of the energy sector, he was able to launch an option for solar energy that brought an extremely hour --e, 4.5 cents per which is half the price of electricity in the united states. you're not going to see all the the reforms it right away. that is one of the ones we have seen. quite apart from the fundamentals of mexico, the exchange rate has been going up and down based on political considerations more than looking at the fundamentals of the mexican economy. the u.s.robably after election, there will still be some potential volatility. we believe very strongly in the wide ranging reforms in the hasomy that the president put in place. i am not sure what you mean by

commercial reverse. >> good morning. congratulations on your reelection. fromi am fr argentina. yesterday you talked with the finance minister about the new property measures. [indiscernible] in 2018 next year. wayyou tell us the argentina can reduce poverty. in my opinion, growth. >> we have been extremely encouraged by what the president and the finance minister have been doing. first of all just to -- the

re-embrace of global markets has been extremely important. at a time when so many countries are talking about closing borders and slowing trade and disengaging with the global economy, the fact that argentina is reengage in such a thoughtful way, it is very encouraging. the reason we now know more about the poverty level is because of a commitment to clear, more accurate data. that is a prerequisite for all of us to engage. because of that commitment to providing cleaner data, we felt comfortable engaging. argentina will be one of our largest petroleos in latin america. the poverty rate was surprising and disturbing. i think the positive to take out of this is argentina has recommitted to providing --urate, transparent accurate data in a transparent

way. there has been many experiences with poverty reduction in latin america. the conditional cash transfer programs, direct support to poor people. there are many issues in terms inincreasing productivity argentina that we are working on. it is a broad agenda. it is policy reform and also trying to create an environment where after many years, we can begin to think about attracting private sector from outside argentina. we are expanding our portfolio and we are optimistic that things will get better. >> for thro, please, in the middle. >> good morning. -- thesere you

meetings were dominated by debt and [indiscernible] how close do you think we are to another debt crisis given the that many countries are coming under. dr. kim: if you look at debt to gdp ratios, they are are still reasonable. there are many countries that are still quite a bit below 50% in terms of debt to gdp ratio. what we are doing now is to focus on things like can we in africant classes infrastructure that will require

relatively less indebtedness and bring private sector investments into these countries? we are watching debt levels carefully. i'm not yet concerned that we are reaching a debt crisis level , certainly not in most of sub-saharan africa that we have to watch it. if you look at the places that have gotten into trouble recently with debt, two of them are lebanon and jordan. they went, jordan went from gdp to overebt to 90% mostly because of the response to the refugee crisis. one of the things that we are now doing is we're being much more strategic and much more flexible in the way we use concession finance. for jordan and lebanon, where providing concessional lending. we took some money from the u k that was given as a grant and blended the to and can provide

15 to 20 year money a close to 0%. we want to show that when countries provide a great service for the world and observing syrian refugees that they should not become indebted and certainly not indebted with short maturity, high-interest debt. we are following it very closely. flexibility that we have been using concession resources will help us even more and being able to respond to renttions like jordan and -- lebanon. >> your goal to and the extreme by 2023, what is your expectation from china to achieve that goal? the second, what will be some of the key areas that you

want to focus on during the second term. thank you. dr. kim: without china we would have no chance to think about severe poverty. there are still people living in extreme poverty in china, but not very many. china is determined to bring that number down to zero in the near future. work in africa, this is one of the places that we have to focus on the most in terms of any extreme poverty. we have many different kinds of partnerships. managed codethe , ourng portfolio project new window was started with investments from china. what it is is our first effort to create infrastructures and asset class and china give us companies private

have joined. what we are doing is taking a number of different infrastructure projects in africa and other parts of the developing world and turning them into an overall portfolio, for step toward creating emerging-market infrastructure as an asset class. china has done it with capital. we have projects where we are paralleln investing in with them in infrastructure projects in africa. lending project to indonesia -- china will be an important partner to end extreme poverty. people are trying to understand how they so rapidly lifted so many out of extreme poverty. the message that we all need to take from china is that the reason china was able to lift millions out of poverty was related to trade and the openness of their economy to

competition. they had to make products that were competitive in the global market. keyoing that, those are determining factors in their ability to end extreme poverty and that is the message we are sending to all developing countries. >> in the fourth row, please. thank you. >> thank you very much and congratulations for your reelection. the question is about the are becoming to be public. the greek funds in countries funds that have a strain in the fiscal budget like mexico, how could it be managed and how could we

lower the risk for those funds, especially if you see the problem of governance or transparency in countries like mexico? country, thevery task of crowding and public sector finances is different because every country has a different policy regime, every country has a different track record and working with the private sector. our commitment is that for every country that has infrastructure needs, we're going to begin exploring with the countries but also with david sector investors derisking is of required? the level might behind. to give you an example, the new mcpp along with the swedish development agency, we will be

taking first loss area does the project falls apart the first percentage and we have not decided what that will be, the first percentage of the loss will be taken by sweden and ifc. we provide political risk insurance or credit enhancement mega, i could decrease the risk. we are looking to provide tools like exchange rate risk guarantees and market will simply not provide an exchange rate risk guarantee. we are looking to do that using our equity. already doing partial risk guarantees, there are many instruments that we have likened lower risk. what we are saying is the world bank group has to work together, all the different groups have to work together to find out what level of de-risking is necessary . this is a unique opportunity.

there are not many good things about the current global economic situation but one of them might eat because these funds are earning so little we might have an opportunity to proud -- crowd in much more private capital than we would if they were earning more. >> thanks a lot. congratulations on your reelection. my first question is you mentioned low income countries continue to struggle. 1%.re seeing projections at do you feel investments in infrastructure have been paying off in africa and of course, this is your also seeing a lot of countries going into recession in africa. if you could comment on that. a second question is, what is

your big picture outlook for africa now that you are having another term, what sectors will you be keen on now that you are still in the seat. thank you. a number of worrying factors is , one .6%h of estimate which we revised downward. we are expecting about 2.9%. that is in the context of population growth of 3%. if growth cannot keep up with population growth, that is negative growth. we are very worried about it. theas a lot to do with falling commodity prices. if there is any good news it would be that commodity prices seem to have bottomed out. infrastructure investments paid off? yes, they have a there is nowhere near enough in africa. the deficit in terms of energy,

in terms of friends is just enormous. when i talk about this new approach to doing everything we can to -- four private sector investment, africa is one of our prime targets. we have to find ways of de-risking the investment in a way that will work. to give you an example of a possibility, in senegal, ifc built a toll road and at first, it came under great critique as they were saying a tourist, it will exclude the four, it will not work, people do not want to pay money to go on a road. after they built it, what happened was that commute times for everybody in the car when down. those who could afford to use it toll road, it cut their travel time down dramatically and it reduced traffic so even the poorest saw that their commute

time trapped dramatically. there are solutions out there that will provide a good return for private investors and can have a very positive development impact like something you would not expect a tollroad in senegal. we are looking at every single possibility where public private investment could provide energy for four people, provide access to roads, while at the same time , providing a return that will attract investors. another example. it was thought that it is options together in africa for solar energy. we have something called scaling solar. we do everything from policy reform, the top look sector side helps with policy reform to providing the forms necessary, just the paper necessary for people to apply. then we run the option.

ago, wea a few months got a price of six cents per kilowatt hour. very low, especially in africa. if zambia can get that kind of price and these were all private sector power companies that made these bids. this is a perfect example of how you can crowd in private sector and provide more energy at a lower cost to people in zambia. we want to scale this up. >> the russian prime minister published a big economic essay where he complained that the global economy system is unduly politicized. we can give-- and

other examples. i want to have your opinion on whether the system is politicized. if that is a risk for the economy. let me see. around certain elections and political process in the future is definitely a risk for the economy. ofertainty about the impact brexit, uncertainty around the u.s. election, uncertainty about elections in europe, these are all risks. at the world bank group what we see is uncertainty. uncertainty is usually very bad

for most developing countries. are cooperating with 189 member governments. despite the fact that it says in of agreementticles we are not supposed to be involved in politics. it is difficult for any multilaterally -- multilateral organization to be apolitical. we do see the impact of politics in our institution. ontry every day to focus providing financing knowledge and support to end poverty. that is our goal. our goal is not to be involved in politics and take a stand one way or the other. one more. >> we will do one more.

>> good morning. i would like to find out how much the world bank will commit toward scaling up the energy sector and which areas of energy we are looking at. is it solar or hydro? thank you. >> i do not know the exact number that we are committing to zambia. we can get that for you, certainly. i think the solar deal i told you about is extremely encouraging. i saw the leaders, zambian leaders in nairobi what we had the tokyo, japanese organized meeting. was, we loved me the solar deal, we want more of it. interesting thing about solar is that especially if you're talking about providing electricity to villages, you can very quickly put in place micro-grids and many grids, not necessarily connected to the central grid but can transform the lives of for all people. in this case there was very

little financing that we had to do because jim be a was able to put together the deal and come through. the government was able to come through with the kind of policy changes that gave confidence to privet sector providers. this was a landmark, the lowest ever received in africa. the average was six cents but andlowest bid was six cents that number was not going to go up for 25 years. if you say six cents for we five years that ends up being 4.5 cents. zambia received a bid for almost 4.5 cents for solar. symbian has a lot of sun. we can scale up solar dramatically still for many other reasons. it still needs base loads, they will need to use other kinds of energy sources. solar not only in

zambia but throughout africa is that -- is very exciting. >> thank you all very much. we will have the opening remarks available and a transcript available in about an hour. thank you. ♪ >> tonight, the recent supreme court oral argument in book versus davis, considering whether to inbox trial counsel was ineffective and whether his death sentence was the result of racial bias, starting tonight at

8:00 eastern. with donaldve trump. he will be campaigning with house speaker paul ryan. the first public appearance together at the fall fest in alcorn, wisconsin. live coverage tomorrow afternoon at 3:30 p.m. eastern. >> a second presidential debate is sunday night at washington university in st. louis, missouri. watch our live coverage at 7:30 p.m. eastern for review and then at 8:30 p.m., the predebate briefing for the audience. at 9 p.m., live coverage of the debate followed by viewer reaction. her calls, tweets, and comments. the second presidential debate, watch live on c-span. watch live or on-demand using her death cap, phone, or tablet. apple desktop, phone or tablet. >> every weekend, but tv brings

you 48 hours of nonfiction books and authors. here are some of our programs this weekend. saturday at 7 p.m. eastern, hillary clinton's e-mail controversy is the topic of an author panel discussion with peter schweitzer, author of ," jerome corsi, "afterwards," the issue --leaked to the manic cables diplomatic cables. is interviewed by the former undersecretary for democracy and global affairs during the george w. bush administration. >> i think leaks are going to be part of government life and the speed at which and the multiplicity of which we communicate with each other now not only in long cables that

short e-mails, texts, social media, tweets, all of that is going to be part of the body politic. >> joseph stiglitz on the future of the euro. .n his book go to book tv.org for the complete weekend schedule. >> joining us at the table, the president of the nea. thank you for being here. one of the reasons we wanted you on was this headline, this story in "the washington post" and elsewhere. the nation's largest labor union plans to link donald trump to a rise in school bullying. don't have to link him, he has linked himself there. there was a study recently by the southern poverty law center,

the premier organization and antidiscrimination and anti-bigotry and they took a poll of teachers that corresponds to the anecdotal phone calls we've been getting at the nea where people have said i've never seen anything like this before. be one kids that seem to the uptick of bullying, they are invoking donald trump's name. when donald trump gets elected, he's sending you back to mexico or you are a terrorist and donald trump will keep you out of my country. --tle girls with headscarves it's incredible. ironically, october is national anti-bullying month. every year about this time, will put up aa lot of good information for people who work with children, parents, scout leaders come anybody around kids about how to

recognize school bullying and how to intervene. sudden, people are calling saying i need this information, send me that link again because i'm seeing something that really concerns me. you and others are calling this the "trump effect." what do you intend to do about it? guest: it was not our term but certainly does describe it. you can google "trump effect" on children and see what comes up. you will see is what we've been hearing about from our educators all across the country . -- thee frightened little girl with the headscarf asking her mom come will we have to leave the country? they are scared.

the kids who at have traditionally, historically been bullied to kids were overweight, i don't like your race or ethnicity, you have a disability, these are kids who are constantly fearful of being different and these are the same categories that donald trump is calling out and kids are listening. host: what actions can nea plan to take? guest: first of all, you have to have educators, parents and anyone else in the circle of with children know how to deal with bullying. you can get really good information on how to talk to kids. one doing the

bullying, the victim and the bystanders. in this campaign, it takes on a new significance for us. we've always been politically active. we are a union, we come together , millions of hard-working educators that work in preschool , k-12 schools, colleges and universities. our we see this affect on children, on our students come in takes on a new importance for us. we will be more involved in this to getn, working somebody who's had a lifetime of service like our clinton -- hillary clinton elected. someone who is a horrible role model for children should be sent back to his reality tv show. host: let's put the phone numbers on the screen for lily garcia, president of the national education association, the largest labor union in the

u.s. she is the first latino to lead this organization. you endorsed hillary clinton one year ago. guest: we did. host: what are you doing on her behalf now? how much money are you spending, where are you spending it? guest: we will be investing more than six figures in direct mail, another six figures in online ourand we are involving members in a way we've never involved them. when you have an online ad, you can actually send that out to millions of educators and they can put it out on their social media. they can get their circle of influence. one in every 100 americans is a member of the nea. we are still predominantly women. both campaigns want badly to have women support them. demographic they

are both looking for. we will be talking about the the "trumpct -- effect" on our students. host: west palm beach, ford appeared marlene, are you doing ok with the storm -- west palm beach, florida. marlene, are you doing ok but the storm? democrat,am a registered democrat. i've made my final decision which obviously will go for hillary anyway. , i wastion this morning trying to get the guest you had on your show -- i'm thankful your guest right now is focusing on children and education. children act based on what they

see on television. donald trump is no role model. for adults or children. we have to be careful what our children watch. kids can be mean. we have a lot of bullying in this country. my final thing pertaining to donald trump, the way i saw him god,p, as a child of donald trump reminds me of pharaoh. we have to be careful because remember when they were warning, asking him to let god's children go? they did not listen. asked to divide the red sea. you see what happens to pharaoh.

donald trump, i cannot understand why we americans would want to put donald trump in the white house. for god's sake, i am a woman and the way i hear donald trump described women, the way he did , heirst african president should not even ask african americans to vote for him. there's a lot of pain in that caller's voice. she said a very important thing about role models. i am a sixth grade teacher from utah. election time was where -- i assign my kids a civics lesson. go home, interview your parents, look at the debate. 12-year-olds can look at campaign ads, they can give their opinions. it was a great time. we know how to separate how to

be a good civics teacher from what we do after school and on the weekends. today i amw if comfortable with having educators assign having kids look at the debates or look at those commercials. the role model we are seeing in donald trump is frightening children. that should tell somebody that something is wrong here. host: suffolk, virginia. donald is our caller. undecided. caller: i've heard the political sides from all these people here talking about demonizing one man and blessing another -- when it comes down to it, look at the and theof what the nea educational system has done with , notumbing down of america holding parents responsible for

theing the kids -- schoolteachers, i understand they cannot turn their back on the classroom in many cities,ies -- inner police cars have to sit in the parking lot. this is not because of one man but because of a philosophy. our teaching system has to allow parents to move kids to schools that effectively teach their child that we can see the difference in the education -- many of our teachers are not qualified to teach. if they had to take annual exams covering their subjects, as a doctor does, as i do in my business and many other professionals, many of them would fail. yet, we entrust these people to take and educate our children. we spend millions to promote since someone hit on politics, the year you remove the bible from the teachers

toolbox, our ethics, morals and the whole community started to go downhill. we have to effectively do what parents will not do. thents do not instruct black children and ethnicities how to behave when a police car stops them. they do not know how to respect individuals. they will run, they will lie, they will do all these things where the parents have just told the kids to challenge authority instead of respect authority. guest: i could not disagree more. that black families do not teach their children to respect authority. i taught in homeless shelters, i taught in the suburbs of utah, i've taught in a lot of different places.

again saw time and time were situations where depending on the color of your skin, you were treated very differently. by the authority. that's what is in the news now. what we have to recognize is that every public school, every single classroom, every teacher has a sacred responsibility. to respect those students, respect the family they are serving. the way theith caller pretrade this. that's portrayed this. -- the way the caller portrayed this. in this campaign, we are seeing stereotypes being thrown out that do not fit the students i taught. moreed to have a respectful tone and get rid of all those negative stereotypes.

host: let's get loretto on the line. a trump supporter. caller: good morning. ms. garcia, i really could not disagree with you more. for one thing, the nea is encouraging this peer mongering -- fear mongering, bullying being blamed on mr. trump. get real. this has been going on for quite some time here. our schools are in shambles. mr. obama has divided this country here and put the civil rights movement back into the 1960's. the respect for teachers is

terrible. i would not want to be a teacher today. they have no control whatsoever. fired as fard be as i'm concerned here. they should let the teachers teach. hillary clinton is a terrible example. done,xactly has she except have these offices here? she is a terrible example here. -- i cringe tod see her in that office here. thiso more deserves position then the man in the moon. guest: let me again respectfully

disagree. you have a candidate who as a young law student started working with the children defense fund. rights fighting for the of special ed students in our poorest communities to get the services they need. donald trump's first job, his as aave him a position manager of one of the apartment buildings in new york city. s his job to make sure they did not rent to black applicants. it is night and day what we see with these candidates. let's go back to what you were saying about bullying not being anything new. i agree with that. we've been dealing with bullying since there have been schools and kids. at a school kids wearing homemade

t-shirts with "white power, vote trump." there were two schools, one was a majority latino school and the other team's kids were yelling "build the wall." we are not making up this invoking the name donald trump. " onle "trump effect children and you will see it is out there and it is frightening. host: what do you see from the candidates in the education area -- hillary clinton says by 2021, families with incomes up to $125,000 will pay no tuition. making preschool universal or every four-year-old. free tuition at all community colleges. donald trump has put this out

there. invest $20 billion toward school choice, give states the option to allow these funds to follow students to public or private schools they attend. a national goal of providing school choice to every student and ensuring universities are reducing the cost of college in exchange for a tax break. guest: hillary's plan makes sense. -- if yoump's plan look at the fine print, it will not cost us any more money because he plans to take it from existing federal programs. the federal programs right now are special education, english , forage learners support our most vulnerable students who live in poverty. we would take it from disabled students, we take it from title i schools.

you would take all the money that has been fought for by organizations like the nea and parents and the advocates for all of those children and you say let's roll it all together and hand it out to people who send their kids to private school. this is not a plan, it's another con from a fraud. host: john in albuquerque, new mexico. on the line supporting hillary clinton. caller: good morning. you are like a breath of fresh air from the previous colors and the earlier segment -- previous callers and the earlier segment. i really pray that hillary gets in, but i'm concerned with the election being so close that getting in, what would happen in terms of overall educational funding like pell grants and student loans?

i have a fear that everything will become like trump university when he gets in. he is so erratic, said disingenuous. -- so disingenuous. i worry about the future of our country. guest: i think we are all worried. guess.ybody's if you go up to hillary's website and take a look at her education plans, you will see those preschool plans, you will see what she would be doing or affordable college. to his website, yes, we've bee

teachers rd for good and doing what they need to do them pire kids and have learning. i was utah teacher of the year, 'm very proud of that, i did project-based learning with kids, which doesn't come up on tests.rdized we've been looking at policies humanize actually education, let that school become the learning community it be. supposed to i have confidence in hillary clinton, that she's listening to educators and parents who want this. it's all d trump,

about some quick fix and in his case, it would be just give all that federal money to folks in private schools. named john r caller from carlsbad. donald trump supporter. good morning to you. wife is a school teacher. i'm actually a registered democrat. the lady on t.v. said she demographic of the united states and yet she's representing just one side f it and i don't have any negative comments about either bothdate, other than, they , i don't problems hink either one would be elected to their party's the nea p, but typically has -- they say they

the students and yet teachers and fight for teachers that are definitely teaching. be you can't have it both ways. you either -- you're either for kids and when you have a bad teacher, you get rid of them, you don't fight for them. i know they say, we have to fight for the bad ones to help but that is just ludicrous. segment s a -- this today seems to be really one -- i don't want to say anything negative, but usually it is not one sided. thanks for calling, john. guest: we have a support osition for hillary because of her lifeline commitment to students and to public education, that is why i was invited to come on to the show. that is what we want people to know and to know her record.

far as the national education association, we support quality teaching. we support proper preparation educators and when somebody is evaluated or there a problem with a teacher, we certainly t teacher, due right to have their process. but, what we want to concentrate how do we build that good teacher? how do we make sure that allowed to do the jobs they were trained to do? majority of ming educators are talented, creative people and we want the ability to do our jobs. endorsement o your of hillary clinton a year ago. was it always hillary clinton? asking, were there divisions between bernie sanders and hillary clinton within the

nea? guest: yes. the bottom line is, we do believe in a democratic process. we have good discussions. were vetted n. fact, all of the candidates were to fill o interview, out forms in writing so that we what are your proposals and your plans. support because of her lifelong commitment to students. everything she's done for dreamers, for special education students, for healthcare for our most vulnerable students, the chip one of her signature ieces of legislation that she helped usher through congress when she was first lady. looked, she has made children and families, specially those in the most vulnerable communities, a ornerstone of why she got up

that morning and how can you not support someone who supported you all those years. it's fair to say education has not been a central theme of election.dential what does that mean to you? is education receiving maybe the local ion at level? guest: hopefully we will never become our super school board and the president of the united states is not your superintendent, that's a recipe disaster, that is kind of what we had with "no child left untested," and we've gotten away from that now. critical and crucial education programs. our college affordability pell grants, the work that we've been doing for and hope while we wait for comprehensive immigration eform, special education, english language learners, title schools for kids who live in poverty. the funding has been an essential part of the civil kids s movement saying all

should have access and opportunity, but it is true that issues are going to be governor's d in the races and in state legislator and school board races, but just having something as important as saying, do we have a good role in the r students president of the united states is now something that people are about.g host: dale calling from indiana, caller.ed hi, dale. liver: yes, mrs. garcia, i a indiana, and i -- you being teach you er, i was wondering if remember when governor pence cut salaries of teachers and enough y didn't have teachers to fill the position because they were such

like ndard pay and it's both trump and pence are dead union, nst any kind of .ny kind of education they double the interest rate on tudent loans, i think it was todd young that voted in on yes, the education is -- i don't know exactly how to describe it, but it is in trouble. that is like here in indiana, we have several counties that taking money and buying needles to exchange with hiv drugs 's taking they don't have in need kids that are

of breakfast and all that stuff, money to buy needles? comments, hear your especially on about teachers etting a pay cut here in indiana. host: thank you, dale. guest: when it was governor disaster for a education in indiana. folks who y other believe that all we need to do is to take public school money fund private schools, it schools.e public there are good examples, good out there and they all involve teachers and the support staff and the parents in the chools actually giving authority to do creative things within the school itself. hat's what we're looking for, someone who will actually trust us to do our jobs. of rnor pence was not one

those governors. host: victoria, moleno, oregon, clinton supporter. hi, victoria. myleno. good morning, host: thank you. caller: i think the lack of that a lot of people who are displaced today, the others areo think the taking their jobs, the mmigrants, i think that leads to bullying with adults and children. these people who think donald will be the savior, we products,tsourced his but i just read the nvestigative reports about him using chinese fuel in his last an investigative supporter said probably the third one. i as researching that, but couldn't find that out. when they interviewed one of his nevada, er necessary they were protesting to form a nion, one of the last casinos

in las vegas and the reporter aid, what would you tell mr. trump? here is this latina housekeeper. if you say, mr. trump, want to make america great again, start with us, let us wage.ze to get a living i think that is kind of the picture in a nutshell. calling.anks for any reaction? yes, a few people mentioned national education as a union, we want to make sure people are treated fairly. advocate for benefit necessary pay, like any other union. what makes us a little also advocate for students, we advocate for extbooks and technology that they need and what a test should easure and what a test shouldn't measure. we advocate for policies that will treat children fairly and time to ect, collaborate with each other and the ing parents into

school. so all of the things that we've union have s our been good for public education our students. we think unions are the way that the middle class. you do it by gathering the voices, the collective action of people who are often very that cuhave some balance with management and sit wayhe table in a respectful and talk about the things that union members, the professionals that you epresent, need to do their jobs. o i appreciate the caller talking about that unions are a big part of why we ever had a class. host: just under 15 minutes left with our guest, lily garcia, nea, national e education association. we have a couple donald trump

we'll ers on the line, hear from them and come back to the guest. millersville, pa, good morning. caller: good morning, mrs. i'm a shgs a, correctional officer. i want to touch upon the education system and the of correction. annsylvania in 2013 spent for facility in central pennsylvania. with the programs going away, adult system inmates losing the opportunity to get an aboution, we want to talk the citizen rates and breaking hat cycle, it starts with juveniles in our education system. and allowing, i agree with you, do their jobs, and more opportunities in the public school systems and in come into before they the adult system. i would like to hear your thoughts on that. ost: let's hold that thought madeline, west

virginia. caller: yes, sir. host: good morning, what is your comment? caller: my comment is if hillary and the democrats are so our children, they're -- about that they let -- pregnancy? they will answer, maybe not to us, but their day will come when hey will answer for all they've -- all the babies that hey took their life and didn't give them a chance. host: thank you for calling. comment first.on guest: we believe that the made the right decision in saying in something as a decision to

end a pregnancy thas to be the of the woman who faces that pregnancy and we believe supreme court was correct on that. of juvenile crime, juvenile justice. first, i want to say that educators have a deep respect our authorities, for law when ement and we're best we work together and work in the students.rest of those we know that law authorities, uthorities right now are reviewing their own practices at they're taking a look whether or not they have the police aining for their officers and school resource officers. sure that make students, that children, that

americans, at members of society, are always rotected, that we look to law enforcement to protect us. and when we talk about what is our schools, it is something that concerns us that we see dropouts who will often become the next folks that are filling up our jails. do something to end that school to prison pipe tlt ine, where children who find themselves in trouble at school get discouraged, they drop out often turn to a dark side. together, we know that we can ind ways to bring some education justice to our schools. trouble, they n need to be corrected, they need a chance to learn from and we have to

practices cipline that sometimes just throw kids away, that say, you're out, instead of trying to work with them so they never get to the they find themselves in an adult prison or situation. ost: let's move on to south jerdzy, new jersey, not far from city.tic clinton supporter. good morning, carl. caller: good morning. ike to say, thank god for the unions, thank god for educators. want to speak to one of your earlier, earlier callers that has taken us a ack to the '60s, and it just speaks to the pink elephant in the room that everybody does not to say. divided m on issues is on racial lines. someone listen to what donald

says and the way that obama has carried himself hrough this presidency and say that obama has taken us back to the '60s, people don't want to that it is maybe some angry white d some people that are mad that obama as president and mad that hillary clinton is supported by many of the minorities. thank you. for calling.hanks next question can take up a hole segment, every student succeeds act, last year's bill, how is it doing? the idea behind the bill is and how is it faring so far? guest: i'm glad have you three hours left. show, right? guest: when we got rid of no was thatt untested, it high stakes mandate that you had test thatstandardized somebody got punished if you didn't hit a quota of kids that

on math and re reading test, that is gone. hat we replaced it with is an opportunity and state to state, they have to develop an card, a ility report dashboard of indicators, of success beyond that standardized test score. indicators like graduation rates, attendance ates, it can also be indicators -- how many kids are graduating high school having already earned college credit? then you'll be able to tell which kids have access to placement, international baccalaureate programs and which kids don't. you will see what to advocate for. for the first time, we got on thatg very important dashboard of indicators, indicators of service and kids.rt for which kids have a professional librarian in their school? a school nurse? counselors? how many kids are given, are

scholarships? you'll be able to focus on success at really mean for those kid necessary a very broad fashion. and each of being worked out in states, every state must develop their own dashboard of indicators, so we have real right nities to get it this time. donald trump supporter. hi. caller: i would like to ask mrs. garcia, she mentioned hillary clinton as attorney and how she loved children. there is a video out there rapist and fended a to have has counseling, it wasn't the fact she got the gentleman off, she down, ripped her to pieces and then got this hers, like she of did something wonderful. for illary clinton is

hillary clinton. , did thisterize trump monster, he's honest, this disgraceful for children. thanks a lot. bye. host: any reaction? don't know this video and i don't believe everything i internet, vino comment, i don't know the video. karen, undecided voter. hi, karen. undecided voter. i'm a teacher and recently moved massachusetts.om i'm calling from kentucky. i taught in both states. teacher for over 15 years. very ludicrous's to think that we could get rid bully nothing schools. bullying has been around as long been aroundngs have f. they are not bullying each whor about a sports team or

won the dancing contest on t.v. the night before, they're each other about what they wear. the best way to deal with a lying isn't to blame political figure, just deal with the children and talk with the it known to make them that, you know, you wouldn't want your feelings hurt try to go from that standpoint. ut to bullying a political figure, i think both political figures are disgrace to our political system. neither one of them have that i can shine up as a point to make the argument hillary clinton is for children. hillary linton is for clinton as much as donald trump is for donald trump. we lost her. respond? guest: i hope nobody heard me say that donald trump is the reason that there's bullies in

schools. we're see suggest phenomenon for the first time in where of history, children are using the name of a presidential candidate, someone wants to be the president f our country, in bullying other children. calling them fat, saying they're mexico, saying head ids who wear muslim scarves are terrorists, we've before.een that it is an effect you can google on trump effect and see what is going on. is disturbing, absolutely nobody has reported that someone hillary's name. she hasn't said anything that would frighten a child. let's do one last call from brenda in new hampshire. hillary clinton supporter. caller: hello. i want to thank you for confirm words and action what the bible says, no them by trump, i ks and donald

think he emerges as the epublican nominee and seems to confirm effect of negative sxit reality-based drama on the public. you feel about that, amount of negative ads on oth sides to me is just appalling. do you think it is due primarily packs?ing from the super i want to know what people want do, what people have done and i want to know what their policies are and i'm not getting just people bashing each other, which i think makes and frankly it's embarrassing. you hit the nail on the head that we are in a horrendous negative rallies, even the debates, where people are other, it's each not good for kids to hear that. graders d my sixth

debate things, they took turns and they used facts and evidence agree, that is exactly what a campaign should be. host: lily garcia, president of nea, the national education association, largest union in this country. very muu journal" live every day. economicsorning, and economic will break down economy. millennial voters play in 2016. the suspension of talks between the u.s. and russia over the conflict in syria. be sure to watch "washington

a.m.al" live at 7:00 saturday morning. >> "first ladies" is the name of the book, present a history that on the lives of iconic american women. mark farkas, what is this? mr. farkas: it is a book that grew out of our series on television, "influence and image." we took that and put it into narrative form. each chapter has a biography, including their time as first lady lady. some had great influence, some had less influence. >> was it easy to find records?

mr. farkas: some were easy. mrs. adams, there were lots of records lobbying him on slavery. martha washington burns all of her papers. you go from one extreme to the other. the farther along in time, you see the adaptation of technology and the role of first lady begins to emerge as well. now, they have a very public role. before, they could kind of get behind the scenes. >> a former first lady is running for president. mr. farkas: the chapter on first woman hillary clinton, you read that chapter, and you know right away, she is the most famous woman in the world. gail sheehy, when she is on the campaign trail in 1992, when

things are getting rough for the clintons -- things i think she would have not happen, it shows a very savvy first lady back in 1992. >> what did you learn from working on the book? mr. farkas: my favorite stories are the ones that i did not know before. lucy hayes, she is ahead of her time. grace coolidge is almost like a rock star in her time. she is opposite of calvin coolidge. you learn even about modern first ladies. lady bird johnson -- all first ladies go back to her as a role model because she is one of the first two takes on causes. eleanor roosevelt, but then there is a little bit of a break take on a cause.

and lady bird johnson takes on this cause of beautification. it is really environmentalism. they really do play a role. it is published date now, they can get a lot done. >> what is the role of richard norton smith? mr. farkas: a great friend of ours, his idea for the series. he is a guest on the martha washington program, the betty ford program. he makes the point that some first ladies have more of an influence on the way we live our lives. look at betty ford. she comes out for e.r.a. -- she was saying things that gerald ford did not want to hear. you think about her causes after she got out of the white house. she has had a lot of effect on people's lives. livese is the book, the

of 45 iconic american women, available at your favorite bookseller and online. recent oral argument in davis. tonight onrgument c-span at 8:00 p.m. eastern. tomorrow, paul ryan and donald trump at the first congressional district republican party of a partyn fall fest, fundraiser. at 3:30 p.m. on c-span. >> before the second debate, we are looking back at past presidential debates saturdays

on c-span at 8:00 p.m. eastern. 1992 debate the between bush, clinton, and ross perot. >> you can move your factory south of the border, have no environmental controls, no retirement, and you do not care about anything but making money, there will be a giant sucking sound going south. >> they are lower wages now and you have not done that. i have just negotiated with the president of mexico the north american free trade agreement. >> we have to increase investment, grow the economy, and reduce the deficit by reducing health care costs, cuts in domestic programs, and asking the wealthiest americans to pay their fair share of taxes. >> and then the debate between george w. bush and al gore.

>> if our national security is at stake, if we are allies of we tried every other course, if we are sure military action will succeed, and if the costs are proportionate to the benefits, i -i would take the- >> in my approach. we got be careful when we commit our troops. if we do what i am planning on doing, getting us energy north america energy independence within eight years, you will see manufacturing jobs come back. president obama: we have to look to the future. why we double fuel efficiency standards on cars. in the middle of the next decade, any car you buy, will go twice as far on a gallon of gas.

>> saturday night at 8:00 p.m. on c-span. watch any time on www.c-span.org and listen at 8:00 p.m. eastern on c-span radio app. the second presidential debate is sunday night at washington university in st. louis. watch live coverage at 7:30 p.m. for a preview, edit 8:30, the briefing for the audience. at 9:00, live coverage followed by viewer reaction. debate,nd presidential watch live on c-span or on demand your desktop, phone, or tablet at www.c-span.org. into the live coverage on your phone with a live c-span radio app. >> some medicare recipients could see an increase in their premiums less -- next year.

a discussion on the increased medicare costs. this is an hour and 10 minutes. [indiscernible] >> it looked like it was, but i guess it was not. i have the privilege of serving as the administrator of the public-sector health care roundtable. i want to take a couple minutes to share with you what the health care roundtable is. it is an organization that represents some of the nation's

largest public-sector health care purchasers, which means we represent the folks who provide health care benefits to the public employee community, the public retiree community, and their families and survivors. cost,sue of quality and those issues are tremendously important to the public sector as we seek to maintain a high level of benefits for our workforce. obviously, the topic of the session today is very important to us, and we are grateful for you being here. i wanted to mention that although this issue is of , weendous importance to us are, because of the nature of the population that makes up our membership, we are interested in health care across the gamut. you all have in your

constituencies employees who participate in programs, many of whom are coalition members. we want to say if there are other issues that we could be helpful to you, we would welcome the opportunity. in that regard, i want to note that standing in the back of the room, our senior policy advisor -- andew mcpherson from i suspect you have worked with him on other issues. i would encourage you to reach out to us if we can be helpful. i want to say a special word of thanks to the folks at the national coalition on health care. larry who have been so involved in preparing the leaderstoday are real and assets, and we are proud to partner with them in this endeavor. want tolly, i just thank all the panelists.

i want to say a particular thank you to the jane gilbert and to chris collins representing two of the founding members of the kentucky teachers retirement systems and the ohio public retirement system. brief introduction who we are, i would like to introduce our friend and colleague. thank you. good morning, everyone. this is turning into an annual exercise because the reason we are here is that costs in the medicare part b program, which pays for physicians is projected to go up 22%. the social security cost-of-living is practically flat. in balance, serious and that is the focus of today.

i and the ceo of the national coalition on health care. we are a nonprofit nonpartisan organizations that represent consumers, providers, payers, purchasers. our mission is health care affordability. today we will reinforce the need steps in take more medicare and the system of health care more generally to keep health care affordable. excellentroduce our lineup of speakers. newman, whoh tricia at the kaiser family foundation will lay out the facts for us. there is no one who is better able to do that. she is the director on health policy and the project on 's future. then andrew is with us from

aarp, an organization concerned about anything that has to do with medicare. jane gilbert is the director of the kentucky teacher's retirement system. and chris collins is the assistant government relations for the ohio public employee's retirement system. we are going to hear from private sector and public sector. finally, we have matt. matt is executive director of the national association of medicaid directors. medicaid is very much a part of this discussion. with that, tricia. tricia: good morning. thank you, john, larry, and the coalition. it is good to be back with several panelists to talk about this issue. i have three goals for myself this morning and you can see how

well i do. i will set the stage and talk about where we are in terms of medicare premiums and cost-sharing. i am then going to explain the nitty-gritty connection between premiums and social security and something called the hold harmless and how that fits together and why. lastly, i will talk about what we do know and what we don't know and when we will know the things that we need to know to understand what is really going to be happening in 2017 for beneficiaries. with those three goals in mind, let's see how we do here. ok, where are we now? we are in a situation where there is a medicare part a where people do not pay premiums. there is part b pays for physician and outpatient services.

part c, which is the hmo, and part d. for people who are in medicare part b, which is what we are going to be focusing on, there are premiums which vary based on people's incomes. you can see, people pay $121.80 per month based on their income. they also pay deductibles, which are affected by this issue we talking about today. another point to keep in mind is many people rely on social security for the bulk of their income, which is about $1200 per month. so what is in store? the medicare actuaries after getting information from social security and the bureau of labor statistics said that they predict that medicare premiums will rise by 22% between this year and next year as will the medicare part b deductible.

so that is a big increase in historic terms. and that is why we are here today. the reason why the premium is expected to go up has to do with the social security cola, which has been expected to increase on top of no cola last year. an underlying issue is what is going on with social security. and then medicare is sort of the tail of the dog getting the impact of what is going on with social security. i just want you to see the projected 20%, 22% increase in premiums and deductibles. what you can see is the income-related premium rises from $170.50 to almost $400.

something people don't normally remember when they think about income-related premiums. for everybody at that level, which is above $85,000 per person, their premiums will also go up by 22%. if this takes effect, the 22% increase goes across the board for anyone who is not protected by the hold harmless. so why are the actuaries projecting another year of large increases in part b premiums and deductibles? how does this all happen? each year, it is the secretary of health and human services who makes the determination of what the part b premium will be. this has not happened yet. in general, the part b premium is based on -- it is an amount that would cover 25% of all part b spending.

everybody pays a premium that if you put it all together, they will take 25% of all part b spending costs in general revenues. that is the calculation the secretary has to make, and then there is a little wiggle room in the language that says there need to be adequate reserves in the supplemental insurance trust fund. based on a 25% threshold, and the concept of adequate reserve, the secretary has the authority to set premiums, and the secretary will set premiums probably within the next month once she knows what is going on with the social security cola. at this point, what we know was that the cola is expected to increase by 0.2%. if that happens, many people on medicare, most people on

medicare, will be protected by something called the hold harmless, which i will illustrate in a which basically second, says, your part b premium cannot increase so much that it makes your social security check go down, because most people have their premiums deducted from the social security checks. and that is a provision in law that is intended to protect people who rely of social security to get by, and the idea is part b premiums should not diminish your social security income. that is the idea behind it. but what happens is when a lot of people are protected by the hold harmless provision, because it would otherwise force their social security checks to go down, if people who are not protected, and i will tell you who they are in a second, end up paying more because they are compensating for the people who aren't paying the full premium. have i lost you yet?

excellent. let's do an example here. this is what you might call the typical year. in a typical year, let's say the social security cola is 2% in the part b premium goes up 5%. i am making up these numbers because i want to illustrate the point. let's say the social security benefit in year one is $1500, and the part b premium is $100. a typical person would have their premiums deducted from their social security check, and they would then take home $1400. got it? so let's go to year two. let's say there is a 2% cola, the social security check increases by $30. let's say there is a 5% increase in the part b premium that goes to $105. there is no hold harmless issue

here. that is a typical year. but this year like last year's not a typical year, or does not look like it will be. last year, there was no cola. this year there is a tiny cola, 0.2%, maybe, we will know for sure in a few weeks. in this example, if the social security check increases by three dollars and the part b premium still goes up by $105, when you take the part b premium out of the lower social security check, what you can see here is the social security check would otherwise drop below $1400 in the following year. because of that increase in the premium. with the holdpen harmless. that is exactly what hold harmless is designed to prevent.

the person instead pays a smaller premium, part b premium, so that their social security check does not go down. i know it is a little complicated, but i thought the example might help. ok. so the deal is, most people are protected by the hold harmless, but not everybody is. i think the folks at the table will talk about what that means for them. new to medicare next year would not be protected by the hold harmless because they did not have their part b premium deducted from their social security check because they did not pay the part b premium. who else? people who don't receive social security aren't protected. people who are billed directly for their part b premiums and don't have their part b premiums deducted because they write a check. people who are duly eligible for -- dually eligible for medicare

and medicaid. that is when the state pays their deductible. and then beneficiaries with higher income are not protected by hold harmless. when you say that 70% of people, you're not going to pay the full amount of what would be your part b premium increase, that 30% of the people who are paying the part b premium pay more than they would have paid if this provision in law was not in place. in this particular case, part b spending is rising faster than it has in recent years, but the big jump in the premium that could happen has more to do with the hold harmless and it has to do with what is going on inside part b and projected spending growth. so, is this deja vu all over again? for people at the panel it is, because we talked about this last year when premiums were expected to rise 52% and there was no cola.

i think it was november 2015, congress stepped up with bipartisan budget act of 2015 which prevented a 52% increase from taking effect and basically increased the premium instead by 16%, which could be the amount it would have increased had the hold harmless not been in effect. will that happen again? it is not clear. the one thing to know about that particular provision of law is that it had a cost estimate to it of over $7 billion, and to make it budget neutral, the love required a three dollar rebate, repayment over time, which increases the premium, both the standard amount and the income-related premium. so what is coming up next? this leads me to what we know and what we don't now. the social security administration will make an announcement later this month.

could be early as october 18, which will let us know what the cola is. if the cola is 0.2%, we have an idea of what the premium could be, but remember, the secretary has some authority with just a -- to adjust the premium, up or down, depending on the reserves in the trust fund. if the cola is bigger than 0.2 percent, then the projected increase we talked about will be lower, should be lower. so after the announcement occurs, then the next step is the secretary will announce what the premium is. if this year is like last year, that should happen in early november. at that point we will know what the deal is. we will know what the premium will be, unless congress takes action. but this is where i get to the point where i say, i'm telling you what we know and what we don't know, and what we will know, and all will the company clear within a few weeks.

-- will become pretty clear within a few weeks. why is this all-important? this is important because people on medicare, many people on medicare have limited incomes. i've always liked to circle back to that because what you see is that half of all people on medicare live on an income of about $24,000 or less per person. it is important to think about the connection between health expenses, like premiums, and income, like social security because putting the two together are critical when we think about retirement security from an older and disabled population. we already know from the actuaries that medicare premiums and cost-sharing take a bigger and bigger bite out of social security payments. this shows you the percentage of social security payments that go for part b in part d. we are building on a base of health care costs going far more -- growing far more rapidly than income. finally, that just looks at

cost sharing for parts b and c. but remember that people on medicare have so many other health care expenses, paying premiums for private insurance, paying for dental care, eyeglasses, hearing aids, long-term care services and support, so all of this, this particular issue we are here to talk about today builds on a broader set of questions about the affordability of health care for an older population with many who live on limited incomes. >> thank you very much for including me. we have to do this again unfortunately. but we are all adept at handling it and knowing what is down the

pike. thank you, john, for inviting me to participate. tricia provided great background and lay of the land to let us know what we are facing. i will start zeroing in on the population affected and the beneficiaries this is happening to. first, it bears repeating that medicare is not free. there is considerable cost-sharing with premiums, co-pay, deductibles, like private plans. as tricia mentioned, supplemental coverage and part d drug coverage is additional and there is no coverage for dental, hearing, or vision. most people are paying out-of-pocket, not just you have medicare, you are set, there are costs besides the premiums. there is no out of pocket cap in medicare, so these costs can add up fairly quickly, especially for someone who was older, a little bit sick, unhealthy, accesses the health care system

on a fairly regular basis. also, not everyone is held harmless. she broke down the groups, but there are numbers associated. 3% of medicare beneficiaries, 16 million people give or take, 2.6 million of those are new to medicare part b in 2017, and another 3.2 million are higher income individuals whose premiums are income-related and are not held harmless. there's a fair number who are not collecting social security checks, for a variety of reasons, as well as people dually eligible -- on medicaid. that's the largest grouping, but i will allow the other panelists to talk about how medicare premiums affect their populations. i want to spend a moment focusing on the new beneficiaries and those with income related premiums, because they are often overlooked in all of this.

to start with, among those not held harmless, including those who do not receive social security, which includes those who have yet to sign up for social security for various reasons. maybe because they have not reached full retirement age and they are still working. you may know that medicare begins, medicare eligibility begins at age 65, but social security begins at four retirement age, 66, so if you want to claim for benefits, everything you are entitled to from paying in over your entire working life, you have to wait until 66, and that will likely go to 67 in the next couple years. you have the opportunity to buy in at 62 and receive benefits earlier, but that is a diminished benefit. you receive less than you otherwise would buy waiting longer. so people are put in a situation where they turn 65, they enroll in medicare, but they are still not on social security, collecting social security benefits for another year or more.

we happen to get questions from many of our members asking for advice really about enrolling in medicare. i know there is a premium spike happening. should i enroll early in social security and claim benefits early in order to avoid the premium increase? even though we don't give personal financial advice, because every case is different, in general it is probably a bad idea to enroll early and forgo higher social security benefits over the course of your life, for one or two years of higher medicare premiums. however, the fact this question is on our minds means that they are worried about medicare premiums and what a temporary spike could do to their household budget and pocketbooks. another component of the not held harmless are those who do not have medicare premiums deducted from the social security checks at the end of one year and the beginning of the next. this is people who may have

enrolled in medicare during 2017, they are not included, but also includes people who might be enrolling right now. right now, october could be too late. by the time social security gets up to speed with enrollment and starts deducting medicare premiums, we have to have november and december accounted holdn order to avoid the harmless limbo, so to speak. so to be held harmless you have to have the end of the previous year in addition to the year affected, which would mean currently, november and december of 2016 in order to avoid 2017. threw this light appear, i know it is hard to read, to provide numbers and context for new enrollees. even though younger beneficiaries, 65 to 69 have fewer health care costs, they

are still spending over $3000 a -- 50% of them are spending over $3000 a year on out-of-pocket on health care expenses, which is a sizable chunk of change when you are retired and living on a fixed income. even though they might be younger, healthier, new to medicare, they are still paying out-of-pocket expenses, over $3000 in many cases, and that is the median. half of them are paying more than that, so it could go up quite a bit. the average is a little higher. is 98th percentile spending significantly higher for this demographic. i would like to talk about a quirk in the income related. people assume, they are higher income beneficiaries, so they can afford higher premiums. unfortunately, to determine those subject to high income premiums, social security of ministration uses the most recent federal tax return

provided by the internal revenue service. used isal, the tax year the year prior to the year filed , meaning for example the 2016 tax return which we all prison related this past spring contains your 2015 income, which is used to determine 2017 premiums. so just as an example, let's say that janet has been working and her salary, she earned about $86,000 in 2015. that is fairly comfortable, upper-middle-class, middle-class lifestyle anywhere around this country. she decides that she is retiring in 2016 and enrolls in medicare now that she is 65. she now lives off of about $50,000 in savings and retirement income, which is reasonable, fairly substantial. however, she still has to pay the higher income related premiums in 2017 because her previous working income is what is counted for the medicare calculation.

so even though she's now living on considerably less than what she was earning during her working life, she is still considered high income and has to pay higher premiums. we urge everybody to remember, high income in medicare is not the same thing as wealthy, and that often gets overlooked. a little background and nuance on the population affected. i will turn it over to jane. jane: good morning. i am glad to be back again this year on this topic, but i'm not glad to be back this year on this topic. i am jane gilbert. i'm with the teacher's retirement system of the state of kentucky. i represent a population as large as 146,000 folks.

however, my main role is responsibility for the 46,000 retired teachers that participate in two health plans offered by the teachers retirement system of kentucky. i am very thankful to have the opportunity and the pleasure to be here to represent those 46,000, and i want to thank a few of those kentucky congressional delegates that i see in the audience, especially zach marshall. thank you for coming. as it has been mentioned this morning, kentucky falls into one of those buckets. we are in the, we don't pay in the social security bucket, along with 15 other states that don't pay into social security. 10 of those, including kentucky, happened to be members of the public soccer -- public-sector health care roundtable. you heard the introduction this

morning in regards to the public sector health care roundtable. interesting that we have 10 of the 15 as members about that roundtable and i am glad to be a part of that roundtable as well. in terms of demographics, i mentioned that i represent 46,000 retired teachers, 15,000 of those are on an under 65 health plan through the kentucky employees health plan, and 31,000 on a medicare-eligible health plan through an advantage plan and a medicare part d drug plan. our average age is 74 on the medicare plan. give a shout out along with my friend willard scott. we have about 42 retired teachers over the age of 100. we have 208 teachers between 95 and 99. we have 750 retired teachers

between the ages of 90 and 94. and we have over 5800 that are greater than the age of 80 years old. so a 22% increase $27 increase , a of the medicare part b premium has a huge impact in terms of my population. when i mention that teacher's retirement system along with other states involved with the public-sector health care roundtable are doing their best to contain costs and work with federal solutions, we also, kentucky passed a piece of historic legislation on shared responsibility house bill 540. ,between that piece of legislature that brought in four new revenue streams into our medical insurance trust fund and reverse a pattern of borrowing from our pension plans to pay for health insurance in , addition to medicare advantage, medicare part d, all

those solutions, we have been able to reduce our 30 year actuarial liability by over $5 billion. in terms of busting the trend a little bit with our medicare eligible health plan, we are bending the trend. in 2006, our medicare premium , in addition to the part b pay directly to social security, medicare premiums were in the $315 a month range. 11 years later it is $260 a , month. again, that is some of the industry's best practices like medicare advantage and medicare part d. one of the things we did as well , in this constant look at how can we contain costs, we did move the necessary years of service for retired teachers

from 20 years of service to 27 years of service. as i mentioned before, we jumped on the medicare advantage bandwagon in january of 2007. nine years later we still have a medicare advantage plan. we also jumped on the medicare part d, known as the retiree drug subsidy in 2006. later, we moved on to a waiver plan in 2010 and just continued to seek a deeper subsidy. another stipulation was for those who retired to the teacher's retirement system, beginning on or after july 1 2002, they must have 15 years of service to be eligible at all for health insurance as a retired teacher. i mentioned shared

responsibility in that piece of legislation. as well as some other federal solutions. we were able to trim $5 billion off of our 30 year actuarial liability. some of the rest of those are just industry best practices. the state of kentucky in many -- and many other states have taken on, as part of their fiduciary responsibility. how have we communicated this to the retired teachers of kentucky? we have given them the worst case scenario, so last year at this time, the worst scenario was $105 a month goes to $159 a month. we are very appreciative for the solution in the 2015 balanced budget act because that made it go from $105 to $122 instead of $159. this year, we communicated the

full possible worst-case scenario of $149 a month. again we are looking at a $22, i am sorry, a $27 increase, which is a 22% increase to the addition of the 16% increase last year. so these increases don't make a lot of sense. downwardse trending kentucky in terms of our medicare premiums, for our medicare advantage plan and medicare part d drug plan trending downward, yet our members are being charged some pretty large increases in medicare part b. in addition to the 10 states who don't pay into social security, and are part of the public-sector health care roundtable, i would like to mention that in all 50 states for those who are on original medicare, they are being asked to pay some pretty stiff

increases in regards to the medicare part b deductible, that annual deductible that applies to those with original medicare. so that is looking at an increase from $166 a month all the way to $204 a month. we are all kind of in this increase together. again, as i was here last year, and here this year, teacher's retirement system of kentucky and on behalf of our 46,000 retired teachers, we would love to see this not to be an annual issue, and we put love to see solutions in terms of the 30% of the states, the non-social security states, the 30% that doesn't pay the increase for the medicare beneficiaries, for 100% of medicare beneficiaries, so we are looking for help to make sure this is the last time i am here in this regard.

i am going to let chris collins with the state of ohio speak as well. he is next after me and we will be available for questions after everyone speaks. chris thank you, everyone. my name is chris collins, assistant relations officer for the ohio public employee retirement system, and i appreciate the invitation to be here today. i will tell you about ohio's experience with this issue. a little bit of background, oper s represents members who work with state and local government, townships, public libraries, and public employees in the state of ohio generally. we have one million members altogether if you add public employees, folks who have time in the service and are not currently working for a public employer, and also retirees, so

a big chunk of ohio is touched by opers. we are one of the systems not covered by social security. opers is just slightly older than social security, founded in 1935, so the potential impact of the med b increase is significant. we have 140,000 plus medicare eligible retirees in our system, and almost all of them would not be receiving a social security benefit. we are their pension. those are the individuals who would be impacted if this increase went into effect. if you look at all the statewide systems in ohio, we have a state teachers system, a system covering school employees like bus drivers, police and fire, highway patrol, we are talking about 260,000 plus eligible retirees in ohio impacted by this effect. it is a large number, but each

one of those people, there are individual stories behind that. in fact, it is personal for me because my father is one of our medicare eligible retirees. last year, when we went through this, we were thankful congress was able to reach a solution, but they did see an increase both for him and my mom for the monthly medicare part b premiums. they had to factor that into their budget and he had his kidney removed in the last year, so now he's going to dialysis three times a week, seeing his physician more regularly. my mom, in her upper 70's, is having additional problems and going to the doctor regularly. these benefits are very important to each of these individual retirees. it is important to remember for each one of those numbers we talk about, there is a story behind that. these are individuals who committed their lives to public service in the state of ohio.

even if you're talking about an increase of what is -- even if you are talking about an increase to $149 for a couple like my parents, that is an month, $60054 every a year that they have to fit into their budget, and that is very challenging. they're certainly not the only population in ohio that might be impacted. we have had reference to folks who are newly eligible for medicare, aging in, and i can just speak to opers, the rate that folks are turning 65. over the last calendar year, we had 8700embers, who have turned 65 in the last year. you can imagine going forward that there are people aging into this program that will be not subject to the hold harmless under the social security act. and any other category that is been mentioned already is the dual eligible population, the medicare/medicaid population.

speaking to our ohio medicaid department, we know the increase could be $31 million for them as a state share. i just want to leave you with a little information and insight in terms of how it is affecting us in ohio and hope that like last year, we can come together in congress and find a solution to help avoid the full impact of this change. i know matt will speak more on the medicaid issue. thank you. >> great, thanks a lot. i appreciate being here and all of you attending and watching on c-span. i represent the national association of medicaid directors. those are the individuals in each of the 56 states and u.s. territories who run the medicaid program. you may be asking, what exactly

is medicaid, and why is that relevant for a question on medicare solvency? very good question. medicaid is the largest health insurance program in this country. we serve 72 million americans. and we spent combined state and federal dollars last year, half $1 trillion. it is a big and important program. why is it relevant here? isn't medicaid the program for the poor, for pregnant women and kids and low income working families? at some levels, yes, that is a lot of people who we do cover. medicaid covers almost half the births in this country, third of all kids, a lot of things. but what is perhaps the best kept secret in health care in this country is medicaid's role in supporting, subsidizing, and keeping solvent the medicare program.

this is not well known, but it is incredibly important. if you think about the diagram of the medicare population and the medicaid population, the overlap has been referred to a couple of times as the dual eligible population. low income, frail seniors, low income with disabilities. it is a relatively small number of people. about 9 million, compared to the 72 million that medicaid covers. but when you think about it from a very blunt budgetary perspective, despite the fact that medicare is primary, and medicaid is just kind of stepping in to fill in the gaps. the gaps happen to be very, very big. medicare does not do long-term care. medicare has serious limitations on things like dental and mental

health services. and medicare has a lot of cost sharing requirements, premiums, co-pays, deductibles. medicaid steps in and covers those. when you look at that small group of people who are already the medicarething program has to offer, we spend 42% of the medicaid budget on that population. that is staggering and not well known, and is critically important. a huge component of that is around cost-sharing, premiums, co-pays, and deductibles, and that what makes this relevant here today. so, tricia talked about the reason why we are here. part b premiums going up, a medicare solvency issue. when you exempt a large portion,