can disagree, but it is completely clear that these issues were debated thoroughly. would also like to clarify some missed recessions my january 2012 remarks. the portion of these remarks that has received so much attention of minutes of critical com component. the possibility that the federal government might not create a federal exchange. occur, then the only way states can guarantee that their citizens would receive tax credits would be to set up their own exchange. i have a believe that health reform legislation in general must include mechanisms for residents to obtain tax credits. -- imulation

official,n elected nor am i a political advisor. i am a economist. the recent response to my exceeds about their relevance and role in health care reform. i will have to live with that. aca is a milestone accomplishment for our nation that has already provided millions of americans with health insurance. we are embarking on a second period there will allow them to select the best insurance plan that works for them. can gothat our country

past the distraction of my comments and focus on the enormous opportunities. >> thank you. mr. goldman. >> i am one of them million from staggering expense of health insurance. these reforms have helped ensure that many americans will not be burdened by crippling debt. i hope that my words today serve as a reminder of why the aca has measurably improved the life of individuals and families. outside of boston.oston

i had the freedom to switch careers. i experience love and heartbreak. watchedame time, i friends become burdened and forgo access. i'm now 33. i have lived in washington dc for 11 years. i am healthy. i have low cholesterol. i am doing well. turned 26, i abandoned a career in nonprofit fundraising. it was bolstered by unbridled optimism. i did not consider that because manageable pre-existing conditions that i would be forced to navigate and i'm friendly health insurance marketplace.

i found great satisfaction making a living working in the restaurant industry. although i worked full time, i was not offered benefits. ventured out into the individual market and applied to several brand-name companies. they turned me down. one company offered a planet $450 a month. i enrolled, even though they refuse to cover prescriptions or office visits. i conducted a cost-benefit analysis and decided that i would rather be under insured. my two years with this ensure was an expensive joke. claims were routinely rejected. it was better than nothing. i received notification that as of 2014 my plan would be can discontinued.

-- that my plan would be discontinued. technical glitches and dead ends, i applied. he answered the many complex questions i had. anh his help and took under hour to sign up for a ppo plan. , it iss of premiums reduced my cost by 60%. i am able to keep those providers i have built relationships with. over the past year, i have had lower day-to-day costs. i estimate that i saved more than $5,000. which in addition to my part-time work as a waiter has made my decision to pursue a career more viable.

thanks to the aca, i can be entrepreneurial and take control over my own future. i no longer feel marginalized. i have the confidence i will be able to shop for a plan. i can find a plan that will meet my needs. getought i was going to similar coverage at the same cost i did not expected to be good as it was. i was thrilled after i enrolled because i was covered of dissipating in history. i have a pretty good education and a healthy family. aca can help me, it can help anyone.

thank you for your time. >> thank you. are you receiving a subsidy at all? >> no. >> i'm glad you found part-time work. you testified before the committee and you use the terminology enrolled in the health care insurance market coverage. normal the appropriate way you referred to in roman numbers. enrollment numbers? had you said enrolled in health care plans you would have had to reduce that by 400,000, isn't that true? that we would have

double counted up, i would have corrected that. that was a mistake. what was considered by anyone to be false and misleading testimony. you included data that included 400,000 dental plans. there were separate numbers, far greater numbers for dental at the time. as those numbers went down, they got combined and the language got changed to enrolled into health insurance marketplace coverage. the question is, did you have anything to do with the use of that term. where you are aware -- yes or no -- were you are aware that dental was included in your testimony. ? >> i was not aware that dental was included in my testimony.

>> i have been accused that i'm going to berate you. i hope you won't feel that way when i done. i was at the kennedy center honors. and successful stupid man. are you stupid? >> i don't think so. >> are in my tm employees stupid people? >> not to my knowledge. >> you said some really stupid things. >> the comments i made were inexcusable. >> you did say in the video we played and that everyone else says seen, you did say that in fact that if people knew the

whole truth, they would not have voted for this. -- direction you were going the reality -- and specifically -- there is a silver plan that is relatively inexpensive. the shifting of some people to pay more than they previously -- for mr. goldman to get a reduction, somebody else got an increase, but an increase to offset his decreased. true that there are taxes and increases for some that is part of the plan? all, i made a clear mistake in trying to conjecture. >> you're trying to conjecture on the analysis of the numbers. gruber -- you as dr.

a smart man at a great institution who has collected over $4 million in various fees. isn't it true that in order for mr. goldman to get his reduction -- and he is happy about it -- that it included those so-called cadillac plans. >> on average, individuals are paying less for health insurance. >> people like me are paying more. cost shifting occurred in your model, isn't that true? model.average fell in my >> it did not fall in reality. this may be the tougher question for you.

you said in these video comments that you had to deceive in order to get this passed. model, the formally and dollars you received to develop , ifprovide those models deception was part of the process by euro statement, why should we believe your analysis? why should we not demand to go into the micro economic analysis and find out whether in fact the $4 million in services you delivered were accurate or whether the books were cooked? has beenount of money overstated. it refers to grants. second of all, no one has questioned the quality or integrity of the modeling. >> that is why i'm axing great shouldn't we question or have

independent analysis of the numbers you delivered to massachusetts for that matter to to the federal government based on your statement that in fact if people knew the truth, they wouldn't and there was a deception. i want to go to the ranking member. that therey reason should not be independent validation of the numbers you use in light of the statements you have made? the quality of my numbers should .ot be reflected i posted information about my model. i can answer questions about the model and how it works. >> thank you. i hope there will be an independent analysis of whether that model would stand the scrutiny of an audit. as i mentioned in my opening

statement, i was frustrated when -- with your statements. you they were insulting. they were especially harmful because they gave the opponents of the aca a pr gift. you did a great job. you wrapped it up with a bow. this has nothing to do with the substance of that issue. debates. now i have to say, i listened very carefully to your testimony because i wanted to hear exactly what you were going to say. a lot of times witnesses who come before the committee avoid apologizing. so you deserve some credit at least for taking this head-on. and taking responsibility for your actions. i know you believe in the aca

and you also worked with governor romney on his health care bill. is that right? >> yes. >> so my question is this. sitting here today, what do you say to those people who are trying to eliminate the aca? and who are quoting your statements as a reason to repeal health care for millions of americans, and many of my constituents? and people who are watching us right now on c-span? what do you say to them? >> i would say that i made a series of inexcusable and offensive comments, where i conjectured with a tone of expertise to try to make myself seem smarter by demeaning others and i apologize for that. but that my flaws as a private citizen, not a politician, not a political adviser, my flaws as a private citizen should not reflect on the process by which the aca was passed, or the success of that law itself. >> now, administrator tavenner, you've been before our committee before, and i have complimented you on your efforts. and i do still believe that you

are a great public servant. by november 20th, hhs reported that it had overstated the numbers of enrollees by about 380,000. chairman talked about that in his opening statement, and he just asked you about it. this was because the hhs included people with dental coverage, too. and essentially double-counted them. how could you -- how could that happen? i mean you knew everybody. they know everybody's got a microscope on the program. so i'm just curious. >> sir, it is a great question. it was inexcusable mistake. and i think, in looking at payments made instead of unique individuals, we counted individuals who had both medical and dental. i believe we have put processes in place to prevent that from happening again. but it should not have happened the first time. >> but you understand that the

mistake has the same effect as dr. gruber's statement. same thing. it gives aca opponents a pr gift that they can use on cable shows, and elsewhere to attack the aca and it's an unforced political error. now i have to ask you for the record, because everybody's go going to ask the same thing, you're under oath. and just tell me, did you intend to deceive this committee or the american people when you provided those enrollment numbers? was that your intention? >> i did not. >> and do you have any reason to believe that anyone on your staff tried to deceive the american people or was this error inadvertent? >> i do not believe anyone tried to deceive the american people. and i believe the error was inadvertent. 6.7 million is a very large number. we are pleased with that number.

this is an inadvertent mistake for which i apologize. >> as a result of the -- now mr. goldmann i want to thank you for being here today. and i'm glad you're working. and i'm glad you're pursuing your dreams. and that's a good thing. as a result of the aca, it is a fact that insurance companies can no longer discriminate against people like you. deny you coverage or charge exorbitant rates because of your pre-existing conditions. how do you feel about that? and i think it's important for people to know what that means. you know, we here a lot of times the negatives, particularly on this committee, but it's good to have somebody who has benefited from this. can you tell us how that makes you feel? >> right. i -- this isn't something i had thought about before. all this. before i really left an employer that gave me benefits, because

it wasn't something i thought was an issue. and i think i took that for granted. and i think a lot of people take that for granted. the health care coverage i had growing up and as a young adult in my 20s was great. and then when i decided to pursue something different, something of my own making, something very typically american, and i no longer had coverage, i -- it came as a shock. so to suddenly have that inability to have my own little pre-existing conditions that many people have, and not be covered, was -- was a very strange and unusual feeling to me. and it was not a good one. so, to be able to enroll through the aca, and to still pay my part, but to know that i'm not being discriminated against

based on something that millions of americans have, it doesn't matter what they are, particularly, it was a relief. and i didn't realize how much of a relief it would be until i actually got enrolled with a good health care provider, as opposed to someone -- or a provider that provided inadequate benefits. >> what was wrong with your insurance before you got this insurance here? you had previous insurance, is that right? >> yes. my preceding insurance. >> yes. >> yes. well, the premiums were almost twice as high. which in and itself, you know, it's a supply/demand issue, i assume. i'm not an economist, unfortunately. although i can make guesses. but i will say that the coverage i had, despite -- regardless of how much i was paying on a monthly premium, was insultingly inadequate. and not just because of what it wouldn't cover. but because of how difficult it was to process claims and how

difficult it was to get any sort of response from the company itself. so, yes, prescriptions, and office visits related to my pre-existing conditions were uncovered, and that required a lot of out-of-pocket benefits, but also even the stuff that was covered was very difficult to get reimbursed for. >> thank you. >> thank you with the ranking member's insdulgence, ms. tavenner i failed to only ask one thing. can your staff provide any of the information related to those -- the preparation of those talking points that was in the subpoena? that was part of what was asked for and not delivered. >> so, we will -- i know that we supplied some information to you late yesterday evening. i will go back and work with the staff to see what else we can get you. try to work with you. >> well, the discovery asked for information related to the false statement that was made by you,

certainly inadvertently, you've called it a mistake, but we asked for the creation of it so we could see who created it, who put the numbers together. you know, it took a staffer 20 minutes to find the error once we got the passwords unlocked, as it wasn't hard to find. so, the question is, and i'll be brief, do -- can you ask your people to the extent that it's already been pulled, and we believe if we issue a subpoena it's already been pulled, our people worked with your people, they knew this is what we wanted, could we have it? because if we have people on both sides of the dais who don't have those facts, that would be the last hearing of this year. so i appreciate that you want to get it to us in the future. but, it's crippling to a great extent to have a hearing in which the main subject of the hearing, which is how did we get misled, and who was involved in it in the process of creating those talking points, we don't have it. so that the question is, can you instruct your people to the extent that there has been any pulling of that document to get it over to us so that people down the dais can ask those questions? i know mr. dowdy likes working off of

facts, not fiction. >> yes, sir. >> mr. chairman. >> 30 seconds. mr. chairman one thing i failed to say. i wanted to when i was complimenting you earlier -- >> you're not taking any of that back? >> oh, no, no, no, no, no, no. i wanted to take a moment, mr. chairman, to express my deep appreciation and respect for your staff, and for my staff. i know a lot of people will be moving on to new jobs. but, these are folks that work night and day trying to present the very best that they can to this committee and to the american people. and i'll take a moment to thank them for all that they have done. this is a key time in american history and i appreciate it. thank you. >> well, thank you. and because of your wise comments, i'm going to pile on just in one sentence, mr. cummings, we do have the best staffs on the hil. they do countless thousands of hours of deposition and transcribed interviews.

they pore over more documents than any other committee of the congress, and they're able to qualitatively search for and find in i.g. reports, in freedom of information reports, and obviously in working with whistle-blowers, things that no other committee could find. and i think that that's a genuine statement for both sides. there's no better set of committee staff than what we are honored to have. and i thank you for bringing that up. we now go to the gentleman from ohio. mr. turner. >> thank you mr. chairman. mr. gruber, you've said that your statements were inexcusable and insulting. i certainly understand when someone gets caught saying something as inflammatory as what you've said how you might want to recant it. however, some of the things that you said were substantive based. and although they may be inexcusable and insulting in that they were said, in the end, they may be true.

and i want to walk you through some of the statements that you made that were substantive in nature, rather than the statements that you made about the american voter. now you've said that you did complex microsimulation modeling. it sounds like a relatively basic model to me. you take from one and you give to another. it's a basic equation of welfare wealth distribution and that's called a tax. and you've made many statements about the obamacare plan as being a tax and i want to go through those. now, i want to remind you, this is not the casual conversation that you've had in the conferences where you've insulted the american voter. this is actually a hearing where you took an oath. you said on march 16th, 2011, the only way we could take it on was first by mislabeling it, calling it a tax on insurance plans, whether or not a tax on people and we all know it's a tax on people who hold those insurance plans. a tax. on january 18th you said if you're a state and you don't set

up an exchange that means your citizens don't get the tax credits but your citizens will pay the taxes that support the bill. a tax. october 30th, 2012, you said we just taxed the insurance companies. they passed it on in higher prices that offset the tax breaks we get. it's very clear, you know, and that's when you went on and insulted the american voter as to the fact that they couldn't understand that basic equation. then on october 17th you said this bill was written in a tortured way to make sure cbo did not score the mandate as taxes. if cbo scored the han date as the mandate as taxes, the bill dies. i know mr. gruber that you believe that your statements were inexcusable and insulting but they do appear to be true. you're not here recanting today your statements with respect to the tax aspect of obamacare, are you? >> i'm here today to say that any conjectures i made about political -- >> this is not a conjecture, mr. gruber. i mean conjecture is i believe it may have been, someone may have been thinking, perhaps they were, perhaps it was. this is your straight-up statements. these are not conjecture. is it your purpose today to recant obamacare as a tax?

>> it is my purpose today to come forward and elaborate and straighten out the interpretation of the series of comments that i made and to apologize -- >> excellent, let's do that then. let's clarify it. mr. gruber, you made these statements, did you not? >> if -- i don't recall exactly. >> you don't recall. one of them we actually saw on video. do you recall that one? >> yeah. >> right. ok. well these statements, we'll enter them for the record, and i can't imagine how you don't recall your own statements, because the american voter has seen them over and over again as you've called them stupid. do you deny making these statements mr. gruber even though you don't recall them? do you deny calling obamacare a tax? >> if you're reading my actual quotes, then i don't deny it. >> i'm reading your actual quotes. >> then i don't deny it. >> ok. so you're not here to recant it or to deny it? >> i'm here to explain that a number of those comments were made in a tone of expertise that i don't have when i was talking about political -- >> mr. gruber do you know what a tax

is? i mean you do have expertise in economics. you know what a tax is? >> yes. >> ok. so you would not deny today that in these statements that you made that obamacare is a tax, would you? >> obamacare is a large piece of legislation with many parts. >> and is one of those parts a tax, mr. gruber? >> there are some taxes in obamacare, yes. >> well the president, as you know, argued that obamacare was not a tax until it went before the u.s. supreme court as to whether or not obamacare was a tax and then the administration argued that it is a tax in order to be able to save it from being declared unconstitutional. so, i would assume that you degree with the u.s. supreme court that obamacare provisions include taxes right? >> the u.s. supreme court ruled on a particular provision of obamacare -- >> you do not disagree with them, do you? >> i'm sorry. >> you don't disagree with them that there are elements of obamacare that constitute a tax? >> i don't agree with their conclusion about the mandate. >> excellent. interesting. different than what you said at these hearings.

now i have a question for you that i'd like you to think back. you said i mean this bill was written in a tortured way to make sure cbo did not score the individual mandate as taxes. did you ever speak to anyone in the administration who acknowledged that to you or who explained that to you or who assigned a problem with you with the construct of that we have to draft this in a tortured way so that we make sure cbo did not score the individual mandate as taxes? and you are under oath mr. gruber. did anybody in the administration have that conversation with you? >> that was an inexcusable term -- >> i'm not asking you about how you believe whether you should have said that or not. it is a factual statement that you were making. did anybody in the administration ever have that conversation with you? >> i do not recall anyone using the word tortured, no. >> did they have the conversation with you that it had to be drafted in a way that the cbo did not score the individual mandate as taxes? anyone in the administration acknowledge it, explain it, or assign aspects to you within that construct? >> i don't -- >> you're under oath. >> i honestly do not recall.

>> mr. chairman, thank you. >> thank you. we now go to the gentle lady from new york. >> thank you. thank you. i want to remind my colleagues that passage of the affordable care act was, in fact, an open and extremely transparent process. we had here in the house over 79 hearings, almost 100 hours of hearings. and prior to the affordable care act, we have to remember that there were roughly 48 million americans, including 2.6 million new yorkers, who were uninsured. and there is even more good news coming out of new york, where insurance rates for individuals are more than 50% lower than they were before the state's marketplace plan began. and i -- i want to say that there have been many reports that have said that the acc

contributed to the slow growth rates in national health expenditures over the past few years. the recent report from the national health expenditure report showed that spending grew by just 3.6% in 2013, and that was the lowest rate of growth since 1960. so that is all good news for the american people. dr. gruber, i'd like to ask you, do you support the affordable health care plan? do you believe that it's sound public policy that helps people? >> yes, i do. >> thank you. >> and administrator tavenner, i represent a large number of hospitals. and i understand that because of the affordable care act hospitals are projected to save $5.7 billion in uncompensated care costs this year alone. how has the aca helped to save hospitals money and incentivize effective patient care?

>> i think the aca's worked in a couple of ways. obviously, to increase the number of uninsured helps hospitals from the standpoint of their bad debt and other, particularly in rural america, where they're very reliant on the number of insured in small volume markets, particularly. so i think that's the first area. the second area, is we've made a point of tying payment to quality. so as you know, we are paying related to whether it's hospital acquired conditions, readmissions, or actually having hospitals report their quality instead of paying purely for volume or per procedure. so i think those are two of the ways that it's helped. and i think hospitals in general are reporting, particularly on the for-profit side, better earnings as a result of some of these changes.

>> well, many people have commented on the fact that we have the lowest rate of growth in health care costs since 1960. can you elaborate on how the aca is slowing down these costs? how is that happening? what is contributing to it in the past few years? >> if you look at going back to the hospital issue, we've certainly seen it in terms of number of admissions and readmissions to hospital. the hospitals have growth rate has been flat, almost to the point of being negative. the outpatient side, we've seen it in some of the growth rates around physician, physician visits. i think in almost every area except pharmaceutical we've seen a slowing in what has been the normal health expenditure rate. >> and could you comment on the affordable carability's payment and delivery reforms? and give an explanation. many people attribute that as a factor in lowering costs. >> yes. i think the biggest point that we've been able to do starting first with hospitals, but now we've expanded it to physicians,

and other part "b" settings, whether it's skilled nursing facilities or home health or otherwise has been to move from a per procedure or a volume orrented payment to a payment that's tied to quality and outcome measures. and i think that has been the biggest change. >> are the affordable care act reforms an important contributing factor in improvements that have been reported in adverse -- other complications as well as a fall of 8% in readmission rates for medicare patients? >> yes, it has been. certainly there's more work to do. and we'll continue to do work through the innovation center and through the medicare area and medicaid, as well. >> do you believe that these reforms in medicare to cut costs, and improve quality, are having a spillover effect throughout the entire health care system? and if so, how? >> yes.

in fact, we actually work closely with -- we try to align medicare, medicaid, and the private insurance market, and we work closely with the issuers to make sure that physicians and hospitals are working from one set of quality criteria. so we're trying to work together. >> well i think this is all good news for the american consumer and for health care in our country. >> thank you. >> with that we go to the gentleman from florida. >> thank you mr. chairman. i'll thank you also for your service. great job on this committee, and it's a tough task. miss tavenner, when we started all of this, we had, i thought -- i heard between 44 and 45 million people that were uninsured. that was just a general figure i heard. is that what you would estimate? >> i don't have that number -- >> ok you should have the number. particularly in your position.

but we'll just say 44. i'll take the lower number. >> all right. >> now you came and you gave us some statistics, last may 7.3 million signed up. and then that was revised. and you apologized today for the the error that at least you claim it. that's 6.9 million people, approximately. there are somewhere between 4 million and 5 million people who had insurance before we had obamacare. that lost their insurance coverage. that's the estimate i've heard. would you agree with that? >> i don't know that number. >> ok. well again i think you should. because this is important. the whole thing is how many people are we covering? if we have 44 million, and you had 4 million or 5 million people that were insured, i'm one of the people. my -- one reason you probably don't have more admissions is my

deductible is three times as much. my premiums have gone up. the premiums i would say for most americans listening or participating have gone up. unless you're involved in some other health care system, your premiums have gone up. we've seen an exception. i have family who've had pre-existing condition, and actually i've seen what they're doing. they're gaming the system. they get the service, and then they drop the care. so, that's also gone down as far as admissions. one reason for less admissions, and less spending. dr. gruber, you're one of the architects of this plan? >> i was an economic -- >> modeling. you did the modeling? you were a contractor? >> yes. >> one of, i understand, about 60 contractors? what did you -- what was your payment for your contract work with the hhs?

>> i was paid less than $400,000. >> $400,000. and i heard that was a sole source contract here? nice way to go. was that a sole source? >> i -- i don't exactly know. >> well, did you compete, or did you have -- you got a sole source contract, i'm told. >> i -- >> ok i'll leave it at that. you got a sole source contract according to the information i have. nice way to go. the other thing is, then you went out to about eight states. did you have contracts with a number of states afterwards? >> yes, i worked with a number of states afterwards. >> and i heard you got between $200,000 and $400,000 a pop from them. my estimate that i've been told by staff is you took down about $2.5 million in this? >> the number -- >> all the money from health care from your involvement, again, about eight states. am i right?

>> i don't recall the exact number of states. >> you can't recall. well, again, i think it would be helpful if you could supply the committee the amount of money, and i'm told it's over $2.5 million. you're just one of the vendors. some of them had contracts for more than $1 billion. but the whole thing gets back to people that we have that are still uninsured. we have, according to the document i got, 41 million people still don't have health care. would you agree with that number? >> i don't know which document you're referring to. >> the latest-the document that we had presented to us says 41 million americans still don't have health care. so we've covered somewhere between 3 million and 4 million at billions of dollars of cost, raised most people's premiums -- >> i think if you look at it outside sources they would tell

you that the uninsured rate -- >> we have over 40 million people without health insurance. this isn't a success in my estimation. i'd like to get and divide the billions of dollars we've spent on this program, the consultants who took advantage of it, and enriched themselves, and we still have 40-some million people. and we can address pre-existing conditions, mr. goldmann, and miss tavenner, dr. gruber. we can also increase the age to 26 for coverage, some of the things that were done. and positive things that i think needed to be done. but do we need -- do we need the bureaucracy, do we need the people who have fed off the public trough in the billions of dollars? one of the contractors that i looked at in a previous hearing had gotten a contract for over a billion dollars and people supposedly came to work on verifying information, and never -- never worked. so people were paid not to work. people were paid to help design

the system. and then profit it and took the money away. to me that's another very good story. yield back the time. >> i thank the gentleman. mr. gruber, when you signed your truth in testimony form you used an exhibit "b" and then you didn't use our form we provided. as a result, we don't have that revenue, which is the state revenue is essentially federal revenue we provided grants. so would you agree to supplement your exhibit "b" so that we would have on your truth in testimony your state revenue that would have also -- you that will that would have also -- you would have also received, since ultimately it's affordable care act related? and >> i'm sure my counsel would be happy to take that up with you. you >> well, actually i was asking would you agree to provide it? >> as i said, i'm sure that's something that you can discuss with my counsel. >> so you're not agreeing to provide it? >> i'm not agreeing or in disagreeing.

i'm saying that's something that -- >> would you confer with your you>> would you confer with your counsel, please? it's a requirement before you go down testify, and as we you reviewed your exhibit "b," are reviewed your exhibit "b," the because you didn't use our form and go down it, we don't have all of your income. and that's become a factor here. would you please -- we'll take a moment. we'll take just a short break. provide with your counsel to see whether you can affirmatively answer that. >> my counsel has informed that my disclosure is in compliance with the house committee rules will and if there's any i will and if there's any additional questions he'd be happy to answer them. in >> ok. we'll do some -- >> -- a request then that the witness provide the committee way witness provide the committee with the amount of money received from the federal from the federal government government, and any other health care care payments that he you and willu and

's something that --

>> would you confer with your counsel, please? it's a requirement before you testify, and as we reviewed your exhibit "b," because you didn't use our form and go down it, we don't have all of your income. and that's become a factor here. would you please -- we'll take a moment. we'll take just a short break. provide with your counsel to see whether you can affirmatively answer that. >> my counsel has informed that my disclosure is in compliance with the house committee rules and if there's any additional questions he'd be happy to answer them. >> ok. we'll do some -- >> -- a request then that the witness provide the committee with the amount of money received from the federal government, and any other health care payments that he received since the beginning -- >> i apologize.

this is a technical rule. >> it's a simple request. can he provide us that? >> and once again, i -- the committee is welcome to work with my counsel on that. >> mr. chairman? >> mr. jordan? >> why doesn't he just tell us? how much money did you get from the state taxpayers and the federal taxpayers? he's under oath? why doesn't he tell us how much he got paid by the taxpayers? >> -- had a job. >> we don't have to wait for him to send something to us. he should be able to tell us. how much did the taxpayers pay him? >> again we have a witness under oath. >> ok. i'm going to -- i'm going to go on to other questioning, and we will see what we can get as a further determination. but it is at this point i'm being advised that this is not an accurate and full disclosure. so we do disagree with your counsel's interpretation. >> chairman -- >> mr. cummings, of course. >> maybe he can during the course of this hearing confer with counsel. >> that's what i'm going to do. real try to do this behind the scenes because i don't want to delay the hearing for what has proven to be, and mr. mica, i will seek additional time for you if we can get the information. >> thank you. >> mr. norton is recognized for five minutes. >> excuse me, i want to thank you mr. chairman.

again for your friendship, for your service, and for the respect you have shown for the american citizens who live in the district of columbia, demand to be treated as free and equal americans, and you have always done that. i appreciate your work on this committee. very difficult committee, and i sympathize. dr. gruber, i accept your apology. i'm not going to question you further. your statements invite acts of demagoguery. you will hear enough of those. i decline to participate. ms. tavenner the 400,000 difference, 400,000 difference trumpeted as if it were worth hiding so small an amount when the affordable care act greatly exceeded our expectations and the numbers that would seen up so that all i can say is if the administration was going to fudge it i hope they would not have been so amateurish. i think the american people will understand how one could confuse people signed up for dental care if you are looking at people who signed up and people who signed up period. those are not the distinctions we were looking for at the time. you are a constituent of mine. i appreciate you stepped forward. the chairman said something about cost sharing in his preface to questioning you. you testified you were not being subsidyized. >> that is correct. >> if that is the case you are like many people who got more cost insurance because you are young and not because cost is shifted to you. that is the nature of insurance. now, i would like to ask -- i note that this hearing is taking

place and we are early in the new enrollment system, enrollment period. i thank you for coming at such a busy time. you had a deputy, the principle deputy administrator is quoted as saying the vast majority of shoppers had a positive experience with healthcare.gov. is that your understanding? if so that needs to be out here given the faux pass of the first few months. >> our second enrollment period has been much smoother, obviously. we have been able to talk with some consumerers. we have also been able to meet weekly with issueers to ask what they are seeing, as well. so far the enrollment process has been easy by folks' terms. i'm sure it's not perfect. >> are you doing the kinds of customer -- that you can quantify, customer experience that you can quantify as to what the experience has been so that you will be able to say that at the end of this period? >> we are. it is early because we are just three weeks in. we are doing surveys through the call center and surveys through -- >> that will be very important because you had such a poor start. i understand you can now candle

quarter of a million concurrent users. is that the case? >> yes. in our testing that is what we aspired to and we were able to handle that type of volume, yes. >> i have some numbers here that open enrollment in 2014 more than 1.5 million americans submitted applications for coverage and that 765,135 individuals elected a plan. how does that compare with the first few weeks of open enrollment in 2013? well, as you might remember we were dealing with a website that was far from ideal. we are pleased with the numbers in the first three weeks but i think we know by one year's experience that individuals will wait until deadlines to sign up.

>> what is that deadline? >> the first deadline is december 15 so this coming weekend we think we will be high volume. february 15 when open enrollment closes for 2015. >> i would like in light of how easy it is to make errors that you will then be called on, in september you testified before this committee and you pledged to address at that time 22 technical recommendations that the gao had made to improve the security of the website. that is always a concern. were these 22 recommendations addressed before the beginning of open enrollment this year? >> yes, they were. we completed our work on all 22 of those recommendations. and then there were six other categories that we have completed the work in that area. probably the only thing that is not totally complete is the

operating agreement with opm and with the peace corps. we have a contractual agreement but we were going through a full contracting process -- >> i think the gentle lady's time is expired. we go to mr. jordan. >> thank you, mr. chairman. the ranking member said these are just mistakes, unforced errors. i think the american people would say something completely different. i would say these aren't mistakes. this is intentional al deception and nothing new. you like your plan you can keep your plan. premiums are going to go down $2,500 on average. the website will work. the website is secure. they have 7.3 million enrollees but forgot to count 400,000 dental plans. and then mr. gruber testified before congress

about obamacare and didn't disclose he was being paid by the obama administration. that is deception. and then we have the videos. the now famous videos. mr. gruber used taxpayer dollars to deceive taxpayers. when obamacare became law he made fun of them and insulted them. how much were you paid, you and your institution by the taxpayer regarding your lectures on obamacare? >> i have disclosed for the committee as i understand my council -- >> i'm asking you a question. give me a dollar amount. paid

how much were you paid? the american taxpayer would like to know how much they paid you to deceive them and then got made fun of. >> the committee can take that up with my council. >> you are not going to answer the question. you are under oath. you come to the committee we ask you a question you are supposed to answer the question. how much were you paid. >> the committee can take that up with my council. >> i want to advise everyone that council has said they are not available to clear up the errors and omissions in the gentleman's truth filing. it does require -- our form requires grants and contracts. we cover all revenue. we only received about $100,000 which is far less than the gentleman's testimony in disclosures which were three grants. as a result the gentleman's disclosure is not complete. so i would admonish dr. gruber, your choice really is answer questions fully here and then supplement or we will seek to bring you back with the full disclosure in order to get all

of the other numbers. it is your choice. your council can advise you. we find your submission deficient. your counsel is ill advised to say it is sufficient because it only includes grants that you have contracts. you've admitted under oath that you have contracts. those are not listed and you are deficientt. again, i want to -- this is our last hearing. if i don't have to recess and come back again, i would like to not have to recess and come back again. so, please, do not make this drag on longer. if you can combiff answers to this -- give answers to this, your recollection, and we will accept an amendment, an addendum at the later date, but the gentleman is entitled to have all questions to the best of your knowledge answered. you took an oath saying you would tell the truth, the whole

ruth, not the truth and only what your counsel says is going to be discussed. it is all questions, all answers. if mr. cummings were sitting in we chair or anyone else, could expect no less. >> mr. chairman, i think his counsel is talking to him. >> mr. chairman? a t on that question, i have politifact document here and they have a fact checker thing that has, you know, all kinds of numbers. they went into this in depth as to what the gentleman was paid. i wonder if we just enter this in as part of the record -- >> we'll certainly be happy to enter in without objection. >> all right. thank you. the gentleman from ohio may continue. i have unanimous consent you

have an additional 30 seconds without objection. >> i think i have a question for mr. gruber on the table. i'm waiting for his answer. >> i was informed i should report all moneys received from this fiscal year and the two previous years. i did that. >> i don't care what you were informed. i care about what i'm asking you. how much money did the taxpayers, state or federal, pay you to have you then lie to them? hat's what i want to know. >> over this year and the previous -- >> no, no. look. this has been a five-year ordeal with this law. we want to know how much you got from the taxpayer and then made fun of them and lied to them after you got the money. >> i don't recall the total. >> we want that information as quick as we can. let me switch gears. mr. gruber, in a strange way i kind of appreciate what you said in the video. it seems for the first time someone came clean and told the truth. you told people you were actually deceiving. here is my one question i want to get to.

politico reported steve rattner called you "the man" when it came to obamacare. "the washington post" said you were the "key architect" of obamacare. the "new york times" said the white house led you to capitol hill to help congress draft obamacare. they said, go on up and help those poor folks on capitol hill get it right. you're the expert. go help those congressmen who don't know what they're doing. the president said he had, "stolen ideas from you" to draft obamacare. you visited the white house 21 times. in your own words you met with the president in the oval office. i have one question. a few weeks ago when the video surfaced, what was your reaction when the president of the united states said you were just some adviser. remember. you're the man of the. you're the architect. been to the white house 21 times. you go to capitol hill to help those poor saps get it right. the president stole from your

ideas. you're the key guy. yet when the video surfaced, the president of the united states throws you under the bus and says you're just some random adviser. what was your reaction to that, mr. gruber? >> my reaction was that my job was to be an adviser and that's at i was >> how many people have you enrolled thus far in the federal exchanges? >> i don't have that number before me but i can get you that number. >> you don't have that number? even if we did we might not believe it based on past experience. let me ask you this. are you familiar with the lawsuit the case king vs. burwell? >> i'm familiar with the case. >> okay. if the ruling goes against and says what mr. gruber said in some of those videos, that, in fact, those states have not set up a state exchange, can't give ubsidies to their enrollees,

have you been explaining it people signing up for obamacare that, look, this all may change in a matter of months? have you been letting people know they might have to pay a lot more on their premiums, in fact have a tax liability they don't know they have today? you got to speak up. >> nothing has changed for consumers. they can still come in. >> no, are you telling people things may change? we got a court case, pretty big case. are you telling them there be a change? >> this is not a closed case. pretty much plain -- >> i didn't say that. i said it might be. are you giving them a heads up that things may change in a big way in a few months? >> i'm not going to speculate about the case. >> i'm asking, are you telling enrollees things may change in a few months? >> nothing has changed for consumers. >> so you're not preparing them for the fourfold increase in premiums and the tax liability they have? >> i have told you, consumers should come in, sign up, enroll -- >> mr. chair, if i could. do you think, ms. tavenner, do

you think it's responsible to not tell the millions of enrollees who are in states that have not set up a state exchange, do you think it's at all responsible not to tell them that things may change dramatically and they'd have a tax liability and their premiums could increase as much as fourfold? >> the gentleman's time is expired. the gentle lady may answer. >> sorry? >> you may answer. time is expired. >> i have told you, this is not a closed case and i'm not going to speculate. the law is pretty clear. >> i will take that as a no you are not telling them because of the statements you just made relative to your opinion of the case, is that right? >> i've said nothing has changed for consumers. they should sign up, come in, and enroll. >> mr. chairman, if we want to get into the court case, no one -- >> no, no. that would be retroactive. >> eleanor, i'm not trying to get into it. the gentleman was entitled to a, no we're not telling people and i want to make it clear when she said why she wasn't telling them that she wasn't

telling them. i think she made that clear as to why she decided not to. >> i think that was the responsible thing to do. we don't know that it would retroactive. >> i thank the gentle lady. the time belongs to the gentleman from massachusetts, mr. lynch. >> thank you. >> wait a second. i apologize. the gentle lady from washington, d.c. has already gone. thank you. mr. lynch? >> is it mr. clay or mr. lynch? >> mr. clay was not noted but if you'd like him to go first i certainly would take him. >> it's okay. >> he is a delightful gentleman who has been waiting to go first for a long time. he looks needy. all right. he's going to wait >> okay. the gentleman is recognized. >> i appreciate that. thank you. i want to thank the witnesses for attending. in my former life i actually negotiated healthcare plans through collective bargaining. i was president of the iron workers union, mr. gruber, and

we were having a lot of problems in massachusetts in our home state with some provisions of the affordable care act, especially the so-called cadillac tax. now, you and i know that for a very long time healthcare, until the affordable care act, healthcare was not taxed. so when i sat down with good employers who cared about their employees, oftentimes they were more willing to give their employees an increase in their health benefits instead of putting it in their wages because wages were taxed through the payroll tax and healthcare was not. so now as a result of negotiating for 75 years on that basis, you've got a lot of the unions across this country that have built up multi employer health benefit plans for healthcare for their employees.

and because these employees have, instead of taking money in their wages, they've taken money in their benefit plans, we've got most of the healthcare plans, these multi employer union healthcare plans are subject to this cadillac tax today, even though it doesn't come into effect until 2018, so now what i'm seeing is that employers are running away from their healthcare obligations. because now they're going to be taxed a 40% tax on everything over and above the limits that have been established under the a.c.a. so i've got formerly good employers who now are saying, wait a minute. i'm going to get killed by this cadillac tax. number one, they're running -- they're abandonning their responsibilities to these plans. they're trying to get out. they're trying to buy their way

out. they're just reorganizing. they are, in some cases, cutting their companies in half so they can try to get below 50 employees. so that they're not covered. they are -- and new companies are not coming into these multi employer plans. so now i've got the unions, a lot of whom are in favor of this bill, now asking me to repeal it, vote to repeal it. they're coming to me. i'm a union member. i'm a former union president. and i got these unions saying, repeal this thing. and now, fortunately for me, i voted against it to begin with. i voted against the affordable care act because, unlike some people, i actually sat down and read it. it was one of the most complex bills that i have ever read. i had a full staff helping me with questions on that. so i think that this has presented a lot of problems for people who thought they were going to benefit from this plan

. how do i fix this? how do i fix this so previously good employers trying to do the right thing by their employees will continue to do that? because these construction workers, they don't work 52 weeks a year. they get laid off in between jobs, they have bad weather, they have broken time. ey needed this format to provide for their families to get health insurance. now these good employers are running away from their healthcare obligations, because they see this tax coming down the road in 2018. a lot of them are refusing to reup on their collective bargaining agreements. they're walking away. how do we help these employees? now they're being told, go to the exchange. we don't do that anymore. we're out of the healthcare business. how do we help those folks?

>> well, congressman lynch, i'm not an expert on collective bargaining agreements. >> i guess. >> what i can say is the way the cadillac tax was designed, there is no reason these employers can't provide affordable and comprehensive insurance under the provisions of the cadillac tax. >> for every dollar over the limit they're paying $1.40. >> once again, given where the limit is set there is no reason they can't provide affordable, comprehensive insurance to their employees under the cadillac tax. >> wait a minute. they're competing with other employers on a bid. you know how this works. if we're bidding on a construction project and you have 49 employees and i have 150, my bid includes $13 an .our for healthcare your bid is zero. how do i win the bid if i'm putting, for every man hour on that job, i'm putting $13 an hour on my bid and you're

putting zero on yours? how do i win? i'm out of business. >> there's been a long-standing problem -- >> you say i can afford it? how do i win that bid, if my bid for every man hour on that job i have to put $13 an hour on my bid and you can put zero the end your people to exchange. you're not obligated to account for healthcare. how does that work? >> the gentleman's time has expired. mr. gruber can answer. >> there has been a long-standing problem of competition between employers who do and do not offer health insurance. the affordable healthcare act tries to level the playing field. >> it doesn't do it. >> thanks, gentlemen. i recognize the gentleman from utah. >> thanks, mr. chairman. mr. gruber, you also did some work for the congressional budget office, correct, the c.b.o.? >> i was on the c.b.o. advisory council.

>> when did that start? >> i don't exactly remember. it was probably -- >> 2011, correct? >> yes. >> when did you stop working for the c.b.o.? >> i did not. i was on the advisory council until i think through 2008. i'm not entirely sure. >> you mean 2011, is that correct? >> no. i did not go to -- >> were you on the advisory council until 2011? >> i honestly don't know when they took me off it, but i did not attend any meetings -- >> were you on the c.b.o. panel in 2010? >> i have not attended any meetings in 2010. >> but you were part of that organization. did you have any communications with the c.b.o.? >> yes. >> so you didn't attend any meetings, but you did have communications? how many times did you attend -- how many times since president obama took office did you go to the white house? >> i don't recall exactly. >> was it more than 20?

>> no, it was not. >> i believe it was more than 20. how many times do you think it was? going to the white house is a significant event. you probably remember it. >> i made a number of visits to the white house, primarily to the executive office building to meet with members of president obama's staff. >> did you ever meet with the president? >> i met with president obama once during the discussion. >> how long was that meeting? >> it was a meeting that lasted maybe an hour and a half, which was about 20 people. spoke for about five minutes. >> was mr. almondorf there? >> yes he was. >> what was your capacity? >> it was a meeting of six economic experts to talk to the president and his staff about costs for healthcare control. >> were you there as a c.b.o. member or an administration member? >> neither. i was there as an economic expert. >> somebody invited you there. you weren't -- somebody was paying you, correct? >> no one paid me to be at that meeting. i was invited by the white house. >> we'll explore that a little

bit more. you provide ll copies of all the work product you provided to the federal government related to the affordable care act, healthcare.gov, or any other healthcare reform proposals? >> the committee can take that up with my counsel. >> no, no. we're asking you. not your counsel. counsel works for you. we're asking you, under oath, will you provide this information to this committee? >> once again, if the committee can take it up with my counsel -- >> no, no, mr. gruber. we're asking you. you've been paid by the american taxpayers. will you or will you not provide that information to this committee? >> once again the committee can take it up with my counsel. >> mr. chairman, this is something we have got to get to the bottom of. >> i think those documents should be part of the public

record. what are you hiding? why won't you give those to us? why are we not entitled to those? >> i am not an expert on the rules of what is discloseable and what is not, but my counsel is, and he'd be happy to talk to the committee about it. >> why will you not give us those documents? >> i'm not concluding one way or the other -- >> who owns those documents? who paid for them? >> i'm not sure. >> you don't know who paid for those documents? >> were you paid by the american public? >> i had a contract. >> was there any work product of that? did you come up with documents, have discussions? >> yes, i had a large number of discussions. >> will you provide copies of all the work product you provided to the state governments related to the affordable care act, state-based exchanges, or any other healthcare reform proposals? >> once again, the committee can take that up with my counsel.

>> will you provide copies of your communication including e-mails, memorandum, presentations, or any other discussions or conversations you had with federal or state officials or employees related to the affordablecare act, exchanges, or other healthcare reform proposals? >> once again the committee can take that up -- >> i need a yes or no. i'm not interested in talking to your counsel. i'm interested in talking to you right now under oath having been paid by the american taxpayers. will you or will you not provide that information? >> you can take that up with my counsel. >> why do you believe you're entitled to not give it to us? >> i don't know the rules of what -- documents and things like that. i'm not a lawyer. >> do you have documents? >> do i own documents? >> do you have documents? >> i have -- yeah, i have documents. >> and you're not willing to give them to us? >> i have all sorts of documents. i have a piece of paper in front of me. i don't understand. >> documents that relate to the

questions that i just asked you, mr. gruber. >> i have -- >> do you not understand the question? >> i have -- i performed grant work for the federal government. it was work product from that work. i do not understand the rules under which that work product is supposed to provide it or not because i'm not a lawyer and you can take that up with my counsel. >> this is terribly frustrating, mr. chairman. we will, i hope, get some cooperation on both sides of the aisle to proceed. i yield back. >> i thank the gentleman. mr. gruber, it does appear that you have regressed in your ability to be political. you answer questions better than any politician sitting at this desk today. it's frustrating. i would contend that your attorney is not giving you adequate representation at this time. this committee has the right to have information that has been requested. ou have regressed from not talking simply off the cuff and

making stupid statements to now being entirely political to the point that you're hindering us in carrying out our responsibility. >> mr. chairman? i would ask the chairman if this committee should consider a subpoena to compel the witness to provide this kind of information if he's not willing to do it on a voluntary basis. >> i would recommend the gentleman take that up with the committee chair whose portrait hangs behind us. i certainly would concur with you. but i'm not going to step in the plafse the full committee chair at this point. thank you, gentleman. i now recognize the gentleman from virginia. > thank you, mr. chairman. dr. gruber maybe this is a good object lesson, the consequences of sort of mouthing off and showing one's superior

knowledge, especially with respect to this committee. i have lopping felt watching this committee in operation the last four years that we ought to post over the mantle on the entrance in here, you know, enter into this portals as a witness at your own peril. all of a sudden now we're talking about subpoenas and lawyers and documents and how often did you go to the white house. it has a familiar reframe in terms of how, unfortunately, witnesses have been handled, unless of course they're friendly witnesses who don't like the affordable care act or believe the i.r.s. has planted electrodes in their brain. and so you're getting the special treatment. you opened the door, unfortunately, because of remarks which you have apologized for in your testimony. is that not correct? >> i apologize for the really inexcuseable remarks i made in those videos. >> thank you. the incoming chairman of this committee asked you how often you've been to the white house. how often did you go to the

romney administration offices of any kind when you were advising the romney administration on the, on what became really the model for obamacare? >> i don't recall exactly. dozens of times. >> dozens of times. did you ever meet with governor romney? >> i had one meeting with governor romney. >> just like you had one with obama. >> yes. >> so does that make you an intimate of the romney administration and the architect of romney care, massachusetts? >> i was an economic adviser to governor romney just as i was to president obama. >> thank you. do you have documents from those years we might want to subpoena? >> ah -- >> let me withdraw the last part. do you have documents from the romney period? >> probably. >> i would hope, mr. chairman, if we're going to have a broad subpoena suggested by my friend from north carolina that it be, indeed, broud and that we encompass all of the romney documents dr. gruber was involved in. i certainly want to see whether

this is a pattern that should be limited just to president obama, because after all there is an antecedent. not just an antecedent. romney care was the model for obamacare, is that not true, dr. gruber? >> i believe it's true. >> i mean, for example, the tax consequences. is it not true that right now in massachusetts, you know, you can be fined if you don't comply with romneycare, and it's all run through the tax administration in the commonwealth of massachusetts. >> it is true if you don't have health insurance and don't meet certain exemptions in massachusetts you have to pay a tax penalty. >> right. by the way, what happens to the uninsured percentage in massachusetts? did it go up? did a lot of people lose their healthcare as predicted by the critics? >> the rate of uninsured fell by about two-thirds to 3%. >> 3%. how many other states have a 3% uninsured rate? >> massachusetts is by far the lowest in the nation. >> lowest in the nation. now, there were also predictions that the fines were

so relatively modest that employers would be tripping over each other to divest themselves of employee provided insurance plans and just go on to the state exchange. did that happen in massachusetts? >> no, it did not. employer-sponsored insurance actually rose by 10% in massachusetts after we passed romneycare. >> hum. can you explain the interpretation of your statement, and i'm going to read your statement, in the law it says that the states don't provide them, the federal backstop will. the federal government has been sort of slow at putting out its backstop i think partly because they want to sort of squeeze the states to do it. i think what's important to remember politically is if you're a state and you don't set up an exchange, that means your citizens don't get their tax credits. opponents of the affordable care act are using these remarks to further the argument that the law does not authorize tax credits for states that did not step up their own exchanges. is that a correct interpretation of the law and

of your statement? >> i don't believe it's a correct interpretation of either the law or of my statement. as i said in my opening remarks, my statement, while poorly worded and much too glib, but i believe the point i was making was that at the time i gave that statement, which was 2012, it was not clear how effective the federal exchange would be. it was not even clear who would be in the white house to implement said federal exchange. as a result, states might be concerned the federal exchange would not be implemented and they would have to set up their own. >> do you agree, dr. gruber, as written the law makes tax credits available in every state regardless of whether the state or the federal government runs the exchange? >> in every opporunity of' had to model or interpret the law, i've always made that assumption. >> mr. chairman, my time is up. i'd like unanimous consent to enter into the record a letter from the head of the c.b.o. to chairman issa dated december 6 and an article by tom harken, george miller, and henry waxman on the affordable care act and

what opponents are cherry picking in terms of facts. >> without objection. >> i thank the chair. >> i thank the gentleman. i recognize myself for five minutes of questioning. it is at least to me apparent today in what we've heard, what's gone on here, that americans now know that government transparency under this administration simply means what you see is not what you get. and that's concerning to me. do you believe obamacare was crafted in a way that was transparent to the american taxpayer? >> i certainly believe that what i've been part of for the last five years has been transparent. >> was obamacare crafted in a way to be transparent? >> i was not here during the crafting of obamacare. >> ms. tavenner, would you say the administration is transparent in its

implementation of obamacare then? you've been here for that? >> yes, sir. i think we have tried to be transparent and we've tried to provide documents including the documents that we sent yesterday. to date, we've already provided 135,000 pages of documents and provided more than a dozen transcribed interviews, so i think we have tried to be transparent. >> but not completely? >> wherever we can, we have been. >> wherever we can. okay. another term that could be used in this hearing. whenever we can. i don't recall. probably. those are reoccurring terms. mr. gruber, the obama administration promised the american people 37 times that if you like your plan, you can keep your plan. when you were working on the law, did you believe, mr. gruber, did you believe that that no one would lose a plan

they liked due to obamacare? >> i believed that the law would not affect the vast majority of americans. >> the vast majority? but did you believe no one, as the president said, would lose the plan they liked? >> as i said, i believed it would not affect the vast majority of americans, but it is true that some people might have to upgrade their plans because their plans were not comprehensive as defined under the law. >> so they helicopter keep their plan even if they liked it. >> what the law says is there are minimum standards to be met. >> why did the president make this representation if his experts, including you, knew it was not true? that some, as you said, would not be able to keep their plan, they would have to upgrade or change it? >> i'm not a political adviser, and i have no answer to that question. >> you acknowledged in 2013 in an article in "the new yorker" that not everyone who liked their plans could keep their

plans, mr. gruber. when you knew that the administration's representations to the american such as in false, this instance, did you ever voice any concern? why or why not? >> i interpreted the administration comments as saying for the vast majority of americans, this law would not affect the productive health insurance relationships they had so i did not see a problem with the administration's statement. >> but you're an economist with model that you described as entirely accurate. your learned professor, we don't take that away from you at all, and, yet, the president, 37 times, said, if you like your plan, you can keep your plan. my ere today to say, in constituency of almost 800,000 people, julie boonstra,

leukemia patient who had a plan she liked, couldn't keep that plan. she's not stupid. she couldn't keep that plan. mark and kate, a young pastor and wife at a local church, now expecting, as of yesterday cannot keep the plan they had and can't find a plan that's adequate for them to replace it. dustin, a hard working young man in my district, spent almost the entire weekend trying to up on to obamacare from a plan that he lost and couldn't keep. as of yesterday morning, i watched him try to get a plan through the website, through talking with people connected with the website. he still couldn't get it. he had a plan he liked. he's not stupid. he couldn't keep it.

numerous constituents have contacted me saying that while they may have found a plan, under obamacare, not necessarily a plan that they liked or they could keep, but found a plan, like mr. goldman, that was reasonable in cost, yet when they got to the point of having to pay their deductibles, copays, out-of-pocket expenses, or the prescription drug costs, they couldn't afford it. i would suggest that, again, transparency here is what you see is not what you get. my time is expired. i now recognize mr. cartwright for his five minutes. >> thank you, mr. chairman. i thank the witnesses for appearing today. in yet another instance of the gnashing of teeth over the affordable care act. the administrator tavenner, you

were not there for the crafting of obamacare. i was not in the congress. many of my colleagues here were not in congress for the voting on the a.c.a. but i believe what the american public wants of us is to make the best of things, to take this law, improve it, make it work for everybody in the united states, and that's why it pains me to have to sit through these hearings while we criticize those who may have said something that under stated or over stated the facts. to be sure, there are people who are traveling through this world and through their lives unburdened by excessive concern for the truth and maybe, mr. gruber, at times in your life you've been one of them, but there is, you know, a chance for repentance and renewal in life. i hope you'll take that chance, mr. gruber.

ms. tavenner, i want to pick up on something that mr. lynch was talking about. he really didn't give you much time to respond, because we only get five minutes. it took him the balance of his five minutes to explain the concern. that was about the cadillac tax. i'm hearing about that at home, as well. i simply -- this is a yes or no question, ms. tavenner. will you undertake to review the cadillac tax and, perhaps, rethink it and engage those with whom you work to rethink it and maybe even go back to the drawing board about the cadillac tax in an effort, as i said, to take this law and improve it and make it work for all americans? >> i think the president has been clear and that he would be willing to work with congress to make improvements to the law. >> well, i thank you for that. i also want to talk about costs

a little bit. in an unguarded moment, the chairman of this committee listed a number of statements that he considered to be untrue or falsehoods. some of them i agree with. among them he listed the idea that healthcare spending in this nation has had the lowest increase in 50 years. i was surprised to hear him list that among statements he considered to be falsehoods. would you comment on that, ms. tavenner? >> i would say that based on the healthcare expenditure report last week that the office of actuary did that that statement was not true. it is the lowest trend in healthcare spending that we've seen. it continues the trend we've seen for the last several years. this year was one of the lowest, for 2013, and the lowest that healthcare expenditure report has on

record since 1960, so i think healthcare expenditure is at an all-time low. there is still an increase year over year but expenditure and the slope of that growth has greatly slowed. >> now, there's not a whole lot refreshing to talk about when we talk about the a.c.a. and recriminations over it, but that's one of them, isn't it? >> that's one of them. i think 6.7 million americans signed up in the marketplace is another. over 9 million new. these are all good things. >> now, in conjunction with that, i've been an employer hrough the 1990's and the 2000 decade. we saw, and we provided healthcare for our employees, and we saw increases that were in the double digits -- 10, 15, even 20% and even higher in some years for the premiums we were paying to cover our employees. it was awful.

i was dismayed by those numbers. it was something that hurt every year to do. what's the -- what's the average increase we're looking at this year in premiums under the a.c.a., ms. tavenner? >> under the a.c.a., while it certainly can vary by region, we are looking at single digits, in the low single digits for increases. in the employer-sponsored insurance separate and apart from the marketplace, 3% this year, which is, again, follows an overall, extremely low trend. certainly, there have been changes in copays and deduct ibbles along with that, but it still is a much lower growth than we've seen in years past. and i share your concerns. >> more refreshing news from you. thank you for appearing today, ms. tavenner, and all the witnesses. i yield back, mr. chairman. >> thank you. i now ask unanimous consent that our colleague from south carolina, mr. rice, be allowed

to participate in today's hearing. without objection, so ordered. we now go to the gentleman from north carolina, mr. mchenry. >> well, dr. gruber, you know, as everyone knows, and the american people know, when the president said, if you like your plan you can keep it, turns out it was the lie of the year. right? this is a very significant thing. my constituents in north carolina and actually north carolinians according to the north carolina department of insurance, 473,000 north carolinians lost their health insurance because of obamacare. so this is perplexing, right? you had a moment of clarity and honesty where you said, it was a lack of transparency that helped pass obamacare. i concur. i appreciate your honesty. i think it's horrific, though, that you participated in some level on obscuring the truth from the american people in

order to pass this bill. now, you apologized for that, and i thank you for that. and the american people hear you loud and clear. and as a sort of a matter of morality, for you to apologize, is really, i know it's a tough thing to do publicly, but i thank you for doing that. so when i think about my constituents, though, did you think that there would be such a large number of folks that would lose their health insurance? >> i don't know the exact number in north carolina, but i -- >> well, 473,000 according to the department of insurance and the "raleigh news and observer." >> what i was focused on was the net increase in newly insured we've had under the law, which has been quite substantial. >> okay. so it's not relevant to your calculation that there would be people that would lose their health insurance? >> that was part of the calculation.

>> it was. so there is churn, would you say? frpblts there's always been churn in this market. >> sure. did you think it would be such a large number that would lose their plans though? >> i don't recall the exact numbers i modeled but we did model some individuals would lose existing plans and move to new forms of coverage. >> i think you anticipated and you are obviously very well prepared, i think you anticipated this question. is it similar or dissimilar to the number you calculated? >> i don't know of a national estimate of how many people have lost health insurance so i don't know how it compares to what i projected. >> so was there discussion at senior levels in the white ouse and h.h.s. about this potential loss of people's health insurance plans? >> i don't recall whether they were. when i was there i can't speak for what happened when i wasn't. >> so there was no moment of moral clarity, of honesty, that you came to publicly that we now know about and most americans know about, there was

no discussion at the time that maybe we should put the brakes on this? we're going to have a lot of people lose their preferred health insurance plan? >> there were, i was present for discussion, as i said, i provided numbers. i was present for discussion of those numbers and interpretation of what they the law terms of how would affect individuals. >> well pause for a moment. the president has been saying if you like your insurance plan you can keep it. gosh. maybe we should tell him that is not in fact the case. maybe he should change his ording a little bit. >> i was not in any discussion of presidential messaging. >> okay. but in the meetings where you discussed these numbers, and you have plenty of experience, you said to this administration because you are in the employ of this administration, you said, there will be people that lose their plans?

right? now, you said there are also going to be people that get other plans, right? but you said, there will be people that lose their plans. did they, did you , was this not registered? did this fall on deaf ears? >> all i know is what my modeling showed and what i conveyed. >> and you conveyed that there would be, in fact, people that lose their preferred health insurance plan? >> i conveyed there would be churn in the market. some people would move to different insurance plans. >> as i said before, my interpretation of churn is some lose and some gain. when you have the president going out and seay, clearly, if you like your plan you can keep it, it was in fact a lie based on your numbers and the data you provide this had administration, correct? >> i interpret the president's statement as referring to the fact that the vast majority of americans would be able to maintain their health insurance arrangements under the affordable care act. >> okay. so you also said that, you know, the only way to pass this type of health insurance is to actually pay lip service to fundamental cost control.

right? you actually need to talk about cost control in order to pass this type of health insurance change. so was it, in fact, just lip service? >> fundamental cost control is very, very hard in healthcare. the affordablecare act does not solve the problem of rising healthcare costs in america. >> it did pay lip service though. frpblts it did more. it is by far the most ambitious piece of legislation in our nation's history in terms of moving forward on cost control. >> okay. so has it outperformed or under performed your model? >> my model as with the congressional budget office model over the budget period did not -- >> no, i'm saying so far. >> so far the law in terms of health insurance coverage and other things has matched fairly well with what the model predicted. >> okay. so that lip service was in fact important to pass it? >> i don't understand the question. >> okay. you said, in order to pass it you had to pay lip service to

fundamental cost control. >> as i said, fundamental cost control is very difficult. but the affordable care act takes all the first steps necessary to try to move us down that path. >> okay. my time is expired. >> i thank the gentleman. i ask unanimous consent to have the actual numbers as they've been revised placed in the record relative to the affordable care act. without objection, so ordered. the gentleman from vermont, we are pleased to have you join us. >> thank you. >> five minutes. >> thank you very much, mr. chairman. a couple of things. number one, mr. gruber, you've apologized for the intemperate, you said, insulting remarks. it's unfortunate this whole debate about healthcare is so fundamentally important to this country, it's been divisive in congress. we had a partisan vote and strongly different points of view about it and, unfortunately, the remarks you made provided clear ammunition for opponents to use to indict

the entire bill. but when you start commenting about what you expect might be a legal outcome, do you have any training as a lawyer? >> no, i do not. >> all right. when you comment on the quality of the mind of the american people, which i think all of us here have a great deal of respect for the people we represent, you would, i take it, apologize for any insulting remarks you made? >> it was inexcuseable that i tried to appear smarter by insulting others. >> all right. and the other thing, i listened to my colleagues here and they talk about folks who had a bad experience with the healthcare bill and some people have had good experiences, some people have had bad experiences, but it is really profoundly important to the american people that they have security about healthcare. is it your view, now going back to your area of expertise, that, broadly speaking, the american healthcare system has been improved as a result of

the passage of the affordable care act? >> yes. >> just be specific as to a number of items that are better now than before the affordable care act was passed. >> the affordable care act has lowered the rate of uninsurance. about 10 million people have gained health insurance according to the latest estimates. it has ended the fact that individuals face preexisting conditions and the inability and the financial insecurity that comes from having to buy insurance on their own, and the affordable care act contributed to historically slow rates of healthcare cost growths. >> is it your also your opinion that the affordable care act shares many things in common with what was called romney care in massachusetts? >> yes, it is. >> and you worked on the -- you worked on the massachusetts version with the romney administration, is that correct? >> yes, it is. >> i think i heard you say that the uninsured rate in massachusetts is about 3% to 4%? >> it's fallen to -- before the -- it fell to about 3%.

it may be lower today. >> my understanding in the passage of the massachusetts bill is that there actually was a bipartisan vote that supported that legislation. is that correct? >> yes. >> which we did not -- that eluded us here, unfortunately, in this congress. now, my view is that there's a lot of things we still have to fix in our healthcare system. i've never had the view that any single bill is going to be the magic fix that it has to be an ongoing process. i'd ask you, in the cost issue on healthcare is the one that i think needs even more attention. but, first, i'd ask you and ms. tavenner what has happened to the growth of healthcare spending since the passage of the affordable care act. ms. tavenner? >> i think, as we discussed earlier, it's at historic lows.

3.7% i believe for 2013, which is the lowest on record since 1960. >> and does that apply across the board, whether a person is in the healthcare -- the obamacare or on their own private or employer-sponsored healthcare? the uld you please put microphone closer? >> i'm sorry. it is across the board. >> dr. gruber, what would you cite as important elements in the affordable care act that has helped slow the rate of growth in overall healthcare spending? > it took a number of steps in away variety of directions to try to slow spending, most notably, changes in the way healthcare providers are reimbursed, penalties on readmissions for hospitals, an enormous reduction which has lowered costs, and really led to very innovative thinking on how to fix our broken medical system. >> my observation is in vermont where we've had an ongoing

discussion about healthcare and are still in the midst of that, we've got healthcare providers, our hospitals and doctors, that are really focused on trying to figure out better ways to treat, to curb infections, to change the billing process, but they're on the front lines. what are some of the things we can do to help them be successful in providing better healthcare at lower costs? >> i think the most important thing is to continue to learn from the ongoing experiments in our nation's healthcare system to try to understand what is working to deliver this low rate of healthcare cost spending. >> ms. tavenner? >> i would agree with that. i would also say we've tried to do this through the innovation centers, some up front help in how to work with electronic health records and build an infrastructure that goes from fee for service to actually assuming risk and looking at it -- >> and accountable care organizations are part of that? >> yes. my time is up. i yield back.

>> i thank the gentleman. >> this week on "q & a" political reporters share stories about being on the campaign trail with senator mitch mcconnell. >> he had plans for four years for this campaign. this started in 2010, right after he saw what happened in the republican primary for rand paul, the kentucky republican senator. rand paul beat mcconnell's hand picked guy in that primary. at that point mcconnell realized, i have to recalibrate everything i know about republican primary politics in my home state, and he started to make changes. he hired key staff. he started to build this very sfiss fated infrastructure knowing this would be the most difficult race in his campaign. >> they knew they were going to spend a lot of money on technology. they had watched the obama campaign in 2008 and 2012. they had watched harry reid's re-election in 2010. -- knew they needed to go

it was a tough race. he was going to have the latest technology. it was 2013 and he said he was going to build the most thorough, campaign ever. >> in american history. >> in american history. he probably got there. >> tonight at 8:00 eastern and pacific, on c-span's "q & a." and to mark 10 years of "q & a" we're airing one program from each year starting december 22 t 7:00 p.m. eastern on c-span. >> two years ago today adam lansayshoont killed 20 children and six adults in newtown, connecticut. several discussions on social media today about the lives lost and those impacted. massachusetts senator ed markey says my heart is with sandy hook families. today and every day we pray for them and all those who grapple with grief and pain of senseless gun violence. florida congresswoman debby

wassermann schultz writes, thinking of the newtown families and fortune touched by gun violence. hugging my kids a little tighter today. and senate majority leader harry reid says, i will always stand with the families of newtown and the vast majority of americans who believe there should be background checks. this morning, we looked at what states were doing to address the issue of mental health care in light of the sandy hook shootings. this is from "washington journal." host: we're going to talk about the state issue on mental health. mary giliberti is the executive director of the national alliance on mental illness. appreciate you being with us. >> thank you for having me. >> congressman markey was providing a federal level perspective. what are states doing and more importantly what are state is not doing? >> that is the question, steve. what are they not doing?

in 2013 we saw an immediate response to the tragedy. we had 36 states in d.c. increase their funding for mental health services. then when we went back this year to see what happened we saw a decline. only 29 states and d.c. increased their funding. that's really concerning to us because $4.3 billion were cut out of mental health services from 2009 to 2012. so we had nothing but huge cuts. we're not back yet to where we were. we haven't even replaced those dollars. we were really hoping to see more states increase their funding. we didn't see that. it's deeply concerning. host: and why is that happening? is this an easier place for lawmakers and governors to cut? guest: you know, i think that's part of it. i think as soon as the headlines fade, the attention fades as well. and then i also think that there's a great deal of bias and discrimination. the congressman was talking about stigma against people with mental illness. but we know that even though the public tragedies might not be in the headlines, the

private ones continue. we take help line calls and our members let us know of all the time they're spending in emergency rooms, homeless, in jails and prisons. you've heard all those things. it is really concerning to us that states have not stepped up here. we know that we can make a difference. we know there are services that really work, and yet they're not being funded. >> the congressman was talking about the state senator who ran for governor whose own son dealt with mental illness. he committed suicide and attacked his own father and earlier had tried to get him admitted to a virginia meptal health facility. is that indicative of part of the problem that states are facing? guest: absolutely. virginia is one of the states that actually did enact some reforms last year in response to that tragedy. what we saw in virginia was more resources, $50 million, allocated to in-patient and out-patient care. a better registry so that when a hospital bed is available, what happened to the senator was that they couldn't find a

bed for his son. they didn't have a registry that would tell you where a bed was available. so that's going to be happening in the state, more crisis services, better procedures for how they deal with people who are in need of help. and they also did some work in virginia on at risk youth, which is important, as you heard, getting in early. so they started to do some programs there. there is much work still to be done in virginia, but they certainly got started there. we'd like to see other states take that up. it shouldn't take a tragedy. it's the right thing to do. >> mary giliberti, the executive director of the national alliance on mental illness, what state is doing the right thing or things and which states do you think need to do more? guest: well, i can tell you that wisconsin, for example, they passed 17 pieces of legislation last year on mental health care. the speaker had a bipartisan task force. some of the things they funded are some of these programs we were talking about that

actually work. so, for example, in support of employment, many people with mental illness want to work, can work, but need some help. there is a program called individualized placement and support that really helps them and wisconsin funded that program so it can go statewide. they also funded work force issues. you heard the congressman and others talk about how hard it s to get access to care. we were talking about training for police, crisis intervention training. many times it's unfortunate but police have become the first responders and police can be trained so that in those encounters they have a more positive encounter with the person and are able to hopefully take them to mental healthcare rather than jails

and prisons. wisconsin is also funding some respite centers where peers can work with people and avoid the hospitals. there are some programs that work. that state is going to also continue its work into next year. they're not done. i don't think any state is done. all states have much, much more work to do, but it is an example of a state that has taken a really strong approach to mental health reform and enacted changes in a number of different areas. host: which state or states are lacking in all of these areas? guest: we have in our report the states that really cut funding this year and we're deeply disappointed to see states cut that funding. i hate to call people out, but, you know, we have decreased states include alaska, louisiana, michigan, north carolina, rhode island, nebraska, and wyoming. host: and more information is available online at nami.org. our guest the executive director of the national alliance on mental illness.

appreciate you being with us on this sunday and adding your voice to the conversation. guest: thank you so much, steve. "washington journal," the washington editor at large for "the atlantic" steve clemmons talks about the senate report on the c.i.a. enhanced interrogation techniques and the impacts on the president's foreign policy agenda. scott patterson executive director of the national association of state budget officers discusses the fiscal situation in the 50 states. political senior staff writer garret graf shares his recent investigative report on the size and scope of the u.s. customs and border patrol. as always, we'll take your calls and you can join the conversation on facebook and twitter. "washington journal" live at 7:00 a.m. eastern on c-span. dd >> monday night on "the communicators," mary gray on the ethics raised by internet

companies harvesting personal data and the economic research on that information. >> the creepy question is a great question, because i think for all of us, you know, as somebody who uses a computer every day, we have certain expectations when we fire up our computers about who sees what we're doing, who we're sharing information with, and any moment if the expectations i have are shifted because i realize that there might be another party who sees what i'm doing, say, for example, you know, if a message pops up and asks if i would like some help making a purchase, there are certain lines that we don't know we've crossed them until it's too late. that's true for researchers. that's true for companies. there isn't a clear sense of what's creepy, because that's so culturally specific. one person talking loudly on their cell phone in a park has no problem with somebody standing next to them on a

bench and listening to that conversation. and at the same time, you can have someone who is trying to have a private conversation and they won't go to great lengths to be somewhere completely secluded. we're not just dealing with the cultural context but individuals' different preferences and experiences around privacy and their needs for that privacy. >> monday night at 8:00 eastern on "the communicators" on c-span 2. >> coming up today on c-span, our "newsmakers" interview with john yoo who served as deputy assistant attorney general during the bush administration. he talks about the recent report on c.i.a. interrogation tactics released by the senate intelligence committee. then former n.s.a. contractor edward snowden talks about his disclosure of government surveillance practices and recommendations for privacy protections. ater, executive chair eric schmidt of google discusses

data collection by private companies. >> welcome to "newsmakers." with the release of the senate intelligence committee's report on enhanced interrogation techniques of terrorism suspects and c.i.a. chief john brennan's response, lots of discussion in this town and >> he wrote legal opinions that affirmed use of certain tactics. thank you for being with us. >> thank you for having me. >> he covers washington. thank you for being here. >> thank you for having me.

>> we are very pleased to welcome our guest, john yoo. he joined the bush administration. thank you for joining us from berkeley, where your teaching now. let me introduce you chart to reporters. eric lichtblou works for the new york times. he is also written two books that deal with the cia, including the most recent "the

c."s next door to her next to him is dan lamothe. would you tell us a little bit more about your arguments? >> ok, sure. thanks for the opportunity. i'm sorry to say is biased. a neutral handed report made a significant contribution. against them by for two basic reasons. one, it excluded republicans. i think that is a serious mistake, especially when you cannot see the underlying documents because of the classification. if you look at the investigations into intelligence communities in the past, those were always done as bipartisan affairs. i was a staffer in the senate. i ran investigations. nothing as massive as the six-year 40,000,000 to 50,000,000 report. the second thing, it is incredible the way the report was done, there were no witnesses interviewed. again, i cannot think of another time in the senate investigation when you refuse to interview witnesses. for me, as a lawyer -- it's like if you go to court and you want a fairchild, but only the prosecution to put on the case. that is why i have been critical. i'm very disappointed in what the intelligence committee did this time. >> eric. >> professor, years from now you will be known as a lawyer who --

gave the legal tactics. for you personally, is that a source of pride? >> i hope it's not only thing i remembered for. who knows? you are probably right. look, i do not rush to do this. i did not volunteer for the bush administration to work on interrogations. i started in july before the 9/11 attacks. i'm just thinking -- this will be domestic policy investigation. they were not going to have the 82nd airborne escorting kindergartners to' to school. well, on the other hand -- i thought was my job to do it. we had just been attacked. we had just lost 3000 of our fellow citizens. huge damage to the united states from a foreign tro