but i do want to ask you about medicaid and a couple of questions about medicaid. first of all with regard to the newly ensured since aca, just a staggering number of americans now are covered, and i don't have the exact number, but we're into the double figure millions and that is significant. children's health insurance i was heartened and encouraged by the proposal. just to give you a sense of what my state pennsylvania, has, right now 147,000 as of january, 147,464 children enrolled. our program is a little more than 20 years old but it is -- i don't know what we would do without the program so senator brown and others who have raised this issue repeatedly as i have, we are heartened and just hope that your commitment to the administration commitment will be honest and the donut hole savings since 2010. seniors who have to pay out of their pocket when they hit a budget gap, the savings, $11.5 billion, effecting seniors, eight in ten customers getting coverage for $100 when you factor in the tax credit. national institutes of health your commitment to increase f

the taxes to pay for medicaid expansion and medicaid are mandatory. so in our state of utah, we send about $800 million a year back to washington, d.c. under the affordable care act and we get no benefit unless we find some way to do that. so, we do not want to expand medicaid in utah. we have a different program called "healthy utah," where we take the money back -- it's our money -- and puts it back, into a better program than medicaid which includes different co-pays, and not as much assistance for those on the upper end, more skin in the game for the recipient, higher cost if you use the emergency room than you would have under medicaid, and a work requirement so that when you enroll as youth you get health care and automatically enrolled into a work program to help you get off of government assistance. you are there in the first place because you are not making enough money. so, if you are able-bodied and unemployed, we want to get you a job. if you are able-bodied and underemployed, we want to get you a better job. so, we think this is a better

that's medicaid. when we put all of this together we assumed and we know that 80% of the money in medicaid is low income seniors in nursing homes so we're talking about seniors in nursing homes. we assume that low income seniors in nursing homes and their families would be able to get the help under medicaid that they need as well as families. in michigan more than 500,000 people have enrolled in the healthy michigan plan. i congratulate our governor and others who put that together. and we've still got time to go on this. so when i look around this panel, we have 11 states represented in the finance committee that still have not provided access for low income seniors to nursing home care or to families and children through the expansion of medicaid. and i wonder if you might speak to what is happening to families and the costs even to states and certainly our hospitals. i know in michigan folks were talking about the number of people coming to the emergency room, getting care, the most expensive way

and that's medicaid. when we put this together, we assumed that they would be able to get the medicaid that they need, as well as families. in michigan more than 500,0 0 people have enrolled in the healthy michigan plan. i con gratgratulate our governor and others who worked on that. we still have time to go on that. we have 11 states represented in the finance committee that still have got provided access to the expansion of medicaid. i wonder if you might speak to what is happening to families in the cost and even to states and our hospitals. i know in michigan folks were talking about the number of people coming into the emergencienemergency emergency room rather than getting it through a doctor in a way that is better for them and contains cause. >> i think the impacts have to do both with the vijs as well as economic impacts. in terms of the individual impact terms, yesterday, when we had folks at the white house that had written the president there was a woman who actually went on to the marketplace

that is medicaid. when we put this together we know 80 percent of the money is seniors and nursing homes and reassume their families get help under medicaid. in those seven roles in the plan. so when i look around the panel with 11 states represented in the finance committee's that still have not provided access with the expansion of medicaid but to speak to what is happening to families and those were talking about those coming into the emergency room rather them through a doctor in a way that is better for them to curtail costs. but states are not given access. >> we have to do as much with the individual and economic impact. in terms of the health and financial security yesterday we had folks of the white house. a woman went to the marketplace because she thought she would pay a fee and found out was medicaid eligible. never had a history of breast cancer in her family actually he had part of a mammogram and it is covered and found out she has breast cancer. but in terms of financial security the ab

fox going here, but i have to mention -- on medicaid, i think the medicaid's expansion has been highly successful. i guess you could have done it separately from the spill, by do not think it would have happened politically separate from this bill. the fact of the matter is that now we are seeing some republican governors who previously opposes. one example what a governor who used to be part of his body. i consider him to be a rather conservative member of this body . he decides that adopt the medicaid expansion with certain waivers. i think you are starting to see that even in red states, with republican governors, that this expansion is taking place. to me, that is an indication that it has been successful. i know my friend from did -- virginia, i do not want accurate you, that we have had this discussion before that when you say that you can keep what you have i never intended, i do not think the president intended for you to keep a lousy plan. we have had this discussion. in other words, yes, it is true. we have a very generous benefit package. certain people who had skeletal plan

things to the medicaid expansion. so there are arguments that this is really going to save money, but the counterargument is that the medicaid expansion under the act -- the federal government has promised to pay most of the costs in the long term. a lot of republican governors argued that you say that now but when things get tight in 10 years come you going to shift for those costs up. i citizens will be so used to it that he will be able to pull it back. host: covering politics and policy. first call for you is from tom in new jersey. tom is on independent line. go ahead. and he totally runs the debt up towards $19 trillion as we are today, you would think the economy

and that's medicaid. when we put all of this together we assumed, and we know that 80% of the money in medicaid is low-income seniors in nursing homes. so we're talking about seniors in nursing homes. we assume seniors in low-income nursing homes and their families would be able to get the help under medicaid that they need, as well as families. in michigan more than 500,000 people have enrolled in the healthy michigan plan. i con glircht nor and others who put that together. and we've still got time to go on this. so when i look around this panel, we have 11 states represented in the finance committee that still have not provided access for low-income seniors to nursing home care, or to families and children, due to the expansion of medicaid. and i wonder if you might speak to what is happening to families, and the costs even to states and certainly our hospitals. i know in michigan, folks were talking about the number of people who come into the emergency room getting the care the most expensive way pos

similarly for medicaid, we have seen a number of years of slower growth in medicaid costs for beneficiaries than we expected in 2010. although there are particular aspect of the affordable care act we have only saw for one year, we had observed others for some time. we have a much stronger foundation with a cumulative foundations with the cost is the medicaid expansion than just from looking at last year's data. although once again there is considerable uncertainty. >> how important is that moving forward? >> as you know the excise tax on higher premium insurance plans have not yet taken effect. it is particularly hard to -- we don't even have the one year in that sense. there is anecdotal evidence of people reporting making adjustments to their plans. to keep premiums on a trajectory below what they think they will be subject to that tax. those are just anecdotes that this point as far as i'm aware. we expected that most of -- there will be a significant adjustment i am players to try to keep -- by employers to try to keep the threshold low. of the total revenue that we show occurring beca

. >> now, these states, some of them have opted in to the medicaid, the expanded medicaid. >> right.many have not. what happens if the whole system is thrown into chaos by a court ruling. what happens to those rulings. do we know what happens if the supreme court rules in that way. we are not expecting medicaid to be affected. the supreme court case is focused on the subsidies. as you point out in a number of states, including where elizabeth is in texas, that chose not to dedicate expansion, you are looking at large numbers of uninsured americans. then we are back to where we were before all of this, where you see the people showing up at the emergency department, in worse health because they haven't had check-ups or screenings, or a story that you heard earlier from ann about catching breast cancer earlier. that will not be the case. >> i understand that in many cases these are people not affected because the states didn't participate. isn't part of the way the system works, a series of payments that flow in different directions from different pairs and holders that make the vast e

the same with regard to medicaid.e federal government wants to do something, they should do what they want to do but don't ask me to take it out of my budget for a program that you want to have happen. so, that's not happened in our state. i don't know if it's going to happen in our state. we will see. >> people could send questions to at politico events. we have to get some audience questions on med educate kade. >> a block grant. if you give us a block grant, by the way, our taxes pay for it. taxpayers in our state are paying for this just like in every other state. so just let us give us our money back and we will run the medicaid program because we would like to take care of our citizenship, you know. we care about our citizens probably as much as anybody else does. >> the most substantive criticism of med cased expansion it's not going to be good for the money even if they are good for the first three years. >> a trillion dollar deficit, would you do business with them? a long term contract with them? >> that's a

and 670,000 people weren't able to access medicaid advantage. and if you're from rural parts of this country that option is very limited. if not, or it doesn't exist. so i would ask that we re-look at that so that seniors who want to have this option can choose that. and our concern is your budget hurts the ability for that to happen. >> so with regard to the first issue, in terms of your two constituents. i want to make sure we understand that. on the issue of the question of abortion and that -- >> let's just answer this question, because i got two more on budget that i need to address. >> medicare advantage issue. with regard to that we want to make sure the program during the period that we have had, we seen a large increase in the number of people in medicare advantage plans. i want to understand your 670, because 99% of beneficiaries have access. there may be something. so i want to understand that 670 better. those number plans quality the four stars we've gone from 67% in the two highest rating categories, 17% to 67%. so we're improving

i have to take a hard look at medicaid for example.the second highest in the country per enrollee on medicaid. not doing a great job necessarily taking care of the vulnerable but spending a lot of money doing it. and then invest in building roads and bridges into schools and development to fundamentally get people back to work. >> we are going to be joined by the governor nixon of misery and talking to some of his staff. their plan for the future is the return of the american manufacturing. they are convinced that missouri is going to be a big beneficiary of that. now some manufacturing jobs have been lost in rhode island. ken rhode island benefit from a rebirth of american manufacturing or is it smarter to go with the knowledge economy direction like boston and new york? >> i think you have to do both. what we have to do is figure out what we can be really good at. manufacturing is a piece of that and is the knowledge economy also. once upon a time, rhode island was the mecca of two remaining texturing. that's what we did in rhode isl

the act was structured in a way to encourage states to expand medicaid. in fact, to go to your larger point, those folks are getting medical care somewhere now, right? they're going to emergency departments. those are costs that are typically falling on state governments already or on hospitals or others. and often those costs are higher because they're waiting to seek care until it really is an emergency. and so, when you really look at the broader picture, if we're implementing medicaid expansion, particularly with federal support, what we're seeing in states that are expanding is it's actually a very responsible fiscal choice that they're making because not only are they improving the health of those citizens they're lowering emergency care costs and others that are currently falling either to state governments or to private hospitals and others that have to absorb them. >> gentleman's time has expired. gentle lady from tennessee, mrs. black s recognized. >> thank you, mr. chairman. thank you, mr. donovan, for being here today. i know this question has

think about medicaid. medicaid is an issue we talked about many times before. my friend paul ryan talked about , it in block grants. give it back to the states. what we do in wisconsin is different than new york or california or texas or even illinois. why not empower innovators at the local and state level to do the things that are in the best interests of their taxpayers and in the best interests of the people they are there to serve instead of the one size fits all mentality. we have something you talked about for years, we are talking about maintenance of effort. why is it that a state or local leader can't make an innovation without federal regulation kicking in that says you can't do that unless you kick certain people off of your program. we were lucky because of the supreme court. i look at that and say i would rather keep the money at the state and local money. transportation, instead of sending a dollar washington where they skim off costs and send it back to me, why not keep it local. see you can fix that pothole in a way that is most cost efficient.

but like medicaid expansion.industry, i wonder why. >> we have a microphone for audience questions and i want to take some if there are any. >> do you want to move to florida? i have realtors names and everything. >> did y'all see in new york put on their tourist website that their weather was so bad everybody should just go to florida? >> my fiance would love that with this temperature. i won't tell her that offer. >> during the 14 cycle you were attacked and you've talked about education a little bit and you won. you were attacked more than any other governor on education reform and school choice. >> on anything. >> i didn't pick the easiest state. i could have moved to a state that would have been easier but i didn't. >> do you have less sons that other folks could take from what you did in florida? even though it's a fairly red state it's still a swing state especially in a presidential year they could take from your message? >> we went after everybody. we've got a significant hispanic population. so i do --

i took the same position with regard to the medicaid. as long as the federal government wants to pay for it, do what they want to do but don't ask me to take it out of my budget. that's not happening in our state. we'll see. >> people could send questions to @politicoevents. >> if you give us a block grant -- by the way, our taxpayers pay for it. the taxpayers are paying for this just like in every other state. give us our money back and we'll run a medicaid program because we would like to take care of our citizens. we care about our citizens as much as anybody else does. >> the most substantive conservative criticism of medicaid expansion is the federal government is not going to be good for the money. even if they're good the first three years -- >> you think with trillion dollar deficits would you do business with them sign a long-term contract with them? >> that's a jitlegitimate certain. that you're going to expand coverage and then they'll change the rules mid stream. >> so when i got elected, what was happening is the federal gov

>> the act was structured in a way to encourage states to expand medicaid. in fact, to go to your larger point, those folks are getting medical care somewhere now. they're going to emergency departments, those are costs that are typically falling inging on state governments already or hospitals or others and often those costs are higher because their waiting to seek care when it's an emergency. if you look at the broader picture if we're implementing expansion, we're seeing it's a very responsible fiscal choice that they're making because not only are they improving the health of those citizens, they're lowering emergency care costs and others that are falling either to state governments or to private hospitals and others that have to absorb. >> gentleman's time had expired. ms. black is recognized for five minutes. >> i know this question has been asked but i want for the record, does the president's budget balance at the end of the ten-year window? >> the president's budget meets the key fiscal tests that we set out -- >> that wasn't the question. yes or n

medicaid is a good program. i wish i had medicaid.we have people in good health physical and mental, we are a stronger nation for that. we need to look at that because when i'm shopping locally and i go and i'm standing at the deli and a woman waiting on me has almost no teeth in her mouth what kind of country with support that? we need to keep people healthy. host: republican line. caller: our governor is bruce rauner. he just recently had the state budget address and he talked about how they make decisions in cuts and reforms. we've had problems with medicaid, with pensions. our state is last in so many arenas. he is doing what he has to do shaking up the state. he's going in there and shaking things up and hopefully getting people to think about things. i like that he has come out there and been bold. host: at 10:00, we will start airing sessions from the national governors association. that is just one of the rooms where the action will take place. the governors will be addressing many things concerning their state, health, taxes,

we have $400 billion in medicare and medicaid savings built in to our budget. and for the first time, we're including a permanent sgr, or doc fix proposal in our bill, fully paid for. it builds on bipartisan legislation, and it adds provisions that would go even further in terms of what we call delivery system reform. making sure that we pay doctors and hospitals based on the quality of care that they're providing, not just the quantity of care that they're providing. so i think this is an area where we've made a great deal of progress. more people are covered. they're getting better coverage. and, in fact we can build on that through this budget and work that we can do on a bipartisan basis this year. >> thank you. >> senator sessions? >> thank you, mr. chairman. appreciate your leadership and look forward to working with you. i agree that senator sanders that the middle class is really hurting. working americans today are not doing well. since 2000 the 2007 median income in america is down $4,000 income for a family. this is catastrophic. this is absolutely o

ruling the supreme court allowed state governments to opt-out of expanding medicaid. obamacare promise states federal funding to cover at least 90% of the cost of allowing more of their residents to enroll in medicaid. 28 states and washington, d.c. took the deal. tennessee republicans did not, citing cost concern cans. >> we agree with the governor on i'm sure 95% of the issue bunceless something significant changes and the existing population can have some cost controls, i just don't think that many conner is vat visits appetite increase entitlements now. >> utah, another stay with the a republican governor and legislature is considering expanding medicaid. tennessee's governor is promising to try again n a statement, a spokesperson said," too many tennesseans are not getting health coverage they need in the right way in the right place at the right time." the spokesperson says the governor will continue discussion the issue with state lawmakers. has lamb's office says the governor would need indication of better support in the legislature before introducing his pla

medicaid is an issue we talked about many times before. my friend paul ryan talked about block grant it if we get that money back and other health care to the states, what we do wisconsin is to the new york or california or texas or even illinois. why not empower innovators at the local and state level to do the things that are in the best interest of the taxpayers and best interest of the people that they are there to serve instead of this one size fits all mentality. we have something to talk about for years. we are talking maintenance of effort. why is it that a state or local leader can't make and innovation without federal regulation kick in the says you can't do that unless you take kick certain people off of your program? we were lucky because the supreme court for your question, i look at that and sal to keep that money back to the state and local level. i look at transportation and say instead of sending a dollar to washington where they skim off cost and send it back why not keep that at the local level so you can fix that pothol

we have $400 billion in medicare and medicaid savings built in to our budget. and for the first time, we're including a permanent sgr, or doc fix proposal in our bill fully paid for. it builds on bipartisan legislation, and it adds provisions that would go even further in terms of what we call delivery system reform. making sure that we pay doctors and hospitals based on the quality of care that they're providing, not just the quantity of care that they're providing. so i think this is an area where we've made a great deal of progress. more people are covered. they're getting better coverage. and, in fact, we can build on that through this budget and work that we can do on a bipartisan basis this year. >> thank you. >> senator sessions? >> thank you, mr. chairman. appreciate your leadership and look forward to working with you. i agree that senator sanders that the middle class is really hurting. working americans today are not doing well. since 2000, the 2007 median income in america is down $4,000 for a family. this is catastrophic. this is absolutely one of

some of that is medicaid expansion. those are people that did not have insurance before. >> the amount of money is equal. >> i think those figures do include the 4 1/2 to 5 1/2 million people who lost insurance, that they previously had when the essential health benefit -- >> it's not a net number? >> i mean i had insurance but there's none on that side? >> that 12 million people were people that were uninsured they didn't have coverage before. in any case what mr. scott said is true. the number of people getting cornered has inyeesed. >> he said just about everybody has insurance. >> that's the goal ultimately. >> you didn't say access you said just about everybody has insurance? >> well, we're not trying to take you on, we're trying to understand. >> we're in the second year of enrollment now, more and more people are enrolling, but whether we get to 95 or 96% at some point. we're not there yet, but we're certainly on the way. >> we understood when this thing happened only half the people that were uninsured would the

they did not expand medicaid.for that reason, i particularly take umbrage with all the thought about the number of people, 860,000 people in my state, that are left in the lurch. i feel that it is because we are not being reasonable as democrats and republicans with each other. with all the brainpower that is here we could have done all that is necessary to ensure that americans are not in the position that they are in with reference to health care in this country. we pay more and cost more than most countries around the world. somewhere along the line it is wrong. let me give you a few facts. 10.3 million uninsured adults receive coverage in the first year of the affordable health care act. additional 8 million individuals enrolled in medicaid or chip in 2014, which is an increase of 14%. in just one year, there has been a 26% reduction in the number of uninsured adults in this great country of ours. we are still in the open enrollment period. from the hhs weekly snapshot of enrollment activity, there have been o

deny education, deny labor rights, deny immigrant rights deny medicaid expansion.es no sense. people are beginning to see how it is detrimental to all people. >> we'll follow these marches and see what kind of impact they have. >>> coming up the link between climate change and a mega drought. it's in the forecast. >>> plus a look at the nbc all-stars, or should i say -- yeah. the nbc not just the nba, all-stars. no. it's called grid iq. the 4:51 is leaving at 4:51. ♪ they cut the power. it'll fix itself. power's back on. quick thinking traffic lights and self correcting power grids make the world predictable. thrillingly predictable. we come by almost every day to deliver your mail so if you have any packages you want to return you should just give them to us i mean, we're going to be there anyway why don't you just leave it for us to pick up? or you could always get in your car and take it back yourself yeah, us picking it up is probably your easiest option it's kind of a no brainer ok, well, good talk meet the world's newest energy superpower. surprised? in fact,

annual interest costs would be larger than the president's proposed spending for national defense, medicaid, or the combined total of all nondefense agency spending. finally, the president's plan adds $8.5 trillion to the debt. over the next ten years, accumulative overspending would amount to $5.7 trillion in new debt, with the federal debt climbing to $26.3 trillion in 2025. based on projected population figures, this would mean every man, woman and child in america would owe almost $76,000 in payments on president obama's debt. that's compared to $56,000 per person today. that's $20,000 per person more that everybody in america is going to owe. i mean, the child that's born today gets figured into that same -- that same cost. that same debt. altogether these were not the numbers i was looking for. i meant it when i said last week that we must confront spending. bring the debt to an end, and ultimately balance the budget. the president's proposal fails on all three elements of the mission. i'll listen to the administration make its case on why it's best to ignore balancing the budget. but

medicaid. democratic state senator david lucas blames republican opposition to obamacare. >> i would say its politics. that's the only thing that i can explain. i'm for it. i've always been for it. i think it's the best thing since apple pie and it would go a long way in helping these hospitals. >> we asked to speak with georgia's republican governor nathan deal on camera. instead his communications department sent us this e-mail statement. the governor implemented changes to the rules and regulations effecting licensure for hospitals which permitted rural hospitals to offer fewer service it is they're in danger of closing. also the governor has invested state resources to expand the number of residency spots in the state to incentivize monther doctors to stay and practice in georgia. back in rich land, they're trying to raise millions for a

many people on medicaid that are now in the expanded medicaid in ohio and kentucky and many, many other states, many of those people hold jobs just like those parents of children who are in the children's health insurance program, those 130,000 ohio children who now have insurance because of the children's health insurance program. their parents are working. those parents are working in places like wal-mart, in places like mcdonald's. they're making $8, $9 and $10 an hour. those companies generally don't provide health insurance and they don't pay wages high enough to be able to buy health insurance. what kind of society do you want to be where people are working every bit as hard as all of us as u.s. senators work, every bit as hard with very little compensation without health insurance, generally without pensions, do we want to say we don't care about you? if you weren't smart enough or you weren't educated enough or lucky enough to get a good-paying job with insurance we're going to turn our backs on you. of course we should not be that kind of society. that is what the expansion of

medicaid -- >> not cost generally? >> on a per person bases medicare and medicaid have been going down. >> i am talking about health care cost generally and not counting the medicaid and medicare. you also said in the last five years the data you are talking about the most recent is 2013 before the health care exchanges existed so it is nice thought but has nothing to do with obamacare. >> that i totally disagree with. obamacare started on march 2010. so the idea that parts of obamacare didn't come into affect until 2013 is not grounding here. many parts of the cost control did come into play. >> let's go to that now. the best way to look at this is at a read the actual law and look there for places that even report to do something with cost. there are a couple examples. hospital readmission penalty for medicare even though the penalty is much luer than you argue it should be. it is meaning full because it focuses hospitals on that issue. there is a penalty for higher than average infection rates i don't know if that d

medicaid expansion has resulted in an increasing coverage. the same time it is resulted in a significant increased expense to the taxpayer. >> mr. scott just about everybody has insurance. oh access. >> we have the lowest uninsured rate we have had i believe administer the united states. 10 million more people have insurance and so we are going in the right direction. >> mr. chairman i'm not going to give you i can't answer your question as far as manifestations but what mr. scott said is true. the number of people who are covered has increased dramatically and i mentioned 12 million uninsured americans who were covered in 2014. that's 12 million people that were not insured previously. that's 12 million people that had no insurance previously. some of that is medicaid expansion but those are definitely people that did not have insurance before. >> as dr. burgess said the amount of money is equal. >> if the gentleman would yield i think those figures include the 4.525 million people who lost insurance that they previously had when the central

the key part was, what actually triggers the moment was medicaid. deck army makes a comment about the president demagogue in on medicaid, and he's got a mother in a nursing home. the present turns around and says, i don't care what happens. i don't care if it comes down around me. i don't care if i go to 5%. you are going to have to put someone else in this chair. i'm never going to go along with your medicaid cuts, and that's the end. i always felt in my heart, that was his mom. in arkansas, the poverty, the health care -- the one thing he wasn't going to do in his heart even though medicare was the great politics, was the medicaid cuts, and that led to what was a brave and great moment. when you think of all the things that happened, we were this far away from a decent amount of the great society being repealed at that moment, and i will tell you, anybody who tells you we had a master plan at that point is smoking something. [laughter] we were scared. we didn't know how it was going to turn out. we were lucky newt gingrich was a baby about being o

congress passed similar provisions restoring medicaid dish payments. and restoration of funding for dish payments were even a part of the president's budget. now obviously, e limitation of the disproportionate share of hospital payments is a portion of the law that should have been read before it was past. most every state's success is largely judged by its education system. admitted will i our public education system has been a challenge for as long as most of us can remember. in fact there is no recorded history of the mississippi's public education system showing statewide success. however i believe the transformational changes brought about by the mississippi legislature in the past three years will begin to show progress. charter schools for the first time in mississippi's history will offer hope to those children trapped in failing school districts. funding early childhood learning programs began in our first legislative session together. and this yearly support doubling the funding for the pre k collaborative program with a total appropriation o

this was a plan to eliminate the entitlement for food stamps, medicaid. most of the politics was over medicare and the earned income tax credit. not only was everything we accomplished was about to be unraveled, but it was going to get worse. the power newt gingrich had at that moment was amazing. right after we were going to go into the present not going along with it, they called and asked to go back and have a final meeting. some of us were pretty worried about putting the president in that position, that he was going to be leading up to that spot. the president gets there, and the meeting starts out. i could go on and on, but the key part was, what actually triggers the moment was medicaid. take army -- take army -- dick army makes a comment about the president demagogue in on medicaid, and he's got a mother in a nursing home. the present turns around and says, i don't care what happens. i don't care if it comes down around me. i don't care if i go to 5%. you are going to have to put someone else in this chair. i'm never going to go along with your me

just found out about medicaid.re are a lot of hidden bills coming due and the only way to pay for them state levels for taxes. >> the office had a hard time quantifying this. more are becoming known now saying this is costing more than originally thought. what do you make of that? >> i am utterly unsurprised. there are a couple different ways. more people show up than you expected. we have seen that especially with preexisting medicaid. the costs come in higher. the subsidies have to be more when insurance prices go up, we have seen a lot of that. >> interesting. always a pleasure even when you are doing unpleasurable things like this. the guy is a brainiac and saw it all coming. >>> what is the difference between me and the boy who cried wolf. for one thing i'm not a boy. what if i told you the other was that he started out joking only to reget it. i never was joking. and now all of you are going to regret it. y your auto insurance premium every month on the dot. you're like the poster child for paying on time. an

another positive another positive reform i am encouraging is the restoration of medicare and medicaid payments which were originally designed to defray the cost of uncompensated care in an effort to assist hospitals i have reached out to our congressional delegation to suggest a portion of the affordable care act that ends medicaid and medicare this payment be suspended. this would return revenue to hospitals which continue to provide uncompensated care in states where expansion has occurred. congress passed similar provisions restoring medicaid payments and restoration of funding or even a a part of the president's budget. .. >> >> sending your early childhood learning programs began with our first legislative session together and this year i will support doubling of funding for there pre-a collaborative program of the total appropriation of $6 million. because of our success we are ranked number nine in the nation with preschool enrollment. to put more funding in the classroom, you you passed and i signed into law a historic $200 million teacher pay raise. performance space pilot pr

those are forced to rely on headichead medicaid, medic care and other programs. we still don't know the cost of financial exploitation but it's safe to say that the there. in the sharp case we did have some ina/*something. i'm talking about care givers, accountants, attorneys and those in the civil service indut ri. ingnat we also intoed this. the sharp case that i told you about concluded two weeks ago. sharp pled guilty as charged and was sentenced to a high end sintence of 43 months in prison. he will be ordered to pay restitution to the money he. whale we were abl to contain some on that. the emotional damage that was dong fong and we need to if out how to respond to this terrible problem. thank you very much skroo thank you very much for your testimony. i am happy that i was able to hear all of two of the witnesses. part of the other two witnesses and of course, i have read your written testimonies. b i want to thank the others who have joined us. senator scott and senator casey since i last acknowledged everyone. i want to start with you because in in what

we have $400 billion in medicare and medicaid savings built in to our budget. and for the first time, we're including a permanent sgr, or doc fix proposal in our bill fully paid for. it builds on bipartisan legislation, and it adds provisions that would go even further in terms of what we call delivery system reform. making sure that we pay doctors and hospitals based on the quality of care that they're providing, not just the quantity of care that they're providing. so i think this is an area where we've made a great deal of progress. more people are covered. they're getting better coverage. and, in fact, we can build on that through this budget and work that we can do on a bipartisan basis this year. >> thank you. >> senator sessions? >> thank you, mr. chairman. appreciate your leadership and look forward to working with you. i agree that senator sanders that the middle class is really hurting. working americans today are not doing well. since 2000, the 2007 median income in america is down $4,000 for a family. this is catastrophic. this is absolutely one of

i've been on medicaid mostly all of my life for medical problems.n sending me bills and stuff like that, with me being on medicaid. so i just received a $13,000 bill, and i'm still -- i mean i've been back and forth to the doctor because of medical problems. my medical problems still haven't been rectified. and they just did surgery on my foot. with them doing surgery on my foot, now i can't walk. i used to be able to walk and they messed up my foot. they put metal in my foot. and now i have a $13,000 bill and i'm getting worser instead of better. >> does medicare and medicaid use these debt collectors for bills through that? >> that's not something that we looked into during our investigation. >> i will say that linebarger did work for the treasury won't for many years and collecting for a variety of federal agencies. i know the treasury department still does work with private >> when these debt collectors work with local agencies, how much access do they have to your government records? >> well, the government agencies they work with supply them w

medicaid is an issue we talked about many times before. paul ryan talked about it in block grants. give it back to the states. what we do in wisconsin is different than new york or california or texas or even illinois. why not empower innovators at the local and state level to do the things that are in the best interests of their taxpayers and in the best interests of the people they are there to serve instead of the one size fits all mentality. we have something you talked about for years, we are talking about maintenance of effort. why is it that a state or local leader can't make an innovation without federal regulation kicking in that says you can't do that unless you kick certain people off of your program. we were lucky because of the supreme court. i said i would rather keep the money at the state and local money. transportation, instead of sending a dollar washington where they skim off costs and send it back to me, why not keep it local. say when it comes to education instead of sending that money here, why not keep that dollar back in the local community so that the local

foundation for this set of downward revisions to the cost of the medicaid part of the aca expansion than just from looking at last year's data, although once again, they are considerable uncertainty remains. >> and on the cadillac tax, about how much, how important that is. >> well, as you know, the excise tax on high premium insurance plans has not yet taken effect. so, it's particularly hard to, we don't seem to have the one year in that sense. there's an ek doe tall evidence people report on making adjustments to their plans to keep premiums on a trajectory below what they think will be sukt but those are just anecdotes. i continue to expect that most of there will be a significant adjustment by employers to try to keep premiums for plans below the thresholds that will subject them to this tax so of the total revenue we show occurring because of this tax i think only a quarter of it we ek pecht will come in excised tax receipts. because of employers hold down premiums and therefore, pay more in cash compensation. to employees because they're paying less than they would in this no

for over 10 million enrolled in medicaid and chip. for three million young adults, three million who are now covered because of their parents' health policy. it's working it's working for 129 million americans with pre-existing health conditions. with pre-existing health conditions who so many of whom were out in the cold. for 105 million americans who no longer have a lifetime limit or an annual limit. and for seniors for seniors who got the benefit of filling the doughnut hole. there's some reference here to increased health care costs. it's a lie. health care costs have been going down. it's a fib. it isn't true. i think what bothers republicans most of all is that it's working and their ideology is blind to success or they don't want to see it. we're going to vote no, what is this, the 56th time? we've lost track how many times we voted no. we're voting no because of the millions of people who were left out by our insurance coverage who now have the decency, have the decency of health care coverage and the protection of health car

healthcare cost just to take one example if you look at the numbers our spending on medicare and medicaid in the year 2020 is now expected to be almost $200 billion lower just in that one year than it was when the president came into office. so, what jason is talking about on the entitlement reform is important that the building on that as well we have a new proposal in the budget which would adopt bipartisan legislation on what's called the doc fix or sgr. we would adopt that and pay for it because everything in the budget is fully paid for and we would add some additional reforms to that legislation that build on what sylvia burwell secretary of hhs has done on the delivery system reform so if we can keep driving those costs will costs will work even when more important than social security or other entitlement issues of the issue of health care cost is the single most important place where we can really been that the cost curve in the long run on entitlement exchanges. >> there is a question on the sequester. >> let me say first off just look at the deficit reductions to date. more of