it put a two-year delay on the applicability of the discrimination provision. >> well, isn't that because you're talking about building ramps and things like that? >> no. no, your honor. there's an even longer delay with respect to those kinds of provisions, but it's just a basic prohibition of discrimination two-year delay, and no one would doubt there's a compelling interest here. and with title vii. my friends on the other side have said, well, this different because there's so many more people who are going to not have this coverage under the grandfathered plan. but with respect to title vii, of course, it's still the case that that employers with 15 or fewer people are not subject to that law, and that's 80% of the employers in the country. and if you run the math, that's it's at least 80% that's it's going to be somewhere between 10 million and 22 million people who are not within the coverage. no one would say that because the coverage is incomplete in that respect, that title vii enforcing title vii doesn't advance -- >> those were decisions those were decisions that congress de, right? >> yes.

>> well, the grandfathering is not a decision that congress made, is it? >> well, the way in which it's implemented is a decision that the agency has made, that's true. but even with respect to the preventive services, i don't think anyone would say that there's not a compelling interest in advancing colorectal cancer screening and immunizations and the things that the preventive services provisions provide in addition to contraceptive coverage. i just think this a compelling interest under any understanding of the term. >> i just want before you get to this point, and my question reflects no point of view at all on my behalf. i just but i took mr. clement, one of his points, which i thought was an important one. he says there are some people here who strongly object to helping with abortions which include abortifacient contraceptives. everybody says, yes, they do object to that and that's sincere. so he's not saying this, but i might. but there is a compelling

interest in women's health and in the health of the family, and they're not having a religious objection to taking it. and so the government has said provide it. then he says, but there is a less restrictive way, and the less restrictive way is the government pays for it. says it wouldn't cost much. you'd have to have another piece of paper that would go to the insurance company that would say, insofar as your employer has a sincere objection against paying this, the government will pay for it. now, what i want to hear, and this not coming from any point of view, i want to hear your precise answer to that kind of argument. >> yes. they did argue i will point out, for the first time at the podium this morning that a less restrictive means would be to extend the accommodation that currently exists -- >> i'm not interested in whether they made the argument sooner or later. what i want to hear from you is i want to hear and it's not

you've thought about this. i want to hear your answer to that kind of argument. >> well -- >> i want to be sure you have a chance to give it. >> the answer i think there are two answers to it. assuming it's before the court and i'm going to answer your honest question directly, but i do want to make a prefatory point here, which is that under the law, under ashcroft v. aclu, for example, the burden on the government is to show that proposed less restrictive alternatives are not equally effective. if they don't propose it, we don't have a burden to refute it. having said that, we can refute it. now, there are two and there are two ways. the first is, they claim that they don't think that the accommodation is a less restrictive means, i take it, because or they haven't raised it before today, because they believe that rfra would require exemptions to that too, such that if you were if you were to provide the accommodation in which the insurance company comes in and provides the

contraception if the employer signs the form, they would say that that signing the form also makes them complicit in the central activity, and that therefore rfra provides an exemption there, too. and of course the test is whether the proposed alternative advances the government's interests as effectively. and if it is going to be subject to exactly the same rfra objections by exactly the same class of people asking for it, it's not going to serve the government's interest as effectively because the rfra exemption will result in no coverage there. the second point being that -- >> so don't make them sign a piece of paper. >> well, whether they sign the piece of paper or not, if they make the rfra claim there, which they have with respect to that accommodation, it will result in it being less effective in terms of accomplishing the compelling interest. in addition -- >> well, we can ask mr. clement what his position is on this. but you say they have already asserted that it would be

inconsistent with rfra as they understand it to provide for a for-profit corporation, like the ones involved here, the sort of accommodation that hhs has extended to so-called religious nonprofits, perhaps with the modification that was included in our stay order in the little sisters case. have they taken a position on that? >> you'll have to ask them. i don't think they have. but they have studiously avoided arguing this as a less restrictive alternative, and i take it's because their theory, at least, would lead one to the conclusion you would have to provide a rfra objection. but now the -- yes, thank you, mr. chief justice. the second point is that you're talking about a very open-ended increase in the cost to the government. now, we don't know how much that cost would be. the reason is because, since this wasn't litigated in the lower courts, there's not a record on it. so i can't tell you what that what that increased cost is going to be, but it could be quite considerable. >> you're talking about, what, three or four birth controls, not all of them, just those that are abortifacient.

that's not terribly expensive stuff, is it? >> well, to the contrary. and two points to make about that. first, of course the one of the methods of contraception they object to here is the iud. and that is by far and away the method of contraception that is most effective, but has the highest upfront cost and creates precisely the kind of cost barrier that the preventive services provision is trying to break down. >> i thought that i was taken by your answer. i thought it was the government's position that providing coverage for the full range of contraceptives and other devices and drugs that are covered here is actually financially neutral for an insurance company, that that reduces other costs that they would incur. >> it is for the insurance company, but for the woman who is going to not get the benefit of the statute if the exemption is granted -- >> no. no. if she if she has the coverage through the insurance company but the employer has nothing to

do with arranging for that. >> well, so, in other words, if they haven't raised a rfra objection to the alternative, but that but as i said, you know, the logic of their position is that you would get a rfra objection. it can't be -- >> still, i want to get press this a little further, and i don't want you simply to just agree with what i'm about to say. >> don't worry. [laughter] >> no, i mean, after all, somebody, a taxpayer, might say, "i don't want to pay for this small war." and it would be a religious ground, and it would be very, very little money, in fact, that you take from him. or the church might say, "i want a sunday morning reduction in the cost of municipal parking." and by the way, that will not only not cost the government anything, they'll make money because nobody parks there on sunday, particularly with this high a fee. now, i'm thinking of -- i'm

trying to figure out where this case fits in that spectrum because i think the answer to the first two questions is no. and i know, so you're just going to agree, and that's what i don't want. i want to understand your thinking on that. >> on that point, i think that question plugs into our view of what the substantial burden test requires, that their view of substantial burden is if you have a sincere religious belief and there is any law with a meaningful penalty that imposes on you pressure to do something inconsistent with your belief, then you may pass the substantial burden test. i think the problem with that test as they formulate it, is that under the two hypotheticals that you just gave, justice breyer, you've got a substantial burden in those situations, because if you don't pay the tax you can go to jail, for example. and so we think the substantial burden analysis has got to be more strenuous than that. it's got to incorporate principles of attenuation and proximate cause, and that when you think about this case where the requirement is to purchase insurance which enables actions by others, that you're really closer to the tax situation than to imposing a direct obligation

to act. so that's how we would think about that issue. but now, with respect to -- >> mr. general verrilli, isn't that really a question of theology or moral philosophy, which has been debated for by many scholars and adherents to many religions. a does something that b thinks is immoral. how close a connection does there have to be between what b does that may have some that may provide some assistance to a in order for b to be required to refrain from doing that that action? >> it's true that it's a difficult question. but it isn't -- >> it is a religious question and it's a moral question. and you want us to provide a definitive secular answer to it? >> no, but i do think the problem, justice alito, is that this court has recognized, and certainly the courts of appeals have recognized, that there is a difference. you accept the sincerity of the belief, but the court still has to make a judgment of its own about what constitutes a

substantial burden, or otherwise, for example, the tax thing would be a substantial burden. or we cited a d.c. circuit case in which prisoners objected to giving dna samples and the court said -- we accept the sincerity of that belief, but it's up to us to decide whether that's a actually substantial burden. in the bowen case in this court, the court accepted the sincerity of the belief that the use of the child's social security number would offend religious belief and commitments, but said they still had to make a judgment about whether that was a substantial burden. so it does have to be, with all due respect, part of the analysis. >> i still don't understand how hhs exercised its judgment to grant the exemption to nonreligious corporations if you say it was not compelled by rfra. >> i don't think -- >> then it must have been because the health care coverage was not that important. >> it didn't grant an exemption to any nonreligious organizations, justice kennedy. it granted an exemption to churches, and that was it. with respect to religious

nonprofits, it constructed an accommodation, but the accommodation delivers the contraceptive coverage to the employees of the nonprofits. it just does it through an indirect means. but there is no diminution of there's no basis for questioning the government's interest with respect to that accommodation because the employees get the coverage, just as they would -- >> well, but that of course is an issue that's being hotly litigated right now, right? whether the employees can get the coverage when you're talking about the religious organizations. >> well, that's exactly why i think you can't look to that as a less restrictive -- that accommodation, extending that accommodation to for-profit corporations, as a less restrictive alternative. precisely because it's being hotly litigated whether rfra will require exemptions to that, as well. >> but you're relying you're relying on it to make your point with respect to the accommodation, and then you're criticizing your friend for relying on the same thing in making his points. >> well, i think i think what justice kennedy i took justice kennedy to be asking me, mr. chief justice, was whether the

government's choice to provide that accommodation reflected a judgment on the part of the government that this was something less than a compelling interest, and i don't think that inference is possible, because the government was trying to use that accommodation to ensure that the contraceptives were delivered. so, with all due respect, i don't think there is an inconsistency there. and i do think, if i could, with respect to the issue of whether there are exemptions that defeat a compelling interest, that i submit would be a very dangerous principle for this court to adopt in the form that my friends on the other side have offered it, because not only would you then be in a position where it would be very hard to see how title vii enforcement could be justified by compelling interest in response to a rfra objection, ada enforcement, fmla enforcement, all kinds of things. and i do think -- >> title vii was passed before 1993, so it wouldn't apply rfra wouldn't apply to title vii. >> well, i think with all due respect, justice ginsburg, i think you could claim a rfra

exemption from title vii. and the problem here would be that and i think one of the things that's significant about the position that my friends on the other side are taking here, is that with respect to exemptions, for example, from the title vii requirement against discrimination on the basis of religion and hiring, congress made a quite clear judgment to provide a very narrow exemption -- churches and religious educational institutions and religious associations, and that's it. nobody else can claim an exemption under title vii. >> except that they passed rfra after that. that made a lot of sense. but the question is they passed rfra after that. >> but i think the further question, your honor, is whether you would interpret rfra in a manner where you would essentially obliterate that carefully crafted or what congress meant to do was to obliterate that carefully crafted exemption and instead say that every for-profit corporation could make a request like that. >> well, if congress feels as strongly about this as you suggest, they can always pass an exemption, an exception to rfra, which they have done on other occasions. and they haven't done it here.

>> well, with all due respect, your honor, i think you could make the same argument either way in this case, that the question here is what congress thought it was doing in 1993, and we don't think, given the long history and the fact that not only do you have no case in which a for-profit corporation ever had a successful -- >> well, we've already discussed that there is no case holding that they can't, right? >> in addition, if you look at the history of exemptions and accommodations in our legislation, state and federal legislation may extend to churches and religious nonprofits, and that's and individuals. and that's where the line has been drawn in our legislation historically. there just is nothing in our current -- >> under your view, a profit corporation could be forced in principle, there are some statutes on the books now which would prevent it, but could be forced in principle to pay for abortions. >> no. i think, as you said, the law now the law now is to the contrary. >> but your reasoning would permit that. >> well, i think that you know,

i don't think that that's i think it would depend on the law and it would depend on the entity. it certainly wouldn't be true, i think, for religious nonprofits. it certainly wouldn't be true for a church. >> i'm talking about a profit corporation. you say profit corporations just don't have any standing to vindicate the religious rights of their shareholders and owners. >> well, i think that if it were for a for-profit corporation and if such a law like that were enacted, then you're right, under our theory that the for-profit corporation wouldn't have an ability to sue. but there is no law like that on the books. in fact, the law is the opposite. >> i'm sorry, i lost track of that. there is no law on the books that does what? >> that makes a requirement of the kind that justice kennedy hypothesized. the law is the opposite. >> well, flesh it out a little more. what there is no law on the books that does what? >> that requires for-profit corporations to provide abortions. >> what if a law like that -- >> isn't that what we are talking about in terms of their religious beliefs? one of the religious beliefs is that they have to pay for these

four methods of contraception that they believe provide abortions. i thought that's what we had before us. >> it is their sincere belief and we don't question that. but i will say, and i do think this important and i say it with all respect, that that is how they that is the judgment that they make. it is not the judgment that federal law or state law reflects. federal law and state law which does -- which do preclude funding for abortions don't consider these particular forms of contraception to be abortion. with all due respect, i would say that i think that, you know, we've got about 2 million women who rely on the iud as a method of birth control in this country. i don't think they think they are engaged in abortion in doing that. it is their belief. it's sincere. we respect it. but it isn't a belief that we think is reflected in federal or state law or our traditions of where that line is drawn. and so -- and i do think that that is what makes this a difficult case. i agree.

and if you disagree with our position at the threshold that corporations that even though you have a situation, and we acknowledge you can have situations, in which a tightly knit group of a small group of tightly knit individuals own and operate a corporation where there is appeal to that, to the argument that they ought to recognize a claim of exercising religion in those circumstances. the problem, i would submit, is with the implications of doing it, the implications for entanglement and making the judgments when you move past that group, the administrability problems, and the problems of inviting the kinds of claims that are predictably going to impose harms on third parties. >> what about the implications of saying that no for-profit corporation can raise any sort of free exercise claim at all and nobody associated with the for-profit corporation can raise any sort of free exercise claim at all? let me give you this example. according to the media, denmark recently prohibited kosher and

halal slaughter methods because they believe that they are inhumane. now, suppose congress enacted something like that here. what would the what would a corporation that is a kosher or halal slaughterhouse do? they would simply they would have no recourse whatsoever. they couldn't even get a day in court. they couldn't raise a rfra claim. they couldn't raise a first amendment claim. >> well, i'm not sure they couldn't raise a first amendment claim, justice alito. i think if you had a targeted law like that, that targeted a specific religious practice, that i don't think it is our position that they couldn't make a free exercise claim in that circumstance and so -- >> why is that -- >> well, but you're getting away from the hypothetical. say justice alito's hypothetical was that the impetus for this was humane treatment of animals. there was no animus to religion at all, which in the church of lukumi, there was an animus to the religion. so we're taking that out of the hypothetical. >> exactly. >> right. well, i think if it were

targeted only at the practices of the kosher and halal practices, then i think you would have an issue of whether it's a targeted law or not. but even if it is -- >> well, they say no animal may be slaughtered unless it's stunned first, unless the animal is rendered unconscious before it is slaughtered. >> well, i think in that circumstance, you would have, i think, an ability for customers to bring suit. i think you might recognize third party standing on behalf of the corporation on the corporations, on behalf of customers. so a suit like that could be brought. but even if you disagree with me at the threshold, even if you disagree with us with respect to the kinds of risks that we think you will be inviting if you hold that for-profit corporations can bring these claims, when you get to the compelling interest analysis, the rights of the third party employees are at center stage here. and that's i think that's the point of critical importance in thinking about this case. and i think, frankly, the point that has been just left on the sidelines by my friends on the

other side. the consequence of holding here that the rfra exemption applies is not a situation like ones in which this court under the free exercise clause or under rfra have recognized exemptions in the past. those have always been situations where it's a relationship between the individual and the government and granting the exemption might result in the government not being able to enforce the law with respect to the individual, but -- >> i mean, the point that justice alito was making is that take five jewish or muslim butchers and what you're saying to them is if they choose to work under the corporate form, which is viewed universally, you have to give up on that form the freedom of exercise clause that you'd otherwise have. now, looked at that way, i don't think it matters whether they call themselves a corporation or whether they call themselves individuals. i mean, i think that's the question you're being asked, and i need to know what your response is to it.

>> well, i think our response is what the court said in part 3 of the lee opinion, which is that once you make a choice to go into the commercial sphere, which you certainly do when you incorporate as a for-profit corporation, you are making a choice to live by the rules that govern you and your competitors in the commercial sphere. but even if you disagree with me about that, what i'd like to leave the court with, is what i think is the most important point here, is that if this exemption were granted, it will be the first time under the free exercise clause or under rfra in which this court or any court has held that an employer may take -- may be granted an exemption that extinguishes statutorily guaranteed benefits of fundamental importance. lee came to exactly the opposite conclusion with respect to social security benefits, that you -- that it was imperative that the employee's interest be protected. and that is the fundamental problem with the position that my friends on the other side

raise here, that they leave the third-party employees entirely out of the equation. >> that's ok for not-for-profit corporations to do that with respect to all of their employees, and some of them are pretty big operations -- >> no. >> that's ok there? >> no, we don't think that. we don't we're not drawing a line between nonprofits and profits. >> they can make you allow them to make this religious objection, don't you? >> no. no. religious nonprofits get an accommodation in which their employees get the contraception. but we are not drawing a line between for-profit and profit. >> but they don't have to pay for it, right? >> the -- >> and you could set that up this way, that these people don't have to pay for it. >> well, as i've said a couple of times, they haven't asked for that until this morning. but the fundamental point here is that you would be extinguishing statutorily guaranteed health benefits of fundamental importance to these employees, and that is something that this court has never done. and i submit that congress can't have thought it was authorizing it when it enacted rfra in 1993. thank you. >> thank you, general.

mr. clement, four minutes. >> thank you, mr. chief justice. just a few points in rebuttal. let me start with the abortion conscious clause. it's because it tells you something about where congress has drawn the line and it tells you the consequences of the government's position. historically, those conscious provisions have applied to all medical providers, including for-profit medical providers. but we learned today that as far as the government's concerned, that's just congress' judgment. if congress changes its judgment and says that a for-profit medical provider has to provide an abortion, rfra doesn't apply. that, with all due respect, cannot be what congress had in mind when it passed rfra. they also suggested if a kosher market takes the trouble to incorporate itself, then it has no free exercise claims at all. now, you can go back and read the crown kosher case. i took it as common ground, that all nine justices thought that if the massachusetts law there had forced crown kosher to be open on saturday, that that would be a free exercise claim notwithstanding the incorporation. the second point i want to talk about is the least restrictive alternatives. in a colloquy with justice

scalia, the solicitor general points out that yeah, well, it's a little bit different from the pre-smith law because now you have the less restrictive alternatives analysis. that's not a small difference. that's a major difference. and it's really the easiest way to rule against the government in this case. because you have a unique situation here where their policy is about a government a subsidy for a government-preferred health care item, and the question is who pays? the government paying or a third-party insurer paying is a perfectly good least restrictive alternative. >> so we go back to the start of my question, that would be essentially the same for vaccines, blood transfusions, non-pork products, the government has to pay for all of the medical needs that an employer thinks or claims it has a religious exemption to? >> not necessarily, justice sotomayor. it will depend on how you -- >> because those things are more important? >> no, not because they're more -- >> it's really the amount of

money -- >> important. but the easiest way to distinguish them is if the government's already provided this accommodation for religious employers. >> well, but they -- >> and with all due respect -- >> they make exemptions for vaccines, presumably, to some people on some basis, but we have a tax code that applies to everybody, but we have a million exemptions. does the creation of the exemption relieve me from paying taxes when i have a sincere religious belief that taxes are immoral? >> i think lee says that taxes are different and not all exemptions are created equal, because some exemptions undermine the compelling interest. now, the reason -- >> isn't there a federal program that pays for vaccines for any children who are not covered by insurance for those vaccines? >> there is, justice alito. of course, there's also title x, which provides for contraception coverage, which is another least restrictive alternative. but i do want to get on the table that it is not true, that we have not suggested that the accommodation provided to religious employers, like nonprofit hospitals, that's not something i invented at the

podium. if you look at page 58 of our brief, the red brief, we specifically say that one of the least restrictive alternatives would be the most obvious least restrictive alternative is for the government to pay for their favorite contraception methods themselves. later in that paragraph, the only full paragraph on the page, we say, "and indeed, the government has attempted something like that with respect to certain objective employers objective employees employers," and we cite the federal register provision where there is the accommodation provision. >> will your clients claim that filling out the form, if you're saying they would claim an exemption like the churches have already? >> we haven't been offered that accommodation, so we haven't had to decide what kind of objection, if any, we would make to that. but it's important to recognize that as i understand that litigation, the objection is not to the fact that the insurance or the provider pays for the contraception coverage. the whole debate is about how much complicity there has to be from the employer in order to trigger that coverage. and whatever the answer is for little sisters of the poor,

presumably you can extend the same thing to my clients and there wouldn't be a problem with that. if i could have just one second more to say that the agency point that justice kennedy has pointed to is tremendously important, because congress spoke, it spoke in rfra. here the agency has decided that it's going to accommodate a subset of the persons protected by rfra. in a choice between what congress has provided and what the agency has done, the answer is clear. thank you, your honor. >> thank you, counsel. counsel, the case is submitted. whip stenynority hoyer, disappointed that scotus delivered a setback to women's health care today. scotus ruling today affirms americans' religious liberties as protected against

-- under the religious freedom restoration act. press secretary josh earnest said the president has long believed women should make their own health care decisions, i'm not their bosses. during a dailyme briefing with reporters. >> good afternoon, everybody. i apologize for the scheduling switch we had him earlier today. it was my intent to be done by now, but instead we are just getting started. i do not have any announcements at the top. i will let you kick off the fireworks. >> what is your reaction to the hobby lobby ruling? >> i knew that would be your first question today. the supreme court ruled today

that some bosses can now refuse coverage for some health health coverage a son views that there are known employees may not even share. they can make decisions for themselves rather than their bosses deciding for them -- president obama has said that they should be able to make decisions for themselves rather than their bosses deciding for them. as millions of women know, contraception is often vital to their well-being. we will work with congress to make sure that any women affected by this decision will still have the same coverage and vital health services as everyone else. president obama believes strongly in the freedom of religion. that is why we have taken steps to ensure that no religious institution will have to pay or provide for contraceptive coverage. we've also made accommodations for nonprofit religious organizations that object to

contraception on religious grounds. but we believe that a company should not be able to assert their views to deny employees federally mandated benefits. we will continue to look for ways to improve americans health by helping women have more, not less, say over their personal >> could you talk about what options you are considering to make sure women have access to contraception you come -- contraception? >> i'm not able to speak to that right now. we are assessing practical indications there are from this decision, including what companies are covered by the supreme court decision. as you just saw, the supreme court pretty narrowly held to the decision. and there are other decisions -- institutions that are treated in different ways. we are also looking at what kind

of health care plans these companies have and how many employees are affected. as we gather more information, we may be able to be in a position to better consider the range of options available to the president. it is our view that congress needs to take action to solve this problem that has been created and the administration stands ready to work with them to do so. but another topic, some advocates are expressing outrage over the letter that the president sent this morning about the minors. they said it is wrong to send minors back to a violent situation in their home country. can you respond? >> i can. our concern principally right now is that we have seen gathered on this western border of the united states and alarming increase in the number of children who have traveled from central american countries

to our border on the southwest. expecting to gain entry and to be welcomed into the united states. they are principally motivated by a disinformation campaign that is being propagated by criminal syndicates that are preying on vulnerable populations of people, who are living in pretty desperate situations. in some cases, they're living in communities that are wracked by violence. in other cases, they are facing pretty dire economic circumstances. and it has led to a humanitarian situation that the president is very concerned about. this it ministration will enforce the law. and what the law requires is ensuring that these children, once they are attained at the border -- and that is to be clear in many cases, what is happening. children are turning themselves into the border patrol agent. and the law requires that these

children be -- that there needs be met, basic humanitarian needs be provided for them. what is also true that -- is that we want to search resources to businesses plagued at this problem, increasing the number of immigration judges and asylum officers and other lawyers to make sure that we can properly process these claims quickly. each child is certainly do -- is owed due process and they will get the benefit of that. at the same time, we are seeing such a large influx of children at the border that we are having a difficult time processing the large number of cases that are now getting backed up in the immigration court system. we have asked for additional resources to make sure that we can process these claims as

quickly as possible. we have also asked for additional authority that can be used at the discretion of the secretary of homeland security to process the cases, if ultimately it is found that the child, or an that is here with children does not have a legal right to stay in the country. they can be returned to their home country and properly reintegrated. that means we are also working with some of these countries where the root of this problem exists. you saw a couple of weeks ago that the vice president traveled to central america and met with the leaders in honduras and guatemala and secretary kerry is traveling to the region this week as well and we will have similar commerce nations with the countries of the region. >> on that point, how much are you actually asking for? is it to glean dollars, $3 million, how much yet -- $2 million, $3 million, how much? >> that will be a question for the court.

>> [inaudible] is that what you're talking about doing for this case? >> no, what we are talking about is pressing congress to take the steps to address this problem, to make sure that the women who work for these companies have access to the preventative medicine that they deserve and that these nonpartisan scientists believe they should have access to. that is what we are focused on and we believe that because of the supreme court decision today, that congress should act to address the concerns of the women affected by this decision. >> with congress as divided as it is now, how likely is that to happen? >> as with a range of other things, we will consider whether there is an opportunity for the president to take some other

action that could mitigate this problem as well. but again, we are still assessing the decision and it too early for me to state what kind of action would be available to the president and what kind of action he would even consider at this point. but what is clear is that there is an opportunity for congress to take the kind of steps that would mitigate this problem, and we hope they will. >> do you see this as a major impact on the obamacare health care law? some have said it is a devastating blow. >> i think it would have been a devastating blow had this same supreme court two years ago decided to declare the of for the care act unconstitutional. they did not. they upheld the formal care act sensually. -- the affordable care act sensually -- essentially. and that has given many americans access to of care. it has also put in to protect -- put into place a wide range of consumer protections, everything from ensuring that young adults

up to age 46 can remain on their -- up to age 26 can or may not their parents health insurance to others. all of this has been in place. -- in put in place. this is one specific set of companies and one group of women who, when it comes to specific access to certain contraceptive services, and that specific problem that has essentially been created by the supreme court. the problem is that the institute of medicine says that women should have access to these types of preventative services. but the ruling allows the bosses of these women to step in and say, well, i have a religious concern.

you are not allowed to make your own decision about whether you would like to edit it for these -- from these services -- like to benefit from the services. we believe that congress should take action. >> following up on that, does the white house have a reaction to the fact that the majority was men writing the decision and in the minority you have three justices being women. the president has talked in the past about democrats being energized to vote in the midterm elections. might this case energized democrats on this issue? >> in terms of the political fallout for my will at the political analysts out there make a decision. the president does, however, believe that there is an important principle at stake. that women should have the freedom to make their own decisions about their health care, and that interference by their boss for whatever reason, based on their religious views, or just their scientific opinion, is inappropriate. one of the core goals of the affordable care act was to put

freedom and that hands of families all across the country, to give them access to greater choices to quality affordable health insurance that would be in the best interest of their family. this decision today, while respected, runs counter to that principle. and the president will look to congress to put in place a solution. >> on bob and donald, the president's choice to head the v.a., this election seems to have come out of nowhere and has been greeted as unorthodox. it turns out mr. mcdonald has made contribution to republican candidates in the past. do you view that is something that might help mr. mcdonald get through the senate? because it might discourage republicans from blocking his nomination? >> mr. mcdonald was chosen because he has a -- the kind of record as a solid manager will be required as the next secretary of the department of

veterans affairs to put in place the covenant that our nation has made with our men and women in uniform. that will be critical to ensuring the country lives up to the commitment to those in uniform. mr. mcdonald himself served in the military and graduated at the top of his class at west point. he served in the u.s. army for five years. and he has a credible story to tell in terms of his management record at procter & gamble. he started at the country -- company as as an entry-level employee and then rose to be the ceo. that demonstrates a lot of character and tenacity, and those we to things -- those will be two things required of the next secretary of the department of veterans affairs. one last thing, while he was at procter & gamble, doctoring ample was -- procter & gamble was widely credited with success in mentoring leaders at the

middle management level. and having the kind of management style that inspires other people in the organization with leadership skills is something that is based on the problems that have been unearthed at the v.a., that will be critical to their success as well. >> someone who can go in and clean house? >> someone who has a lot of experience and has enjoyed a lot of success in managing a large company. the v.a. is a large organization that is performing very important work. there are some important changes that need to be made to ensure that important work is actually getting done. having somebody who has experience in the military, has strong bipartisan support for taking the job, and has a proven track record of implement in changes in large organizations to great effect can make some -- to great effect, that makes him the right choice for this task. >> there are reports that the

terrorist threat in syria may be translating to security issues for the nations air force. is that something the white house will be looking at? a lot of people are heading out traveling and have vacation plans this summer. is that something americans should be concerned about? >> i am not in a position to comment. the department of homeland security is regularly reviewing our security procedures to adapt to the threat that we face by our transportation system. and advisories are required to adequately inform the traveling public. i do not have an announcement right here at this point to make. for more information, i would refer you to the department of homeland security. i will move around just a little bit. >> [indiscernible] do you find it ironic that both the united states, the russians,

and iran are sending mixed messages to prime minister maliki? collects we have offered to support the iraqi government and the u.s. has provided significant assistance to the maliki government, in the form of train that is ongoing, through the embassy there in iraq, but also in jordan. there have also been a number of military sales from the united states to iraq to try to support the maliki regime and the iraqi government. what we have been some -- disappointed by is the fact that mr. maliki has not pursued the kind of including -- inclusive governing agenda that we think will be required to ensure long-term success in iraq. we are working closely with the maliki government, and all the political leaders in iraq. you have seen the phone calls between secretary kerry and iraqi leaders and vice president biden and iraqi leaders in pursuit of encouraging the

government to pursue a more inclusive agenda. that is what we are focused on. there is one piece of military equipment that has attracted a lot of attention. a delivery of f-16s is scheduled for later this year. the u.s. is committed to living the f-16s to iraq as quickly as possible. delivery of the first two aircraft had long been scheduled for this fall, pending final preparations for housing and securing the aircraft, completion of pilot training, and completion of required administered of details, which the iraqi detail has said to complete. there are logistical details to be accounted for. but once the logistical concerns have been addressed, we are still committed to moving forward. >> [indiscernible]

do you believe that prime minister maliki is a viable candidate right now? >> that is a decision for the iraqi people and the iraqi political leadership to decide. we are urging racks leaders -- urging iraq's leaders to them together in forming the next government. we are hoping they will act quickly so the government formation can move forward after the first session of the parliament is convene on july 1. we are urging all leaders across the spectrum to treat the situation with seriousness and begin a quick negotiation to determine than the -- the makeup of the next government. and that has to be an inclusive one. >> under the circumstances, and the u.s. has committed and sent advisers -- has the president had conversations with any world leaders in terms of their

commitment in-kind? in other words, they're kind of special forces advisors, etc., to going there to address this crisis? >> over the past couple weeks, you see that we have read out a number of conversations that the president has had with world leaders, some of them on ukraine, some of them on the situation in iraq, and others. i don't have any and digital details -- additional details from these conversations. but the president is interested in working in a collaborative fashion with our allies and other interested countries in the region to try to encourage the political leadership in iraq to pursue this kind of including -- inclusive governing agenda. in order to the dress the threats proposed by -- to address the threats proposed by isis in iraq. the government needs to make it clear that each system has a stake in the country's future

and the country's prosperity. >> does the president hope that any of his allies, friends, former allies, world are presented as, will in fact be encouraged to send advisers or special forces to iraq, as the u.s. has committed? >> i'm not in a position to give this conversation any more detail. i would assume, and with a lot of confidence, that the leaders in other countries would be making a similar activation to the one of the president has made. which is, our interest in a country, or our activity in that country will be governed by what the president said to be in the best interest of american security. that will continue to be the criteria the president will use as he makes decisions about u.s.

actions there, and i assume other countries leaders -- other country awesome leaders will be making similar decisions. >> [indiscernible] agree with the supreme court premise that companies have freedom of speech and companies have freedom of religion? >> as you have heard, -- well, as the constitutional office -- constitutional lawyer that sits in the oval office will tell you, he reserved judgment until a reading of the decision. what we have assessed so far is that there is a problem that has been exposed, which is that they are now -- there is now a group of women of indeterminate size who no longer have access to free contraceptive coverage simply because of religious views held not by them necessarily, but by their bosses. we disagree anticonstitutional lawyer -- and the constitutional lawyer in the oval office

disagrees. primarily, because there is concern about the impact it could have on the health of those women. ultimately, the it -- the aca was to allow better health and greater options to those women as they seek health care. in terms of the broader legal analysis, that is something we will get to. >> the law that is applicable says -- currently, the one that is in effect now, says that a child shall not be placed in a secured facility absent a determination that the child poses a danger to itself or others. these facilities that you're proposing to build, it appears that the law says they should not be put there until they are a danger to themselves or others. is this the part of the law that the industry should want to

change? >> the facilities being open are specifically to meet humanitarian needs of these children, to make sure they have a bed to sleep in, a roof over their heads, access to food, and other basic needs that any child has. that is the point of these facilities being opened at a couple of different military facilities. you have seen them support and perform the coordinating function with hhs for housing these children to make sure these needs are met. more broadly, what we are asking additional funding to do is to deploy more immigration judges, lawyers, asylum officers, to more quickly and efficiently evaluate the cases of these children. and when it is determined, after

going through that legal process that these children do not have a legal basis for remaining in the country, the administration is seeking greater authority to be expressed, or a greater authority that could be used by the secretary of homeland security to resolve their case. and in many cases, that means returning them to their country where they came from. >> those children are staying in the united states and staying with either family or foster homes and they are not staying in facilities because they are not allowed to by law. are you trying to change the law itself? will you as congress to change the law that was passed? >> in terms of that specific legal request, i would refer you to dhhs. we are trying to confront a very specific problem. that is the large number of children that have appeared on the southwest corridor

unaccompanied -- border unaccompanied by an adult that maybe a company by criminal element making sure their humanitarian needs are met. >> can you do these things you're saying? do you want to send more of them back home or keep them in dissension -- and attention centers and have them adopted by other families? can you do that legally now? do you have to change the law? >> is my understanding that the greater authority we are seeking for the secretary of homeland security would allow us to address the rubble more directly. it would put the administration and a posture where we can work quick we process the claims come in to do a better job of determining who has a legitimate claim for remaining in this

country and who doesn't. if it's determined that they do not, these children or these adults who have arrived in the southwest border with children can be returned quickly and repatriated to the country where they came from. i want to make one thing clear, this happens to be a priority of border security and national security. we are talking about children largely. it's a humanitarian situation that has the potential to only get worse. that's why it's important that we follow the law in terms of meeting the basic humanitarian needs of these children but also making it clear as the president did last week that parents who may find themselves in an increasingly desperate situation in their home country, despite that desperation, should not be looking for an opportunity to put their children and the hands

-- in the hands of a stranger who is likely a criminal to transport them safely to the united states. that is not a good option. it is not one that any parent should pursue. >> if many of these children are vulnerable,s is the president concerned that speeding up the process of them being removed could violate their due process? what does the it ministration plan to do about that? >> we are committed to make sure we are following due process. we are seeking to make sure we have access to more judges, more ice officials and asylum officials who can make sure that due process rights are being respected. when it comes to repatriation, one of the things we have done and this was part of the

conversation that the vice president had with the leaders of the central american countries 10 days ago and will be part of the conversation with the secretary of state and the same countries will be about american resources that can be used to try to help stem the flow of these refugees. we have ongoing partnership arrangements with law enforcement officials and military officials in these countries but we want to work with them closely to try to meet some of the knees of these communities and try to stem the flow of people from desperate situations. >> wouldn't you be sending the children back to more danger? >> we are cord knitting with these countries that we have a way to repatriate these kids and away as safe as possible. -- we are coordinating with these countries that we have a way to repatriate these kids in as safe a way as possible. i must understand that putting their child and hands of a stranger who is promising to

deliver them to the united states is not at all a wise decision. >> in addition to hobby lobby, there are six or seven other high-profile cases at the supreme court. how concerned is the president about the direction the supreme court is pushing the country and the law? >> that's a pretty broad generalization. i think i have been pretty clear about where our disagreement lies in the comes to this specific ruling and the problem that it creates for women employed by the country. that disagreement notwithstanding, this administration will obviously abide by the rulings of the supreme court. >> there has been a ruling last week on the abortion buffer

rule. it seems that -- is the president worried about supreme court pushing judicial oversight into a general direction. >> i would not make a broad assessment like that from this podium. april, do you have a question? >> yes i do. >> you are being very attentive. i want to go to a question asked about the va. leading into the process of naming a new head of the v.a., who has the president consulted with? >> there was a commitment by this administration to reach out to all the stakeholders. i should say to a wide range of

stakeholders. this was to make sure that the criteria that was being used for deciding to nominate mr. mcdonald was inclusive of the qualities that will be required in the new leadership over there. that sort of highlights the kind of credentials that mr. mcdonald is to this task. he is somebody who served bravely and our military, graduated at the top of his class at west point, served for five years in the 82nd airborne division in the united states army, and has decades of experience running a large organization, multinational company, that is headquartered in cincinnati, ohio. he brings a wealth of experience and skills to this task. determining that he is the best person for the job was based on the skills he brings and the skills that are required is

something that was discussed by senior members of the white house as they conducted this search with the wide range of stake holders. >> for over 35 years, c-span brings public events to you. offering complete gavel-to-gavel coverage of the u.s. house, all as a public service of private industry. we are c-span -- created by the cable tv industry 35 years ago and brought to you as a public service by your local cable and satellite provider. watch as an hd and follow us on twitter. here is a look at what is coming up on c-span. next, live call-in program on e-cigarettes. two senate committees recently held hearings on the issues. we will look at key portions and then get your reaction with were

calls and reaction on twitter. he is shifting resources from the interior to the border. :20 we will show oral argument on the contraceptive ruling. >> depending on your kind of you, the devices you are either looking at are either promising tools for quitting cigarettes or a new way to get children addicted to nicotine. e-cigarettes, or electronic cigarettes, a booming business have caught the attention of federal regulators and congress in recent months. tonight on c-span we are going to bring you a look at the issue from both sides, all sides actually with portions of recent senate hearings on the issue. a bit later on we will be joined by michael folder bomb of the associated press. he covers the tobacco industry or ap. we will be joined by mr. photo bomb.

in -- you can also join the conversation of facebook. it would require warning labels on products and no free samples. it would call for the disclosure of any ingredients in the e-cigarette and also any health claims made by e-cigarettes hard,ies would require scientific evidence. some of the proposed regulations . they are in a comment time now ahead of making a rule on e-cigarettes. the proposed regulations do not put restrictions on liquid flavors. no restrictions on the advertising of these products.

the last two issues were the focus of a recent senate commerce committee hearing where jay rockefeller, chairman of the committee sharply criticized to e-cigarette makers. we will show you that in just a moment. a reminder later on, we will open up the phone lines for your comments. we will hear your comments on facebook and twitter as well. >> today the committee is examining the marketing of e-cigarettes. i should warn you i am emotionally on edge on this whole subject. i am on edge. we will hear today from the tobacco companies they are just marketing to adults. i will find an amazing answer and we will probe that.

he cigarettes are battery-operated products that vaporize a lick -- liquid containing nicotine. we all remember that, don't we? eight people with their hands raised. we know the cigarette are somewhat in cigarettes are somewhat different. but nicotine is nicotine. but ok for little kids. they're looking for things. they are looking for things that they get to see a lot of in advertising. one of the nice things you can mimic the act of smoking. it is cool. kids are cool. these products are relatively new, and the long-term health effects are unknown at this point. to me raises the question, why in heavens name are you going ahead and marketing these things and selling these things and putting them online when the results of the health studies

which are being done seriously are still out. why would you do that? you want to make money. that is your answer. that is your answer. you will tell me you were just talking to adults, but you are not. you want to make money so you plunge in, get what you can and the studies come out and you go ahead and do it until the fda puts nice rules and regulations on you. these products are relatively new. the products are unknown. others are concerned it may reduce quitting by encouraging dual use of e-cigarettes.

but we have not done enough research yet to resolve this question. that is not the focus of this hearing. instead we will focus on how marketing of the rates e-cigarettes reaches america's youth and what consequences that fact may have. addiction under any form is a bad thing.

not sure what the long-term health consequence. not sure the short term health consequences but there is an opening in the market. >> if you put west virginia and south dakota together, you have approximately 72% of the united states territory. health experts are sounding several learns on the virtually unregulated products. in addition, e-cigarette recalls related cause calls to poison control centers to be very much on the rise. and particularly involving

under the age of five. yes, five. moreover, some studies indicate toxins other than nicotine may be found in e-cigarettes. we don't know that. he don't know if the answer is yes partially or not at all. we don't know, do we? so we hold off until we know. and then we go ahead. some have chosen a very different course. given the health concerns and lack of damage a -- data indicating health benefits it is imperative to restrict youth exposure to e-cigarettes. simply stated, children and teens should not be guinea pigs.

i do not understand the corporate view on that. you do know what the results are with nicotine and cigarettes. it does not reflect well on corporate america. e-cigarette use among teens more than doubled. a study found that an awareness of e-cigarettes among youth is virtually in the quintess. i guess they have to see

something like advertising. we will talk about that. use awareness has coincided with a flood of recent e-cigarette marketing activity. a report published this month in the journal of pediatrics found youth exposure to e-cigarette advertising on television increased 200 and 36% in two years. go for that dollar. a legacy foundation pretty

loudly and pretty clearly they are getting the message, particularly when they aim the message in tv and magazines. this will really come down hard towards kids. senator durbin will be here and he will be able to speak.

the results of the inquiry, and that is all it was were troubling. the joint brief port we issued this april concluded e-cigarettes manufacturing -- manufacturers are aggressively promoting products using techniques and vendors that appeal to you -- youth. now, i understand that whatever young people go to you will find adults. you say we're really targeting just have toss you overlook the fact that a lot of adults would not go to what you're targeting. but we will see. have surveyed companies include sponsorship of youth oriented sporting and cultural events, handing out free product samples -- that is really nice. free product samples.

neutral. nothing aggressive about that. nothing about enticing the money flow to pick up in that. using celebrity spokespeople, god rest her soul. ads that reachon large youth audiences. imposing youth restrictions. marketing and flavors that could appeal to children. i am an adult, so what i'd be attracted to cherry crush? peachy keen? vanilla dreams? no, i would not. i probably would have been. so that is the way it works. the dollars flowing in. this review provided just a snapshot of activities of nine market leaders in this industry,

but there are hundreds of companies that do this. in the marketplace. for example, the flavors identified in the report for fillable liquid can be found in thatrs include bazooka jaw is no turn on for me. gummy bears. no. no, that is not the adult stuff. chocolate tootsie. that is not adult stuff. that is aimed at children. product like these are more like a candy shop display then delivering a nicotine vapor. it is not hard to see how they could appeal to kids. many of the practices of e-cigarettes companies are using to pitch her products are a cigaretteor marketing under measures include the comprehensive 2009 family smoking prevention and tobacco control act, which passed and his in law but these

restrictions do not currently apply to e-cigarettes. loophole in the law. a chance to rake in cash, worry about the kids later. 4000 kids in west virginia. is that important or not? to me it kind of is. the companies may not be looking at that. it is worth noting that tobacco control law was enacted following years and years of litigation that uncovered internal tobacco companies documents showing despite claims they only promoted their products to adults, the industry has targeted young all as a critical market. of course you have. money is.ere the that is where the buying is. that is where you have cash in .our pocket

12, 8, 14. out you go. you want to be cool to me you can hold one of these things and look like you're glorious swanson. was that her name? in april, fda proposed rules to regulate e-cigarettes. but finally these rules could take a long time. making them complete. meanwhile, the e-cigarette industry is booming and tobacco companies with a history of marketing to youth have been jumping into the market. the e-cigarette industry continues to rapidly evolve. we need to hold companies accountable. that is the american tradition.

gm is finding out about that, toyota found out about that. accountable for promotional activities that encourage kids to start using e-cigarettes before what we -- before we know what the health effects really are. don't wait for what you might be getting into. what harm you might be doing. maybe congress and fda would be where they are, slow. then again those four thousand kids from west virginia not maybe at the top of the list. look soe-cigarettes similar to cigarettes, we must make sure e-cigarettes marketing denormalized smoking for american youth. an area where we are making tremendous progress.

after a long amount of time. in any event, i look forward to talking about these issues with the major e-cigarettes company are presented here today in the panels accomplished expert. now, senator svend. -- thune. >> thank you. allow me to add my birthday wishes. i am sorry you're stuck spending it with us. i want to thank you for today's hearing and think today's witnesses for appearing before the committee. according to the world health organization, more than one billion in the world. sadly one year alone more than 5 million will die prematurely due to direct tobacco use. in 1976 professor michael wrotel, a leading expert people smoke for nicotine that died from the tar.

these products may help reduce the number of individuals who smoke combustible tobacco cigarettes. talked or david abrams and the american legacy foundation, a nonprofit organization dedicated to reducing tobacco use funded masterdst from the settlement agreement between state attorney general and tobacco industry in 1998 has called the e-cigarette intentionally disruptive technology able to render the combustion of tobacco oxalate. the director fda center for tobacco products recently said we have to have an open mind for the potential of emerging technologies to benefit public health. ofaddition, a recent study

the university college london on the efforts to get people to stop smoking found they are 50% more effective. many argue their product is an emerging technology and warned they do not follow the response on science may inhibit the ability to create a safer product or smokers. at the same time, we need to be mindful even if they are shown to be last armful to tobacco cigarettes, nicotine is addictive. the long-term usage and health effects of the products are currently unknown. opponents also believe they are a gateway to tobacco cigarettes. recent studies have shown with an increase in e-cigarette marketing overall wellness -- awareness of e-cigarettes is growing and some advertisements are reaching youth audiences. in addition, the campaign for tobacco free kids represented by mr. myers has identified a

similar campaign and seem as advertisements from combustible cigarette companies decades ago. while this is not necessarily the case for all companies, it raises understandable concerns about the targeting of the advertising. there has also been a recent rise in the number of calls to poison centers related to children and e-cigarettes. the american academy of pediatrics represented here today has raised concerns about the lack of child resistant packaging on the products. the fdathis year proposed a deeming rule to regulate products. a number of questions are being asked about how these products should be regulated, especially how they can and cannot be marketed. even these are relatively new products and the extent to which they may provide benefits to public health, i believe sound science should drive the discussion for federal regulation. i also think we should all agree

that children not be able to purchase his products. my home state of south dakota has banned the sale or use of e-cigarettes by those younger than 18 years of age and several other states -- and several other states have done the same. while i am opposed to smoking in general, i lurk -- look forward to learn more to reduce harm to current smokers. as with most issues we face in congress, i believe more scientific investigation and thoughtful discussion is needed. esther ballin is here to discuss some of his work to start a dialogue between various stakeholders on these issues. as with many highly idolize products and is in the middle -- with use.

hopefully we can shed light on the pros and cons here today. thank you again for the witnesses for appearing today and look forward to hearing your testimony. let's start with doug mccaskey. >> good afternoon, and may i add my birthday wishes. >> please don't. >> happy birthday. >> i am a practicing pediatrician and associate pediatrics at the benefits of dartmouth. i am here representing the american academy of pediatrics at membership at 62 thousand pediatricians. i am the chair of the tobacco consortium and conduct research on tobacco and adolescence. members of the committee, it is talkeasure to be here and about electronic cigarettes. pediatricians have known and unknown risks and health of the -- help and faqs. we are seriously concerned they made late adolescence to a lifetime of nicotine addiction

and could serve as a gateway to traditional cigarettes. the aggressive marketing and impact on youth is particularly worrisome. the evidence is clear tobacco and advertising directly impacts the youth. use of the cigarettes is rising dramatically and we believe it is clearly linked to advertising. while there is much we do not know yet about the products, we know enough to say this, we must act now to protect children against the risk from e-cigarettes. they have mentioned devices that contain nicotine, flavoring and other chemicals. contrary to claim, they are not without significant risk. augustine is a psychoactive drug with a high level of toxicity and rapid addiction. overdose can lead to has -- caesars and death. it can be absorbed through the skin and comes with work by safety warnings to handle with gloves, masks and protective clothing. the lethal dose is somewhere between one and 13 milligrams

per kilogram of body weight. it would be a much lower levels for children. pediatricians fear it is only a matter of time before a young child dies. indeed, this has led to a recent spike in calls to poison control centers. it is colorful, often smells childandy and smells like -- and has childproof packaging. it is enough to kill several average size curious toddlers. we find it completely unacceptable no federal laws require the containment of liquid. the omissions are also not harmless water vapor. cause theent can carcinogensns known

-- carcinogens. all that the it lower than found in normal cigarettes. they are particularly concerning because of the well-known appeal of flavored tobacco use. this is well understood by e-cigarette manufacturers. kids may be particularly vulnerable due to an abundance of fun flavors such as cherry, piña colada. notably, the same company market e-cigarettes and cherry, noah and piña colada. other flavors include cotton candy, hapten crunch. clearly enticing children. young people being enticed this particular concerning because the adolescent brain is particularly perceptive. it e-cigarettes cause nicotine

addiction to adolescence, there is a risk the users will progress to use tobacco products. anecdotal -- anecdotal reports suggest it may help to reduce or quit smoking. at this point for the research is made to determine how it can play an official -- beneficial role. researchers need to identify whether they're used as abridged to the neck cigarettes, delaying or intimidating -- inhibiting the complete smoking cessation. there is another concern, the renormalization of smoking. we know children do what they see. important we do not allow it to re-normalized the issue -- the appearance of a smoker. know, it ise concerning e-cigarette use is growing dramatically. nine percent of 13-17-year-old are using electronic cigarettes. marketplace a large role in advertising. by celebrity

endorsements, glamour models and eventt -- sponsorship. these marketing practices must stop. we support the regulatory authority to regulate tobacco products for the protection of public health. it would be a tragedy if we fail to regulate cigarettes in a way that protects children, only later to find out we caused serious harm. the message is simple, we have a duty first to protect the children. thank you very much for the opportunity to speak here today. lex thank you very much. now mr. matthew myers. >> i am matthew myers, president of the campaign for tobacco free kids. mr. chairman, minority

member and members of the committee, i want to thank you for the opportunity. we have worked with many of you were over a decade to help pass the law giving the fda authority of thegarettes and all tobacco products, precisely to address many of the concerns that you raised today. over the past several years we have seen a dramatic growth in the marketing and sale of e-cigarettes. despite the rise in the use of e-cigarettes, as you correctly noted come a little is proven. either about the health effects or their population impact. position is that responsibly marketed and properly regulated e-cigarettes could benefit the public health. if in fact they helped people switch off of cigarettes to either the exclusive use of e-cigarettes or quit the use of nicotine altogether. however, e-cigarettes pose a

potential health risk to the public if they are not used by smokers or other tobacco users to stop altogether. if they cause children to start or read glamorize smoking in the eyes of our nation's children, or if they discourage smokers from quitting by providing doses of nicotine to sustain addiction rather than help people quit. as you correctly noted, as a result of the failure of the government to act swiftly and the most irresponsible action by the manufacturers and marketers by cigarette companies, the marketplace for e-cigarettes has turned into a true wild west. the rapidly growing and today completely unregulated e-cigarette marketplace has not only outpaced the science, the behavior of the e-cigarette industry itself raises serious concerns about the ultimate effect of e-cigarettes on the

public health. how e-cigarettes are made can also impact whether they are effective at helping people quit smoking cigarettes or whether they lead to sustained cigarette use or introduce a whole new generation to smoking. unfortunately it appears a substantial segment of the industry is neither designing their products, norm are getting with an eye towards reducing the who smokepeople cigarettes. let me address the issue of marketing, because it is the one this hearing is about. the marketing practices, scenes and images of the e-cigarette manufacturers today exactly as you noted are virtually the same as those used by the cigarette manufacturers to successfully attract kids to smoking cigarettes for 50 years. it is a battle we have been fighting and are slowly but significantly winning. for e-cigarettes today what do we see? we see celebrity spokespeople with scenes like

freedom and imagery like this. sawee the use of sex as we with the cigarette companies with scene and images like this. we see placement in the swimsuit issue of sports illustrated with placement of the brand name on the bikini -- bikini bottom honest deadly cloud model and probably the magazine read by more adolescent boys than any other single magazine in the united states. we have seen a return to sponsorship of sporting events, youthoncerts, attended by all over the country. cigarette companies use the exact same images in the exact same places in the exact was tragiche impact and we're still paying for it. it was a dramatic rise in flood in youth tobacco use.

mr. chairman, as you correctly noted, today we see a decline in cigarette smoking some of but we are also seeing a rapid rise in youth and experimentation of e-cigarettes. should be surprised. while it does not take a rocket scientist to look at these ads and figure out who they are targeted to, we have a whole the of science done by national cancer institute, the institute of medicine, the surgeon general and a plethora that have looked at the techniques in marketing and directly ande causally related to the increase in use of cigarette smoking among kids. logic and science to say the same techniques will not have the same impact on our nations youth with regard to e-cigarettes. thewill hear, i am sure, e-cigarette manufacturers say we do not target kids.

well in fact, that is exactly what the cigarette companies have been saying for the years. to this day i have never admitted running a single ad that targeted kids. the third prong of the eight was weat stood up there don't market the children. let me quote from judge kessler's decision in the case the federal government brought against the tobacco industry eight years after the tobacco industry promised to stop marketing to kids. this is the same company that marked the blue e-cigarettes. judge kessler found exactly the opposite. correctly said, and i won't repeat, it is not a surprise we're just seeing the dramatic rise in youth, because

in the past 2-3 years we have seen a fundamental change in e-cigarettes marketing and on -- a fundamental change in the amount of marketing. what we're seeing is the start of a potential tsunami because not that e-cigarettes are good or bad, but because of the behavior of the eason your -- e-cigarette manufacturers and marketers. that is what is causing the rise here with regard to this. not a surprise we have seen the dramatic rise and should not see the risee takeoff in unprecedented levels unless something is done to stop a kind of marketing i have shown you. the same is exactly true with flavoring. they are asked king asked to turn the world upside down. the exact same flavors you quoted that prompted congress to ban the use of characterizing flavors and cigarettes are now being found in e-cigarettes. we are hearing the same thing from them. these are not about targeting

kids they say. here is a bottle of eve liquid. cinnamon bun flavor. i would pass it around but your fingers would stink and i would have to caution you not to open it because it says if it passed just your skin it is toxic. if you inhale it, it is toxic. yet it is sold over the internet with virtually no controls. flavors of blue cherry crush with this. is it a surprise that the data is showing an increase in youth of these very flavors? cited a tobacco company's own website, but i could cite you a string of internal tobacco industry documents" that says these flavors appeal primarily to young people. whether or not they may help someone quit smoking, we don't know. they appealnow is

dramatically to young people, and unless someone gets a handle of the marketing of the flavors and a new study out in just the past few weeks shows the number of new flavors is literally exploded, and i can guarantee you no one is testing those flavors as they would have to if they were regulated by the fda to see whether the flavors entice kids. atshort, this hearing comes exactly the right time. it is an urgent need for our government to step in and protect our kids. unless the fda acts and acts rapidly, and unfortunately the proposed regulation does not even address the question of

e-cigarettes marketing or the flavor of e-cigarettes, so that our kids will continue to be human guinea pigs for the un-industry that has demonstrated no responsibility and how it has marketed, where it is berkowitz, to whom it it has targeted products. we urge you to take strong action to ensure the issues are addressed. thank you. lex thank you. now mr. jason healy. -- >> thank you. themarket leader in e-cigarette industry. we welcome you, sir. >> chairman rockefeller, i am jason healy, founder and president of blue e-cigarette. it is a privilege to come here today to speak about a new product that has tremendous potential to reduce tobacco-related harm and disease and hopefully play a role in

eliminating traditional cigarettes. back in 2008 i tried my first electronic cigarette. as a smoker i saw tremendous opportunity for myself and other smokers. i immediately saw the innovative product could provide an alternative to smokers who enjoy smoking or who struggle to quit like myself but do not want the negative effects of traditional cigarettes on their health. convinced e-cigarettes are just as much of directors -- a disruptive force to tobacco as digital cameras were to the film industry. alone in seeing the potential. public health experts have long considered harm reduction and effective approach to reduction of risk caused by various behaviors. great progress because we desperately need an thatnative policy complements prevention and cessation. different types of nicotine use

among what the fda calls for risk. some activities carry less risk than others. lacking combustion, e-cigarettes fall dramatically low work on the continuum compared to traditional cigarettes. that is only logical that has traditional cigarettes are some much different. a recent study by our research has found harmful constituents present in cigarette smoke is e-cigarettes. similar to that found, findings are consistent with other third-party research. i have included a summary of this analysis. >> could you say the last sentence once again? >> to the harmful constituents? >> our the research has found harmful constituents present in cigarette smoke were at undetectable levels in the vapor of even -- blue e-cigarette and

similar to that found in room air. we support regulation of e-cigarettes and committed to working with the fda. manufacturing and it's to ensure safety, age appropriations to ensure it is a product for labeling to ensure that consumers are supported by responsible manufacturers. we are encouraged the preamble to the proposed regulation seems to acknowledge regulation should be proportional to harm and a one-size-fits-all approach is not appropriate. the director of center for tobacco products when he said we have to have an open mind for the potential to benefit public health. act to fade --y advocated and supported state legislation to prevent minors from purchasing electronic

cigarette and we require third-party age verification for online sales. as a small company marketing a product in an emerging market with the challenge of introducing at product that did not exist in the u.s.. with the help of the parent company we adopted strict and responsible marketing restrictions that reflect a whileand focused substantially reducing risk to promotions. voluntary restrictions such as limiting ad placements to media and event were the target audience is at least 85% of adults match or exceed restrictions adopted by comparable adult consumer product companies. as an industry leader, we believe the marketing restrictions demonstrate responsibility. to reiterate, the marketing focus is to communicate to adult smokers. witheviously provided you an exclamation of the voluntary marketing restrictions we have adopted. this in theuded

submission and have provided to the committee. there is tremendous untapped potential to positively change the lives of adult smokers. new way ofes a thinking and involves compelling market to normalize the behavior and as a result, de-normalize smoking. so they know it is a viable alternative force the trial. using a we believe variety of flavors is critical to keeping adult smokers who have switched from returning to more harmful, combustible cigarettes. these are most likely the most significant harm reduction products ever, making less harmful products available as soon as possible should be a top priority. thank you. lex thank you very much. now mr. kreg weiss.

i am the president and ceo of enjoy. it is an electronic cigarette company with no affiliation to the tobacco industry. we are proud to say our corporate mission is to obsolete tobacco cigarette and the death and disease it has left in its wake. i would like to focus on what i believe unites us and members of the committee with the center for tobacco products and dedicated men and women in the tobacco control movement in public health. we look over to a day when combustion cigarettes are no longer part of the american landscape. we work appalled that the has taken andic continues to take each year in the country, including 480,000 americans dying each year from tobacco-related illness. the evidence clearly indicates

it will be required for e-cigarette. it gives smokers who either cannot or will not quit a positive alternative. it provides them with the nicotine they are addicted to without the combustion of tobacco. as stated by the 2014 surgeon general's report, the birth and -- the death is overwhelmingly caused a cigarettes and other tobacco products. understand the great suspicion caused by the 2012 marketplace for the first of the three major american cigarette companies. while major tobacco companies have now entered the category as cigarette sales fall, they did not create the industry in most companies do not sell combustion products.

enjoy, establish more than five years before the first american tobacco company purchased is independent of the tobacco industry and has no incentive to come -- promote tobacco use. reports from a cdc survey that experimentation of e-cigarettes among youth has risen should be taken seriously. however, early fears they would entice young people to initiate with the products and migrate to combustion products appear to be unsupported by the data at this point. should ber, no minors using a nicotine containing product of any kind. the maximum public health benefit will be achieved and mitigating risks to youth without constraining the ability for e-cigarettes to effectively compete with combustion cigarettes among adult smokers. bans on sales to minors, which we were among the first to support are essential. we have long supported the

regulation of the category. this was not part of the proposed regulation. subjecting electronic cigarettes to file advertising restrictions promote to adult smokers. smokers will not purchase a smoking alternative that they are not aware of. it is important to aware of -- be aware of we face the same advertising restrictions and the big winner will be tobacco. still, even responsible television and other advertising should be delivered in a manner consistent with the assertion that it is intended for adult smokers rather than for kids. the television campaign friends don't let friends smoke is a clear illustration of the

principal, and we need more, rather than less of this kind of advertising. analyzing information collected in the may 2014 report on e-cigarette advertising that was referenced in opening remark, the american liberty foundation found the data suggest the marketing of njoy is more focused on reaching an adult audience. according to the surgeon general , nearly 6 million of today's children will adopt smoking, grow up and die prematurely from cigarette caused disease if resident trends continue. the best thing we can do for the help of all of our children is to ensure they grow up in a world in which neither their parents nor any of their adult role models are smoking combustion cigarettes. providing smokers who cannot or will not quit with a positive alternative may be long-sought solution to a math of public health problem that has cost millions of lives and more and more members of here and rod are making their voices heard in

support of the technology. there is too much at stake to do it any other way. we look forward to working with the committee to achieve the goal of obsoleting combustion cigarettes. thank you. >> finally, mr. scott they lick. -- balin. >> happy birthday, sir. tobacco and health policy consultant. >> yes, mr. chairman, members of the committee come and thank you for the opportunity to be here. i have spent much of my professional career dedicated to working in the public health arena, and in particular, tobacco and nicotine area. worked for the heart association for many years. so i have been around for a long time. so i also feel the age. i come here today to give you my thoughts on issues being raised

in the hearing as well as unrelated issues. some of those have come up or on what is a very dynamic, mostly charged and rapidly changing environment. this includes the broad topics of how all tobacco and nicotine should be regulated including advertising and marketing. i and many others, including the director of the fda center for tobacco products legally or in a new era, a sort of evolutionary next stage looking to develop a more comprehensive rational and workable approach to regulation of all tobacco and nicotine products. this next stage could potentially be a significant as the requiring of fda oversight over tobacco just a few years ago. it entails how best to regulate the growing spectrum of products i'm including e-cigarettes that hold significant promise for phasing out or one day eliminating the deadly

combustible cigarettes but has to be done right. isentails using what commonly referred to as risk today which would regulate product based on risks and intended uses. on are the days when we could conveniently say all tobacco products were equally harmful. the fda oversight has changed the equation. science and technology and innovation have changed the equation. new entrants into the marketplace have changed the equation and consumers have changed the equation. while there are many issues needing to be addressed in the new era, two general areas of focus come to mind when it comes to reducing the harms caused by the use of tobacco. worst homily need to ensure that no one under the age of 18 should be able to purchase any tobacco or nicotine product and that we do everything feasible to prevent initiation, and use by anyone under the age of 18.

this includes advertising and marketing. intentionally or unintentionally appears to children and adolescents and includes a conversation about what restriction should be placed on flavorings. cans generally agreed if we prevent youth initiation we're a long way towards advancing the public health objectives. second, we need to ensure the approximately 40 million smokers in this country are provided with consumer acceptable regulated alternatives to the deadly toxic cigarette. that is what is killing people in this country. earlier, many years ago people smoked for the nicotine and died from the tar, which in many respects what this discussion is all about today. to do this effectively, we do need regulations that recognize their artistic differences in relative risk between the products. one size does not fit all. we should also be encouraging better and miller -- more

focused research. and encouraging competition rather than stifling it. changingapidly environment, it will be essential that we approach the discussions of these issues and a more civil manner. that is actually happening. i appreciate your leadership. i believe there is a lot more in common ground than people think. the institute for environmental negotiation at the university of virginia has been at the forefront in holding the safe haven tobacco dialogues where individuals can discuss things in a non-adversarial manner. the first of the dialogues involve the public health community and tobacco growers that actually lead to policy changes in this body and the house that led to the enact and of the tobacco control act.

that was monumental. additional safe haven dialogues are being planned and we will try to expand the discussions to include a broader number of people. this is also a place where interested parties can make them heard. of theree the specifics proposal. i believe it is looking for new ideas and approaches. the door is open, and i think the fact they have that covered issues related to marketing and advertising of e-cigarettes allows that discussion to start taking place in the agency as well. mr. chairman and members of the balancee, there is a that needs to be achieved which in my view can be a win-win for public health. you can deal with the issue of regulation including the impact

of advertising and marketing as well is helping millions of addicted adult smokers. while we're making some progress, it is not enough. barely not enough. as dr.roaches are needed ken warner just told time magazine a few days ago. i agree with him. i need to think outside the box on some of these things. within the next 10 years i would like to see the number of children and youth using cigarettes cut by 75%. the number of adult smokers cut at least in half. a major shift away in the manufacturing of deadly toxic cigarettes to the development of manufacturing and use of significantly lower risk science -based regulated products. i believe this coupled with market competition and cooperation amongst various stakeholders we can do it. we can save a lot of lives in

the process. thank you. flex thank you. -- >> thank you. i don't even know where to begin. i guess what you are saying is you have a corporate board it, youand you've made decided the corporate purpose would be to reduce cigarette smoking among adults. therefore you want to e-cigarettes as a way of so doing. >> yes, the corporate mission is cigarette. the >> that would lead to the conclusion you do not do advertising in some of the magazine and tv that have been discussed. you do not advertise in areas that would appeal to youth. would not need to do

that because you have a different mission. the adult you are working on, not working on kids. >> that is correct. >> so you do not do advertising? advertising targeted towards adult smokers. >> is that advertising the kind discussed by mr. myers? >> he did not hold up of many of the advertisements. as i mentioned -- >> you understand what i am saying, in other words, appealing to young people. >> i do not believe they appeal to young people. >> life is easy. life is easy when you can work like that. you are on the record there. not everyone has to answer. i am worried obviously about e-cigarette marketing reaching

youth that appears to be the case. way tohave figured out a get nine and a half million people who read advertisements, 14 million people who see aboutisements e-cigarette, that is an interesting discussion. but limiting cigarette marketing to youth has been central to the to prevente effort young people from becoming addicted to smoking and it is nicotineblished that is the addictive ingredient in cigarettes. so mr. myers and dr. kamsky, would you agree that amid a sustained and prolonged smoking prevention and tobacco control efforts there has been an encouraging decline in youth rates in cigarette smoking in

this country. there has been a wonderful decline in the rates of smoking that just came out last week. prevalent for high school youth. there have been great strides in reducing cigarette smoking among our youth. >> i get the drift. the target audience is just adult smokers they say. and that the other youth do not figure in. is -- this gets so to the integrity of corporate culture what people will do when they are given the chance to make money. i am sorry, that is so deeply embedded in me that is why i said i am on edge emotionally on this whole hearing.

but by blanketing a wide for righty of media with advertisements, are these companies also creating the risk of introducing a whole new generation of young people 0-5 to the highly addictive substance called nicotine? >> yes, sir. that is exactly our fear. ofre is a whole generation young people that have grown up since the master settlement agreement and other restrictions who have never seen a tv gay marriage -- glamorizing cigarettes and the kind of advertising. concerned thatly while e-cigarette company should be free to inform adult consumers, there are ways to do it that do not require them to put advertisements on bikini

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