers, looking at folks and businesses and those trends, working with , if navigators and brokers each of you would talk to me a little about moving forward. >> our outreach program we have

of federalb grants funding to about 32 nonprofit organizations on all the those grantswith organizations are hiring people to go into the community to work with people from many different cultures and different language groups to work with them face to face to help them understand health insurance and then the affordable care act, and if they are interested in looking into applying, they will assist them with going to our application process for enrollment. we work with more than 2000 and insurance brokers. in addition we have an entity program where there are six connector,ch with a each of these working with local agencies. when i was way out in western maryland i was meeting for another reason with a group that

is the sole mission to help people get health care. for many years they work with the medical community. they said, we are part of the coalition that got funded, so we have some great organizations across the state. it's one reason we have been able to hit our goals despite the i.t. problem. >> i think that is important. -- i appreciate the reference to your partners. tell me what you would do differently going forward. some states are still really struggling. we could do a lot better in new mexico. although we did a good job we could do a much better job for example in medicaid out reach. >> i appreciate this question because one thing i can say based on massachusetts experience of the last eight years, outreach and education is one of the most critical efforts. it is one of the most important outreach area.

particularly the lowest income is hardest to read. if you look at massachusetts reform records we have 97% remaining are primarily low income, and we are very proud to see the fact that we were able to break in 200,000 new people into subsidized coverage, and that is a major step forward relative to where we were. we have a lot of learning still to do. to it, but it's going to get harder and harder. the people who are not insured often have never had insurance. believe it could be affordable. that's a core outreach message we have done with both advertising and also on the ground. the other thing we are continuing to develop, this is complex stuff, and having person to person support in english --

>> i have only got 45 seconds left. we know that eight out of 10 hispanics are likely eligible for one of the medicaid programs or coverage, yet we have half of the hispanic population is not going to be insured. steps. we have too many >> there was a very big and important latino community. 18% were latino. have doubled the rate of ensuring latinos. it takes education. >> if the chairman will allow we will do a quick answer. >> we have certainly seen the

importance of working with agents and brokers on the ground. they are with every community. they know the community is very well. the other area we have been focusing on is working with communities, helping them understand the importance of coverage and working in their light which is. >> thank you very much. similar to other states working with community partners to help and walking out citizens step-by-step through the process. >> i really appreciate all that. i am very grateful for those responses. i would love for everyone to consider, maybe at a future hearing. in my state i went to several different enrollments, and they and this notion of

anding for appointments having it more in depth in depth than going to an appointment with a sister -- we lost 50% of the folks in that line of touches. i think that is too much. thank you, chairman. earlier, you received 180 million in taxpayer grant dollars in the state of maryland. >> yes. >> you have spent approximately -- 120rds of that million? spent 100.we have >> you had to hire 200 more call centers? in

but that's correct. >> you said the state of maryland is meeting our goals. i think a lot of people disagree with that. >> i was referring to the enrollment goal. i would agree we don't meet our with regards to the website. >> my understanding is that the enrollment target number was 150,000 for the state of maryland, and you have enrolled 60,000 people. approximately 260,000. for the individual markman we assessment,idual and they estimated around

75,000. >> i thought you said the enrollment number was 150,000? >> no. >> we have a document that says that. >> if that's the case i haven't seen it. >> where is the 75,000 coming ?rom >> it comes from the university of maryland in baltimore county. we could provide a letter that explains that. >> that your target goal? >> our goal was for a qualified health plan, but insofar as how we are doing in terms of health plan enrollment -- >> our understanding is you took what hundred 80 million of taxpayer dollars, the federal agency involved in implementing, and they said the enrollment should be 150.

you can take the money but you get someone independent to tell you what your goal really is. what was that number given to you? >> that was the estimate given. it was a revision of a report they did in the last couple months. >> what was the initial number? was 150nitial number thousand. >> imagine that. the number i just said. when did you get the revision? you are close to that, and you get a revision. how convenient. suddenly we are close. it is bringing the standard down. >> you can look at the letter they gave, but i don't consider -- toid to be indivisible

be invisible. >> suddenly when you are not coming close the standard gets revised by some independent agency marilyn goes to to get the number it likes. only one who thinks you are doing the job. you have a democratic congressman from your state. i have four letters from congressman john delaney from the state of maryland, where he says this is such a mess, we encourage you to switch to the federal exchange. it's not republicans sending the message. the problems all associated with the federal exchange you have a democratic congressman from the state of maryland saying you are such a mess we should tag this and go to federal chains. >> i don't disagree we had a major i.t. problem.

goal. haven't hit your be 150. supposed to that is markedly short from your goal. >> that was an estimate, not a goal. it was in error. when did you let the federal government know you were going to come far short of this 150,000 number? did you have to give periodic reports of where it would be? >> we have been working closely with the federal government the whole time, so we have been providing weekly public updates on where our enrollment is. >> let me ask a couple

questions. i am over my time. in your statee lost insurance because of the affordable care act? >> i think very few. there weren't that many cancellations. there were notices of nonrenewal. the carrier allowed them to renew for 12 months if they wanted to. reports,ing to our individuals in maryland were going to lose their insurance because of the affordable care act, and what you are telling me is your revised goal is approximately the same number. 75,000. your revised goal of people you are going to sign up is we are going to sign up the people who were kicked off of the affordable care act? >> the problem is there is also a market outside the exchange.

we are going to see it in and out of the exchange including the people who renewed the policy to be far more than 2013. you have probably as many people outside the exchange as in the exchange, plus you have people who renewed early and are still in those plans, so our carriers predict significantly more enrollment. >> you may predict that. 73,000 marylanders are going to be kicked off their plan because of the affordable care act, and you are telling me the goal you were supposed to meet by april 1 was only 75,000. >> you are comparing apples and oranges. >> i am comparing people who got kicked off because of this law and the number you said you were going to sign up because of the exchange, which is roughly half of what the team gave you. >> i think apples and apples would be the size of the individual market before and after.

people had coverage before versus after. we are seeing not only the exchange enrollment, the outside exchange enrollment, which is going to be at least that, but the fact that people could and roll early. >> i think you are leaving out the fact that your calculation is those who were kicked off. they were kicked off the plan. >> they were in the individual market report. apples to apples would be you were in the individual market before. you are in the individual market after. saying isber you are your goal, 75,000, you have lots of people kicked off. you had people who didn't have insurance before you were -- sign up,shine up and we are back to the original point. they said here is $180,000. your goal gets revised in the last few months down to 75, and

we have a congressman from your own state in the other party who said this is such a mess you should have switched to the federal exchange a long time ago. back in january he was calling for you to switch. that investigated possibility. there is no disagreement about whether our website works like we wanted. it didn't. the president said in late september -- he gave a speech in maryland days before the launch promising obama care will be "smoother in places like maryland where governors are looking to implement it rather than fight it. what are you saying that would give the president the assurance this was going to work great when it didn't work well? how can the president make that

statement where we have a democrat member of congress saying this is such a mess, go to the federal exchange? what was he basing that on? were you saying everything is going to be fine? was well known there were going to be glitches. the federal government was communicating that. >> the president didn't get the memo. he just said it would be smoother that they were working to implement this rather than to fight it. >> we were surprised by the scale of problems after april 1. >> i want to go to this slide. a whistleblower gave us this. this was a report. we will give this to you. this is difficult to read, but we think this is important.

the red our is problems associated with significant delay or risk. this was a report given to you back in february, 2013. it shows you knew a year ago there were going to be big problems, and you didn't communicate that with the federal government who is giving tax dollars?on in >> the federal government received our report. >> the president had access to this report before he made that statement just days before the launch of the affordable care act? >> we are communicating with the agency we work with. i would say subsequent to that we were able to make progress. toof course you were going make progress. when it is this bad you have no lace to go but up.

>> in june of 2013 we passed an important test. i think it probably gave us more optimism than was deserved at the time. >> i am way over. i appreciate the chairman's indulgence. >> i would like to have my 12 minutes, just like mr. jordan. let me go to you. to mr. jordan. i wonder how many people he helped and roll under the affordable care act. i know it has been difficult. you know, the last three saturdays i spent all day were tryingle who

-- i sponsored to events all day to get people and rolled under and therdable care act, glad that ifd i'm the website had a problem that we wouldn't throw our hands and say throw everything out. i stood with people who waited all day to enroll. i don't know what you say to people when they said this is the first time i have been able to get insurance in years because i had a brush with rest

cancer. i don't know what you would say to this person. don't apply to the affordable care act when it is the law? i'm not sure. we can nitpick and go ring go backhe rosie, but i to what i said in the beginning. this is not just about a website . as i understand it, the figures were adjusted. to agoing to refer february 2013 article. i'm just going to read from it. issaid the new number 70,000. at thet was corrected university of maryland and baltimore county, a nonpartisan health research organization its error weeks

ago and sent the letter dated to the health secretary of the exchange board. was a footnote to one chart that included open enrollment beginning next fall for 2013 coverage. does that refresh your recollection? do you have that letter? >> i have that letter here. >> did you go seeking that? how did that work? what happened? problem. you have a people have problems every day. they don't just throw up their hands and get upset and say, i cannot do it. they find a way to get it done.

sometimes we make adjustments. we make adjustments every day of our life. review the reason i have that attitude is my mom and dad had a second grade education. sharecropperser and worked like slaves. we believe in the can-do attitude. i am hoping we believe in the can-do attitude in maryland. would you explain that to me? that mr. jordan made such a big deal out of this? a more reasonable estimate of combined enrollment would be 100 60,000 including approximately 70,000 in the -- 160000 including

approximately 70,000 in the exchange. people said, now you're probably going to lower that goal, but we didn't, even though we were way below 200,000 at that point. the governor wanted us to shoot for 260,000. even though the overall estimate has been lowered by the people we hired to do an independent analysis, we are not changing our goal. >> iund up exceeding it. was all day trying to help people get insurance. to speak with the organizers. these are people not making a lot of money but giving their blood, sweat, and tears because they wanted to touch somebody's future and change the trajectory of bed. one of the things that was very

interesting -- we had so many people trying to get health care , and correct me if i am wrong -- that we had to basically put the people in the queue and say, there are so many we can't even get to the mall. we are going to have to get back to you in the week. is that what is happening? -- we can't even get to them all. >> we expect the numbers to be higher than they are now. right now our call center is getting calls from people who were not able to enroll in march. it could be several thousand more. to suppress 300,000 against the goal of 260,000 in the face of incredible i.t. challenges. >> the can-do attitude.

let's talk a little bit more about the contractors. when i served as the ranking ofber of the subcommittee the transportation committee, we had a situation where we had contractors that were building boats for the federal government , and the boats didn't float literally. someimes i think contractors have moved to a culture of mediocrity. it's so very unfortunate. road,continue down that we will be in a situation where i think about a trip i made to israel years ago, and there was a saying, if we are not better we will not be.

better, we will not be. can you talk about the contractual situation here, what happened? you said you had some bad situations that happened, and could we have foreseen some of that? think the major in retrospect -- although it was hard to know at the time, the states based the decision on whether it was better to build a computer system from scratch or to rely on existing products, and we thought it would be less risky to rely on existing products. that had ana system ibm software for eligibility, and it was portrayed as out of the box being able to work. we would just be able to configure it very easily. this has been a big point of discussion in some of our state

discussions. we have shared with the state parts of the bid and theated to this, software did not work as advertised or even come close. it created a whole range of problems we had not anticipated. more -- the did states that did more of the building themselves were able to , particularly in california and new york, and in the end because we can reuse a lot of the software and hardware, we're going to go with particular solutions in connecticut. >> does the state of maryland plan on recouping some paid for the development? >> we do intend to seek a

recoupment of the funds. absolutely. >> now you are going with the lawyer. is that right? >> correct. .- with lloyd what are the plans? >> the plan is to take the system developed in connecticut and has been successful and move it into maryland with minimal plug itand basically in. you have to build the interfaces and change certain elements of the website and use it in maryland for the fall open enrollment session. who is going to fund that? how will maryland fund this? >> we will be putting our plan in a corrective action plan for the federal government, and we will be seeking to have the same partnership funding we have had so far.

say, and i said it in your introduction. forow what you have done maryland and what you have done for baltimore, and i know the dedication of you and i'm sure all the other people sitting there. when we had medicare part d, we had problems. and look atback some of the comments made back we had folks who said on both sides of the aisle, we have got a problem. we are going to work through it. we are going to get there, and we got there. now you don't even hear about glitches. it's like ancient history. i can recall medicare.

we held the same kind of events. went toof the congress all kinds of meetings, town halls. and you voted for it, but it was the law. we wanted to make sure that it worked. i hear all of this, and i do wonder. i really wonder, and i know there are problems with the affordable care act. nobody has denied that. i wonder what it would be like if we could join in together to address those issues. say, whener used to you're dead, you are gone. so what we are talking about is trying to save people's lives. we are trying to make sure we

keep people healthy. we want to make sure we give people a piece of mine. .- of mind i want that for my colleagues constituents, and i wanted for mine. i think we have one life to live. this is no dress rehearsal, and this is that life. about theught to be business of trying to help each other live the very best life we can, and i will yield back on hat. >> will you yield to mr. jordan for just a moment? >> it's really simple. what happened is the federal government enters into a contract with the state of maryland. the initial terms were 150000 androle he is in the market 180 million dollars going to the state of maryland. they were going to go after some of the contracts they felt didn't will fill their end of the deed ideal -- end of the

deal. 180 million dollars if you sign up 150,000 people, and we say, we made a mistake emma we're only giving 75. the plan is simple. are you going to return some of the money? >> inc. you, and i will consider that. having looked at this document i am not exactly sure who this document was shared with. >> i am going with you. a number you gave was 140,000 people. >> i was referring to the document handed to me. i wanted to be clear. i thought it was a different document. we will follow all the applicable laws and to the extent we are able to recoup funding i hope it will be you refunded. >> are you going to return federal taxpayer dollars?

150,000 enrollees, you get 180 million dollars. you didn't meet that. you changed it. are you going to return all the money? >> we are going to follow up with double laws. >> you're going to go after those who you feel didn't fulfill their part of the contract related to the functionality of the website. >> that's correct. >> it's ok to go after them but the taxpayers don't get their money. >> i think the taxpayers should get back their money. >> unanimous consent for one minute. i noticed mr. lee was shaking his head. why are you shaking your head? did you have something you wanted to say? >> the document prepared was withred not as a document us, but they pulled from a range

of things, and i will note the california estimate in the ofument and towards the end open enrollment, i thought that was the goal for open enrollment. we had independent estimates developed. we have talked about those. enrollment,en high-end estimate was 800,000. at the end of two rounds it was 1.2 million. athink you are alluding to september internal memo that was never part of our contract, but they got the numbers wrong. >> i didn't say anything about california. i was focused on maryland. he said it was revised down to 73. i would ask unanimous consent to look at the letter from congressman john delaney suggesting they switch to federal. >> i would ask unanimous consent

that the article dated february 23, 2014 at the hilltop to the interimr executive director of the benefit exchange, dated february 31st, 2014 be entered into the record. >> without objection. >> thank you, mr. chairman. as a schoolteacher i thought the students there were three branches of the government. legislative, judicial, and executive. checks and balances. they should have taken my class because they keep writing checks and the constituents get the balance. i also told my constituent bills were brought to the floor, went to committee, and brought to the floor again for debate and considered passage. passed befores

congress can read and debate the bill. shame on congress for allowing this to happen. circumventede who the congressional procedures that allows billions of dollars spent and the divisions it is costing this country is inexcusable, because congress passed a bill before it was read and debated. this is shameful. it seems here, listening to all these debates, the good, the bad and the ugly, the money that was spent, and all we have is billions spent and division in this country. hearing -- well, let me say this, in congress we are the fiduciaries of the public's today, after

hearing your testimony and reading this testimony, all i see is more money wasted for failed system, coverups. that is what i anticipate. losses will be filed, and every citizen knows, somehow, something that someone is going to be swept under the rug and more money spent. how many uninsured people are in the state of california? i look forward to knowing at the -- >> to knowar the population? >> 35 million people. >> how many people in california have enrolled to the state exchange? in california

exchange products. >> 35 million people in the states and 1.2 million people signed up. well, if it was a good product, you think -- you think people would be the pastor door. of those who have enrolled in the state exchange rate paid for their insurance and those have -- 85% of those are paid a premium. >> to not many people are going -- insurance through that exchange? >> absolutely. >> thank you very much, mr. chairman. i want to ask a question of the contractors. i don't think there has been in all the hearings that we have had, enough of a focus on the contractors. congress is so busy fighting off

the affordable health care act itself. i must say that the number of is had problems. when you combine that with the problems we have in the federal exchange, it really does show that technology is overrated. shows thatit also since this has not been found just in the federal exchange, this rollout problem, this problem with technology just in the state of that state, but rather through a wide cross-section of states, that we .re dealing with a new problem we ought to approach it that way. was new to thet government, state and federal alike, it certainly looks like

what we did not anticipate, is how new it would be to these contractors. that was perhaps overrelianc faith put in the contractors. i know one of them, see gr, had its fingerprints on a number of the states as well as the federal exchange. believe that that is accidental. ask you who used cgi. record was what its with massachusetts? i see that massachusetts no longer uses cgi. those of you who used cgi, and there were several of you did, would you speak up and indicate whether you checked to see what

cgi's experience had been in doing precisely this kind of work, at least in massachusetts? >> thank you, congresswoman, for the question. first of all, let me say that they see has many components. i.t. implementation is one of them. we work with a wide range of different contractors, and some of them have been delivering excellent performance, ensuring our overall success. ini'm asking you about cgi particular. >> cgi was involved in massachusetts aca implementation, specifically with website development. we engaged them through a competitive procurement process guidelineswith applicable to us. unfortunately, cgi's performance has been disappointing. they were behind schedule in delivering a required functionality. >> did you use them from the

beginning? -- no, the health connector was engaging cgi for the first time with this contract. out your ownlled program, did you use cgi? >> no, we did not work with cgi. it was a much simplified, very different website development and we work with a local vendor. >> what led you to use cgi? >> why did we use them? we went through a competitive procurement process to identify its> what about cgi led to selection? >> it was selected through a procurement. >> everybody was selected through a procurement. >> i'm sorry. i am just turned answer why we ended up. the have experience or some other factor that made them stand out among those who theeted for -- >> it was

best vendor among the respondents. >> in what way? >> they demonstrated experience. >> in this kind of work? >> yes. used cgi.suda, you what made you use his company that had that experience across a number of states? >> i was not with the hawaii health connector time the decision was made. but my understanding is that we went through a procurement process and they had been selected for the federal exchange. >> to any of you know whether cgi had experience doing this kind of work before? did anybody else at the table you cgi? operablead experience to this experience that you engage them to do? knowledge, ms. yang and mr. matsuda?

>> as you know, aca implementation is a new project for all of us. i would not say cgi was engaged in identical projects, but in terms of comprehensive system integration, cgi -- >> mr. lee, did you consider cgi? think, as iy don't recall, cgi did, or it was not one of the finalists for us. they were a if bitter, but the folks who did the did not have direct experience. general to look at track record, cost, staff they coulded, before you endorse a selection. >> states had a heavy burden, because congress in a spite amendment, made numbers of congress and their staff go to the exchange and took them out of the federal program. it worked pretty well. kehave to go back and ma

sure they did not use cgi. we will have to look at these contractors and see what was the difference in the experience with the contractors in particular. when you're doing something entirely new, which congress has not taken in consideration, it probably that you're asking contractors to do something they have not done, either. the problem with this is, we assume that contractors do something much bigger. the big parts of the private sector. we assume that these must be sent contractors who have done, who have handled things in the country so surely they could do the health care exchange for a particular state, or for that matter for the united states. say onerman, if i could thing, this is a note for the record, that mr. desantis from graph, which he said showed, and question

witnesses, on the theory that it shows that these contractors and others, including the federal exchange, had in fact performed below cbi expectations considerably. please note for the record that a great manyd now other states, are directly responsible for that, because they have failed to allow poor and middle class and disabled people to get health expansion of the medicaid exchange. had -- iad happened, i would have no doubt that the goals would've been met. if you don't take responsibility for why there is a reduction in the uninsured americans, takes a zpah. mr. chairman.

>> in my state, we also have that. some of those individuals were covered by our ensure oklahoma program prior to that, and a loss that. part of the waiver issue was, we had to remove that as a safety net. >> chairman, that doesn't take care of those when you have an expanded medicaid. did you have expanded medicaid? >> we did not have expanded medicaid, but we did have coverage with our ensure oklahoma program. >> my remarks were limited to those who failed to expand medicaid and had no other way, obviously, of assuring them. i just asked this question of the whole panel. are in charge of your exchanges in your respective states. i will go down the line. yes or no, have you enrolled through these exchanges that you are in charge of?

yes. >> mr. sharp stain. no. i'm a state employee. >> are you enrolled through the very exchange you are in charge of enrolling others? --thursday coverage echo through state coverage. >> i need to apologize and correct a statement made earlier. mr. desantis asked about the enrollment of our qualified health plans on april 1. the correct number is 57,000. question,ct to your congressman, i am not an employee of the state. self-employed, and did not

apply for insurance to cover oregon. , and iso the question ask this because this is one of the questions that my constituents ask about the laws that we live under. so i would ask you, there is a concern i have about personally , andifiable information folks are putting information into the exchange, and the safety of that information. you know, would you personally personallyhat identifiable information is safe through your exchanges? >> what i do know since i've started in this position is that i have verified the exchange was given full authority to connect

to the federal after passing all necessary -- >> we have concerns with the federal hub as well. are sharing perhaps some concern? >> no. >> to me ask you again. we guarantee that personally identified information is safe to your change? >> i believe so, yes. recognizing that nothing is 100% safe, maryland is very safe. things i canot of happen. no known incursions. to your point, my personally identifiable information is in there. i did start an application. i put in my social security number. at no qualms about doing that. >> were you able to complete your application? i did not completed because i have coverage. i was just testing it. >> this is one of our highest priorities in terms of

protecting people's private information. we have not had a data breach. i would not be comfortable, i wouldn't be letting the exchange that herithout knowing so information was protected. >> so the safety of personal information is our top priority. we are certain the data is secure. we have had no data breaches and no incidents we know of of individual, financial or personal health information being breach in any way. >> security is a top priority for us. we do everything we possibly can to protect the information that goes in. >> we guarantee that? >> congressman, israel much a top priority and we do >>rything we possibly can -- cover oregon also meets a cms security requirements which have been validated by cms. we're not sure -- we are not

aware of any security breaches. >> i wanted to at least ask that. applicationsost and incorrect subsidies, it is not an error proof system we have. obviously. ults ande been fa failures. every story for you, mr. sharp stain. in your system in maryland, i have a staffer whose mother was given a notice by our ensure that due to the affordable care act her insurance was discontinued. she had to go into the exchange. she began a three-month long process to enroll in your exchange. that you have about 4000 applications in your state that were given incorrect subsidies or lost applications. is that about the right number?

reported a number similar to that. >> her experience is one that i know very well. your daughter and threw her telling the story. when you are talking about the first roadblock for her and filling out application was a question of for citizenship, which she could not verify, she called the health line -- he called the helpline. it is obviously helpful in all your states, as you will attest to. people have problems with the website. they have been noted. i don't have to recount the spirit in her situation, she was told to the hotline to fax her, i believe it was her driver's license and social security number, to this open fax line. she asked, do i put it to your attention? no, you just fax it to that

number. is i concerning to you that you have somebody strivers license and social security number given to some random fax number in order to proceed with the application? >> is not just a fax in the corner that people wonder by. >> i would hope not. >> it isn't. it is a fulfillment center and they have an approach to secure personal information, two. we have to verify things like whether people are able to urges coverage under the law. >> so there are folks that are privy to that fax machine, or whatever the technology is you use, privy to that? are they vetted? is there some safety and security that i can offer that there was for her information? >> yes, you can. -- >> graby for the

that for me. and enrollment broker for medicare program. they work in many states, they are a very big company that has an extremely strong policy of her tech thing -- of protecting private information. chairman, final question i have, you all have in your metrics and number of enrollees. measurement ofur the success of your respective exchanges, do you have a cost per enrollees? for instance, the state of maryland has spent about 100 -- about 100 $50 million in that range to build a website and exchange. is that right? >> so far about $129 million. >> so about 200 thousand dollars

per enrollees? >> again, we enrolled 295,000 people. it would be a lot less than that if you were too divided. if you look, from our perspective, if you look over , people inrs medicaid are not invisible. that is how to get coverage. >> they previously had coverage. i am talking about -- >> they did not, a lot of them did not. >> how many? >> the vast majority of them did not have coverage. >> these are people who have all gained coverage since january. >> this is about the market adding individual -- about the individual market getting access to insurance, is that not a fair measurement for this? >> i don't think so. it is also how people on medicaid get access to insurance. >> at that medicaid was actually an insurance program. >> the vast majority of people in maryland, single adults for

example, did not have coverage. now they have coverage up to -- >> the vast majority of adults in maryland did not have coverage? >> single adults not have coverage in maryland. even if they were very poor. chairman, i don't object to my colleague having to time, just want to make sure that equal time is granted to others. >> alleges ask one final question. if the gentleman was here to see mr. cummings, i am being a little less greedy than he was with the time. as members of congress, we are little greedy with the time. .r. cummings is coming back in i would revise that. mr. cummings is appropriately useful with this time. >> with the gentleman yield? >> i used the exact amount of , mr. --t the gentleman

>> how about this, i will yield back. i certainly appreciated. thank u so much for your generosity, mr. chairman. i certainly appreciate the kind summit colleagues. i was sure he the same kindness. >> mr. kennedy, for the record, i was not objecting. arson return to make sure that the minority was granted equal time. something out do of order. you can see it for 2.5 hours per do you like a moment just to stand and stretch? has also right here been here 2.5 hours. she's going to get the next question. we like to stand for just a moment? we would take just a very short recess just to be able to stand.

>> thank you, mr. chairman. our constituents i want to thank you. i would like to thank you and the members of this committee for their unanimous consent to allowing me to participate. mr. chair, one of the reasons why i asked to participate is because of the fact that the people of hawaii are also very concerned about the reports of the money spent on our connector

. mr. matsuda, i do want to say up front that i know you have inherited this. the connector went into effect in 2011, july specifically. you came on board in november. so to the extent that you can address on these concerns, i would appreciate it. first of all, one of the things that we must all understand is that hawaii is truly different. i know everybody says that, but hawaii is truly different areas where the only state that has the prepaid health care law that went into effect in 1974. i think that is part of the issues that we have to understand as we look at these numbers. i saw the letter sent to the governor, and it speaks to 205 million dollars going to the hawaii connector. i think they computed it out at about 44,000 per person. let's start there. mr. matsuda, $205 million was the grant that you are entitled to. how much money did the state actually use? >> as of the end of this past

calendar year, we spent 57 million out of that amount. >> is my understanding that there was a request to ask dan so you couldend, spend the remaining amount. the state has been denied that come as a correct? >> the grant cannot be used beyond this calendar year, that is correct. correct so the 205 million the $205 million, how much money do you get to continue to use? >> in addition to the $57 million that is artie been spent, we have -- we are obligated under contract and additional $50 million. we have about $100 million roughly, the federal grant money that has it to be obligated or spent. the amount, or the portion of that that is related to operations and maintenance,

versus development money, which can be extended to next year, has yet to be determined. we are working with cms to figure that out. we just got that decision recently. obviously, we want to be careful about how we use taxpayer dollars, so the development money will be used to the extent sa to improve the system to fit our unique marketplace. >> what you have testified before the state legislature is that, and i think i misread you speak earlier, is that the hawaii connector cannot self sustained. if you base it. on the amount of moneys that are coming in, in terms of premium, percentage, two percent, is that correct? >> yes that is what i testified to. >> is in line with a potential request by the -- to the hawaii state legislature for state funds of approximately 15 million per year to continue the connector. it may be less because of the number, but that was about the

amount, am i correct in that? >> actually, we are going through a process right now to figure out how we can reduces expenses substantially below $15 million. >> of the state is aware that it has to kick in, in essence to cover the continuing cost of the connector? >> yes, but you think it is important to put into context. the issue for us on the revenue side is that because of the prepaid health correct, virtually all small businesses in the state artie have insurance for their employees, so those were little incentive for them to leave a system that they have become accustomed to for almost four years. so think it is incumbent on that -- on us looking at that market this reality to try to reduce the cost of the operations of our system is much as possible. >> if we could go through this for quickly, there are said to be 100,000 total uninsured in hawaii. of that number, at least 60,000

are really going to be covered by medicaid expansion. it only number that can be enrolled is about 33,000. is that about right? that are in eligible because of it -- because of immigration status. people whoe the currently have insurance that might be able to find better quality or lower-cost insurance so the the exchange, potential on the individual marketplace is probably bigger than just the 33,000. mr. chair, if i can have a little bit of leeway. >> i will give you some of mr. connelly's time. >> thank you. esther masuda, the thing that i really wanted to get to is quite candidly a level of frustration i have had with your predecessor and whoever was there. we voted thee when aca, however, i do know that the aca has an exemption for hawaii. i think it is 1560 which is

anticipated in the original law. this is because of our prepaid health correct. i've always asked, what have you done or what does it mean. we have not gotten a response on that. i do also know that there is a movement in hawaii that we avail 1332 ofs of section aca, which is an exemption of the provision. it is supposed to be because you have a, for lack of urban description, it is called the waiver for state innovation. of course we like to think that we were the major innovators in any kind of health care. but that doesn't kick in until 2017. the question is, why haven't the state or the connector looked at this? the problem is the fact that prepaid health and the aca are not meshing well.

that is our problem. there's a reason the connector doesn't work, that is why we can't go on the federal system, because it does not take into account the uniqueness of hawaii's law. review grew with me that that is your fundamental problem? that is the reason is not working? >> that is correct, congresswoman. we are anxious to take advantage of the waiver in 2017. in fact, we wish it would occur earlier. exemption in the the law itself that exists today? it is section 1560. why haven't we availed ourselves of that? or is there a way that you can of healthsecretary and human services and say, we have got this waiver in the law and we know you probably this waivers for and 2017. buy a view not done that? >> my understanding is that it only refers to preserving the

exemption that we have for the scopeer erisa. of the aca is much bigger than that and includes other areas of the law. it is a competent legal evaluation it needs to be made to see if we can take advantage of it and the way that you are suggesting. >> we haven't done that yet? >> i do know it is under consideration by both the legislature and the state administration. we are trying to assist with that. >> thank you. mr. masuda, this is something that you inherited, but not withstanding, you can imagine how people at home are very frustrated with this. actually, they're very embarrassed her people are seeing we have all this money, and we have only enrolled less than 8000 people, but the enrollment of lesson 8000 is really a function of the existing laws that we have that are not meshing. i would appreciate it if you'd keep us apprised of that. that is always been a question that we have constantly asked, i have causally asked, is why

haven't extension in the law, not use it in an afterward we took 2017 when we are clearly an example that the provision of 1332 was intended to not have to address. we are truly innovative. would you not agree echo >> yes. >> thank you very much him and thank you mr. chair. you, mr. chairman. thank you for your courtesy to our colleague from hawaii. welcome to this fascinating panel. could, on the subject, we sort of move beyond the partisan talking points. ,f there are things to be fixed why not come together and try to fix them echo if there are things to be celebrated, why not intellectually be honest and celebrate them? ,f you go into a subject matter unrelentingly for four years in opposition, then you are

probably going to have the kind of problem we have a today's hearing heard in the majority staff memo, the hearing purpose, currentays, the enrollment numbers of obamacare are significantly lower than expected. whoops. actually, they're significantly higher than expected. they have reached the highest's number that the cbo set for them. every vice numbers after the website rollout and are at 7.1 million and counting. can anyone on the panel think of a brand-new program from scratch in less than six months that enrolled 7.1 million people? anybody? no heard that in california. -- not even in california. ms. yang. that wevidual mandate have ann romney care and

obamacare, do you know what his wellspring was? liberal democratic idea? >> sorry. . . the heritaget of foundation. it was a conservative republican idea enshrined both in the theachusetts -- because conservative republican philosophy felt correctly. therefore, they had some skin in the game and thus the individual mandate. in fact, no less a figure than republican speaker newt gingrich said that one of the reasons he opposed the clinton health-care initiative back in 93 and 94 was because it lacked an individual mandate. today, because of partisan politics, that individual mandate, conservative republican intellectual wellspring, is now referred to

as socialism. to have an individual mandate requirement in massachusetts that preceded obamacare, ms. yang? >> absolutely. >> is it working? >> is working very well. what happened to the population of uninsured massachusetts? smallre is a very percentage of our residents that were uninsured, prior to the implementation of the aca. about three percent. we are very optimistic that number has further shrunk because we brought more people in to coverage. we expect that number to be even less than three percent now. >> is that not the second lowest uninsured population in the united states? >> at that was the first lowest >> i am happy to concede to massachusetts. >> then you are more successful than i thought. >> thank you, congressman. , iso, in terms of websites

heard the testimony here that websites are not the same as the exchange. websites sometimes do have coaches, sometimes big ones, unfortunately. did massachusetts have twitches when they started? , congressman. in fact, i would just say that the website that we launched in 2007 looks nothing like the website that we had prior to the aca. even the pre-aca website went through a journey, both from a performance perspective and a functionality perspective. technology is meant to evolve over time. it is meant to be innovated, improved as we get experience and react to the market. so we unfortunately experience challenges with the website, we were not panicking. we have gone through this before. these are things that we need to

work through. we have worked through it before. aca is competent, but it is not beyond technology. there are technological solutions. we need to identify the right vendor. we need to put the right team in place, and we can fix them. >> would it be fair to say that the goal here for the aca, the affordable care act known as obamacare, is never to have a perfect website, it was to get people enrolled. the website is a method not an end. >> that is exactly right. i would say look no further than massachusetts. we did not have the good fortune of having a state-of-the-art modern website. we had something very simple, but easy to navigate. we demonstrated the concept, but we didn't really have the benefit of the aca website, which really brings it to the next level. it does bring a lot more convenience to people. it does improve people's experience, but the aca is about

coverage and massachusetts is dem asserting it. thingslee, one of the asserted by some of my friends on the other side of the aisle who are never going to give this ever a positive mark of any kind , is that actually the number of people enrolled is masking the fact that it equals or is less than the number of people who have in fact lost their health care coverage. how many people are enrolled in california again? >> first to cover california directly in our plans is 1.2 million. 1.9 million enrolled in medi-cal. we don't know, and this is one of the things is up for discussion, the number of people that are rolled directly with their health plans and affordable care act compliant plans with essential benefits. we think that for the vast

majority of the individual market that converted on the plans this year, and come to our marketplace, they were suddenly eligible. now they are the and -- in the individual marketplace. >> enrollment in california is not exceeded by the number of people who lost their private insurance plans? idea that you but lots of coverage. the vast majority of kept their coverage with an existing pan or -- with an existing plan -- the term of loss coverage, people converted coverage. brand-new a phenomenon? apparently for the first time ever in history, people are losing their coverage, and insurers are canceling the coverage. is that nonew insurance company can turn people away that knock at their door. once knew is that people cannot be turned away because of their health condition.

health plans cancel policies at their whim previously. if people left jobs they were left eventually without insurance, etc.. ofare in a new set circumstances, but not this of circumstances that people changing types of coverage are losing coverage. >> thank you. mr. chairman, you been generous and i yield back. >> let me run through a few things here. the way your agency set up for the funding stream. how is your agency funded? is a general revenues or percentages? i would like to just quickly know how it is funded in the days ahead. currently we are only funded by the federal grant. percent feee a two

that is assessed against all plans are sold in our marketplace. >> of the two percent fee is what covers that, and then plus whatever general revenues allocated. >> yes. >> a premium assessment across all state regulated insurance. >> what is a percentage? >> is about $40 million a year. >> was a percentage? >> whatever it is, it works out to about $40 million. >> three percent, five percent, 0.2%? give me a ballpark figure. >> it is probably in the one -2%, and isn the 1% all state regulated. have historically been

funded with a combination of state funding the general fund. insurance carrier administrative fees. the reason is because of the one hand we serve as a dissipation channel that really provides backroom function for the insurance company. at the same time we perform inicy responsibilities service to the state. we envision that model will continue hosting aca. we do not have expectation of additional federal funding to support the administration. we have not yet made a decision at this point in terms of the fee presented historically. it is between 2.5% and 3.5%. >> ok. >> our ongoing revenue is going to be based on a carrier administration fee. the current fee is on a per , which is anth base little over four percent premium. we will be adjusting that on an annual basis based on what our revenue needs are.

but per member per month, is that the individual who holds a policy? where is that? >> is built into the premium. >> $13 90 five cents? >> this enables health plans to lower their costs, because our cost per acquisition of what it means to enroll an individual is far less expensive than it used to be in the individual market. the individual plans have a longeron and there is no any underwriting costs because there is no underwriting. >> it is amazing how people will be a path to your door if they will be fined. i'm not being critical of you. there's definitely a good promoter. >> actually, when we talked to thousands i'm serving, for the vast majority, the penalty is not and incentive. for some is a factor, but for a small minority.

>> there was a deadline that we face as well. >> chairman, we are funded through an assessment policies sold through the insurer. that is up to 3.5% assessment. >> this is per policy is sold through the system, not all. in maryland it is everybody, right? company.urance just was so being sold to the system. >> thank you, mr. chairman. going forward, our financing is based on a 2.5% premium sold through the exchange. >> as you have in roman coming through, obviously one. ended and another is opening up next year. you're looking at a budget, based on what is coming at this point, and what you have, is the agency sustainable? is the target there to be able ?o make

>> right now, the target is sustainable at the level that we have enrolled and the protection is going forward. as many of our colleagues have spoken, you do have to manage theexpense side to match revenue side. >> we expect that with the aroma we have we can do that. >> and chairman, yes, it is sustainable. >> is absolutely sustainable and we will be balancing both our expenses and revenue. when you look at the 1.2 million that have enrolled, we are very confident we can have a very good proposition in california. >> i also believe we will be sustainable. we have 30,000 qualified health care members. we also have over 100,000 cornwallis care members. we also have 5000 small businesses. and lastly we have 138,000 subsidized members in transitional coverage. we expect a meaningful percentage will be exchanged as well.

>> yes, we believe it will be sustainable. sustainability for hawaii is going to be a challenge. we are trying to figure out how adjust expenses and other ways to increase revenue. >> most of the states have found a way to get the balance. i would assume your interaction with other states. you know other states and having issues? >> no i do not. any state that has a small population like we do and a small number of uninsured will be facing the same kind of challenge. >> ok. mr. van pelt, i want to talk about the co-ops. that is a new invention as well. obviously, that is in the middle of the market heard several of you have co-ops in the market. oregon health and health republic, both of those names ring true there. each receive $60 million to

start up as a co-op. i familiar with how they're doing and how they're functioning within the exchange? >> no, i can get that information for you. it has been relatively low enrollment numbers. >> how's that working? the initiative was, the initial was to create some nonprofit that is sitting out there so if compete, or the would go into places to market would not go. have you experienced that they are good competition for the others? >> we have had a very good turnout in terms of profit, taxable nonprofit and not-for-profit plans. i can't say there has been much discussion or analysis of the impact of the co-op. >> when you say there's not much discussion or analysis, can you tell me if there's any sense of relief that the co-ops are there? we would not have met articles about them? >> i don't believe so.

i've not heard any of that conversation. or the way organ market has worked with both and all of the profits kind of health plans, i don't believe it is felt that this has been a void that they specifically filled. >> same for massachusetts and maryland in maryland has evergreen, massachusetts has minuteman. is that correct? >> yes. >> how's that working and functioning? this is a new invention. >> we are glad the minuteman was interested in competing in the massachusetts market. this is not the first time we have had a new entrant into the market. >> to not many enrollees did have this point? -- do you know how many

enrollees they had at this point? >> i will have to find out. >> their goal was 37,000, is what they had hoped to enroll. >> i would defer to you on that. >> just try and figure out. again, it was a hundred 56 million dollars given to start this co-ops. so hopefully going to an area that was underserved. i'm trying to figure out in massachusetts if there was a meeting in need of underserved and whether hundred 56 million -- and where the $156 million goes. >> to my best knowledge, they continue to be very interested in competing in the massachusetts market. i would just say that as you know, massachusetts is artie well served in terms of the insurance company. manyve great coverage and carriers competing.

minuteman comes in with a low model that could offer additional options for members to shop around. we continue to believe that they are able to deliver that once we have the functionality. >> anything we can fill in the gap on? >> i would say it is probably too early to answer the question about investment. >> $65 million to help start the co-op? is quite a bit of competition in maryland as well. >> maybe not as much as in massachusetts. i would say that evergreen is really focused on the control of costs through very aggressive primary care approach. >> to nominate a sign that the this point? >> their signed up on the order of a few hundred. their prices were higher than the market leader. i think that hurt them in the

first year. think there is in the small-group market where the prices are more competitive. is that you take a couple of years to really understand the role and see whether they are able to succeed. up, as youblems came approaching deadlines, getting to october the first, was a key person that you're supposed to communicate with or that would give you something to sign off? person you arent to report to that said here, we have some issues, we don't know where we are, we are still working through our testing for security. we are not launching well. we have to have a delay, whatever it may be. who is the point person? -- who was the point person? i think a name was amanda

kelly. cowley.a the name was amanda? >> cowley. >> somebody had to sign off. >> mr. chair, similarly, i believe the contact at the time was amanda cowley. >> i do not have that information today. i can get that for you. cowley is the director of state exchanges. she was -- we also had a state officer who dealt with day-to-day responsibilities for making sure all the elements were approved.

>> amanda was a point of contact. we were in constant contact with the entire cms team. >> mr. matsuda, i don't think you are there at that time. we have a document, and i will get your copy of it, it says for policy development, this is a piece that walks through, as far as how you're getting the core, as massachusetts was walking through this. again, i want you to get a copy of it. we can talk later. this is an august document, talking about the website and how things are working. .rowsing anonymously was a good submitting an application was ago. eligibility determination no go. shopping, no go. enroll, no go. quoting information, no go. , of the 70 core

functions, only five were assessed as a go in august. was there a conversation at some point to say, we have a lot of no gross here. let's stall, with delay. if so, who that go to, to be able to say. we may need some extra time. >> a couple of things, mr. chairman. i can explain this document. this appeared to me with a steering committee minutes document to report the discussion that took place at the time. we did go through the comprehensive evaluation of the readiness of the system before we deployed the system on 10 one. -- on october 1. this is a record of each component which ultimately led

to our decision to deploy we did deploy and also what we did not deploy on october 1. >> was is something you held to account to to keep them informed? a mentioned, we are in constant indication. >> the who is what i'm looking for. amanda cowley was the director for state exchanges. also her team, that included our state offices. >> avidly more questions. we will follow up in the days ahead. coming, andate you for the conversation. you are all working very hard. no one has tried to push back and say you not working hard or try to make something work. frustration is that this is a round peg in a square hole at times.

we assumed we assumed were going to get away before. we did not get away before. having that flip and some a working state plan had to be punched to try to get into a website that was working, we had all the chaos of that as well. what you're doing and what you're trying to deal with is honorable. i appreciate your service on that area the mess that surrounds all this in the law and trying to execute a law that has many many complicating and conflicting parts in it, is a major issue. i think we will continue to be a major issue. with that, grateful for a time to be here. and we are adjourned.

>> during this month, c-span is pleased to percent are winning entries in this year's student can't figure documentary competition. that encourages high school students to think about major issues. one of our second prize winners is mckinley layer, a junior from jenks high school in jinx,

oklahoma. >> short forehand. ok? six balls. >> am a high national ranking and i want a state championship. i could not be as good as am today without the help of my sister. i became interested in the impact of immigration. topersonal research that we conclude that the most important issue facing congress today is immigration reform. for the impact of immigration on the arts, i visited an internationally acclaimed dance company, tulsa ballet.

>> tulsa ballet is a very place lots of different countries and nationalities. >> it might be a small ballet company in the middle of america, what we are a world class organization. we have choreographers and stagers and dancers from around the world. we have 25 dancers and 16 of them are foreign. so, immigration plays a big role in our company. our spanish dancers, they give a different emotion onstage than do the chinese dancers. but when every one comes together, it is really beautiful and they feed off each other and they learn from each other. to look at the impact of imigration on the sciences, visited a chemistry lab at the

tulsa.ity of >> it's null one in chemistry, it helps that they are working as graduate students, working as docs and faculty members. most of the graduate students school beocs at any going to be foreigners. so these students when we get then they contribute by working in those research labs in pharmaceutical in chemical companies. and they do that work that ultimately results in the of society. >> meeting incredibly talented people, i was astonished that be discriminated against civil my because of where they are from. >> one of the most negative aspects of our current imgriggs system is the labeling. we talk about bullying in school and name calling and how wrong that is. but we