don't know firmly right now. i know that is the plan. i will get that information to you. >> the time has expired. the chair would recognize mr. engel from new york. >> thank you, mr. chairman, madam secretary. i appreciate your coming here today to answer questions about the affordable health care act. you know, my republican colleagues' actions here remind me of a story i read when i was a little boy and that's the story of chicken little who ran around yelling the sky is falling, the sky is falling. but unlike chicken little, my republican colleagues are actually rooting for the sky to fall. republicans are holding this hearing today under the auspices of an investigative hearing as if they want to get to the bottom of what went wrong with the website in order to help fix it. but i don't think, madam secretary, there's one person in this room who is naive enough to actually think that the republicans want to see this law work. they voted over 40 times to repeal the law. they shut down the government and threatened to force a

default in order to stop it. they're rooting for failure. madam secretary, can you tell us what would be the impact on americans health insurance if republicans had been successful in their efforts to defund or repeal the affordable care act? >> well, i think that the estimates of the congressional budget office is that would have increased the deficit by about $110 billion in the first decade and close to a trillion dollars in the second decade. we know that we have 42 or 43 million americans without health insurance at all, some of them medicaid eligible and some over the medicaid eligibility. 30 governors so far, republicans and democrats, have declared their support for moving ahead with medicaid expansion, but absent that, the affordable care act, those folks would be without any kind of health security. and in the private market, what we know is it takes a real toll. but i'd say the biggest issue is

not just the financial toll, not the community toll, not the country toll, which is significant. i have a good friend who runs the cancer center at the university of kansas. i was with him and cancer researchers recent low, and he said that if you get a cancer diagnosis, you are 60% more likely to live five years and beyond if you have insurance than if you don't. i think that's a pretty powerful statement for why we need affordable health care for all of our citizens. >> well, thank you. the republicans have not been able to defund or repeal it, but they have denied requested funding, they have raised specious arguments about death panels and socialized medicine and worked to intimidate groups to help the implementation effort. there's been a spreading of misinformation about the cost of coverage. we hear some of that today. and to actively dissuade the uninsured from seeking coverage. madam secretary, how have these

tactics impacted your ability to implement the affordable care act? >> well, i don't think there's any question that a lot of people need a lot of information. i think it's one of the reasons we had millions visit the site, try to visit the site. it's why i am so frustrated and disappointed that the site is not fully functional and why i'm so committed to getting it functional because clearly there is a demand. we need to get information to people about the law. this is the law. this is not any longer a debate. it was a law passed by both houses of congress, signed by the president of the united states, upheld by the supreme court, the president was re-elected, it is the law and people have benefits and rights under that law and we've got to get that information so they can make good choices for themselves and their families. >> well, thank you. it is the law. and frankly i find it disconcerting that my republican colleagues have done nothing but root for this law to fail for the last three and a half years and now there's a big show here of being upset at problems with

the website of keeping people from signing up for coverage fast enough. so i would just say to my colleagues on the other side of the aisle, you're really on the wrong side of history here. the website will be fixed and millions of americans will be able to get quality affordable health insurance coverage through the affordable care act. and again, i thank you for being here today, madam. >> mr. pitts, chairman of the health committee. >> thank you, mr. chairman. welcome, madam secretary. have you personally tried to register or enroll on the website? >> sir, i created an early light account so i would see the prompts that were coming to people who were interested. i did work my way to the application feature fairly early on, but frankly i have affordable health care so i -- >> i just wonder if you've been through the process that millions of americans are having to go through. madam secretary, the initial website crashes appear to be largely a result of the decision

to prevent browsing of the plans. cgi federal testified at our hearing last week that they had designed the website to allow users to browse and compare plans before having to create an account. ms. campbell told us that two weeks prior to the october 1st launch, they were told to turn off the browsing feature. were you aware in september that this decision was made? >> sir, i wasn't aware of that particular decision that was made by the cms team. i was aware that we were paring back some features to not put additional risk on the website, which is ironic at this point. >> and who made that decision? >> administrator tavenner made that decision. >> and do you know why that was made? >> yes, sir, because we were anxious to get the website up and running and functional, which we clearly have failed to do to date, although i would

suggest the website has never crashed. it is functional, but at a very slow speed and very low reliability and has continued to function. having said that, they pared down some of the features, feeling that it would be better to load them in later. one was the shop and browse feature. another was the spanish version of the website and the medicaid transfers. all three of those issues were pared down in september to not load the system. >> thank you. last week cgi federal and qssi testified that cms was responsible for end-to-end testing and that they believed that months of testing would have been preferable to two weeks. do you believe that two weeks was enough time to complete testing of the entire system? >> clearly not. >> and when were you made aware of the result of the test, including the one where the system collapsed with only a few hundred users? >> leading up to the october 1st

date, we had regular meetings with not only a team at cms but administrators involved. i was made aware that we were testing. as we found problems, we were fixing those problems. i think there is a cgi report at mid-august identifying some problems and between august and october that became the punch list for cgi to fix those problems. that's why you test. >> now, in "the washington post" there was an article that said about a month before it opened a group of ten insurers urged agency officials not to launch the site because it was riddled with problems. were you aware in september that insurerers recommended the delay of the launch of the exchange? >> i was not aware. i know everyone was concerned that there were risks and likely to be problems with a brand new integrated insurance system. i don't think anyone ever

estimated the degree to which we've had problems in the system and certainly the contracting partners did not. >> and did hhs respond to the insurers' recommendation to delay the launch? >> sir, i can't -- i wasn't in the meeting. i don't know what occurred in the meeting and i don't know who they talked to. >> can you find out and answer that question for us? >> sure. i will get back to you. >> thank you. thank you, mr. chairman. >> mr. green. >> thank you, mr. chairman. madam secretary, thank you for taking time to be here today. i represent parts of east and north houston, harris downy, and our district has one of the highest uninsured rates in the country. even worse, we have one of the highest rates of people who have jobs but don't receive their insurance through their employer. it's for this reason that i believe houston would be a good place for you to come and spread the job about the tremendous benefits of the affordable care act. however, we learned your office is unable to attend because of scheduling conflicts. hopefully we can have an agreement that sometime in the future you'll come to the fourth largest city that probably has

the highest number of uninsured in a metropolitan area. of course we're in the state of texas that has the number of highest uninsured in the country. it's important to me and our constituents to get it right, and that's why i share your and the president's disappointment the website is not working as planned. november 30th is not soon enough. me and my constituents have been waiting for years to be able to purchase health insurance and we owe it to them to get the marketplaces up and running. the contractors have not served our country well and should fix it or not be paid. now we're hearing about the cancellation letters bowing sent boy insurance companies to customers notifying them that their plans are no longer offered. are these americans losing their coverage because of the affordable care act or because these plans were changed after the enactment of the act? >> i would say it's the latter, sir. if a plan was in place since the enactment of the act, no one would have received a cancellation. >> so if somebody in america had an insurance plan before the act

and the president was correct. if you have -- if you like what you have, you can keep it. >> yes, sir. >> if the plans were changed and now they have to comply with the new law. >> they could either choose to be grandfathered and keep the same plan, which meant the same benefits and actually the regulation allows insurance companies to charge medical inflation plus a trend line so they didn't have to charge the same price, they could increase it, they could increase co-pays, co-insurance. what they couldn't do was cancel benefits that the policyholder relied on. they couldn't disadvantage the policyholder. but if that plan is in effect, absolutely it is still in effect. >> but some of these millions of letters we're hearing about are probably because their plans changed after the act. >> absolutely. and again in the individual market, plans change every year. insurers find new products. >> and these plans are not allowed now because they're completely inadequate. they don't offer the minimum essential benefits, is that

correct? >> that is correct. >> and having been a state legislator, and i know as governor in kansas, i assume every state has some type of minimum mandated benefits that they have for their health insurance plans. >> they do, but it applies again, sir, in the past usually to the group markets where 90% of covered americans get their policies. this market has always been the wild west. >> so if americans get letters from their companies about cancellations, they're eligible to purchase on the exchange? >> or out of the exchange. individuals who aren't interested in financial help they can go outside the exchange, inside the exchange, their insurer can offer them plans. they have choices they have never had before. >> and because of the benefits of the affordable care act, 80% of their premium dollar will come back to them. >> that's correct. >> and that's not true -- i know it's not true in texas, but i don't know any states that have that 80% requirement. >> no state had it, i would suggest, in that broad base

prior to the affordable care act. >> let me give you an example of one of the plans i found out during casework a few years ago. a large company provided $25,000 maximum benefit for their employees in the year. most employees didn't know about it and until this one constituent found out that she had cancer. and the bill ended up being $300,000. and so that's some of those plans that are not being allowed to be sold now, is that correct? >> well, not only would the plan have a limit on out of pocket costs per year, it will have a limit on a lifetime out of pocket cost and it will take away the notion that you would run out of your coverage in the middle of a treatment, which a lot of plans do. >> i know i'm out of my time, but it's like buying a car. it may look good but if it doesn't have a motor, it's no good to have that car and that's why the affordable care act. >> it saves a lot of gas but doesn't get you anyway. >> the gentleman from oregon, mr. wallden. >> thank you very much, mr. chairman. governor secretary, we're delighted to have you before the

committee. you and i both know how important this issue is to all americans that we get it right so i hope you can appreciate we're trying to understand what we missed along the way. and one of the things that bothered me was the letter that was sent from your agency to the gao back june 6th. and i'll read in part it said we're in the final stages of finalizing and testing the i.t. infrastructure that will support the application enrollment process. hhs is extremely confident that an october 1 the marketplace will open on schedule and millions of americans will have access to affordable quality health insurance. i'm just an average guy from a small town in oregon. but when i read that, it tells me you believed everything was good to go, the testing was in place and we should have full confidence everything would work, correct? >> that's the letter i signed, yes, sir, or whoever. >> actually it was signed by your assistant. >> yes. >> so i went into this believing

in your response, your agency's response to gao things were ready to go, we should have full confidence because when somebody uses the word extremely confident, it tells me you're extremely confident. second piece then, when we had the testimony from the witnesses last week, i asked them about the end-to-end testing and what the industry standard would be and they should it really should have been months, especially for a project of this magnitude, and yet we heard it was only two weeks. now, in august, gci told cms in their -- >> cgi. >> i'm sorry, cgi, thank you. on august 9th that there was not enough time in the schedule to conduct adequate performance testing. did that make its way all the way to you and do you think there was adequate time? >> sir, clearly as i've said before, we did not adequately do end-to-end testing. the products were not locked and loaded into the system until the third week in september.

each of the component parts was tested, validated, skbaindependy validated. >> all those worked, right? they told us their individual modules tested and med specification. do you concur with that analysis based on what you know. >> i do concur with the testing that was done. >> so it really was the end-to-end which is why some of us thought we should delay until it could be done right to avoid this very collapse that now is upon us, and i realize not everybody agreed with that. the second piece gets back to "the washington post" which i understand you haven't had a chance to read but the four pinnochios about the president repeatedly saying if you have a plan, you'll keep a plan. we all heard that to mean i've got a plan with a company, i'll continue to have it even if they make minor changes when in fact your own rules say that's not what's going to happen. if minor changes are made, that

means the plan changed, that means you don't get it. >> sir, that isn't true. the rules did not say what you just suggested and i think the estimate given that there would be turnover in the market was really an outside projection. it wasn't our rules. it was a snapshot of what happens in the market. that plans change so dramatically over time that the estimate was they wouldn't be -- not because of our rules but because of insurance companies business decisions -- >> but you set up those market rules that they had to comply with, correct? >> only if they chose not to grandfather the policy. >> but that meant they couldn't make any change. >> any grandfathered policy in place still would be in place. >> but if they made any change -- >> no, they could make changes in pricing, they could make changes in benefits, they couldn't dramatically disadvantage the consumer, but they could have trend lines. they had a wide corridor to make sure that a similar plan so if a

consumer liked the plan, the plan if it stays in place -- >> so here's the practical implication. i've got letters from constituents who have gotten letters from their insurers who say because of obama care, they're no longer going to be in the individual market or at least with that plan in the individual market and the result is this person from cove, oregon, said i was paying $600 for a $3,000 deductible now it costs $800 for a $5,000 dedu deductib deductible. a woman whose job had 40 hours, now down to 29, neither has health insurance nor enough income to live on her own because of the way this law is getting implemented. i realize my time has expired. general lady from colorado. >> thank you very much, mr. chairman, and thank you, secretary, for being with us today. i want to follow up on a couple of those questions that mr. walden was asking you about cgi. as you know, chairman issa

released this document, monthly status report from cgi last night and it looks to me like sort of a technical document that has a punch list of outstanding open issues. some of them do highlight items that upon first read seem to be alarming. for example, one of the entries said due to the compressed schedule there's not enough time built in to allow for adequate performance testing. and this certainly in retrospect sounds bad. but the date of the document that chairman issa released is september 6th and then on september 10th, four days later, cgi came into this committee and testified under oath, quote, cgi federal is confident it will develop -- deliver the functionality that cms has directed. and we're -- we're trying to figure out, at least i'm trying to figure out how cgi is now coming in and saying, you know, we warned everybody that this wasn't going to be ready when

they came in and directly told me that they would be ready to launch on october 1st. so it kind of raises a question how these statements can be reconciled. one explanation is that cgi was lying to this committee. i think that's unlikely. another is that cgi thought that the items flagged in the report were like a punch list that could be addressed. so here's my question to you, madam secretary. was cgi telling your department the same thing that they told the committee on september 10th, that the company was confident that its programs would be ready? >> congresswoman, all of the contractors testified here in september and again, i think, last week before this committee, and the testimony was fairly similar, that they were ready to go in september. they were asked last week if

they had suggested that we should delay the launch date. each of them said no. >> so they never asked you to delay launch date? >> they did not. and frankly, i think it is not valuable at this point to do a lot of pointing blame, fixing the blame. what i want to do is fix the problem and i think we need the whole team to move ahead and we will report back regularly. >> right. but we're relying on these contractors. >> i understand. >> to fix this. and so that goes to my last question, which is mr. zients has now come in and he says the site is going to be functional for the vast majority of users by the end of november. is that right? >> that's correct. >> and given what cgi told us and the other vendors, do you believe that that is correct? do you believe it will be pretty much ready to go by the end of november? >> i do. and i think that we are making improvements each and every day.

it is easier to use now than it was two weeks ago. it is way from where we need it to be. >> so it's not like it's all going to be fine by the end of november, it's beginning to improve already. is that your testimony? >> it is a continuous process as websites are. patches are made, and as we find issues, we are fixing them in realtime. >> and you'll guarantee, yes or no, that people will have privacy when they go on the site? >> absolutely. >> now, i just want to say one last thing. i was on the washington journal program where callers call in this morning and i had a man, max, call in and he said he got one of those letters from the insurance companies that his insurance was cancelled. so what he did is he went on to the website and he -- on to the federal exchange and he found a better plan and now he's going to sign up. so i would hope that that's what everybody would be able to you and i thank you, mr. chairman. >> mr. terry.

>> thank you, mr. chairman. i'm pleased to hear that the website will be fully operational by the end of november. would you be able -- would you come back to our committee so we could see if that's actually accomplished and how it was accomplished? >> i will make every effort to do that. >> okay. you were governor and state insurance commissioner in kansas, and i reached out to our state insurance commissioner and governor and found out that they have absolutely no data about nebraskans who have either tried to enroll or enroll. as you know, nebraska is one of the states that opted not to do their own exchange and rely on the federal exchange. so it's interesting to me that neither our insurance commissioner nor the governor's office had any data about

nebraskans. and enrolling in these plans. i also asked our insurance commissioner if any of the navigators, if they knew who the navigators were and whether they had to apply to be certified or licensed, in essence like an insurance agent would be, and they told me they have no clue who's been authorized by hhs to be a navigator and work with people in nebraska. so this is concerning to me. so i'm going to ask you a few questions along this line. first of all, do you have data on how many people in general in the united states have tried to enroll in a plan through this website? >> no, sir. we do not have any reliable data around enrollment, which is why we haven't given it to date.

>> or have any data on how many people have tried to enroll but because of the problems have not been able to accomplish that? >> no, sir. i can tell you i met with insurers last week and one of the priority fixes is the so-called 834s, the document that sends an individual's name to a company and verifies it. that is one of the systems that is not working. >> i appreciate that. and the contractors i asked specifically about the information of how many people have tried to enroll and enroll, and they say they do have those numbers but can't tell us that because of a contract with hhs saying that they -- they're gagged on that information. >> i would suggest that the numbers are not reliable -- >> well, my question is going to be, though, will you on the record right now authorize them to give us those numbers and let us determine whether those are reliable. >> no, sir. i want to give you reliable confirmed data from every state

and from the federal marketplace. we have said that we will do that on a monthly basis by the middle of the month. you will have that data but i don't want to turn over anything that is not confirmed and reliable and that's what we'll do. >> but that data out there exists. >> sir, i would tell you right now it is not reliable data. according to the insurance companies who are eager to have customers, they are not getting reliable data all the way through the system and that's one of the real problems that we have. >> some of the people that have clicked on and tried to get or enrolled, i'm not asking about what they enrolled in or whether they came in and said they were 65 and were quoted something that they were 27 years old, that should be a pretty reliable number just on the surface -- >> the system isn't functioning so we are not getting that reliable data. insurers who i met with said that that is the case.

we know that there's 700,000 applications -- >> the reliability of that data certainly flies in the face of the testimony from the contractors. all right. i yield back. >> miss caps. >> thank you, mr. chairman. thank you, secretary sebelius, for your presence here today and your testimony. i too am frustrated with the flawed rollout of healthcare.gov, i do appreciate your long standing commitment to improving the health care options for all americans and fixing this website quickly. i think it's important to note that in my home state of california and other states as well, the new exchange marketplace, we call it covered california, is working. rates -- constituents are finding that rates are as much as 29% less than those that they found on the marketplace last year. i'm thankful my constituents now have this option. as i look around to complement takes nationwide, it seems clear to me that political decisions

in individual states have really made the difference for consumers. the governors and state legislators that embrace this law are delivering for the communities, but those elected who are trying to ignore the opportunities presented and continue to throw up roadblocks both here in congress and in state legislatures should not seem surprised that there are significant bumps along the way. this seems to me to be completely disingenuous. having embraced the law since open enrollment began october 1st, californians have started nearly 180,000 applications with more beginning every day. i know my time is limited, but i want to have a second to mention a conversation i had just last night with a telephone town hall to my district on the central coast of california. one of the first callers i heard from was a mother from santa barbara. her name is merril. she wanted to tell me the story

of her son. her son is 28 years old and he had been paying $425 a month for his insurance before the affordable care act. she was happy to report that he has already applied through cover california and has found a policy that works better for him and has all the essential health benefits covered, which his former policy did not, and now will only cost him $109 a month. this is significant savings for her son, and this is a story that's being repeated at least in california often. so there are millions of residents in many states who have now set up their own websites and market places. in those states tens of thousands of people are now as we speak signing up for coverage. this is demonstrating that the affordable care act is working. new york and washington, over 30,000 people have enrolled. in oregon over 50,000 people have been enrolled. kentucky, 31,000 have been enrolled. we could go on and on. the success of the state exchanges, which is where this

is meant to be implemented shows how badly this law is wanted and needed, how much it will be of help to so many people who want quality affordable health care. so my three quick questions to you are this, madam speaker. what is your assessment of how this first month has gone in the states that are running their own marketplaces, which this congress intended that the affordable care act work? >> well, everything we hear from the state-based markets is that they are doing well. they have not submitted data yet. we again are working with them around a monthly schedule so that they will confirm medicaid data and enrollment data and we'll see the real numbers at the end of the month and make sure that they are available to the public. but everything we hear is that they see the same demand. they are eager to enroll folks

and that that -- >> and what do you think this success shows about the demand and the interest for affordable health insurance on the part of constituents? >> well, i don't think there's any question that in spite of a series of roadblocks and blockades and a lot of misinformation driven by a $4 million marketing campaign last year, americans are eager to see what their benefits may be under the law, what their opportunities are, how to get health security for themselves and their families, and we want to make sure that they see those benefits. the website is one of the ways to do that. the call center, on the ground enrollment, personal outreach are a variety of ways and i would tell your colleague, mr. congressman, i'd be happy to get you the list of the nebraska folks who are on the ground. it's available easily. it's public record so i'd be happy to send it to you so you could share it with your insurance commissioner and governor. >> the general lady's time has

expired. the gentleman from the great state of michigan, mr. rogers. >> thank you, madam secretary. get through some questions here if i can. is it your testimony that every night to try to increase the functionality of the system your hot swapping codes so my understanding is between two and four write new code, put it into the system. yes or no? >> clearly i am not hot swapping code. there is a technical team -- >> you are in charge of the operation that hot swaps code on functionality. you're trying to improve the functionality, yes? so that happens every night? >> no, i don't think it does happen every night. it's periodically between the hours of 1:00 and 5:00 but is not a nightly feature. >> has each piece of code been security tested? >> that's my understanding, yes, sir. >> each piece -- each piece of that code has been tested? yes or no. >> i don't know. >> that's -- >> i can tell you that security -- >> that's a much safer answer, trust me. >> it is an ongoing operation

that as code is loaded, you need to retest over and over and over again. so whether it's pretested, i can't tell you. >> you need to test the code. >> it's simultaneous -- >> have any end-to-end security tests been conducted since healthcare.gov went live october 1st, yes or no. >> my understanding is there is continuous testing as -- temporary authority to op ralt calls for. >> yes or no, has an end-to-end security test on healthcare.gov went live, yes or no? >> i will finding out exactly what testing they're doing. i know they're doing simultaneous testing as new code is loaded. >> are there any end-to-end security tests run after every new piece of code is put in the system, i'm not talking about testing the code. >> i can get you that information. >> i can tell you they're not and i'd be interested to hear why not. if you'd go to tab 2 quickly in your book. >> i'm sorry, what book, sir. >> you have a tab there -- if

you go to tab 2. while you're looking, i'll read. dated september 27th. and it is to marilyn tavenner. there are inherent security risks with not having all code tested in a single environment. finally, the system requires rapid development and release of hot fixes and patches so it is not always available or stable during the duration of the testing. secondly, the security contractor has not been able to test all of the security controls in one complete version of the system. and if you look in the first part, which is most troubling at all, it says due to system readiness issues, the security control assessment was only partly completed. this constitutes a risk that must be accepted before the marketplace day one operations. so let me tell you what you did. you allowed the system to go forward with no encryption on

backup systems. they had no encryption on certain boundary crossings. you accepted a risk on behalf of every user of this computer that put their personal financial information at risk because you did not even have the most basic end-to-end test on security of this system. amazon would never do this. pro flowers would never do this. kayak would never do this. this is completely an unacceptable level of security and here's the scary part. we found out after the contractors last week that an end-to-end test hadn't been conducted on secure, not functionality, because if it's not functioning, you know it's not secure. your ongoing hot patches without end-to-end tests, the private contractors told us it would take a very thorough two months just for an integrated end-to-end security test that i'll tell you has not happened today.

why? because you're constantly adding new code every night to protect the functionality of the system. you have exposed millions of americans because you all, according to your memo, believed it was an acceptable risk. don't you think you had the obligation to tell the american people that we're going to put you in this system but beware, your information is likely to be vulnerable? would you commit today, secretary, to shut down the system and do an end-to-end security test -- >> no, sir. if you read the memo. >> oh, i have read it. >> it depose on to say that weekly testing of our devices, daily, weekly scans are going on. this is a temporary authority -- >> that's not what the memo says, number one. and number two, the contractors will tell you -- >> mr. chairman, point of order. i think the witness ought to be allowed to answer what was a speech by the colleague because he's raised a lot of issues. >> if the general lady will

quickly answer. >> there's been no other speeches here today? that's shocking. >> does the secretary wish to respond briefly? >> sir, i would just say this document is a document signed by administrator tavenner which discusses mitigation strategies for security that are ongoing and upgraded and an authorization to operate on a permanent basis will not be signed until these mitigation strategies are satisfied. it is under way right now but daily and weekly monitoring and testing is under way. >> mr. chairman, there are people using this system today and she just admitted today the system isn't secure -- >> mr. chairman, she didn't admit that. you said it but she didn't say it. >> the gentleman's time has expired. mr. doyle. >> thank you, mr. chairman. madam secretary, welcome. those of us who fought for this law, who voted for this law have a vested interest in its success

and the concerns that you hear expressed on this side of the panel are real because we want to see americans get health care. i think it's somewhat disingenuous for my colleagues on the other side of the podium here to have this faux anger and this faux concern over a bill that they absolutely want to fail and have rooted for its failure and have voted over 40 some times to repeal this bill, never putting an alternative plan on the floor for the american people, but just to simply say they want to make sure this plan doesn't succeed. and i think their real fear is that the plan will succeed and the american people will learn the real benefits of this plan, not the propaganda campaign that's gone on by the republicans for the last three years. madam secretary, i think one of the keys to the success of this plan is that we get young people to enroll in this plan. and i have some questions about

some enrollment concerns that i have. now, i understand that you've said approximately 700,000 people have applied for coverage via the healthcare.gov and the state exchanges, is that -- >> they have completed an application. >> right, which is different from enrollment. >> that's correct. >> so my question is are you expecting -- i know you don't have exact numbers yet, but are you expecting a large number or a small number of enrollments during the first month? what is your thoughts on that? >> well, our projections prior to launch were always that there would be a very small number at the beginning. we watched the massachusetts trend which started slowly and built. i think there's no question that given our flawed launch of healthcare.gov it will bow a very small number. >> in the massachusetts plan i think the first month there was 123 people signed up, less than 1% of the overall first year enrollment in that first month. we saw the same kind of numbers

in medicare part d back in 2006. m madam secretary, young americans are the most likely age group to be uninsured and a lot of us are concerned that because of the problems that we've been having with the website that a lot of these young folks may not come back on. you know, they have very short attention spans. i've got four kids that all work on the internet. if they can't get something in five minutes, they're on to something else. what do we do and what plans are in place by your department to encourage young people to go back and revisit that site and to make sure that we're getting young people looking at that site and accessing it? >> step number one is fix the site, because we don't want people to be invited back and then have a bad experience a second time around. i think that's absolutely right. the site is particularly important to tech savvy younger generation folks who we need to enroll.

i think that we have -- fixing the site is step one. step number two is getting information to folks that the law even exists. a lot of young people haven't followed this dialogue for the last three and a half years. >> i think we need a real marketing campaign and really need to reach out to young people. >> we intend to do that. >> especially at the end of november when you say this site is going to be working a lot better, to make sure they're checking that site out. >> you bet. >> one of my four kids is self-employed, he's paying about $140 a month for a blue cross plan. he's eligible for a subsidy. we browsed that site. he'll be able to get coverage for about half of what he's paying right now and that's good news for us because i think my wife is paying his premium so i think we're going to save the money. but i think it's important. we had to prod him to go on that site and enroll. and i think for a lot of young people, they're not going to do it unless it's easy. so it's important we get that fixed. >> i agree. >> thank you. >> dr. murphy, chairman of the oversight subcommittee.

>> thank you, madam secretary, and welcome. you had mentioned that the people who did the technology on the website made a number of mistakes. you mentioned verizon. when we had them before the committee they said it wasn't their fault, they were told within hhs there were problems there. >> verizon wasn't involved in the website. >> i understand. but they had a role, cgi had a role, other companies, et cetera. i'm just curious in this process what decisions did you make that affected this for better or worse in terms of the data, the ease or problems at the moment and being able to track how many people are actually enrolled? >> my decisions specifically to design the website, i was not involved. i am prohibited to choose contractors. we go by the federal procurement and i got regular reports on

exactly what was done. >> what about the part with regard to getting data in terms of how many people are even enrolled or trying to enroll. >> again, the application process at this point does not work end to end very well and we do not have reliable data about the end -- >> i'm just trying to find out if you had asked them to say, look, i'm in charge of this. i'm going to want a regular report, how many people tried to ep roll, houp people have enrolled. >> we have prioritized for our contractors that specific fix. believe me, the insurance companies are eager for us to get reliable data to make sure that their data matches ours, and that is not there yet. >> i appreciate that. i'm trying to figure out if you told them that was part of the plan of what they were doing. we're hearing from thousands of people who have had their policies cancelled. in fact i heard from one in insurer in pittsburgh that cancelled 30,000 individual policies. they said they expect 50,000 to 30,000 to enroll in the exchange plans. to date the number of people who have signed up for that plan is

10. 10. now, i'm concerned a lot of these individuals and families aren't going to make it by january 1 so i'm wondering do you know how many families will not have been able to keep their insurance by january 1? do you have any matrix to help you understand what that number will be? >> sir, by law that has been in place at the state level. insurance companies must give their customers a 90-day notice about a policy change or plan cancellation. >> i'm just wondering if you have a mechanism where you will know, is something know -- >> will i know if your constituent signed up for an individual plan, no. >> people across america. and do we know how many policies will be cancelled? is it a thousand, 10,000, 1 million, 5 million? do we know? >> we know that in the individual market a number of the plans being sold are not grandfathered and are not currently meeting the law. those notices have gone out. we know that there are about 12 million people in the individual market.

a number of them have grandfathered plans. a number of them have plans which meet the essential health benefits, so i can try to get that. >> let me put a face on that. person named paul wrote to me and said i'm supposedly one of the families this act was supposed to help but it's hurting more and would make it harder for my family to live. we'll have less money for food and essential items. i have a wife and four children. another person wrote i received -- or i had a 2013 plan which if you include the premiums and out of pocket total liability was $5,300. for 2014 total liability is $9,000. single mom, i want to convey i'm one of the millions of people having their health insurance canceled because it does not meet the standards of obama care. i liked my insurance. i especially liked the price and now i'm being forced to sign up for something that will be way more expensive. as a single mom who's self-employed i'm worried about how i'm going to help my bills. i hope you have a mechanism to track who these people are, she's not eligible for subsidies but the costs are going to be

driving her down. >> sir, again, i would suggest that there is no requirement that any of those consumers sign up for a plan suggested by their company at a higher price. they have now options. >> but if a plan changes -- >> health underwriting without pre-existing conditions with some guarantees around -- >> she's searching and can't find a plan that she can afford. she can't find a plan she can afford. >> the gentleman's time has expired. mr. butterfield. >> mr. chairman, before my time begins, i have a parliamentary inquiry. >> yes, go ahead. >> mr. chairman, i'm always sensitive to committee decorum and before i do it this morning, i want to ask unanimous consent that i be allowed to display the democratic twitter handle. >> go right ahead. >> hearing no objection, thank you. secretary sebelius, thank you so very much for coming today. i would like to ask you about the document that my rip colleagues have just released.

this document is an authority to operate memorandum, to operate the federally facilitated marketplace for six months and implement a security mitigation plan. this document, as i understand it, describes security testing for healthcare.gov. it says that security testing of the marketplace was ongoing since its inception and into september of this year. in fact it says that, quote, throughout the three rounds of security control assessment testing, all of the security controls have been tested on different versions of the system. that's good news. but the bad news is that it goes on to say that because of system readiness, a complete security assessment of all the security controls in one complete version of the system were not tested. this document indicates that cms postponed a final security assessment screening but in its place, cms did put in place a number of mitigation measures and it concluded that these

measures would mitigate any security risk. question, are you familiar with this document? >> yes, sir. >> is it correct that this document recommends implementing a dedicated security team to monitor, track and ensure the mitigation plan activities are completed? >> yes, it does. >> now, is it correct that this document recommends monitoring and performing weekly testing on all border devices, including internet facing web servers? >> more than recommended, it's under way. >> is it correct that this document recommends conducting daily and weekly scans? >> yes, sir. >> does this document recommend conducting a full sea test on the marketplace in a stable environment? >> yes, sir. >> is it correct that this document recommends migrating the marketplace to cms's virtual data center environment in the first quarter of next year? >> yes, it does. >> my understanding is that an

independent security expert is performing security testing on the code that powers the website on an on going basis. is that correct? >> that is correct and miter did an assessment of the system, gave us a preliminary report. they are in the process of posting their final report. that did not raise flags about going ahead and the mitigation strategy was put in place to make sure that we had a temporary authority to operate in place while the mitigation was going on and then a permanent authority to operate will be signed. >> finally, do you have confidence in these and other measures you are taking to protect the security of americans' personal information? >> i do, sir. >> thank you. this is the third time you said it during the hearing and we believe you. thank you. what you're telling us is that these remedial actions and the ongoing security testing from miter are protecting the security of the website. that's a message that it's important for the public to

hear. my republican colleagues do not want this website to work. i am convinced of that. they want to block the aca at all costs and even shut down the government to stop the law. for the last four years, they have taken every glitch, every simple glitch and hiccup in the law and tried to exaggerate its significance and that's happening today and it's so disappointing. thank you, mr. chairman, i yield back. >> dr. burgess. >> mr. chairman, i wonder if i may make a request also. i would like to request unanimous consent that my opening statement could be made part of the record. >> no objection. >> and further i do have a number of questions, many have come from constituents. i'd like to submit those as questions for the record and ask the secretary for her attention to those so we could get answers because they, after all, are important questions. okay. thank you, mr. chairman. it just came to my attention that on cnn's website that the

site was hacked just last week. and i will be happy to make this available to you. >> the cnn website? >> the cnn ran a story that the healthcare.gov was hacked last week. again, i will get this to you and would appreciate your response to that. mr. terry had asked a question about he wanted to get the information about the number of people who had signed up and you said you wouldn't provide that because it wasn't accurate. would you provide us with the number of people who have been able to enroll on the telephone. the president gave an 800 number in his speech. could we get a number of people who enrolled on the telephone? >> no, sir. we do not have reliable enrollment data. we will have that to you by the middle of november as we committed. to we are collecting state data, we are collecting telephone data, we are collecting paper data, we are collecting website data. we want it to be reliable and accountable. >> telephone data doesn't seem it would be difficult to compile

since the number is likely quite low. >> the telephone goes through the system, sir. >> the president designated a glitch czar, jeffrey zients. you're familiar with his appointment. >> i asked him to serve in this capacity. >> many of us on the subcommittee of overnight investigations in energy and commerce were not as comforted as you by that selection because if you recall his history with this subcommittee is not great. he was involved with solyndra. we asked him to come and talk to us about solyndra in 2011. he refused, requiring a subpoena to be issued by this subcommittee. will you commit to making mr. zients available to our subcommittee for our questions? >> congressman, you are welcome to ask mr. zients to come before the committee. he is volunteering his services to us for a period of time. he has been appointed by the president to start in january as the head of the national economic council. he was the deputy director at omb for management and

performance. i am thrilled that he is willing to take on this assignment and help us drive the management -- >> again, his appearance here will be important. now, a lot of people are asking if the president's words leading up to this law, if they matter. and the statement in the "washington post" today edited the president's statement and say if you like your health care plan, you'll be able to keep your health care plan if we deem it adequate. that seems like a more operational statement. especially if you go back a few years into the federal register and i'm quoting from the federal register from july 23rd of 2010. just a few months after the law was signed. the rule -- the interim rule for dealing with the grandfathering written into the federal record because newly purchased individual policies are not grandfathered the department expects a large population of policies will not be grandfathered, covering up to and perhaps exceeding 10 million people. i hope the president was

apprised of that before he made these statements, because clearly his statement wasn't operational. >> again, that's an insurance company choice and that was a snapshot of what the market looks like. the president made it clear and our policy was to put a grandfather clause in both employer-based coverage and in individual coverage. >> but in the federal register, those were the comments that were recorded. >> this isn't a government takeover of anything. these are private insurance plans and private decisions. >> you serve at the pleasure of president. we're all aware of that. but we have had many of our employees here in front of this committee and you do have to ask yourself are these being purposely misleading or are they really not that smart. so i am going to ask you this morning for the sake of the future of health care in this country, will you please ask for the resignation of gary cohen because he has repeatedly come to this committee and misled us? >> i will not, sir. >> the gentleman's time has expired. >> mr. chairman, point of

personal privilege. i just think the record ought to be clear about jeffrey zients. he was invited with less than a week's notice, he couldn't make it that day, he asked for some other day. he went to omb and had nothing to do with the solyndra contract. he did come before us and talk about it, but his sole role was to represent omb and i don't think there ought to be any disparagement of jeffrey zients, he's a well regarded public servant. >> thank you, mr. chairman. welcome, madam secretary. now, we all agree the website problems must be resolved as the country developed the internet and the concept of the websites so there are high expectations. the fact that the hired private contractors could not build a ready website in three years is inexcusable and after it's fixed

i hope the administration will hold those at fault accountable, but we can't lose sight of the big picture that when this is all said and done, every american will have affordable quality health insurance and health care. this is a goal, i believe, of all democrats and republicans. the aca is working in california and is working in my district in sacramento. i just want to tell you about a letter i got from a constituent. dr. congresswoman as a self-employed contract employee i've had individually purchased health insurance for 11 years now. insurance that has gone up every year, sometimes more than once. insurance that wouldn't let me add my daughter when my ex-husband stopped his insurance policy that covered them both. insurance that i underused for fear they would drop me. insurance that has just dropped me anyway because they decided they would no longer offer individual plans. this could have happened to me at any time. i'm so grateful that the affordable care act provisions make it possible to get health insurance beginning in january

for me and my daughter. as all is happening, i have finished graduate school and started my own business. slowly but surely things are happening and i expect to be hiring my first employees in the next six months. the provisions of the aca are helping me in this too. i can clearly see what costs me to provide health benefits for my future employees, understand these costs and build my business plan accordingly. and that is just one of the letters i have received. now, i've also heard from my colleagues on the other side of the aisle complain again and again about how health care reform is increasing health care costs. but the empirical evidence shows something quite different. the recent trends in medicare spending growth are really quite remarkable. medicare spending growth is at historically low levels growing by less than one-half of 1% in fiscal year 2012 following slow growth in 2010 and 2011.

the same is true on the private side of health care. personal consumption expenditures on health care, everything from health insurance to drugs to hospital care rose by just over 1% in the past year. this is the slowest increase in nearly 50 years. madam secretary, what does this data tell us about what has happened to health care costs since the aca became law? >> congresswoman, you're absolutely right. in the last three and a half years since the president signed the affordable care act, we have seen a great slowdown in the extraordinary cost increases year in and year out for health care. in the medicare plan, in the medicaid plan, in private insurance and in underlying health care costs, which affect every american. some of that has to do with some of the features that are currently in place around different care delivery and different payment systems that we are helping to drive, given the tools that we have with the

affordable care act. more quality outcomes, trying to prevent hospital readmissions, looking at hospital-acquired infections, medical homes that prevent people in the first place or help them stay healthy in their own homes and in their own places. >> so it's true that the private insurance costs are growing at the slowest rate in decades also, is that true? >> that is true. >> am i also correct that the aca premiums are coming in even lower than predicted by experts, like the cbo? >> they're on average about 16% lower than was estimated that those premiums would be, and that's the premium, not accounting for the number of uninsured or underinsured americans who will then qualify for financial help since they don't have employer coverage, they get some help from the taxpayers, paying for that coverage. >> thank you, madam secretary. >> dr. gi in. grie. >> madam secretary, when you spoke at the democratic national convention in charlotte last

september, one of the first statements you made about the affordable care act was, quote, but for us democrats, obama care is a badge of honor because no matter who you are, what stage of life you're in, this law is a good thing. first, if you already have insurance you like, you can keep it. and i end the quote. i'd call this a red herring that misled voters, intentional or not. now, perhaps had you known that millions would lose their coverage, families would face financial disaster as one constituent recently told me or that the exchange rollout would be plagued by the multitude, multiple delays we have seen, you would not consider it such a badge of honor. the fact is, your words and those of the president, as he campaigned last year that if you already have insurance you like, you can keep it, seem to be directly refute ed by the millis of cancellation notices already sent to americans just in the past few weeks.

whether your statement was inaccurate or as mr. hoyer said yesterday not precise enough, it does strike me that millions of individuals who by listening to speeches like yours voted, believing one thing, now found themselves without coverage and are now scrambling to find coverage in a marketplace that offers more expensive plans with fewer options. in response to my constituents' calls for help, i created a portal on my website, no patches or fixes needed, that allows those who have experienced problems to reach out and tell me about their personal experiences. in just the last few days, my office has received dozens of complaints regarding increases in their monthly premiums. i received one such notice from a mother in her early 50s who just received a notice that not only will her insurance premiums double but she will also have to switch insurance to keep her