speakers include health and human services secretary sylvia burwell. this session led by massachusetts governor charlie parker your. >> but i couldn't everybody. i'm charlie baker, the government of the commonwealth of massachusetts on the nature of the nga's health and human services committee. i'm glad to be joined today by the committee's vice chairman and should governor maggie hassan as well as by governor bevin who sort of along with governor shamblin, drop us all into this conversation in a big way at the meeting where back in february. i want to start first of all by saying how much i appreciate the fact that so many of our fellow governors signed onto the compact that we develop to deal with this issue. last count we had 46 governors who signed onto the compact represent about 250 million americans. certainly for us in massachusetts and a government of the folks around the table this is probably the single biggest public health issue you a dinner with. i know based on the conversations i've had with secretary burwell and others have big deal t

burwell: we are. one of the announcements over the period, i should have highlighted, i'm glad you raised it, doing the takebacks has been an important part of our d.e.a. partnership in terms of that work, as an important thing. this was feedback from the governors. you've told us, get v.a. engaged. we got them engaged. many of the steps we've taken. takeback's an important part of the feedback. i think the other thing where the d.e.a. is taking the lead is the issue of heroin itself. and the illegal and illicit drugs that start that way. prescription drugs can become, you know when they're not used, illegal. that's where they're focusing the most. our connection occurs through the office of the national drug policy coordinator at the white house, but also the chief of staff has taken an interest. dennis and i have been interested in this issue for a long time. so he actually even has a person in his office who works directly on the issue with us together. that's how we get our biggest connect with ou

this is structure and not a rerun of burwell. this is simply a core provision of the constitution that says it is the role of congress to appropriate money. the law doesn't have to change if congress votes to appropriate funds to. there is not any authority for that money too spent. >> thank you, i yield back. recognize the gentlelady from florida, ms. caster. >> thank you, chairman. thank you witnesses for being leer. approximately 20 million americans have gained coverage since the affordable care act became law six years ago. my republican colleagues look to repeal the law and the republicans in congress have decided to sue targeting the diagnose so insurance companies could no longer block them from purchasing insurance. another part of the law was intended to stabilize insurance markets because this was a fundamental change in the way it is ruled. it is important to have an important insurance market especially when it is state-based. another part is to make sure our working neighbors can go in and purchase a policy. this ha

health and human services secretary sylvia burwell was in today's meeting. i spoke with her before she met with the president and asked her about the path forward on fighting the zika virus, if a bill is not passed before summer break on capitol hill. >> i think you know, there are 2,900 cases of zika in the united states. and we know that over 500 pregnant women have tested. we keep focusing on the things we need to do in terms of keeping people informed, making sure tests are available, and that we're trying to control the mosquito. and at the same time, the funding is an important part of that. and i'm hopeful that we can have a negotiation, that can get us to a place where that funding comes true. because it's extremely important, without that funding, in august, we won't be able to continue the next steps with regard to vaccine research. >> you know what republicans are saying? they're saying, we were there, we were across the finish line, and it's the senate democrats that blocked it. and it's the back and forth between the politics on the hill. but yo

burwell litigation prevents the administration from complying with our request. in your professional opinion does the house lawsuit preclude the congress from conducting oversight over the source of funds for the cost sharing reduction program, yes or no? >> no. >> okay. and why not? >> because the supreme court has addressed this issue in at least two major cases, one of them a tea pot dome case united states versus sinclair and that question specifically arose, that the witness got up and said i'm involved in a lawsuit that i'm going to have to testify at, i'm going to leave my testimony for that lawsuit. for that he was held in contempt of congress and the supreme court upheld it saying there's no way that he can avoid, you know, the breadth of -- and the need of congress to continue investigations into knowing what was going on there. a second case some years later, you know, came to the same conclusion with regard to a witness who claimed that the committee had litigation that was going on, this would, you know -- might cause him concern, even reveal evidenc

>> the meeting was a meeting between the president and secretary burwell, the cdc director tom frieden and me. we gave the president an

burwell which you referenced. that brief was on behalf of democratic leader pelosi and other members of the house democratic caucus. it supports the administration's determination that it has authority to fund the affordable care act cost sharing provisions that are at issue in that case and in this hearing and my sole narrow mission here is to explain why. to begin with, as all of us here know, the cost sharing reductions program was designed and has in practice operated as an integral component of the affordable care act. however, house leadership and district court for the district of columbia judge contend that there is no appropriation for the cost sharing reductions even though, as they concede, 31 us c-section 1324 does provide a permanent appropriation for the law's complementary premium assistance tax credits program. with respect this assertion is at odds with the aca's plan for restructuring individual insurance markets with the mechanisms congress designed to effectuate that plan, with textual provisio

health and human services secretary sylvia matthews burwell.following her remarks and a discussion with the governors here, we'll turn to our second panel of experts from washington state, the dea and vermont. i've had the pleasure of working with and introducing secretary burwell american once. ... >> toss work that we've seen across the board, the leadership that this aggregation in terms of the road map presents i've seen in individual states as well x. hopefully, we all feel we have heard your voices. these conversations we've had since the first nga the summer right after i was confirmed in terms of the things you all have been focusedded on. that's a lot of what we have spent our time on. and i thought a what i would do quickly is run through an update on some of the strategy and progress we've made there and then touch on a few other things, and then let's have a discussion. i think you all are familiar with our three-part evidence-based strategy. you all know me, i work in the threes. number one, that issue of making sure we are having

burwell and the cost sharing reduction provisions are absolutely integral to that. so that's how works. >> thank you. since congress passed the affordable care act in 2010, the number of uninsured in the united states has fallen by 20 million people. this is a remarkable achievement. such an achievement would not have been possible without insuring that all elements of the law work together as designed to provide a stable and accessible insurance marketplace. in his opinion in king v. burwell chief justice roberts wrote, quote, congress passed the affordable care act to improve health insurance markets, not to destroy them. if at all possible, we must interpret the act in a way that is consistent with the former and avoid the latter. mr. lazarus, can you apply this same reasoning to the csr program? >> well, i would say that, if you take the approach that chief justice roberts elaborated there he was applying it to the premium assistance tax credits and stating that under that approach they, the law, ambiguous provision in the law should be interpreted to make them

>> the meeting was a meeting between the president and secretary burwell, the cdc director tom frieden and me. update the president an on various aspects of the zika issue. epidemiology and the status of the outbreak in central and south america, particularly concentrating on puerto rico. with the number of travel-related cases and the number of individual women who are pregnant and infected. he wanted an update as to the status of the vaccine development program. it was a lot of discussion back and forth and he went away from that pretty well briefed. >> what is the status of that development? >> faxing development? -- vaccine development? several candidates in various stages of development, preclinical, a few getting ready within a few weeks. probably hours will go at the end of august and the beginning of september into a phase one trial to determine if it is safe or induces the kind of response that you predict would be protective. that usually anticipates a couple of months. 2017 isnning of predicted that we would be able trialance into a efficacy to ask if the vaccine works. does

i'm referring to king versus burwell for anyone who has followed the litigation surrounding the aca. but i did want to ask the panelists about an area of law or areas of law that you as lawyers see the influence of justice scalia or which parts of jurs pruns has he had a big impact on and especially if it relates to work, feel free to explain to us how. if each of the three panelists would like to respond with that. we'll start with erin and move to the left. >> justice scalia had a tremendous impact on a number of areas of law. but i'll take a quick step back and look at his overarching impact. so justice scalia as we all know believed in originalism. and what originalism means, there's variants of it but basically that if you're looking at the constitution and interpreting it as applied to a case today, the fourth amendment, for example, you need a warrant to search a cell phone. those questions go back to what the fourth amendment meant at the time of the finding, he has changed the debate, not only looking at the constitutional test but looking at statutory text. as megan mention

health and human services sylvia matthews burwell.ollowing her remarks in discussion with the governors here we will turn to our second panel of experts from washington state, the d.e.a. and vermont. i have had the pleasure of working with and introducing secretary burwell more than once who has been a tremendous champion and partner to states. she has been terrific in managing all aspects and elements of h.h.s.'s vast portfolio during her time in d.c. on behalf of the n.g.a., i wish you great success in whatever you choose to do next and we are glad to have you here today. the secretary: thank you for your leadership in terms of the committee and what we are focusing on today. it's a pleasure to be here as always. i had the chance to see leadership across as i look around this table whether it's the document from my own home state or even recommendations on books to read about the issue to the work, governor leading in her state. so across the board, the leadership that this aggregation in terms of the road map presents i have seen i

so i met with secretary burwell and many of our colleagues to ask how could this happen. how could a state force people to violate their beliefs. i will tell you, during that meeting and the members were there, too, we don't have an answer to our question. but, madam speaker, why is this even a debate? why would the administration want to force someone to violate their conscience? as president obama himself said early in his presidency, and i quote, let's honor the conscience of those who disagree with abortion. i agree wholeheartedly with that statement. voting for this bill isn't voting against abortion. it's voting against compulsion. it's voting to reaffirm that mutual respect that's necessary for a free society. and only with that respect can america live in the liberty we have so long enjoyed. i yield back. the speaker pro tempore: the gentleman yields back the balance of his time. the gentlelady reserves. the gentlewoman from colorado is recognized. ms. degette: i yield to the distinguished ranking member of the energy and commerce committee, mr. pallone, 1 1/2 min

we've come back to secretary burwell. the president said, change the provision on the pain management survey that hospitals are telling us encourage doctors to overprescribe opioids. wcialtion at first they didn't -- wrl, at first they didn't listen, but to the president's credit and secretary burwell's credit, they listening and they did it at the urging of congress. they've increased the level of prescriptions that treatment doctors can prescribe. that was something that senator paul, senator markey, democrats and republicans in the house wanted to dovment we might do more of it, but that was the deal. and then we came up with a partisan opioid bill in the senate and in the house. it has contributions from half the democrats, many of the republicans, and in the house it passed 400-1 over there. over here it was 94-1 -- pardon me, it was 400-5 in the house. 90-1 here. it has more than 200 groups across the country that says opioid abuse is an re epidemic d a crisis. so let's fix it. so we have a substantial step to fix i

i mean, the 240 prescriptions that secretary burwell was talking about, those were all legally-prescribed, for the most part, written in this country. and part of the authorized approach to pain management that grew out of the reforms of early 2000s. and, i mean, i'm one of these people who thinks we're dealing with that right now. so it's very hard to me, for me to understand how that sort of fits with this. but i'm looking forward to reading it and seeing what it does. >> so the only thing i'd add to that is there's no question that this is a complex issue of addiction which is not all about pills, although we know that doctors overprescribed in the 1990s. and that, you know, hospitals encouraged them to do so because of satisfaction surveys and the joint commission created pain as the fifth vital sign. but at the same time, in essence, when we actually use m.a.t., to some extent you could say that's legalizing, right? we are giving people opioids to make them stable, to make them healthier and to allow them to become productive members of society so they don't have to steal to actually

today, we have another instance of the administration's obstruction, the committee invited secretary burwell or a someone of her choosing but the department has failed to provide anyone. this administration is trying to avoid congressional execuscruti and that begs the question, is someone trying to hide something. we look forward to the hearing the witness's experts opinions. i want to personally thank the committee for what was done for mental health reform, particularly my friend, stead faf fast in investigating an important question of the nation. it's powerful what came through and i want to thank you for that. now i recognize mr. gat for five minutes. >> thank you, mr. chairman and thank you for the praise on the mental health bill, it was really a joint effort, there were a lot of bumps in the roads and difficult negotiations, that is an example of what this committee can do when we really work together. and as i said, in this committee, and on the floor, it's a really good first step, now we need funding and i think we all know that. unfortunately, today's hearing is not a productive

prior to king burwell, we heard the same litany, the tax credits in federal change was a violation of the law and the supreme court didn't agree with that. but we are larrying it over and over again. it turns out it was a good program, i can personally testify to that, when it was implemented there were delays because it is very complicated in implementing these complicated laws. they said it was quote wise unquote to do this. i think these charges of overreach reflect the reflection of this administration demonizing the act. >> it is reason to believe the executive branch acted appropriately in executing the law. my republican colleagues have been examining this for two years. today's hearing is the filing of a lawsuit questioning the constituti constituti constitution constitutionality of the program. it follows interviews with 13 current and government officials from four federal agencies. my question is congress has a wealth of tools. have they used their legislative authority to review this. >> i think the fact that congress republicans have taken no such steps to pass such legis

. >> today health and human services secretary sylvia burwell fending for the cost sharing reductione affordable care act. she will appear before house energy subcommittee live, 9:15 a.m. eastern here on c-span2. >> booktv has 48 hours of non-fiction books and authors every weekend. here are programs to watch out for. saturday, 7:00 p.m. eastern, hillary clinton's 1996 book, it takes a village is a topic after roundtable discussion with gill troy -- >> 1993, 1994. it takes a village is hillary's branding. >> it was a big moment right then to declare as she did in this book, i'm a moderate. >> amy parr of the hill. >> she is pushing ideas she is pushing today. equal pay and you know, child care, which is a huge issue for her right now. >> at 8:30 p.m. eastern, gary byrne discusses his book, crisis of character. a white house see set cvs officer discloses his first-hand experience with hillary, bill and how they operate. on sunday at 9:00 p.m. eastern afterwards, heather mcdonald discusses her book, the war on cops, which looks at policing in america. she is interviewed by deloris brow

his nephew burwell bassett went to new hampshire and said, it would really please your aunt if you could get her. he was unsuccessful. then shortly before his fatal illness, he learned that his own personal body servant, christopher shields, a man who replaced billy lee who's now injured, was planning to run away. washington had spent a great deal of money. christopher had been bitten by a rabid dog. washington had sent him up to pennsylvania to a supposed expert doctor to fix him and now he learns that his favorite servant is planning to run away. with all this, you might say, who can you trust now. washington -- it's kind of a blow, you know. you think these are the people i'm taking care of. he's not as sensitive to their needs as you wish he might be. now another glimpse of washington can be seen in his relationship with george washington park custis. now, the washingtons never had any children of their own, as most of you know, but they raised two different sets of children. first, martha's two surviving children, patsy who tragically dies of epilepsy at the age of 17, and her son j

the waiver section has been there all that time, but burwell wasn't flexible enough until toward the end, it was too late, do it through the waiver system, do it your own way. so legislating is fascinating and interesting. we have to help kids see if you look back to see how it was done, then you can see what was good about that and wasn't. currently because boehner made that commitment and started that process, ryan is even better about it. ryan will have a program that the house republican members are going to run on so that he can get them out from under whatever the dialogue is at the time. and the structure of that, under newt, the republicans did it with a contract for america. that was a pretty loose group that did that. it was signed off by everybody, but ryan has said to the committees, listen, i'm not going to tell you because you saw how boehner got completely done in by his own folks. so boehner's only choice was to go to the floor and let the body work its will, so to speak. i have seen speakers do it on the other side. it's happened. it used to be part of our process. a

i have met with federal leaders in washington, d.c., and have spoken with hhs secretary, sylvia burwellnd d dr. tom friedman and tabletop ex sear ises er sizes and done other things. i've written to dr. barack obama for preparedness items across our state. i used my executive authority to allocate $26.2 million in state funds for zika preparedness, prevention and response in florida. following the confirmation of the first confirmed case of microcephaly in the infant born in florida, i called in the cdc and florida professional, and that mother did not contract zika in this country. so we called on the cdc to host a call with florida medical professions including ob/gyns to discuss their neurological impacts and what precautions new and expectant mothers should take. we've reached out toairport and port directors to ensure they have the resources they need and zika preparedness round tables across florida counties. i will continue to be in constant communication with state and local leaders. as of now, 28 counties have received funding to combat zika. the department of health is contin

addition to the letter signed by every republican on the committee i sent you to secretary secretary burwell april 29th. not givers is inadequate was on in my letter. i asked for clarification about whether the proposal constitute human subject research. and submitting that letter for the record and i hope that you had expedited answer to that. i'm number one question among dominicans parents i have over this proposal is a result of a hop on practices that ours mall, particularly in rural areas like most of my state of iowa or for those patients with rare diseases. the first question, what is hard to the ms have with regard to treating patients served by smaller practices, those in rural areas and those with rare disease is. >> yes, senator, i share your commitment to his mall and rural practices. i grew up in a small town in texas with a two-person family is caring for her family. we did oppose to include rural and small practices, but we also noted in the proposed rule that we were concerned and focused on the access issues than we would address the fact that the issues at needed to restoc

and has he talked to sylvia burwell, the head of ch -- c.h.s., who was the head of president clinton's race initiative when he was president of the united states? mr. earnest: i recall the day when the president made that declaration and i think it reflected some impatience on his part. the president's view is, we spend a lot of time talking about these issues. he's impatient to start seeing some results. i think you can expect that the conversation that he's having today with law enforcement and the conversation that he'll have with a more diverse set of views on wednesday will be focused on what are specific steps that we can take to address some of these racial disparities in our criminal justice system that are persistent, and measurable, but what are also some steps that we can take to do even more to support our men and women in uniform that have an extraordinarily difficult job? the president's talked at length, as recently as thursday night when he ave ride in warsaw, hours before the shooting in dallas, i might remind you, about what a difficult job our men and women in unifor

addition to the letter signed by every republican on the committee, i sent my own letter to secretary burwell april 29. i have not yet received an adequate response. in my letter i asked for clarification about the -- whether the proposal constitutes human subject research. i'm submitting that letter for the record, and i hope that you would expedite an answer to that. number one question, among the many concerns i have over this proposal is the result it will have on practices that are small, particularly in rural areas like most of my state of iowa or for those patients with rare diseases. the first question, what safeguards does cms have with regard to treating patients served by smaller practices, those in rural areas, and those with rare diseases? >> yes. so, senator, i share your commitment to small and rural practices. i grew up in a small town in texas with a two-person family practice, practice caring for our family. we did propose to include rural and small practices, but we also noted in the proposed rule that we were concerned that -- and focused on the access issues and we would

the president offered a meeting with senator mcconnell, secretary burwell and director of o.m.b., shaunonovan to work on the zika crisis. the speaker and the republican leader refused that meeting. we offered to reintroduce the senate bipartisan zika compromise from what we sent to the house. we'd do it again as a free-standing bill. that bill had 89 votes. 89 senators voted for that. we've offered republicans legitimate compromises. that wasn't the only one. in the hopes they would join us at the negotiating table. it is clear they don't want to stay in d.c. they want to rush to cleveland and wave the flag for donald trump. that's why they're opposing imaginary on zika legislation. "the wall street journal" reported yesterday -- quote -- "senate majority leader mitch mcconnell today rejected that offer saying the time for such negotiations has passed." talking about our offer, the latest offer. the republican leader is saying there is no time to work on zika. well, mr. president, i just suggest that i disagree with that. starting this friday, right here, july 14, we're going to begin t

burwell and shaun donovan,ed leader of the office of management and budget. this is an opportunity for members of congress and the administration to get on the same page about zika and chart a path forward. speaker ryan and senator mcconnell said no to the meeting. they wouldn't meet with the two members of the president's cabinet. democrats were disappointed, but we continued to look for a solution. the only solution at this point would get doctors, researchers and health experts the zika funding they need with by passing the senate's bipartisan compromise as soon as possible. we were willing to do more. but, mr. president, the senate compromise that i just mentioned passed this body with 89 votes. it passed again today, if it were brought you up by the republican vote fo -- republicar for a vote. i spoke with the republican leader and asked him to consider this legislation. we would even be willing to do more. i toled told him that. he would not commit one way or the other. yesterday i had my staff reach out to the republican leader's "star" staff. we haven