that in and of itself you can provide feedback to a provider about that interaction. we have a 4.8 average rating. we have to appear review so it is double blinded and so our doctors worked together to ensure quality across the board and we have a host of other match or exceed overall prescription rates retracting below in the average is on both of those. as other initiatives feel passionate about that is the practice being virtual and technology driven and the amount of data that we consume and analyze back for one of the single sources we measure for the providers to make sure that they are happy and productive. they love getting that data and seeing how they are attracting versus other doctors and practice. so getting that feedback that has been a huge lever driving the standards and outcomes. >> i also want to suggest you may have a t-shirt and if you have any things to put in it before we close out. i know you are holding onto a good one. [laughter] >> keep calm and carry on. something like don't worry, healthcare is getting better. each of us are pushing hard to

providers. one of the more difficult conversations any safety net provider has when they're trying to bring in new physicians and dentists to say we hope to have a job for you in two years, it really limits our ability to have realistic conversations with providers we need to help several patients. two years is a short planning cycle for any small business to try to address changes in the environment. . a longer planning cycle would make us more effective on how we deliver care to our patients. every health center must meet criteria. what are the conditions that must be met to receive these grants and how does an applicant demonstrate a need. there are 19 basic requirements to fund to be eligible to receive funding. each one of those areas must be defined and documented in a competitive grant application which occurs every three years. >> thank you. what you do is critical. we appreciate your efforts. >> it is critical for us to show congress that we do what we say were doing and that we are who

this program has proven effective at placing providers , providers were young and energetic and willing to work hard in some of the most medically underserved and challenging areas. the state children's health insurance program provides healthcare coverage to over 8 million children across the nation through flexible capital lots allotment to state, they have been able to successfully support children while providing states with opportunities to tailor their respective programs as to best meet the needs of their populations. however, the programs are not without challenges. in regards to the community health center fund we are interested in seeing how health centers and best maximize this investment. exceeding in areas can be difficult and i look forward to learning more as to how the federally qualified health center can continue to deliver results and where improvements might be made. as for the state children's health insurance program, there are multiple points for consideration, as is the case with other federal insurance programs. there are considerable concerns regarding the long

we provide a kind of choices. before individuals were able to purchase the kind of coverage that was actually responsive to them. that fit their system, their lifestyle, their situation in life. that is what you get folks to buy coverage and providing coverage they want to purchase as opposed to what the government dictates to them they have to buy. >> senator let me turn to the question everyone will be thinking about this week. which will take up, since the plan was brought forward this week, five republican senators have announced their misgivings. there may be four or so others who share those misgivings from various reasons. you are going to be, you can only afford to lose to. you're down five and maybe more. how do you get from where you are now to the 50 votes that you need? >> if you listen to at those five said, and we have talked with every one of them. another senate leadership has as well. the president is talking with folks.if you talk to them, what they will tell you anything they were part of your c

with broadband we can provide phone service and now broadband high-spied internet.he cable service is not whatted used to be, high cost, cable programming, sports programming, broadcast programming for retransmission consent and it is failing. it's very difficult for a cable operator to break even on the cable side of the business, which is why broadband is so important, giving consumers more of a choice that we can't give them on cable through the broadband pipe. so, i agree with the article. agree with the statement that this is a very difficult thing, and many of our companies are looking at primarily focusing on maximizing broadcast, knowing that cable is something we tried to deal with, tried to provide choice, but we have little ability to do it because of those who control the content. >> tom larsen, is video a losing proposition for media companies? >> it's certainly our worst product. makes the least amount of money. but it is always been a big revenue driver. paid in a lot of ways for the network that is able today to deliver broadband. we're not ready to

able to directly provide a stipend to caregivers iraq andar from afghanistan but does not provide thegency to provide this to pre-11 -- from pre-9/11 wars. this seems particularly wrong because elderly veterans are a vulnerable group. senator dole, i know you addressed it in your testimony but i want to come back to underline it. when it comes to providing additional support services, what are the consequences of classifying caregivers of veterans from post-9/11 war separately from caregivers of veterans of earlier wars? unfairs a very legislation. we need this legislation we are focused on today because as soon as possible we need to begin to meet the very unique needs of service members and their caregivers. it is frustrating to me because these pre-9/11 caregivers have been providing services for years with no acknowledgment, without anyone really acknowledging the services they are providing and without the resources to provide some respite care for them. an opportunity to have a stipend, which can be very helpful. to have the same benefits as post-9/11 do when they are dealing wi

looking at extending funding for the program and federal health centers provide primary medical care for underserved communities. texas congressman michael burgess chaired this hearing. it is about two and half hours. .. [inaudible conversations] >> the subcommittee on health will now come to order. the chair wishes to observe that today's hearing was originallyna scheduled to occur lastheduled wednesday morning. but on that wednesday morning, the capitol hill family and theo entire country with stockton horrified to learn about my room. this past week has been so weird and difficult for all of us in many different ways. the number of friends in deed to leave the hospital. they competed to need our prayers and best wishes as they fight to heal to recover and join us again. the tragedy reminds us that whar unites us is more important than what divides us. we are not first democrats or republicans. we are americans. we love our country and respect our colleagues. we are saddened, but we are strong. we are troubled that will unite around our common duty in common service to our fellow c

seems like there's a new provider every day. so that's been done in an open, free marketplace that was created by networks we built. so i think he recognizes that you should let the market work if it can work. >> host: so the fcc last year put titleii into motion. >> guest: right. >> host: what was, what did mediacom do in preparation for a potential title ii? >> guest: well, you know, it's hard. i mean, i think we had to take a gamble last year on whether to invest in our network or not, and our chairman decided that despite all the regulation that was happening at the federal level, he was going to take a gamble, and he decided to invest a with dollars over three years -- a billion dollars over three years to become the first cable company in america to go all -- really all gigabit. so this year we prepared our next last year, this year we're launching in 1400 communities. we've done 500 already this year in the first three months, and we'll do another 900 by the end of the year. and we're going to be the leader in that space.

agreements and the funding provided by our government. the market decrease in our base funding level over the past few years had forced the army to mortgage long-term investments for the benefit of near-term readiness. like wise, in oco not fully represented on this chart, as large contingency operations have become smaller, the arm's budget has been reduced consistent with the requirements of the contingency operations we are supporting. as is clearly portrayed on this chart, the funding levels of the recently enacted 17 budget and 18 base request are consistent with the administration's goals of the future. with this fy '18 president's budget submission the following are some of the main highlights of our request -- first and foremost, the budget has been formulated to provide the combatant commands with the best trained and ready land forces that we can generate. to do that, we must fully fund the counterterrorism and counterinsurgency necessary for the current fight while also building decisive action capabilities for potential major

s recognize as much for their ability to provide confidence of healthcare as our ability to provide detailed evidence collection and maintain chain of custody. researchers identified myriad, acute, health issues that occur at higher rates in sexual assault patients than their non-assaulted counterparts. s.a.n.e.'s have the ability to attend to the unique health care needs of patients, connect patients with follow-up resources and referrals for long-term medical issues, and collaborate with professionals within the medical community and with ancillary disciplines to target individualized care of sexual assault patients across ossy are lifespan -- acr their lifespan. research is greatly needed to understand how patient outcomes differ with specialized sexual assault care when that is provided. while it is become clear patients that receive s.a.n.e. care have improved outcomes, there is no research to provide data related to healthcare outcomes. i hope you'll give consideration to what i shared. i appreciate your time and are willing to answer any questions from the task force, thank you so muc

capability to provide more accurate targeting. the navy increases the buy of the surface to surface missile module to provide lcs the ability to protect sea lanes and move forces quickly through a choke point or other strategic waterways. the submit provides substantial investments to modernize capabilities in order to continue to overmatch our adversaries. it includes key investments in cybersecurity to ensure resiliency in operational technology, advanced efforts to outpace the threat in electronic warfare and information warfare domains is supported by the consolidated float network and enterprise services and the navy multiband terminal system. various ship and submarine modernization efforts include the tactical system which provides submarine sonar, imaging, electronic warfare systems and advanced electronic warfare and attack capabilities. the ddg modernization ensures that fleet mods meet or exceed expected service life. another enabling spares is funded to 85% of the requirement. the marine corps and pnc continues to bala

the better care act provides funding to make health care more affordable for low-income and high-risk residents. giving states flexibility was an important priority for us in drafting the better care act. obamacare took the opposite approach attempting to impose a one-size-fits-all solution on every state in the union. the problem with that is as pretty much impossible for a massive federal bureaucracy to hand out one conference of solution that will somehow meet thef needs of everyone in this country not to mention the top-down one-size-fits-all solutions that are seldom the most efficient or affordable. bureaucracy costs money after all. my goal in drafting the better care act is to make sure the states have the flexibility to address the needs of their specific populations that we met provide an and innovation fund to help them meet the particular needs of their residents. we also empower states by simplifying the waiver process by which they can seek relief from some of obama cares demands by allowing them to encourage a greater variety of health care solutions.we give we give sta

new providers. one of the more difficult conversations in the safety net provider has when they're trying to bring in new physicians, new dentists, is to have that discussion about if the lead time to recruit these providers is one to two years, to say we hope to have a job for you in two years, it really limits our ability to have realistic conversations with new providerred that we need to help serve our patients. two years is a short planning cycle for any small business tol try to address changes in the environment, and certainly the healthcare environment is changing rapidly, and a longer planning cycle just would make us more effective in how we deliver care to our patients.an >> thank you. also, every health center must meet cite criteria and how does an applicant demonstrate the need for health services and i have a 30-second time left. >> there are 19 basic requirements to fund -- to be eligible to receive healthcare center funding. other one -- each one of those areas must be defined and d

i'm happy to provide any detail in q&a. ranking members of the committee, thank you for this opportunity to testify. congress' goal when it passed the fisa amendments act was to get our government powerful tools against foreign threats. the government has used the authority to monitor suspected terrorists overseas and interrupt their plots. that is exactly as it should be. we are here today because of the other things that section 702 has been interpreted to allow. the government is not simply monitoring foreign terrorists or foreign powers. instead it is scanning the content of almost all of the international communications that flow into and out of the u.s., and acquiring hundreds of millions of communications each year, including a large although still unknown number of american's communications. in addition, despite being required to minimize the retention and use of american's data, the government keeps the data for years and routinely searches it for information to use against information in ordinary criminal cases. i

i'm looking for assurances that when we do new provider agreements on any contract with nonva care providers, we're good at making sure they understand more or less we have a lot of mills and they get these people hooked and they keep them hooked. how are you going to ensure -- what's your oversight, are you prepared for this? >> well, i don't think we're doing good enough job in this. i think the country needs to do a lot better. >> we have challenges within the va ourselves. a lot more needs to be done. you had very little control when you were out at the private sector. >> i think we've made good progress in the va. we've seen the 33% reduction in opioid use in 2010. i have the concern about going out to the community. >> what i'm saying is the contrast you write, if i'm a provider. if i'm nonva provider, the new act let's that person come to me. i contract with these people. is there conditions on that if i prescribe -- if i follow a prescription guidelines, are you going to be monitoring that as far as opioid prescription guidelines. >> i think this is a really good area for us to come

the data that they provide. i do not work for nass and why they ask the questions that they do and the reasoning behind them i'm not actually sure. i'm glad to get the answers for you, but i assure you that the information that they use is information that we use in how we support some of the information that we provide in support of what epa does. i'm glad to get the information from nass and they can better explain on how they come up with the questions and how they use the data. >> the other question that i have is what role does usda play in the endangered species consultation process during the registration review and do you think you have sufficient data and reworld scenarios and management practices that reflect the use of products in the field? >> usda does not have a formal role in esa consultation. consultation occurs between epa and the services, meaning fish and wildlife service and the national marine fishery services. we are a side partner i'll say, we can provide data. any information on crop prod

what it does is it provides debt forgiveness. you want to work for the va for x number of years we'll forgive the debt you've incurred in medical school. is that an idea that makes sense to you? >> senator sanders, both of the ideas you said and that the ranking member talked about make a great deal of sense to me. i do want to see va care diluted because we're getting more veterans into the community. i want to see more veterans in the community because they need the care and va can't provide it right now. so what we're proposing and hoping to work with you in this new choice program are the two things you've talked about. right now, we're restricted to a 1% transfer from care in the community back into the va or vice versa. we'd like to see that opened so we could take money that was in the budget for sending veterans out and reinvesting more into the va. we think that's important. it should be done at the local lev level. on the gme issue, graduate medical education, couldn't agree with you more. the program that you were help

i went to congratulate you on cosponsoring legislation that provided employer mandate and also providedor the idea that insurance cannot, you know, deny coverage to people who have a pre-existing condition. all of that-- all of those ideas are part of romney care in massachusetts and all of those are part of the reportable care act and part of the a portal care act that republicans seem to like the least are those ideas. there is real irony in this. i like those ideas. i studied economics. i like market forces and making them work. you came up with a good idea 1983, and i just wish you would work with us to try to make sure that those good ideas-- the reason why the marketplaces are failing light places like you mentioned in ohio in your statement, mr. chairman, the reason they are not working as we basically undermine the individual mandate so people don't know if they need coverage. young people aren't. we have taking off the training wheels, so to stabilize the marketplaces in insurance companies lost their shirt in 2014. light-- they lost less money 2015, it got better. they raise t

and other providers. and so that was the good side. on the downside, it did -- they did point out challenges. and a lot of those challenges were connected to the fact that we don't have a national program. right. because for us to move forward with single payer, we would have to get waivers from the federal government in a number of areas, for those of you who really know this stuff, erisa, medicare, you know if we want a pool that includes everyone, that has to deal with people who are employed in self-employment -- self-employed kinds of concepts, we have to get waivers to do all those things. clearly where we are now would be -- with the trump administration that is going to be a real challenge. having a national program, we would also, you know, the nding of it would be a lot easier because it would be spread out over a lot more people. but what the rand study did show was that we could, as i easier mentioned, provide the best health care to the most people at the most affordable price in that we would -- it would cost us no more t

i would be glad to provide a. reporter: you guys. >> i understand there is proprietary information in the report that nasa produced. will you provide a copy to the subcommittee? >> yes, sir they will. >> habitat research which you know a lot about. in the 2017 on the plus appropriations bill provided no less than 75 million for habitation and research activities to support human exploration beyond lower orbit. the committee supported this activity. partial spaceflights which you are very familiar with has been at the center of space habitation since the development of the skylab in the late 60s and continues today with the handling life-support systems and science operations of the international space station. the fiscal 2000 budget proposes 120 million for this emerging habitat research and i want to know more about nasa's long-range plans for managing these programs. my question is what role do you see marshall spaceflight center having in this new habitat activity beyond the low earth? >> when you think about m

in addition sls will provide nasa with a versatile platform to deliver planetary robotic science and space-based astronomy missions. sls is a vehicle that will make it possible, will make possible meaning of nasa's goals to push the boundaries of exploration. i look forward to initial launch of sls and work to see that a crew large will follow soon after that i believe we must have an active budget reflect these launch decisions and to meet our nationals -- nations goals. if of the pieces necessary for exploration are not ready we will lose time and waistlines in the near term. it could be used for other important activities down the road. nasa i believe must ensure that the rigor with which it reviews its own missions is applied all of its activities and avoid pressure to send astronauts to space at any cost. this growing segment that nasa should change the way it does business. it should be when lives in the roof sources of the nation are at stake. nasa is very popular with the public. it also has a significant amount of data for sciences to use and understanding the universe aroun

but they also provide for economic activities, including diving and snorkeling. but at the same time, corals protect your coastline. there has been a rise in ocean temperature. and this has an impact on your corals becausthen this leads to coral bleaching, and then you lose the corals because then you d up with dead cols. when coral bleached, you observe the white corals, and once they're dead, they are usually taken over by tough algae. the resources that you had and the activities that you could carry out on a coral reef, then you've lost that. sims: most of the main challenges that our country is facing is related to climate change. the reefs closer to the inner islands are the ones that are most impacted from humans. these reefs are more likely to die off faster. what you see is that fishermen, they have to go out further and for longer to catch the same amount of fish. the price of fish goes up, and people then have to pay more for fish, which is sad. i'm currently working on the seychelles marine spatial planning initiative. the plan will look to facilitate

insurance provider in the country. singles it out above everything else related to health care in this country. cuts more than $800 billion out of that health insurer. that insures more than 75 million americans in this country. and we don't know if the republicans' bill is going to pass. without it even trying to get a single democratic vote for it. there's drama tonight as to whether they can get enough of their own votes to pass this thing. but today they unveiled it and because of what it does to medica medicaid, this is part of what happened in response. at around 1 is:30 a.m. today, about 60 people, a lot of them in wheelchairs turned up at the offices of the top republican in the senate, mitch mcconnell's office. they blocked the entrance to mcconnell's office. they were chanting no cuts to medicaid, save our liberty. one of the protesters held a sign over the entrance to mcconnell's doorway, capping medicaid equals death to the disabl disabled. a number of the protesters got at of their wheelchairs and laid on

a huge opportunity to do this better, to minds of vast amounts of data and provided to the provider in a way that makes their practice easier and a tremendous amount of opportunity to harness the world scientific data. it typically takes a scientific advance between 12 and 18 years to get embedded in the practice because it is such a happenstance random process and all kinds of change management philosophies so it gets stuck and what if we could bring on advances forward? we will see a dramatic revolution in how healthcare is provided, which will change everything and if we manage it right for the batter. it is an exciting time. >> so many questions to talk about. and additional clinical -- and it was about to get worse when i talked about macro and the federal government, adjusting payments based on whether you could have certain quality measures which are administratively measured. what are your thoughts on how something like that would affect physician consolidation or other types of changes in the physician marketplace as more technology is needed and more support connected with pr

for service providers. there really is a difference between something being intellectually free and economically free. another way to think about it, one might be interested in open internet, that does not mean a free internet. what we have already seen, we know it will be reduced investment, it is obvious that theoretical perspective as well as empirical perspective, there has been several studies where singer did a study showing a fall, not just in the rate of growth of investment but in absolute decline and the level of investment, which is very suggestive of regulatory uncertainty. reduced of this is deployment, it will lead it to competition. we can have reduced quality of services and what i think is interesting when we talk about the issue related to the digital divide, it shows markets will be hit most by this reduction investment and it will be the economically marginal markets. access andare about adoption, these are rules that are going to make that much more difficult to have and much more diffi

the edge provider. that's where if there is going to be privacy regulation, we need to focus on the company that are using and monetizing that data first. peter: mr. larsen? to look at to look at things very simply. i follow the money. if you look at who makes the most money out of the internet ecosystem, it's the edge providers. so if you take facebook, apple, google and microsoft, they have, checked, $325 billion of cash on their balance sheets. you look at the top four isp 's, comcast, charter, verizon havet, they $350 billion in debt. the numbers might be slightly the point is, is that the companies that are taking the risk, borrowing the money to are beingnetworks, criticized, being made out to be villains whereas the companies off thell the cash internet are being lauded for their wonderful innovation. badnot saying these are companies in the sense that they haven't done amazingly innovat ive things. tonjust saying they make a of money off the internet. and for them to go scott free with no regula

you can provide health care. it saves lives. if you believe in protecting human life -- [applause] in the united states at the moment we have 28 million people uninsured. according to the national academy of sciences, at that level of uninsurance, 22,000 of our fellow americans die every year of treatable diseases because they can't see a doctor. that is happening every single day in the world's richest country. that's a disgrace. why do we let that happen? other countries don't let that happen. you how many brits die because they can't see a doctor? zero. france, zero. germany come zero. south korea, zero. other rich countries don't let this happen because he cover everybody, it saves lives. . the second point. this is not quite so obvious. it he cover everybody, it saves money. it is cheaper. [applause] this is the argument in colorado when arguing for universal health care. it costs less. i said this in congress. members of congress said that is counterintuitive. i will cover more people and save less? absolutely. go to any o

community care provider. we just need your help to make it happen, including funding to keep up with veterans as they choose v.a. thank you and we look forward to your questions today. chairman isakson: thank you, dr. shulkin. we appreciate your attendance today. i want to start off with my questions on the appeals process. i have consistently said that any change in the process to improve it must include an acceleration of and dealing with 70,000 veterans whose claims are pending today. would you agree? secretary shulkin: i would like to see that happen. chairman isakson: i'm going to give you a chance to make an amendment on that. if both appeal reform and budget requests are adopted in this budget, would v.a. be able to begin accelerating decisions for those 470,000 appeals pending? secretary shulkin: the appeals that are in the board of appeals are the one that is were most -- we're most concerned about. if the senate votes to move the appeals modernization forward, as i think you're saying, mr. chairman,

>> these are peels that providers have said they don't believe the government is providing the resources necessary for them to be able care for their patients. the numbers are staggering. nearly immediately and claims were down to 700,000 now we can take care about -- we met with the individuals and their high-quality folks. they're trying to get the appeals through the process of trying to make the right decision. we have encourage them to talk to stakeholders and individuals about why we have the increase in claims there is a problem there, it means the system isn't working. to the degree it should to allow individuals to care for the patients and be compensated. we've identified the opportunity for law judges to review higher claims and have magistrate judges to lower claim so we can get through a larger volume of claims on an annual basis. no we tried to decrease the burden of reporting. for the providers so that there is less likely possibility they would need to feel the need or desire to file a claim. it's a major problem that we're working through and we are committed to getting

some of our rural health providers may very well have to close up shop. right now more than one-third of rural hospitals are already at risk of closure. but if you look at where the hospitals that have been forced to shut down in recent years are located, they are almost all in states that chose not to expand medicaid. we should learn a lesson from that, mr. president. i know for a fact that if hospitals shut down, health care delivery in rural new mexico would be decimated. these and economic impact would be severe in these small towns. sm single hospital closes in a small rural community, nearly 100 jobs are lost, taking moreee than $5 million directly out of the local economy. a recent report by the economic policy institute estimates that if congress passes trumpcare into law, new mexico alone would see a loss of almost 50,00 50,0s by the year 2022. thanks in large part to the major coverage gains that we've seen under the aca, the health care sector has been new mexico's strongest area of job t growth for the last five years. new mexico added over 40

they provide and are critical to the joint force. and we provide unique and many capabilities. and so again, trying to maintain that balance. sometimes forces and that gets noose tough tradeoffs. let me give you a good answer to that question, okay? sure. >> last year the flying hour budge was funded at 90%. and i was told a big part is because the air force didn't have the maintainers to create the money needed to get to 100%. so what is the executable level this year? >> again, we're funding flying hours so to what we can execute and that is 9 it2% of the requirement. as we address the pilot short fall and every year as we bring on more retainers and as we retain people, you know sh that's going to get better and better. but that's a key element to our readiness recovery. so we'll continue to fund flying hours and weapons sustainment to what we can execute. >> ladies and gentlemen, there is the final question. >> over here. >> numbers for rdt & e say in your briefing book say 23.9% to 24.7% but in the overall d.o.d. book it says 25 to 30. can you explain the discrepancy? >> i

can't provide it right now. so what we're proposing and hoping to work with you in this new choice program are the two things you've talked about. right now we're restricted to a 1% transfer from care in the community back into the v.a. or vice versa. we'd like to see that aperture opened so that we could actually take money that was in the budget for sending veterans out can and reinvesting more of it into the v.a. we think that's very important. it should be done at the local level when every local business makes its decision about what services the v.a. needs to strengthen. on gme issue, graduate medical education, couldn't agree with you more. the program that you were helpful in crafting was a great success. >> is it working well? >> it is. it is. and we need to do more of it. we are proposing exactly what you're saying, which is creating more gme spots. the country needs them. v.a. would pay for them. and in exchange, it would be like the military or public health service -- >> or -- [inaudible] >> nationa

or that awards contracts to servicers or providers that have never demonstrated the capability to provide that service. and sadly, that's the system that we have in place right now. so what we're looking at is the entire array of the d.m.e. system and the goal is to make certain that all americans, regardless of where they live, have access to the kind of services whether it's hospital beds, whether it's wheelchairs, whether it's home oxygen, whatever it might be in the d.m.e. space, these are quality of life issues for so many, many people and from my perspective, we have failed to date in making certain that we ensure the kind of accessibility that folks eed. senator thune: finally we discussed the rule that all outpatient services be provided under direct supervision which has been delayed annually since then for small and rural hospitals. you expressed interest in working with me on a permanent extension of the nonenforcement of this policy. i'm wondering if you have an update on where things stand from the department's perspective. i think the permanent nonreinforcement of something

there just aren't enough other providers as i heard from medical providers throughout my state when i was governor there to absorb all of the patients that planned parenthood cares for now. trumpcare also includes harmful language that restricts women's constitutionally protected right to access abortion services. additionally, under trumpcare if you're a mother given birth could now be considered a preexisting condition that insurance companies could use to discriminate against you and charge you more. and trumpcare would increase the cost to women for maternity care in two ways. first, it would undermine the requirement that insurance companies must cover essential health benefit, including maternity care. in fact, the congressional budget office says the house-passed trumpcare bill would increase out-of-pocket spending for maternity care for women who have private insurance by thousands of dollars per year. second, trumpcare slashes medicaid funding. medicaid pays for nearly one half of all births in the united states meaning with a 25% cut in expenditures over the next decade that

this is a budget that is providing more care and services to veterans. in doing so we have a responsibility to taxpayers and to veterans to make sure that the resources of our current programs are being utilized properly. so we are going back and looking at programs and saying, all those resources, could they be reallocated in different ways not to withdraw total dollars from veterans, but could they be revised and reallocated to work better for veterans? indicates fiu, i think that what we propose -- in the case of iq, revision to make the program and resources that are going currently to some veterans to help additional veterans. i understand that there's a lot of passion on this, and we will have plenty of time to work with congress and with our veterans service organizations to make sure that we are getting this right. >> i want to ask you another question about the budget, but just a follow up on that. a lot of vsos considered to stealing from them, to be changing so fundamentally a way iu is connected. what your response to that? >> i have such gre

doctors provide health care. if they are allowed to by federal law and given the opportunity to get reimbursed and have a system. but people don't generally like trial lawyers. the fact is trial lawyers do a public service. because they represent people, when they do it on contingency fees, they do it for people who wouldn't be able to hire a lawyer but have been harmed and they go in on the idea sometimes they get nothing, and if they win they get a contingency fee. when they win they win because a jury, which is like little focus group of america, says, there was a duty that the doctor breached and a harm done to the patient and the patient should be a little focus group of america, . now, my chairman says this is just like california. there he goes again with that reagan stuff. reagan was 40 years ago, i think. 35 years ago, whatever. and california, this isn't california's law. this goes further than california on joint liability and the fact is, when you eliminate joint and several liability on -- in certain

so what happens is you can compile pel an electronics communications provider to provide the government with assistance to accomplish the acquisition. so the government would engage with one of the regular companies that provides the communication services that are the subject of potential acquisition, and the government will reimburse the company for having done so. and there's also a liability shield as well. so a company that receives an order or directive to then, you know, perform an acquisition can't then be sued by somebody claiming that they're information was acquired without their consent, because there's a liability shield associated with that. in terms of over sight, there's ap kind of host of mechanisms that kind of range from mechanisms internal to an element of the intelligence committee out to grelgs committe committees and beyond. the inspector general of the department of justice and the specter general of each element, they can review concompliance. at least twice a year the attorney general and dni assess compliance with respect to minimization procedures. twice a ye

it gives you link to the 14 state d.o.t.s and the information they're providing. it has link to the national center of excellence for operations, link to the nasa sites. we try to make it as easy as possible for people looking for good information to be able to find it. also, it's not just the normal traveling public. freight, companies that move our goods and products that we need and enjoy, they already have to be very safety conscious for cars that dart in front of the trucks or finding limited parking spaces for tractor-trailers or how they make sure they meet their hours of service. well they need to be preparing as well that favorite spots they may have for knowing where to find the secret parking space along the way. others may know about that as well. so whether it's the public or the truckers, plan ahead. one thing to think about is this is occurring in august. vacation time. so rush hour traffic may be a little slower than normal in these areas where there's places that have more people coming to enjoy this. august is also probably if i asked the audienc

caller: i am actually a provider . i have been a provider for 16 years and i have watched pre-affordable care act and post affordable care act and i want to make a comment on the benefits of the medicaid expansion. john: please do and stick around because our guests may have questions for you. caller: ok, well, i question what is the alternative if they cut medicaid expansion or take it away? what is the alternative for people who are going to be uninsured because they do not have medicaid? pre-affordable care act, in my office, i saw people devastated by health care costs. people came in with $225,000 bills for a two-week hospital stay. takendicare expansion has that away and provided care for so many people that otherwise would have gone bankrupt, not having insurance and not being able to afford out-of-pocket costs through private insurers. so what is the alternative after they take away $800 billion from the medicaid pot? mostson asked the important question. the medicaid directors had said, while republicans are a

>> these are appeals that providers have said that they don't believe the federal government is providing the kind of resources necessary for them to be able to care for their patients and as you mentioned the numbers are staggering. nearly 1 million claims, down to 7,000 now. we can take care of around 20,000 up until recently. what we've done is met with the individuals and their high quality folks. these are folks just trying to get these appeals through the process and make the right decision. we put a focus on that. we talked to -- we've encouraged them to talk to the steak holders and individuals out there about why we have this increase in claims. there's a problem there. it means that the system isn't working to the degree that it should to allow those individuals to care for those patients and be compensated for that care. we've identified the opportunity for the administrative law judges to be able to review higher claims and move in the direction of having math straight judges review lower claims so we can get through a larger volume of claims on an annual basis. then we tried

they were provided practical sport, emotional support to provide information.g now is scaling all that up to be ready to work with the authorities around the community assistance centre that being established. we will help coordinate the way that works so that people will get the right information, we will subside up a support line to survive provide support line to survive provide support to be brought and work alongside the social work teams and making contact with every household and family who were elected by fire and family who were elected by fire and evacuated. —— affected by the fire and evacuated. we will also be ready to welcome people for the tragic funerals that will take place and we will use our support skills to enable that to happen in the most sensitive way possible. we have had an extraordinary three or four weeks with the tragic attacks in manchester in london where the red cross has been incredibly active on the ground for both of those events. but this is actually on a bigger scale, in terms of the numbers affected and the trauma for the co

we promised that if we would provide -- we promised that we would provide relief to the millions of americans suffering under obamacare. and, mr. president, this bill delivers on that promise. i hope we will have the opportunity soon to vote for this legislation because it is time to give the american people access to real health care reform. u veryesident, i yield the floor much, mr. president. the presiding officer: the senator from michigan. ms. stabenow: i just want to take a moment because we have all been so focused and there has been so much concern about what is going to happen in terms of health care in this country, and so many people have called me concerned about whether or not they are going to be able to continue their cancer treatments or whether their child's going to be able to get the operation that they need or whether their mom with alzheimer's is going to be able to continue to get nursing home care and so on, and i want to thank everyone who has told their story. we spent six months. this debate, this fight isn't over yet, but it started the day after we were all sworn i

an observation of the eclipse by adding 10 provided the first provided theght first test of this pivotal theory. science is what it is all about here for us. it is first of all, the signs of the sun and its environment, it is about astrophysics. planetary scientists such the moon and planets elsewhere, and earth science, all of which will be involved in this important spectacle. this eclipse will be really important for us. it will be providing unprecedented vantage points. in space, on the ground. for that will you start the movie? have 11 all, we will spacecraft that are flying. two of them with our sister , and the spacecraft, a bunch of them as shown here are looking at the sun. looking at the corona. is like a crown around the moon. these observations will look at all colors from x-rays. there is one spacecraft at the , along the shadow at the earth. looking at that unique vantage point. we have a whole series of spacecraft orbiting around earth. back fromion coming earth providing a unique experiment of how solar radiation interacts with the atmosphere. we are making observations w