about making life better for service members. if you had a catastrophic situation in the family where you had extreme costs related to an exceptional family member there is also a fund that we would propose to ensure that those out-of-pocket costs did not get excessive. we plan on that for about 5% of the people. so there is help their. -- there. >> thank you, chairman. i want to thank all of you for the hard work and thoughtfulness that you put into this commission and for having this important discussion with us. today, i am walking back and forth between this committee and the budget committee. as i look at where we are, to use the word holistic in a way

that i think the point needs to be made here is if you look at where we are, for example, the president's budget which was just submitted, by 2021, what we are paying in interest will exceed the defense budget. as i look at the work that you have done on the bipartisan commission and we look at what the biggest drivers in our debt are overall, looking at the big-budget, mandatory spending, programs that we need to have similar looks at medicare, social security, very important programs to people, i appreciate that you have done all this work. we are looking at our military stepping forward first and making many changes. i think we need to look across the entire budget, ytoo. where we are, we are going in 2016 two defense budget, only 3.1% of gdp and 14.3% of federal

spending, which is the bottom of historic rates since 1950. the reason i want to put that in perspective in the big picture for everyone, we look at the sacrifices that our men and women in uniform make. this separation from family, the sacrifices they make putting their lives on the line, all of that. the work that you have done is very important and we look forward to delving into it more deeply. i hope it is a bigger congress as we scoot between here and the budget committee that we will look at the big picture and we will not be sitting in a situation where we will continue to shrink because we will not take on the other hard challenges that need to be taken on for this nation. it would be great to see a group like you look at the bigger picture as well. i just wanted to say that and thank all of you for your work. in terms of a specific question i wanted to follow-up on the retention issue.

obviously, that is important to all of us in terms of keeping the very best military in the world and wanting our best and brightest to join the military. as we look at your proposal on retention, what assumption does the commission use regarding economic commissions in the country and operational tempo? what did you assume would be the rest of the private economic growth? that always drives what opportunities are best and brightest have -- our best and brightest have. and also operational tempo. >> it took us quite a bit of time, looking at that and the liberating over those issues. we have experts that come in and talk to us about the millennial's and what that means , the social environment and those kinds of societal changes that have taken place and how that would affect retention.

i will ask the commissioner to speak to the specifics of your question. >> i would totally agree with the chairman. we did. we provided for its ability at the 12-year mark, continuation pay. that is not a fixed amount. we will allow the services to set that amount based on the economic conditions at the time. the retention rate that they need to continue past that 12-year mark. everything we did was based around and operational -- from peacetime to the fact that we would have to deploy the entire force. if you told me when i was in the army operation center that we would be able to maintain the all-volunteer force at the tempo that we did for 13 years, i would have told you there is no way whatsoever. and we did.

i had aviators that literally new that they were going to be back down range. they would stay down for a year and come back and get another year at home. that down range. why they did that, a lot of it is your patriotism, love of country, and admission that they believe in. i think it is critical that, in times when we do not have that operational tempo, we give the services the tools we need. you will find throughout our report that we have done that. everything we can to give that flexibility to maintain those retention rates. i would argue, for the earlier question, as i live around washington today, the biggest issue today is uncertainty. they do not know whether they will have a job tomorrow. there is real concern in the force as you see folks how far

the cuts are going to go. is there a future for me here? i think our retirement plan speaks to that and puts us in a much better position should we ever have to cut the force again to provide people who are leaving something when they leave. >> i want to thank all of you. i have some questions i will submit for the record. i would just say, general, to your point, that goes to the sequester issue in terms of continuing to diminish what we are going to spend on our overall force. that is something we need to do something about. thank you. >> thank you. there was a modeling component to your question. i would like to pick that up for the record and get back to you. we do have some specific details for that. >> thank you. >> general, i wish that every member of the senate could have heard your last comment because as you know, we are in very

significant trouble with regards to sequestration. you reflect the views that were expressed in this committee by our for service chiefs last week and i thank you for that. >> i want to thank all of you for your service to the country. you have all done so many extraordinary things for us. congressman blears -- thank you for all your work. i also want to say, the importance of the extended care you are providing for family members, what you have done in that area is really significant and will change lives for family after family. general, i wanted to ask you about the unified drug formulary between dod nva -- and va. you have done exceptional work in trying to stop the scourge of suicide.

you have worked scott -- you have worked tirelessly to provide solutions and answers here. if you would tell us, a little bit, the challenge when you transferred from dod to v.a., what that is causing. >> thank you very much, senator. i really appreciate that. when i was chief of staff in the army, i had new idea -- i had no idea there were two different formularies between dod and v.a.. i thought that everyone who was using drugs as they were supposed to and were taking off-labeled depressants, that when they showed up in their v.a. on day one, they would provide that prescription to the doctor and he would automatically refill it. that is not the case. we have two different drug formularies.

dod, just about anything the fda has approved, they do. when the if it -- when someone gets on the right drug at the right dosage and goes over to the v.a., many times they find themselves in a situation where the doctor looks at them and says, i am sorry. i cannot refill that prescription. you will hear a lot of different stories from folks. i continue to have soldiers come to me -- just last week, i met with one that had the exact same thing happened to him. if there is any -- if there is anything we can fix to get at this suicide problem it would be to make sure that once we get a kid on the right drug, have the right dosage, wherever he goes in the system, he is able to get that same drug and not be told, i am sorry, that is not in our drug formulary. >> isn't there also a confidence factor for that person, that they feel comfortable with the

drugs they are receiving and the treatment they are on and changing it up is like a life-changing experience? >> what they do is they go find a private doc to give them the prescription and they pay for it out-of-pocket. we have told them, we are going to take care of you. this is your benefit. they go and they say, i am sorry. you cannot have that drug. no one cares if we get saint joseph's aspirin in dod and bayer aspirin in the army. that is not the issue. but on this drug formulary issue, these things that you have to be weaned off of, we should not put our servicemen and women in the situation when they transfer over to the v.a. if it is not in the drug formulary, someone should hand them a card and say, go to your local pharmacy and get the drug. >> we are losing 22 veterans the

day -- a day to suicide. in the active-duty, we lost 132 young men and women to combat in 2013. we lost 470 52 suicide -- 475 to suicide. so your efforts are life-changing. as we transition from dod to v.a. for a number of our young men and women, obviously, there are electronic health record challenges. what is the next largest challenge we have to tackle and knockout? >> thank you very much for the question. we spent a lot of time talking about dod and what effect that has on the health care for the veterans. i am going to ask commissioner boyer to speak to the specifics of that question first.

>> when you look at our recommendation 8, we are asking that the joint executive committee has authority -- it just does not have power now. we are asking that you give statutory power to implement the recommendations. when we met with secretary mcdonald, two things we learned. we agree with the commission but can you also -- this was not in our recommendation and i brought this to you. the secretary would say, i would like to have parity. when the deputy of the v.a. meets with the undersecretary personnel, it is not safe. if you raise that so that the deputy secretary of the v.a. and the deputy secretary of the dod meet and give them authority with the power to implement, the difference.

-- big difference. in terms of the antidepressants or antipsychotics, let the experts make that decision with where the formulary should be blended. with regard to large capital products -- projects, never again should we have the scenario whereby we struggle trying to get the timelines for the building of an army hospital . that should not ever occur to us again. with regard to the specifics of your question, what do you really anticipate, the biggie that will happen next, it really is this challenge as the country moves to set the standard for electronic health records. we have the scenario whereby you are responsive with regard to the v.a. and the scheduling debacle. we said we will move to this choice program. senator mccain, as you talked about, we will have this

increase of more non-ba -- non- v.a. care. when you were in the veterans affairs committee, we were spending about $400 million for non-v.a.a care. today, it is only going up. dod has a contract to create their own new version of the electronic health records. v.a. is doing the evolution of this and they want to make sure, as they moved to their new programs, they have data standards so they can be bidirectional. the v.a. is doing more non-v.a. -based care. they have to be able to communicate with the v.a.. we are talking about bidirectional so they can communicate. that is a huge challenge. in dod, as they moved to their

electronic health record and we make recommendations to move towards the selection of plans meaning there will be a lot of care provided in the private sector, this setting of national standards with how the country will communicate is extremely important. that is what i see as the biggie that is about to come. it is about your leadership and setting those national standards. >> thank you to all of you and thank you for your extraordinary service across the board. >> thank you. i want to thank the members of the commission for the great work you have been doing for the country. i first want to get a sense of the big macro issues, the competing issues that you have seen, mr. chairman, as part of your mandate. in particular, what i was interested in, is there a

concern about the projected growth, the benefits of retirement that ultimately could be taking away from training and readiness? i think we all want to make sure we are taking care of our troops. sometimes, what gets lost is ultimately, the best way to take care of them is to make sure that when they go fight and come home alive, is that an issue that the commission has had to deal with, this tension between competing issues that we are looking at with regard to military expenditures? >> can i take that question? >> thank you very much for your question. i knew that commissioner kerry would want to answer this question. so i going to ask him. >> i am notoriously holistic

about thinking about such things. i argued and i think the commissions were persuaded that, for us to address this problem that you identified without addressing the big one -- the big one is social security-medicare. that is crushing all of these accounts. be unfair to identify military requirement -- retirement as the big problem. it is easy to address -- to address social security retirement without medicare is saying that we are going to balance it on the back of our military retirees. that would be the wrong thing to do and would send a terrible signal. >> can i jump in here? i had to deal with exactly that question when i was comptroller. first of all, there is a huge misunderstanding as to how much is being spent on our military as part of the defense budget. people think it is 50%.

it is not. it is 29%. we wrote about that in our report. if you add the civilians, that brings it up to about 40%. that is a whole other category. that is not something we focused on. the real issue is, can you modernize what you are monitoring to the military and what you are spending if you can spend less and modernize more, all the better. we started with modernizing choice, what my fellow commissioner does not like, holistic approaches. that is where we began. and then we learned at where things fell out. it turned out that you could save money as well. you could do better by your people and still save the government money. which tells you how inefficient the current system is. not deliberately so.

when the all-volunteer force started, who was in it? mostly young men, unmarried. now look what we have. a completely different kind of force. we have to be concerned about echo programs, childcare, a lot of different things that just were not paramount in 1975. that is how we approached it. that was not the driver and it should not be. >> i am not just talking about procurement. i am talking about hard training for our troops. >> again, this is not the issue. the amount of spending on personnel has been at a level -- the real problem is there is not enough money going to defense

full stop. that is the issue. >> and you hear that costs are unsustainable, the baseline used for that was year 2000. why was that choosing -- why was that chosen as the baseline to prove that costs were unsustainable? congress made a lot of decisions to improve the personnel system. we did redux reform. we did the v.a. formulary reform. we changed the pain tables and we did try care for life. we did the g.i. bill and the pay raises. there is a clever reason why the year 2000 was chosen. >> i am telling on myself now. my staff used to tell me to come up here and if you look at my testimony, i always quoted the fully-burdened cost of a soldier. i learned through this commission work that the cost of a soldier has not really gone up

. it is what you hang on that soldier. look at an m-16 rifle and what it looked like in vietnam and look at that same weapon system today. with all of the bells and whistles we are putting on it. when you look at the cost, you are rolling in the additional cost of other things and applying that to personnel which i was totally wrong in doing that and i apologize. >> one last point which is really important. general pointed out that he could not imagine and neither could i when i came in, that we would be at war for 13 years and be able to keep all of the people we kept. if congress and the executive branch had not done what it had done, as the congress men said, do you think we would have kept them? >> let me add to that. this commission was created legislatively. we are limited in the sense that

we had to assume a volunteer force and we would not take anything away from anybody who has it now in certain areas. a lot of the commissioners might have had great, grand ideas. we try to stay within the confines of our legislative directives. >> thank you. >> general, it is very rare that we get an apology from a general before this committee. we will mark this as an historic moment. i thank you. >> i am surprised balloons and confetti is not drop from the sky. [laughter] >> senator hinrich. >> i want to thank all of you for what a difficult charge this was. coming from a state with incredibly high rates of volunteers i want to say how much i appreciate the fact that you came to these recommendations unanimously serving in this body right now. we do not hear that word,

unanimously, as often as we would like to. i want to ask if you can elaborate a little more for everyone who is here and serving for this panel about the process that you used in terms of gathering feedback from our service members, from their families at military installations, and at the veteran service organizations. that was one of the things that i was concerned about in this rocks us -- in this process. i was concerned with the love -- i was impressed with the level of feedback as you move towards those recommendations. >> thank you so much for the question. we spent a lot of time traveling across the country, meeting with different -- meeting at different military installations. we met with active service members, reserve component members, as well as retirees. we held town hall meetings with public hearings as we travel.

-- traveled. we would spend a lot of time trying to really listen. we listened very carefully to the comments that the service members and their families shared with this commission about things that they really were concerned about. they talked about tempo, the challenges with that. they talked about the long waiting list, trying to get their child into a childcare center. they talked about not getting access to health care and the problems that they had with trying to get specialty care and waiting to get through the referral system. all of those kinds of things are what we used and we received tens of thousands of comments that came into the office from

service members about things they were concerned about. we also received many responses from the survey. the survey was a very instrumental part of this process. we sent out the survey to 1.3 million retirees. we sent it out to our active components and reserves and received over 150,000 responses back that said, here is what it is that is important to us. here is what we prefer. here is what we value. they basically stacked one benefit over the other. we have a good indication of what is important to them. >> i want to thank you for that. i want to move my next centered -- my next question to the center. i appreciate your comments about the culture of service that exists in our native american communities. that is one of the reasons why

new mexico has had such an enormous overall rate of volunteerism, military volunteerism, over the years. i wonder if you have looked at the recommendations in terms of having the sort of tsp model and a contribution portion, that if you serve as an enlisted person for four years at the beginning of your lifetime career and you build that early nest egg through this process, what that looks like at age 65 plus, whenever you actually retire. and what impact that would have on travel communities as well as rural communities, where there are hybrids of volunteerism. >> excuse me. i have an allergy, not a cold, so you will not catch it. we do have a problem in the sense of our native americans --

i just could not get mine to go through the academies. but they do join the service for three or four years and they have a high rate of service and they are very proud. in the reservation in your state, they have the american legion of veterans and so forth. this is the component that they would take out, at least. most of them with no retirement. they would have at least 1% that the government would have contributed. after two years, they could contribute up to 6% or match. but they will have something. it depends on how our stock markets work out. in our country, we have to depend on the citizen soldier. in my view, it is just to retain everybody for 20 years.

it is to retain them for 3 5 6. in my case, i surge -- i served for three years and i got 2% a year for the time i was in the military. most do not get that. we also have the thing that most of them do not go back to careers. they go back to unemployment and they do have all of the problems. for them to have some connection to some small retirement benefit at the end i think would be a good thing for us to have in our country. >> i would like to have commissioner higgins follow up on that question. >> i am out of time. would you be willing to indulge? thank you. >> thank you. >> thank you, senator. tapping into the economic power of the united states through the savings plan is indeed a really

powerful financial incentive. we looked at your point about examining what kind of growth experience, when the individual arrived at retirement age say 67, and the individual had no personal contributions but still would have $18,000 available to them in their savings plan. if they contributed and received the full matching 5% of their base pay, they receive, at age 67 over $90,000 in benefit that would be available to them. it is a pretty powerful mechanism and i think would serve any community including native american. >> thank you, mr. chairman.

gentleman -- gentlemen, i echo the message from the rest of the committee. we have been on the campaign trail together for a couple of months in the last year and we have met a lot of numbers of the native american tribes. they truly are a warrior society and we respect what they have provided to our country in terms of service to the armed forces. my question to you today is that you are trying to put together a system that, while it is similar -- at least, you want similarities for services provided. you are trying to provide these services as benefits to a whole lot of different groups. you have the folks that are over the age of 65 those between 60-65, retirees who have left the armed services after 20 years of services but have not yet reached retirement age. you are also looking at those individuals who are still within

the military. then you are looking at those who are coming into the military. how do you transition this from what it is today? i got a letter from a man who had served in iraq. he had 20 years and came back. he says, after sequestration the message he gets is my retirement, because i have done my 20 years but i am not yet 60, is i get my retirement but instead of the inflation factor, i get the inflation factor -1%. the savings to us was $6 billion. he says, in the middle of sequestration, the first thing people do is come back to the servicemen and women who have served to be the first to give back. why are we the first in line to get cut? today, i think the challenge that this commission has in the challenge that this committee is going to have is to go back to a lot of those same individuals

and say, here is $12 million that is being reduced or relocated -- reallocated. those of us who came in and thought we knew what we had for retirement and health care, why is it -- how are we being taken care of? is there a transition plan that says, we get to choose a or b? i think the work that you are doing is important to do. the challenge that we have is, how do you convince these men and women who are serving or have served that they have options available? and is there a transition plan that you have thought about for those individuals? >> thank you very much for the question. we do spend time talking about that very issue that you raised in your question. as we thought through all of the transition assistance kind of challenges that service members face when they are transitioning

out, we took all of that into consideration. i am going to ask commissioner chris carter to talk to the specifics of that. >> thank you, mr. chairman. once again, with my colleague to my right, the holistic approach that we took -- senator, the retirement -- first of all, to make sure we did no harm was one of the mandates given to us. senator kerry also mentioned something important and that is that we do not try and balance the bank on the backs of the military. we tried to not do that. in terms of specifics, some of the programs -- you know, we can talk about this later on if you want to, but we talk about ramp programs. we do not transition automatically into something that might cost a little more to a retiree or service member.

something that will be built up over 15 years, for example. one of the things we thought was vitally important in all the things we recommend is a sense of financial literacy. if our recommendations are adopted, it would be a very robust financial literacy component for all the troops. that starts when they are in boot camp, sailor or basic training, and at various points in their career so they can make good financial decisions going forward. what the federal government does often impacts them and that cannot always be counted for. promises have been made. sometimes, promises have been -- i do not want to say broken, but perhaps bent a little bit. when you do the financial planning and enable the service

member to have the tools at their disposal to make good financial decisions, the impact of the bending of the promise by the government may be reduced somewhat. so i have a son who is a corporal in the marine corps. he is making a little bit of money now and he came to me and said dad, what do you know about ford f-250's? i say, i do not know much, but i know you cannot afford one. the kids are making those decisions. they do not have the money necessary later on. we want to have a robust financial training system so they understand the value of money. they understand the value of money eight are in their careers. when they hit the 12-year mark and they are making the decision, do i want to stay and continue on or go off, the money

is there to make a good financial decision for them. to try to reduce the financial impact of maybe a brand promise, we want to empower the service member with the ability to make good financial decisions. i would only add also that the specific thing you said about someone who served 20 and is retired is grandfathered into the current system. they will not be part of this system now. the benefits may fluctuate and change. that might affect the co-pays but that is over a 50-year ramp. but that 20-year person is grandfathered into the current system. it would not change. >> thank you, mr. chairman. i hope, when we are all done with this, that the thought of bending the promises is one that we tried to get away from. >> that was certainly our

intent, senator. >> i think you should see the recommendations as a continuation of what congress has done for the last 13 years. our goal is to improve the quality of the -- of paying benefits for our military. that is the primary objective of the commission. we set up a group of holistic recommendations that we think accomplish that objective. >> we tried to keep the faith. >> let me just say that. it is just summarizing what my colleagues have said here, that everything that we did was solely done to protect the benefits, protect the interests of the service members. i would not want anyone to get the impression that we were actually cutting benefits for the service members. quite the contrary. even though we yield savings as a result of the approach that we took, the reforming the structure of those programs,

there is no interest on our part to reduce the benefits of service members. in fact, we want to support those and improve those benefits. >> senator kaine. >> thanks to all of you for your service. this is an incredibly important topic and a very difficult one. maybe even a thankless one. i had a chance to look over the recommendations and i see a lot of positives. some of the focus on financial literacy, the transition from veteran status to civilian life in terms of employment training and assistance, these are important recommendations. i will make an editorial comment that has nothing to do with any of you. you all were asked to serve on this and you said yes and you have done a good job. i am not a particularly sensitive person, but when i walked in and it is a panel and we are supposed to talk about military compensation and there is not one woman sitting here, it is like wow.

really? one of the first things that happened when i got into the senate was secretary panetta opened up women to combat. we have so many women serving in the armed services. their thoughts on these things are critical. i have a youngster in the marine corps. as he is talking to his guys, they are often talking about what their own families are saying to them about in-flight commissaries exchanges retirement, health care. it was probably on us or the executive, but it seems so obvious that if we were really trying to have a military that is open to women -- >> strike probably. >> then i will make it as a point -- obviously not critical to any of you who said yes, but i am just stunned. >> i would invite you to

actually meet the women who served on the staff. they are sharp -- >> i am 100% certain of that but it is no substitution for none of them sitting there. we have panels looking just like this, where the folks backing of the panel members are smart, incredibly confident when it. i just want to see some women at the table. let me ask about collaboration opportunities. i do not think this was gotten into when i was gone, but what are the collaboration opportunities that we can harvest between the dod health system and the v.a.? looking down the road, there have to be some economies of scale. there also haven't -- there also have to be some improvements. did you get into that at all or what thoughts would you have for us? >> senator kaine, thank you for the question. we spend a lot of time talking about the dod-v.a.

collaboration. it was mentioned earlier by one of my colleagues that, as we talk about the formulary issues we talked about shared services. we talked about the need to do better standardization, have standardized policies. we have had conversations with the secretary of the v.a. about that as well. we talked to people at the department of defense about that as well. i am going to ask commissioner buyer to talk about the additional specifics as to how we respond to the challenge of that and what we did about it within our recommendations. >> thank you. earlier, we talked about the real empowerment of the joint executive committee and it really lies at the heart of ensuring that two department of government work together seamlessly. as that soldier, sailor, marine

transitions from their active status into the v.a. they should not feel it. as soon as they come over, they should feel that that medical record is there and that there is true continuity of that care. the executive committee that has the authority does not have the power to implement. they just create a lot of paper. we are recommending that you give the joint executive committee not only parity between the dod and v.a., who lead that committee, but give us the power to implement it. >> so the recommendations on blending the formularies with regards to antipsychotics or antidepressants, let them set the classifications of the drugs and how it should be blended. extremely important. john gurley spoke to that earlier. the other would be on capital

projects. whether it is building of military hospitals, avi hospital -- a v.a. hospital in close proximity, have some resource sharing. when you go around, there are a lot of local agreements. it is personality-driven. a lot of things that work and are affected by those crucibles the joint executive committee can centralize those decisions rather than being decentralized. with regard to the medical information, the joint -- the executive committee can really drive how the electronic health record is developed through its evolutionary process between the evolution of this stuff -- of vista and this new electronic health record about to come out at dod. and then we have the providers providing care to the dod.

what we are recommending, the civilian plans, you have doctors out there providing that care. it is between your doctor at home and the doctor from the mtm. when they transition over -- you want to make sure the v.a. is interoperable, too. >> that is very helpful. my sense is that secretary mcdonald understands collaboration. there is a collaboration moment that is coinciding with the issuance of these recommendations. we ought to do what we can to take advantage. >> when we get with the secretary and deputy secretary they had met with us previously and they had initiated the policy paper. we had a chance to talk to general gurley about it. they were asking the doctors of whom they default to the

prescription that dod doctors had written. it is nice to put it on paper. i would feel more comfortable if it were something that the joint executive committee looked at and gave it the implementation authority to make sure that if you had a prescription on active duty, a mental health drug, when you go to dod to ensure that you are going to get that drug is extremely important. there are a lot of social ills that occur if it falls back. >> thank you, mr. chairman. >> could i just add, at the beginning, the chairman invited us to speak our minds, is dangerous in my case. i think his collaboration idea is not going to work. i do not think he will get to where you want to go unless you start considering putting these two together. it is going to be dod that is

going to be in charge of it. i think you have to go further. i would give this committee both authorizing and appropriating authority so they cannot rope a dope you. you need substantial change to get where you want. this is almost a seven-your story about walter reed. what do we need to do? i spent a fair amount of time thinking about this. we have a good recommendation. you are going to improve collaboration. unless you consider putting these two systems together and changing the rules, this committee both authorizes and appropriates. unless you at least consider those two things, it will be difficult to get the kind of changes that you want. >> we have always agreed with that but -- >> i want to go back to the question or follow up on the

question this senator asked about the perception. senator kerry, i think he responded to it. the perception that we are losing people because we are not competitive with the market. you made the comment that we are at or above market. can you expand on that? >> i did say it and i cannot expand on it. we are at or above where we are in the private sector. it was congressional action that did it. we need to maintain that status. >> so the perception that people are leaving at year 10 days on the same pay or benefits may not be right. there may be other reasons they are leaving, but not paying benefits? >> it is likely that you have individual cases. particularly technical individuals. doug was talking about one of the problems we have got. one of these new civilian

companies forming up, they will pay for security costs. i think you will find exceptions to it, but in the aggregate, you will see that military pay is at or exceeds what is available to civilians and benefit package as well. and i am for that. jenna crowley talked about it earlier. i came into this commission believing it is likely we have a problem with paying benefits. i do not believe we do. that is not the problem. the problem is with retirement issues. i think it would be grossly unfair to address military retirement without taking on social security and medicare. >> let me follow up my having commissioner higgins talk. we did quite a bit of analysis and review around. -- around that. >> thank you, mr. chairman. senator, i believe, in a general

sense, retention today is probably as good as the military has ever seen it. having said that, there are select skills that have always been historically, very difficult to maintain. some of the stories that you hear often are, let's say nuclear-skilled individuals are always difficult to retain. once they acquire those skills, they are provided a lot of opportunities on the outside. in recent years, what emerged was the 10-year departure of special operators. those people acquired significant skills during their tenure in the military that now have very high values placed on them in the private sector. and the military responded to

that with a significant bonus that turned the tide in that community. the navy has always struggled with additional bonuses and several of their high-demand skills. as a general, and this may rely mostly on the economy and the unemployment rate, but as we move through these last few years, retention has been quite good. whets one final question for the chairman or as directed by the chairman. the recommendations that you put forward, how have they been embraced by the stakeholder community? i have heard it said that we are providing more efficiency and value. it sounds like there are winners and not a lot of users. are there areas where there are concern among some of the stakeholder groups? >> i think, at this point, the feedback that we have gotten from the mso's, vso's,

stakeholders of that like, they were very simply, to what we have done at this point in time it would be premature to say that they are 100% on board at this time because they are still looking at the details and they will do their analysis as well. i think the dod is doing the same kind of thing. though i think the general feedback at this point, from the department of defense and the joint staff is that they totally understand the merits of our report, what we are recommending and how those recommendations support fiscal sustainability of the compensation programs. the fact that we have been able to achieve efficiencies by reforming the structures of those programs without taking away any benefits -- in fact, adding benefits in most cases

for service members. >> thank you, mr. chairman. i want to commend senator kaine for his observation that it is always good to have women at the table. as well as on the committee. having said that, i looking at your retirement plan. i thank all of you for your service. i am looking at your retirement plan which significantly decreases the number of members who will receive benefits. i think that is commendable. the plan does require contributions, basically, mandatory 3% deductions from service members' pay as well as, depending on investment return -- can you share with me what the current service members think about a mandatory 3% contribution and what concerns you have about volatility in the market that will probably arise

and what assumptions did you make regarding market volatility in coming out with your charts regarding retirement benefits? >> thank you senator, for the question. on each of those counts that you just mentioned we looked at those. the response about regarding what service members think, we were informed that service members felt very strongly that this is an increased benefit. that is kind of what they are wanting, what they are looking for. i think they told us that they really want choice. they want the flexibility of being involved in helping to design the kind of compensation package that they prefer and how

they would receive pay. those things were very important to them and they mentioned it to us. i will ask commissioner zakheim to talk to those benefits. >> first of all, in the united states generally 97% of those who are put automatically into a plan state in that plan. that already gives you one indicator. another indicator is that right now, 40% of the military are voluntarily contributing. 4 out of 10 without any kind of automaticity, government matching, or anything like that. if you take those figures and put them together, you are going to get an answer that tells you that they will all see the benefit of that.

frankly, you can always opt out if you want. >> that part, i am reassured by your responses. on the markets? >> what we have assumed is that the money would be invested in very conservative kinds of funds . obviously, again, you can choose from a variety of funds. our assumptions were that this would be -- there is one particular fund that would follow people's life stocks. when you are you under -- younger, probably willing to take more risks. as you get older, you get more conservative. i think the record of tsp itself and the fact that civilians stay in and that military voluntarily go in tells you that they trust the fund managers and they are making their own choices. i think we felt very comfortable

with the recommendation in terms of market volatility. >> thank you. that is reassuring. i am looking at one of your other charts. it is chart 9 pregnancy and childbirth and newborn care are the top two procedures done in the military treatment facilities. if we move into the private sector insurance market, what kind of effects do you think will occur as a result of that in terms of costs and other impacts? these are huge numbers for these two procedures. >> thank you for the question. commissioner buyer could you respond first. >> i am going to do a tag team with the general in response to this. i think this chart, when you look at it, is surprising. it will be surprising to a lot of people when they look at this. there is this assumption that

the medical providers are providing procedures that really hone the skills that make those doctors and nurses combat-ready. when you look at a chart like this, you go, well, i suppose building the cohesion of the medical team, that is an added plus. with regard to the skill sets that are needed, something is missing here. what i am going to do is tag team with the general here because there are two pieces of this. as we move to the selection of plans, we want the mtf to be part of the network. because the procedures that the mtf needs are not these procedures that you see in the chart. the creation of the joint this -- jointness and essential

medical capabilities, i am going to pass it over to the general. >> it is critical that you understand the concept of essential military capabilities. that is built into what we are doing here. those things, simply stated, transfer to the battlefield. when you are shown this chart, they are going to argue that, hey, we get a lot of great training in taking care of those childbearing issues and childcare issues. all we are seeing is that, if there is a way we can rearrange your workload to give you more of the kinds of things you see in combat, i think it is essential. as you talk to different interest groups, as a retired person, i am looking at how you are going to provide care for me in my golden years. if you get stuck on that, you will miss the essential piece of what we have to do in the

medical area and that is care for our men and women when they are sent into harms way. and to make sure that we have people who are trained to do that based on the kinds of work they are going to get. >> thank you, mr. chairman. >> senator leahy. >> thank you, mr. chairman, and thanks to all of you who are appearing before us today and who have served this commission to make recommendations that are so important. this is something that will have a profound impact on the men and women who are currently serving or have previously served in our military. i hope that all americans particularly those who are currently serving or who are foreign veterans, can take the time to give these recommendations the thorough consideration they deserve and they can become part of a debate that we need to have.

we will figure out how we can provide better for the needs of those who have served us in the past and serve us and simultaneously let us maintain the viability of our military. i ask this question to anyone who would like to answer it -- did the commission finds that a current lack of retirement program similar to that one recommended by the commission, that that is having the absence of a plan like that right now is having an impact on recruiting. for example, currently we don't have a plan in the military that provides benefits for anyone who serves less than 20 years, is that impacting recruiting? >>for example, currently we don't thank you for the question. we took a very strategic

approach at designing the right kind of structure for the compensation program that would really support an all volunteer force for the future. as we designed that program, we took the structure, in terms of how we might make a recommendation, to modernize a current retirement system, and we wanted to make sure that we knew exactly what was of might make a interest to the service members. the recommendations that we provided, we are absolutely convinced that they are the right set of recommendations here. it does two things. it supports the retention needs by the services and it also supports the recruiting

challenges that the services would have. we believe that the recommendations that we have made will absolutely take care of all the recruiting, retention needs and it is very important that they also support the current force profiles which is among the services we are very interested in giving them tools so they could make those adjustments and continued to meet the recruitment and retention needs as we move into the future. >> if we were to adopt something like this, you think it would help recruiting and retention? >> absolutely. >> let's talk about the commission's finding -- let me quote this. the current compensation system is fundamentally sound and does not require sweeping overhaul. ".

-- close quote. but it does recommend that service members ponied nutritional assistance be transferred into the snap program, formally known as food stamps. if service members are in need of snap benefits, and if the report is contemplating that some or many will need snap benefits, that would of course be in addition to the regular compensation does that undermine your conclusion that the current compensation structure is adequate? >> when we talk about the current compensation structure we are talking about the pay table itself. we did not see a need to change it because it has supported the all volunteer force for the last 42 years and the last 13 years of war.

because there are constant changes that have taken place, a new generation in the requirements of the service members themselves -- snap there is an important purpose that the snap program served. we took a look and talked to that extensively. i will ask commissioner carney if he would respond, senator i would like to ask you to follow up as well. >>i will ask commissioner if i could, i have one very minor follow-up question. i would be curious to know how many people might be if you would eliminate ffsa if we would be how many enrolled in snap and what the increased the cost would be? >> the number of and rowley's in snap from the department of

agriculture is somewhere between 2000 and 22,000. that is the best information we have received. on the ffsa, it is 285 people altogether in the military. now ffsa is kind of restrictive. you have to get through your chain of command to get it. does that impact your career? these things make it less attractive and less useful, certainly for the near territories. for overseas, it may still serve some useful purpose, but the snap program is the fact that it needs to exist for some of our military. it is something easier to get and provides better nutritional value for the families that require it.

so, phasing out or reducing the ffsa program is not a bad idea. >> thank you mr. chairman. >> senator mccaskill. >> first, i want to note that your recommendations were unanimous, is that correct? >> yes. >> that is quite an extraordinary thing for all of us on this side of the table. we don't see much that is unanimous, especially with the makeup of this particular commission. i have worked with many of you and i know it is bipartisan and you come from different perspectives and i know you come to the commission with different viewpoints at the beginning and the fact that you worked this hard and came up with a proposal that was adopted unanimously -- and i hope before we get off to

the races, that we pause a moment and realize that you might have got this right. this might exactly be what we need to be doing. i want to compliment you in that regard. first of all, i think our country needs to save more and our military always sets the example in terms of the values and ethics -- so i think the way this plan and braces savings is terrific -- and braces savings -- embraces savings is through a thick. and it most american -- is terrific. and i think most americans don't know that your match is not made in the military and the fact that we would move to match for members of the military makes terrific sense. here is the tricky part. if we will reduce defined

benefits to 40% and someone can retire with 20 at 38 -- they cannot access that until they are 59.5. then not to long after that they would be looking at social security. during that. of time, assuming someone is retiring at 38 or 40 from the military with 20, was there any of time, assuming someone is retiringdiscussion about making a special rule or special circumstances with someone could access tft before they were 59.5? >> i will ask -- these are the type of questions that these former comptroller's love to have. >> i have missed him. we had great work when i first

arrived in from and it so i am happy to hear from you. >> thank you so much, chairman and senator. [laughter] right now, as you well know, retire at 20% and then you start to get a monthly. by definition, the 40% you are speaking about you will get. in addition to that, once you retire, you can get a lumpsum payment if you choose to do so. so you in fact have given the individual much more choice than he or she has today. you can choose the lump sum payment and you will get that with reduced payment until full social security kicks in, or you can say, no, i am staying with my 40%, my monthly payments. you basically now are in much

more control of your financial situation. one other point as well we've put a huge premium on financial education. we spoke to some of the foreign militaries to see how they do it. right now, you take an 18-year-old, 19-year-old or 20-year-old and give him or her -- fire hose them for a few hours about financial management and it is in one year and out the other. what we are proposing to do is to have regular sessions at key points in their careers. key promotions -- or something happens to your family life, you get married or have children, so they can learn the nuances of financial management in a way that when they hit the 20 or if they leave sooner, they can make an informed choice about what

they want to do with the money. to answer your question it seems to me that you are putting the person in uniform at a far greater advantage, even with the 40% because of the lump sum because of the financial education they have today. >> i know my time is almost up and i thank you for that. i will continue to have questions about whether they should make contributions matched to the tft, and whether to make amendments to whether they are eligible to pull out before, whether that makes sense to the commission. some questions about why not just going to the fehpb instead of creating another system, what is the advantage there and are they substantive or are they political -- and finally, i want to recognize the general for the

trailblazing he worked, i am familiar with how hard you have worked both while you are active and after your retirement, but i am a little worried about the most expensive recommendation you made which is about another command, standing up a three star. we have tried to work against having so many -- as you know, dates tried to do away with the forces command -- and i'm trying to think how this new $300 million or year stand up benefits what we have now. because every branch -- i have to be convinced that we need another group at the pentagon. i have a great deal of affection or all of our generals, but three stars are expensive especially with everything that goes with them and what are we

going to gain by adding this new command at the pentagon? i am over my time by one minute 48 seconds, so i don't know if the chairman once that to be answered now or whether you want that for the record. that is the only part i get skeptical about. >> let me just very quickly -- i know we are out of time, but i would like to take the opportunity to respond to that -- let me just say really quickly, the readiness command that was recommended, we really deliberated on that and we took a lot of time and spent on that. every recommendation wequickly, the made in this report was made with that in mind -- the need for readiness. there was a readiness implication to every recommendation that we made. when we proposed the command we did this in the context of understanding that this is much bigger than the medical

readiness component that it has oversight for. it is much larger, in terms of an umbrella that fall under the terms of readiness. we were basically wanting to make sure that it would ensure success of medical readiness that we must have proper oversight. that means having the right person in charge with the right kind of ranking to be able to go to the budgeting meetings and those decision-making venues and hold the presence as the other service chiefs and have influence with the certain generals. i will last commissioner correll he to speak to that -- correlli to speak to that if he will. >> will only say that it is

essential that in this process we keep our mts a vital -- viable training ground. that we have the ability to include our corpsman and medics. there will be a tendency -- we give dependency opportunity to get their healthcare on the outside, there could be a tendency in future agenda periods to draw down on what is left, with our eyes covered not realizing that we may have to employ the people in that mts far away to support those individuals in combat. to me, that is an absolute essential piece of this entire thing, to ensure that we do not allow that to atrophy, shouldto we enter an extended period of time

when those resources do not have to be deployed. every single one of our recommendations -- i went through them and i understand where i extended period of went for. without getting into great detail, i will tell you every one of our recommendations impact readiness in some way. someone from a joint readiness perspective -- member this is critical someone to make joint readiness perspective has to look at the entire readiness portfolio, including medical to make sure we maintain that. and i will end by saying that 300 million is a conservative large number. when we took down jeff, -- jifcom, many of them were transferred and we could not totally put our hands on it and you will see a much smaller bill

than the 300 million cited in our report. >> thank you all for a lot of hard work and a lot of good product. to those who want to suggest alternatives, we are welcome. we will take any new, good idea to make this better. to those who think we're wrong we will accept criticism but not demagoguery. congress requires you to do your job, do you understand what we were asking you to do? were we trying to get you to fix a broken system? there is the attitude of, if it is not broken, do not exit, what was your -- do not fix it.

what was your mandate? >> it was our understanding that our mandate was to modernize. >> so it wasn't from congress to go save money? >> absolutely not. >> so it was your understanding that congress wanted you to look at a 70-year-old system to make it better? >> right. >> do you agree we have the best combat medicine at any time in history of the modern military? >> after 13 years of war we do i don't believe we had it going into this. do you>> we have got it now. >> we have to maintain it. >> that's right, don't lose it. a core function of military health care is to make sure the verses are ready to fight you -- forces are ready to fight. and we have to hang onto that, right? >> that's right. >> i was reading that 25% of the

deployment was disqualified for dental problems? >> true. >> that is true because your brother is a dentist. we have overcome that i don't want to go back to that system. of having a health care system that doesn't make you ready to fight and cannot keep you in the fight and save your life if you get injured. that i don't want to gosenator kerry probably knows more about that than anybody. those are my guidepost. as to retirement, no one is suggesting that we are changing the retirement system to 40% for those on active duty, are you? everybody is rent fathered? -- grandfathered? >> that's correct. >> if i just walked in not knowing the context i would think a 40% retirement change had been recommended for those not on act duty, that is not true?

this chart, who did your polling? >> that was done by truechoice, it has to do with a survey we. >> i cannot -- we conducted. >> i cannot imagine a survey were 80% would not prefer something new to something they have. you feel good about those numbers? >> we feel very good. >> what about the retired community about the proposed changes? >> the feedback that we have gotten is -- >> you can pull retired military members to find out. >> we pulled retired as well as active. >> what were the numbers? >> let me take that question the record. >> fair enough. it seems to me that the jury is

in that people on active duty like what you are proposing and if they had enter option they would take the new system. what we need to understand as members of this committee is where is the retired force? the health care changes are not grandfathered, correct? >> that is correct. >> at the end of the day, your recommendations on health care are driven by the fact that we think we can provide at her choice, more efficient for the patient and department of defense and at the end of the day, your get more choice instead of coverage, correct? >> that is correct. >> if we do nothing, in terms of health care costs, it is exploding the dod>> overall budget. correct? >> that is correct senator. >> because you have a situation we have to deal with retiree health care at the expense of

fighting tomorrow and that is a choice we do not what to make. thank you all for your hard work. >> thank you all for your service, not just on this commission, but many of you have served us and other ways. i've questions for retirement proposals and if we have time at the end commissary proposals. could we get just on this commission, but chart three up? chairman, i will direct like questions you. this shows on the left, the current benefit system, 20 and half pay on the right, you show your blended plan of a defined benefit along with them tsp match -- was there any consideration about moving to a pure defined contribution

system? >> we have a defined benefit system now, and to move to a complete defined country visions system, we believe would not give us all of the retention benefits of the traditional military retirement in -- retirement. retention that's what we wanted to keep them because we can take care of our retention needs and recruiting needs. >> does anyone else want to elaborate? so, i understand that trying to keep benefits roughly the same or in this example, a roughly better than one goal, gives personnel flexibility another go benefits roughly theand maintaining the force is one go, so the assessment of the commission is the 20 year defined benefit plan is

important to maintain for the full 20 years? >> yes, that is assessment of the correct. >> any consideration of a stair steps approach? rather than saying it is the one at 12 years or another four year extension? for having two or three periods where you encourage people to reenlist or officers to remain? >> the current program as it is today, we have the senate page and those bonuses that they are being paid. we have those programs already. this would be that career retention which would take the service member to a point of having 12 years with a four-year obligation to get him to that 60

-- 16th year. >> so not many people leave after 12 and few leave after 60 -- 16? >> that is correct. >> under this proposal, let's say a hypothetical e seven who served three tours downrange seven or eight years downrange three or four deployments, he would be leaving with his contributions to his defined contribution land and the government matches that, right? >> if he elected to -- >> if he didn't reenlist in eight years. >> yes. >> do we have any problem retaining this kind of midcareer, senior nco, senior field grade officer in the six to nine year range? >> it depends on the military occupational a shelti. -- specialty.

it is one thing to maintain and infantrymen who hauled a 60 pound rock up the mountain in afghanistan, as opposed to some and chain -- trained in i.t. skills and can find work in other areas. that's why it is essential that continuation pay -- that we can apply different amounts depending on the military occupational specialty. rather than stairstep, i believe our modeling showed this was the critical period. without this it was eight years 27 days. the model that was in place before was if i can keep someone under defined contributions of 60% past that magical mark, i had a better than average opportunity to maintain him longer. but this tells us the 10 to 12 earmark is critical -- 10 to 12

year mark is critical. >> i have been stationed at bases, fort campbell stands out in my mind that had a nice commissary and a better walmart 2% or outside the gate -- walmart supercenter outside the gate. and there is a need to provide the choices our servicemembers have become accustomed to, is or anything about setting local sites on bases and forts about whether or not a commissary is needed? >> senator cotton, we spent quite a bit of time talking to servicemembers and family members across the country. the polling told it's the same thing.

we had people in different places how they perceive the value of the commissary, overwhelmingly, the support was that people believe it is very unimportant to retention to have the commissary's there. there are people who would tell us we have the shops and we talked to some of the big shock warehouses in some of the stores, the walmarts and others about the benefits they would offer if they were to offer a benefit, at the end of the day no one was willing to stand behind the comments they made. our intention here was to make sure we could protect the benefits of the service members and they believed that this was a big savings to them and they believed it was a retention tool. that is how we went forward.

>> can i just add that several of the big changes talked about issuing a card. when we asked the representatives point-blank, would you do it? changes talked about we never got a straight answer. at the same time -- we did here there are people who order food online, but by and large, people want that. they want it because it is convenient, it is near them, it is military, it is responsive to their needs and so we looked at that and made our recommendations based on the feedback. different folks will have different requirements. overwhelmingly, this is not something they wanted to go away.

>> proclivity to use the commissary is based on a whole bunch of things. there are arguments about how much it saves. if you even cut the high number a 31% in half, it is still a great savings that an e7 with four kids and a wife who made a decision to stay home and be an at home mom, it is an unbelievable place for them to save the money they need as part of the benefit we provided them. >> thank you all again for your service and this important report. we look forward to working on it and having dealt with junior invested men, the financial literacy proposals are important as well. maybe we should add that to our orientation as well. >> i would like to request consent to include written statements from outside groups for up to 30 days from the conclusion of the hearing, any objection?

now awarded, i would also like to thank the witnesses for their excellent testimony and extraordinary competition -- contribution. >> thank you mr. chairman. >> last week, outgoing defense secretary chuck hagel was honored. wednesday, the senate armed services committee holds a confirmation hearing for ashton carter. the president's nominee to be

the next defense secretary. next on c-span, the u.s. house debate on a bid to repeal the affordable care act. that is followed by president obama's remarks about people who benefited from the health care law. then later nancy pelosi discusses proposals to help the middle class. on the next "washington journal" congressman gene green on the gop efforts to repeal the affordable care act, the senate -- president's proposed 2016 journal" congressman genebudget and childhood vaccinations. and representative whitman is here to talk about the president's defense department

budget request. later, c-span's tour of black colleges and universities kicks off at howard university department budget in washington, d.c.. our guest will be dr. wayne frederick. you can join the conversation with calls and comments on facebook and twitter. >> the political landscape has changed with the 114th congress. not only are there any three new republicans and 15 new democrats and 12 new republicans and one new democrat in the senate, there are also 108 women including the first african-american woman in the house in the first woman republican in the senate. the congressional chronicle page has lots of new information including voting results and statistics. new congress, best access. >> tuesday, the u.s. house voted

239-186 to repeal the current health care law and work toward creating new health care legislation. three republicans joined all democrats in voting no. nine total members did not vote at all including speaker boehner. the house has voted some 60 times to repeal the current law and the measure next goes to the senate and president obama has promised to veto the bill. this is two hours and minutes. i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. mr. pitts: mr. speaker, i rise today in support of h.r. 596 sponsored by bradley byrne of alabama. today the house acts once again to repeal obamacare. millions of americans continue to feel the harmful effects of

the president's health care law in almost every corner of their life. recently, i heard from a president school teacher who told me that many of our local schools are having trouble finding long-term substitutes for specialty classes, such as art music and physical education. under obamacare's new definition of full-time work, substitute teachers are strictly limited to 3 1/2 days a week. children are simply missing out on these important classes or being pushed into packed combined classes. many of our local schools had to outsource cafeteria workers and other part-time positions. school districts are spending too much time worrying about federal mandates rather than the best way to teach children. republicans have no shortage of

good ideas to replace the president's health care law. last session there were hundreds of bills introduce to reform health care with more affordable choices. we will hear many of these good ideas and other reasons for repeal today, and i look forward to hearing from my colleagues. the american people continue to oppose the president's health care law, and today house republicans will stand with them again. i reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from new jersey is recognized for 15 minutes. mr. pallone: mr. speaker, i yield myself such time as i may consume. the speaker pro tempore: the gentleman is recognized. mr. pallone: thank you, mr. speaker. you know, i have great respect for my colleague from pennsylvania, but i just think that more and more of what i'm hearing from my republican colleagues is what i call fantasy land. this isn't the america we know where in the past few years when the affordable care act has taken effect so many americans who didn't have health insurance now have it. something like 19 million americans who were uninsured

now have health insurance. millions of young adults have health insurance because they were able to stay on their parents' plan. 129 million americans no longer can be denied health insurance for having a pre-existing condition. seniors have saved so much money on the prescription drugs. i could go on and on but i don't need to. americans like the affordable care act. it is working. we cannot go back. we cannot let -- turn over the health care system again to the insurance companies that will have skeletal plans, don't have good benefits, raise premiums to whatever they want and not actually have any help from the federal government. when you repeal obamacare or the affordable care act, you are abasically americans a tax increase because they're not going to be able to get the tax credits or the subsidies that help them pay for their premiums and make those premiums affordable. this is not a -- this is working. this is happening. this isn't something we can just throw away and the republicans say they have some kind of -- what did my colleagues say, the g.o.p. has

no shortage of good ideas. what ideas? four years ago when they first took majority in this house, the house republicans passed a similar repeal bill instructed the committees to come back with alternatives and it never happened and it will never happen again. oh me might have a few good ideas here and there, but they have never come up with a comprehensive plan to provide americans low-cost health insurance and insure most americans. that's what we've done with the affordable care act. we are not going back. we are not going to repeal. this is fantasy. the president will never sign it, and i just wish they would stop wasting our time and getting to things that will actually make a difference to the american people. i reserve the balance of my time. the speaker pro tempore: the gentleman reserves the balance of his time. the gentleman from pennsylvania. mr. pitts: mr. speaker, i'm pleased to yield two minutes to the gentlelady from tennessee, a vice chair of energy and commerce committee mrs. blackburn. the speaker pro tempore: the gentlelady is recognized for two minutes. mrs. blackburn: thank you, mr. chairman. talking about fantasy, mr. chairman i think that it finds its root in this comment from

jonathan gruber who was the architect of obamacare and i'm quoting him. if you had a law which said that healthy people are going to pay and sick people will get the money, it would never have passed. lack of transparency is a huge political advantage. call it the stupidity of the american voter or whatever, but that was critical for the thing to pass, end quote. now, mr. chairman, that is the fantasy on which this was based. it does not work. it has driven up costs, and indeed we know that 70 of our democrat colleagues have crossed the ideal and have voted with us -- the aisle and have voted with us to repeal different provisions of this law because it does not work. it is not making insurance more affordable. it is costing more. one of my constituents, emily, her insurance was $57 a month before obamacare. after obamacare, with the subsidies, $373 a month. another constituent jimmy is

saying he can't afford to offer the benefits now because the way obamacare has driven up the cost of insurance. it is -- it has closed his business. that is our choices. that is why we are here. it does not work, and it is time to get this law off the books and, yes, there are lots of ideas. you know, mr. chairman, for my colleagues just to know energy and commerce, we have over 100 bills that have been filed that would repeal different provisions of this law and we are doing it because the american people have said, we are tired of this. it is damaging health care. it is returning us to the day of the old major medical when you had higher premiums, when you had higher out-of-pocket costs and you had less benefits. now, our colleagues across the aisle, mr. speaker, may say that those are not suitable plans, but guess what, that is what obamacare plans are

becoming. it's time to get it off the books, restore choice and option for the american people. i yield back. the speaker pro tempore: the gentlelady's time has expired. the gentleman from new jersey. . mr. pallone: i yield one minute to our democratic whip, mr. hoyer. the speaker pro tempore: the gentleman is recognized. mr. hoyer: this bill is about restoring choice not to have insurance, not to have the assurance if you get sick you won't go bankrupt. that's what this bill is about. thank you for the microphone. mr. speaker, this house is about to hold its 56th vote to undermine or repeal the affordable care act which came to us by the way, by route of the heritage foundation, as i think probably most of you recall. but this vote is different than the previous votes, for one significant reason. since the last repeal vote, the health insurance marketplace has opened and is working. over 9.5 million americans have signed up through these marketplaces for health care coverage through 2015 so far. that means with today's vote,

republicans are choosing to take away health care coverage from millions of americans. this vote will also remove patient protections and cost savings reforms. to make matters worse, tate's vote would also defund -- today's vote would also defund the bipartisan popular chip program that helps states cover uninsured children. it abandons children as well. in 2011, when house republicans voted to repeal the affordable care act, they included language that said they would replace it with something else. and notwithstanding i say to my friend, mr. pitts notwithstanding, mr. speaker, that, they have not done so. however, they still have failed to give us an alternative. i urge my colleagues to vote no. i yield back the balance of my time. the speaker pro tempore: the gentleman from pennsylvania. mr. pitts: mr. speaker, i'm pleased to yield two minutes to the gentlelady from north carolina, member of the health subcommittee, mrs. ellmers. the speaker pro tempore: the gentlelady is recognized for two minutes.

mrs. ellmers: thank you, mr. speaker. thank you, mr. chairman, for this very important discussion that we are having today. i rise in support of h.r. 596, with aims to repeal the patient protection and affordable care act, otherwise known as obamacare. obamacare has been a costly disaster to my constituents in the second district of north carolina and across this country. i have heard numerous stories ranging from young women to senior citizens, and they all touch on the same underlying problem. obamacare is unaffordable and the results are severe consequences. as a nurse, i know that repeal alone is not enough because the american people need high quality patient centered health care. i am so proud to be standing with my republican colleagues and many of the democrats that we serve with who are now going to say to the american people

not only are we against this awful law, but we are for good patient centered health care and we are going to provide that plan of action for the american people to see. we need to stand with the american people who are overwhelmingly disapproving of obamacare. with that, mr. speaker, i yield back. the speaker pro tempore: the gentleman from new jersey. mr. pallone: mr. speaker, i yield one minute to the ranking member of the health subcommittee, mr. green of texas. the speaker pro tempore: the gentleman is recognized for one minute. mr. green: thank you, mr. speaker. i rise today to express my staunch opposition to h.r. 596 legislation to repeal the affordable care act. yesterday was groundhog day. today's vote really feels familiar. the house has now attempted to repeal or undermine the affordable care act more than 56 times. it's disappointing that the republican leadership continues its partisan campaign to undermine the a.c.a. and create barriers for millions of uninsured americans having access to health insurance. based on the latest estimate from the congressional budget

office, 19 million americans and 20,000 in our houston area district would lose their health insurance this year if the a.c.a. is repealed. these are people who would be without coverage today if it were not for the a.c.a. h.r. 596 would take away critical benefits and health care coverage for hardworking families. not only that this bill would increase the deficit repeal reforms that help slow the growth and health care costs, and undo basic protection that is provide security for the middle class. it's long past time to stop playing political games on health reform. we need to work and enact reforms that improve and build on the a.c.a. for the good of the american people. i return the balance of my time. the speaker pro tempore: the gentleman from pennsylvania. mr. pitts: mr. speaker, a lot of those people are on medicaid and can't even see a doctor. i'm pleased now to yield two minutes to an outstanding member from pennsylvania, mr. rothfus. the speaker pro tempore: the gentleman is recognized for two minutes. mr. rothfus: thank you, mr. speaker. i stand here today listening both to the rule of debate and

debate we are having right now to my colleagues on the other side of the aisle who ridicule our relief efforts and joke about the number of votes that we have taken to repeal obamacare. well, mr. speaker my friends across the aisle may think this is funny, but it's no joke to the folks i represent back in pennsylvania. it's not a joke to the mother who walked into the pharmacy and found out her drug cost -- that cost $40 under her old plan, the one that the president promised she could keep now costs $700 because of the skyrocketing deductibles that she has. it isn't funny to people who received cancellation notice in the mail and have been forced on plans with ridiculous out-of-pocket costs. a woman i spoke to can't go to a doctor she's seen for 20 years, definitely isn't amused by obamacare. there wasn't one single republican who voted to create the train wreck that's known as obamacare, and we made our opposition abundantly clear to votes before we went to the

ballots last november. i urge my colleagues to give americans what they asked for and support this legislation. do it for every american who was lied to about the real costs of this law. do it for the millions who have been hurt by this law. and let's find a better way ford. -- forward. i thank the speaker and yield back. the speaker pro tempore: the gentleman from new jersey. mr. pallone: i yield one minute to the gentlewoman from california mrs. capps. the speaker pro tempore: the gentlelady is recognized for one minute. mrs. capps: i thank my colleague for yielding. mr. speaker, it's not a joke. it's disheartening that here we are for the 56th time, again considering a bill to repeal the affordable care act. and this time it is different. this time repeal will do more than simply take away the important consumer protections that hold insurance companies accountable and make sure everyone is insurable. this time it will actually take health insurance away from millions of families.

plans they have both chosen and paid for. this time it will hit families where it hurts, raising their costs by erasing the benefits that make their insurance more affordable as well as raising medicare prescription drug costs. this time tax credits will be lost, leaving employees without coverage and few if any affordable options. we all know that the affordable care act is not perfect and there are clear areas where we could work together to build on and improve this law, but today's repeal vote would turn back time. reverting back to a system everyone agreed was broken. the american people deserve better than that from us. i yield a no vote and yield back. the speaker pro tempore: the chair will receive a message. the messenger: mr. speaker a. message from the secretary. the secretary: mr. speaker. the speaker pro tempore: madam secretary. the secretary: i have been directed by senate to inform the house that the senate has passed without amendment h.r. 203, cited as the clay hunt suicide

prevention for american veterans act. the speaker pro tempore: the gentleman from pennsylvania. mr. pitts: mr. speaker, at this time i'm pleased to yield two minutes to the gentleman from michigan. the speaker pro tempore: the gentleman from michigan is recognized for two minutes. moo lenar -- mr. moolenaar: thank you, mr. speaker. our nation has over $18 trillion in debt and this law adds to it by spending more money we don't have. the cost of coverage subsidies alone is expected to quadruple over the next 10 years acording to the c.b.o. the federal government is picking up the tab for medication expansion and it will eventually pass the enormous financial burden on to state budgets. in the last decade alone, michigan has gone from one in eight residents enrolled in medicaid to approaching one in

four enrolled in this unsustainable government program. what's more, this law has the effect of throwing a wet blanket on the economy. small business owners say rising health insurance costs are their biggest concern, and the health insurance tax costs them $688 per employee. school districts have cut the hours of part-time employees and businesses can't afford to hire more employees because of the costs of mandated coverage. we have even seen colleges and universities cut back hours for student workers and now they earn less money to pay for their classes. individuals, families, and businesses all face continuing uncertainty over health care coverage and its costs. the administration alone has made 28 changes to the law, including delaying mandates changing verification retirements, pushing back enrollment dates because the website wasn't ready, and

expanding waivers to deal with the cancellation of millions of health care plans. five years after it was signed, the president's health care law is still changing. last november, the department of health and human services proposed 35 more revisions. it's time to permanently repeal the excessive spending, the economic pain, and the continuing uncertainty caused by this law. and replace it with patient centered alternatives with lower premiums that allow individuals to choose the coverage they want. it's time to empower patients to take control of their health care choices. i yield back. the speaker pro tempore: the gentleman from new jersey. mr. pallone: mr. speaker, i yield one minute to the gentlewoman from illinois, ms. schakowsky. the speaker pro tempore: the gentlelady is recognized for one minute. ms. schakowsky: here's what my constituent laurel wrote me. thank you, i'm tired of all this belly aching about health care so i want to share our story. we are small business owners and

have a very expensive policy for our two employees, but we have been stuck with that approach because my husband and one of our kids has asthma and therefore uninsurable. our health care broker sent us all the health care information for the next year and our yearly costs will go down if we switch to one of the obamacare options in illinois. although we don't qualify for subsidies, it's cheaper in all scenarios. if our usage is similar to what it was the last three years, our costs go down 20%. the policy is better. everyone in our family is now insurable. my kids still under 21 may be able to get dental insurance. and the out-of-pocket maximum is lowered if someone really gets sick. wow. she says these savings don't include the benefits, no deductible checkups and preventive drug benefits which have already saved us $1,800 this year. our health care broker and his partner are signing up for obamacare options themselves.

i'd like to know what all those republican grandstanders who have been blocked action at every turn are now wringing their hands have done for me lately. i yield back. the speaker pro tempore: the gentleman from pennsylvania. mr. pitts: may i inquire of the time. the speaker pro tempore: the gentleman from pennsylvania has 1/2 minutes remaining. the gentleman from new jersey has nine minutes remaining. mr. pitts: mr. speaker, at this time i yield two minutes to the gentleman from alabama, mr. palmer. the speaker pro tempore: the gentleman is recognized for two minutes. mr. palmer: thank you, mr. speaker. i rise in strong support of h.r. 596, a bill that would fully repeal the affordable care act offered by mr. byrne of alabama. right now americans are being forced to buy a government product or pay a penalty. the constitution mandates freedom, not the purchase of health insurance or any other product. we all remember this promise, if you like your health care plan, can you keep it. and 2013, a reported 4.7 million people in 32 states lost their health insurance when their plans were canceled. that's just the beginning.

the congressional budget office projects seven million more americans will lose their health sponsored coverage in 2016. americans were promised that with obamacare their premiums would be lower. instead premiums have skyrocketed. some groups have seen their premiums increase by 78%. at the same time household incomes have gone down. today four years after the pass ang of obamacare -- passage of obamacare, there's still 41 million people without health coverage. there are millions of people out of full-time work and millions more forced into part-time jobs. obamacare must be repealed and replaced. mernts should be allowed to buy the health insurance they want and need. we need market competition between health insurance providers, and people should be able to buy their health insurance across state lines. this would result in more choices for plans and at lower cost. we need portability so that when a person changes or loses a job, they don't lose their health i shurens. and we need -- insurance. and we need innovative reforms

for medicaid and for controlling cost, promoting healthier lifestyle choices, and reforms that treat people with dignity. h.r. 596 starts the process of reforming our health care system by repealing obamacare. this is the first step toward true affordable health care that puts people back in charge of their health care choices. thank you, mr. speaker. i yield back the balance of my time. the speaker pro tempore: the gentleman from new jersey. mr. pallone: mr. speaker, i yield one minute to the gentleman from north carolina, mr. butterfield. the speaker pro tempore: the gentleman is recognized for one minute. mr. butterfield: i thank you mr. pallone, for yielding. i rise in strong opposition to this bill. this vote today marks the 56th attempt by house republicans to dismantle the a.c.a. if enacted, more than 19 million people who were previously uninsured would lose tax credits and subsidies that make insurance affordable. members who voted for this bill are telling the american people that access to affordable, quality health care should be reserved for only those who have the means to afford it.

let me just tell you a story very brief story about a man named carlton stevens jr. from my hometown of wilson, north carolina. last year was a very challenging year for the stevens family of five as they found themselves uninsured. as mr. stevens and his wife found themselves between jobs and on a new town, they prioritized finding health coverage for their family. mr. stevens visited the federal health insurance marketplace to search for coverage and was surprised and elated to know that he and his family qualified for credit of approximately $800. he and his wife were able to purchase insurance for the entire family for less than $200. . mr. speaker this bill would deprive families, like the stevens family in their time of need. i wonder why the republicans are doing it again. i yield back. the speaker pro tempore: the gentleman from pennsylvania. mr. pitts: mr. speaker, the number one health care concern of the american people is cost. the president promised american

families they would see $2,500 reduction in premiums. president obama was wrong. according to one study from the manhattan institute, american families are seeing premium increases of an average of 49% increases. this time i'm pleased to yield one minute to the gentleman from arkansas mr. hill. the speaker pro tempore: the gentleman from arkansas is recognized for one minute. mr. hill: thank you, mr. chairman, for yielding. thank you, mr. speaker. i rise today in support of h.r. 596, which repeals the president's flawed health care law in its entirety and provides to the congress a clean slate to implement patient center health care reform this nation needs and deserves. the majority of americans are opposed to obamacare and it's harmful, intended or unintended side effects which have increased costs, decreased health access, lost jobs, work hours and wages for many of our hardworking families.

this is an opportunity to recognize the flaws of mandates and a top-down approach to health care and allows us to finally consider ideas that will result in a health care system that empowers and encourages individuals to take control of and responsibility for their health care through the use of tools like health savings accounts and incentives that reward healthy behaviors. we need targeted transparent well-thought out reforms that acknowledge the complexity of our health care system and with the right kind of reforms we can get the right kind of health care that's affordable and accessible. i yield back. the speaker pro tempore: the gentleman from new jersey. mr. pallone: mr. speaker, i yield one minute to the gentlewoman from florida ms. castor. the speaker pro tempore: the gentlelady is recognized for one minute. ms. castor: the affordable care act is a great help to american families. now, most americans have health insurance through their employer, and the a.c.a. provides important consumer

protections for those families. they cannot end your policy if you get sick. your co-payments and premiums have to go to health services and not profits for insurance companies and for your kids aged 26 or younger, they can stay on your own health insurance plan. for americans on medicare, the a.c.a. is saving you money. in fact, since passage of the a.c.a., more than 7.9 million people who rely on medicare have saved almost $10 billion on prescription drugs. you have new wellness checkups, and the affordable care act extended the life of the medicare trust fund for more than a decade. and finally, before the a.c.a., many americans were barred from health insurance because of a previous diagnosis of cancer, diabetes or something else. the affordable care act has been a lifeline for them because it ended discrimination and created new marketplaces for americans to shop for the best plan for their families. in florida alone, my home state, 1.5 million floridians

have already signed up for a plan in the marketplace for the upcoming year. 1.5 million floridians. please, colleagues, don't take this away. vote no on this bill. the speaker pro tempore: the gentleman from pennsylvania. mr. pitts: mr. speaker at this time i'm pleased to yield two minutes to the gentleman from georgia, mr. heist. the speaker pro tempore: -- mr. pitts: the gentleman from georgia mr. hice. the speaker pro tempore: the gentleman is recognized. mr. hice: since passage in 2010, obamacare has a full takeover of the health care industry and they were sold by false promises that obamacare would lower the costs and increase access to care. the first most egregious promise when the president himself said if you like your health care plan you'll be able to keep it, period. no one will take it away no