45 minutes, look at the affordable care act. new changes the current healthcare coverage in 2015. i guess are julie rovner and margot sanger_katz. ♪ host: good morning, everybody. here are your headlines. center michael graham from new york will now resign after pleading guilty to tax evasion. meanwhile, louisiana republican congressmen acknowledged monday that he spoke at a gathering hosted by white supremacist leaders in 2002 while serving as a state representative. more on the stories in the papers today. but first, we will focus our

"washington journal" on the affordable care act. we want to take your temperature on this. you oppose or support it? call in, send us a tweet, go to facebook, or send us an email. start dialing in in, the phone lines are open. we want to know whether or not you support or oppose the affordable care act, or have you change your mind since the first year of implementation. the "new york times" has a story about the affordable care act on its front page. it deals with medicaid.

that is the front page of the "new york times" with what is going on in kentucky. we're getting your thoughts on whether or not you support or oppose the affordable care act. sam, good morning to you. caller: i support present obama on his health care. how can anything present obama goes through when the republican party will be in charge on the first of the year. they do not even respect the way america runs. the top leadership position in america __ they have nothing but whites.

then we hear this about steve's the __ in louisiana. [video clip] >> obamacare is hurting our families. i'm sure, the house at some point next year will move to repeal obama care. it should be repealed. it should be replaced with common sense reforms the respected dr._patient relationship. whether that can pass the senate, i do not know. i know will pass in the house. that does not mean we shouldn't do other things. there are bipartisan bills that have passed the house, sitting

in the senate that would make changes to obamacare. there is a bipartisan majority in the house and senate for repealing the act. i think there's a bipartisan majority for getting rid of the act. how about the individual mandate? *democrats and republicans who believe this is unfair. just because we cannot get everything we want does not mean we shouldn't try to get what we can. host: the house speaker speaking of the affordable care act. go ahead. caller: i'm starting from a basic consideration of the fact that competition in the inserts business has worked so well when it comes to auto insurers.

i understand the medical insurance considerations __ they going every aspect __ you a are talking about facilities. but, that competition could be served by thinking that it could be improved with different companies competing __ what we've seen in the auto insurance. host: you see more insurers getting in the game? caller: yes, i see that. at the same time, it is everything but we're talking

about __ we saw him a system that was created with regional competition happening. let's look at the major healthcare insurers __ i do not believe there is more than maybe 50. i've used this term before __ regional monopolisitc activity. healthcare is so complex. it is interwoven, the activity of these insurers. as well as medical facilities with legislatures in certain states. exactly one party __ it is not one party that is responsible, i don't mean just political party. it is really complex.

all i'm noticing is that competition has been hindered. whatever aspect of the affordable care act that promotes competition, i believe it is a step in the right direction. host: erica from ohio. caller: i would like to say that i approve obama completely. he is doing an excellent job. i do not understand why older people do not accept that he has done the best. he is trying to save our system in many different ways. he is saving money. he is telling people go to urgent care, go to clinics. for minor issues, we should not

go into the hospital for surgery. our family do not have money for funerals. we cannot die. we deserve to pursue life, happiness, and liberty. host: when did you sign up for the exchange? caller: a couple years ago. in 2011 or 2012. host: the first year of implementation was the last year. caller: i have been following it very closely. i am a doctor overseas. i do not __ host: we will move on to bob.

when did you sign up? caller: i'm not involved in the exchange. my insurance to my employers have gone up over $1000 in order to pay for the affordable care act. my deductible has doubled during the same period. it is costing me close to $1600 plus another $3000 a year to cover the cost of my health insurance program since affordable care act went to place. my wife has a severe disease so i have to pay the whole deductible. her first treatment in january each year cost $10,000.

host: what did you play say about this? caller: we could make adjustments to take on the formal care act, he said. host: peter, do you support or oppose this law? caller: i oppose this law. my cousin is a doctor in kentucky. he is hiring a new person to deal with the affordable care act. his hospital where he works at __ tthey are about to go bankrupt because of this law. it may be great for people getting in there. they are taking a loss. eventually, medical care

facilities will get closed down. laid off about 15,000 workers in about two months. host: bill in connecticut. you are enrolled, when did you sign up? caller: thank you. i have cancer, stage iv. i lost my insurance because of that. i was not that far along, but there was a space of time or was not getting any treatment. because of medicaid, i was able to get insurance that would help me stick around for a little bit. i am for it. host: when did you sign up? caller: this year.

host: what was your experience like, given your situation? caller: i did over the phone. the lady was very nice. i got a letter in the mail telling me it was approved. it was really great. host: how much you pay for premium? caller: fro medicaid nothing. host: you are on medicaid. caller: i know people look down on that, but i worked all my life. host: do you have any out of pocket cost? caller: the normal stuff. host: what were your medical bills like before?

caller: i didn't have any because i couldn't afford it. when you get in the cancer world, everything is ridiculously expensive. i couldn't afford it. if i'm making not enough money and i am on medicaid, i cannot afford one month a prescription of the medicine i'm taking. host: a news conference last week talks about the affordable care act. she addressed some questions. [video clip] >> oone month ago people were raising questions whether or not consumers would come to the marketplace. today, after reading the news, work out budgets, talking to friends, 1.9 million americans have chosen to come to the marketplace and get coverage for the first time. there are also questions about

whether insurers would decide that the marketplace is a good place to do business. there now 25% more issuers offering plans to consumers who can choose on average 40 plans. there were also concerns whether these plans would be affordable. they are. while some predicted that premiums with skyrocket __ nearly 8 in 10 can get coverage for $100 a month or less. there were also questions about the technology. today, while our work is not done, we must continue every day to be vigilant, the consumer experience is considerably better. host: health and human services

representative talking to the media last week. our question today, are you opposing or supporting the affordable care act. if you are enrolled in the exchange, please call in. we will continue with more calls, but first to the papers. a republican from louisiana says, i detest any kind of hate group. he acknowledged on monday that he spoke to white supremacy group __ to a group hosted by a white supremacist leader back in 2002 when he was a state representative. he says in the paper this morning __ i detest any kind of hate group. he also told the paper to say __

for anyone to suggest that i was involved in a group like that is insulting. michael grimm of new york will resign from congress. he said at the beginning of the fbi investigation into tax evasion that he would not. he pled guilty. after yesterday, he says he will resign from congress.

that is from the "new york times" this morning. back to your thoughts on the affordable care act. we will go to a democratic call her from north carolina. caller: good morning. i signed up last year. host: what was it like? caller: it was good. i do not have to pay any premium or deductible. host: to know what the cost will be? caller: not much, $16 starting. host: so no premium last year now it will go up. caller: it went up.

i do not know what it will be next year. i am unemployed. i think god for it. i have not had insurance for a long time. it is a blessing. thank god i can go to the doctor. i'm healthy, thank god. host: we will go to jeff from the prostate, a republican. caller: i definitely ooppose it. my son goes to school in south dakota. he cannot even get it, it is $250 a month with a $4000 deductible __ he is a student in college. how does that happen? host: is he under 26? caller: know __ no, he is 27.

on the congressman and his taxing __ al sharpton owes the country $4 million and he has been in the white house how many times? i wonder if the president ever looks at al sharpton to ask about that money. host: moving on to mark. what is your policy like? caller: not very good. for 30 years, i was on blue cross. i am a farmer. it was canceled.

blue cross offered us a different policy, but none of our hospitals would take it. i had to go to united healthcare. i now have a much higher deductible. i had a really rough time getting it. nothing was getting signed up, but billing me. they wanted to take it out of my bank account. i really don't like giving anyone else my financial information. i'm sure it is good for some people, but not for me. host: usa today has this headline this morning __

by the way, hhs announced last week that about 6.4 million consumers like their plan and federal marketplace or were automatically be enrolled. new consumers make up 30%, or 1.9 million. new provisions __ penalty for not having

insurance will go up next year. hope, do you support or oppose? caller: i'm an independent caller, i support this law. the reason i support it is because i'm enrolled in a private option exchange. basically, it is our state version of medicaid expansion. i enrolled last year. i have my own small business. when i found out that i was eligible for medicaid expansion, i was able to go get a complete physical. my health has improved. my cholesterol coming down. my weight is coming down.

i also tested negative on the mammogram. my bone density is good. also, my husband __ who is on medicare __ since passage of this law, and since it began implementation for medicare recipients before 2014 __ in the last two years, his premium has not gone up. what is really exciting is that the doctors i had before, get to keep. the hospital i was going to is also participating in our plan. i have arkansas blue cross blue shield. this year to another to __ i did not have to pay a premium __ i was able to invest more in

my business, and purchase my own dental and vision plan. which is quite affordable. host: how much is it? caller: might dental premium is going $37 per month. that is for comprehensive dental and vision. i'm able to maintain my health with dental care __ regular cleanings, and getting my eyes checked. this has been amazing. in our part of the state, our economy is improving. the hospitals are actually hiring people. the whole healthcare community is starting to thrive. host: i will move on to get some other voices. a republican in texas. do you support or oppose?

caller: i oppose it completely. i personally have three children. my wife and i __ we are independent workers. at this time, they are trying to quote me $1600 per month for me and my family. that is our premium. so all these people calling in about their $15 or $20 per month, god bless them. i would be jumping up and down to. but, people who work hard, like i have all my life, and now you tell me i have to pay $1500_$6000 per month for policy __ that is ridiculous. that is as much as my mortgage. host: i wouldn't ask you, how does that compare to your other

bills. caller: i am paying for a lot of people who are not working. host: is your family healthy? caller: yes. we are healthy. we could go to a $600 ddeductible. what that means is they will not cover anything up to $600 __ if we do that, that gets my policy to $1200 per month. we are all athletic, healthy people. this is how it is affecting me. no, it does not work. there constantly punishing those of us who worked hard in high school, worked hard in college. host: d_ i asked how much you

and your wife __ do you mind if i ask how much you and your wife make each year. caller: on a tax return it will say $180,000 per year. that is not how much i make each year. we pull people together and we made a new business. i did not get that money that i'm having to pay taxes for. host: will go to air connects from ohio. you are enrolled in an exchange. caller: i do have an accent, but i was born in ohio. right now i am training for the armed forces, i have trained overseas. i am a single parent.

my son has a dad. for 17 years i have not received child_support. it was not for obama, i would not have health care, i would not have food stamps. here in ohio there is a lot of discrimination for people with an accent. my parents are from spain. it is not fair with this guy just said. people are cheap, they do not want to pay co_pays. they do not want to go to the pharmacy __ they do not want to look for the cheap glasses at the dollar store. they were expensive and fancy stuff. host: i want to give you some other headlines. the "washington post" on the front page with the air asia flight. reporting that it is one of 90

flights to have vanish. also, the front page of the destroyer uss sampson will join the search today. that is from the u.s. navy. the financial times saying that missing aircraft raises questions on crowded skies. experts say regulators and air traffic controllers are under increased pressure. according to one expert though that monitors flightsafety 2014 has been the fewest fatal accidents since modern aviation began after the second world war. only eight large passenger aircraft have been lost this year, with an average of 17 in each of the past 10 years. on ebola, it has been confirmed that there is a case in scotland

from a health care provider that was in africa. front page of "wall street journal" says -- after slow ebola response world seeks to avoid a repeat. in a special section -- session next month in geneva the world health organization is expected to consider recommendations, including a proposal that a commission, an outside review of its ebola response. inside the "new york times" this morning in the science section they have a piece that is also featured on the front page about ebola -- the deadly escape. it is a lengthy article looking at the ebola epidemic in west africa, rising to the attention of the world this summer, but there was a fleeting moment in the spring when the deadly virus might have been stopped. the "wall street journal" reporting that the irs says

tax-filing season will be on time this year. the "washington times" reporting on visa expansion, raising concerns -- a program for wealthy investors has increased 700% under president obama. that is on their front page this morning. on police in this country, the "washington times" reporting that senator patrick leahy is seeking bulletproof fasts for crops. he wants to expand a program in the wake of recent attacks. the program had been expired in 2012 because senator tom coburn, a republican, thought the program was wasteful. it helped fund the purchase of more than one million bulletproof vests for state and local police since 1999. senator patrick leahy looking to renew that program. we will go to brad in iowa,

independent caller. what are your thoughts on the affordable care act? do you oppose it, support it? caller: i oppose it totally. host: why is that? caller: my insurance premium has more than doubled starting january 1 -- has more than doubled. starting january 1, it goes up again. i forced to pay for it. starting january 1, i am now covered for reconstructive breast surgery if i have to have amos sector me. my son is in a union. his health insurance is gone from $20 a week to $46 a week. my parents' medicare supplement has gone up over $1000 a year. my doctor quit a clinic in which i go to. they choose to have 14 doctors,

but it is now down to four doctors. my father's specialist has retired at an age of 48 because of obamacare. host: all right, that was brad in iowa. the ap has an update on that airasia flight. they are reporting that searchers are combing the java sea give recover debris and bodies from the jet that crashed sunday morning with 162 people on board. at least six bodies pulled from the water have been taken to an indonesian navy ship. our conversation continues on the affordable care act. we will talk with two veteran health care reporters. julie rovner of kaiser health news, and margot sanger-katz health correspondent for the "new york times", right after this break. ♪

>> the c-span cities tour takes booktv and american history tv on the road, traveling to u.s. cities to learn about their history and literary life. this we can, we partnered with time warner cable for a visit to austin, texas. >> we are in the private suite of lyndon and lady bird johnson. these were the private quarters of the president and first lady. i mean private. this is not part of a tour

offered to the public. this has never been opened to the public. you are seeing it because of c-span special access. vip's come into this space, just as they did in lyndon johnson's day, but it is not open to visitors on a daily basis. the remarkable thing about this space is it is really a living, breathing artifact. it has not changed at all since president johnson died in january of 1973. there is a document in a corner of this room signed by the then architect -- archivist of the united states, and lady bird johnson telling my predecessors, myself, and my successors that nothing in this room can change. >> we are at the 100 block of congress avenue in austin are to my left, just down the block, is the colorado river. this is an important historic site in the city's history because this is where waterloo, austin's run assessor, was.

it was occupied by four or five families, including the family of j carol. i am standing at about the spot where the cabin was the road this is where lamarr was staying when he and the rest of the men got wind of the a buffalo herd in the vicinity. they jumped on their horses on congress avenue -- it was just a muddy ravine that led north, and the man galloped on their horses . they stuffed their beltsville of pistols and rode into the midst of this herd of buffaloes. lamar shot this in arm as buffalo for a he went to the top of the hill where the capital is, and he told everybody that this should be the seat of the future empire. >> watch all of our events saturday at noon eastern on c-span2's book tv and sunday afternoon at 2:00 on american history tv on c-span3.

>> "washington journal" continues. host: we are continuing our conversation on the affordable care act. two longtime reporters are here with me to help with the conversation. margot sanger-katz is the upshot health correspondent for the "new york times." julie rovner is a senior correspondent with kaiser health news. julie, i have a question that might be difficult to answer precisely, but is the affordable care act working? guest: of course, it depends who you ask. if you use metrics by the congressional budget office, how many people be expected to sign up for medicaid and for the exchanges, then, yes, it is. right now, as of today, the numbers are hard to parse because we're halfway through the sign up for 2015 coverage. the last numbers that the administration reported were

about 6.5 million people in the federal exchange those 37 states. those include people who were automatically reenrolled who did not come to the exchange and put in new information. they were automatically reenrolled in their existing plan or one similar to it. i think there is a little under 2 million new people so far, and that is for coverage that starts january 1. more people can sign up until february 15. and the penalties for not having insurance in 2015 go up a considerable amount to $300.5 or 2% of your income, whichever is greater. host: one of the metrics that people look at -- has the rate of the uninsured fallen in this country? guest: that is something we can say with certainty. the number of people without insurance has gone down substantially, and that is a result of the affordable care act people have signed up for medicaid and for these new insurance exchanges.

some people have signed up for employer coverage that they turned down before because they are now required to have insurance. the best estimate is somewhere in the neighborhood of 10 million people have insurance that do not have it before. that is just for 2014. the people signing up for next year they may bring that number down even more. host: will the exchanges get as many people with insurance whether they are federal or state or medicaid? guest: a major goal was to try to reduce the rate of uninsured and make insurance acceptable and affordable. some of those people cannot get insurance because of a pre-existing condition and no one would give them insurance am a so the exchange has, to some degree, solved that problem. insurers cannot dems -- cannot discriminate based on health and just -- based on health history to some people cannot inch --

cannot afford insurance before. the expansion of medicaid and the availability of federal subsidies on the exchanges has made insurance accessible to more people. is 10 billion a big enough number? is that the right number? it is hard to know. he we know more people will sign up in the coming years. even after fully implemented estimates are that there will still be tens of millions of americans who lack health insurance. that is a problem. host: julie rovner, is health care insurance affordable? guest: for many people but not for everyone. one way to look at it was through the way supreme court wrote the law, not the way it was written. congress intended medicaid to be expanded in every state for everybody up to 133 percent of poverty. everybody above that would have access to subsidies on the exchanges. the supreme court decided that that medicaid expansion was voluntary. we now have a little more than

half the states trying to expand medicaid. some of the states that have not are some of the states with the largest, potentially, eligible population states, like georgia, texas, and florida. so a lot of people have fallen into what we call the coverage gap, and those are people who have incomes that are too high to qualify for regular medicaid. if you are a tireless at old chances are you are not going to qualify for medicaid no matter what your income is. for parents with low incomes but not so low that they qualified for medicaid but not more than 100% of poverty, which is the threshold at which you can get onto the exchange, all of those people are caught in the gap. several million people who were supposed to be eligible for affordable coverage under the law and who are not. plus, there are people who do not earn a lot of money you are finding not that great a value in some of these plans. it is depending on where you live. it depends how much competition

there is. in some cases, the premiums, even with the subsidy, the premiums may be low but they have very high deductibles. some people have said, i will just pay the penalty. host: what has been going on a 2014 with premiums and deductibles for people getting into the exchanges? what do you expect in 2015? guest: people are signing up now for 2015. one of the things that has been pretty remarkable is the number of insurers who have come in experts that have decided that, yeah, maybe we should get into this after all. so there is more competition in a lot of places, particularly where there was not much competition before. that has reduced premiums. obviously, premiums are all over the place. it depends how old you are. so your individual situation may vary. in general, they're looking at the silver plan, the second from

the bottom plan, the one in which subsidies are based. most analysts are finding that where there had been very little competition, that tended to be the most expensive plans. where there is more competition the premiums have come down. in some cases, those premiums may still be higher than some other premiums, but at least we're sort of coming closer to an average. we are sort of taking off the very top, if you will hear it's of the various -- if you will. in general premiums have not gone up as much as they do normally. the individual market tends to be a market with a lot of fluctuation. premiums do go up a lot each year. the idea that the average increases each year, some are in the low single digit range, is really surprising. host: margot sanger-katz, what about deductibles? what do you expect? guest: the health law restricts

the amount that health insurance can charge people in sort of total out-of-pocket costs. the total amount you spend including your deductible and your copayments and other kinds of payments, are capped, so the deductibles are not really changing very much. some individual plans are tinkering with, you know, you pay a little more deductible you pay a little less in copayment, and you come up with the right formula to make the product most profitable for them. in general, deductibles are kind of staying put. host: according to kinsey and company analysis, the nationwide median deductibles if you have a bronze plan, about $5,100 you're it for a silver plan, $2500. let's walk through the plans and what you can -- what are they? remind viewers. guest: they list the tiers by me dals. bronze, silver gold, and

platinum is the deluxe plan. they have to do at the percentage of an average person' s medical costs that the insurance will pay for. if you are a typical patient and you buy a silver plan insurance is going to pay for about 70% of all your medical costs and you will be responsible for about 30% through deductibles and other payments. the bronze plan, the least expensive plan, covers about 60%. the platinum plan, the deluxe plan, pays 90% of your expected medical costs. host: let's get to calls. william has been waiting in louisville, kentucky, and independent. caller: i do not have obamacare but my daughter is a registered nurse. i do a lot of volunteer work with her. i take people back and forth to a clinic some and they are on obamacare but they do not have any way to get down there. i help my daughter out with it.

i drive them back and forth. i take them down to a family clinic ok? these people do not see a doctor. they see registered nurses. i do not think they have ever seen a doctor. the place is filled with a lot of poor people. i am sure there are a lot of immigrants and many are illegal. but they all -- they do not see physicians been my physician who is from vietnam is threatening to leave the country, because he said he did not come to america to get involved in socialized medicine. my doctor -- my daughter hates it. she's is the nurses are not qualified to make accurate diagnoses. i realize people do not have anything. i can afford to pay for my insurance be a i know people who cannot. they then if it from it. but people who do not needed are not being benefited by it because premiums and deductibles are going up. while i feel sorry for the

people that i have to bring down there and that she takes care of i also feel sorry for those people who have to pay for it. it is a two-way street. host: julie rovner? guest: on the question of seeing nurses rather than doctors, this is one of the ways the health system is working to bring down the costs of health care. there are lots of different kinds of nurses. there are less trained and more trained nurses, advanced practice nurses, nurse practitioners. it has been shown through a series of academic studies that they do a very good job doing a lot of general primary care. a lot of doctors work hand-in-hand with nurse practitioners. a lot of nurse practitioners work on their own. the idea of sort of making the health care system more efficient is that everyone works up to the limits of their license. they do that highest level they are trained to do. nurse practitioners are seeing people who have primary care

needs, and then they send others to the doctor. the idea is that everybody is practicing the most efficiently. it is supposed to be the future of health care. it is just now starting up. seeing nurses is not necessarily substandard care. in many cases, it is considered the top level of care. they refer you to the doctors the way your primary care doctor will refer you to a specialist when you need one. it is not true that nurses are not trained. nurses get very upset about that. host: margot sanger-katz, he talked about a physician who wants to leave the country because he did not sign up for social care. when are we hearing from doctors? guest: one thing that is often confusing in this moment is that the affordable care act is happening and that is changing a lot of rings about the medical system and about the health insurance system, but our medical system has been in flux for a long time. a lot of the problems people are

experiencing now are things that have been simmering and going on for a long time. i think there are a lot of ways in which it is hard to be a doctor now, or harder than it was in the past. it is more expensive. there are more complications having to do with insurance. those things are really true. they are not necessarily, or even really at all, because of the affordable care act. a lot of times you hear from doctors about frustrations with the way the business is working with the with the practice is working, and they feel they have less autonomy than they used to have. there are people retiring or complaining or throwing of their arms in frustration. doctors say they would not recommend that their children enter medicine. but that is not necessarily because of the health law. things are changing about how the medical system works, and that has been going on for a long time. host: what about the industry as a whole, have they benefited from the affordable care act? guest: in general, yes, the

insurance industry is doing well. it depends, some were counting on medicaid expansion, because the hospital industry serves everyone who shows up at the emergency room. many of those people do not have insurance. many of them would have been and are eligible for medicaid now. they were really planning on having that -- even at a low payment, having medicaid pay for people for whom they were providing free care. that is a big concern in the states that have not expanded medicaid. there is a big push by the hospital industry -- in those states that have not expanded medicaid yet -- to do that, to make sure some of those people who are eligible are covered. host: lisa is watching from shreveport, louisiana. caller: thank you. i am having a major problem. i signed up on december 8 for

united health care, and i am from louisiana. and if they told me the paperwork. i never received it, and now i called back yesterday and they told me that i had to get back online and make a payment and i do not have a credit card. i'm on my dad's account, and he does not want to give his account number. i do not know what to do is stop i do not know what doctor to go to. i have no paperwork. i do not know what to do. can somebody help me, please? guest: i think the problems you are describing are problems a lot of people are facing. the way the exchange works is definitely better than last year. you can select a plan on the website. a lot of the communication between the exchange and the insurance companies is not perfect. some of those insurance companies, sometimes the processes can be flawed.

i would recommend to go back to the website and perhaps contact united health care again. host: she said she will not receive the insurance until she makes a payment. that is a crucial step. guest: that is true, and it is important for everybody to remember. even though the deadline is the 15th of the month before you want the coverage to start, the coverage does not start until you make that first payment. sometimes people do not know where to send the payment, how to make the payment. as she said, sometimes the information-passing is a perfect between the exchange and the insurer. on the front page of healthcare.gov, there is a button easy to find that says "bfind health near you." it is good to find someone locally to intercede on your behalf. guest: i think for the long-term

insurance companies, they generally do want a credit card or a bank routing number for automatic payments. my understanding is that for the first month, there is more flexibility. you may be able to pay with a check or prepaid debit card. host: good to know. we are dividing the lines by republicans, democrats, and independents. we have a fourth line for those of you enrolled in the exchange, whether it is the state exchange or a federal exchange. josh's calling in on that line in charlestown, indiana. caller: we were on the exchange, and our premiums tripled. basically, everything that we found for a cheaper plan, none of our doctors were in the coverage. so everything we found, you know, if something does happen and we go through our deductible and premium, everything will add up to about $20,000. so we're just going to go without.

we are automatically reenrolled, but we are going to try to cancel that and pay out-of-pocket. it is a lot easier that way. host: are you healthy? you are assuming your expenses will not be that high? caller: yes, we are all healthy. host: do you know the penalty increases in 2015? caller: yeah, it will still be a heck of a lot cheaper than getting the insurance. we do have the funds available if we have to. we can pay up to the $20,000 out-of-pocket. but what we would really like to have is a catastrophic plan something where we pay everything out-of-pocket up until a certain point, and then let it kick in. host: why is that not available? caller: it is. it would be one of the biggest you know, for maybe $1500 a month, but that is just crazy. we are healthy. host: ok, i thought your finish.

julie rovner? guest: there is a catastrophic plan available. it is not part of the tier levels we were talking about. it started out, you had to be under 30 two qualified to although, last year, with all the problems and planes being canceled, they added a number of people who can get into that catastrophic plan. if you cannot afford plans there were a number of exceptions that allowed people to leak into that catastrophic plan. in general the regular plans are almost catastrophic plans. -- the bronze plans are almost catastrophic plans. one thing that tends to happen for people who see dramatic premium increases, that may be because the plan on which their subsidies were based changed.

it is entirely possible that there is another plan that might be closer to what they had that would be considerably less expensive. sounds like they did explore their options. guest: if you look around the country, we did an analysis and particular plans that were popular in 2014 for people who were new, some of them are facing an average increase close to 10% for the very popular plans from 2014 14. for the premiums. if you stay on the same plan, you're looking at a pretty big increase. if you are willing to switch plans and shop around, the increases are much lower. you can get something at a 3% or 4% increase, on average. in general, it is a real advantage to looking around. if you like your plan and want to keep it and are willing to pay more, by all means. but the way this is supposed to work is by having the plans compete on prices. there are people who lower prices, so there may be better

deals. the department of health and human services estimates that more than 70% of people can get a better deal if they are willing to switch. host: what is going on with subsidies? how do they work in 2014 and what will happen in 2015? guest: subsidies are based on a person's income. they are also based on the price of the second least expensive silver plan in the market. if you buy that plan, you'll have to pay a certain percentage of your income to buy insurance. if you buy a cheaper plan, that you can pay a smaller amount. for more expensive plan, you have to pay more. it is pretty complicated. there are reasons to go back to the marketplace, even if you are going to renew into your same plan. that allows you to recalculate what your income is, like if you got a raise or changed your job. as julie said, some of these lower-cost silver plans are shifting around of the market. that will affect where your subsidy is, and it is worth looking at that.

host: julie, how does it work when you go online? how do you know that you're going to get a subsidy? guest: the good news for people who did not sign up for 2014 is that there is a much shorter application process. unfortunately for people who did the writing and signed up in 2014, they still have to go through sort of the longer form to re-up. but it is probably worth it because starting next april or whenever you do your income taxes next year, you'll have to reconcile the subsidies you got this year with the income taxes for next year. you could end up paying some -- it depends how close the estimation was to your income and the subsidy hear it but if your income has changed, you do not want to be getting a subsidy that is too much or too little. you will be cheating yourself and will have to pay the government back at the end of the year.

it is worth going back in, and yes, it is a little bit of a headache, but walk through it again. a lot of people had trouble at the front end. they forgot their password or their password does not work. that has been a little bit of an issue. the system is still new. host: yes, and after one full year of implementation, there are still some things to work out. that is our conversation with all of you this money joined by julie rovner correspondent with kaiser health news and margot sanger-katz, health care correspondent for the "new york times." we are taking your questions, comments, and concerns for the affordable care act. we will go to sally next in michigan, and independent. caller: hi, i am totally opposed to this obamacare thing. it is all great, in theory. i would love it if everybody got good health care and everybody -- everything was pleasant.

but he is robbing peter to pay paul, and it is doing terrible things to our liberty. it is another law. it is another law. the government has no business being there -- another law. that lady that called earlier -- i will not give them a credit card number. i will not give them an e-mail number. they will not be taking things out every month -- heck no. they're going to have to take a money order in the mail every month if i decide to allow them to force this law on me. i am getting really upset about this. host: sounds like you are. caller: and the insurance companies -- oh, my gosh. what a legal mess. smoking is definitely going to become illegal. and then the sugar thing -- they will be in your houses and more.

everything is going to become more illegal because you have got to be healthy. host: margot sanger-katz, can insurance companies put restrictions on what you can and cannot do if they're providing you health care insurance? guest: there are some rules that allow them to do that. if you smoke, you can be charged a higher premium. it is really the only category besides your age that can affect what you pay. employers, outside the exchanges, employer plans which is where a lot of americans get their health insurance, they are allowed to institute wellness programs. they will charge penalties or pay you bonuses depending on whether or not you comply with various rules. there is a lot of flexibility in how employers can set those up. it is true to them if you do not exercise maybe or lose weight or meet some sort of standard, you may be charged a higher premium. host: tabak, florida, republican. you are enrolled debbie. what has been your experience?

caller: i can tell you, i just used the plan the night before last. i was in the emergency room, and i had not paid my premium yet. when i signed up, i was told that i do not have to pay until the summer -- until december. i got the invoice in the mail that said if i did not paid by the 15th, my insurance was canceled. i called the nurse to ask if i was ok to go or if i should go to the hospital. i went and everything was fine. i was seen by a nurse's assistant. they gave me prescriptions for medication. i went to the plan pharmacy walmart, and that is where it got really confusing. i was supposed to have a tiered plan were certain prescriptions, if they are generic, they can

only be $10, you know, up to $25. first, they give me the bill. and i said, i do not think you applied my insurance. and she said, no, and sent me to another lady. the lady said you have not been active since 1999. i was like, i was just issued this insurance in november november 10, and i assure you it was not since 1999. then they send my coverage did not start until january 1. now i do not even know if my hospital stay was covered. on my invoice, when we talked about how premiums went up prior to this, i had insurance and paid $185 a month, single and with obamacare, it was $384 a month. now i get my notice that because i do not pay november and december, which i was told i do not have to start paying until

january, i do not even know if i can retroactively pay. it has gone up to $470 a month. i am going to have to let it go. i'm going to have to pay this month and try to pay retroactively for december and hope that they cover the hospital visit. then i am going to have to go on my own. i mean i am an independent contractor and do not make a lot of money. i get child support and try to supplement that with working as much as i can. host: what did you go to the emergency room for? caller: i have asthma and i thought it was either pneumonia or bronchitis and likely, it was bronchitis. i needed a breathing treatment. i did not have any medication and was having trouble breathing. host: julie rovner, what do you make of her story? guest: a little bit confusing. generally through open enrollment, the plants do not

start until january 1. i am not sure if there was a december 1 start. but if you have certain situations, you can sign up in the middle of the year like if you meet certain criteria like losing a job or getting married or diverse -- divorced. but during open enrollment, the plans start january 1. in general people have confusion with their insurance companies all the time. it is what it is people have them with medicare medicaid, and with private insurance companies. host: with her doctor visit, it turned out to be bronchitis to the cdc this morning or yesterday announcing that the nation is at the epidemic threshold for the flu. is that typical of er visits? what does that mean for health care insurance? if you are going to the er for

seasonal things like the flu how does that impact the industry, the providing of health care, and how does that factor into the affordable care act? guest: this is looking to be quite a bad flu season this year. i was looking at the statistics yesterday. the flu comes and goes. there are different strains each year. some years we get a really bad flu season and some years are mild. when there is a mild flu season, we take credit for maybe having taken better care of ourselves or for the vaccine being more widely distributed. but when you talk to the scientists, a lot has to do with the actual flu virus. this year, it is pretty bad. the flu can be quite a serious illness, especially if you are in a vulnerable population, older people and children. it is not uncommon for people to require hospitalization as a result of the flu. in general, things like asthma

aggravation, it is thought that if you are getting really good care from your primary care doctor and you are taking the right medications and doing what you should do for your health, you should not have to go to the emergence room very often for things like asthma. but if you have asthma and get the flu, it would not be uncommon that you might need to seek hospital care. it is an unfortunate thing that we have this disease that comes around every year and can be very serious. guest: one of the ways that the health system has changed over the last, not just decade, but the last two truck or three years is the emergence of the urgent care clinics and the minute clinics. their primary care clinics just about everywhere. it is a place to go for people with the flu. the caller that just called in, she has asthma, a respiratory problem, so she should go to the yard. that is what the er is for. but if it is just a

garden-variety, you feel terrible, they do not want you cluttering up your doctors office and giving everybody off the flu. urgent care clinics were created for that sort of thing. there are medications for the flu and if you take them early on, you can reduce the severity of it. it is good to see a medical professional. these are sort of places that are less expensive, a more appropriate level of care than going to an emergency room. emergency rooms often get so many people with the flu in the winter months. that happens every year. host: san mateo california, mary democratic caller. caller: i'm 65 and on medicare now. i just turned 65 last year. i do have supplementary plans.

i have glaucoma and i also have a syndrome where you do not have enough moisture in your eye and you also do not have enough saliva. so i have two sets of eyedrops i have to use, and only one of them was available through any plan i could find. the other one -- i am also a veteran, so i did have some help from the veterans administration. i get one of the eyedrops from the v.a., and i get the other drops from the health care that i pay for. the second problem i have is it is a multiple sclerosis-type nerve damage that has caused nerve old the rock that these and i take medications for that and have been for 20 years. with the affordable care act has done is they limit the number of

pills that you can take. they do not care about the dosage. they care about the number of pills. you can have 180 pills no matter what the dosage, and that is all that is paid for. after that, you pay for them. last year, even with medicare and with the two health plans that i pay for and with the veterans administration, i paid 29% of my income on drugs. host: margot sanger-katz? have you heard this, that there is a restriction on the amount of pills? guest: i am not familiar with that restriction. it seems plausible to me. the benefits are administered through these programs, and it is similar to the insurance exchanges set up by the

affordable care act. seniors engadget's marketplaces and choose from the stiffer private plans. each of them covered every kinds of drugs and they have different structures in terms of how much you pay out of pocket. overall, seniors are pretty satisfied the cause they have been enabled to get prescription drugs more affordably than before, but there are certainly limitations and a lot of rules. it may be that someone with complex health needs may need to shop each year and make sure that the particular drug plan they have chosen is appropriate for their needs. host: john from florida, and independent. caller: how about religious beliefs -- will this be on your income tax return about why you do not have my health insurance and religious beliefs? guest: there is a religious exception purity cannot be, you know, i belong to a church and

my car needs extensive repairs. but there is something called religious sharing ministry. people basically come together and give money to pay for a group's medical expenses. that started before the affordable care act. that is an allowable exception. there are some religions that do not believe in traditional medicine, and they are exempt. but that is not sort of an open -- you cannot just say that my religion does not believe in this. you have to follow that up if you want to claim that exemption. host: what recourse is there if millions do not pay the fine? guest: the recourse that they have -- all the people that say you can be put in jail, you cannot be put in jail. they can basically attach your income tax refund -- that is the

main thing. they're not going to come after you for anything more than that. you could the radically game the system by changing -- you could theoretically in the system by saying you do not have a refund and then not having health insurance, and then there is nothing they could do it but if you had a refund the next year, they could attach it the next year. the most you'll get for punishment is they will withhold what you are owed in a refund. theoretically, they are not allowed to buy insurance on the exchanges at all, you must be in the u.s. legally. host: another tweet -- why not just lie about your income? debbie from arkansas democratic caller. caller: i just called in yesterday and canceled my silver plan. i could afford it when i first got it. then they wanted to start

charging me, like, $88 a month $40 per prescription that is non-generic. the problem is, i am asthmatic and have diabetes, and everything i have is not on the plan. so i would be paying like, $380 a month for my medicine and $50 to see my specialist and $25 to see my doctors, and i do not make that much. i told them that there is no way i can afford this. host: margot sanger-katz? guest: this is a good example of a person who should go back to the online marketplace and look at other options. it sounds like the particular plan she chose for 2014 is changing and does not meet her needs anymore, but there might be another plant that does not charge such high copayments for the drugs she needs or the visits she needs or may have a lower premium. the news organization propublica

as a really useful tool that compares how much you have to pay for java kind of drugs and doctors visits. it is a really easy tool on their website, propublica.org and you can compare the plans. that might be a first step for her. then she can go back to the exchange and see if she can find coming affordable. host: we are talking about the affordable care act, dedicating the whole show this morning to it, after the first full year of implementation of this law. julie rovner is in your correspondent with kaiser health news. margot sanger-katz covers health care for the "new york times." i want to show our viewers this tweet from a representative -- for 13 million americans, $65 billion in tax credit are at risk in and political attempt to undermine aca in court.

when is this going to be brought up? guest: on march 4, the supreme court will hear this case. that was a surprise. everybody expected it would probably go to next term. there was not a split in the circuit yet. the appeals courts were not yet in disagreement on this. it is a very arcane case if you will. it hangs on wording in the affordable care act and where subsidies will be available. there are a couple places in the law where it says tax credits will only feel ball -- available in an exchange established by the state. the question is, does congress really mean that only state-run exchanges could provide subsidies or did they assume that subsidies would be available everywhere? it is pretty clear from the rest of the law that they assume subsidies would be available in all 50 states.

even if the states do not establish their own exchange then the federal government well. we were talking about this with medicare part d. that is with the federal government did. it created a fallback. is that if there were not enough plans, the federal government would do it, but there were plenty. other never have been sort of the federal government needing to step in. in this case, the federal government did need to step in. it is now running the exchanges for the 37 states but what people pushing the case are arguing is those subsidies being provided in those 37 states are illegal, therefore, people should not be getting them. the case will be heard at the supreme court on march 4. a decision is expected in late june. people expect that this will be the last case that the supreme court decides. it is the most controversial. host: any indications on the decision? guest: there was concern that because the supreme court did not have to take it but it did, it takes at least four votes to

accept the case, so there are at least four votes and one would assume that there are four justices that think the court needs to decide this sooner rather than later and publicly because they think this is illegal. the question is, is there a fifth vote to make a majority? it would create all manner of chaos, not just for the people who might lose their subsidies, but for the entire individual market in those 37 states. because all of these at it people would not be a what to afford their insurance. the healthier people would drop their insurance. the sicker people would keep it. suddenly, your market is only full of sick people. premiums would go up dramatically. we would have a spiral where the hell is people drop out to the sickest people stay in. becomes a really big mess host: quickly. -- host: there are lawsuits about

the affordable care act. are they going anywhere? guest: many say it is illegal because it is a tax law that started in the senate. they took a bill and stripped out all of the text and then inserted the health law. that happens pretty much every day. if that were the case, an awful lot of tax-related laws would be illegal. that one seems pretty unlikely to go anywhere. there is also the continuing fallout from the hobby lobby case from last year, the case about religious freedom. last year's case decided for-profit organizations they're so concerned about what will happen to the religious organizations that are not exempt cover religious colleges and universities, in particular, and hospitals, and what they are obligations are for making sure that contraception is provided. at this point, they do not have to provide it, but they are

supposed to report to the government who their insurer is so that the government can arrange for it to be provided. that is making its way to the court speared that probably will not be heard until next term. host: other new provisions of the affordable care act in 2015 that take -- they go into affect -- this losses physician payments are tied to quality of care they provide. employers who employed a certain number of employees will need to provide a minimum level of insurance coverage to full-time employees. the penalties of not having insurance, they go up in 2015. margot sanger-katz, from that list, what are you watching for in 2015? guest: the employer mandate is a pretty big change, something that was supposed to happen last year. it was postponed a couple of times because, i think partially for political reasons, but it turned out to be pretty tricky to implement. for it to work, the government has to know who is employed by

various committees and whether they are getting insurance and how many hours a week they are working. if you are a business with more than a certain number of employees and you have workers who are full-time, anyone who works more than 30 hours a week needs to be provided with a minimum level of health insurance or you have to pay a penalty. there is a lot of administrative behind-the-scenes things to happen before that goes into effect. it was considered an important part of the law, because most americans who are working age get their insurance through work. i think there was a concern that if there was no requirement that employers provide insurance to their workers that maybe they would drop them and everyone would have to get their coverage through medicaid or the exchanges. seeing how this plays out will be interesting. seeing how the government does it in the behind-the-scenes parts of it, but also what it means for employers. most employers do provide insurance to their workers, but there are employers,

particularly in certain kind of low-wage sectors where providing health insurance will be a financial hardship for them, and the ways they decide to comply will be interesting to watch. guest: one of the ironies is that if the supreme court were to rule that subsidies were not allowed in the exchange run by the federal government, it would actually also make the employer mandate unenforceable, because the way the employer mandate is enforced is only if you do not offer coverage and someone who you employed goes to the exchange gets coverage and gets a subsidy. if there are no subsidies, there is no enforcement for the employer mandate. it would take away the individual subsidy, but it would take away the enforcement powers for the employer mandate. guest: the supreme court takes this up on march 4. a decision is expected in june. host: alexander in miami, florida, an independent.

caller: the problem i have is i applied for the affordable health care the first year, and they told me i was not qualified, i did not qualify like, last year. that only i did not qualify and they would give me an exception for the whole year. my girlfriend applied to choose a very low income, only makes light $800 to $1000 a month. they dropped her off medicaid. he said she had to apply through healthcare.gov. she applied, and i do not know why they denied her subsidies. she has four kids, and they're trying to make her pay up to $250 a month. there are still all the bills to be paid. i do not understand, why is that like that? host: why didn't she try medicaid? caller: she tried and they dropped her off medicaid.

they told her to apply it healthcare.gov. and she is only making $800 a month and you have to pay $250, so you're better off just paying the one-time payment of the penalty. just be without insurance for the rest of the year. host: ok. julie rovner? guest: florida is one of the states that do not expand medicaid. because she is a parent, she is eligible but a lot of those eligibility levels, particularly in the south for parents -- i think in louisiana, it was 15% of poverty, you had to earn less than that to qualify for medicaid as a parent adult. as a non-parent adult, you are not eligible at all. so you're generally not eligible for medicaid. so she may be in that gap.

it sounds like she earns enough. but if she earns enough to make it to the exchange, then she should get a subsidy. she may be in the gap and they're trying to get her insurance, but she does not earn enough for subsidy. her kids should be covered by, if not medicaid, then chip. host: pennsylvania, democratic caller. caller: good morning. i have a thing i would like you to write down, to ask all the congressmen you have on the show, ask them what they're going to do about the pre-existing conditions that are allowed in the medicare supplement insurance program. they can deny you coverage because of pre-existing conditions. let me verify this -- the affordable care act did wave pre-existing conditions. that is the law, and it is a criminal offense to do that. but there is a provision in the affordable care act that allows

the insurance companies to keep doing this the cause -- keep doing this because it was drawn up in the law. all these insurance companies with medicare can deny you with pre-existing conditions, and they have the right to ask you -- there are about 20 questions they can ask you that have to do with pre-existing conditions. they can verify and accept you or deny you because of pre-existing conditions. host: turn off your tv so you can hear the answer. margot sanger-katz? guest: i actually do not know about these enough. guest: i know about this one. there is an open enrollment for medicare supplements. when you first become eligible for medicare then they cannot deny you for pre-existing conditions. if you try to buy a supplement later, if you have something

else then they can. this was a big issue when they redid the medicare supplement market in the 1990's. there are some issues that one of the big problems is that people leave traditional medicare, go to medicare advantaged and then want to go back to traditional medicare, and they may not be about get their supplement that has they can deny you for pre-existing conditions. there have been issues with this on and off over the years. there are issues with people who have disabilities and people under 65 on medicare. when you first do medicare there is an open enrollment, the way there is an open enrollment in the affordable care act, we can buy any medicare supplement and they cannot deny you. host: julie rovner did write a book about health care politics. john in 20 legs, wisconsin independent caller. caller: good morning, thank you for c-span. i have a couple quick comments and then a question. in 2012, me and my wife lost our

jobs. she got a job for $10 an hour. one of our daughters has a pre-existing condition. insurance was about $650 on the market without obamacare. but in december, we applied for obamacare and got it for $100 a month. well, that worked out good for us. my mother, she is caught in the gap between 60 and 65, and she cannot even get health insurance with diabetes. we sent her on to one of the places where the people help you get the insurance, and they set her up and she has been happy as pie. she gets everything she needs beer like case, in march, i got a job -- she gets everything she needs. my case, in march, i got a job. i called aca and canceled my insurance when my company insurance kicked in. come to find, we're very busy

people -- they kept charging my bank account for the insurance and i did not get it canceled until october. i am wondering, is that going to be a penalty or a problem for me when i go to do my taxes this year? guest: guest: situations like this happens. insurance companies want automatic payments. i don't think it will go into taxes, but think you will have to do some fighting. host: democratic caller enrolled in exchange. go ahead. caller: happy new year to all you people on the east coast. we are the siberia of america. i will not make any more jokes. i wanted to say __ i'm lucky, i

do not make a lot of money, i'm 64. this goes directly to a person from florida, three call to go. minnesota participated in the medicare __ whatever. therefore, i paid $21 a month. my income is just under $16,000 per year. obviously, not a lot of money and year. but, i __ i get a nice subsidy. $21 per month is my premium. luckily, i'm pretty healthy. i do not need to see a doctor besides two or three minor things. obamacare has worked for me, i guess. i want quick suggestion for a possible topic __ the complexity of signing on to medicare.

in about one year, i will have to decide what i want to do with medicare a, b, c, d, medicare advantage. i've heard the advantage plans are varied day just __ very dangerous to get into. maybe that would be a nice show to have. host: all right, tom. guest: medicare is very complicated. people come to me a lot with the questions about medicare. it sounds like he has exchange coverage, not medicaid. he will be eligible for medicare soon. those are people waiting have the most to gain from the affordable care act. other than those with the pre_existing conditions.

insurance is still very expensive, and even more expensive for those who are older. more expensive for those who are younger because they're subsidizing those who are older. it is now affordable. others have retired early and no longer have access to insurance. host: a comment on twitter saying new data from the national center for health shows percent of americans without health insurance is at historic low. guest: we did some analysis on demographic characteristics on the new and rollers. what we saw is that it is mostly the disadvantage __

people of low income, african_americans, hispanics are signing up with higher rates. people in rural areas are enrolling with higher rates. who are the people who did not have insurance before, who are the ones who were shut out before. a largely throws that power of the medicaid expansion. so came __ we're talking about what happened. some states did not expand. we're saying there's a huge disparity between the states expanded and those that did not. if you are low income person in a state like minnesota, and you are likely to get insurance. if your low_income person a state like florida, your options are much more limited.

host: y'all to break it down by race as well, you were talking about that. you can see, more whites or asians with health insurance. that is going down as well. guess that every groups all rejections. certainly, the groups that were most disadvantaged fall the most substantial gains and are starting to catch up. host: will go to cornelia. caller: hi, everybody. basically, i believe that our entire medical system in america is broken. obamacare is not helping. if __ it is making it worse.

we need health savings plans __ ffrom the bottom up. our pharmaceutical companies are in cahoots with fda. talk about the military_industrial complex. we have a pharmaceutical industrial complex that is running our medical system in america. guest: the pharmaceutical company __ if you look at __ we have the biggest profit margin. to go to the broader issue __ there are a lot of people who are still unhappy with the functioning of the healthcare system. the affordable care act was never intended to fix everything with the healthcare system. it was intended to make a start. mostly focused on coverage. secondary focus on cost.

thanks give a push on the system is changing anyway. there are still people who want to go far off in one direction, far off in another direction. if you look at the difficulty the congress has just passing the affordable care act __ it is difficult to imagine anything that would more drastically change the system. the system is on a path to changing itself. host: this is a story that was tweeted out __ there's an obamacare rule saying that the government could reenroll you and obamacare, choosing your plan, dr. and coverage. guest: this shows the challenges that people have in implementing this plan. say you sign up for plan in 24, then you go __ you take no

further action. the government will reenroll you automatically in that plan. obviously, you can go in and counsel. what we found the fear is that the plans that were really popular the first year are experiencing the highest increases in premiums. what the government has proposed is giving people a choice __ when he signed the first time you can say in advance, if i do nothing, i stay in the same plan, no matter how expensive it gets. or, consumers can say, if i do nothing, i would rather stay in the cheapest plan. they were not have control __ it would be an automatic process.

i think is important to note that even if the government goes through with this __ people have a choice as to what default option exists. also, everyone every year has option to go in during the open enrollment period and shop around. this would only apply to people who take no action. all evidence to suggest that people are better off going back and doing the hard work to shop for the better plan. the premiums are changing and other parts of plan are changing to. guest: people can still change up until february 15. they will get a letter saying they are reenrolled in a plan. or the plan does not exist anymore, you can reenrolled in a similar plan. no matter why, you should go back and make sure.

maybe the premium is the same, but how much you pay for your drugs, or your doctor, that may have changed. you can always go back and look. you may want to go in and change. no matter what, it is good to go in and look at your plan. if you're in it now and you've been reenrolled, you have until february 15. guest:'s proposal to change the switching mechanism, it is not final. it is just a suggestion that the government has put out. it may or may not become final. host: bob from virginia. caller: i hope santa claus was very good to you ladies. basically i want your opinion on my opinion. i called in several months ago and made the same point. it seems that in this country we forgotten to be what it's like to be a society __ the gentleman who called an earlier was talking about paying for reconstructive surgery __

it seems to be __ i cannot build a road individually, but as a society we can. i do not have any children, by do not mind paying my taxes towards the education of other children. seems like we're forgotten what it is like to be a society. guest: this is the whole concept of insurance. bad things only happen to a few people. if everybody pays in a little bit, you can afford to pay for the big amount for the bad things that happens. for healthcare, everyone needs some. that is why it is so expensive. there are very few people who never go to the doctor. that was certainly the idea __

one of the big problems of for the affordable care act, was only people outside the system, there were not enough people inside the system to spread the cost. and, the people inside the system were paying for the people outside a system. why not bring more people inside the system and have them pay something. that is basically the aca in a nutshell. host: what has happened to the cost of healthcare in this country since the aca. guest: one of the goals of the aca was to lower the cost of healthcare. anyone who pays the health insurance premium seats that it every year it seems to go up. i have been a problem for the economy. the federal government pays for medicare, and i've been getting more expensive. it is a real head when the

premium or deductible goes up every year. wonderfully, costs have been going down since 2002. we now have a lot of years of data that show we aren't in an unprecedented slowdown. it is hard to give the affordable care act too much credit for that. it is possible that is making some contribution around the edges, i think it is more coincidence. there are a lot of other factors that explain what we're seeing right now. i think there is a hope of monks those who broke the law that some things in the lock and help to sustain that trend. it is a really important trend. the country really needs to get a handle on healthcare costs.

host: let's talk about politics a bit. here is a tweet from a republican in tennessee saying __ we will use every tool in the toolbox and __ two in __ to end this destructive program. guest: they do budget reconstruction every year. it is a piece of the budget process. the way the process works is each part of congress passes the resolution, they work together to come up with a resolution between the two houses. many years, involves what they call reconstructive.

it has been used in previous years to do a lot of things that have to do with healthcare. obviously with the tax code, those are big programs. one of the nice things in the senate is that it cannot be filibustered, and you only need 51 votes to get it. host: is it a mandate? guest: nine the way that if the spending bill does not get passed, the government get shut down. if the resolution bill does not get passed, the government does not shut down. in 19 six, they actually has two reconciliation bills in the same year. the big important thing is that you do not need a majority and

it can't be filibustered. they are saying that since the affordable care act was passed with the reconciliation process, they can on passive with the same process. the truth is, it was actually passed in the reconciliation process. when it passed in 2009, they had 60 votes __ they basically use the reconciliation bill as a way to do a congress report. there are many things in the reconciliation bill that were not in the main law. the reconciliation bill must be budget related. they could cause a lot of problems for the law, but they cannot repeal the law. the other thing is, if they can get to the house and the senate,the president would veto anything that would really undo

the health law. the republicans may have some items they want to tinker around with, but a full scale assault seems unlikely. host: republican of georgia was our guest on newsmaker recently, we asked him about this process. you can watch the full thing on our website c_span.org. he said that the lawmakers will be getting together in their annual retreat and he will be listening to his colleagues before deciding. host: i think with the republicans want to do with the affordable care act is __ they have this big dilemma, if they take apart the most controversial saying, that could make a lot more popular. they do not want to do that. the things they could do is __

passing the medical device act. they do not want to maybe end up having a law that is more powerful or quote on quote fixed. they are caught in a rock __ between a rock and a hard place. host: miles go ahead. caller: i am a republican, but since i have been watching obama in office __ our economy was on a cliff, but now it is better, and more people are getting health coverage. we were a party of families, morals, and values. what has happened to our society when we do not even want to take care of the poor, the kids, the families. there's something wrong here.

host: margot sanger_katz, part of the spending we have seen recently is triggered by people spending on healthcare. guest: healthcare is a really big part of our economy. it is not a small thing on the margin. it is a lot of dollars that people spend, the government spends. it really matters for the overall health of the economy. host: congressman tweeting this out __ a new poll shows that the number of americans who say healthcare is personally unaffordable is skyrocketing under obamacare. guest: that is not true. there was a recent gallup poll and they asked people these questions __ is the amount of money you are spending

affordable for healthcare. they basically, there's no change over the past few years. there are people who find it is unaffordable, but is not changing. host: jerry from chicago. caller: listen, i want to comment on one of the previous callers. i have medicare but not a supplement. i got an advantage plus plans through humana. i guess it depends on the state you are in, by the state eight dollars. i just want to know, do not go for medicare b. i am also a tax advisor.

last year we informed all the clients about the mandate. next week, i will be in office calling all my clients to remind them to bring their 1095 form. i'm glad you later on it explain this to the callers in the country. it is very important. thirdly, for a country like ours, it is hard __ it is not a free enterprise. i think there is something we can do. host: we will go to joe __ joan in maryland. caller: my husband and i went to our annual exam in december.

i was expecting to get blood work __ the kind of exam that president bush had, they do blood work, they found he had a narrow artery, they put a stint in and now he is fine. the annual wellness visit is not the same as what many referred to as a yearly physical exam. medicare does not cover the yearly physical exam. medicare is specific as to whether it includes __ by the way, this is john hopkins physicians. what is included? talking about your risk factors, measuring your weight, height, make a prevention plan based on __ what? this to me was like a joke.

medicare will go bust according to the statistics i've read in 2026. will we be put into the exchanges? there's also a bipartisan agreement that the itba __ independent payment advisory board is a rationing plan. nonphysicians will be making plans as to what you can have and what you can't have. guest: letter with __ let's start with the last one. it does not exist yet, it is very controversial. mostly does not exist because it was created to recommend ways to reduce medicare spending is it reaches a certain threshold.

medicare spending is leading that historically low growth. nothing is on the horizon that would trigger anything from that. one of the things it specifically says is that it may not recommend any rationing of care. they may have to come of other ways of reducing spending. there is a standoff over that. at the moment, does not matter because it is not being triggered. if i could go back a couple calls and talk of medicare advantage again. if you want to go into a medicare advantage plan __ bbasically a private plan that takes over for medicare. you do have to continue to pay your premium __ that is busy what pays for the private plan.

i misspoke __ there is a guaranteed open enrollment, but only for certain plans. if you come back to traditional medicare, and want a supplement, you may not be able to get back to the one that you had. host: david from york. caller: i was losing to the last caller. are you saying that if you have a pre_existing condition, you cannot get a plan? host: i do not think we said that. caller: the law says that if you go to the marketplace and want to get health insurance, your price will only be based on your age, where you live, and your income. in the old days, health insurance could say, sorry, you have diabetes, no health insurance for you. or, you could have it, but it would be very expensive __ those days are over.

guest: i think we're talking specifically about the medigap plan. host family will go to kerry in south carolina. caller: my husband had health insurance, he lost it. we said, okay. my husband is diabetic. we cannot afford that affordable care act because we worked a lot. i work over 60 hours per week. we have four children. when in college, when in high school. because of that, on paper __ our health insurance would be almost $1500, only including two children. that is double my mortgage.

we will take the penalty. we have to take the penalty. it is ridiculous. the fact that now my husband has no health insurance __ he is now off his diabetes medicines because we cannot afford them. believe it or not, he is doing better than when he was on medication. guest: i'm sorry for your situation. i assume that you have gone and tried to get someone to walk through it with you. host: where would she go to do that? do you call? guest: on the website there is a place that says if you want to find local health, there are people who can walk through the options with you. sometimes these people are

trained, and they are better at seeing where you may do the best. you want to make sure you get a doctor, a particular drug __ work all that out. host: we have a couple more minutes here with our guests. guest: i think that highlights a group of people who are not very benefited by this law __ they make enough to where they don't get a cheap rate, but they do not have enough to cover the premium. i think the law is __ for people like this caller, maybe the family makes over a certain

amount, but they have a mortgage, they have to pay for their children's education. host: how may people are there in that situation? guest: i do not have an answer for that. guest: percentagewise, they are the smallest percent. we do not know in many cases why they do not have insurance. in fact, those who are in that threshold is very low. it is probably people living in very extensive areas, or people with kids in college, people with other expenses. guest: i spoke with one person who live in new york city __ they said their full cost of this premium is out of reach for us. there are not a lot of people in this situation. i think this blog can make it hard for those people who are in insurance. host: it sounds like a lot,

what these people have to pay, when we hear from the people. we will go on to brian in michigan. caller: my question is __ i am between jobs now. my girlfriend has medicare she is on disability. i cannot afford it. i am in between jobs. it seems like __ his feet, and everything, this penalty is more trying to get money from the poor people rather than helping anything. just like another tax. i would like to afford health insurance, i have issues too. i cannot afford $300 per month.

if i could, i would be making a payment on a new car or something. host: that is our last phone call for you to. i want to ask you, what you looking towards next in 2015? guest: i want to see how this enrollment. winds up. and, what the republicans do, whether they want to make a show, or just pieces of the law. guest: there are a lot more people getting health insurance now. we do not know what their experience will be. that will be something to look towards in the future. the other thing, what does this mean for people's budgets. while this provides some people with a financial cushion. that is our hope that we will have to measure and see.

host: to follow their reporting, you can go to kaiser.org, or go to twitter. margot sanger_katz rexford __ wwrites for the "new york times." thank you both very much. we appreciate you spending this morning with us. coming up next, we will continue talking about the affordable care act. we want to know about your experience with the law. we'll get your thoughts here in just a minute. ♪

>> new year's day on the c_span networks. here are some of our featured programs.

for a complete schedule, go to c_span.org. >> the c_span cities tour takes both tv and "american history tv" on the road. traveling to u. s. cities to find out about the history and literary life. this weekend, we partnered with time warner cable for visits austin, texas. >> this is a private quarters for present lyndon b. johnson and the first lady.

when is a private, i mean this is not part of a tour to the public. this has never been open to the public. you are seeing this because it is c_span special access. it is not open to our visitors on a daily basis. the remarkable thing about the space is that it is a living, breathing artifact. it has not changed since present johnson died in 1973. there is a document in this room that was signed by the van architects of the state, and lady bird johnson saying that nothing in this room can change. >> we are at the 100 block of congress avenue in austin. to the left is the river, the colorado river. this is an important historic site __ it is where waterloo

was. it was just four or five cabins that were occupied. this is where lamarr was staying when he, and the rest of the men, god word of the buffalo herd. the man jumped on the horses. congress avenue at that time which is the muddy ravine. the men galloped on the horses __ they had stuffed their belts for pistol, and fired and shouted amongst these buffaloes. lamarr shot this enormous buffalo. froom there, he went to the top of the hill where the capital is __ and he said this should be the seat of the new empire. >> watch this and more events from austin on book tv and

c_span3. >> "washington journal" continues. host: we're back for last hour on "washington journal". we continue our conversation on the affordable care act. what has been your experience with the law. we want to hear your stories. also, if you are enrolled in an exchange __ whether state or federal __ call in. join the conversation on twitter, facebook, or email us. we will get your comments in just a second. first, i want to show you with the health and human services secretary had to say last week in a news conference talking about the first full year of implementation of the flaw, and the questions that have been raised.

[video clip] >> one month ago, people were questioning if consumers would come to the marketplace. 1.9 million americans have chosen to come to the marketplace, and get coverage for the first time. there were also questions about whether insurers would decide the marketplace is a good place to do business. there are now 25% more issuers offering marketplace plans to consumers, who can now choose up to 40 plans, up from 30. there are also concerns about whether these plans would be affordable, and they are. while some predicted that premiums would skyrocket __ most, not all __ premium growth has been relatively modest.

now, he intend returning consumers can get plans for $100 per month or less. there are also concerns about technology. and today, while our work is not done, the consumer experience on healthcare.gov, is considerably better. host: if you want to watch a hold press conference, go to c_span.org. we're getting your thoughts on the aca this morning. michael, you are up first. caller: mike spence is not been __ my experience has not been good at all. i work for the third_largest software manufacturer in the

united states. i had to negotiate from 85 $15 __ from $815_$730. host: explain that. it went to $730 under the negotiations? caller: correct. on top of that, tthe industry is changing, of course, i have an hmo. now, i have coverage __ it does not cover some things.

i have higher co_pays. i'm sitting here, i don't even want to go to the doctor, it cost me $50 out of my pocket just to go to the doctor. host: can ask you how much you make. caller: i make about $20 per hour. i'm not poor. in 2015 __ if that plan gets put into effect. now, it has been rescinded, my membership was restricted by the government on how we can negotiate a contract. our company change millions of dollars __ my membership, and we're taking a beating. my health care has at least

doubled. i took a 15% increase because of the affordable care act. 23% increase. how is this good? host: that was michael. we will go to shane next. caller: i have not had __i'm actually on health care for my job. i just want to get my few points. i think that people need to have healthcare because of the fact that there is a problem with people having pain. when that pain is not resolved, it affects your work performance.

host: garry is next. caller: i was just listing to the gentleman from new york, thank god the democrats are waking up. yyou think a person like me __ 76 years old __ having to pay an additional $1500 this year. at&t always took care of this. with this, yyour have certain companies to get insurance from. he has had so many people. but, he does not care. it was all about obama from the

beginning __ i'm going to do something that no one else has ever done. the dumb democrats of their supported him. now, some democrats are waking up. that is my comment. host: let's show you what a republican had to say. in november, he was talking at the press club in washington. here's what you have to say. [video clip] >> the plight of americans certainly need to be addressed. it was not the change we were hired to make. americans were crying out for the end to the recession __ not changes in healthcare. this makes sense considering the 85% of all americans got the healthcare from the government __ medicaid, medicare __ or their employer.

if health care costs are going up, it did not affect them. the affordable care act was aimed at the 36 million americans that were not covered. it is reported that only one third of the uninsured are even registered to vote. even if the uninsured cap with the rate, which they likely didn't, you would still only be talking about 5% of the elector. host: here is a headline from the hill. a democrat from iowa was recently quoted saying the law is really complicated. we will go to jana from florida.

caller: complicated is the keyword. the first year when i rolled in __ it was really hard to get on, it was difficult to work with the system. when i finally got in, there is only one company serving our area. they had 250 plans to choose from. i read every single one of them. when i found the best time for me, i said, okay, i'm now eligible for subsidy. then, to do the subsidy, their only 10 plans to choose from __ those were kind of crummy. i took the claimant was available. all year long, i did not go to the doctor, it was going to cost so much __ i thought, i mari paying $600 per month for one person. doing the math __ this year i said i'm really going to figure this out.

every time you think you are about to get something good, it turns out it is not. the bottom line __ if you add up the yearly premiums that you pay and the total out_of_pocket if you actually get sick and had to use it __ you're looking at $14,000 per year out_of_pocket for one person. that is 25% of my income. so, the government gives me a subsidy. okay, so you get $3000 less. still, you are looking at a lot of money out_of_pocket. $10,000 pper 10 years that $100,000. i think it is a big insurance scam. they're always trying to trick you to pay a lot of money, and not get service. now, i'm on hmo, i joined the like it.

i do not have confidence in it. host: a democrat from wisconsin. does your state have a state exchange or federal exchange? caller: it is a federal exchange. well, i do not know about all these other people. my wife is enrolled in it because she is under 65. the premium __ what she would have to pay would be $800 or $900 per month. she is only paying $152. i think it is one heck of a good savings. all she has to do is __ when she goes to the doctor, it cost her $175.

out of that, all she pays is a $25 copayment. these other people may be getting jerked around. but, i will tell you, that is the best thing as happened since we ever had insurance. she is doing just fine. host: how old is she? caller: she just turned 62. host: so not eligible for medicare yet. caller: right. host: what was it like for you before the affordable care act? caller: the insurance company that she had before the affordable care act came in __ sh might as wel not have had it. she would go to the doctor, or she had had blood drawn, whatever, she would almost have to pay 100%. i told her __ i might as well take the money you are paying,

i forget his family how much it was per month, i might as well put that in my pocket and pay for it when you go because your insurance company is not doing anything. host: and __ ed in north carolina. caller: thank you for taking my call. i just want to address them gentleman from wisconsin. i do not like the word subsidy __ your friends and neighbors are paying it for you. that is where the money comes from. you got a good deal because your neighbors and your friends are paying __ something about 80% or 85% of your healthcare premium. that is why it is a good deal for you. the guy from new york __ in my

opinion, it usually have independent and republican callers. most democrats supported this. that gentlemen, from new york, he was complaining __ you made your bed, buddy, sleep in it. host: in other news __ this is from the "washington post." [video clip] >> is the united states more racially divided than it was when he took office six years ago? >> no. i actually think it is __ in its day_to_day interactions __ less racially divided. i think the issue has surfaced, in a way that is probably healthy. the issue with police and

communities of color being mistrustful with each other is hardly new. that date back a long time. it is just something that has not been talked about. for a variety of reasons. in some cases __ everyone has cell phones now, you can record some of these events. it has gotten a lot of attention. i think that is good. i think it points to our ability to solve these problems. it is understandable that the polls may say __ race relations have gotten worse. when it is in the news, and you see something like ferguson, or the garner case in new york __ it attracts attention. i assure you, from the perspective of african_americans, or latinos, who have been dealing with this

all their lives __ they were not suggest that somehow it is worse now than before. host: present obama in an interview with npr. the interview being released yesterday. he won the gop that he plans to use the veto in 2015. he says, i have not used the veto pen often in office __ he says, i expect there may be times that i will need to pull the pen out. from the guardian __ the present saying he is considering an embassy in __

the interview was conducted the day after obama said he would normalize relations with cuba. npr really seen that interview yesterday. we will go to phil. caller: i'm a little surprised about the experiences your callers have had. i want to talk about daughter. she is 29 years old. she got a policy that cost her $125 per month __ it went up to $180. she has come out ahead. her employer does not offer insurance.

to the one caller who complains about this being a reassignment of acids from your neighbors __ that is incorrect. if you look at the log, most of the money for the subsidies comes from people who make $250,000. i think it is a pretty fair way to subsidize people who cannot afford good health insurance. she got a good policy, she is happy with it. host: said it sounds like you know the law, what you think about the medical device law. caller: that is really a small part of it __ i think they should keep it. i would not be surprised if it goes away, but it is a very small percentage of income that they are using. host: brian from michigan.

caller: i get the affordable care act. before that, i was paying $600 per month in premiums. i was ready to drop my insurance because of this. now, i am paying a fraction of that. i'm paying probably close to $150 per month, and have a $350 deductible. i think go to bed at night not worrying about losing my house. some of these people __ i know some will not even try to get on it because they don't like obama. i don't know. people have to try it. the guy that was on from new york __ paying $47 per month in a premium __ he makes $40 per hour. host: $20 per hour.

caller: __ i thought you said __ he said $20. host: brian you have experience with large healthcare bills, before the affordable care act. caller: oh my god, it was horrendous. i would have to pay $15,000 just to use my insurance per year. i have the same doctor, the same hospital. i have no problem. i go hunting for taking care of. you still have to pay your deductible. i sleep good at night now. host: we will go to willy in colorado.

caller: i have two issues __ i worked in medicine for years, my daughter is a doctor. we all believe that __ i always thought it was like 35%. they are saying 50% of the test and things done on patients are done to cover their pain. they had no choice, because if you get to now practices, and you are not working anymore. reform was never brought up during the discussion of this law. primarily because the lawyer support the democrats. that is my first question __ how do you feel about that

reform. that would probably cut at least one third. the other is the bronze plan. 40% of people who sign up for obamacare have the bronze plan. the bronze plan is a $6000 deductible. of what use is that the poor people. what it does is it causes them not to go to the doctor at all. there just as well off with a bronze plan as no plan, because they're not going to the doctor __ who can afford a $6000 deductible. host: we will go to tennessee.

caller: good morning. thank you for taking my call. two things __i wanted to say that if obamacare -- if it is still the affordable care act, if that was not there, there would be 30 million americans who would not have the opportunity to get coverage. secondly, and the most important, is that if we had a catastrophic illness or some kind of pandemic, and individuals in america came down sick. individuals who didn't have health care with for the emergency room's, destroying the health care system. we need to have something like this. we can go back and make changes. that is the word we need to get

into our minds. it set of getting our minds against it, we need to get on board, and make it right. this is something american needs. >> listen to what the speaker of the house set the day after the election. he talked about changes the republican party would like to make to the law. [video clip] >> obamacare is hurting middle-class families, and to create more jobs. the house, i'm sure, will move to repeal a obamacare. it should be repealed and replaced with commonsense reforms that respect the doctor-patient relationship. whether that can pass the senate, i don't know, that i know it will pass in the house. that doesn't mean we shouldn't do other things. there are bipartisan burea -- bipartisan bi that would make

changes to obamacare. there is a bipartisan in the house and senate --. there is a bipartisan majority in the house and senate for getting rid of the independent payment advisory board, the rationing board in obamacare. how about the individual mandate? there are democrats and republicans who believe this is unfair. just because we may not get everything we want, doesn't mean we shouldn't try to get what we can. " the speaker of the house talking about what republicans would like to do on the affordable care act the day after the election. spending time getting your thoughts on the law and your experience with it. new york, a republican. welcome to the conversation. caller: i have been listening. i am not a member of the

affordable care act. i have insurance the reunion plan, which will be taxed as a cadillac tax in the future. members of congress and their staffs get subsidies through the aca. even though they are not entitled to them because their income exceeds the limits, but they have carved out a special plan for themselves, which obama approved, because they could not exempt themselves from the aca because it was politically incorrect. secondly, i hear the analogy of car insurance. comparing that to health care. you do not have to buy a car for car insurance. you don't have to get insurance if you do not buy a car. here, they are forcing you to buy something. even though the supreme court said it was a tax and

technically you could not buy something, if you are a good driver with a good safety record you pay less insurance. the poorer drivers, which i analogize to the sicker population with pay more. this is a perverse incentive. >> ok, frank. denise in california. what is your story, denise? caller: it is great. they really take very good care of us. we have our own state exchange program. i want to talk about my sister in texas. she is 72 years old with mds. she has to have chemotherapy once a month for the rest of her life. they told her because they don't have the program, they refused it, that she would have

to have a thousand dollars. she said there are a lot of people who signed up for the program. they receive it. now she only has to pay $200 a month for the rest of her life to get her chemotherapy once a week each month for the rest of her life. i have a sister in florida who did not take the program either because of their governor. those people get it to. they apply individually, and get it themselves. the state may not take it, but there are a lot of people who get it. the republicans will lose a lot of hope and support if they try to do anything with this program. caller: did -- host: denise in california. we will talk about the law after its first full year of

implementation. we want to get your stories. this is about airasia. bodies and plain debris are being pulled from the sea in the area where flight 8501 vanished in rough weather going from indonesia to singapore. a lot on that story. in the "financial times" their headline is a missing aircraft raises questions. regulators and air traffic controllers are under pressure. in the story it notes from one industry expert, that 2014 has seen the fewest nato accidents since modern aviation began after the second world war. only eight large aircraft have been lost this year, compared to 17 in the past years. the uss sampson has arrived in the area to help with the search

after the indonesian government asked for the united states to help with its search. also the first page of "the washington post" that airasia flight 8501 joins a long list of missing planes. it is among 90 commercial airliners that have disappeared in the past 7 decades. the map is showing fights that have vanished without a trace. that is on the front page. we told you at the top that michael grimm has reversed himself, and will resign from congress. "the new york times" says that decision came after a discussion with the speaker of the house. mr. boehner appear to have done what other things could not. persuading mr. michael grimm to go away.

he could face a prison sentence of two years or more, and should not participate --. mr. grimm is expected to seek probation for tax evasion. also, a story about the republican of louisiana. he said he did speak to a group that was hosted by a white suspenders -- white supremacist when he was a state representative in 2002. he says in that interview that he detests any kind of hate group, and does not associate with them. we will go to jim in washington. an independent caller. go ahead. caller: i listened to the two

women before. then you showed a brief clip about someone from the government talking about the half-million people who signed up. the people explaining how most of us don't understand how good we are being treated use a lot of new regulations and statistics and come up with baffling information. all of the numbers i see including all of the people who are subsidized and all of the unions that are automatically enrolled, the current enrollment is around 20% of the population. i could be wrong but i think after the passing of this law the obvious answer to some of this debate is 75 percent approximately, of american citizens are choosing to violate the law. this is the law. they still can't get people to sign up.

that says a lot about how inadequate this legislation has turned out to be. host: lidia. good morning. caller: thank you for taking my call. host: you have to turn on your tv, and listen through your phone. caller: i'm not live, right? host: you are. caller: i am from stuart, florida. i have a two-part question. had i fully shop programs. after you fill out the application the state gives you three choices. how do i know what the differences are between the last plan in the new plan each year? host: if you go do it healthcare.gov they have areas to search the different options. they also have, we learned from

our two earlier reporters, the ability to call people near you that you can go and see, or talk on the phone with, to figure out your options. hi, paul. caller: in 1982i was in an accident and became disabled. because i was so young, i got the minimum amount. now, i am 56. i still live on $700 a month. finally, i got onto my father's -- medicare supplement. i was paying $25 a month for that.

as soon as the aca came on, it went up to $400 a month. that meant i could not afford it. my prescriptions are $10,000 a year. it has not done anything for me. host: paul in big pine key florida. other headlines. the fbi was briefed on an alternative sony hat theory. agents investigated that the hack said that research pointed to laid off sony staff, not north korea. another saw that in the blame game around the attack. politico.com if you will read

more of that story. in "the wall street journal" a couple of stories. this one about the irs. tax filing season will be on time. the start has often been delayed because of late congressional action on tax laws. this time around, the irs will be able to incorporate 50 temporary tax breaks passed in mid-december into that computer system. the marketplace section of "the wall street journal" says that for ups and fedex it was a merry christmas. they delivered 90% of express packages -- 98% of express packages on time. what do you think of the affordable care act? caller: good morning. i am thinking about enrolling. i am a veteran and covered

through the veterans administration. i wanted to comment that a lot of the conservatives and republicans always blame the democrats for the affordable care act. in truth, the democrats stood more for a medicare for everyone part e. president obama neglected to look at that. he went with this to cover any exposure the insurance companies and large hospitals, and medical providers may have had in the changing of the law. really, it was a give away to big business, and not a democratic idea. it was a business consideration. happy new year, greta. host: same to you, randy.

hi joe. caller: i am on the affordable care -- affordable health care. my wife and i were previously on cadillac insurance. we were living in nashville, tennessee, working for the state. we have relocated to idaho. here, she is working for $12 an hour at a local art gallery. a lot of companies don't have insurance. she is earning $12 an hour 25,000 dollars a year, i am substitute teaching earning $500 a month with no benefits. our total scum, we have no children, and this is straight off of healthcare.gov. i went with the local insure -- local insurance agent who walked me through it. there is a cut off of $31,460

for a household of two. if you make $31,460 or less your benefits are wonderful. when these people call and say they are really liking it and i think that is great, we need to do something about insurance in our country, this is like making sausage. ugly unfair, but anyone who is below the use cutoffs -- below these cutoffs you are getting a great deal. a low monthly premium. here is the kicker. i will close out by saying that we make over 31,500 year only because we have our condo that we are renting in nashville. we are not making any money, it is paying the mortgage.

with the irs that is considered an income. host: what about the depreciation of the condo? caller: that is a small amount when you add in property management. if one of the callers could help me, income property, if you get an income, is that considered part of your monthly salary? anyway, if i was making less than 31,000 year i would get silver choice 4000, blue cross of idaho. it would be $160 for both my wife and i for premium. that would be $80 each. awesome. $10 office visits. this is below 31,000. $300 is our deductible. our out-of-pocket would have been 4000. that is why -- out-of-pocket

would have been 4800 -- $4000. that is why people say that it is catastrophic. but they would only be covered if they had a heart attack. here is the kicker. our deductible is $2900 each. ouch. every office visit, i pay $180. i just had a wart frozen off my face for $180, each, i had two. a are contagious. host: so you have to pay each time you go until you reach $2900? what about preventive care? caller: i was covered for my flu

shot, and i'm grateful. some of my wife's female things like mammograms, are slightly covered, but i am not sure. host: mike, go ahead. caller: i was concerned about the fact that this health care law was put to the american people as an insurance. that we would all have less payment and a savings of $2500 which is not true. there is no savings at all. my insurance tripled. i had blue cross, and it went up $150 a month. when this program kicked in. i lost that insurance. i'm going on 68. i've always had insurance myself, i didn't need a

government agency telling me i needed to buy something else. something needed to be done, but i don't think this was the correct way. host: all right, mike. we will hear from anne. caller: i am disappointed. i've had the obamacare four-year. -- for a year. when i renewed do an independent agent, and my sister has the same plan in a different area in florida with the exact same plan. hers was -- the us same amount of money made each year -- hers is $20 for premium and mine is $70 for premium. i don't understand how they can do that. host: vern in indianapolis. what is your experiment? caller: i am retired government.

we are outside of obamacare. when you look at it in a macro you hear the stories of individuals liking and not liking. it is about centralized government. you can fix everything in the private sector. you have heard issues of buying across state lines and so on. if it is so wonderful, shouldn't gruber be like a saint? when you try to centralize health care, you will see a lot of doctors retire. you're already hearing the rumblings. on a macro level, small businesses are unable to expand. investments are waiting for this to get fixed. you will see republicans in congress attempt to do that. you will still have harry reid filibustering. and the kid in the white house

with his pen. it is horrible when, on the outset of how good the country could be, not even the pipeline. we don't even need that. we're still do find so many resources. the potential is there. obamacare is slowing it down. it is like trying to run in a vat of molasses. it is unusual we are living in these times. host: here is what you and others can expect in 2015. and for the affordable care act. physicians payment will be tied to the quality of care they provide. employers, this is the employer mandate, to employ a certain

amount of employees will need to provide a minimum amount of coverage to their full-time employees. the penalties go up in 2015. if you didn't get insurance, and you aren't adult, there is a fine for $325. for children it is $162 and $.50. hi amy. caller: thank you for taking my call. i am generally a supporter of obama care. there are two issues that should be addressed. my sister-in-law, who makes $20,000 a year running her own business, and has two adult children to support, is having trouble getting bounced between obamacare and medicaid. she goes on obamacare, and they say you qualify for medicaid. medicaid says that you don't qualify. i think because one of her

children is 19 and the other is 20. the gap between the plans someone needs to solve the problem when people are falling between the cracks. there is another problem, that is my brother-in-law who is part of the union -- he is a pipefitter. he works at various jobs in different locations. he doesn't have full time -- it's not a 9:00 to 5:00 type of job. you will be on-site for weeks and then not have a job for couple of months, then be assigned to a different location . this health care only covers him while he is actively working. he is part of a union. yes to pay for his health care through them.

whether he gets a supplemental plan or not. he is taking money out of his paycheck to work -- for his insurance when he is working that it does not cover him consistently. you would think that the unions would have been involved in making sure that their employees -- i don't understand how this will be handled if he happens to be out of work at the time he files his taxes. will be penalized? what is he supposed to do? host: we had time for a few more phone calls. i want to share this headline before we end today. it is a piece in "the new york times" about john ensign. the fbi investigated if he improperly sought lobby work for a former aide, douglas hampton.

prosecutors did not bring charges. mr. hampton pleaded guilty to violating a one-year ban on lobbying. through ace -- through a freedom of information act 3000 pages of internal documents or gotten a hold of and reveal that they are decision was seen as a sign of skittishness about public corruption cases against former senators ted stevens and the senator from north carolina. in 2011, assessing the chances of prosecuting mr. ensign a prosecutor wrote that the mere response of helping a former senate employee to find work is not enough. they wrote it is a tough case to win.

more on that if you're interested in "the new york times." patrick leahy wants to renew federal programs that help to fund the purchase of one million bullet-proof vest's for state and local police since 1999. legislation to restart the program was blocked by senator tom coburn. he insisted the competition -- the constitution did not give the federal government a role in funding local police agencies. that is from "the washington times." stephen from west virginia. a democratic caller. stephen, you have to talk. you're on the air. caller: ok. i work in the coal mines. i have a pretty good job. for a while. ever since obamacare went into

place, i used to pay $80 a month for my insurance and have 9010 coverage with hardly any deductible. now my deductible is $3000. i pay $196 every two weeks. there are four of us, and i hope we don't have to go to the hospital. host: jerry, you are the last caller. what is your experience? caller: first, my wife and i are in our 70's. we both lost our health insurance, but that is not my comment. the website cost the people of this country a billion dollars at the last count that i heard. there are 300 million people in america, perhaps more. if the government would have

sent each person in this country $2 million they would not have spent as much money right now as they would've spent signing up the website. think what it would have done to your country -- to this country if you and gone to your bell box and found a check for $2 million. you could've bought your insurance anywhere you wanted to go for the rest of your life. they give the economy. the money they spent on the website is gone. it will never be recovered. the website is still not working like it is supposed to. host: we will leave it there. thank you for calling in and weighing in on the affordable care act. "the washington journal" would be back here tomorrow morning. enjoy the rest of your day and week. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2014] ♪

>> this year is the 10th anniversary of c-span's q&a. we are featuring one interview from each year of the series over the holiday season. telling the story of how he became gash came to the u.s. as an illegal immigrant and became a brain surgeon. remember in public speakers who died. starting with howard baker. in a 2000 seven interview looking at his congressional career, and his time as chief of staff to rep -- to ronald reagan. >> when i was first elected