so i appreciate that all the work that our cbo's do and have done around this. so this is not a but, but an and. so i see this as where we are. it's growth. it's the expansion of this work so that our cbo's and all of our grass roots organizations don't have to work as hard to convince people that this is an investment that needs to be made. so i am very much on the side of going out broadly so that when we do go to the ballot, you know, we've all set through many a campaign rocking ourselves in the corner hoping we are going to get the 66 percent or 67 percent that we need in order to get parcel taxes and what have you. i feel really confident that the approach that we're taking is so much more thoughtful around all the things that we want to do for children across the city and how we can leverage everything that we've already put into it and how we can grow this and so i think, you know, we're going to need our, all of our organizations and all of our parents and all of our neighborhood associations and we certainly want to get business to think about this ver

the input that came from san francisco communities, cbo's, i think really had a really good design. there were some probably little flaws here and there but actually it's a model that's i think really worked. now we're combining with p, i still think that that community stake holder community should really derive what this looks like and it really shouldn't be about, you know, who in city hall thinks this should be a certain image or whatever. it really has to be that kind of measure and that's going to be important for sharing that. for me, my druthers, if we're going to have one measure it's going to be the size or more as the children's fund, the same size or more as peace to get that amount together. i'm not sure they should be together at all. that means we have to have a high threshold to peace and we have to have a lot of community buy-in to do that. i think that buy-in coming from all across san francisco signing off as we did for the children's fund in 2000 would be really effective to be sure that it's strong and we can pass. >> first of all i'd say that we're looking at t

cbo is not have a choice. the law requires the of the baseline that reflects current current law to they have parameters put in place on them that allows such a gimmick to proliferate. the point i would make is -- if all of this grant a deficit reduction were real, then why does the budget never balance? why are we adding $8.20 trillion of debt in this budget? my time is running out -- i want to ask you a question -- kaine your budget, beginning to occur savings in 2021, 2023, for a total of $4.10 billion. rate butd the growth your baseline claims that cost growth is within that parameter. this is a sincere question -- where does the $4.10 billion come from? how does that mandate in this budget get that savings if you assume that a clerk -- medicare cost growth is below that? >> medicare cost growth has come in quite a bit. we believe the affordable care act is helping drive that. works is thatad there are components put forth in context. you're talking about a fraction -- >> i understand that. >> we believe t

we see other cbo's come and go. but we stay. we are serving the underprivileged asian community immigrant communities. they don't have the means or language skills to do better in their life. so we are helping them in many other ways. and also have small business owners to enhance. and how to strive in a bad economic time. i am telling you that district 10 and bay-view hunter's point is the future. so i ask seeking your attention to come to this area and look for the future. here we are, we are not doing very good economically, but we are rich in spirit and we are rich in talent. thank you. >> thank you, mr. chen. and now district 11 community representative, rachel ebora and nicole agbiyone. and then we have omar community collaborative, gwen brown. >> good afternoon, i am the executive director of burnle heights. >> good evening, our organization works through the vitalized commission street in excelior planning collaboratives. 57% are foreign born. 74% of the households are considered family households. 18% of the residents l

that is the warning from former cbo director, douglas holtz-eakin.e could be hit with an individual security tax. he will explain when he joins tracy byrnes and adam shapiro the next hour of fox business. don't miss it. [ male announcer ] in your lifetime, you will lose 3 sets of keys 4 cell phones 7 socks and 6 weeks of sleep but one thing you don't want to lose is any more teeth. if you wear a partial, you are almost twice as likely to lose your supporting teeth. new poligrip and polident for partials 'seal and protect' helps minimize stress, which may damage supporting teeth, by stabilizing your partial. and 'clean and protect' kills odor-causing bacteria. care for your partial. help protect your natural teeth. care for your partial. if you've got it, you know how hard it can be to breathe and man, you know how that feels. copd includes emphysema and chronic bronchitis. spiriva is a once-daily inhaled copd maintenance treatment that helps open my obstructed airways for a full 24 hours. you know, spiriva helps me breathe easier. spiriva handihaler

the cbo now reduces ten-year cost projections each of the last three years. your deputy administrator has said that part d costs have remained quiet and expected to decline in 2014. in the past three years, the review has stayed essentially flat, about $30 a month. i believe this indicates that there is something going on in the party, which is that private sector has to compete for the business of tens of millions of seniors. that is one reason that those costs have been less than projected. i encourage you to learn from and not undermine part d. in your budget you target party again, particularly the medicare advance programs, which is radically important in our state. i would ask you to take a look at that part d success rate. i think that is where some of the reforms can and should be made. thank you for your time today and your service. quite see why, senator. the why, senator. >> senator menendez. is a lot to a plot in the budget, certainly the hundred million investment to research all timers disease, something that's at my mothers life. the funny for

as former cbo director, whose cbo scores include dynamic economic impact for policy changes, and would they use dynamic scoring in the case of elaborating on this bill, -- >> it's good to have this topic, this discussion with you again. i have lot of scars from the previous incarnations. no, cbo does not. i've been yelled at many times over that. my point is that simply, when you get a cbo score which won't include those effects, recognize it's in that regard and know that there are benefits being counted in the impact of the legislation. >> if dynamic scoring should be used to measure economic benefits of immigration reform, surely, also, major -- measure dynamic economic benefits of lower rates of taxation as well. you usually agree with that. >> i do sir. >> but i'm trying to point out here that you can't have it both ways. maybe they're going to show that this is very positive from the standpoint of the economy, if you use dynamic scoring, but if you use static scoring, it's not going to come out so well. i have a question for our witness. you said this in your statement, so it's j

as cbo. and our user fee was predicated on that number. and when we are going through, we have extended discussion. so i think we believe that that number is appropriate and the user fee would cover that number of. >> okay. details on the application of title i has been lacking, as you know, especially as relates to the associate of exchanges and efforts to educate consumers without enrollment. could you commit to providing a biweekly update on the establishment of exchanges in enrollment, including milestones, deadlines, and progress reports? >> yes, sir. i think we have submitted some early work, but a survey think at this point, we are kind of going through four stages with the exchanges, and i think we are now entering the part where consumer outreach and education is becoming more important. so i think we'll be able to give you biweekly updates. >> it's something that we're really concerned about and we want to make sure we are on top of it as well. in public speeches you've said that th

we have additional processes for outreach and public input through the mayor's office, cbo-stakeholder meetings, hearings out in the community. and then we've also got a public hearing that's focused on budget and financial planning at the commission. so those are all open to the public, and opportunities for discussion. >> supervisor mar: thank you. >> thank you. >> chair farrell: is there anything more to the presentation you want to cover? >> just the only item is that the board of supervisors budget and legislative analyst worked with us closely on the legislation. they made some recommendations, which we're in agreement with. we thank them for their work and for helping identify some places where we could trim this down a little bit further. >> chair farrell: supervisor breed. >> supervisor breed: thank you. i know this is not great news, but it's better than what we had anticipated news. and i'm really happy that there are creative ways to try and figure out a way to deal with this huge deficit. i did have a more specific question. i noticed that some of the concerns, specificall

as former cbo director, whose cbo scores include dynamic economic impact for policy changes, and would they use dynamic scoring in the case of --borating on this bill, -- bill -- >> it's good to have this topic, this discussion with you again. i have lot of scars from the previous incarnations. no, cbo does not. i've been yelled at many times over that. my point is that simply, when you get a cbo score which won't include those effects, recognize it's in that regard and know-- incomplete in that regard and know that there are benefits being counted in the impact of the legislation. >> if dynamic scoring should be used to measure economic benefits of immigration reform, surely, also, major -- measure dynamic economic benefits of lower rates of taxation as well. you surely agree with that. >> i do sir. >> but i'm trying to point out here that you can't have it both ways. maybe they're going to show that this is very positive from the standpoint of the economy, if you use dynamic scoring, but if you use static scoring, it's not going to come out so well. i have a question for our witness.

you look at the cbo numbers.asically contraction of about 3% of gdp since 2011, which is bigger, that's more antistimulus than the stimulus ever was. we're doing a lot of contraction on the fiscal side. why should we surprised if shows up on a economic slowdown? >> david stockman, your book, 734 pages, to sum it up, you believe everything that washington has been doing since the crisis is hurting a lot more than helping, including stimulating the economy. >> i think the machinery of government is failing. that's the problem we face. a real threat to the main stream economy. that's why the numbers are far more serious than what you heard friday than is being suggested by the white house. the truth is, if we were still counting the labor force the way we did in 2000, the last time the stock market was where it was today, the unemployment rate would be 13.1%. we had a massive drop out of employment. it's not from retirement. that we're not even beginning to appreciate the harm and the damage and the hurt going on in

the cbo did a study looking a physician services between 1997 and 2005. it showed that overall there was an actual real cut in the per service payments from medicare to a position community. 5%. pretty remarkable. they pay their physicians less in real terms in 2005 than it did in 1997. overall physician service cost went out 35%. the reason was volume and intensity of use when up by 40% during that a year time frame. three remarkable, actually. you dig into the data and say essentially what it implies is that beneficiary communities were using and need 40 percent more services for their care of a years later. that is a very unlikely occurrence. so there is lots of volume in medicare program. a third point would be that when you look at medicare and its influence, you can see the inverse by looking at when there is large penetration from the medicare advantage program, essentially the hmo program. several studies have done, and a recent one done by michael czerny and others indicates that when you have large medicare advantage penetration in the medicare

as former cbo director, whose cbo scores include dynamic economic impact for policy changes, and would they use dynamic scoring in the case of elaborating on this bill, -- >> it's good to have this topic, this discussion with you again. i have lot of scars from the previous incarnations. no, cwo -- cbo does not. i've been yelled at many times over that. my point is that simply, when you get a cbo score which won't include those effects, recognize it's in that regard and know that there are benefits being counted in the impact of the legislation. >> if dynamic scoring should be used to measure economic benefits of immigration reform, surely, also, major -- measure dynamic economic benefits of lower rates of taxation as well. you usually agree with that. >> i do sir. >> but i'm trying to point out here that you can't have it both ways. maybe they're going to show that this is very positive from the standpoint of the economy, if you use dynamic scoring, but if you static scori, it' not going come out so well. i have a question for our witness. you said this in your statement, so it's just

and i think congressman, what we know is the cbo is a nonpartisan objective body. they are looking at strategies in the market. what you are referring to in terms of current rate increases, first of all, is not impacted by the full implementation of the affordable care act because it is not in place yet. and secondly, it is really a situation where there are costs going up and down. but what we know is they are rising at a much slower rate right now than they did three years ago before this was passed. we have insurance departments, many for the first time, with aggressive rate review strategies in place where they are actually looking at their rates, they are rejecting the double-digit increases, and we have the so-called 8020 rule which has never been in place before for the insurance companies where they have to spend 80 cents of every dollar of health benefits, not ceo salaries or marketing plans, but health benefits. and the companies that didn't meet that threshold returned about $2 billion last year to customers. people all over this country got checks back

the cbo is the one about a few weeks ago so it does include that data. and your own dataindicates the same thing which is these costs are unsustainable by any measure. and i hope you'll look at some reforms that were structural and i know that, you know, you support in the budget some means testing is france's but i would ask you to look at medicare part d. merrie tavener the note h.r. nominee for cms can before the e committee, tell us that shall cause or party are 40% less than the original estimates. cbo has now reduced its projections over 100 billion each of the last three years. your deputy administrator has said that party costs have remained flat for years, expected to decline in 2014. if also reported over the past three is the average monthly benefit print has been essentially flat, write about 30 bucks a month. so i believe this indicates there's something going on in part d which is frankly that private sector has to compete for the business of tens of millions of seniors. and that is one reason that those costs have been less than projected.

his budget has the economy growing more rapidly in the near term than does cbo.has lower interest rates. that is a way to have budgetary savings. his budget has the usual games on budget gimmicks what we count as usual spending we don't have it explain. we'll pay doctors more in medicaid and now explain how we do it. if you strip all that away and look at a apples-to-apples comparison you will find that house budget cuts, $4.6 trillion over the next 10 years and balances. the senate budget cuts, $600 billion over the next 10 years and the president's budget cuts 580 billion. since he raises about 600 billion in taxes at least, there is not a lot of spending control there. that is the heart of the issue. ashley: you mentioned, gimmicks, doug. what in your mind is the biggest gimmick in this proposal? >> well, i think you have to look at the fact that he is still counting $500 billion in reduces spending from stopping the wars in iraq and afghanistan. those have been stopped. it's done. and we do have ongoing problems in medicare to pay the doctors. we need to have

>> no, precisely need to continue to do much maligned affordable care act as you know according to cboeduces health care cost extends the life of medicare and ironically even though chairman ryan opposes it . savings from medicare precisely for that region and and the savings cleaned from the revenue in the fiscal cliff deal something he claims to oppose and uses it for budget purposes. the president will do it in a balanced way . that's what the american people want. the president received accolaids from the right to be willing to revisit the reform and measures in the increase of cost of living and cpi . there was concern about how that would affect tax brackets. it would translate in a middle class increase over the decade. is that a fair concern. >> the so-called changed cpi, reformulation of the way that cost of the living expenses are tied to inflation and a technical adjustment that was sought in a specific request by republicans. >> i understand. it would mean. >> it is not preferred policy by the president. it is a demitration as part of his budget of his seriousness of purpos

living in hunter's view i encourage the department leaders and effective officers to work with cbos in order to provide the desperately needed services to my community. transportation, jobs, job placement and readiness and youth enrichment services, and all other capturing a healthy environment. thank you. >> i am a resident for more than 20 years. three years ago our community had some program for our asian residen residents, which by the way is largest in district 10. last year services for us have reduced to the point this semester all of our

working very hard to make sure their bill is revenue neutral and that will not cost anything from a cbo score. i also heard the members and not worrying so much about that. >> they are worried. one of the things we are attempting is to make sure the bill does not cost the american that they money and expenses occurred in the implementation are borne by the immigrants themselves. we want a rigorous e-verify getem, a system where you a job, 60 million people initiate a job every year. they go and apply for a job every year. this is yourem verified by the american government as being legally in the united states and legally able to vote. if the employer hire someone who does not go through the system, the weight of the law should fall on them like never seen before. there should be penalties in jail sentences so we do not hire people and documented in the country ever again. upt will cost money to set the verification system. we are going to set it up. that guarantees the american people that they feel we are not fooling around edges going to legalize american -- 11 million people. >> the

. >> it is 2023 per cbo's solvency for medicare. >> talking about that -- >> late into -- >> in your budget you are proposing a change to social security that is solvents ten years longer than medicare and would changes do you make in medicare, no structural changes really. you are cutting benefits to providers, doctors, hospitals and clinics but not structurally changing medicare. >> it doesn't justify social security in many programs, point number one. the president -- >> it doesn't involve -- >> does it affect medicare? >> the president's budget -- does it affect medicare? >> on a very small basis. >> why are you focusing on medicare? >> that is what i want to do. $70 billion in savings including increase premiums for high income beneficiaries and save $1 trillion. >> that brings solvency to what year? >> 2020s. >> additional four years, right? >> late into the 2020s. >> if this is your proposal, these are our priorities, you have protected us either, haven't put out a plan besides cutting reimbursement that go to the benefits of our seniors. >> to your point extended medicare sol

it's the cbo who has been saying that. in the long run will will effect people.he defense department defense department effect them. people laid off. these are real things unfortunately by making up things and exaggerating they undermine the real people that will be hurt by this. >> bret: what's tough sometimes to listen to, charles when they forget what they said before or at least testimony as that they forgot what they said before. >> i think it's willed am nearby. the real story. ed henry is being cynical. the story first clip of the secretary saying we are going to have to cut the border patrol and today they discovered in the headquarters of dhs a pot of gold that had been there the whole time they didn't know where it was. it was discovered like last week. and they now are able to fund the border security: look, it's very obvious what happened here. in the experience in the past when there have been shutdowns or threats of shutdowns, republicans took the blame. that was in the 1990s with the government shutdown and with the debt ceiling. if anything bad ha

thinking about what bay vac does, i think maybe we can talk about how bay vac can actually train our cbo's either the staff members or youth leaders spending time in the program to run classes or if they can be the one teaching classes. the one thing that is a barrier if the instructors themselves don't look like you or aren't from the neighborhoods that they are from. i think being to have an instructor that went from the high school and they stand up here. i know the street you fwru up in. i went to the schools. i think that already takes away one barrier i feel. i think part of the -- i don't want to call it intimidation but feeling it's not your place, your space in not seeing those folks. i think we have amazing organizations who is staff grew up in the neighborhoods that maybe can go to a different place and actually help one the programs from cyc or mow magic. just a couple ideas out there. they already know the youth and they will drive the young people themselves because they have that relationship alreadiment i think we need to go deeper than outreach. i don't know the to say go

living in hunter's view i encourage the department leaders and effective officers to work with cbos in order to provide the desperately needed services to my community. transportation, jobs, job placement and readiness and youth enrichment services, and all other capturing a healthy environment. thank you. >> i am a resident for more than 20 years. three years ago our community had some program for our asian residen residents, which by the way is largest in district 10. last year services for us have reduced to the point this semester all of our class, citizenship classes are all gone. our once vibrant community center almost had no services for our english speaker. or whether (inaudible) senior for this budget please make sure all of the outside programs organized that ask for public funding, service responsible for our resident needs and for -- and they must got our import and not represent to us what we want in our city to make sure our city (inaudible) public funding program that treat our api population will get proper funding in language access, community organization and service

thinking about what bay vac does, i think maybe we can talk about how bay vac can actually train our cbo's either the staff members or youth leaders spending time in the program to run classes or if they can be the one teaching classes. the one thing that is a barrier if the instructors themselves don't look like you or aren't from the neighborhoods that they are