disfigure conservatism or do not portray what our views and principles are, i as a party leader and others, i assume, as well, have an obligation to defend our principles from being distorted and we'll continue doing that. look, i am who i am. i'm a i believe in specific policies and i'm going to speak out on those each and every time. here's what i can control and here's what i can do. i as speaker of the house am going to lead an effort for all of the members of the house republican caucus to offer an agenda to the country so that we can take an agenda to the men and women of america to show them how we get america back on track. more than 2/3 of the people in this country think america is headed in the wrong direction. that's not just as republicans. we as another party have a moral obligation and a duty to offer a very bold and specific alternative course so that if we win this election then we

have an obligation and a mandate given to us by the citizens of this country to go on course, to put those reforms in place, to get the country back on track. that's something i can control. that's something i can be involved in. that's something i can help deliver. that's what i'm focused on. thank you very much. >> who's your final four pick? [captions copyright national cable satellite corp. 2016] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] >> house minority nancy pelosi held her briefing at the capitol. she discussed several issues including the 2017 budget, the zika virus and the flint, michigan, water contamination water issue. this is about 20 minutes. ms. pelosi: i see some wearing green here. good morning. what a week, huh? yesterday, president obama presented his nomination for the next justice of the supreme court, judge merrick garland. he's a widely respected jurist who embodies wisdom, judgment and a dedication to justice for

all americans. as the chief justice for the d.c. circuit court of appeals, judge garland has the experience and the legal accumen to serve on the highest court of the land. he has a power command for the law, a deep respect of the impact of the lives of hardworking american people. what we're seeing here and hope this is temporary is a disrespect for the constitution by the senate republicans. the american people expect judge garland, the president's nominee, to be given a fair hearing and a timely vote in the senate. the senate should do their job. i remind six justices had been confirmed in the presidential year. three of them, one kennedy, one cardoza, one bran dies. today, however, speaking of the court, the house republicans are continuing to push their radical anti-immigrant agenda before the supreme court. house republicans have brought forward a resolution

authorizing the speaker to file n anti-immigrant amicus brief. but they won't tell the house or the american people what they're planning to say in it. republicans call for tearing apart families and deporting dreamers? will they yet again suggest a religious test for perspective immigrants? will they ask the court to explore ending birthright american citizenship? sadly, there's not much difference between donald trump and house republicans when it comes to a record of appalling anti-immigrant statements. an agenda of discrimination. furthermore, republicans have denied democrats the opportunity to have a meaningful vote on our alternative amicus brief in support of the president's immigration executive action which we filed with the court last week, 225 house and senate democrats. very proud of that. it's ironic they're filing -- they're having this vote on st. patrick's day. last night we had a

celebration. irish american heritage, while i do not have irish grandparents, i do have irish grandchildren. one of them was there at the dinner and we talked about immigration. the tee shack talked about immigration when he was here at the speaker's lunch. and what it's about is all the irish who is here. 50,000 who are here who couldn't even go home for a family funeral because the law would not allow them to come back into the country. they are not here shall we say, fully documented and we need to change the law. comprehensive immigration eform. so here we are filing an amicus brief that is not only this. we don't know what the amicus brief is. it's maybe yet to be written but also how it's paid for. i think they said hopefully it ill be pro bono.

and the republicans -- road to ruin, it continues down the path that speaker ryan has taken us in his previous ryan budgets. it devastates good-paying jobs, lacking investment in education, the future of infrastructure in america, bandoning seniors diending medicare and $1.6 billion in cuts. and yet it's not brutal enough for their tea party element. it's a freeze and cut. oh, no. it's a cut and freeze. cut the domestic agenda and then freeze it for 10 years. it's tough to find -- stomp growth in this country. the republican conference is clear. to take us back to radical

tricking down economics that shattered our economy and hallowed out the wages of america's working families. democrats stand for a budget that is a statement of our values, that creates jobs, raises the paychecks of hardworking families, invest in the future of our country while reducing the deficit in a balanced and responsible way. i don't think we should leave ere until we have some action. we were saying no budget, no paycheck. and they made big fanfare about that and we say at least we shouldn't adjourn until we do and until we have a statement of supplemental that will support our initiative on zika, on flint and on opioids. this -- i don't know how they know every day of delay -- trying to control zika, nvestments in research and the

rest, what that means in terms of public health what that means to women of childbearing age that a bite of a mosquito can completely destroy the brain of your child. rest, what that means in in any case, we have work to do. we shouldn't leave until we do it. i hope the speaker will bring a supplemental before we leave. the senate would still have to act upon it but at least we would be that far down the road. with that i will be pleased to take any questions. yes, sir. reporter: has speaker ryan set a formal deadline on completing puerto rico by the end of this month. it looks like it's not going to happen. i understand the democrats are in bipartisan talks. can you give us a progress report on where these talks stand and when there might be a product that the house will act on? ms. pelosi: the question is, will we have a law of the land by march 31? well, at this point we will t, but we should have a bill

i think n and again, the republicans are acting in good faith on this. i'm in communication with them. it is the bill that they will write. hopefully the advice and consent that we are giving and hopefully consent we can give them is predicated on information that we have as to how urgent this is, how timely it is for us to do something. it would be my hope we would see something before we leave here that would be marked up as soon as we come back and taken to the floor immediately and sent to the senate. reporter: is chapter 9 -- extending chapter 9 to the territory off the tables? ms. pelosi: actually, you have to talk to the republicans about that. i have some idea where it's going but i don't want to -- we it sort of a until we see

we don't know what it is. reporter: madam leader, the president went to cuba this weekend. obviously, human rights has been an issue important to you. what would you like to see him say and do on that score during this historic visit? ms. pelosi: well, it's a historic visit to begin with. and a visit that takes place in the last year of his presidency with an important focus on the relationship between our two countries. it's no secret that the regime is headed by people who are, hall we say, very late in life in terms of their service and leadership of that country. so whirle other presidents have focused on regime change in cuba, our focus will be on improving relationship between our two countries and, again, the president's focus on

honoring the values of our country in terms of human rights and the ability people to speak out without having to go to prison. we'll see what form it takes there. i was there last year. i led a delegation following the president's announcement and the excitement in cuba over the prospect of a better relationship with the united states was palpable. it was just so exciting to be there at that tifmente the -- we met with leaders of the lgbt community, people in the arts community, people in the faith-based community and the rest and people are optimistic that some good news may be on the horizon. again, i don't speak to the president in words he will use there. you will see that but i think the emphasis on human rights is something you can't deny. as you know, i've been to china on this subject. again, there are overarching

issues that are important and the relationship but we lose all credibility to talk about human rights anywhere if we don't talk about them in situations like this. reporter: and is this visit enough to influence that human rights issue? certainly there are some on the right here who think he shouldn't go because of the human rights issues? ms. pelosi: yeah. there are people here who never want to lift the embargo. in other words, it is -- the times are changing and even other generations, the people who have said that have been in my office saying we have to find another way. nd so we'll see as this term of administration of cuba leadership talks about transition that the transition will be one where human rights are respected. if the government of cuba wants to be visited, they have to respect the rights of their people. yes, sir. reporter: on monday, energy and commerce had a roundtable on head injuries and for the first

time an official conceded the link between the sport and brain injuries. wondering if you could see a congressional role there and if so, what is it? does congress have power to influence this? ms. pelosi: it's very interesting. congresswoman jan schakowsky, who has been a leader in so many initiatives in the congress, whether it's a woman's right to choose, fairness in our economy, she co-chairs the senior -- the list goes on and on of her accomplishments but talk about sports, front page of "the new york times." it's amazing you enter the popular culture and so people are watching. it's not just about sports. it's about our children and their participation in sports. or in my case, grandchildren and their participation in sports. it was quite remarkable that the representative -- high representative of the nfl made

that admission and that connection. so we'll see as we go forward. i think it depends on a number of things. the action nfl will take, congress will always maintain an interest, as we did in -- shall we say -- other aspects, whether it was baseball and any assistance they made had in the performance drug -- performance-enhancing dugs but certainly we will have a role but it depends on what they do. it depends on technology in terms of what these new helmets can protect. and it depends on also just the idea that you shouldn't be butting heads. you shouldn't be butting heads. maybe it changes the nature of what is a foul on the field. reporter: do you think the congressional role is just funding, is it research, is it c.d.c. or do you see it as osha governs the workplace? ms. pelosi: again, you evaluate what the problem is.

and the initiatives taken to orrect it. i think a sport especially played by many children and families across america, they will want to have congress put a bright light on this. and it will be interesting to see where we go from here. that committee has been very courageous, whether it's henry waxman in terms of baseball, whether it's henry waxman in terms of tobacco. now this, again, having an impact on children in our country as well as the athletes. reporter: on appropriations and budget, specifically, two-part question here. what do you think the house needs to complete on budget or supplementals to support a recess? and have democrats reached any conclusion on whether they support -- to pass 1070 if the

g.o.p. can agree on a budget? ms. pelosi: let's see. in other words, we have to make a judgment about what we would upport when we see what it is. it is my understanding that senator -- leader mitchell, mitch mcconnell will proceed with the budget process or not. that's probably what will happen in the house as well. in terms of what has happened in the past, in terms of deeming we'll see the context of what it is. it is my understanding and, again, we talk about deeming -- assuming there isn't a republican budget, we don't know that. it came out of committee. couple members -- republican for it.did not vote none of the democrats did. it's even been mentioned that one other budget committee members would only vote to get it out of committee but not on

the floor. so we'll see what that is. but a budget is in many countries, if you can't pass a budget, this is a vote of confidence. i think it's really important for all of their chatter about how important the budget is the pride that the speaker takes in the ryan budget that it does not even as bad as it is -- it is a road to ruin, as i said. it's not brutal enough for the tea party members of his own caucus. so we'll see. we will proceed one way or another to do the appropriations. reporter: and what specifically do you want to have done before we break for recess? ms. pelosi: we need a supplemental. we need a supplemental. we'd like to see some action on the budget but in the absence of that we need a supplemental. we need a supplemental to deal with zika, with opioids. i hope would also include flint, michigan. these are emergencies. energies. and in some cases the president said he wants to pay for. in flint, ok, we have a

pay-for. zika, that is an emergency that needs to be treated as an emergency. it would be really important for us -- what do we say to the women of america that so much s at risk by being bitten by this insect when we went home without doing something. and we're losing time. we're losing time right now. we have to act. we'd like to see at least on those three fronts a supplemental. there are things that don't rise to the same level of emergency but are timely and perhaps would be included in that. one last question because we have to give up the room in a minute. thank you. yes. reporter: what do you think of emily's -- spending millions of dollars against chris van hollen, i know who you're close

to, in the maryland senate race? ms. pelosi: i'm close to donna edwards and chris van hollen. i boo highway the fact they are -- i boo-hoo the fact they're leaving the house of representatives. they're both wonderful members. we'll see how it turns out. it won't be look. what is it, april -- reporter: april 26. his campaign basically says it's a waste of money because they're so -- he's pro-choice. she's pro-choice. ms. pelosi: from a policy standpoint it won't make a difference. more women in the senate, that's their goal, i would hope that it's not at the cost of more women in the house when it's between a democrat and a republican who will vote pro-choice, pro-gun safety, they are some of the -- are a very astute organization. we are blessed with many members of congress because of the work of emily smith.

people of maryland have a great choice to make. and so i wish them well in that. but i wish that they weren't leaving the house. that's my overriding thought on the subject. thank you, all, very much. happy st. patrick's day. help out last night. didn't score in the first four minutes and then, boom, right back with the golden state warriors. reporter: here's the most important game. are they going to surpass the bulls' record? best overall season? ms. pelosi: do you think steve has a conflict of interest? reporter: you as a fan of the golden state warriors, do you think they'll bet the bulls' record from the 1990's? ms. pelosi: i certainly hope so. it's interesting that steve kerr is -- when we went to the white house. when we went to the white house for the championship, golden state warriors from last year, steve kerr got up there and, of course, the president is a upporter -- a fan of the

bulls. they had their little wanter back and forth. when the -- when he interviewed steve kerr. when steve kerr got to the microphone and said i understand at the end of the year you will be an independent agent. the president showed some of his moves. i don't know what will come of that. in any event, we're going all the way. we're going all the way. isn't it remarkable? isn't it remark dble reporter: do you think the spurs will -- they played a pretty good game, spurs and golden state? peleds pelosi -- ms. pelosi: i think since we got so high up. going to 45,46. and -- they were like 40 could be we win and they would surpass it but now we're so far out. reporter: any loyalty if maryland plays california in the second round? ms. pelosi: i love both the teams. i root for the terps.

i root for california. i revisit when i was rooting for the 49ers to win their division and this and rooting for baltimore, the ravens, to win and they ended up together at the super bowl, oh, my gosh. i didn't mean all in one year. anyway, thank you, all. happy st. patrick's day. >> coming up today, live at 5:00 eastern here on c-span, white house national security advisor susan rice, she'll deliver her remarks on foreign policy in the western hemisphere. she'll focus in on president obama's upcoming visits to cuba and argentina. it's hosted by the atlantic council. you'll be able to watch it live here, again, on c-span starting at 5:00 p.m. eastern. earlier today, the house oversight and government reform committee held its third hearing on the contaminated water situation in flint, michigan. e.p.a. administrator gina mccarthy and governor rick snyder testified before that committee and they were called on to resign by several

committee members. we'll show you all of today's hearing tonight starting at 8:00 eastern here on c-span. >> this weekend the c-span's cities tour hosted by our charter communications cable partner takes you to montgomery, alabama. on "book tv" -- >> we show you a house that was the turning point for scott and zelda. when they moved here, the idea was to regroup. what this house was was a landing pad. it was a regrouping, as i've said, stage, and it wasn't the sort of place where you're going to find scott and zelda engaging in domestic activities, if you will. it was the sort of place where they were going to be planning their next move. >> and on "american history tv" -- >> so what happens in the 1958 campaign is, you know, wallace really does try to reach this

racial moderate and really tries to campaign for the poor and working class alabamians, campaign for progressive improvements and gets the support of the naacp in this initial campaign. but unfortunately he loses by a pretty significant margin to john patterson and he completely is devastated by this loss. wallace, you know, all he wants to be is governor and he really is upset by this loss and he considers it a failing. and so when people ask him what the takeaway from the 1958 campaign is, he says, you know, i tried to talk about progressive improvements. i tried to talk about good roads and good schools, and no one would listen. but when i started talking about segregation, everybody stopped and started listening to me. >> watch the c-span cities tour saturday at noon eastern on c-span's 2 "book tv" and sunday afternoon at 2:00 on "american history tv" on c-span3.

the c-span cities tour, working with our cable affiliates and visiting cities across the country. >> officials with the health and human services departments inspector general's office and the government accountability office outlines some recommendations on how to improve the ongoing implementation of the nation's health care law today. they testified before the senate finance committee. senator orrin hatch is the committee chair. senator ron wyden is ranking member. senator hatch: the committee will come to order. it's been a little bit disruptive this morning. we have a lot on our plate. it's a pleasure to welcome everybody here this morning. today, we'll be talking with representatives from the office of inspector general for the department of health and human services and from the

government accountability office. i thought their ongoing oversight work with their healthcare.gov and enrollment in the federal health insurance marketplace. now, i want to thank both entities for their hard work on these issues and acknowledge the contributions both as they help this committee perform more accurate and timely oversite. now, it is no -- oversight. now, it is no secret that i have been a fan of the so-called affordable care act, and as we approach the sixth anniversary of this law and look closely into how it's working and being implemented, the evidence overwhelmingly shows that i and the many others who opposed the law from the beginning have been right all along. the facts speak for themselves. when obamacare was signed into law, h.h.s., o.i.g. and g.a.o. have cumulatively released at least six dozen reports dealing various operation and implementation issues demonstrating the numerous

areas where the law is falling short. these reports are specific and focused on key operational failures like enrollment controls or system issues, some of which we'll hear more about today. let's keep in mind that g.a.o. and h.h.s., o.i.g. are not partisan entities. they are independent watchdogs tasked with the responsibility of objectively and dispassionately assessing what is and what is not working in various federal programs, including those created or amended by the affordable care act. and there is no better record showing how this has happened than the reports we received from these offices. today we're going to specifically discuss operation issues related to healthcare.gov and enrollment problems at the federal eninsurance marketplace otherwise known as the federal exchange. let's start with healthcare.gov launch.

with the problems of shortcuts and deployment of healthcare.gov and its supporting systems, customers, really consumers, encountered widespread performance issues when trying to create accounts and enroll in health plans. after numerous inquiries and reports, we know what caused these performance issues. for example, there was inadequate capacity planning. the centers for medicare and medicaid services, c.m.s., cut corners and did not plan for adequate capacity to maintain healthcare.gov and its supporting systems. there were also problems with the software that were entirely avoidable. c.m.s. and its contractors identified errors in the software coding for the website but did not adequately correct them prior to the launch. now, we saw a lack of functionality, as c.m.s. did not adequately prepare the necessary systems and functions of the website and its

supporting systems prior to the initial launch. c.m.s. also failed to apply -- recognize best practices for system development, which contributed to the problems. admittedly, since the initial launch, c.m.s. has taken steps to address these problems, including increasing capacity, requiring additional software quality reviews and awarding a new contract to complete development and improve the functionality of key systems. however, many of the problems have still not been entirely resolved and continue to cause frustration. especially for consumers trying to obtain health insurance. i wish we could boil all this down -- boil down all of obamacare's problems to the functions of the single website. indeed, if this was just an i.t. problem, all of our jobs would be a lot easier. excuse me. however, the problems with obamacare and the federal insurance marketplace, in particular, excuse me, go much

deeper and many of them go unaddressed. now, we know, for example, that the enrollment controls for the federal marketplace have been inadequate. during undercover testing by g.a.o., the federal marketplace approval -- approved insurance coverage with taxpayer funded subsidies for 11 out of 12 fictitous or phone online applicants. in 2014 the g.a.o. applicants, which once again were fake, make up -- made up people. obtained a total of about $30,000 in annual advanced premium tax credits, plus eligibility for lower insurance cost at the time of service. these fictitous enrollee maintained subsidized coverage throughout the year even though g.a.o. said either clearly fabricated documents or no documents at all to resolve the

applicant's inskintses. and while the subsidies, including those granted to g.a.o.'s fictitous applicants are paid to health care insurers, they nevertheless represent a benefit to consumers and a cost to the government. now, g.a.o. did find that c.m.s. relies on a contractor charged with document processing, you know, to well, y uncover the -- to uncover and report possible instances of fraud. yet, g.a.o. also found that agency does not require that the contractor has any fraud detection capabilities. and according to g.a.o., c.m.s. has not performed a single comprehensive fraud risk assessment. they recommend best practices of the obamacare enrollment process. until such assessment is completed, c.m.s. is unlikely

to know whether existing control activities are suitably designed and implemented to reduce inherent fraud risk to an acceptable level. in other words, c.m.s. isn't even sure if c.m.s.'s fraud prevention systems are designed correctly or if they're effective. lastly, chilly it is not the focus of the -- while it is not the focus of the reports covered today, another matter we've been tracking closely and where the g.a.o. is issuing a report today is c.m.s.'s oversight of the health care co-ops. we had a hearing on this topic late january where we examined a number of financial and oversight-related speculations for the abject failure of the co-on program. today's g.a.o. report describes c.m.s.'s efforts to deal with financial or operations issues of the co-ops, including an escalation plan with the co-ops with serious problems that may

require recollective -- corrective actions. as of november, 2015, 18 co-ops had enough problems that they had to submit to a c.m.s. escalation plan, including nine that have discovered operations. and just last week we heard that yet another co-op, this one in maine, is on the verge of financial insolvency despite the fact it had been on a c.m.s. mandated escalation plan. in other words, c.m.s.'s efforts to address all the problems by co-ops appeared to have failed just like virtually every other element of this program. the failure of c.m.s. to adequately implement the co-op program is well-documented here on the finance committee and elsewhere. as with so many other parts of obamacare, the rhetoric surrounding this is failing. with nearly half of the co-ops closed, the failed experiment has wasted taxpayer dollars and forced patients and families to

scramble for new insurance. with so many co-ops now in financial jeopardy, i believe that c.m.s. should work with and not against states to safeguard taxpayer dollars. so we have a lot to discuss and i look forward to hearing more from the officials we have testifying here today. so with that i'll turn to senator wyden for his opening remarks. senator wyden: thank you, mr. chairman. mr. chairman and colleagues, it is old news that the initial rollout of healthcare.gov three years ago was botched. it is new news that the inspector general of the health and human services department recently said, and i want to quote here. this is a quote, colleagues, from the inspector general. c.m.s. recovered the healthcare.gov website for high consumer use within two months

d adopted more effective organizational practices. that's what the inspector general said. that the department recovered the website for high consumer use within two months. that quote comes from one of two reports looking back at 2013 and 2014 that the finance committee will be presented with today. and i think we ought to start by recognizing that the story here is well-documented. after the launch went badly, some of the best minds in technology and a new contractor were brought in. they scrambled to overhaul the system and the exchange was soon up and running, and the c.m.s. c.m.s. is -- and the center for medicare and medicaid services is following up on the inspector general's recommendations which the inspector general notes in his report. in the most recent enrollment period, nearly 10 million americans used healthcare.gov to sign up for a plan or

re-enroll automatically. in my home state, which had its own problems, close to 150,000 persons have used the website to sign up for a plan as of january 31. that's up by more than 30% compared to last year. the committee will also hear an update from the government accountability office on what has been called the secret shopper investigation. the government accountability office first brought this study before the committee in july of last year. i'm going to repeat what i said back then. on this side of the aisle, we don't take a backseat to anybody inciting fraud and protecting taxpayer dollars. one dollar ripped off is one dollar too many. but let's recognize that what was true last summer remains true today. this g.a.o. investigation has not uncovered one single shred of real-world fraud in the

insurance marketplace. t was built on fictitous characters with specially created identities, not real consumers and not real fraudsters. it's true the government accountability office found there are sometimes differences between the information on some of these insurance applications and their tax forms and citizenship records. but when it comes to these inconsistencies in people's data, this investigation can't differentiate between fraud and a typo. and meanwhile, health and human services did not look the other way when it finds the red flags. in 2014, the year of g.a.o.'s investigation, the center of medicare and medicaid services closed more than 100,000 insurance policies because documents didn't match or weren't provided. tax credits were adjusted for nearly 100,000 households. in 2015, health and human services closed more policies and adjusted more tax credits. if you come at this from the left, you might say that's too

harsh. if you come at it from the right, you might take a different view, but there's no basis whatsoever for the argument that health and human services ignores problems and people's records or leaves the door open for fraud. it seems to me rather than rehashing old news, we ought to be looking at the facts and talking in a bipartisan way about how to move forward together. because of the affordable care act, the number of americans without health insurance is at or near its lowest point in half a century. for the 160 million people who get their insurance from their employer, colleagues, premiums climbed 4% last year. let me repeat that. for 160 million people who get their insurance from their employer, premiums climbed only 4%. working age americans in oregon and nationwide with

pre-existing conditions, 80 million people or more, can nong lower be denied -- can no longer be denied insurance. so instead of battling out what happened three years ago, we ought to be pulling on the same end of the rope and solving some problems. for example, democrats and republicans ought to be working together to look at ways in which we can provide even more competition and bring cost down for consumers, and a lot of you in this room have worked with me on that issue for some time. second, there are going to be spectacular new cures in the future and the real questions as to whether our health care system is going to be able to afford them. here, senator grassley has worked very closely with me to put together a bipartisan case study, which looked at one blockbuster drug involving hepatitis c. solving the cost of these blockbuster drugs is going to take a lot of hard work. it, again, can only be done on a bipartisan basis. and finally, i want to express my appreciation to colleagues on both sides of the aisle

because i think we are on the cusp of being able to make real progress on a huge opportunity for older people in our country and that is protecting the medicare guarantee. this very sacred guarantee we have for seniors while updating the program to look at the great new challenge which is chronic illness. i want to thank senator bennet, who was out in front on this issue, for some time. he's not here but senator isakson and senator warner were champions as well. i want to express my appreciation for the chairman for the progress we are making. now, i have to make some comments with respect on something we didn't know about until about an hour ago and that's this matter of the co-ops. what we have said is that we want to work in a bipartisan way to improve a variety of sections of the affordable care

act. now, this new material on the co-ops, which neither i nor anyone on this side knew was available until about an hour ago. i will look at what can be done on a bipartisan basis going forward, but my work, and i think the work of colleagues here always ought to come back to this idea of making health care policy more accessible and more affordable and for now, and i certainly haven't seen this report. i'm not going to be participating in any celebration of people suffering because the co-ops were tied up in a connelly induced economic straitjacket. -- congressionally induced economic straitjacket. thank you, mr. chairman. senator hatch: let me introduce today's witness. the first witness is erin bliss, evaluation and inspections in the office of inspector general or i.o.g. or

h.h.s. ms. bliss served in many roles since her career began. i think your career began in 2000, if i got it correctly. she started as an analyst for the office of evaluation and inspections and later went on to serve as a senior advicor where she provided management, advice and expert analysis to the inspector general and other senior executives on priorities and internal policies and operations. afterwards she worked from 2009 o 2014 as director of external affairs at oh my god! . and was responsible for overseeing and -- at o.i.g., and was responsible for overseeing management with the administration. congress, media, the health care industry and providers and the pub. ms. bliss received her bachelor's degree in government from the university of notre dame before receiving her masters degree in public policy from the university of chicago.

now, our second witness is mr. seto bagdoyan in g.a.o.'s forensics audits and investigative service mission team. during his g.a.o. career, mr. bagdoyan has served in a variety of positions, including as legislative advisor in the office of congressional relations and as assistant director for homeland security and justice. mr. bagdoyan has also served on congressional details with the senate finance committee and the house committee on homeland security. we're glad to see you back here again. i pronouncing that right, bagdoyan. pretty close. ok. he had a number of senior positions in the private sector including most recently focusing on political risk and homeland security. mr. bagdoyan received his bachelor degree in economics

from claremont mechanical strategy and a b.a. from pepperdine university. i want to thank you all for coming. we'll hear the witness testimony in order that they were introduced. so ms. bliss, just please proceed with your five-minute statement. ms. bliss: thank you. good morning, chairman hatch, and other distinguished members of the committee. thank you for the opportunity to testify today about the office of inspector general's case study which examines the management of healthcare.gov. this is the website consumers use to apply for health insurance through the federal marketplace. as as well-known, on october 1, 2013, the healthcare.gov website failed almost immediately upon launch. yet, within two months, c.m.s. had substantially improved the site's performance. how did such a high priority

project start so poorly? and how did c.m.s. turn the website around? our case study provides insights into these questions and lessons learned to help healthcare.gov and other federal projects work better. we believe that our assessment of the intersection of technology, policy and management can benefit a broad range of federal projects and programs. our report chronicles the breakdown and turn around of healthcare.gov over a five-year period. this morning, i'll summarize the highlights. from the outset, the healthcare.gov project is the high risk of failure. it was technically complex with a fixed deadline and many uncertainties. still, h.h.s. and c.m.s. made many missteps in its implementation. most critical was the absence of clear leadership and overall project responsibility, which had ripple effects. policy decisions were delayed,

affecting the technical decisions. policy and technical staff from in silos and not well-coordinated and contract management were disjointed. changes to the project were not well-documented and progress not adequately monitored. this culminated in c.m.s. not fully communicating or acting upon many warnings of problems before the launch. c.m.s. failed to fully grasp the poor status of the build. one reason was that no one had a full view into all of the problems and how they fit together. red flags raised to leadership, did not always flow to staff working on the build and staff did not always alert leadership to problems on the front lines. c.m.s. was unduly optimistic. last-minute attempts to correct problems were rushed and insufficient, and the two months before the launch c.m.s. added twice the staff to the project and cut many planned

website functions. and just 72 hours ahead, c.m.s. asked its contractor to double its computing capacity. even with these efforts, the healthcare.gov website experienced major problems within hours of its launch. the website received five times the number of expected users, but the problems went beyond capacity. the website entry tool worked poorly and decoding defects caused dysfunctions. c.m.s. and its contractors did not have coordinated tools to diagnosis these problems. however, c.m.s. pivotted quickly to make corrections to the website. they brought in additional staff and expertise from across government and the private sector. one key was creating a badgeless culture where federal employees and contractors worked together as a team. c.m.s. designated clear leadership, integrated policy and technical staff and developed redundant systems to

avoid future website problems. c.m.s. also took a more realistic approach to building website functions. it practiced what officials called ruthless prioritization, which focused on effectively developing the most critical functions, like re-enrollment, and delaying other features. they measured progress and monitored problems to respond more quickly and effectively. these factors contributed to an improved website and important organizational changes. looking ahead, c.m.s. continues to face challenges and improving health care-game and managing the federal -- healthcare.gov and managing the federal marketplace. this includes 30 recommendations from o.i.g. we'll continue to monitor c.m.s.'s responses to our recommendations and management of this and other programs. thank you, again, for inviting o.i.g. to speak with the

committee today and i'll answer any of your questions. senator hatch: well, thank you so much. mr. bagdoyan. mr. bagdoyan: thank you, chairman hatch, ranking member, members of the committee. i will talk about our february, 2016, report on enrollment and verification controls of a.c.a. health care coverage during the 2014 open enrollment period. our results have based on extensive forensic analyses of relevant data from c.m.s. and i.r.s. ncies, such as and d.h.s. during the 2014 applicant and enrollee universe and our undercover work we performed for that period. a central feature of a.c.a.'s enrollment control is the federal data services hub which is the primary vehicle for c.m.s. to initially check information provided by applicants against various federal data sources. in addition, the a.c.a. established a process to

resolve inconsistencies, i.e., instances where applicant information doesn't match that from marketplace sources. in terms of context for our work, coverage offered through the federal marketplace -- excuse me -- is a significant expenditure for federal government. current levels of coverage involve millions of enrollees of whom about 85% receive subsidies. c.b.o. has pegged subsidy costs at about $880 billion for fiscal years 2016 through 2025. i would note that while subsidies are paid to enin surers and not directly to enrollees they nevertheless represent a financial benefit to them. as i stressed before, a program of this scope and scale remains inherently at risk for errors, including improper payments and fraud. accordingly, it is essential that effective enrollment controls are in place to help

narrow the window of opportunity for such risk and safeguard the government's investment. against this backdrop i'll discuss our two principal and analytical result. first, they don't analyze aggregate outcomes of data queeries, either the extent to which a query agency delivers a response to a request or whether an agency reports that information was not available. in this regard, for example, we found that s.s.a. could not match 4.3 million queeries related to names, dates of birth or social security numbers, and 8.2 million squaries related to citizenship claims. queeries involving 31

million people related to income and family size and within this 1.3 million people had i.d. theft issues. and finally, d.h.s. couldn't match 510,000 queeries related to citizenship and immigration status. accordingly, c.m.s. forgoes opportunities for gaining valuable insites about significant program integrity issues, including vulnerabilities to potential fraud as well as information useful for enhancing overall program management. second, we found that c.m.s. didn't have an effective process for involving inconsistencies for applicants in the federal marketplace. for example, we found that 441,000 applications with about 1.7 billion dollars in associated subsidies still had about 679 thousand inconsistencies unresolved as of april, 2015. that's four months after the close of the 2014 coverage year. within these, c.m.s. didn't resolve social security number

inconsistencies for about 35,000 applications with about 154 million in associated subsidies or incarceration inconsistencies for about 22,000 applications with about 68 million in associated subsidies. by leaving inconsistencies unresolved, c.m.s. risks granting eligibility to and making subsidy payments on behalf of individuals who are ineligible to enroll in qualified health plans. one important example emphasizes this point. according to i.r.s. accurate are vital for income tax compliance and the reconciliation of advanced premium tax credits through filing tax returns which is a key back-end control under a.c.a. in closing, our work today collectively shows that c.m.s. has assumed a generally passive approach to managing fraud risk in a.c.a., weakening the program's integrity. accordingly, we underscore --

we continue to underscore that c.m.s. needs to make a.c.a. program integrity a priority and implement effective controls to help reduce proper payment and fraud and prevent them from occurring early in the life cycle. we made eight recommendations to c.m.s. in our report which will help mitigate the vulnerabilities and risks we identified. while the agency agreed with the recommendations, it is incumbent on c.m.s. to implement them in a timely fashion and achieve and sustain measurable results. mr. chairman, this concludes my statement. i look forward to the committee's questions and i appreciate the indulgence for an extra 30 seconds. senator hatch: the office of the inspector general criticized healthcare.gov and the marketplace describing

internal controls such as inadequate procedures such as checking enrollees. how is the case study differ on the same topic? ms. bliss: thank you for your question, chairman. the case study is one of a dozen reports that i.o.g. has issued on the federal marketplace. most of those were more taggetted audits or evaluations, examining aspects of eligibility controls, payment accuracy, contracting and security of information. the case study took a different approach and cast a wide lens at c.m.s.'s management of the project in its entirety from multiple perspectives and over a long period of time and ordered a gleaned lessons learned in what went wrong and what went right in order to help this healthcare.gov project and other federal projects moving forward. senator hatch: thank you. r. bagdoyan, your report

talked about the data services hub which is the electronic clearing-house for checking applicant information against federal databases. you said they need to make better control of this enrollment process. can you talk more about that? mr. bagdoyan: the data hub is key environment for a.c.a. it's upfront. it process loose of queeries for information. a lot of those queeries, all of those queeries are in fact not captured for future analysis. we believe that such capture and analysis will provide c.m.s. with a lot of insight into potential indicators of improper payments as well as fraud. so comprehensive control system would theoretically enable that

sort of analysis for the long term, and we do actually have a recommendation to that effect at c.m.s. senator hatch: thank you. we have a long -- we been long told by c.m.s., don't worry, even if there are issues with awarding subsidies. everything eventually gets fixed when people file their income taxes, unquote. but g.a.o. found practices that undermine tax compliance. am i right about that? mr. bagdoyan: yeah, it's a umber of the inconskintsies we identified. - inconsistencies we identified. s.s.n. inconsistencies and according to i.r.s., whom we discussed this at length, they told us that this was not only important for tax compliance purposes but also for the tax reconciliation process to

reconcile the advanced premium tax credits at the end -- this is the third main back end control, if you will, in the overall setup. so without that information that's accurate and relyable, i.r.s. pointed out -- reliable, i.r.s. pointed out their job is made much more difficult to not only do the tax return processing but also reconcile the subsidies. so it's a long-term problem if it's not addressed. senator hatch: all right. ms. bliss, what are the most important lessons learned from healthcare.gov for the administration and do you think the lessons learned from your case study apply to other large programs and projects, whether being planned by the department of health and human services or other government agencies? ms. bliss: thank you. we certainly do. the intersection between policy, technology and management is not only

essential for healthcare.gov but we believe these lessons will apply to other federal projects and federal programs. we gleaned 10 lessons learned and i'll highlight what i believe the three most significant. first is establishing clear leadership. we found that the lack of clear leadership and overall responsibility and clear lines of delegation had ripple effects, caused a number of cascading problems across the project. and made problem resolution more difficult. we also found the disconnect between those working on the policy and making decisions and those working on the technical aspects of the project created problems on both sides and delays in policy decisionmaking compressed an already tight time frame for achieving the technical build successfully. so better integration across lines of business, policy and technical as well as a cross-government and contractors through this

badgeless culture are some of the keys we thought a correction and success. and then finally taking a posture of continuous learning, which means being flexible and adaptable, especially with a startup-type project, like healthcare.gov, was. we found that c.m.s. got stuck on an unwinnable path and it was too late before they realized and tried to make changes. so keeping that continuous learning posture, being innovative and flexible and constantly monitoring for problems to adjust plans where needed. senator hatch: thank you. senator stabenow, i'll turn to you. senator stabenow: mr. chairman, thank you. and welcome to both of you. ms. bliss, i'm wondering. just a yes or no question. based on your case study, do you think healthcare.gov website should be taken down and completely a new website be built?

ms. bliss: no. senator stabenow: ok. like many of my colleagues, we're very frustrated what happened in the past. clearly you laid out the problems with the launch, and i think everyone agrees that there were serious problems with the launch of healthcare.gov. . it created a lot of uncertainties. certainly for people in michigan to get coverage in 2013, but that's six years ago. wure now in year three -- we're now in year three of the affordable care act marketplace operations. when we look at the report, the report is sort of looking backwards. we can agree, problems. the question is moving forward. and how do we address the fact that over 20 million people have received health care coverage because of the affordable care act. and saving people's lives. that's not just a rhetorical statement. i've talked to people who were able to get surgery or care for their children that they've

never been able to receive before. and save lives. i think that is a good part of things, when we talk about the numbers, real life experiences of people. the uninsurance rate is the lowest it's ever been. and medicaid expansion has resulted in literally millions of our most vulnerable families receiving the care that they deserve. given the fact that the a.c.a.'s the law of the land and it's our responsibility to make it better, i first want to say that i hope that owla all -- that all of us will work on, how do we make it better? that's why i appreciate your recommendations as we look forward, not just on this particular website and process, but in others as well. the question is, how do we make it better? we want to make sure that we have quality access to health care for every american, whether it's medicare, children's at

health program and so on and so on. so with that in mind, let me ask about any other recommendations from a g.a.o. standpoint that you haven't already spoken of today. on how we can make things better. because frankly i want the over 20 million people that have health insurance today that didn't have it before and have the peace of mind to go to bed at night knowing they're going to be able to take their children to the doctor if they get sick, i want to keep that. i'm hopeful we can even get as to zero as possible in terms of the number people in our country that don't have access -- that have access to health care, that we can get to zero the number of people who don't. i'm interested in your recommendations on how we go forward, to work together to make the system work better. mr. bagdoyan: sure. thank you for your question. as you mentioned, we operate under the premise that this is

the law on the books and my charge is to help make it work as intended. with that in mind, a report makes eight specific recommendations. we tried not to be too prescriptive, to allow c. prmplet m.s. -- c.m.s. some latitude to explore various options. however, the key recommendation, i believe the big picture recommendation, is for c.m.s. to conduct a comprehensive risk assessment of the entire program, sort of tomorrow to -- top to bottom, and identify the control vulnerables -- vulnerabilities and the risks for improper payments and fraud. in that regard g.a.o. issued in july of 2015 its framework for managing fraud risk in federal programs. so that's a comprehensive leading practice compilation from the private and public sectorers that would provide the agency with quite a solid

road map to perform that risk assessment. so everything should flow from that assessment in terms of the types of actions, policy changes, control improvements and so forth. ms. stabenow: are you working -- is there reaction on this? are they objecting to that? mr. bagdoyan:. no i think i should give c.m.s. credit that they accepted all eight recommendations, including this one. but as they say, the proof is in the pudding. they need to execute, do so successfully, and then achieve results and sustain them over the long term. this is not a done proposition by any means. ms. stabenow: you've made the recommendations, they've accepted all eight recommendations and they're in the process of doing them? mr. bagdoyan: that's correct. we had informal discussions as well as the formal letter of responding to our recommendations. ms. stabenow: thank you, mr. chairman. >> mr. coats: thank you, mr. chairman itcht want to thank our two witnesses. lord knows where we would be if

we didn't have g.a.o. and inspector generals. the alarming malfeasance and incompetence of the rollout of this plan is just stunning. and here we are, you know, we can't just simply brush it off and say, well, this was a bad start but everything's going great now. the cost to the taxpayer probably will never -- probably we'll never know. but thank goodness that we have your organizations providing us a ormation and spurring on seemingly bureaucratic nightmare that exists within the federal government in terms of handling these kinds of programs. anybody in the private sector that had done this would have been bankrupt. investors would have lost all their money. it's stunning to continue to

observe what it takes to get these agencies to -- i think they're well intended. just overwhelmed in terms of the complexity of getting this done. i go to the floor of the senate every week and talk about waste of the week. i've referenced your name. not as a part of the problem, but as part of the solution. and the information that you've continues e for me to stun people had they hear about some of the incompetencesies. i was particularly interested, because i think it speaks to a bigger problem. what was called the secret shopper, where you deliberately , e applications as a test

you made applications for compliance with the affordable are act and subsidies. 11 of the 12, i think my numbers are right, everything you submitted was fraudulent. but 11 of the 12 were accepted. and even after it was revealed that it was accepted, follow-up to be lls pretending that person, who was given notice that they were not eligible, were accepted. that percentage is pretty high. and if you multiply that out, it just really makes you wonder if this whole thing wasn't so intent on st providing numbers to make it

look successful that we really weren't getting the information , the verification that we needed. and then there was the question with c.m.s. at one point releasing a statement, well, we're not in the verification business. i think basically on what you've just said, they are now taking a different stand on that. but i wonder if you could respond to where are we now in erms of verification capacities, so that we don't have this fraudulent and wasteful situation moving on? i'm happy to have either one of you or both of you address that. but this social security -- it just seems easy. an evaluation of social security numbers to determine their validity would make it fairly easy to make a

determination as to whether they qualified or whether they didn't qualify. where is c.m.s. in terms of putting that process in place and what is the success to date of that process? mr. bagdoyan: sure, if i may, ms. bliss, take a first crack on that. i appreciate the plug on the floor, senator. mr. coats: sure. mr. bagdoyan: in terms of where c.m.s. is with the controls, what we call the control environment, which is a series of controls designed to verify information and identify potential indicators of fraud and so forth, as our undercover work indicated both for 2014 and 2015, where we're equally successful, there are -- there is a semblance of controls in place, some basic things in , ace like identity proofing the document reconciliation process, to clear inconsistencies, for example.

but in each case we were able to work around those reasonably easily. and obtain coverage both for 2014 and 2015. the vulnerabilities are still in place. now, with the recommendations we made in this report, actually in late february, we made eight recommendations, as i explained to senator stabenow. the big one is to perform a comprehensive risk assessment. that's going to take time, it's going to take time for c.m.s. to absorb the results, and then craft hopefully appropriate solutions for the future. this is a long-term proposition. it's not going to be an easy fix. mr. coats: i think this speaks to the point that we got a bad start and everything's going great right now. everything's not going great light now. -- right now. this is going to take a long-term effort to try to put these verification procedures

in place and to be able to say that we are successfully voiding fraud and waste. at an inefficientsy -- inefficiency and taxpayer cost level that is absolutely astounding. withdrew the -- due respect to my colleagues, to t ombing ut this as -- tout this as something that's happened in the past but is corrected now and we're sailing into a bright future, i think we have a lot of work to do. thanks, mr. chairman. >> thank you, mr. chairman. i want to again say that we said the initial rollout was botched and appreciated the inspector general making it clear that a couple months in there was serious progress. mr. wyden: you all reported that after the first open enrollment, you said the agency demonstrated a strong sense of urgency to take action,

accepted new work processes, and they, quote, improved the health care -- www.atlantabraves.com site un-- the healthcare.gov site substantially within two months. what were the operational and strategic changes that were made after that first open enrollment? and do you feel they're better equipped to deal with the challenge now? ms. bliss: thank you, ranking member widen, for that question -- wyden, for that question. as we discussed in the case study, some of the key strategic and operational changes that were made as part of the correction were to, one, establish more clear leadership and designate roles and responsibilities, and this time they did it in a way that really brought together staff cross all of rs a the important business lines

that were affected and needed to be involved in the correction. that included the policy people, the technical, the communications and the contractors, all coming together. with the influx of experts from across government and the private sector, there was the potential that it do could have become more chaotic but in fact we saw that the reverse was true. it was well organized. folks are working together in a badgeless culture as a team, there was better communication, there was better measurement and monitoring of problems and progress in order to apply solutions for quickly and effectively. mr. wyden: in fkt effect -- in effect, after the first few months, which everybody has acknowledged were not ideal, your characterization was essentially well organized? ms. bliss: it was much better organized. mr. wyden: good. mr. bagdoyan, first, i'm probably the biggest users of g.a.o. products here in the congress. -- i don't heard me

take a back seat to anybody when it comes to cracking down on actual real world fraud. my question to you is, isn't it correct that when you testifyed before the committee last year -- testified before the committee last year, you stated that the secret shopper investigation failed to uncover a single real world example of fraud? mr. bagdoyan: yes, that's what i said. and i would also couch that very carefully for you and the committee. the intent of that investigation was not to uncover fraud. but to flag control vulnerabilities as well as identify indicators of potential fraud, which i think we did quite successfully. just want to make clear, my charge is not to find fraud, fraud is determined through a separate criminal proceeding in

court, to definitively determine that. so my job again is to look for vulnerabilities and controls, as well as identify indicators of potential fraud or improper payments. mr. wyden: let's go then from last year, when there was not one single real world example of fraud, to where we are now. is it correct to say that the entire investigation failed to identify any actual fraud? mr. bagdoyan: again, i would refer to you my answer. that was not our intent is. so if i'm not looking for fraud, i'm not going to find it. what i'm looking for is vulnerabilities and controls and indicators of potential fraud, such as the inconsistencies can the social security numbers, as -- with the social security numbers, as well as in the case of the i.r.s., 1.3 million people having potential i.d. theft issues. which is a significant red

flag. mr. wyden: i think that, as is always the case, you all are right to talk about various issues that ought to be part of the debate. that's not what's going on here. what people are saying is, this is fraud. fraud, fraud, fraud. and i appreciate your taking us in a, i think, better balanced view. ms. bliss, h.h.s., you all do audits. o.i.g. does audits. have you uncovered in connection with this any confirmed cases of fraud? ms. bliss: no, we have not. had any cases that have resulted in criminal convictions or civil settlements to date. we do have a few investigations that are ongoing and can't predict what those outcome it's will be -- outcomes will be. mr. wyden: look, i don't know

how many times i've said in this committee that when their big, important issues, and certainly the affordable care act is right at the top of it, need to work in a bipartisan fashion. and there isn't a program anywhere in government that you can't find opportunities to work together and be bipartisan. i ticked off a inform am them. the chairman and i -- a number of them. the chairman and i working together on the future of the medicare program. chronic care. senator grassley and i finishing what i think is a blockbuster study looking at hepatitis c. and it raises the question of when we have cures, will people be able to afford them? what i think is important is that to do bipartisan work, we've got to move away from, first, the path, because everybody has acknowledged that the first few months were botched. i don't know how many times you can say it. but you all, and i read your comment after the first few

months, you said they had made substantial improvements. i think i can come back to it and perhaps read it one more time. center for medicare services recovered the health care government website for high consumer use within two months. now, that's the new news. that's just a few weeks old. that's new news. i want people to hear that and i want people to hear that there were no actual real world ases of fraud uncovered. now, one final question, if i , ms. bliss, is, do you disagree with the statement that i made with

respect to the accomplishments of the affordable care act? that is not your formal role as inspector general, but does anything strike you as being inaccurate there with respect to the uninsured rate or anything of that nature? ms. bliss: as an independent oversight agency, we don't take positions on whether particular programs should exist. but we look to make sure they're operating successfully. mr. wyden: the question were about the facts and what i think again is this is a hard fact that's not in dispute, that the uninsured rate is now at or near the lowest level recorded across five decades of data, with about 20 million previously uninsured americans gaining coverage. since the act's provisions went into effect, so i'll keep the

record open so that if you or your agency has any information suggesting that's wrong, i'd sure like to know about it. ok? ms. bliss: thank you. i don't have any information suggesting that that's wrong. mr. wyden: wonderful. mr. chairman, thank you. mr. scott: do you have any information suggesting those numbers are right? ms. bliss: i cannot validate those numbers. i don't have any reason to believe they're not. mr. scott: but you have no indication either way, actually. ms. bliss: i have no basis. mr. scott: if i say the number is 30 million, you have no reason to believe it's not 30 million? ms. bliss: i don't have a basis for validating that number. mr. scott: mr. bagdoyan, our ranking member asked you several questions about fraud and i certainly understand and appreciate why so many americans look at this process and become disenchanted. your objective was never to

figure out how much fraud was in the system. your objective appeared to me to be to show us how fraud would be -- could happen. is that accurate? mr. bagdoyan: yeah, essentially, senator, you're correct. the big picture we're looking at is any vulnerabilities in the controls that are in place and also for any indicators of potential fraud that pop up. for example, our ability to circumvent the controls we encountered during our undercover work. we did that for 2014 and we repeated that experience in 2015. in which case we were successful 17 out of 18 attempts. i would have to caution that, of course, further to the point that senator coats made earlier, that is not a projectable number. so we have to be very careful that that doesn't represent the actual universe, that is just a data set that we use to continue our work in this area. mr. scott: thank you very much.

no one's going to mistake me for a fan of obamacare or the a.c.a.. i'm not a fan of the website nor the actual policies, the legislation. i think at the independent payment advisory board, what some have referred to as death panel, the ability to ration care into the future, this is one of the classic examples of why so few americans have the same appreciation that others have talked about of the a.c.a. think about the fact that we're , lking about taxing americans whether it's their income or profits, an additional 3.% tax, raising somewhere over $120 billion, another reason why so few americans have the same positive opinion we've heard from some of our friends on other side. think about the whole notion of how the health care law is going to regulate the posting of calories at pizza parlorers, grocery stores, all over the place.

and by default, increasing the price of these groceries, these pizzas, and other nonfood items. reducing the number of employees' hours, talking about the impact on middle income america, so many americans losing perhaps up to 25% of their income because of the a.c.a. we can see why, as so many americans have found themselves frustrated with where we are with the a.c.a., that it's not old news to them. it's not old news actually when you think about the fact that so many americans are facing higher premiums. we've heard so many different numbers this morning. we know that at least some states have seen an increase of more than 25% of their health care costs. two states have seen those numbers go over 35%. those are real dollars for struggling americans who cannot afford the cost of health insurance.

not only are the premiums higher, the deductibles are higher, the out-of-pocket expenses are higher, the only thing that's actually lower are the doctors to choose from and the hospitals to go to. we've seen a catastrophic occurrence under this health care law. and even at one of the most recent democrat town halls, young lady who supported president obama, supports the health care law, said that her premiums had doubled, tripled. her concerns were strong. clear. here's one real case example thank, i hope this is no longer happening. a young man named tom from south carolina who created an account on healthcare.gov was called shortly thereafter by a man named mr. dugele. from a guy maimed mr. justin hadley from north carolina. who had done exactly the same thing, gone online to the healthcare.gov, and created an account. what he found populating his

account was information from mr. dugele. he called h.h.s. and could not get any assistance. finally they called our office and during one of the hearings we were able to get that situation solved or at least the beginning of the situation solved. can you guarantee me that that situation is no longer occurring anywhere within health care -- healthcare.gov? blissably i cannot guarantee that. we've over-- ms. bliss: i cannot guarantee that. we've overseen controls to ensure that both the website and other parts of the program and identity verification, eligibility verification are working properly. but we have raised concerns about some flaws or weaknesses in those controls similar to g.a.o. and i can't make that guarantee. but we're certainly working hard to identify where there's a vulnerability of that happening and make recommendations on how to improve it. mr. scott: my last question, since i'm out of time so quickly here today, back to you, ms. bliss, is that it appears that, as we've

celebrated the success of improving the system in the first couple months, i will note a new trillion-dollar program, one of the recommendations was for clear eadership. earth shattering. thank you. mr. isakson: thank you, mr. chairman. i apologize for missing your testimony and i aapproximately jies for being late. but -- i apologize for being late but i do have one question based on a letter i sent previously to c.m.s. mr. bagdoyan, do you agree that increasing the utilization of the existing tested data sources is one easy way that c.m.s. could reach the mutual goal of expanding program integrity and management? and better fraud risk? mr. bagdoyan: yes. that's in fact one of our recommendations to c.m.s. is to consider doing that on an active basis, both to capture

the data and then analyze the data for whatever indicators that they may throw off. and act upon those, yes. mr. isakson: do you know when they're going to move forward on that and doo it? mr. bagdoyan: as i stated before, c.m.s. has accepted those recommendations. they are on record in writing, as having done so. as i said in my opening statement, it is now incumbent upon the agency to take action on a timely basis. as i said, it will take time to work through this. it's not an easy fix, it's not a short-term fix. fix.not a won and done mr. isakson: i apologize for being late because you covered t in your opening statement. i appreciate your testimony to

that affect. mr. bagdoyan: the data are available, definitely. >> i want to thank our witnesses for appearing here today. the work that each of do you is very important, as far as we're concerned. you and your organizations, it's vitally important to this committee and we're thankful for the quality product of both the h.h.s., o.i.g. and g.a.o. produce to assist us in our policymaking and oversight efforts. mr. hatch: i also want to thank my colleagues for their participation in this important hearing. i think the hearing has been insightful, it's been enlightening. unfortunately i think this hearing further revealed that we are only now getting to the water level of the obamacare iceberg. it seems to me. as premiums continue to skyrocket, and insurance options become more and more limited, an increasing number of americans are being hung out to dry. over the past year we had a reasonable amount of consensus on several of the unworkable and failed provisions of obamacare. for some reason, many still

have their heads stuck in the sand hoping that things will finally start working out at some point. i implore my democratic colleagues to work with me and my republican friendses to repeal and replace the so-called affordable care act before it's altogether too late. insurance premiums and health care costs continue to rise and little is being done to stem the tide. it's high time to put partisan politicking and bickering aside and find workable bipartisan solutions. there's more we can do. there's more it seems to me we have to do. honestly, i ernestly believe we can do it. the american people deserve better than what they have right now and more importantly, than what they are about to have in the next few years. i encourage each of my colleagues to meet with me and find workable solutions. and i encourage both of you to keep doing the jobs that you're doing.

they're very important to this committee and i think to our country at large. i would ask any written questions for the record be submitted by thursday, march 31, of this year. and with that this hearing will be adjourned. thank you for being here. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] [captions copyright national cable satellite corp. 2016]

>> live later today here on c-span, national security advisor and former u.s. ambassador to the u.n., susan rice, with a look at the obama administration's approach to the western hemisphere. she'll be speaking at the atlanta down -- atlantic council in washington, d.c. that's about a half hour away from now. before that, though, a discussion about president obama's choice for the supreme court. this is from today's "washington journal." >> washington journal continues. host: we are continuing our discussion about merrick garland, the supreme court

nominee. we have greg stohr, the supreme court reporter from bloomberg here to break it down a little bit more. tell us a little bit more about judge merrick garland. tell us about his background and personal story. guest: he is originally from chicago. president bonded over that yesterday in the nomination. he has been on the federal euros court in washington for 19 years and prior to that he was a prosecutor and left a job in private law practice to become a prosecutor. the most notable part of his career, he oversaw the investigation and prosecution of the oklahoma city bombing as well as the unabomber trial. he talked a little bit about how his experience has shaped him yesterday.

talk a little bit about that experience, being a prosecutor and dealing with victims of crimes. guest: he talked about a number of things, talking to witnesses. i think he described them as mothers and grandmothers and try to convince them to come forward to cooperate and testify against people. the veryalked about moving experience of being responsible for making sure that prosecution of the oklahoma city and thatent properly justice was done there. those clearly were very formative experiences in his professional career. host: talk a little bit about his time on the d.c. circuit. it is called the second most important court in the united states. what kind of reputation did he develop on the bench? terms, an general

moderate, a consensus builder, not someone who wrote sweeping opinions but is generally devoted to craftsmanship. when most people think about the courts they think about hot button social issues like gay rights and gun control. because of the unique docket of the d.c. circuit, the have a number of regulatory topics. they do not have the kinds of cases that other judges around the country have, so we do not know a whole lot on how he would rule on abortion or class action lawsuits, or any number of issues. we have a volume of stuff on how he views administrative agent. host: we want to bring our callers into this conversation as we continue to talk about merrickcourt nominee garland. democrats can call in at (202) 748-8000.

republicans can call in at (202) 748-8001. independents can call in at (202) 748-8002. he has been called moderate and we do not have a broad body of decisions to take that from. what do you think burned him that reputation? guest: part of it is my mentioned before, not writing big, sweeping opinions. he is not someone who goes out of his way to say, i see a constitutional right that has not been previously recognized by the supreme court. some people would even call him conservative on criminal law. perhaps, this comes from his career as a prosecutor, perhaps for other reasons. to the right of antonin scalia comes to criminal law issues. we will have to see it if he gets onto the court, but that is

an area that if people are juxtaposing how he might roll on other areas, he may be relatively moderate or conservative on some criminal questions. host: let's take a call, a democrat, we have eric from glen bernie, maryland. you are on with greg stohr. caller: good morning. host: good morning. caller: i just wanted to reiterate that the biden role, which everybody is talking about 's speech or thoughts on the floor was talking about decide tos would resign while the election , it hadwas going on nothing to do with extraordinary circumstances if a supreme court justice would die.

that, ok,ar the fact you should not resign just to put another member of what you think will be a right-leaning court or left-leaning court on the court for that purpose, which everybody knows, they could deal. -- they could do. no joe biden's whole speech was theicated on the fact that resignation of a supreme court justice, not the death of a supreme court justice. if you are going to use the biden rule, use it correctly. host: let's talk a little bit about the biden role. -- rule. joe biden speaking about waiting to make a supreme court nomination. guest: that was, as the caller

said, that was the summer before -- it was in an election year but after the supreme court term ended, and it was anticipating that somebody might retire after the term ended in late june. that did not happen, so the caller is right that the circumstances were little bit different. that is sort of in this whole debate over whether the senate should consider the nominee. that is kind of what you find throughout history, is that there is no situation that is really exactly the same. there are some where people have been talking on the other side of the issue, but there is no perfect precedent for what we are having now. host: our next call is from mike , calling from richmond, virginia on our republican mind. -- line. caller: good morning. republican, iam a

would prefer if they would just go ahead and give him a hearing and vote him down. if the idea is that we cannot trust the president to make a that willjustice actually look at the constitution and say, you know the constitution says what it says and we cannot keep turning it on its ear. to say it says what it does not say just because people want certain social changes to take place, they should just get up and explain, this is the reason we are voting him down. we look at the president's past picks and see the way they look at the constitution. why should we think there would be something different going on here? i do not said that, think the constitution actually requires congress to give them a hearing because. simple, there is no time limit -- because pure and simple,

there is no time limit placed upon which they must do that. there is no reason for the this --- how can i put there is nothing in the constitution that says advice and consent cannot take the form of refusing to consider. the device -- advice to the president is do not bother. host: let's let greg stohr respond to that. guest: certainly people would agree with the caller that it might be wiser to go ahead and have a hearing. the question is a political judgment the republicans are making, whether or not it will be harder for them to oppose merrick garland or any other nominee after the public gets to know that person and hears from that person. thehe second point,

constitution certainly does not explicitly say the senate has to do anything. the president is supposed to nominate somebody, and it is really a question of which model you believe the constitution embraces. is it that no nomination get onto the court without both the senate and the president a green? -- i agreeing? thes this some more president is entitled to his or her amount of difference -- is going to beit a great debate over the next couple of months. host: let's talk for a minute about the impact that merrick garland, if he does get a hearing and somehow makes on the court, how he may impact the court right now. split, you a 4-4

write that he could help the court regain its ideological center. you say that he will potentially be a pivotal vote and some of the country's most divisive issues including campaign finance, gun control, abortion, and class-action lawsuits. he would replace the late justice antonin scalia a, an anchor of the court's conservative wing and probably supplant justice anthony kennedy at the court's center. tell us more. guest: i am sure you have written a thousand times, anthony kennedy is the justice on this case. again, we do not know everything about merrick garland, but based on his general philosophy, it is presumed -- pretty reasonable to suggest on those issues and a whole lot of other ones, he may be the justice in the middle and

kennedy becomes one of the more reliable conservative votes. , butremains to be seen that would be a huge shift for the court. if president obama or a future democratic president can fill this vacancy, it will be a significant shift for the court. fast,ains to be seen how if you have five democratic appointees, let's say they all think citizens united was a bad decision, that is a reasonable supposition. will they moved to overturn that decision right away? merrick garland may not be that quick to just overturn something. this could be a volatile time. we have three other justices who are going to be over the age of 78. depending who gets elected, we could easily see the court shifting significantly to one direction or shifting back-and-forth. it is a volatile time for the

court and may also be a reason why whatever happens with the garland nomination, the justices may be sort of conservative in how quickly they move because they recognize they are in a volatile time and do not want the law shifting back and forth depending on who has the majority. host: currently we have eight justices on the court. of garlandnation does stall, how will that affect the court? guest: we have a number of cases where those of us who cover the case think it could be a 4-4 split. involvingase could be mandatory union fees. we all thought it would be 5-4 with public-sector employees having a right to say no, i do not want to support the union. it seems like the court is divided 4-4.

what happened is the court will issue a decision saying, we are evenly divided, we will leave intact the lower court decision that says states can force those workers to pay union fees. but it does not set a nationwide precedent. becausecomplicated different cases have different situations. we can talk about immigration, and the court always has the option of saying we are going to hold over the case until next have a nicee justice, and we argue it. callers, weo our are talking with greg stohr from bloomberg. jim on our independent line is calling for michigan. caller: the point i want to make is that the framers of the constitution wanted a government that work. -- that worked. in designating the

responsibilities of the congress and the president, they used the word "shall." and shall he and mandatory, they must. it does not give them discretion. i have to disagree with your the framers would impose upon the president the point -- point -- a timent at the same congress has a constitutional duty to give advice and consent. if people would just read the constitution and also read the federalist papers, there's at least nine or 10 federalist thers discussing on how articles of confederation did not work. host: let's give greg stohr a

chance to respond. guest: that is certainly the argument that democrats and liberal scholars are making, that the framers intended a government that works. in terms of the word "shall," it says the president shall nominate and with the advice of appoint. point -- it does not explicitly require the senate to do something. it is certainly an argument that people are making, and their arguments on both sides. debate note this is a that was going to have to happen in the political sphere, this sort of discussion among politicians and others. it is not something that will be able to go to court to challenge. say,folks on the left there is no way to go into court

and say the senate has to act. host: our next call is from the democratic line, we have frank from spanish fork, utah. caller: the last caller made me think of a second comment, i will say it real quick. even though it says that congress, it does not say they shall do something, i think we should keep it in mind that they were elected to serve. i would take that to mean they were supposed to cause the government to function correctly , not stall for political reasons. the reason i called in the first place, if we are going to use the argument or the debate of the biden discussion about , isibly retiring justices what the republicans are doing don't we have to take into consideration the fact that republicans have been struck -- have been such obstructionists

for the past eight years? they have made their own bed and i think that is their own fault. guest: one argument that i heard is the voters should success is decide. -- decide. this is interesting and along the lines of what the caller was saying. thatthe argument is elected representatives do have a responsibility to act and in terms of democracy, maybe what be ableis for voters to to make a judgment on senators as to whether they voted for or against merrick garland, and that would be the best way to have this be a democratic moment. that may be an argument that democratic's use going forward. debateit is a great about how they should be handled. host: the republican leaders in

the senate have said that the decision not to consider this nominee does not have to do with the nominee's credentials, it has to do with the fact that it is an election year. there are some groups that did take a look at his record and are opposing some aspects of it. times, it washington says that people tried to tap a moderate to fill the seat of justice scalia but ended up picking a fight with powerful second amendment groups that say judge merrick garland has shown .ntipathy toward gun rights ,n one 2000 case, judge garland who sits on the u.s. circuit court of appeals for the district of columbia, upheld a clinton administrative effort to store gun buyers records. do consider the landmark case that would later establish the

second amendment's protection of a personal right to bear arms. this is probably the most anti-gun supreme court nomination in decades, said brian rogers. case atenced the heller the supreme court. does his record on the court really tell you about what his stance on second amendment is? guest: i am not sure it does. two interesting cases, two pieces of information absolutely . the first one was not a second amendment case, it is a case of agency deference he. in favor of the ability of the clinton administration to hang on to records of people who underwent background checks to purchase guns. instance, case was an this is the case that ended up

being the heller decision, a landmark decision, but all we have from judge garland is a vote to consider the case. we do not have an explanation. there was a panel of three judges that ruled in favor of gun rights in what at that moment at least was a big ruling, as the supreme court had not yet said there was an individual right under the constitution to bear arms. judge garland, along with a total of four judges, including one republican appointee said we want the full d.c. circuit to consider this case. ,e do not know whether he said thought that ruling was wrong. we do not know whether he thought it was just such an important issue that the whole d.c. circuit should handle it rather than a three-judge panel. we will see think more questions looking into his judicial rulings even though the

republican leadership in the senate says it is really not about his qualifications? guest: i think we will have some. i was really struck yesterday by how little there was. there was this, and that is certainly something worth discussion. in part perhaps because all of the people president obama considered, he can make the coast that judge garland is the most conservative/moderate, and there is not a whole lot of material. if you talked to people on that side of the issue before hand, many of them were saying, we do not want this to be about the person, we want this to be about the process. host: we are talking to greg stohr of bloomberg. he covers the supreme court, and we will go to our next caller on the republican line, james from chattanooga, tennessee. caller: i just wanted to say that mr. mcconnell was given a

really good job and nobody stood in his way. and i think that even though i am republican, i feel like this other guy, he was there for us with the oklahoma bombing. -- i do not know if anyone has ever been to that museum over there -- but they have this mock explosion. they put you in a little room and you are like, what happened? you see all the destruction that happened afterwards, and he had to lead the case to make sure that mr. mcveigh was put to death. it is a wonderful thing that he did and there is no more conservative person in my heart. if you have ever been to that museum, go to the oklahoma bombing museum and see what this great man has done. i am republican, i

can tell you that if hillary takes office, she is not going to do something really nice for us, for a conservative guy like this on the bench. guest: we can also discuss what hillary clinton might do if she's elected president. i think that's a very interesting question about how this whole thing will play out. host: that plays a role in the discussions among republicans in the senate. some of them have indicated that perhaps in the lame duck session, if hillary clinton is elected, they may change their minds. guest: right. there's certainly fear among republicans that since obama has nominated somebody who at

least for a democratic president is conservative. that if hillary clinton can choose whoever she want, she would choose somebody who is more liberal. so the thinking is, if she wins the election in november, that we better, republicans better confirm garland before she has a chance to a number nate somebody worse from our standpoint. very interesting question, whether she would if she had that chance, nominate somebody more liberal than garland or stick with him. host: we have a tweet from matt that reads -- host: so we've seen how this discussion has seeped into the political discourse. the presidential race as well. our next caller from cleveland, ohio, on our democratic line. we have dorothy. good morning. caller: good morning. the first thing i want to say

is, what these republicans must understand is, this is a 50-50 country. second of all, the biden rule, is no such rule. there was nothing voted on to make it a biden rule. that was an opinion about that time, when they keep bringing it up. and another thing that gets me is, ok, they said that president obama do not follow the constitution. well, the senate ain't following the constitution either. what i would like to know is, it's been a 5-4 court for a long time. and most of the time it favors republicans. so what difference does it make if it's a 5-4 court on the liberal side? this is what i understand. they act like the court has to be all conservatives. why can't it be a moderate court? i don't see where, you know, everybody making this big case about he's not conservative

enough or this, that. it should be which ever person is elected to the court, whether he be moderate, conservative or liberal, it shouldn't matter to the country. host: let's give greg a chance to respond. guest: as you menged earlier, i mentioned in my story, we have not had a supreme court with a majority of democratic appointed justices since 1969. which is a really, you know, it does sort of stand for the notion that it's generally been a conservative court. now, that being said, a lot of those republican appointed justices during that period of time have turn out to be more liberal than what folks thought. so, i saw in "the new york times" yesterday, they mentioned that garland being on court would give us the most liberal court in 40 years. and that's probably true as well. but we have, i think both sides have gotten a little bit used to the notion that it will be -- it is a court dominated by republican appointees and this

may be a moment where we see something different. host: and we're talking to greg stohr of, a supreme court reporter from bloomberg, formerly covered the justice department and the federal trade commission for bloomberg. you formally clerked for u.s. district judge frank kaufman of baltimore as well. so, judge garland, he was considered by president obama twice before. for the first two vacancies that came up during the president's tenure. why do you think he wasn't chosen then and why do you think the president chose him now? guest: a couple things. first of all, i think the president selected two women for the two earlier vacancies. the first latina justice. and by all appearances he's i had license to appoint

someone with that philosophy. in order to get potential support from the republicans and other callers. host. yesterday he talked about his own judicial philosophy yesterday. let's talk about that. mr. garland: justice is in a large part what distinguishes this country from others. people must be confident that a