federal medicaid spending is a percentage of gdp.hat's an astonishing 30% increase in the federal portion of the program. mandatory health spending under the president's budget actually increases by $72 billion. since the modest $366 billion in savings over ten years are wiped away by a proposal to fix the physician payment formula. i wish you could see that budget contains smoke and mirrors but it doesn't. it is rather a transparent ab i did indication of any attempt to fix the crisis. medicare remains on a path to bankruptcy and with its senior impoverishment. under the president's baseline estimates, medicare and medicaid are projected to spend $11.1 trillion over the next ten years. this level of spending is simply not sustainable. according to the 2011 medicare trustees report, the hospital insurance trust fund has $8.3 trillion in unfunded liabilities and is expected to be insolvent by 2024. real choices, difficult choices are necessary but the president refused to make them. he refuses to neighboring them now. astonishingly, t

on the second question on medicaid, i know this has been discussed. many states, including mine are wret willing wi wrestling with the challenges and debating the finance committee. we were able, you know, to include it in some flexibility in an effort to bring down for parents and children down to 133% of poverty level. maine happens to have the most -- one of the top five most generous programs in the country for parents. you can see the red line, that's maine. the point is states are grap wlg deficits. that is what our amendment was all about, to give them flexibility in the event of budget deficits. you have written to the governors back in february of last year that you were committed to responsiveness and flexibility to expedite review of state proposals to address some of these problems in medicaid. in addition, the medicaid director suggested in your department reductions in eligibility solely for budgetary purposes would not be experimental pilot and demonstration projects. there is obviously a concern, you know, exactly what authority you ha

we must fundamentally restructure our medicaid program. we must also rebalance and move our most vulnerable citizens from institutions to community care. these cuts and these reforms are not enough. we must also grow and build our economy and my paramount priority at all times is economic growth and jobs for the people of the illinois ... this budget invests more in education from birth until university i believe that jobsite follow brain power ... that is also why this budget emphasizes our commitment to public works because i believe that jobs follow solid infrastructure ... i want to thank the members of our new budgeting for results commission comprised a budget officials legislate tors and volunteer citizens. the budgeting for results process focused all of us on our core priority is and increased openness in the entire budget process. the chairman of the commission the want to thank you you worked closely with other legislators and former budget director and many many more including the recipient of the economics nobel prize thank yo

the medicaid patient in this community can not only see a doctor, the medicaid patient can see any doctort i could see, as the head of the health plan. the requirement of being a physician in our network is that you agree to see all of our members. you know, doctors really like the idea of providing healthcare for everybody, so just about all the physicians in mesa county take part in this system. but that's not the only surprising thing about medicine here... at the same time they expanded access, the doctors created a mechanism to keep costs down. as the dartmouth atlas shows us, this community provides healthcare for about a third the cost of a place like, say, miami, florida, and yet, the results are better here. lower cost, better outcome. how do you do that? from the very outset, we believed, the administration and the physicians, that there has to be some oversight. if it was just open-ended and no controls, frankly, the budget would have been busted from the very outset. the doctors used billing information from the health plan to compare one doctor's performance with another. the

if they are, they are transitioned to medicaid. if they're eligible for chip, they will be involved in chip. host: samantha artiga is currently uses the director of the kaiser family foundation commission on medicaid and the uninsured. we go to more calls. port charlotte, fla., tom is on the line. caller: i am recently unemployed, like a lot of us across the united states. i am a single father with a daughter. i have gotten involved in this medicate thing. i am taking my daughter to one place where everyone goes. i am seeing a lot of fraud. they have been taking care of my daughter's teeth. they referred me to a place in sarasota to get braces. i drove up there. there are 22 seats with 60 people. the dentist is running us through likehe is basically deng everybody but taking money for each cattle he runs through. i wonder if there is a watchdog watching over what is going on with these medical people in charge of our money. guest: the medicaid and chip programs have requirements for program integrity and to insure the dollars are b

reduces unnecessary medicare -- medicaid spending. sometimes, as things happen here, congress passes imperfect legislation. rather than address the imperfections, the legislation before the house today gives up on our grappling with this long-term care crisis altogether. we have overcome challenges like this before. in the early 1980's, social security faced a crisis. what happened? did my republican friends, concerned about having an imperfect law on the books, castigate what they called roosevelt's care and bring to the floor a two-page bill to revoke the social security act? that's not, thankfully, what happened. what did happen is democrats an republicans worked together with president reagan and strengthened social security. as a result, social security continues to keep millions out of poverty, ensuring against the universal risks of ole age, disability or death of a breadwinner. the amendment i offer today would prevent repeal of the class act from taking place if failure to implement the class program would increase state and

medicare on s-4 -- >> medicaid on s-4 is. >> i thought you said medicare. >> medicaid. $372 billion of spending in 2015. net interest 384. >> yes. >> you go to nondefense by 2017. 553 versus net interest of 4 -- excuse me, 570. by 2020, net interest payments will exceed defense. so what you've offered us is a budget with the fastest growing line item being net interest and a future for this country where net interest by 2020 will exceed what we spend on defense, exceed what we spend on nondefense discretionary and what we will pay also for medicaid. i ask you, sir if you really do believe that that is a responsible budget as to deficit. >> i really want to be responsive and maybe this needs to be done, chairman in follow-up because table s-4 is the adjusted base line. that's not actually the president's budget. the it would be very difficult for me to comment off of an adjustment -- >> i believe the data is off of your budget. >> this is the base line that at the beginning of my presentation i described as an accurate reflection of business as usual. so i think that if we want to start

the budget includes $360 billion in savings and reforms to medicare and medicaid. and compare the medicare ones to the alternatives we've seen from your side of the aisle. you guys go much, much deeper in transforming changes to medicare over the time that we would never support. but we're trying to find responsible, sensible ways to get more savings out of the medicare-medicaid system. as we all recognize, we made unsustainable commitments in those programs. >> and also on the budget, you're taking credit for war reductions and a lot of other things that may or may not be real. >> i'm glad you raised that question. we're treating the overseas con continue sen ji operatio continue generalcy problem and we're treating it more responsibly than the republican budget of last year. we're treating it like the republican budget last year. we're giving ourselves -- we're proposing to count those savings and allocate a substantial fraction. but we allocate the savings differently. we're proposing to put more to deficit reduction. part of it to a substantial investment progr

i have to say as a member of the committee with jurisdiction over the medicaid program and a senator it's more than frustrating to be shutout of a discussion affecting not only medicaid beneficiaries in my state, but institutional providers such as hospitals, scheduled nursing facilities and home health care providers. if the law was meant to be transparent and a member of the financial committee and a united states senator can't get information about the process, which is what we're constantly being told over, something is wrong with the process. >> senator, let me see if i can address your concerns. the essential health benefit model that we chose for the job is so-called benchmark model which would allow a state to use a popular employer coverage or states employee coverage or federal employee coverage existing as a benchmark. but always of the rules apply including the 10 category ris of mandatory coverage. none of that is waived as you look at a benchmark for a particular state and i would say that we tried to balance affordability with comprehensive coverage in order to get a s

leading medicaid go back to the states, we know it will work but yet we cannot get there. we can do the same thing on medicare and while paul ryan came out with the idea that hey you can stay on medicare the way it is or you can keep the private policy and medicaid can help you pay for it. this was something the democrats can't accept, not because it doesn't work, not because people won't get even better health care. it's because it's no longer controlled in washington. that seems to be the common denominator of everything we are dealing with and social security, we can move it more towards an individual plan rather than something that is controlled in washington. we could save money. we could save the program. became give people better choices but that is the main point of the book here, why we can't compromise. it's not a matter of what works and i know this sounds cynical but i have been here 12 years and you can show the facts to the other side and it's not about whether or not it works. over whether or not we would be better off. it's controlled. that is why i talk ab

every dollar we save in medicaid saves the federal government $2. i was in washington the day before yesterday at the white house with the president's health policy adviser and deputy chief of staff and also the head of cms, the agency that oversees medicare and medicaid. and we took documentation that we ran through the omb that

and then medicaid we need to change the medicaid into block grants for the states and essays that this is an important part of the supreme court case on this power of the federal government to force state to expand the medicaid program. the question i ask him who do want to be in charge of their health care companies are more bureaucrat, government bureaucrat or to yourself? jenni williams, the premier of newfoundland part-time province that i went to the states of miami to not sigh miami to mount sinai hospital to admit her surgery done because i couldn't get it in newfoundland and i was going to be on a long wait in ontario. he went to an off-site in a car paid out of pocket and had his surgery done. when he came back, they were furious because this is their signature issue. janie williams said, i headed down there because it is my hope, my heart and it's my choice. universal choice is the key to universal coverage. we are on the road to serfdom unless this legislation is repealed and replaced. repeal and replace that the only solution. as our dear friend p.j. or works as if you thin

new york spent twice as much on medicaid as california. he said the spending would grow 18% in the next four years, but that the federal stimulus and health care expansions made it harder for states like new york and california to cut expenditures because of the strings attached. he said -- quote -- "these strings prevent states from substituting federal money for state funds, require states to spend minimum amounts of their own funds and prevent states from tightening eligibility standards for benefits." so while the federal government -- that was the end of the quote -- is burdening the states with hundreds of billions of dollars in medicaid liabilities, the president has made it worse by forbidding states from tightening their eligibility requirements as their economies shrink. the administration and the congress has left governors with little choice but to cut in other areas, and that usually turns out to be public higher education where 75% of students go to school. so why is tuition going up? the biggest reason is us, the congress, w

then medicaid, we need to do change to medicaid. we need to do block grants to the state. this is an important part of the supreme court case on the power of the federal government to force states to expand their medicaid programs. the question i ask him who do you want to be in charge of your health care, a bureaucrat, a government bureaucrat or you yourself? as danny williams, the premier of newfoundland in canada, said i went to the states to have my heart surgery done because i couldn't get it in newfoundland and that's going to be on a long wait in ontario. he went to mount sinai, paid out of pocket and had his surgery done. so when he came back, the canadian media was furious because this is their signature issuer, single player health care. he said i had done their because it's my health, it's my heart, and it's my choice. universal choice is the key to universal coverage. we are on the "road to serfdom" unless this legislation is repealed and replaced. the only solution. as or different p.j. o'rourke said if you think health care is expensive now, just wait until i

some states cut core servicings like medicaid, but in wisconsin, we added some $1.2 billion to medicaid

medicare and medicaid and other programs. that's an important step. the same way we do in other sectors that keep going at it. >> what about social security? >> social security is solvent until 2036. at the same time, the president has expressed his desire to begin to lean into that issue to do it in a balanced way. and he looks forward to working with members of both the house and the senate. >> so the -- the compacts will change? >> i tonight clear on social security, that's not our immediate problem. we should get on to it but that's not your immediate problem. >> but the compact will change. it has to change. for you and i, you're a smart guy, a successful guy. it's not going to be the same for you when you're ready to retire as it is for those who are 55 and above. >> we need to keep the basic compact that we have, and we need to go about any reform that we do in a balanced and fair way. >> so it will change. so i want to touch a little bit on something within, and i'm a farmer from indiana. and i support eliminating direct payments. i've been an

and then medicaid. we need to do -- change to medicaid, we need to do block grants to the states, and this is an important part of the supreme court case on the power of the federal government to force states to expand their medicaid programs. the question i asked, who do you want to be in charge of your healthcare? an hmo boy, a government bureaucrat, or you yourself. as danny williams, the premiere of a province in canada said, i went to mt. sinai hospital to have my heart surgery done because i couldn't get it in newfoundland. i was going to be on a long wait. he went to mt. sinai, paid out of pocket had his surgery done. when he came back the canadian media was furious. this is sir issue, single payerhawkhawk, and danny williams says it's my health, my heart, and my choice. universal choice this deuniversal coverage. we're on the rod to cerf dom unless the law is repealed and replaced. and that's the only solution, and if you think hillary rodham clinton -- if you think healthcare is expensive now,

>> yes, a question on the revisions to the projections for medicare and medicaid spending. you say in there that you're expecting i think it's a $29 billion increase in outlays for medicare and $24 billion increase in outlays for medicaid. elsewhere it says that you're revising down medicaid projections because of utilization changes. i wonder what's the net difference in cbo's view of what's going to happen to those programs in their outlays? >> i don't think i have at hand the revision to the entire stream of medicare numbers or medicaid numbers over the decade. we can certainly -- find, we can find those for you. it simply means taking one row one table here and subtracting a table from a table in an earlier report. >> do you expect, that the programs will spend more than expected in the august update? or is you, i don't know if we've made large revisions to the projections at this point. i should say although this is the big, outlook, we get more of the data we use for updating the health projections between now and our march baseline. and moreover, we have not updated

the biggest drivers of spending are medicare, social security, medicaid too. >> that's all true. that's beside the point of my question. i'm trying to talk about fairness here. if you're going to get off on medicare and medicaid, maybe you can help persuade some on the other side of the aisle that addressing those entitlements would be a good way for us to help reduce our budget deficit. >> i agree with you that we have made unsustainable commitments in medicare and medicaid. we're going to have to slow the rate of growth in those commitments. >> one of the proposals in the budget, was it not, that there be somewhat of a premium increase means tested for medicare part b and i think d, is that correct? >> i think you're right. you have a modest set of changes that would in effect increase the share of those benefits paid for by the most fortunate americans. that's correct. >> let me ask a couple other questions, get to this question of how you do tax reform. you talked about lowering rates, broadening the base, eliminating the special purposes and so on. and the president had a go

on medicaid they just want to shift the costs on to the states. so the states could tell a lot of very poor people i am he a sorry, we don't have enough -- i'm sorry, we don't have enough money to take care of you but we are not required to under federal law. they said they didn't want the affordable care act, they wanted to repeal it, but they haven't told us what they want to put in its place. they said that this was going to be repeal and replace. they proposed a repeal, we have no proposal to replace it. the republicans now want to take a part of the affordable care act, the class program, that is a one and only significant initiative to put in place to deal with our country's long-term care crisis. they said those that are supporting this bill that the class act is not the right solution to our long-term care problem. i don't think it's perfect, either, but the solution is to amend the program to make it work, not just repeal it and leave nothing in its place. if we leave nothing in its place, we have the status quo. and what is the status qu

are we wasting money in medicaid and what we found out? we just were not using the best practices. >> senator, i have to get to a debate. i have to gavel this down. i think we should have this once every month. >> really? >> really. you run such a huge agency. and the one thing i'd like to just say is that if you could, we've given copies of our letter and your letter which we felt was unresponsive. if you could answer that by the end of this month, we would be very appreciative and have your folks answer that. and be responsive. i'd really appreciate it. with that, is it okay if i -- >> madam secretary, i'm just going to ask, we'll submit follow up questions on writing on the issue of foster children. >> absolutely. and it's something we would love. commissioner samuels and our assistant secretary is very eager to continue pursuing this issue. >> good. thank you. >> thank you, madam secretary. >> thank you. >> thank you for being here. with that, we'll recess until further notice. >> at 8:00 on c-span3shgs the history of u.s. space policy

governor snyder i want to talk to you a little bit about medicaid, switching gears to health care. and as we know, the new health care law significantly expands medicaid and it's going to put a real financial burden, not just on the federal government, but of course on the states as well. and it's significantly underfunded, and many of us are concerned that states cannot afford to devote these scarce resources to their medicare program. so i'm just curious if you can comment on any particular consequences that you see this current health care law having in michigan from your perspective in state government, and how are we going to pay for these increased costs, not just on the federal level, but how are the states going to be able to handle this, and have you talked to your other colleagues, governors, other governors as well, about medicaid expansion and the impact that's going to have not just on your state but all across the country, and with that i'll listen to your answer. >> i appreciate that question, and two dimensions in particular, i did health and wellness, because it's

and what that budget did is took $700 billion out of medicaid. mr. chairman, it replaces the rising cost of health care costs on seniors through a plan that ends the medicare guarantee. and it slashes important invest ams in infrastructure, education, science and research. so those are the choices we have. and, mr. secretary, i know you're going to elaborate on the plan that you have. i think it's a good plan. it's a responsible plan. and it's a balanced plan. thank you, mr. chairman. >> we're going to agree to disagree. >> chairman ryan, ranking member and members of the committee, thank you for giving me the chance to talk to you about these important questions. i'm going to talk about four things just briefly about the economy and the challenges we face there. then a bit on the near term imperatives on growths and jobs. i'll lay out the broad element of our strategy and then talk about the contrast between where we disagree. i'll give our version of where we disagree. first on the economy. the economy today is gradually getting stronger. we have a

others felt we needed deep cuts in education and medicaid. i'm proud of the fact that we were able to work together, the legislature and the governor, democrats, republicans. we came together and found a better way. we protected classroom spending and medicaid, and we did not raise taxes. public officials must never forget that we serve the public. not the other way around. that's why in a time of shared sacrifice i felt it important to lead by example. we eliminated the chefs from the governor's residence. cut salaries there by 55%. it worked out well. chuck even learned how to make more than just baloney sandwiches. and i kept my promise to get rid of the ultimate symbol of waste and excess. we sold the state's luxury jet. we cut waste across state government, cut cell phones, got rid of non-essential state cars, and the governor's office we slashed our budget and reverted over a half a million dollars back into the savings account. cabinet secretary salaries were cut by 10%, and we dramatically reduced the number of political appointees. a

as millions of americans retire, then those costs and medicare, medicaid start to increase again. that's why we're saying openly and directly to you that we're going to have work to do. now -- what you do is, i think on your budget although i know you're going to have a new one coming is you would lower that path in ways that would substantially increase the burden of health care costs on middle income seniors. and although we agree with you, we're going to have more work to do. but we're not going to adopt an approach that would undermine that basic benefit. >> go ahead and show slide a if so you brought it up. i know you didn't actually want. the red is the status quo. that's the base number we're on. >> you could have taken it out to 3,000 or to 4,000. >> this is last year's budget. >> yeah, right. we cut it off at the end of the century. economy, according to cbo, shuts down in 2027 on this path. >> i like this chart. i saw this yesterday. you're talking about a half century going out. but if you look at the gap between us -- >> i understand the gap. >> it's a pretty small gap

we already have a real problem in medicaid. but we don't want to turned me care into medicaid where there is a problem of access to the physicians because we're not providing adequate payment. so i strongly urge that we look to resolve this issue in a permanent way, keep the promise of medicare, not ask the medicare beneficiaries to pay the price for congress's error in adopting the sg in the first place. yield back my time. >> senator cardin? >> that was good. >> really time for the house majority. so it will be dr. price. >> thank you, mr. chairman. and i want to thank my colleagues for all of the work and comments that we've had about the tell you that this is one of the major issues that is dictating how long physicians stay in practice. i spent 20 years in the private practice of orthopedic surgery. and just to highlight one of the items that senator kyl made reference to, i had a prance in 1984. i ended my practice in 2004. when i completed my practice, there was nothing, nothing for which i was being paid more in absolut

by the same token every dollar we saving medicaid saves the federal government $2. i was in washington the day before yesterday at the white house with the president's health policy adviser and deputy chief of staff and the head of cms, the agency that oversees medicare and medicaid and we took documentation and ran through the omb and showed that oregon saved $15 billion over the last 20 years on the oregon health plan and we can save $20 billion in the next ten years with our new health care reform and we asked them for several hundred million dollars a year each year for the next five years to make this transition and response was extraordinarily positive. [applause] that means we will have the resources necessary to make this transition. those dollars are not going to come to oregon to prop up the delivery model. they will flow through the coordinated care organization that will actually produce those savings over the next ten years. acting early in february to authorize the bill out of the health insurance exchange and authorize the expansion of coordinated car

newt gingrich campaigning in ohio had this to say about medicare and medicaid fraud. >> the governor is a competent administrator of your money. $16 billion and $110 billion of your cost. in south florida today, professional criminals say it is safer and more profitable to steal from medicare and medicaid than to sell cocaine. >> obviously, it's tough to make that apples to apples comparison. statistics on fraud is hard to compare. the government estimates on the high end, one in $10 of medicare and medicaid spending is lost to fraud. worth noting, the federal government put more resources into finding fraud and trying to recover more and more of that money. >>> coming up, an ad campaign with real kids talking about real issues and how it hurts to be obese. some people say it is shaping the kids, changing the children and it's the wrong approach. one of the girls is here to talk about it. wow. wow. but you can help fight muscle loss with exercise and ensure muscle health. i've got revigor. what's revigor? it's the amino acid metabolite, hmb s i'd race down that hill without a helmet.

some states cut core services like medicaid, but in wisconsin, we added some $1.2 billion to medicaid and our reforms allowed us to expand family care, our long-term care program for seniors all across the state. [ applause ] >> still other states used budget tricks. i didn't want to pass that on to my sons and their generation. i wanted our kids and grand kids to grow up in a wisconsin that's at least as great as the one we inherited. [ applause ] with that in mind, we balanced a $3.6 billion budget deficit with long-term structural reforms. we thought more about the next generation than we did about the next election. [ applause ] and isn't that what you elected us to do? [ applause ] we kept our promises. it's why our ranking as a good place to create jobs actually wept up faster than any state in the country last year. [ applause ] we went from years of being ranked in the bottom ten to break into the top half of states to do business and hire people. because employers appreciate that we took our fiscal problems seriously and we addressed them with real solutions. [ applause ] ano

this will allow state government to better manage our medicaid expenditures while ensuring virginians receive the high-quality health care that they need. you arrive here tonight, ladies and gentlemen, in i think a particularly pitiful time in the life of virginia and the life of our nation. the world around us is changing with incredible speed. gone are the old regimes in iraq and libya and egypt and india. facebook and twitter replaced texts which replaced e-mails which replaced phone calls. iphones rule. products and procedures get obsolete quickly. even one-term governors, but not too quickly. in the midst of all this uncertainty and structural change, i think virginians want government to provide stability by funding and providing its core services well. they want good jobs. they want safe neighborhoods. they want successful schools. they want a modern transportation system. a clean environment and strong families, and just an' yaul opportunity to achieve the american dream. we are a nation that rightly guarantees equal access to opportunities. we don't guarantee outcomes. that's

medicaid, medicare. i think this president has very much stepped up to the plate, both in the negotiations over the summer and in this budget. i think all that is holding us back from progress but has been, quite honestly, a resistance from too many on the republican side, particularly in the house of representatives to do a balanced package with revenues. i think there are clearly some republicans who would like to engage in that kind of grand compromise. but unfortunately, not enough. >> unfortunately, we are out of time. our office, as was at the white house, any questions you have, please get in touch with us through e-mail or phone all day today. we'll be happy to answer your question. thank you. but del >> now online at the c- span video library, speeches from last weekend's conservative political action conference. >> we must out start -- we must outsmart the liberals. off we must outsmart the stupid people who are trying to ruin america. >> it is about one country united under god. we are not rea

identity between obamacare and romney care, everything from health plans providing expansion of medicaid coverage, the exchanges in individual mandates, to a level of benefits that both plans have to offer and insists it's just not credible, paul. when romney says that, i'm going to repeal obamacare, i hate this plan and yet, i want to tell the american people what i do and said, and i love romney care. so, the voters are understandably confused. >> all right, romney says himself. i didn't have 500 billion dollar worth of medicare cuts and this was a state program, and the states have a right to experiment and you expected, you liked it in massachusetts and that's very different than the federal program. you're arguing that that, those differences aren't going to sell. why not? >> the same person designed both plans, john mcdunna who has called obamacare, romney care with three more zeros, instead of millions we're talking billions and when romney says, well, we didn't cut medicare states have no authority over medicare, that's a bogus claim. and he says, well, we didn't raise taxes, wel

it proposes hundreds of billions of dollars of cuts in medicare and medicaid. it proposes to shrink what people call the discretionary part of the government, meaning the whole part of the government is not about defense, national security, medicare, medicaid or social security. to cut that to the smallest share of gdp since president eisenhower was president. now, alongside that, because we want to get our deficits down to a sustainable level, we're proposing some tax reforms that would raise revenue, that's correct. if you don't embrace those tax reforms that raise revenue, then you have to find another $1.5 trillion in cuts. and you're not going to be able to find them without going right to medicare, medicaid or national security. so we don't do that -- we don't propose this with anything but a basic view of the nature of the constraints we face and the responsibility we bear to put these deficits on a path to more sustainable. we don't do it because we think revenue increases are terrific, are great, best to always avoid them. it's just we face some choice

cut medicare and medicaid. >> here is mitch mcconnell on the senate floor today. >> the president's goal isn't to solve our problem but ignore them for another year which will insure they get worse. once again, the president is shirking his responsibility to lead by using this budget to divide us. >> senator, is voting on the payroll tax cut separate from the extension of the unemployment insurance, that is a mistake in. >> i don't think it should be separate, ed. you have two huge issues, clearly i'm not a great fan of the payroll tax holiday, but the middle class needs a tax break but at the same time we cannot forget that long term unemployment in this country is very, very high, and we also need to make sure we don't cut drastically the reimbursement rate for doctors who serve medicare patients. >> back to the budget for a moment, i have to say i thought it would have been a bigger number now that we will be winding down.

and availability so a consumer doesn't have to figure out where he or she might fit if they are medicaid eligible, kids are eligible for the childrens insurance program, someone is eligible for the exchange or credit for the exchange but the system indeed encourages that, so there were some, again, early i-t money to look at a more comprehensive approach. we are gathering states on a regular basis to share with one other what are the templates, effective strategies, what is already in place, what this looks like to try to minimize people having to start all over again and to accelerate their progress toward an effective exchange i-t system that works. >> senator cornyn? >> thank you, madam secretary. we're having a shuffling here, we'll get through this. i note that the rate of uninsured in the country was at 17.1% in 2011, up about 7% over 2010, and even more than that from 2008. and one of the reasons given for the increased number offen insured is the number of individuals losing employer the congressional budget office originally estimated some 7% of employees would lose their employ

going to cover it for free and those women who don't get it from their insurance will get it from medicaid so everybody's covered that that's that's my concern about the republican ticket is that kind of rhetoric chris why is there not room not to pick on you but i think that particular one those kind of things come out of the words of out of the mouths of my own that there's a lot of women in america who look at that go on wait a minute you know why should contraception if i need penicillin my pharmacy you know it's covered under my pharmacy benefits if i need something for it to think it's covered under my pharmacy benefits but if i want to get birth control pills and start covered what's magical. for about ninety percent of women who have . health insurance through their employer that are you know not those that are covered by the church they already get it for low income women which people say we're not covering it is covered by medicaid in every state what about planned parenthood we're finding those people who maybe are in the gap already so this is an artificial problem created or a