think of anybody more perfect to do hhs.there were so many bumps in the road -- i think that is innate, and we have discussed that. enormous programs of the vast consequences. i don't think it ends. it is 15, 20 years before things settle out, and the various decks and crannies are taken care of, and people -- various nuts and crannies are taking care of, and people feel comfortable. and you just get down to the care.ss of doing health so we need you, sylvia mathews burwell, very, very much. i think you gathered from a statement that i am probably going to vote for you. [laughter] but you're not just about budgets. you are about people, and you are about fighting for people that other people will not fight for, and you are fighting for people who could use a little help, and you are fair to people who don't need any help. you are just a fair person. a tough manager. probably the smartest person in the city. mr. chairman, i am proud to present you sylvia mathews burwell. >> thank you, chairman rockefeller. that was a wonderfu

very often, the entire world looks to hhs for leadership. just last friday, this country confronted the first ever incident of mers (middle east respiratory syndrome) within our borders. hhs responded quickly to educate the public, investigate the situation, and develop a path forward. that was done through the cdc. the gold standard for public health in the world. china has named its public health system china cdc. we will count on our next secretary for exactly that kind of informed, decisive action in the face of future challenges and crises, and to provide a steady hand overseeing an incredible range of activities across the department. for example, she will be responsible for research efforts at the national institutes of health, among other agencies. this federally-sponsored research has made the united states the world leader in biomedical innovation, and has resulted in countless discoveries and breakthroughs, from the extraordinary application of genomics to cutting-edge pharmaceuticals to an unprecedented understanding of the human

think of anybody more perfect to do hhs.there were so many bumps in the road -- i think that is innate, and we have discussed that. enormous programs of the vast consequences. i don't think it ends. it is 15, 20 years before things settle out, and the various decks and crannies are taken care of, and people -- various nuts and crannies are taking care of, and people feel comfortable. and you just get down to the care.ss of doing health so we need you, sylvia mathews burwell, very, very much. i think you gathered from a statement that i am probably going to vote for you. [laughter] but you're not just about budgets. you are about people, and you are about fighting for people that other people will not fight for, and you are fighting for people who could use a little help, and you are fair to people who don't need any help. you are just a fair person. a tough manager. probably the smartest person in the city. mr. chairman, i am proud to present you sylvia mathews burwell. >> thank you, chairman rockefeller. that was a wonderfu

the secretary of hhs the authority to expand successful demonstrations to a wider range of health care providers so that we can cut costs without compromising care or improve care at the same cost. and i just want to ask about your strategic plan for using your statutory authority to expand these efforts where the data demonstrate that we can get better outcomes at lower costs. >> with regard to my philosophy, and i think it's important to have things be databased. having had the opportunity to do grant making in my other roles where one sees and creates models. what i think you want to do is you want to find the models. there are, i think, conditions with regard to which are the most successful. and then which are the most likely to scale. because that's what we need across the nation. and you have to consider both questions when considering what you would scale. because what you want to do is get the largest impact you can. that impact is a combination of both what the measures are of success, but it's also your ability to make it go broadly across the nation. and that's how i think

very often the entire world looks to hhs for leadership. just last friday the country confronted the first-ever incident of mers, the middle east respiratory syndrome, within our borders. hhs reacted immediately developed a path forward basically through the center for disease control and prevention. i might just add the cdc, the gold standard for public health in the world. i was just reminded the other day that china has named its public health system china cdc. we will count on our next secretary for exactly that kind of informed decisive action in the face of future challenges and crisis and provide a steady hand overseeing an incredible range of activities across the department. for example, she will be responsible for research efforts at the national institutes of health among other agencies. this federally sponsored research has made the united states the world leader in biomedical innovation and has resulted in countless discoveries and breakthroughs from the extraordinary application of genomics and understanding of the human brain

hhs has done that. in terms of leadership, the key is leadership. reducing improper payments what were they last year, $50 billion in medicare and probably 20 in medicaid. the key is leadership. talk to us about leadership. talk to us about leadership. what you learned. what you brought with you to omb. what you learned there how we can make further progress at department of homeland security, department of health and human services. i live in homeland security world with coburn. what did you learn in your current job that will enable us to get better results for less money in some of these very expensive programs? we need to save money. >> i think one of the things i've learnedcu is being very specific about what you're trying to achieve in the space, in terms of, very quickly, are the mosts importantbe levers. i think in our conversation today, there have been a number of things where actually there are conflicting interests and i think what's important is as a leader to be able to quickly get to the problem solving in terms of articulating what a

i understand there have been some small steps taken by hhs, but not a lot has taken place. to my mind, this should be a no-brainer. if we can get some of the sites, perhaps more user-friendly as an additive to help that, i hope you will work with me and these web-based entities to make sure that there is better technology integration this area. >> i welcome the opportunity to think about the best way to do distribution. and harkening back to senator isaacson's russian and your comment, the dissolution mechanism in terms of how people can easily access and receive health care. >> and clearly, there may have been sites that were private sector sites that had a better reputation than the federal exchange. if we can find ways to utilize that and integrate that technology, to me, it seems like we want to expand that. i hope we can work together on this. again, an issue that i raise you, au -- raised with little more, kitty, about cms changes recently in the hospice benefit. i think as this is being rolled out, it is confusing and lacing a lot of unnecessary burdens on hospitals,

i realize that is much bigger than what you are getting ready to take on at hhs. i am not asking how to fix the how yourticular. but would approach an organization that size without many problems? >> first, i think you need to get into what is causing the problems in the magnitude of the problems. you quickly have to establish is the problem coming from? is it systemic? is it cultural? is it a targeted problem? once you understand what kind of problem you're dealing with, you have different types of solutions. if it is a cultural issue, you have to do change management. that takes energy, effort, leadership, by ian -- buy-in. if it is a target of space, that is a different problem. is the problem, theagnitude of it, and other thing is sending culture, sending signals and important parts of doing this. the approach you just described to be appropriate for congress to take? or just someone in your position? >> with regard to -- i think there is a role that congress and the executive branch play together. there is an important oversight role that congress plays. that

>> senator, with regards to the specifics of the discussions thaten hhs and the state, is something in my current role i am not familiar with. what i can talk about is the philosophy of how to think about these issues in terms of medicaid and medicaid waivers. there are a couple principles. i think it is important starting the conversation to be clear about what the fundamental core principles that are essential to implementing our, whether that is the affordable care act or state waivers other states may be applying for. i think the second thing that is an important principle is flexibility. differentates have situations and we need to consider that. bringing both of those things together something we need to do at the beginning of the conversation as one works through how to get to a potential yes. >> ground zero for medicare .raud is south florida

does hhs have a working group to address medicare appeals? if so, has hhs crafted recommendations to solve the backlog issues going forward to? >> yes. as you point out there isn't hhs wide workgroup to address the backlog. cms is part of that. we are in the process of coming up with recommendations. i don't believe there are finalized yet. >> what is the timetable on that? >> i think we could brief the committee on the very shortly. >> thank you. i now recognize ranking member mcdermott for five minutes. >> thank you, mr. chairman. from a patient standpoint you walk into the emergency room, or whatever, and you get put in one of these statuses or the other. does it make any difference to the patients, to the beneficiary which status they are put in as to how they are treated? >> as to how they're treated, not for me benefit perspective? >> yes. i'm talking how they're treated as a patient. >> i would hope not. i would hope the patient is receiving all the services they need that are medically indicated. >> so then the difference is in the pa

>> the first one is a challenge by religious nonprofit groups to the hhs contraception mandate. they say this is the choice they're left with, either providing cost free contraceptive access in direct violation of their faith or signing off on a form that will authorize a third party to do that. they don't want to be complicit in something they can't condone. >> whether the government believes it is or not doesn't matter! it's the believer who believes. and it's the believer who has the freedom. so it's not up to the government to start parsing religious doctrine or telling us which ones apply and which ones don't. >> and today the government continued to argue what it has all along, that it's provided this optout procedures. if these groups would sign the forms they're no longer part of the equation. >> and the second case would go further? >> it would. this one is aimed at getting rid of the law altogether because of the way that it came to be. the plaintiffs' tern argued today that this originated in the senate, the health care law did, but it tha it's a revenue generating re

states have also generally sought permission from hhs to charge premiums and add cost-sharing. some states have sought permission to produce traditional medicaid and if it's and some states have added wellness incentives. there are some pros and cons to these alternatives and we are going talk a lot about this today. among the pros first and foremost these alternatives are allowing states to break through political barriers they have faced and expand their medicaid programs. depending on the approach and i'm really preferring to the private -- to the premium assistance approaches these approaches have the potential to reduce churn when people's incomes change. .. in a tradition expansion and out of pocket costs to benefits might reduce access to care. i'll stop there and turn it back over ted. >> okay. thanks very much. good context setting. let me do little housekeeping before we turn to our speakers. in your packets their is a wealth of good information, including a blog post from sarah and her colleagues of the commonwealth fund and is excellent and lying and so the differen

. >> the president in explaining the problems of the va sounded a familiar theme he did during hhs and the gao which is that it is a systemic bureaucratic issues, helping technology in one place. in another case, there wasn't enough manpower over here and another case middle management not getting the issue to the top and my question is when ig reports or stuff gets percolated out we find out that is the reason as far as the president is concerned. that essentially if there was any department that we spent 10 days scrutinizing to find out is just as mismanaged, this technology each identified at hhs that he identified to the va is systemic around government and if that is the case is it time to do something about the management of government? >> i will say a couple things. one, as you know the president does have a reorganization of management initiative that he has urged congress to work with him on and i wonder if you to talk to some folks in congress to see how eager they are to take up reforms but let's go back. mark inflating a couple things. the challenges the creation of a new e

that's why i advised her against taking the leadership position at hhs.all, who would recommend their friend take over as captain of the titanic after it hit the iceberg? obviously, she ignored my advice and accepted the nomination anyway continuing her pattern of public service. and you know the scope of her responsibilities far in excess just of hhs, medicare and medicaid services, food and drug administration, the national institutes of health among several other divisions add up to $1 trillion budget with 80,000 employees. she will have her work cut out for her. i recommend strongly ms. burwell and hope the committee will endorse her nomination. i thank you, mr. chairman. >> thank you very much, senator mccain, for being here. i know you have a busy schedule. if you need to leave, please feel free to, but thanks for being here. appreciate it very much, senator mccain. and now we'll turn to senator manchin, who probably has some good words to say about a person from henton, west virginia. senator manchin, welcome. >> thank you, mr. chairman. and thank

does hhs have a working group to address medicare appeals and has hhs crafted recommendations to solve the backlog issues going forward? >> yes, mr. chairman. there is an hhs-wide work group to address the backlog. cms is part of that. i'd be glad -- we're in the process of coming up with recommendations. i don't believe their finalized yesterday. >> what's the timetable on that? >> i think we could brief the committee fairly shortly. >> thank you, mr. cavanaugh. now recognize rank member dr. mcdermott for five mints. >> thank you, mr. chairman. from a patient standpoint you walk into the emergency room or whatever, and you get put in one of these statuses or the other. does it make any difference to the patient to the by-we, which status they're put? as to how they're treated? >> as to how they're treated front a benefit perspective? >> i'm talking how they're treated as a patient. i would hope not. >> i would hope not. i hope patients receive all treatments medically needed. >> so the difference is in the payments that is received by the hospital or that the patient has to make depen

so i put a little bill in to make sure that hhs turns that information to us 30 days after they receive it. but what we're seeing is increases keep going up. there may be some who have increases that go down, but the vast majority of the average american families in the middle class are going to go up. >> when you say 30 days for hhs to respond, i do notice, history suggests, when the news is favorable, hhs, the white house, what have you, you get that out in a nanosecond. when the news is not, that's like a slow boat to china deal. the fact that a lot of these numbers and data points are not forthcoming makes me think they're getting worse, they're not getting better. >> yeah, i have to argue that they're going to get worse. last week we had a little hearing and i said are they going to get better as promised? are we going to see the average family with a $2500 deduction? none of the folks representing insurance compan raised their hand. we walked it down to $1500. nobody expects the average family to save money under the obamacare policy. >> all right. when you talk about these saving

will you help the state of vermont work with hhs to make sure that we can facilitate that process and give vermont the opportunity to lead the nation in that direction? >> senator, if i am confirmed i look forward to working on that issue with you and the state. >> okay. another issue that is dear to my heart and i know to senator harkin's heart, we've worked together on it and to many people, the crisis in primary health care and the need to go forward with community health centers. one of the reasons i voted for the affordable care act is that the majority leader and others worked very hard to substantially expand community health centers. in fact in the last four or five years i think we've added 4 million more people to gain access through community health centers, in my state about one quarter of the people will get their primary health care through community health centers. we are in a difficult problem right now because we're facing a cliff, as you know. and that is as a result of the aca funding we were able to expand community health centers. if that cliff goes into effect it

talking about last wii's hearing up to capitol hill with the hhs nominee sylvia burwell.hat challenges does she face for the affordable care act if she is confirmed, which looks likely? guest: first of all she has to joke -- she has to juggle it with everything else. everything from scientific research. of course, the fda as well. dump lamenting the loss certainly has a lot of challenges -- certainly implementing the law has challenges. success of the law will to some of them depend exactly on whether rates are kept in check. that they still have a number of website,th the including finishing the construction on the back end. they have to deal with a number of lay changes that were made to the law. terms ofdepartments in whether the employer requirement is going to stay in effect. that is a requirement for companies with more than 50 workers to provide coverage or pay income of the. open question about what it will be implement it. she also have that has to negotiate with a 25 states trying to persuade them to expand medicaid which is something a predecessor ash or the cu

saw the white house doing the send inre.gov debacle, one of its most trusted fixers to go into the hhs bail kathleen sebelius out of the problem, in this case, he has ,ent his deputy chief of staff who has long ties with the hill, because he's to be legislative director for the white house, they sent him to help with this review of what the problems are, .here is a bit of a difference that was centralized and in one place. v.a. nva hospitals arefuse any one of them can be a problem. and so once you start seeing two or three or four, it starts looking systemic. and i think that's the problem that the white house needs to get ahold of right now. >> host: and the washington times front page story this morn was warned that there were schedule failures that threatened to deny veterans' timely health care. what do you make of this story and the impact that it has on this week for the administration? >> guest: well, you know, the white house likes to say that i think it was bob gates, former secretary of defense, who warned the president at the very beginning that he should realize that every

this is a final regulation hhs has.he previous one would be operated in a revenue neutral way meaning they would only give insurance companies as much money as was coming in. in this final regulations they said we are not going to operate this in a revenue neutral manner. if there's not enough money from insurance companies will have taxpayers make up the difference. that is why it is a bailout. stuart: there's not enough money coming and because too few young people are signing up, too many older sicker people are paying out a lot, not bringing up much and taxpayer is going to make a difference. i am trying to cut through the clutter without getting on a tangent. it is a bailout. >> it is a bailout but we don't know whether they are paying more in yet. these payments are not going to happen until june of next year. however the republicans's chance to stop this bailout before it happens is going to be this september when the appropriations bill comes up. that is the only chance republicans have to stop the problem of ho

respect to secretary sibelius, at the time i thought it would be a distraction to replace somebody at hhs at a time when we were trying to fix that system. if i knew that we bear down on it and get folks enrolled, i knew it would work. in each instance, my primary decision is based on, how can i deliver service to the american people, and how can i deliver for our veterans? because there are people in integrity, in both cases of secretary sibelius and rick shinseki, their view is, what is it that will best deliver on behalf of folks who have been let down. >> at the time you felt she had so many knowledge -- so much knowledge on what went wrong, you could not afford to lose that. as someone with three months of experience at the department have the capacity to attack the problem quickly now? >> we will need a new v.a. secretary. sloan is acting. sloan would be the first to acknowledge that he has a learning curve to deal with. the nature of the problem that has surfaced and has been the cause of this attention is one that we can start tackling right away, and without completely transformi

respect to secretary sebelius, at the time i thought it would be a distraction to replace somebody, hhs at a time when we were trying to fix that system. i wanted to just stay focused because i knew if we bared down on it and we got folks enrolled it would work. so in each instance my primary decision is based on how can i deliver service to the american people and in this case how can i deliver for our veterans? and because they are people of integrity, i think in both cases of secretary sebelius, but certainly in the case here of rick shinseki they have got the same priority. their view is, what is it that is going to best deliver on behalf of folks who, as rick said this morning, have been let down? >> i remember at the time you felt she had so much knowledge about what had gone wrong that you couldn't afford to lose that. >> right. >> does somebody with three months in leadership at the department have the capacity to attack the problem quickly now? >> well, we're going to need a new va secretary. so sloane is acting. sloane i think would be the first to acknowledge he is going to h

that does not necessarily make her a great choice for the secretary of hhs.e matter is what we have to ask ourselves is will she be the ambassador of obamacare just taking the cues from the obama administration or will we, in fact have the secretary of health and human services for the american people? once we understand that, then we will know whether or not she should have smooth sailing or she should hit potholes the p question i'm going to ask, will continue to ask, has to do with clarity and specificity on the number of folks who have not only enrolled by their standards but actually enrolled and paid premium which is is the definition of someone being eligible for obamacare. >> if she is from omb and does not know the stuff that happened -- >> no doubt. the fact that she has been a very successful part of the administration as it relates to omb does not necessarily men that she can have the significant contribution necessary as the hhs so i'm looking for -- are the facts because -- at the omb she had an opportunity to see what's happening in the adminis

. >> item 10 approve an increase in the construction contract cost contingent for contract hh 954 r 2n the amount of 605 thousand and up to 77 consecutive calendar days and authorize future modifications to the contract. . >> commissioners mr. ritchie. >> to increase the contract amount due to design changes encountered there and also some effects of the rim fire on the facilities at the intake switchyard which accounted for increased costs as well so we'd recommend approval of the item. >> are there any questions for mr. ritchie. >> seeing none i'll entertain a motion. >> so moved. >> it's been moved and seconded. >> is there any public comment on item number 10. >> seeing none public comment is now closed all in favor please signify by saying aye the aye have it the motion carries. . >> next item please. >> improve the schedule and budget of the march revised improvement program in compliance with california assembly bills and seek supervisor's approval for reappropriation of existing funds. >> we have to have a public hearing on this one mr. president. >> good afternoon. >> good af

obama stood by hhs secretary kathleen sebelius because officials were confident here that the brokene website could be fixed. the white house is not so sure about shinseki's ability to repair the damage at the va. john and christine? >> all right, our thanks to jim for that. all this comes at the same time that more democrats are joining the chorus calling for a larger investigation and calling for the secretary's resignation, including congressman steve israel, a member of the house leadership and the head of the democratic congressional campaign committee. he tells jake tapper on "the lead," he now wants the secretary to step aside and is asking the attorney general, eric holder, to launch a criminal probe to find out what happened. >> i want to know if anybody, anybody at the va doctored papers, engaged in a cover-up, withheld health care for veterans. they need to be investigated. they need to be prosecuted. they need to be fired. >> the inspector general's report finds the va awarded bonuses to top officials based in part on performance goals, including shorter appointment wait

find a way -- able to -- in orderorward to pursue an alternative, states have to get permission from hhs and also have two increase eligibility up to 133% of poverty. unders used its authority section 115 to grant permission to states who want to do this. that section allows demonstrations to advance the check those of the medicaid program. the secretary has broad authority to approve these demonstrations, but is required to did terminate demonstration meets medicaid objectives, provides additional oversights, including an evaluation, and she has to ensure there is input into the process and make sure it doesn't cost more than it otherwise would have under a traditional expansion will stop so far, hhs has granted waivers for three states -- arkansas, iowa and michigan. we're going to hear the details today will stop pennsylvania's waiver application is under review. new hampshire is in the process of applying in the states are taking very different approaches. michigan,xception of most states are using what is referred to as mandatory premium assistance for medicaid funds to pay for the

severe ses, oyment cest stress-lated illns like hh bld pressure and behavior suchsutance use, falyiolence, or suici. whato you re l when you le job? u seore than incom you loseelionships you had with people at work. you lose self-esteem. you may lose the confidence that you can get back into the labor marke as well. dr. price and his colleagues at the unirsity of michigan developed the jobs project-- preventive intervention r recently unemployed workers. the goal--to hp strong people matain their strength through th stressful pio and to give those who need it spial skills. in this way, to get peop ck into good jobs and to prevent depression, anxiety, and other psychological disords. i thk en you first get la off, you thrgh many . you're madt yourself themploye you feel depreed and emrrasse i tnk. the jobs project staff reuits people fr unempyment lines. the goal is to prevent disorders, so the staff recruit people who don't already have seris psychogicaprlems. each group meets for five consecutive mornings. duringhis time, participan and trainer develop a rapport that is key the success t

let's go straight over to bertha coombs who has been lisping into the hhs conference call. what are we learning? >> conference call under way. here are the headlines. the number is still 8 million people having signed up through april 19th. remember, a lot of states ext d extended giving people that sign to sign up. 2.25 of them are between the ages of 13 and 34. if you count people under 35, the number goes up to 2.7 million. that's about on target with what the administration had wanted. the really interesting thing is some of this states some of them that do not have their own exchanges actually saw their numbers double. over the last month and a half. we saw texas go from 295,000 at the beginning of march to 733,000, making it the third largest state in terms of enrollment. and florida vaulting to number two with nearly 1 million. california which had been very proactive had a very strong website. ends up with 1.4 million. but some of those numbers, again, may still be coming in because some of those folks haven't yet paid. back to you guys. >> all right, bertha coombs.

i think he's dealing with this quite similarly to how he dealt with hhs and secretary sebelius. he decided not to fire her because the idea that there was you don't want to sack the captain while the boat's going down. you want them to be able to sort of fix it and stay on the job until it's repaired. and then, you know, frankly, push them out. >> let me ask drew. drew, nobody knows more about what's going on inside than you do right now. you've been all over this story for months and mons and months and tried to interview secretary shinseki on many occasions. he's rejected all your reiestqu. do folks inside the va worried deeply about what's going on, do they believe if he were gone tomorrow, it would change? >> i don't think so. many believe that shinseki was kind of caught in the dark on all this. it's this kind of mid-level bureaucracy that runs these vas all across the country. they all know each other. they all promote each other. and it's that kind of entrench bureaucracy that the folks on the inside see as being the problem. but to mr. nicholson's point, i just want to a

assembly of paris decided to approve the application of kazakhstan upholding the two thousand fifteen hh and the chicken climbing is plain that he will be a great show in the center of a maki customers are people in the making. the federation is considering organizing such a at the north square us to ask where's a good place from auntie people to meet the sport. you might see the torch will only consume and she was in coombs seeking more income support. and i know the day. chelle. room room with them mm. when i you will win. when was the view. the we were when the boom. view. it has. we've been with the view. they do dvds. shh shh. do i really should. for more. once the energy. with my nineteen wolf. i have a couple. it says. it was awesome. enjoy it. i know. i was really nice up. it works is that that's why it's good to get that anywhere. teachers or different. all content is a huge tree and ended with the korean classical music forgot. i pointed it out. i guess. opened. i walked toward him. they have bought a lot. the photo. to me. with a dynamic and powerful performance. obama has hel

sylvia held it recently and she is moving to hhs, fred. >> and julian castro, people will remember seeing him during the national convention, see that videotape. he's a twin, actually, and he and his brother kind of made to be rising stars, at least, in the political front. his brother also holds office on a local level. right? >> reporter: that's correct. joachim castro is a congressman but i would point out, fred, this is a very interesting development, because if confirmed, julian castro cannot be overtly political during the mid-term elections and in the 2016 elections, because of the hatch act, government officials can not make overtly statements in their official capacity. a rising star only 39 years old and pretty hot on the fund-raising circuit but won't be able to do as much as that as a cabinet secretary, but i would point out he is the youngest mayor of a top 50 american city, and part of his profile has been to revitalize the downtown area of san antonio. he's attracted a lot of business. the tech sector to that area bp so this sort of -- this job fits his profile in his curre

hhs touches the lives of hundreds of millions of people. from cradle to grave, it receives m

interesting pattern here that you heard from the president and you heard it from the crisis in the hhs in the rollout and heard it from the irs mess of the bureaucratic shenanigans there where the president says that the systems are outdated and there is not a good reporting system here, and it makes you wonder if there is a department, and how many departments if they had a bunch of the media scrutiny and political scrutiny would hold up or would we find out the same thing that the systems are outdated, and too much patronage and too many people not reporting things up the chain of the command and the only way that you find out about the problems is when it something happens and then you have lifted up the rock and oh, my god, look at all of the bugs. >> and looking at all of the bugs, the president was asked if sloan gibson, someone who has been there since february of 2014, when he was confirmed by the senate even though he is acting and will be paired with rob nabors, can someone with this lack of experience if it is fair to say at this level come in to deal with this problem. >> w

you senate the top you could see the senate voting this head of hhs taking over for kathleen sebelius there is a shakeup at the white house, moving positions around. julian castro. host: what is the president doing here? guest: he is bringing in shaun donovan, the current secretary of housing, into the white house. as what he wants. castro, whojulian is popular and well-liked at the white house, one of two brothers who have made a name for themselves in politics. his brother is a member of congress. so, if donovan goes to the budget office, he will be are placing sylvia, who will not have a vote this week on the services, anduman then castro would come in as isretary of housing, if he confirmed by the senate. it is an interesting move because castro is really kind of a known figure, a rising star within the democratic party. his base is at -- as mayor of antictonio in the his community. this is an attempt to raise his village -- his visibility. to give a hispanic more prominence. certainly, the life set -- the white house has come under criticism. tom perez is the one who stands out i

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risk of improper payment by employing vast auditor experience and using federal publications such as hhs, oig, gao and cert reports. every issue a recovery auditor seeks to review submitted to cms for rigorous valuation and approval process. issues that are approved are posted to the recovery auditor's provider portal in advance of any activity. cms has limited the recovery audit medical record request to 2% of medicare claims for any given provider. all medical reviews are conducted by licensed and experienced clinicians who undergo extensive screening and comprehensive training. when a provider disagrees with an audit finding the provider can initiate a discussion period before formally appealing the denial. this is in addition to the usual cms appeals process. though the program has proven to be cost effective recent constraints have caused a significant decrease in recovery audit reviews. first, as part of the implementation of the two-midnight rule a moratorium was placed on recovery auditors, preventing audittings of short-stay hospitals for 18 months. second, cms announced the pro

-- to replace somebody at hhs when we were trying to fix the system.and got folks enrolled, it would work. in each instance, my primary decision is based on how can i deliver service to the american people and in this case, how can i deliver for our veterans. because they are people of integrity -- i think in both the cases of secretary sebelius but certainly in the case of ric shinseki, they've got the same irony. the -- same priority. is how to best deliver on behalf of the folks who have been let down. >> she had so much knowledge about what had gone wrong that you cannot afford to lose that. ins somebody with 3 months the bishop of the department have the capacity to attack the problem quickly now -- in the leadership at the department have the capacity to attack the problem quickly now? >> there is technology that he will have to learn and deal with. but the nature of the problem that has surfaced and has been the cause of this attention is one that we can start tackling withoutay, and completely transforming the system we can immediately make som

so with him continuing to stay there, the pressure stays on the v.a., the same way it stayed on hhs, the same way it stayed on the irs with lois lerner. that's minu ae that's my opinion. >> one thick is when you get rid of someone in chag of a scandal, it somehow goes away. with obamacare, sa beebelius we away and we haven't heard about obamakaifr. it spt fixed but the with person in charge of it is gone and we're not allowed to ask questions. that's the danger if shinseki goes away. that doesn't mean he shouldn't be fired. and the reason barack obama won't fire him is because if he fires him, that is an admission that someone in his administration screwed up. and barack obama has never admitted that his administration has made mistakes and he won't do now. and let's not forget that president obama has never really had a problem with firing generals. he's pretty much purged a lot of the generals in our military on disagreements about the war. but for some reason, he's not willing to step up to the mrailt and say, you need to go, get this fixed. only barack obama can make the issue of

the way that provision was hhs diminished that guarantee. for legislation that would've allowed policies to continue to be sold. >> to democrats have any chance of retaking control of the house in the midterms or is the country comfortable with divided government no matter how messy and infuriating it can be sometimes? >> it think it is a challenge for the democrats. i think the house is going to turn on the ability of each member running for reelection to get out his or her vote. elections are driven by turnout. if democrats are successful in turning out votes, which we normally are, i think we are going to do ok. >> thank you so much. when bottom line continues, more on the memorial dedication museum. at the 9/11 former new york city mayor and chairman of the 9/11 memorial michael bloomberg discusses the project. ♪ >> crews are mopping up about $10,000 of oil that sprayed into streets after a pipe burst. the 9/11 memorial museum opens to the public on may 21. and held a dedication ceremony today. former new york city mayor michael bloomber

. >> does this remind you of kathleen sebelius and hhs? >> they're going to have a lot harder time with him because he's a long-time soldier. he's a vietnam veteran. and he has a disability. so i think we're going to have a lot harder time getting him than -- >> he beat out kim kardashian in the google search. >> that's an accomplishment. >> resignations in politics are not just about cases of doing justice to people. there's a symbolic effect. the next veterans administration head and the next head of any cabinet department is going to learn from this ask more questions. if not to say, well, i didn't know and i wasn't responsible, those aren't good answers. because you're actually -- the reason he needs to be -- to resign or be fired is to encourage the next person to do a more careful job. >> i agree with you that there's a symbolic value and also this is how traditionally presidents have shown they're on top of it. i'm 2ke78ding the resignation today of so and so. but shinseki resigned tomorrow, it doesn't fix the problem. my question t

and of course that would replace silvia matthews who was tapped to replace secretary sibilias at hhs. they only say they have no personnel announcements at this hour. this is significant news for all of the reasons that you just mapped out, of course, mayor castro is a rising star in the democratic party. he spoke at the 2012 national con recession. there is information that he could possibly be a vice presidential pick, and this elevates prominent hispanic -- so significant on different levels, but the news out of the white house today is that according to government sources, he intends to tap mayor julian castro to head h.u.d. >> new fall out on that controversy at the veteran affairs commission. new information about the phoenix v.a. center. we have details from other v.a. hospitals where sharon helman worked. they say that records were manipulated to make patient wait times see shorter there. >> it's been more than a month that attentions that 40 veterans died while waiter for care at the phoenix v.a. to date, the obama administration has failed to respond in an effective manner.

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