medicaid. if we expand medicaid under obamacare, 400,000 virginians would get health care. virginia has some of the strictest of deeply standards now, so a lot of people, working poor, would be able to get medicaid coverage. we have found that because virginia covers a lot of things like you to go to the hospital, the state has to pick it up. the health department gets services and can't pay, the state takes it a. community services board provides dental health services, and under obamacare there is no parity. virginia carries it now, but if we expand all of those people will be coming with medicaid, 90%-100% paid by the federal government so that things paid for today on the state will be paid for with a medicaid card if we expand. one calculation estimated that the general fund to virginia, if we expand and pay the state match, the general fund will be $555 million better off because a lot of things are paid for with the state i'm will be paid for by federal money would be better off than it

know one medicaid prgram you know one medicaid program.' are 50 of them!" p ((take gfx2)) six months before the medicaid expansion program was set to take effect-- 24 states had accepted the plan. 21 had rejected it-- and 6 were still considering their options. in ohio alone-- 13 billion dollars would add 366- thousand dollars to the roles. ((i'm using this figure, because there is no federal figure and i think this helps paint the cost picture.)) der ((take sot)) e "people might shoot themselves before they voted for it." ((take vo)) there's concern about the national debt. and in some statehouses lawmakers are worried washington won't hold up it's end of the bargain-- and stick states with bigger bills and bloated roles. at some conservative think tanks the concern is expanding the program fundamentally changes it. alt ((take t)) "it would expand medicaid to cover able-bodied adults who don't have children who aren't disabled, who aren't pregnant and wh aren't elderly and it does so while providing no requirement those individuals seek em

who pointed out that he lives in michigan and michigan has said no thanks to two medicaid money. he said if you live in one and a half times a year add or below poverty or whatever you know where you would be eligible for medicaid and you live in a state where that medicaid eligibility has not been extended so there won't be an obamacare. medicaid option available to you as there will be in all the other states what do you do you go in and buy it on the exchange and then get a tax credit is that the option and if so how does that work there is a medical need to do things which one is that for the people there are some people that are going to be that will be caught between the eligibility for the medicaid expansion if it's not occur. in some of those folks the period where you come into the folks between two hundred one hundred thirty eight percent of poverty would be able to purchase and. there are folks who will get caught and that's why it's so important that we continue to fight in these states to expand medicaid because otherwise it's putting pressure on overburdened communi

medicaid. all of the hospitals or bodying each other out because it is a privatized system that we have already. that is what is making it expensive to go to the hospital. >> let's all be respectful, please. let's all be respectful, please. the problem is you can't lower the cost of health care by just mandating everyone beyond the insurance is regulated beyond the government. you can't do it. you can't over regulate the industry and the prices go down to the it's not going to go down. and i've heard from republicans and democrats who are very concerned about it. so, it is not just one side at this point it is certainly not one-sided and it is important to remember when we talk about working together when obamacare was passed with one party passing it, the one-party basically passed it over the objections of the other party. the other party completely objects to but i think that is a serious flaw in the way that was passed. you have to have an agreement between the party on the issues. >> i com

more than medicaid does.ut i will tell you that one of the things that we are asking for in the medicaid reforms with the feds is we want a prenegotiated set of parameters in which we can innovate. and v.c.c., when it's expanded, we'll have a lot of adults come n who have been previously uninsured and we expect them to be high-need individuals. we'd like to sit down and say we'd like to use you, but when you get v.c.c. the current rules don't allow restrictions of networks and restriction of assets. we would have to take that program to c.m.s. and we would have to ask for permission and they'd have to bless it. frankly by the time that was over we'd all be gone. so what we're asking in advance is to be able to do innovative programs like that across the state. that is one of our requirements. >> thank you. >> there's one question you asked about doctors. this one will not directly affect doctors very much. you'll be taking insurance, just like you're taking insurance. but you're going to be asked -- i assume

s some will for both private and medicaid, but it is explicitly not having medicaid reach across andell them who they have to contract with or what they have to pay. it's to actually get them newly covered under the affordable care act, the same coverage that privately covered individuals have in the tax subsidized insurance under the affordable care act. it neutrals the access difference by us using the same plans that private individuals will pay. in our approach, if you're not medically frail, you will not have the option to go on traditional medicaid. you will be able to select between one of the q.h.p.'s on the private exchange, as do those who come through the federally facilitated exchange nd have that same choice also. >> people who were eligible for medkead and then getting coverage. >> that was one of the things over the last 60 days we've spent a fair bit of effort on. the afford cable care act, on the private exchange, there's a people 5% -- for the 128%-158%. it's 5% of family income under new guidance. so it's essentially and through the insurance commissioners planned

let's hear from vince in minneapolis, was on medicaid.-- who is on medicaid. hi, vince. caller: hello. i wanted to go off of medicaid and suspend my social security payments because i want to go back to work to the bankruptcy court.because i still maintain my lawyer's license. i know from bankruptcy that there is a lot of people who filed a medical debts because of -- medical debts and it bankrupts them because of uninsured accidents. the aca does not address that at all. host: what happens to people who have had catastrophic medical situations, can't pay the bills, have to declare bankruptcy? can that still happen? guest: yeah, absolutely. the hope for those who support the act is that it will happen a lot less when employers are mandated to offer employees coverage, and individuals are mandated.-- individuals are mandated to have coverage. this should go a long way towards reducing medical bill- caused bankruptcies. there is nothing in the bill that would preclude bankruptcy from happening. guest: or nothing that, if you have had a situation where he-- you racked up a

we performed medicaid back in 1997. --are one of the few states and through private companies managed care plans. we have already done that. that is not something will bathe to do again because we have done it. there are a lot of people who are not in the managed care fors the we call that fee service. what we are trying to do is bring people into the managed care plan as some said that is a hassle. world, know in today's when you go in for treatment i can tell you about my mom a few years ago. she had pain right here. can anybody tell me what my mom had? what was her problem? her gallbladder? yes. she had an orthopedic surgeon. mom did not like they either. now that momnow was having pain right here. go toow she does, shasta primary care doctor and the hospital in the cardiologist and finally the general surgeon. and two weeks later, she is on the floor in pain and my dad calls. that is what we have been doing and health care to people. we send them here and there. what we are working with the plans is trying to be bet

program they can also enroll in medicaid for coverage to start january one as well in both cases. is whether they sign up for private coverage the exchange or whether they enroll in the medicaid program if their state is doing that coverage will start january first and that's the next milestone in addition to coverage starting and number of important insurance reforms come into play starting january first for example as you were just mentioning people with preexisting conditions who today can't necessarily get into the insurance marketplace they will be guaranteed coverage insurance plans won't be able to turn them down at that point. and. apropos of this when i when i announced a week or so ago we're going to dig into this subject and get a lot of a lot of feedback as you can imagine one was a e-mail from a friend of mine tom joyner who's who pointed out that he lives in michigan and michigan has said no thanks to two medicaid money and. he said if you live in one and a half times harbor to your ad or below poverty or whatever you know where you would be eligible for medicaid and

it differentiates them medicaid care or traditional state medicaid programs were providers are paid a much lower rate. we are buying the same health plan that the tax subsidized individuals about 138% are receiving and we are putting in safeguards so a provider doesn't know whether the individual is medicaid untouchable or tax subsidized. we are intentionally trying to eliminate a providers knowledge whether the individual is medicaid funded or tax subsidized and therefore the payment rates have to be the same. >> yes, i'm sorry. last question. >> hi, strategic communications. this is just a general question. i'm sorry if this is our debate answer. i am just trying to understand what the difference in the job roles is between sisters and navigators because it seems like they do -- it is just a different turn for the same kind of thing. i'm just trying to understand what the difference is between the community as sisters and navigators actually do. >> e-mail, long story short is they are doing very similar roles. the navigators have a certain set of prescribed roles in the last such as

we want our patients with medicaid, or people are poor and have medicaid insurance, we want them to have access to the same physicians that amitabh or darius or try to have access to the that is the broad vision we have here. at the end of the day, take a point is her plan should not cost more than the aca. >> thank you. now we're going to turn to first nina owcharenko. >> great. thanthank you so much for havine today and it's a great presentation. i would tell the audience that the report itself is chock-full of great information and is more than even i think the presentation itself has shown. there's a lot that the authors get into. and with those kind of walk through what the complexes and dilemmas of the current health system are. and i agreed with many of the issues that were raised in the report, as joe already mentioned from the comment about the disciplines or marketer relies on stopgap measures to rethink its gap, kind of the lettering and living on top of a broken system the inequities in the system that have a healthy poor subsidizing the wealthy is an important one and even t

but i would say the medicaid battle has to continue. we cannot forget that for the lowest income working pennsylvanians, if you don't expand medicaid you will still have -- the numbers i was given -- about 95,000 individuals here and over allia about 200,000 individuals in pennsylvania who would not have any financial help at all. that would be a terrible tragedy as we implement this important law. i will give you the shorter one. i can't even remember the longer one. phila.health, go to the website and with october when coming up, we are gearing up to partner in many instances with the navigators and we will talk about some of our enhanced efforts to make sure people are getting the word out. -- i truly do not understand -- i have read some things. i have not been able to have any understanding as to why the state of pennsylvania is not expanding medicaid. we hear about costs and the governors have figured out that it brings in money and it does not cost you any money so i don't know -- i truly don't know what this is about. i don't kn

you have medicaid data. if not, you should get it. you have data on your employee populations, you have data or can get it on your retiree populations. the largest purchasers of health care for of you in your state. and so you can move a lot of material around. as i bored you back in february, states have many, many levers to pull. you control the entire spry of health care in -- supply of health care in the state, you have antitrust powers, pressuring powers, and by deploying those in good ways, you can actually change the system with some rapidity. so we're hopeful to be able to help. we had 24 or 5 of your governors' health advisers in washington earlier this week to begin getting them to talk to each other asit was the first te ever had all the health advisers together at once, and they've begun those discussions and share what they're working on. equally important, learn what we might have to offer them and importantly, too, for them to tell us what you need. we may not have guessed right in some cases. but i think if we can take

we do the same thing for those people that we ensure that the medicaid program.edicaid may be infallible -- may be valuable but the network is small and shrinking quickly. medicaid patients are not allowed to come on and say, i'm going to accept, i want something more generous than the medicaid program that ending offered by the state and willing to supplement it with my own dollars. so what we want to do is increase the amount of choice that patience and workers have in the marketplace. how are we going to do that? what we're going to do is provide premium supports. so what we'll do is we'll offer premium support to americans, and to the 50 million, for the purchase of any chosen plan. you get a premium support and you can supplement and that premium support with your own dollars if you want a more generous plan than a plan that is being subsidized by the premium support. the third piece of our plan, which is probably the most innovative is the elimination of community rating. community rating is very popular with people because what it does is it says, gee, we'

medicaid is second class health care., it's highly partnership tiff from the federal level. we do have evidence that if states are given flexibility in it, the state of rhode island was given flexibility in the closing days of the bush administration to implement an interesting plan to basically take the value of medicaid and rather than give it as a government benefit to allow individuals to access that money for private benefit and to have a whole series of other regulatory freedoms that are not allowed to any other state and this experiment worked mightily in rhode island, the state is spending about the same amount of monday that i it was in 2008, which is the rest of the country is spending a lot more per capita on medicaid, it's spending about the same or slightly less and yet it's providing additional services and the state is able to manage the case load and it's able to manage its own budget which is what we ought to be trying to do which is to allow, provide flexibility to the state so they can solve the particu

obamacare expands the number of people on medicaid by about a third. federal government picks up the tab for a number of years and then the states pick up the tab. but the latest round of activities, many of them involve the so-called navigators. the middle of august, the federal government let contracts involving hundreds of millions of dollars to states to so-called navigators. these are people who are supposed to navigate the exchanges and buy insurance this fall, starting october. some said they can't undertake certain activities. in ohio they're not allowed to compare and contrast different types of plans. we're hiring a bunch of people who may work for united way or planned parenthood or a community group. they're be being hired between the middle of august and the program begins on objectctober . so a lot of states have said whoa, we don't want people who have virtually no training, whose background we don't understand to be out there trying to do things that professional insurance agents have a lot of training to do and we're technically worrie

. >> reporter: he said it is better to have medicaid?those are his exact words. >> reporter: dr. fata wouldn't treat her husband until she was approved for medicaid which she didn't know at the time she was part of an elaborate medicare, medicaid scam that lined his pockets with tens of millions of dollars. >> every time we could go for a checkup or whatever, the first thing he would ask, have you heard from medicaid yet? no, we have not. well, we have to wait for that because treatments are very expensive. >> reporter: he wouldn't do any treatment? >> nothing. >> reporter: so your husband had this growing tumor and he said you need medicaid before we start? >> yes. >> reporter: she brought her husband to another facility where he was treated immediately and proficiently. and now federal investigators say nancy's story was the tip of the iceberg. according to the indictment, less than two weeks ago the fbi interviewed an oncologist that worked with dr. fata. they told the fbi dr. fata would give medically unnecessary or inappropriate dos

privately run rehab clinics get medicaid money.ear-long investigation by cnn and the center for investigative reporting has found a system riddled with fraud and poor oversight from billing for phony patients to allowing convicted felons to run rehab centers. because it's happening in california, it is big money. state and federal taxpayers are on the hook for tens of millions of dollars every single year. investigative correspondent drew griffin has this report. >> mr. aluno, drew griffin with cnn. george has run a taxpayer funded drug rehab business in southern california for the past six years, which is surprising because for the last 11 years he's been on a list of people banned from billing medicaid. convicted of student loan fraud, george should never have been allowed to even open this clinic called gb medical. i'm asking you a few questions. you seem to be the center of fraud allegations. >> no. >> have you been faking signatures onto sheets of paper and billing the state for the money? guess what else? he is facing felony

and it also starts going in to how to apply for medicaid. west virginia use medicaid to pay for nursing home services if they stay long-term. >> i got you. >> and then this talks about what medicaid doesn't pay for. >> the first 20 days she is here through rehab? >> 100%. >> and then the next 79 days medicare pays part and her insurance will pay the balance? >> as long as she meets the criteria of skilled services. if she doesn't have a specific plan that pays for long-term care, you can choose to pay privately. and that's $265 a day. some people don't have that. and typically, that's when they make application for medicaid services. it's a tough, tough transition, and it's a tough decision. let's see what we can do, and then we'll just take it a day at a time and see what her status is. thank you for entrusting us with her. we're all on the same team. >> you betcha'. >> you be a good girl. you work on therapy now. and i'll see you tomorrow. >> yeah. >> you'll be right here. i know. >> you'll be here. you be good, girl. don't fight with the

and it also starts going in to how to apply for medicaid.est virginia use medicaid to pay for nursing home services if they stay long-term. >> i got you. >> and then this talks about what medicaid doesn't pay for. >> the first 20 days she is here through rehab? >> 100%. >> and then the next 79 days medicare pays part and her insurance will pay the balance? >> as long as she meets the criteria of skilled services. if she doesn't have a specific plan that pays for long-term care, you can choose to pay privately. and that's $265 a day. some people don't have that. and typically, that's when they make application for medicaid services. it's a tough, tough transition, and it's a tough decision. let's see what we can do, and then we'll just take it a day at a time and see what her status is. thank you for entrusting us with her. we're all on the same team. >> you betcha'. >> you be a good girl. you work on therapy now. and i'll see you tomorrow. >> yeah. >> you'll be right here. i know. >> you'll be here. you be good, girl. don't fight with the nu

i think one of the challenges we find on the medicaid side right now. we pay medicaid costs 75%. we pay about 70% of that, per state. that's one of the things we have to consider. we're already cost shifting 30% on to everybody else. we, the government program of medicaid and medicare. medicare has been typically below cost, too. so it becomes a little bit of an unfunded burden on providers. it has to be worked out. you can't have a sustainable long-term program when you promise something but yet you don't pay for it. >> there is one other thing obama care is cog doing, and that is providing funding to increase the number of providers. --there will be providers in there. scholarships for doctors to go into under-served areas, nurses, physicians assistants and building up the numbers of providers. >> that's what i wanted to say, congressman. just a number of private health insurance. >> just like a doctor is not required to take insurance from any company. we are under a -- we are increasing -- it is a great time right now if you are interested in get k into the health care field

you mentioned medicaid. obama care is effectively simply a federal pays both sides large medical program. that's really what it's becoming. the federal taxpayers will be on the hook for huge amounts of money. all we're asking for is that you obey the law as written, and you provide us information when we believe that you created a rule that the last panel couldn't find language to allow you to have that interpretation. you said here said under oath, that, in fact, you had a significant number of people, career professionals, who did analysis. you've begin this committee no such analysis. i'm sending you back very simply. you were pretty close to a useless witness who came saying "i don't know," and if history is of any indication, the things you said you'll take back for the record, you won't come back with any answers. you didn't send 500 pages. you didn't send 386 responsive pages. you acceptability almost nothing. the american people, if they are going to spend trillions of dollars, and if they're going t

it's not clear if he did the same with the medicaid program. indictment alleges he told a patient that hit his head in the office he would need chemotherapy before he could be treated. milton burrs was another patient. he had a mild form of leukemia and was doing well without chemo. he switched to dr. fatah because he wanted to go to a closer hospital. his son says fatah started an aggressive chemo regimen, in retrospect, aggressive and bizarre says jeffrey. >> somebody from the staff would come out into the parking garage and give my dad the chemo therapy right there in his car. >> basically, fatah was treat thing like it was a mcdonald's or burger king, drive through and get your cancer treatment. >> i heard it compared to that, and it appears that way to us. >> reporter: now jeffrey burrs is left to a memorial to his father. milton burrs died four months after dr. fatah started his aggressive chemo therapy treatment. >> he died when his kidneys failed and shut down. he spent the last few hours of his life in excruciating pain, on morphine. >

a big part of obamacare is the expansion of medicaid. everybody making under 138% of the poverty level would be eligible for medicaid. we're seeing some states are putting forth the expansion. about half the country is not. right now tennessee has not officially said which way they will go. as of right now they have not decided to expand medicaid. what would happen to the people that would have qualified? if you fall under the poverty level, you can go to the exchanges but you will not be eligible for the subsidies. it puts a lot of these people in a tough position. there are millions of people out there that are in states that are not expanding medicaid. they are not eligible for subsidies. they are going to be left in many of same positions they are right now. you rely on places like community health centers or go without. that is why there has been so much pressure on states. the key threshold is if you get to that $11,500 mark you would be eligible for a huge subsidy that would cover 95% or 98% of the premium in the exchanges. host:

. >> reporter: but he insisted it's better to have medicaid?> absolutely. >> reporter: he says nancy would not treat her husband at this medical complex in rochester, michigan, until she was treated for medicaid. what she did know is she was part of an elaborate medicare/medicaid scam that lined his pockets with tens of millions. >> every time we went to the office, the first thing you would ask, have you heard from medicaid yet? no, we have not. we have to wait for that, because treatments are very expensive, and -- >> reporter: so he wouldn't do any treatment? >> he would do nothing. >> reporter: your husband had this growing tumor and he said you have to have medicaid before you start? >> yes. >> reporter: nancy went to another facility where he was treated. now investigators say nancy's story was the tip of the iceberg. according to the indictment, the fbi interviewed an oncologist who worked with dr. fatah. that doctor told the fbi that fatah would give chemo "where it is medically unnecessary or inappropriate dosages." the fbi said that o

i think one of the challenges we find on the medicaid side right now. we pay medicaid costs 75%.e pay about 70% of that, per state. that's one of the things we have to consider. we're already cost shifting 30% on to everybody else. we, the government program of medicaid and medicare. medicare has been typically below cost, too. so it becomes a little bit of an unfunded burden on providers. it has to be worked out. you can't have a sustainable long-term program when you promise something but yet you don't pay for it. >> there is one other thing obama care is cog doing, and that is providing funding to increase the number of providers. so there will be providers there. scholarships for doctors to go into under-served areas, nurses, physicians assistants and building up the numbers of providers. >> that's what i wanted to say, congressman. just a number of private health insurance. >> just like a doctor is not required to take insurance from any company. we are under a -- we are increasing -- it is a great time right now if you are interested in get k into the health care field that

and when it comes to medicaid i looked at that and said why is putting more people on medicaid necessarily good thing? what i want is fewer people uninsured when which i have on my plan. i cover everybody living in poverty and everybody above it gets transitioned into the private market or into the exchanges. and so we've moved people, transitioned them out of what previously had been medicaid dependence because i don't want more people dependent on the government, i want them to control their own destiny -- >> how will the poor do? i asked this. your neighboring state, ohio, run by fellow republican john kasich, i had john on the radio show on saturday. and he has an interesting take. he's a big tax cutter. >> absolutely. great guy. done great work in ohio. >> yes, he's done great work. he's also on a campaign to help poor people. and he's been joined by your friend paul ryan. he's been joined by eric cantor, majority leader of the house. you know they put money -- they bought into the medicaid. they put money into various mental illnesses. they put money into various food programs. gover

one pillar is expanding medicaid for poor folks. another is the individual mandate that everybody over a certain income has to have health insurance. the other pillar is that employers are obligated, 15 employees are obligated -- employers are obligated with 50 employees to insure their employees. the delay was seen as a setback by republicans, who keep arguing it is very difficult to implement this law. it was seen as a source of relief by a lot of employers. one of the things going on with this law -- remember it was passed in 2010. it was suppsoed to be, "that gives us four years." what's going on now is the time to get new rules out are squeezed. rules are still coming out even as we are sitting re employers were trying to figure out how they were going to comply with the law. the administration decided, we will give them a year's break. we can all take a breather and figure out we are going to do this. guest: i was at a seminar by an insurance broker in california. this room was full of employers that were athar plastic about t

when medicaid covers your service, you have no choice. you go where medicaid want pss you to go. >> reporter: check meduck hopes to do better for himself and his mother. >> i'm looking now at how i'll position myself financially to support my needs when i get ready to retire. >> reporter: planning ahead is the most important step. for "nightly business report," i'm bertha coombs. >> challenging problems for millions of american families. if you want to read more log on nbr.com. >>> we begin the market focus tonight with an earnings report from the billionaire next door. warren buffet reporting net profits jumped 36%, revenues were also strong more than a billion dollars above estimates. because it's high price per share, burke shierp hathaway up to $176,500. it's up 31% so far this year. chevron's so/so profit report held down the dow a pit. profits fell 26% because of higher costs and softer demand for crude and repairs in u.s. refineries. investors traded more shares than usual and chevron was down as much as 2.5% before rebounding to $

or obtain medicaid or chip coverage. many of the americans who will shop have never had health insurance, so the process of selecting, implying, and in rolling will be unfamiliar to them. to reach these populations, cms is providing outreach, education, enrollment assistance in a variety of ways. in june, we relaunched a new consumer focus health care.gov website and a call center to help americans prepare for open enrollment and ultimately to sign up for private health insurance. since then, thousands of consumers have contacted us via the live web chat or our toll- free number. healthcare.gov already has had over one million visitors. consumers in the marketplaces will also be able to get in person help from navigators, in person the sisters, trusting the people connected to their community who can help them walk through the process of applying for coverage. they can also work with insurance agents and brokers as is true in the market today. to select a qualified health plan. these insurance plans in the marketplace wi

we need to expand medicaid. our current medicaid system is broken. it has $3,500,000,000 over budget other projections from last year. which has a severe implication on this budget. we are trying to deal with these existing medicaid systems, which is putting a burden on the point in time. i have had very cordial conversation with a secretaries. but with the secretary there are regulations that have within the last two weeks. with medical groups and insurance companies we are figuring out the details and interpretations of the regulations. because these regulations could make or break our budget. just in the past week and a half come in the new regulations come on board, which allows hospitals to do a screening process of any patient that comes into the hospital we cannot afford the care and we have asked the hospital to do the screening and that the screening shows that they can or cannot get on medicaid. we put it on and there is a two month period. we are trying to figure out if they didn't qualify, does the state get a refund of the hospital did n

is close, special agent in charge tom o'donald walks us through the alleged scheme. >> he billed medicaid for prescriptions he didn't need. >> reporter: a plan that went on for more than a year. he enticed patients to bring prescriptions to his pharmacy, but instead of filling prescriptions and handing out drugs, he allegedly handed out cash. >> 20 bucks, 30 bucks, 40 bucks per script. >> reporter: from there investigators said he billed medicaid for drugs partially filled or never dispensed at all, including billing for refills and would rake in the cash. focussing on medication for hiv drugs. >> they reimburse 14 to $1500 for a 14-day supply. when you have drugs that high for reimburse mtd, there is a black market for it. >> reporter: a scheme, according to investigators, that is being played out right now at small pharmacies all over the country. so why would patients want to get involved? he says in some cases patients don't want to take their medication and are just looking for pocket money. >> a lot of times they will go back and report their medications were stolen, get police repo

the medicaid provisions threaten to withhold not only the medicaid expansion but i'll medicaid funding in a state if the state refused expansion. that would clearly have significant consequences on the most vulnerable populations. even with the expansion the statute denies tax credits to the poorest of the working poor because there is a minimum income requirement. my co-panilist may think this is a policy but it's indisputable that this is in fact what the text of the statute does. some say it would be absurd to oppose raising requirements without subsidizing health heale but that is also what multiple provisions of this act clearly and indisputably do such of his tax at provision. some may think that the way the act was designed -- but that does not make it any less the law. the relevant statutory language was not an accident or an error. it was the choice of those in the senate to want state basic changes to play a key role in health care reform. others prefer the federal model. and has a -- had a built in enacted the model based on unconditional tax credits may tax credits may been

you mentioned medicaid. obama care is effectively simply a federal pays both sides large medical program. that's really what it's becoming. the federal taxpayers will be on the hook for huge amounts of money. all we're asking for is that you obey the law as written, and you provide us information when we believe that you created a rule that the last panel couldn't find language to allow you to have that interpretation. you said here said under oath, that, in fact, you had a significant number of people, career professionals, who did analysis. you've begin this committee no such analysis. i'm sending you back very simply. you were pretty close to a useless witness who came saying "i don't know," and if history is of any indication, the things you said you'll take back for the record, you won't come back with any answers. you didn't send 500 pages. you didn't send 386 responsive pages. you acceptability almost nothing. the american people, if they are going to spend trillions of dollars, and if they're going t

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. >> there are be no finger wagging on medicaid. >> she's probably give had him a hug -- >> maybe not a hug. that's wildly optimistic. >> on medicaid though, the deal is really, really good and it is hard for governors to pass it up and she recognizes. that's why she was such a warrior for this in her state, did things that no other governor has done, especially no other republican governor has done. folks like rick scott and rick snyder in florida and michigan have not gone to these lengths to do it despite the pressure they are facing. >> we've now given jan brewer her kudos, janelle, but there are all sorts of other things jan brewer is shepherding in the state of arizona. i think the voter suppression piece is really interesting. >> certainly. >> we talk about the efforts and that the attorney general are making to, if not unwind, then to stop the voter suppression efforts happening literally all over the country. the fact that the arizona state legislature is trying to make districts less competitive by putting minorities all in one quadrant and everybody else in another. it's am

we want our patients with medicaid, people who are poor and have medicaid insurance.want them to have access to the same physicians that any of us have access to. that's the broad vision we hope to obtain here. at the end of the day, the take home point is our plan shouldn't cost more than the aca. >> thank you. now we are going to turn -- >> thank you for having me me today. i would tell the audience is that the report is -- more information and more than even the presentation itself has shown. there's a lot that the authors get in to. it really walks through what the complexity and the data limb ma of the current health care system are. i agree with many of the issues raised in the report. as joe already mentioned from the comment about the dysfunctional market that relies onleyer stopgap measure to prevent the gap. the layer and layering on top of the broken system. they have i think that's is why we realize how hard it is to overall the health care system. and a really good contribution to the discussion on this and a experiment about how the system could work if

program that allows for disabled medicaid patients to get care at home. that's a very good program. it's got a lot of bipartisan support and, of course, rick perry wants the state to be a part of it. you go to other states and see a bigger effort to get the medicaid expansion because it's millions of money to cover their constituents on the federal government's dime. at this point, you will not have the republicans winning that argument. the law is going into effect and not getting defunded and the question is whether or not they can quiet ted cruz voices to take advantage of what the law actually offers them. >> but if we see the crowds that came out last night, an example, in dallas, just one of nine cities that the heritage foundation hitting on its cross country defund obama care tour and the crippled movement's next stop going to tampa, florida. jim demint suggesting that the president may actually sign a bill that would defund his signature piece of legislation. take a listen to this. >> senator demint, what is the point of voting to defund obama ca

you all have data and medicaid data. if not you should get it. you have data on the employee population. you have largest purchasers of health care for many of you in the state. you can move a lot of material around. states have many, many lever. you control the entire supply of health care. you have antitrust power and purchasing power and regular regulatory power. and by deploying those in good way you can change the system. we're hopeful to be to be help. we have 2 or 25 of your governor's health advisers in washington earlier this week to begin getting them to talk to each other as we. it was the first time we had the health advisers together. and begun the discussions, of course, in sharing what they're working on. it was important we need learn what we might have to offer them and important for them to tell us what you need. we may not have guessed right in some cased. but i think if we can take successful experiment, if you let me call it that, and test them other places and see how we can opt them to your state and local health practices.