servicesthe armed committee member loretta sanchez trainingut military and the strategic challenges the u.s. bases around the world. later, the conversation with -- with the about the diana about the housing market. you can join the conversation by phone and on facebook and twitter. >> all caps and long, c-span takes you on the road to the white house. unfettered access to the candidates. comments ong your

twitter, facebook, and by phone. and always, every campaign event week cover is available on our website at www.c-span.org. clinton talksry thet gun violence in th u.s.. she spoke at a town hall meeting in manchester. this is part of c-span's road to the white house coverage. >> ladies and gentlemen, please welcome hillary clinton! [applause]

>> first of all, i want to thank you all for your patience. patience is a virtue. if you are voting, please think of lieu delasandro.

now listen, we are here today to isten to a woman who has every credential possible to lead this ountry as we go forward. we have a woman who is ven afraid to talk about guns and who is not afraid to address the issues head on. you are in a community college today. we know what happened in a community college in oregon. we know with great sadness that those who passed away, passed away for no reason at all. none whatsoever. we have a woman who has win herself the ability to make a difference. cheers and applause]

and indeed, you will have a chance to vote for her in the primary and in the general election. [applause] so without further ado, i'm kerwin. introduce erin she lives in the area, she has two children. social worker. she said it doesn't pay a lot of money, but she loves it because she was taking care of people. and isn't that what life is all about? we take care of people, they take care of us. the country is better off because of that. without any further ado, erin kerwi flfment. [applause] erin kerwin: hello.

my name is erin kerwin, i have two children, and i have the honor of introducing hillary clinton today. i live in a beautiful community not far from here, and in another time we could have posed in a norman rockwell painting. to me the devastating consequences of gun violence have always been a concern. in what feels like a past life, i was a social worker. i handled mostly domestic violence and sexual assault cases. what struck me over and over was he immideacy of gun violence consequences. watching the assault weapons ban expire in 2004, i could not understand why we could not make progress or enact policies to protect gun violence and death

from guns. last month everything changed for our family. a woman not much different from anyone else in our family was shot and killed on our street. it was a sunday evening. there is no explanation for this killing. my first thought went to my kids. thomas who is a little bit too wigly to be here today, is in first grade, and eleanor is my fourth grader. on the night of the shooting, we had had a cookout on our street. what a difference 24 hours might have made for us, and my heart breaks for her every time i think of it. if you are a parent, gun violence prevention has to be an issue for you. [applause] if you are a husband, a brother, a sister, a wife gun violence

prevention has to be an issue for you. from oregon to south carolina and everywhere in between, gun violence is leaving families struggling with unimaginable grief and loss. as a nation, we can do better. i think if we elect the right person, this is a fight we can win. i think hillary clinton is the person who can win that fight for us. cheers and applause] she has the tenacity to tackle gun violence, and she never gives up. she has a record of achieving results. please join me in this fight, and please join me in welcoming

our next president, hillary clinton. [applause] hillary clinton: thank you, thank you very much. [applause] thank you very much. i'm delighted and honored to be ere. lou has been a friend of mine for a long time and a senator representing this district, this city, and this state even longer. i thank him very much for his support and his friendship. thank you, lou.

i want to thank erin and eleanor for being with us. erin's story is unfortunately way too common. we are here on the campus of a wonderful community college, there much like the one in oregon. where young people were going to school, and some not so young. the victims i read are between 18 years old and 67 years old. people attending classes and improving their skills, teaching, learning, thinking bout the future. which was so ended, senselessly, tragically. on that very same day that those people were killed in oregon, a five-month-old baby strapped into her car seat in the back of a car was killed by a stray bullet in cleveland.

the third baby in just a few months to be murdered in cleveland. between 88 and 92 people a day are killed by guns in america. the last figures we have for a whole year is more than 33,000. it is the leading cause of death for young african-american men, the second leading cause for young hispanic men, the fourth leading cause for young white men. this epidemic of gun violence knows no boundaries. t knows no limits. and when this happens, people are quick to say that they offer their thoughts and prayers. that is not enough.

ow many people have to die before we actually act? before we come together as a nation. [applause] hillary clinton: you know, on the republican side, mr. trump was asked about it and said something like you know, things like that happen in the world. governor bush said yeah, stuff happens. no. that is an admission of defeat and surrender. to a problem that is killing 3,000 americans. it is time for us to say wait a minute, we are better than this. our country is better than this. and their steps we can take -- [applause]

-- there are steps we can take -- hillary clinton: that improve gun safety and further the prevention of violence by guns. and today, i am supposing -- proposing what i consider to be common sense approaches. a majority of americans support universal background checks. in fact, a majority of gun owners support universal background checks. we had a bipartisan bill that didn't make it through the senate. but we need to go back and, with all of our hearts, working not just in washington, but from a grassroots up, demand that we have universal background checks. [applause] and we have to also -- hillary clinton: we have to close the loopholes. you know, we've got what is called the gun show loophole, and we've got what's now being called the charleston loophole.

when the brady bill was passed, which wasn't easy, as you recall, but it did pass. exceptions were made for gun shows, and then later, it was extended to include online sales. 40% of guns are sold at gun shows, online sales. we need to close that loophole. so that when we have a universal background check -- [applause] hillary clinton: it will cover everybody. another loophole is what happened when the young man who murdered the nine people at bible study, in the church basement in charleston -- applied for a gun. the loopholes that they don't get the background check done in three days, you can still go by the gun. it turns out he had a criminal background, and you know how

record-keeping is. people will start -- were still searching for a. of the end of three days, he goes and buys a gun, as we don't yet had it -- had an automated enough, we don't have information shared from all levels of government. and he got his gun. and was determined to go and use it to kill nine innocent people. we also must address the very erious problem of military style weapons on our streets. [applause] hillary clinton: you know, people don't really have a chance. lots of times, when terrible murders like this take place, someone will say if we only had more guns. you walk into class, you are driving your baby around in a car seat, you are going to

church. and somebody has an automatic weapon, or even worse -- an assault weapon that is a ilitary instrument of war, and you are somehow supposed to be able to stop that with your own gun? that has never made any sense. [applause] hillary clinton: and so from my perspective, we have got to keep guns out of the hands of people who should not have them. domestic abusers, people with serious mental health problems, there's got to be a better tracking and record-keeping. i remember the terrible massacre t virginia tech. the shooter there had been involuntarily committed. and there was no record of

it. and if there is information about people who are ex-felons, who are suffering and serious mental illness, who are domestic abusers, you got to get that information into the record-keeping, so that the universal background checks will actually show you that here is somebody who shouldn't have it. people say to me does this really work? i can tell you this. the best data that we have is that since the brady bill implemented background checks, more than 2.4 million people have been stopped from buying a gun. and over one million of those were felons. there were records of those particular potential purchasers. [applause] hillary clinton: and i want to work with all of you. i want to work with sensible gun safety advocates as well as gun owners.

i want to work with people from the grassroots up come all the way to washington. because how much longer will we just shrug? oh my gosh, something else terrible happened. whether it's in your neighborhood, erin, or at a community college, or the murder of children in their classrooms. we are to go to the town hall portion of this. but i want to ask one of the mothers from sandy hook, if you wouldn't mind, to just come join me for a minute. because i want you to hear from her. because so many of the parents -- [applause]

hillary clinton: you know, so many of the parents of these precious children who are murdered have taken the unimaginable grief that they have been bearing, and have tried to be the voices that we eed to hear. i want you to introduce yourself and maybe talk about what you and other parents are trying to do to get the changes that are necessary. > thank you. my name is nicole hockley, and i'm the managing director at sandy hook promise and also the mother of dylan, who was six years old when he was killed at sandy hook elementary school. gun violence prevention was nowhere on my radar. before losing my son. i wish it had been. i wish i had done something long

before something that i thought could never hit my community hit e. as part of sandy hook promise, we focus very much on gun safety legislation. and the commonsense practices you are speaking of, so thank you for taking this on and speaking out. we also very much focused on what can we do to get ahead of the violence? to get upstream of it and help identify and intervene, help people learn how to know the signs of someone who is at risk, and get help before they even get to the state of picking up a weapon to hurt someone else. i think it is a comprehensive solution that is needed between gun access and responsibility, as well as mental health and wellness. and working together with all of the other organizations, and all the other people, as well as

yourself, i have absolute faith that we can deliver the solution and protect children across america. [applause] illary clinton: thank you. ou know, i think we just heard really reinforces how nobody knows what might happen. because we haven't done what we eed to do. to try and make any of us, but particularly our children, safe. that's what behind the proposals

i'm making. they are not new. there's nothing unique about them, other than the fact that i am so determined we're going to do everything we possibly can to get this done. [applause] hillary clinton: i know there are a lot of people here. we have a big group from moms demand action, and from dad's as well. i want to commend them. as they are grassroots organization that is really trying to bring these issues to the public attention. we need more of that. i have said we need a movement, that people really will be part of, no matter what other issues that is on your mind, that you are about -- our safety. the great hope that we can protect people who are going about their daily business should be at the top. and therefore, i'm really asking everybody, regardless of

olitics or partisanship or candidates or anything else to think of the ways that each of us can do more to try to provide that measure of gun safety that will save lives and prevent iolence. let me start by asking people, if you want to say something where you have a comment to make on this, or any issue, i would like to start this issue because i know there are people here specifically on this issue and i want to be sure to hear from hem. dick congressman

ssmwsmovepltsmtsm -- former congressman dick swett. congressman swett: it's wonderful to have you here. john alston a pleasure to be with my good friend the clintons. i want to give everyone a background on our relationship with regards to guns. in 1994, i voted in favor of a crime bill that had in it an assault weapons ban for 17 assault weapons out of nearly 800 weapons that were on the street. >> i'm not looking for any attention, but i received a letter prior to the vote that i thought would be worth sharing with the people here. i shared it with hillary earlier. it is a letter from ronald reagan, and it is dated may 5, 994, and it's written to congressman dick swett.

i'm reading off of his own handwriting. fred ryan told me of your conversation, and i know you were thinking very carefully about the assault weapons bill. as a longtime gun owner and supporter of the right to bear arms, i too have carefully thought about this issue. i'm convinced that the limitations imposed in this bill are absolutely necessary. i know there's a heavy pressure on you to go the other way. but i strongly urge you to join me in supporting this bill. it must be passed. sincerely, ronald reagan. [applause] >> i've watched hillary and her husband bill worked with people on both sides of the aisle for nearly 30 years. she is someone who is going to solve this problem. she is going to be a leader who will make this problem ultimately, go away. i have every confidence that as our president, hillary, you will be able to tackle this problem that we began trying to tackle back in the 1990's. and i'm so grateful for your leadership, and i look forward to supporting you in the upcoming elections.

thank you. hillary clinton: thank you, thank you very much. well, we have a lot to talk about, that's for sure. this gentleman in the green shirt. >> thank you. we are all the way from arizona, i grew up in tucson, arizona. i am a gun owner and the support of the second amendment. but i couldn't give you more credit that we need to deal with the wrong people getting guns. especially with mental illness. as you know, in tucson, we had a person who had all kinds of trouble and was able to buy a gun, as you said, virginia tech, louisiana, that person had been committed. from a gun owner, from a red state, and a person who owns guns, more power to you. [applause]

hillary clinton: thank you. thank you. yes, the lady right here. here comes the microphone. >> thanks for picking on me. i have a question about the cdc, nd research that was cut off early in the 90's by the republican party. i think that if you can bring that back, if we could convince legislature to fund research into gun violence, what causes it -- i think we're hitting a lot of marks with that because we are getting mental health issues, we are getting what role guns play, how quickly people can off someone with a gun when they want to. if we can just analyze that data, i think we will be a lot better place. hillary clinton: i agree with you. what she is referring to is that the centers for disease control is responsible for looking at public health issues. if there is dirty water that is making people sick, we are expecting them to tell us what

to do to prevent that. so, they were researching gun violence and trying to figure ut who is more likely to commit violence, what kind of arning signs there might be. and for very sad reasons, basically, you're right. the republicans stopped the research. it even goes further than that. there is a law in florida -- i want you to hear this because it was so shocking at first that i really didn't believe it. there is a law in florida that makes it a felony for a pediatrician to talk with families about being sure they keep guns safely away from hildren. literally, a doctor can go to jail in florida. if you are a pediatrician, and

you are running through checklists, are you keeping the household poisons out of the wave your kids? especially if you have toddlers exploring everything. you make sure your sharp knives are kept away, are they high enough up so kids can't accidentally get them? it seems perfectly reasonable to me to say if you have guns in the house, are you sure they are really secure? because too many little kids get a hold of them. we read about it every week. they kill themselves, they kill their friends. i think it is a doctor's responsibility to try to work with the family so that the family can try and keep their babies safe. if you are in florida, you could go to jail. i want to make the argument and work towards the results that we an learn a lot more about what

are the characteristics of people who should not have guns? as we were just hearing from the gentleman from arizona, as we are learning more, certainly what we know about the killer from sandy hook, now the killer from oregon, there probably were some comments, some actions that might have set off some alarms in people. but if we don't have the good information so that people can be better informed, how do we help them? i agree with you. no issue should be beyond study in america. that's like a denial of everything we believe in our country. [applause] hillary clinton: going along with that, so far as i know, the gun industry and gun sellers are the only business in america that is totally free of

liability for their behavior. nobody else is given that immunity. and that just illustrates the extremism that has taken over this debate. i was really struck when dick swett was leading the letter from ronald reagan. and the fact that when he was facing a very hard choice, which many people believe cost him his seat in congress, because he voted for the crime bill which contained the brady bill, which led to the background checks, which led to more than 2 million people not getting guns who were felons or domestic abusers, or otherwise ineligible -- he paid a big price for that. here's a letter from ronald eagan. when the nra was on one of their tirades, calling the alcohol tobacco and firearms enforcers jackbooted thugs, president

george h.w. bush resigned as an nra member and said no, i'm not going to be associated with that. [applause] hillary clinton: ideally, what i would love to see is gun owners, responsible gun owners, form a different organization and take back the second amendment from these extremists. [applause] hillary clinton: ok. thank you. this lady right there. here comes the microphone. >> i'm so glad to see you, mrs. clinton. i know this is a big issue in the united states, but i'm from afghanistan. i'm thinking about my country, every day, more than 200 or 300 people died over there.

i want to know what your opinion after you become president of the united states, do you want to pull out all united states soldiers or are you thinking they are going to stay there? rom my opinion, we wanted them to stay there for afghanistan, for protection. i want to know your opinion about that. thank you. hillary clinton: thank you. first, i want to say how distressed i am by the bombing of the hospital. i know that defense secretary carter has said there will be a full thorough investigation to try and get to the bottom of that. but it is deeply regrettable. it came within the context of the taliban taking back over a city in the north, and the afghan army, which has performed very bravely -- this is not an army the runs away. this is an army that stands in fights.

but they don't have the experience, they don't have a lot of the support that they need to be as successful as they are trying to be. i think that we have got to continue to work with the afghan government and the afghan military to support them. because they are fighting. it's a different story in other parts of the world, but they're in afghanistan, people are fighting for the gains that have been made in the last 13, 14 years. there still is a lot of conflict, there still is a lot of danger. the tal pan is not going away. going taliban is not away. we know that. but there has been so many

positive developments. the number of girls and women in school, at work, studying in the united states, going home to try and help their country, businesses that are able to perate now as opposed to being under the thumb of the taliban and being forced to basically pay tribute all the time to the a lotn -- there have been of advances in health. afghanistan had the worst maternal mortality rate in the world, and things to help for not just the united states, but other countries, working with afghan doctors and nurses, mothers are surviving childbirth. some of the things that are so basic, that are now so much better in afghanistan. i don't know the specifics of what i will be facing in january of 2017. but afghanistan is a country that has tried. and the people are really focused on getting beyond the violence in the extremism from the taliban. and i don't think we should just walk away. i will do what i can to

help. [applause] hillary clinton: here comes the microphone. >> my name is jeannie, i was born on belmont street right here in town. it is no longer the city i was raised in. a lot of that is because of drugs, and because of gun violence. my question to you, hillary, if i can call you that -- hillary clinton: or you can call e val. [laughter] [applause] >> or val. my question is, last week a reporter asked dr. ben carson one question. that question was, as president of the united states, what would you do in advance to assist the folks of a horrible events like hurricane joaquin. he kept a very short and distinct, and his three word

nswer was -- i don't know. along with that, as you said last week, a reporter asked jeb bush what he thought about the the tragedy in oregon, and he ept it even shorter. horrific se to that ragedy was, "stuff happens." i would like to know from you -- you explain to this audience and to the nation, why those would not have been your responses, and why, as president of the united states, you are ready to lead from day one. thank you. [applause]

hillary clinton: let's take the natural disaster question first. because hurricane joaquin was on everyone's mind. thankfully, it didn't hit as hard as they feared, although south carolina is getting battered with terrible torrential rain. i think one of the most important decisions any new president has is who is going to run fema, and who is going to be prepared to work with cities, states, and the national government to get prepared for incoming natural disasters, to get pre-positioned the equipments and the food and the experts that you are going to need to be able to help people. i will take that very seriously. looking for someone who has

real, hands-on experience, not from 30,000 feet flying over it, but who has been there, who is had to go in and figure out what to do to help people evacuate, what needed to be done to try to do as much as possible to help people save their homes, but not stay in their homes. there's just a lot of hard-won wisdom. because of climate change, we are seeing an increased number of weather events. all over the world, not just in our country. we need a mapping project. i will give you a perfect example of why i disagree so profoundly with the current republicans, we've heard the

letter from ronald reagan, i told you about president george h.w. bush. the current republicans in the congress are trying to cut dramatically the money the federal government puts in to weather forecasting. to me, that is so penny wise, pound foolish. we have got to have the best possible weather forecasting. not only for agriculture and you know, everyday occurrences, but also to get ahead of natural disasters and events like big storms. i will appoint good people, i will look across the government to figure out what we need to do better so that we have excellent communication with states and local governments, and that we keep people well-informed, so they can make good decisions for themselves. and that we move really quickly to come in after something's happened, because we can't stop the weather, we know that. but to be really ready to get in there to help the cleanup and the recovery. i think that people need to be empowered to help themselves to. i'm a little worried that sometimes the federal government has the message of don't do

anything until we get there. that's not my message. help each other, help fix the problem, help work, take pictures and report things because people are afraid to do that because then they say i want to get some help from the disaster assistance funding, i was going to say, does nothing to do with the weather. [laughter] but by the time i go to the college, what will the united states you like? mrs. clinton: that is a great question.

can i ask you how old you are right now? >> 10. mrs. clinton: so i have a little time but not a lot. >> [indiscernible] [laughter] [applause] doing to clean up. here's what we spent on why would an boarding, and the big vacuums to clean up the dirt. i'm very hands-on, very practical, very let's get it done. that's how i view that. [applause] hillary clinton: all my goodness. this young lady right there. >> thank you. i was going to say, it has nothing to do with the weather. [laughter] by the time i go to college, what would you like united states to be like? hillary clinton: that's a great question. can i ask you how old you are right now? >> 10 years old. hillary clinton: so i have a little time, but not a lot. [laughter] [applause] hillary clinton: first of all, i wanted to truly be the country we all love and cherish. and has given so much to everyone of us who is here in this room today. that still holds out that same promise to you, but if you work hard and you do your part, you

will be able to get ahead, and tay ahead, and pursue your reams. that's what i want for every young person in our country. that means we got to get the economy working better so it it produces more jobs with rising incomes, and i have a lot to say about that. but it's really critical, because i want you to feel like whatever you choose to do, you're going to be part of this great country of ours. i want the education system -- is that like it's working pretty well for you. i wanted to work for everybody. and particularly, starting with our youngest kids to get them off to a better start so that they can be successful in school. and i want college to be affordable for you, so we got to get the cost down. [applause] hillary clinton: i have outlined what i call the new college

compact to do just that. i just don't want to see young people with ambition, talents, a good work ethic, not be able start school or finish school because it's too expensive. and they can't afford it. we have got to deal with that, and we've got to get the cost down so that people don't go into debt. i know that this is a problem in new hampshire. we have to refinance the death of people have so they can be more free to pursue their own interests, and they can actually move out of their parents homes and maybe rent or buy one. and get on with their lives. with health care, i want us to have more and more people who have insurance, so they have quality, affordable health care. i want us to deal with the big substance abuse epidemic, so that we begin to turn the tide on heroin and pills, and other addictions that are ruining peoples lives. and going back to the gun discussion, we have got to have more treatment for mental health, we have to figure out how to help more people get the treatment, assuming it is available. hillary clinton: i want the world to be safer, i want the world that you will become an adult in the still be led by the united states, because there is no alternative. the united states, if we don't

lead, nobody leads. we have a vacuum. the vacuum is filled by a lot of bad actors, including terrorist groups who will take advantage of their neighbors and eventually even threaten us. and i want to protect our rights, our civil rights, human rights, gay rights, women's rights. i want to protect the rights of americans. we have a lot of work to do. i can't possibly, even as president, do all of that. it has to be done by everybody working together. everybody standing up for the kind of country that we want to live in, that we want to see for our children. i'm a grandmother, as maybe you know. i will just say this. i am the granddaughter of a actory worker.

my grandfather worked at the mills, and he did it to support his family and so his sons of have a better life. and they did. all three of his sons ended up going to college. my dad started a small business. it was really small, but it provided a good middle-class life for us. here i am, third-generation, asking all of you to elect a president. that is the american story. i will do whatever i can, as will my husband, to help our granddaughter have the best possible life. but you know what, that's not enough. it's not enough. and that's what i want people to understand. you shouldn't have to be the granddaughter of a former president or secretary of state to believe you can fulfill your dreams in our country. you should be able to be the granddaughter of a factory worker or the grandson of a truck driver and have that same opportunity. so every single day, i'm going to wake up in the white house and i'm going to say to myself, what am i going to do today to make sure every child in this country has a chance to live up

to his or her god-given potential. that is my mission as president. [applause] so many hands. right there. i will give you my microphone. >> good morning. thank you for taking my question. you are right. every day or every week we're hearing about children dying on the streets or in their schools at the hands of strangers with guns. we are also hearing about children dying in their homes by the hands of their caregivers. we are seeing child poverty continued to increase as children slept through the shredded safety net. and we're hearing from college

professors and employers that young people are coming to them not ready to learn or prepared for 20% three jobs. as president, what policies would you look to move forward in your first 100 days to protect our children, and prepare them for their future? hillary clinton: thank you. sadly, her question really points to what's been happening in our country, where over the last 10 years, because of the great recession, because of the huge loss of jobs and wealth that people had built up before 2007, 2008, poverty is on the increase. today, 51% of the children in our public schools are eligible for low or reduced cost or free lunches. we were on a good path, may i say, in the 1990's, we were on a good path to lift more people out of poverty vi lifting

families out of poverty you helped to lift children out of poverty. we are going to have to redouble our efforts, do all of that again. i give president obama enormous credit for taking us out of a deep ditch that he was in when the republicans left. here are a number of things we have to do. the top of the list is more jobs, raise them in wage so that people who work full time are not still living in poverty, and they can provide a better life for their children. more jobs in general, and there

are a lot of great projects, we ave a lot of roads and bridges and rail track and airports and ports and everything else in our country that is deteriorating, entities to be built up, maintain, so we are more competitive economically. that would put millions of people to work. nd i think we can combat climate change by more clean energy jobs, which would be millions of jobs and businesses, if we shifted the incentives that are still in the tax code and other parts of our

government for fossil fuels to wind and solar and advanced biofuels, we would be a head on the climate change front, and we would be putting people to work, and we are already seeing that in some parts of our country. we just need to do it all the way across. i think people who work for corporations should be able to share in the profits, not just the ceos, but everybody. up and down the line in those companies. very much like market basket, place you all know, because they now have profit-sharing for their employees. i think we need to do more to support small business, which creates 60% of the jobs in america. right now, we're behind in small business creation and growth. we used to be number one, we are now not even in the top 10. i want to do more and more credit, get rid of regulations and licensing in the barriers that stand in the way for people to start their business, like my dad did. and be able to provide a good middle-class life. and once we get the economy moving again, then we can turn our attention to how we can be good partners with families with children are at here are some of

my thoughts, and i have worked in this area for a very long time. first and foremost, we have to keep them safe. and free from violence by strangers or those within their own homes and families. we also need to help kids who may not have the opportunities that many of our kids, and my grandchild has to get ahead, that means you have to have early childhood education. hillary clinton: it's not just a nice thing to do, if you don't prepare kids in their first five years, when they get to school, they will be behind. there will be an achievement gap. and then it's really hard for the kid in the family of the school to close that gap. i happen to think talent is everywhere. but i don't think opportunity is. i don't know what we're losing because we have poor kids who are not given a chance to really get off to a good start, whose brains are not being stimulated the way that will help them get a vocabulary so that they can be successful in school. i think the early childhood peace of this is very important. health care is essential. i helped start the children's health insurance program back in the 90's to take care of 8 million kids. hillary clinton: and that's why i find states that don't want to expand medicaid to be really missing the boat. we need to have people healthy. how can we have a competitive economy if they can't get their

basic health needs met? that's particularly true for kids. my first job out of law school was with the children's defense fund. we would go into areas in the schools and kids couldn't see, we stopped having school nurses, we stopped testing their eyesight. i found out that i couldn't see in fourth-grade. because i didn't know i couldn't see very my mother would have taken me to find out, but i thought the world was a big impressionist painting. i just got up really close to the tv set. then we had and i examine school and i found out i really can't see. there are so many kids that are not getting those basic health needs met. that also holds them back. and then of course, once we are in school, i think we should start respecting teachers again who are actually in the classroom with the kids, and try to help them help the hildren. i literally could go on all day. i will just say one more thing. we now have a hunger problem again.

a lot of us thought that was behind us. we have both a hunger and a nutrition problem. we have maybe not the kind of hunger that turns people into what is obviously physical malnutrition. but we don't have adequate nutrition in a lot of neighborhoods and communities, and we don't have a lot of families who understand how to best feed their kids, because what they can afford is not necessarily good for their kids. but it's affordable. you know we need to do more work on this to get back to where there isn't that sense of either hunger or poor nutrition i can really affect a child's developed.

this is something i would do as president, but i would ask everybody to help me do, because there is work to be done in every community, including manchester. the gentleman in the blue shirt. >> hello. i guess i'm wondering what we're going to do about mental health in this country? this come up so much with substance abuse to various shootings -- just the general state of our lack of funding for all of the service providers out there. i think this all happened after we de-institutionalized mental health, and we had a promise to fund it, but we never did. how are you going to change that? hillary clinton: you are absolutely right. some of you remember that. back in the 1980's, we had a lot of debate over big institutions, where people were housed, but in many cases, they were warehoused. and the results of a lot of investigations which showed how people were not be adequately cared for was to shut down a lot of the institutions.

at the same time, those who were worried about what would happen to people if there were no place for them guaranteed, we would have funding and timing alternative for mental health. so we shut down the institutions, by and large, and we never really invested what we should in mental health alternatives. that's going to be something that i push very hard. as you mentioned gun violence, which is something that is often directly related to mental health problems. he addiction issue, a lot of people with mental health challenges are self-medicating with alcohol and drugs. so than they have a dual problem that has to be addressed. i think as we move forward with the a affordable care act, we have to enforce the decision that was made, that people with physical health and mental health can get treatment. the right now, a lot of

insurance companies, a lot of states, a lot of businesses are not providing the kind of support you need for mental health. when somebody is either convinced, or decides to seek mental health problems, they very often are told we have no place for you, come back in six weeks or three months, and who knows what will happen. you know where most people now who are presenting with mental health problems show up? they are in our jails in our prisons. it's understandable, because they are harm to themselves or to others. they often act out in a way that draws attention of law enforcement. and in most places in the country, there is nowhere else for them to go, so they are put in jail. and they may be held there for a long time. without any treatment, and in the end of in prison, they are still not getting adequate

treatments. the other point i want to say about this is, because we have over prescribed painkillers, the opioids we have a lot of people who have gotten very addicted to them. and that creates a mental strain on top of whatever other problems you might have. and so we now have a lot of people who have to try and withdraw. and we have about 23 million people who are addicted in america. so when they go for help, only one in 10 can get it. see you got this real double whammy, people with mental health problems are getting help, people with addiction and substance abuse problems are not getting help, and you got to figure out how we take resources and treat both people simultaneously, because too often, they become interconnected.

and then we have a real problem. i pledge to you, i'm going to do everything i can, more facilities, more trained people, more insurance coverage, more revenues. you can call on somebody, you know everybody. hillary clinton: that, and attention. he told me we only have time for more question. >> a man who lives next door to hear, his name is sanders, i think. he has an idea about sending kids to college for free, as he thinks they do in europe. it's not actually free, but you have a plan that would sort of make him back down a little bit on this? hillary clinton: i will speak for myself. he is clearly more than capable of speaking for himself. we're going to have a debate in about eight days, so we will have a chance to contrast. applause praws -- [applause] but if you are interested in this issue, and i think everybody is, how we get college more affordable, and how we refinance student debt -- go to

my website, hillary clinton.com. it's called the new college compact, but very briefly, i do have a different approach. first of all, my approach is been, thankfully, endorsed by a lot of people because i think what it does is it addresses many aspects of this problem. first, we've got to get the cost of college town. colleges and universities have o quit raising tuition and costs on students and families. if all we do is to say we are going to have free college, but we don't really put pressure on the colleges and universities to lower the cost, you're going to continue to see costs going up, and then the cost of the quote free college will go up. that to me is unsustainable. first and foremost, i want colleges and universities looking at, and administrators they need, how many buildings they need, connie different courses are no longer really relevant. let's take a hard look at what we're doing on campus. yet those costs down so we can

keep tuition down. secondly, i have said that the federal government -- i have a plan, $350 billion over 10 years. about $35 billion a year, where we would match for every dollar that the state would put in to making college more affordable for their students, we would match them for to one. they would have to agree on some of these changes the public colleges and universities to get the money. and then, if you choose a public college or university, i will make it possible for you to go without borrowing money for tuition, but i will expect something from you. like, for example, 10 hours of work week. i worked when i was in college, i worked when i was in law chool. hillary clinton: i want young people to know that this is an important value. and yes, you have to work for

it. but it will be for a public college or university, possible to not borrow money for tuition. for living expenses, i will make it possible for the pell grants to be used for living expenses. because what happens now is young people who get a pell grant, they often find it doesn't even cover tuition anymore. so we will deal with the tuition side on the public college and university. and then we will deal with the living expense side. if you do have to borrow money, it will be with a low interest rate. and i will forgive loans to people who do public service jobs after a period of time -- hillary clinton: so -- i have to tell you. i don't think college should be free for donald trump's children. i think people who are well off

should have to pay for college. i'm interested in the middle class, and working people, and poor kids who deserve to have a better shot at going to college and graduating. [applause] hillary clinton: i feel strongly that, when you already have to -- who has student debt still? oh, yeah. we have 40 million people in america was doing debt. what i want is to refinance all the student debt. because right now, if you have a home mortgage, or you're making car payments, you can refinance it. we for bid you from refinancing tudent debt. and at the event i did earlier in holland, a young woman way in he back who said her just rate -- hollis, a young woman way in

the bact who said her rate was - i want us to refinance it, i want to provide everybody the chance to pay back their loans as a percentage of their income. if you are a firefighter or school principal, or social worker, or a police officer -- whatever you are doing that you want to do, but you are not making a lot of money, you are not going to have to pay back at that high interest rate. you are going to be able to pay back at about 10% of your income. when i got out of law school i went to work for the children's defense fund, i didn't go to a big law firm, i went to work for a nonprofit because i wanted to work on behalf of kids. i was lucky enough that the university at that time offered me the chance to pay it back as a percentage. both bill and i had loans, and he was a law professor and i became a law professor. we were making $14,000, $17,000

a year. we were paying back our loans by what we can afford. i want this to be, as i say, a compact. where people do their part, obviously, young people how to do their part, families have to do what they can afford to do. colleges have to pitch in and get the costs down. and the federal government will partner with states. we've had this example of medicaid. if the state says no, we don't want to partner with the federal government, then i will write institutions like this one. i do want to me to colleges to -- i do want community colleges to be as inexpensive as possible, because it is an important step for a lot of oung people to take. thank you all very much. [applause]

and theousing market real estate industry. "washington journal" is life each morning on c-span. you can join the conversation by phone, and facebook and twitter.

general john campbell take questions about the recent bombing in afghanistan. he will be testifying about u.s. operations in afghanistan. we will have live coverage at 9:30 eastern on c-span3. later in the day, va officials testify about veteran legislation, which includes a veterans health care bill. also on c-span3. in u.s. commander afghanistan spoke to reporters about the american airstrike that destroyed a doctors without borders hospital and northeastern afghanistan. john campbell took questions about the incident that killed patients and aid workers, and injured dozens.

>> i offer my deepest condolences to the innocent civilians who were harmed and killed on saturday. i ago the secretary's comments work the doctors without borders does throughout the world. they have provided invaluable medical assistance to those throughout the world in afghanistan as well. konduz has been fighting to remove the insurgents. aty knowingly put civilians significant risk of harm. services are in the

air. they provide valuable support to the afghans. afghanistan is an area of active grounds. therefore, they retain the inherent self-defense. we've now learned that on advised3, afghan forces that they were taking fire from enemy positions. they asked for your support from u.s. forces. an air strike was called to eliminate the taliban threat and civilians were struck. the reports indicated that u.s. forces were threatened in the airstrike was called on their behalf. i orderedn reported, a thorough investigation into this tragic incident. it is ongoing. the afghans ordered the same.

we hold those responsible accountable and we will take steps to ensure mistakes are not repeated. we will await the outcome of the and thi investigation and share the results once it is complete. the united states military takes ordinary steps to avoid harm to civilians. the taliban chose a urbanized area, purposely placing civilians in harms way. necessarye to take steps to avoid future sibling casualties. i want to offer my deepest condolences to the civilians hurt on saturday. i offer my condolences to the crew and aircraft that crashed on friday, october 2. hade and all of those who fallen before them are the true heroes of our efforts in afghanistan for the past 14 years. i will take a few questions. >> general, your revelation that

it was the afghans that advised -- have yous ordered a suspension or change in the current rules of engagement? campbell: i will tell you our men and women continue to understand the rules of engagement. this was a case. again, more will come out with the investigation. opportunity to talk to the investigating officer, was up and konduz now. that is why i passed out this additional information. i want to be able to let the investigation go its course. assistnot suspended support to the afghans. fallback or of failsafe system is there in the process of afghans asking for american support?

thebell: i don't to cover rules of engagement in this form at this point in time. those will come out of the government investigation and make sure they are the same type of russians that everybody will want to ask. it will come out. this raises doubts. does this bring into question the current strategy to train the afghans. to they have the ability to take over that fight? does it train questions about the current timetable for the withdrawal of u.s. troops? campbell: i will take those questions from congress in washington. i have been very public that the afghan forces continue to get better and better. i am proud and honored to serve with them. three times in afghanistan. are now, compared to where they were, is very astounding. they continue to be resilient and continue to need our support in areas we identified years ago that be tough on the army. to work withnue

our afghan partners, continue to train and assist. i will be talking about that when i am in washington. >> just to clarify. there were no u.s. troops on the ground at risk at the time this strike was called in? is that what you are telling us? forcesl: the afghan called in for fire to support them because they were under direct fire. we have u.s. special forces that continue to train, advice, and assist at the tactical level. the impression people got after the first couple days is that they were firing directly on u.s. forces. as i have talked to the investigating officer, as we continue to get updated information, that was not the case. >> also, you don't want to talk about rules of engagement. i understand that. is there anything you can factually tell us about u.s. troops, u.s. aircrews, and the rules that they do operate under to not strike restricted

targets, such as possible mosques and schools. people have a lot of curiosity about this. it is generally understood that those are targets you do not strike. can you talk about that? broadly, we don't strike those kinds of targets. >> what kind of plane was it? gunship. ac30 >> did you authorize this airstrike? hose initials are on the authorization? does america have to authorize strike?0 to campbell: i will not get into those kind of details. we will wait for the investigation. they are demanding an independent investigation.

will this provide us enough information if it does the military channels? will it provide enough? u.s.ell: we have both investigations, a nato investigation, and the afghans are conducting an investigation. if there are others out there, we will coordinate those as well. >> what does this mean for the rules of engagement going forward in terms of air support in afghanistan? continue, going to for your purposes, as it was? i am going to hold that question until we get to the investigation. i don't want to get into rules of engagement. they provided you with coordinates for civilians in afghanistan. did you receive those

coordinates? campbell: that will come out in the investigation. ask.nted to to half an hour, they try get the coordinates and say, we are under fire from washington and kabul. why didn't that get at the in of command faster? ll: the questions you are asking are the same questions the commanding officer is asking. tags underre no u.s. fire at the technical level? campbell: the afghans as for air support from a special forces team on the ground. the initial statement that went out was that u.s. forces were under direct fire. i am correcting the statement here. this,t so i understand

how close were the forces to the afghan forces that were caught in the strike? were they with them at the time? l: all the questions you are asking are very good questions. they are questions the investigating officer will look at. i will have a preliminary report and the next couple days. the senior investigator is on the ground in konduz today. i spoke with him this morning. as they get additional suremation, i will make it's made available. our forces and the afghan forces work very hard to minimize the civilian casualties. i will not get into the different platforms. these are good questions.

they will come out in the investigation. we will make sure there is a u.s. piece of this, a nato piece of this, and the afghans as well will conduct an investigation. this and as we have additional information we can provide, i will make sure we do. thank you very much. onon c-span, a conversation the cost and availability of health insurance exchanges. presidential candidate hillary clinton talks about gun violence. on this morning's "washington journal" who will get an update on the transpacific trade deal. next monday on c-span's new in 1830,andmark cases" dred scott was enslaved.

scott married harriet robinson. the doctor died, he tried to buy his family's freedom. sued.fute ansed and he follow the case. we explore 12 supreme court rulings by revealing the lives and times of the people who were the plaintiffs, lawyers, and justices in these cases. they, live at nine upon p.m. eastern on c-span, c-span3, and c-span radio. order your copy of "landmark cases" companion book. you can order that at www.c-span.org. the third annual open and roman. -- the third annual open enrollment period begins november 1. oft, a look at the cost various plants available in

insurance marketplaces across the u.s.. the alliance for health reform posted this form. this forum. >> we are going to be talking today about what to expect. the challenges of signing up the remaining uninsured population and more. on behalf of our honorary cochairman, i would like to welcome you and to think the for being ourfund partners in this event. moderating with me today is

sarah collins to my right. she is vice president of the health care coverage and access program. the rest to introduce of the speakers to my far left. there is john gable, the senior fellow at an orc at the university of chicago. the actuary at the american academy of actuaries. and on the other side of sarah is carey.she is responsible of the implementation of the kentucky exchange. and then, mila kaufman who had a shorter commute. she is the executive director of the d.c. exchange. if you are watching us live we welcome you2 and encourage you to tweak your questions to us. we will try to get them to our speakers to answer today. you can use the #oe3. tweet with us

today. #0e3.shtag is i will turn it over to sarah collins. sarah: i will think the alliance and think the panelists for coming today, and to extend a warm up onto the audience. and looking ahead to the 2016 ann enrollment period, estimated 29 million people remain uninsured. millionmates that 10.5 uninsured people are eligible for coverage. in addition, about 9 million people currently have coverage through the marketplaces. most, if not all, will want to reenroll. to gain some insights into both what current and prospective enrollees will be thinking about, i am going to share some recent findings from the commonwealth fund affordable

care act tracking survey. i am going to focus in issue ofr on the affordability. i will highlight that about the cost faced by people currently enrolled in the plans. at howalso look affordability factored into people's decisions about health plans when they shop in the marketplace last year. our analysis of the survey data showed that premium costs for people with marketplace plans are comparable to those with employer plans, among the low and moderate income adults. fewer people in marketplace plans said it was easy to afford their premiums, compared to those in employer plans. differences were never among

those with low and moderate incomes with regard to deductibles, people and marketplace plans had higher deductibles on average, compared to those in employer plans. but again, differences were narrow among adults with low and moderate incomes. among marketplace and relays, mostum costs were the supportive factor in their choice of a plan. affordability was the top reason given by adults who shop in the marketplace but did not end up and rolling. -- enrolling. about 60% of adults with help pay $125 a month. people in rolled in employer pay thatort a play thathey much. most employers pay a part of the

employee premiums. the effect of the subsidies was most pronounced for people earning less than 250% of the poverty level. people with higher incomes in thantplace plans paid more people in employer plans. this is because the amount of the premium subsidy and marketplace plans phases out at higher incomes, which means people pay increasing amounts of the premium as income rises. overall, adults with marketplace plans consider their health insurance to be less affordable than people who have employer coverage. the differences in perceptions and affordability between adults and marketplace and employer plans are wider than higher income adults and they were in lower income adults. people in marketplace plans reported higher deductibles and those in reporter -- and employee plans. -- of adults

differences and deductibles between those in marketplace plans and employer plans were whiter among higher income adults than they were among lower income adults. this is likely because people with incomes under 250% of poverty that enroll in silver level plans in the marketplaces are eligible for subsidies that lower their deductible co-pays and out-of-pocket limits. in the most recent open enrollment. premiuma moment period, costs on average mattered more to people than whether their doctor was in the plan network. consistent with this finding, we found that more than half of the marketplace and relays that have the option chosen plan with a limited or narrow network of providers, in exchange for a lower premium. people who visited the

marketplaces but did not enroll in a plan, affordability was the key factor in their decision to walk away. they could not find a plan they could afford. looking at little more closely at this group of adults who told us they did not end well because they could not afford a plan, and also excluding people who gain coverage elsewhere, 26% were living in a state that has expanded medicaid. they were not eligible for the premium subsidies. more than half of those who cannot find an affordable plan had incomes in the range that made them eligible for the subsidies. people push off in the marketplaces, but did not enroll, had greater difficulties, comparing features of health plans, compared to people who did and wrong. 50% said it was difficult to compare the premiums from different plans. 60% of those who did not enroll said it was difficult to compare

plans by what their potential out-of-pocket cost might be. receiving personal assistance appears to make a difference in whether people enroll. for demographic differences, we found 70% of adults said they received some kind of assistance ended up enrolling in a marketplace plan or medicaid. only 56% of those who did not receive assistance in rolled. enrolled. the affordable care act subsidies have been effective in making premiums for marketplace plans to milan to those in employer plans. people in marketplace plans have high deductibles. cost was the most important factor when people were considering plans. it is the primary reason why many adults did not enroll. this suggests that many who shop for insurance may not have the information they needed to help them buy coverage. many had difficulty comparing basic features of plans.

personal assistance does appear to help people enroll. the lack of medicaid expansion in 20 states is clearly an insurmountable barrier for the poorest residents. i will stop there and look forward to your questions. if you were in the room with us, you have the results of these tracking surveys that sarah is discussing. they are in your folder on the left side. if you are not on the room with us, you can still access the materials on her website www .allhealth.org. i will turn it over now to john. those ofint out for you standing, their seats on the other side of the room. john: thank you, maryland. i would also like to think sarah .

i would like to think sarah and the commonwealth fund for making this possible. howard like to thank ed for his many years of service. bringing the work of the research community to the policy community. let's go back. this is a history of employer-based health insurance since 1988. i show it to provide context for the historic record. now, you may be asking right now, why are you showing employer-based insurance? why not individual insurance? the answer is simple. ofause we are incapable

showing that record for individual insurance. i want to emphasize three points. one, there is a history of volatility. take 1989. premiums increased 18% that here. secondly, premiums almost always outpace increases in workers' wages and the overall consumer price index. resultslet's turn to for exchanges. this is early information. fairly early -- very early information. it is limited to five northeastern states. most are very small states. it is also why these five states. these are the states that posted all the information so far on their websites.

, thef that information cost sharing information, in addition to premiums. currently, in these five states, we note that the average increase is 4.9%. the median is 2.1%. add thatuld also mckenzie says the number of carriers coming into the marketplace in this current year will be up. it looks like it is up at least 10% for last year. that might have a dampening effect on premium increases. if we look at the benchmark plan, and the benchmark plan is so important because it is the basis for what the federal government will pay, and also, the basis for what enrollees will pay.

we see an average increase of 6.7%. the median is 5.8% kaiser family foundation recently posted an increase in benchmark plans for 14 states. their numbers are lower. average is 4.4% for the benchmark plans. happening to cost sharing? we know in your employer based health insurance, deductibles today are about seven times as great as they were in the early 2000's. in deductibles has held down premium increases. on these exchanges we do not see much change. we do see on average, a drop of about 5.9%. the median is 3.3%.

important point of cost sharing is the out-of-pocket max. here, we see the max increase 5.8%, that it is almost entirely due to maryland. the median increase is 2.3%. me summarize what these early returns are. how typical are these five states with the rest of the nation? it is difficult to say. but we do know is that are great differences from state to state. last year, 10 states had double-digit increases and according to our data, the overall increase was 0%. daresay,is what i based on early returns. average premium increases will be higher than last year.

benchmark plans show greater increases than the average increase for silver plans. up, but it isoing catastrophe, as a some have reported. but instead, what we see is withhing more in line employer based health insurance. the historic average is around 7%. where we have been at 4% for about the last four years. sharing remains stable. thelyn: let's move over to american actuary. corey: that he the alliance and commonwealth fund for allowing me to dissipate. jon provided an overview. now, i will give you some information on the drivers of

t may underline these trends. a quick reminder of the claims of premiums. claims reflects not only who has coverage, but also, that their medical spending is. other premium components include administrative cost and profit. and of course, laws and regulations can affect each of these components. i want to get into this slide in detail. the wanted to highlight some of the elements in the premium development process. one thing insurers have to do is to determine their plan designs and perform actuarial testing to make sure their plans fall into irs.of those mental tears theirill project

information forward to 2016. insurers also have to negotiate with providers to get the provider payment rates. to about three major drivers of 2016 premium changes. the first of these is medical trend. that is the underlying growth and health care spending. medical spending has been relatively slow recently, compared to historical trends. prescription drug spending has been increasing fairly rapidly due to the introduction of specialty drugs. on average, 2016 premiums reflect a medical trend of about 6%-8% and a prescription drug trend of about 10%-12%. the second major driver of premium changes for 2016 is the scheduled reduction in the reinsurance program. the reinsurance program

subsidizes plans for their high cost enrollees. it does so by offsetting some of those high-cost claims. by offsetting claims, the written sherman -- the reinsurance lowers premium. the reduction means there will be a lower offset of claims. the lower offset will in turn produce some upward pressure on premiums. the reduction in the insurance program could increase premiums. here is more detail on the reinsurance program parameters and how they are changing over time. it ofird major driver premium changes is how the expectations regarding 2016 risk will profile differ from those that underlie 2015 premiums. as a reminder, when insurers put together their 2014 premiums,

they did not have a lot of information to go on, in terms of who would enroll in coverage, and what their help spending would be. plan here,r that insurance had a little more information to go on. had the first few months of the moment in 2014. in 2016, insurers have a lot more information on their own experience. in terms of who enrolled in coverage, and what they are sp ending. they also have a few months worth of data from 2015. and if they have more information, they are able to take their assumptions regarding 2016 accordingly. these changes and assumptions can either lead to higher or lower premiums. i noted earlier the need to adjust prior experience data when projecting that forward to

2016. in 2014, and release who are more likely to enroll early in january for coverage are those who would be more likely to have high health care needs and high health care spending. where's those who are healthy may have been more likely to delay coverage to later on in the open enrollment period. that is one thing that needs to be adjusted for. another adjustment might need to be made to reflect pent up demand. inple who are newly insured 2014, those who were uninsured in2013 been in coverage 2014, might experience a temporary spike in their spending based on pent up demand. until theyf services got coverage. some of that will be temporary. it is not expected to be at that high level permanently. not accounting for these two andgs, enrollment timing

the kind of demand, if those are not accounted for, this could result in an overestimate of 2016 claims. insurance might also need to their risk profile expectations if they think that the increase in the individual mandate penalty will be more people to obtain coverage, especially among the healthy people. who have in people lower health care needs could put more downward pressure on premiums. slides showed how premium changes can very across states. is of the reasons for this the transition policy. this allowed individuals to hold onto their non aca compliant coverage. this is referred to as "grandm

othered" plans. many, but not all states, adopted a policy. did have theo transition policy, people kept their old plants might have been those who were more healthy because they might have gotten lower premiums and did not care about pre-existing condition exclusions. they kept their old coverage. people who had high health care needs and a lot of pre-existing conditions, and maybe previously have been rated higher because of some health conditions, they would be more likely to switch into the new aca compliant coverage. might seeition rule opposedncreases as to states who did not. i just want to point out that we hear a lot of information that is coming out the past couple weeks regarding premium changes. i want to caution you that this is really just looking at averages, either in the state as

a whole, or for particular insurers. what a particular consumer faces in terms of his or her own premium changes likely going to differ from the average. the premium change that a consumer faces will reflect that consumer's particular plan. consumers can also have changes in their premium subsidy eligibility. they may have other changes as well. those are things to keep in mind when comparing the consumers individual premium change as opposed to the change in the market as a whole. thank you. marilyn: thank you, cori. we will turnout to carey. carey: thank you for inviting me here today to talk about the kentucky health care exchange.

exchange,-based kentucky was able to develop an integrated eligibility system with online real-time determination of eligibility for medicaid and qualified health plans. this is why we were able to enroll over half a million people into coverage for the first time. decrease ratein a of the uninsured from 14.3% to 8% based on some recent u.s. census data. this was the largest decrease in the nation. a gallop pole for individuals under the age of 65, we decrease the rate of the insured to 29%. that was the second largest decrease in the nation. prior to the affordable care act, kentucky basically had t

wo insurance companies in the individual market. when we launched connect in 2013, we have three insurers that offer products on our exchange. due to our success and 2015, we insurers andional were very excited to say, 420 16, we will have eight insurance companies offering products. for 2016, we will have eight insurance companies offering products. without the affordable care act, kentucky citizens would not have these additional choices. i wanted to note that outside of the exchange in our regular commercial market, there threeout two or additional insurers that will offer products. in kentucky, we plan to have a

passive renewal process. individuals can remain enrolled in their current health plan and they don't have to do anything at all. ,ctober 1 we issued a notice advising the individual that open moment was coming up. that we were going to have more insurers and for health plans on the exchange. tound october 21, we planned mail out our open and roman packets. the individual's premium amount for 2016, if they keep their coverage, as well as their aptc amount. we are encouraging everyone to check out their options because of the new insurers and new plans available. as part of the passive renewal process, we will be accessing the federal data service hub to

verify income. if we are unable to verify income, we will issue an rfi, requesting documentati of income. it is a new feature of our system that we implemented in 2015. if they don't provide proof of income within the 90 day. we will0 day period, utilize what is on file with the irs. -- for 2016, we will assist the consumer in assessing the best health care options that meet their needs. during open enrollment 2 we identify thousands of individuals who had purchased a gold or platinum plan. they were actually eligible for cost reductions if they had selected a silver plan. as a result, we sent out a letter to these individuals in

december, notifying them of the availability of cost sharing reductions if they had selected a silver plan. it's that time, we have developed system functionality, as well as our regular shopping where the silver plans will be -- displayedst first if you are eligible for cost sharing reductions. we have special messaging strongly encouraging individuals to select the silver plan on the screen if they are eligible. in personuest of the as sisters, we will be launching in thet application individual market, as well as for medicaid enrollees. the tablet application allows the user to enroll from start to finish. intuitiveilizes an and conversational process. many kentuckians are overwhelmed

with the number of qualified health care options to choose from. they often times do not select the plan that best meets their needs. we have seen individuals by a whoinum and a gold plan hardly ever go to the doctor and we have seen people purchase a bronze plan who are heavy utilizer's. as a result, for open enrollment a cost shopping tool to assist individuals in selecting a plan that best meets their needs. with this new cost shopping tool, individuals will enter their medical condition. they will also be asked to write their health status, from poor, to average, too good. they will also include any health care providers they are saying, their physicians, maybe

the hospital they go to. the frequency of the physician visits will be collected as well. ofy will also enter any type prescription drug medication that they are taking. , if there is am future medical need, such as a hip replacement, they will enter that information on the system as well. based on all the information that is entered, the system will display the best value option for the applicant. a connect retail store at the mall in lexington, kentucky. it was highly successful. we had over 7000 visitors. applicationst 6000 local agents, in person assisters, and state staff helped with the store.

we will have a second store with this open enrollment in louisville, kentucky. enrollment 2016, we will be conducting statewide education and advertising through television, radio, cable, old boards, and media, social media. target certain populations with tailored messages. there are 18ties, that probably have a higher uninsured rate than we would like. we are working with the university of kentucky rural extension office, hosting enrollment events with local agents and in person assisters. we are also running newspaper and radio advertising in those counties. we have targeted 32 counties in kentucky with low dental health. we will be distributing 10,000

toothbrushes to health care clinics and schools. we will increase our efforts and marketing dental plans that are offered in connect in those counties to increase advertising. andviduals on transitional grandfather plants who could obtain their coverage through connect and receive a discount are targeted as well. we sent out mailers to households. we are running commercials and ads, advising of discounts through connect. that is the only place you can receive a subsidy on the exchange. we have an early renewable fact sheet available, instructing people how they can enroll through special enrollment. we are targeting the justice population. we are working with the statewide healthy coalition, comprised with collection

personnel, federal, state, and county. connectors are on the project as well. we've actually produced a 2-3 minute video by former inmate, educating individuals about the importance of health insurance coverage once you are released from prison and on how you can actually obtain that coverage by enrolling through connect. we have allocated resources to the prisons and the jails for education and enrollment. it is important for the justice population to continue a course onceeatment or medications they are released. these efforts will help ensure that they enroll in coverage as soon as possible and continue treatment. mila could not have time to any better. marilyn: we're going to turn the at theone over to mila

d.c. exchange. if you are following us on #oe3.r, the hastag is after mila finishes, we will turn to q&a. withan ask your questions the microphone set up in the room. or, there is a green card in the packet, on which you can write down questions. the staff will be circulating throughout the room and we will pick them up. if you are not in the room with us and are following on c-span two you can tweak your question at #oe3. mila? mila: thank you so much. thank you to dr. collins and the commonwealth fund for continuing to do research and invest your's

our research dollars to the approach on the ground. i would also like to think that howard for his many years of leadership. he, i'm sure, mentored many people in this room. his leadership and his contributions we will mess. maybe he will reconsider retirement. the affordable care working in the district of columbia, just like it is working in kentucky and most states. census, our the uninsured rates dropped. in the district of columbia, as we had a veryow, low uninsured rate for many years. through the years we have invested a lot in coverage expansion. and expansion to medical care efforts.

team was very proud when the census report came out. it really did matter that we were on the ground finding a hard to reach population. wille not done yet and we not stop until every single person, child, individual who lives in the district or works in the district has access to affordable, quality health coverage. since october 1, 2013 when we opened for business, over 166,000 people have come through us. on the individual marketplace side, over 24,000 people have come to us. over 120,000 people were found eligible for medicaid with us. we have no wrong for policy. you complete one application online and instantly you will get your medicaid eligibility or eligibility for aptc.

we havell group side, had over 21,000 people come through us. that includes members of congress and designated staff. hill that from the are my customers, thank you very much for being my customer. side, we haveual a very healthy risk makes. you often hear if you only in short older people with a lot of claims and premiums -- claims, premiums will be very high. we made it a fact that we in short people who are older, innger, and everywhere between. our biggest in short h poole is olds.year we have a diverse population,

choosing diverse levels of coverage. bronze is 29%, as you can see. gold is 23%. and 18% of enrollees are in platinum plans. that is on the private and individual side. that does not include congress. the most possible -- the most popular level of coverage is platinum. 32% are in gold. employee choice. that means a small business can choose a choice of carriers and a choice of products for his or her employees. in fact, about two thirds of our small businesses offer choice to their employees. out of the 840 employers we looked at, two thirds offer a choice of carriers by choosing

metal level and allowing the enjoyed -- allowing the employees choose which carrier end.want to be enrolled or offering products of the same carrier. and that means employees can choose all levels from that carrier, from bronze to platinum. our role is to advocate for all of our customers and we advocate for the lowest possible premium rates. with outside actuaries who review rate filings and provide extra analysis to the insurance regulators. they argue for the lowest possible premium rates through d.c. health link. we also advocate for our customers by empowering our customers to have access to all commercially available products from all carriers doing business in the district of columbia. as we go into this open enrollment period, we are

deploying many new tools for our customers that we did not have before. we are ableled that to launch in all plan dr. directory. the english version is up on the website. the spanish version is available in data on our website. datae has been a lot of switch. when a customer makes a decision about a health pbahealth pba, and later find out the physician is no longer participating, it may be too late to switch plans. open enrollment is done. directory isdoctor designed to help the customers have access to better information. a couple weeks ago we launched plan match.k health

that is powered by the washington consumer checkbook. it is very similar t what carrie described for kentucky. our customer or potential customer can go on dchealthl and pu tin th -- put in their information and the tool will give you all health plans ranked in order. it will give you your total anticipated cost. it will give you that for an average year, as well as a bad year. we believe that kind of consumer empowerment tool