Transcripts For CSPAN Health Care Law Implementation 20140621

You are in person assisters, government officials, Health Literacy educators, Insurance Industry leaders, outreach specialists and organizers. Everyone here understands the importance of our work to engage consumers and spread the word about how they can benefit from coverage under the Affordable Care act. And for those of us who have been working on expanding Health Care Access and awareness for year, we know weve reached an incredibly important milestone. Thanks to the exceptional work of the people in this room, more than 14 million americans and counting have received Health Coverage through the marketplace, medicaid, and chip. Give yourselves a round of applause. Despite an unexpectly rocky start, you all made history by powering through some negative news cycles and keeping your eye on the ball. You stayed focused on educating consumers because they were hungry for the facts about how the law could benefit them and their familiesful you connected consumers with free, inperson help from persons in their communities. You made sure they knew about the opportunities for Financial Assistance, which finally made Health Insurance a reality for millions who couldnt afford it in the past and you stood ready to handle the surge in signups as the deadline approached. Here at enroll america, we reached more than five Million Consumers across the country with information about enrolling in coverage. But we didnt do that alone. Our over 230 employees worked hand in hand with over 2,000 Partner Organizations and tens of thousands of volunteers who shared our commitment to connecting consumers to the information and are sources they need to get covered. Through empowering local officials and public leaders, we reached thousands more and encouraged them to learn about the options available to them. We met consumers where they were online and in social media and shared coordinated enrollment messages with our partners to increase our reach even further. We worked with community colleges, faith groups, goth officials and key local organizations, just like all of you, to reach as many consumers as we could. One of my favorite parts of this first Enrollment Period was when i had the chance to travel through texas and ohio in early march, in our countdown to get covered bus tour. In this bus tour, i saw the true scope of the work and how unique it is from community to community. In dallas, i stood with 17 pastors on stage who pledged to educate their congress gation about their new options. In mcallen, on the border in texas, i stopped by a local library where enrollment assisters set up shop every single day to enroll their community. In cleveland i saw an overflowing enrollment event hosted by Cuyahoga Community college. Each city was different and the effort in each city looked different but in every city there were local organizations and leaders with a vision to see the need and willingness to fill it. That local knowledge and personalized outreach was crucial to success. And that is why it is so exciting, really a true pleasure, to be here with all of you today, so i can thank you in person for the work youve done and we can celebrate together. Theres also someone else who wanted to thank all of you as well but hes a very busy man and couldnt be here today. Hes someone who needs very little introduction and who has played a pretty big role in expanding coverage to millions of americans. So without further ado id like to play for you a message that he recorded for all of you. Hi, everybody, thanks for being part of our effort to enroll america. We have always said change doesnt come from washington, it comes to washington. Cheage happens when ordinary americans stand up and make it happen and thats what enroll america han doing from the beginning. Today eight million americans have signed up for private insurance plans through the marketplaces, some getting covered for the very first time. What does that mean . It means peace of mind for working families, it means freedom for young people who want to change jobs or entrepreneurs who want to chase new ideas. It means justice for every woman who can no longer be charged more just because shes a woman. Its why many of you joined this fight in the first place, Community Leaders to the navigators and faith leaders and elected officials. I could not be more grateful to you for all youre doing to help americans get covered. But we cannot let up now. As we look toward 2015, we need you to keep telling your stories, keep spreading the word, keep standing up for folks trying to get coverage, because the other side has billionaires funding campaigns to scare the very people the Affordable Care act would help. But we got something better. Weve got you. And ill take you any day of the week. So thanks for all your hard work. Together were going to make sure this law works for everybody, and keep fighting to restore opportunity for all. [applause] we are very grateful that president obama took the time to record that message and were also grate to feel his administration for their ongoing commitment to providing opportunities for americans to find the Health Coverage they and their families need. As you heard the president said, now that millions across the country are experiencing the peace of mind and Financial Security that comes with quality, affordable Health Insurance, some for the first time ever, now is not the time to slow down our efforts or to rest on our heels. Which is why we are all here. You all know that very well. Everyone in this room brings a unique perspective from his or her experience which presents us with a valuable opportunity to learn from each other and reflect on our accomplishments. Identify areas we can improve. And strengthen our partnership. So we can continue to build on this important work for years to come. To kick off that process, we wanted to bring together experts from across the Different Industries who played a Critical Role in the Historic Development of the last year. And take a look back on what we all just experienced system of im very excited, really thrilled, by the lineup of Prominent Health care leaders, from the Insurance Industry, the policy world, and state and federal governments who have all agreed to join us today. And i am particularly honored that kathleen sebelius, who as secretary of health and Human Services shepherded the Affordable Care act from an idea into the law of the land, and then to a reality for millions of american families, has chosen to be here with us, with all of us, in her first public appearance since leaving h. H. S. Well hear first from each of our panelists about their different perspectives on the first Enrollment Period and then well have time for a Panel Discussion to reflect on what worked well and the obstacles we face. To start us off, id like to welcome to the stable one of americas leading Health Policy expert the president and c. E. O. Of the Kaiser Family foundation, dr. Drew altman. [applause] good morning, thank you very much, ann. When i was in State Government, i was described in a major newspaper as a nice guy trapped in a deadly serious face. So, im really very happy to be here theres just no way in the world youd ever know that. I wanted very much to be here today because millions of uninsured people got coverage in this first a. C. A. Open enrollment season and no one did more to make that happen than the people in this room and, you know, while sure, the partisan debate about the a. C. A. Continues and we know we have more work to do with an open enrollment season coming, while many are trying to figure out what the a. C. A. Means for them, on behalf of many of us in this room and in this country, who spent our intine entire lives working on the issue of the uninsured and the millions of americans who got coverage buzz of you, thank you for what you did this year. The enrollment success in year one is also the result of leadership and i think when you ask, who are the leaders that you think of when it comes to expanding coverage, number one, two three, four, five and six on the list are secretary sebelius and governor bashir and i would add to that list, ann. Even though she likes to stay in the background, she cant hide any longer. Its a pleasure for me personally to be here with everyone who will be on the stage in a minute. Now, as c. E. O. Of Kaiser Family foundation, im sure youre expecting a lot of data from me this morning, because thats kind of the organization ive established but im throwing out my own script. I want to tell you three quick stories and make a few base expoints. The first is a story from my time in State Government as new jersey Human Services commissioner under a great governor named tom kean who you may just remember, it was a while ago, as chair of the 9 11 commission. I made my name in State Government doing welfare reform but one thing i put great effort into was developing a schoolbased Services Program for youth across the state of new jersey. We actually did a lot of good things in new jersey. We even kept the bridges to new york open. You know, in case we had to escape from new jersey. Anyway, i was in cumberland county, south jersey, and at the time it was the poorest part of the state and had worse statist exs than camden and newark. Its actually below the masondixon line. I asked young people what were the most important parts of the program, the clinics, the midnight baseball, you know. And there was this one young guy, very small, i remember he was sitting in the back of the room and he just looked up at me and said, commissioner, youre just an idiot. Its not this or that service. What we really need is somebody we can talk to who we trust. From that day on, whether it was organizing services for atrisk youth or h. I. V. Prevention programs in big cities across south africa or health care for the homeless programs in the u. S. In big cities or outreach for the uninsured, here in the states, communitybased outreach has been a cornerstone of really every Successful Program that ive been involved with. Our surveys show that about half of the uninsured have been uninsured for two years or more or have never had insurance. About 20 do not have access to the internet. The National Debate that we had this year focused on the website problems and focused on what i called the a. C. A. s actuarial mission, making sure there were enough young and Healthy People in the risk pool that its a healthy risk pool and thats very we have to have that. Thats a very important thing. But there is a social mission too. What really is the point of all of this, it is not also to reach the longterm uninsured, the folks who need the coverage the most, and that will not happen without Community Based outreach and enrollment services. And thats not just in the survey data from me. Its a lifelong lesson they first learned when the young gentleman in new jersey called me an idiot. By the way, on the unfortunately politicized question of whether any of the folks you helped get coverage were previously uninsured, while i cant release numbers yet, we have an important study of the nongroup market coming out on thursday of this week which will show a large percentage of those who got coverage in the exchanges were in fact previously uninsured. So, so much for that. My second story is about a guy named duffity. Hes about 40 years old he, clears timber in the santa cruz mountains, not far from where kaiser is based. He works like a dog, when he gets work, which is not often from early in the morning until it gets dark. He has all kinds of Health Problems i wont go into. When i asked why he doesnt have coverage he, said he couldnt afford it. So i showed him the tax credit, i also showed him the deductibles. He had no idea what a premium was, or what any of it was. He had no insurance, had in computer, had no idea how to use one he, had no idea where to go for health. He had heard about obamacare, but read that obamacare was broken so he didnt pursue it. Ultimately he went to the local county social Services Agency where they walked him through the process, and he qualified for medical. Health coverage had been unaffordable for him and knowing about the credit and the medical coverage made all the difference in the world for duffy. This should be no surprise to anyone in this room because since the beginning, i think, of recorded time, every study we have done of the uninsured has shown that the main reason they uninsured dont have coverage is they cant afford it. It also matters that duffy now was required to buy insurance, there was a penalty, it would grow, there was a deadline, duffy didnt know that. It mattered to him. So for duffy and millions more according to the research, the Financial Assistance and affordability really matters. Its a central message. It may be the central message and the mandate matters too. There are a lot of other stories in the duffy story about families and friends helping, the National Media as a srs of information, but let me close with my last story. This is a story i tell occasionally, its one of my favorite stories. Its the story of my first day on the job as Human Resources commissioner in new jersey. The problem was i couldnt find the job. Theres no reason to go to trenton, new jersey if you dont have to go to trenton, new jersey. So i went, and i wandered around and couldnt find the building. There was a big building, i thought it was the place but it didnt have a sign in front of it, there was a guard, he said, its in there kid, just go in there. So i went in, i had my big idea. This was how i was going to take control of this very large agency. I went up to the ninth floor and said hello to everybody and then i said, my big idea, whats wrong with all of us, we are the largest organization, we were then in new jersey, bigger than the Drug Companies in the state of new jersey. We should be proud of what we do here. There will be a sign in front of the building. Nine months later, after the job was stopped because the wrong procurement was used and then stopped again because the wrong union team worked on the job, then we got a letter that said this job should not go forward because its too small to do. They called me to the front of the build, the press was there, about 1,000 people were there, it was my birthday, there were stories, will commissioner got his sign . There was a sheet in front of the building, they pulled the sheet back, and there it was, new Jersey State Department of hunan services. They spelled it wrong. I wanted to keep the sign and change the services. It took me nine months to get a sign. Changes like the a. C. A. Take time. Thats really true. Especially for a law like the a. C. A. That depends so much on people, their income, their circumstances and where they live. In the National Debate about the a. C. A. , its either good or bad. Thats the debate were having. A binary debate. Depending on your partisan politics. But if you somehow force people to take off the partisan glasses, i think the defining policy of the a. C. A. Is a variability. I wish our congress could learn from that, we dont have that, but maybe states can look ahead. Maybe the policies of the a. C. A. Will change after 2016. Maybe it will no longer be call obamacare. But one thing i do no is more than any other factor, it will be your effort the efforts of the people in this room, that determine success reaching people who need coverage the most. So on behalf of the kid in new jersey who called me an idiot and duffy and the new Jersey Department of hunan services, whatever it is doing these days, thank you very much. [applause] thank you so much, drew. Next up, we have one of the most experienced and insightful leaders in the health Insurance Industry today, the president and c. E. O. Of independent blue cross, dan humphrey. [applause] good morning. Ann, well done. Thank you so much to enroll america for including me in this important discussion. I have to echo something drew said. One of the heroes in getting well over eight Million People enrolled across the country is anne and the work that enroll america has done. I think she deserves a round of applause. [applause] its an honor for me to be here with governor bashir, the great commonwealth of kentucky. Though im pennsylvanian, i have a fondness for kentucky and even in the dark days of the rollout, governor bashir was one of the folks that stood up in front of the National Media and talked about how things were working in kentucky. Though many of us werent so sure at the time, he was steadfast in his belief that this was the right way to go. Also, secretary sebelius, whether she was insurance commissioner or governor of kansas or in her latest role as secretary of health and Human Services, regardless of ones politics, its amazing that an implementation of this magnitude, of this complicated nature, could be done in such a short period of time. So i am thrilled to be here with them and of course with drew who you heard from. Before i get started, though, id like to acknowledge another group of people and thats you in this room. If you think about the grass roots effort, if you think about educating people on the need for enrolling in some plan to cover themselves and cover their families, you were there day in and day out. Congratulations to you as well. I know youre from all over the country, as anne mentioned so id like to give you a quick, brief understanding of who independence blue cross. Is we are headquartered in philadelphia. Were the blue plan for five county philadelphia, southeastern part of the state of pennsylvania, but through our affiliates, were in 24 states and the district of columbia. And we touch the lives of about nine Million People in all those jurisdictions. As a leader of a major health insurer, people always say to me, wow, you must really have been busy over the past year with reform. And its true. And id like to give you a quick thought on how things change. I can remember, with the rollout and the problems with the website, i could not walk around the neighborhood, i could not walk my kids to a school or event without somebody stopping me and asking me about it. Just this past weekend, you may be able to tell from my hoarse voice mitigating circumstance oldest daughter was married. Certainly there were a couple hundred of their friends in their mid to late 20s who really, is one of the key targets of the incredible reform initiative. And there was a lot of dancing a lot of fun. I tried to be one of the younger people. Not successfully. But not one question about reform. And thats not because theyre disinterested. And thats not because they dont worry about it. Its because theyre finally getting it. Theyre finally being educated. Theyre finally understanding the importance of taking their own, being accountable for their own care and their own coverage. Thats a positive thing. So i just wanted to give you that piece. But it is true, the fact of the matter, at independence blue cross, we have been preparing for reform for years. I know i speak for all the blues across the country. We believe that reform was needed system of since the law was enacted in march of 2010, weve been an active participant. Have we voiced our concerns about several areas . Yes. Secretary sebelius and her team were always there to listen. They didnt always agree, they didnt always support our position, but they were there to listen. In the Insurance Industry there was a lot of concern about reform. Some Insurance Companies decided, were going to wait it out. Were going to see how this plays out. But the blues, for the most part, jumped in, and at independence blue cross, im happy to say we led the charge. Heres why. Regardless of ones politics, regardless of where you stand on the Affordable Care act, regardless of who you support in your local elections and your state elections and your federal elections, the Health Care System was and in some ways continues to be broken. We needed to change it. When Health Care Spending accounts for nearly a fifth of americas Gross Domestic Product and when more than half of American Adults go without recommended health care, when we spend more on health care than any other nation in the world, and yet americans are no healthier, when 50 to 60 million americans have no coverage, somethings wrong. Somethings broken. The Affordable Care act is not going to solve all the challenges facing americas Health Care System, but its a start. And through your efforts and the efforts of organizations like ours, its a very good start. Reform is for the big reform has been a big shift for our insurance business. Traditionally, independences main customers have been other businesses. More than 36,000 large and small employers who provide health care for their employees. We have small Customer Base in the individual consume market. We know that all this is about to change and has changed. As we move forward, individuals become the key part of our efforts. Its now not only a consumer of a business to business business, its a business to consumer business. The Affordable Care act has led to what some call the amazonification of Health Insurance. Consumers can go online to a Public Exchange and in a few clicks see a range of Coverage Options and sort them by price. In our markets, we had 13 different products, 30 variations, im happy to say the lowest priced, people could shop and find what they needed. This is a great opportunity for an individual to get coverage. At independence we found that consumers were drawn to our competitive prices and unparalleled network of physicians, hospitals and other Health Care Professionals in our market. I am very proud to tell you that in the first open Enrollment Period, we gained more than 285,000 enrollees. Now, you might say, ok, thats a lot. Well over eight million enrolled. That doesnt include in the various states where we do Medicaid Managed Care, where we picked up several hundred thousand because folks now have access to coverage. But we budgeted, remember, 285,000, we budgeted well under 100,000. So that should speak to the success that you have fostered during this Enrollment Period. This vastly exceeded our expectations. I believe that there are a number of reasons we were successful in signing up so many individual consumers. For starters, weve gone the extra mile to make it simple and easey for consumers to sign up for coverage and get the care they need. Also, we particularly want young people to enroll with us. As i said earlier, weve used Digital Media to reach out to them where and how they went to be reached. Were pretty successful and although we didnt expect it, 30 of our signups in pennsylvania are individuals between 18 and 34 years old. Thats promising. Overall, we didnt wait for people to come to us. We went out into the community to meet our future members where they live, where they work, and play. Ann referenced all the places she visited from texas to ohio. We were there too. In some cases working closely with you in those Community Centers, in those churches new york those schools, wherever it might be. Our mobile education retail center, the independence express is a perfect example. This is a truck, you might have seen a picture of it in the New York Times at the beginning of rollout. Its a truck. We think of it as the apple store of enrollment. People came off the street and there was an ipad there, there was one of our representatives, they were educated, they were shown how to get onto the website. At the time, if there were problems we were able to help them understand what their coverage possibilities were. We also found that while traditional means of advertising are important, the key to reaching this new Consumer Group is the personal touch. Thats why people like you, here in this room are so critically important. Community and religious leaders, people in the medical community, friends and neighbors, all of you, encouraging citizens throughout the country, in your communities, to get covered, to understand your coverage. Its very important and its made a huge difference system of whats next . Now that we have these new members and part of our business, were determined to help them understand the value of what they purchased. So that they take advantage of all the programs available for them to stay well or get well. So here were continuing to reach out and educate thousands of people, and this is going to be an important part of your role going forward, to understand that Health Insurance is not just about carrying a card, its taking responsibility and reaching for the points of care where and when you can get them. So, as i said, and in closing, reform is just under way. It was a great first year. Regardless of ones politics, this is not a perfect law. This law will change over time because each of us will have input. What will not change is the fact that eight million americans, plus those in the medicaid arena, now have access to care. They wont go back. They wont allow us to go back. And its our job now, not just to educate them about having the card, but how to use the card and how to get healthy, thousand stay healthy, and thousand to live a fulfilled life because of the security of coverage. Regardless of the carrier, regardless of the network they use, they have the coverage they need. So im very excited, anne and all of you, to be here today. We as an industry are proud. We as blue crossblue shield plans are proud that we have been the leaders in enrolling people across the country. I look forward to this discussion to hear how we can do it better, how we can help you do it better and next year when we convene, millions more americans will be part of the this great effort. Thank you very much. Thank you. [applause] thank you, dan, for your leadership and being with us this morning. Now it is a real treat to introduce the man who led one of our nations most successful statebased marketplaces, the governor of kentucky, the honorable steve bashir. [applause] thank you. Kentucky. You know, about nine or 10 months ago, most of you in this room who are not from kentucky, although weve got some kentuckians here where you. There we go. But the rest of you, about nine or 10 months ago, when you heard kentucky, if you thought anything, you may have thought oh, kentucky derby. Thoroughbred horses. Kentucky fried chicken. Isnt that where a brown liquid called kentucky bourbon is made . Let me tell you how important kentucky bourbon is to kentucky. We have 4. 3 Million People in kentucky. We have 4. 9 Million Barrels of bourbon aging in kentucky. Id like to say that each of us kentuckians have one and well share the rest with you all. But im sure that nine or 10 months ago when you heard kentucky, you didnt think, for instance, education reform. Although kentucky was the first state in the union to adopt the common core standards. [applause] we were the second state in the union to adopt the next generation science standards. We just raised our dropout age from 16 to 18, so weve got some great things going on in education reform. [applause] economic development. Were doing some great things. Weve set export records. Were bringing Foreign Direct Investment into the state and diversifying our economy. Lots of great things going on. But you also wouldnt have thought nine or 10 months ago when i mentioned kentucky, one of the most Successful Health benefit exchanges in the country implementing the Affordable Care act. But thats what we are. And were here today to give you kentuckys perspective as the operator of a highly successful statebased Health Benefits exchange. By now, i know that our story is familiar to most of you. On the federal level, we are called a red state. Although honestly, on a state level, five out of our six statewide Office Holders are democrats. As you know, our two u. S. Senators are among president obamas most vehement critics. And quite honestly, voters in kentucky dont support the president very strongly. But nevertheless, kentuckys embrace of federal Health Care Reform has been passionate and public. Last fall, the New York Times published an oped that i wrote admonishing critics to get out of the way, get over it so that we can get health care for our people. [applause] and president obama himself gave kentucky accolades, with me sitting in the first ladys box during his state of the union address. He referred to me as a man possessed when it comes to finding Health Care Coverage for my people. Now that was both humbling and quite honestly thrilling. But let me tell you, kentuckys success isnt because of Steve Beshear. It was a team effort and its because of people like you sitting right town here in kentucky. Right down here in kentucky. [applause] in the days after the first Enrollment Period ended, we had signed up 421,000 people for coverage through what we call connect. Kentuckys health care connection. About 75 of those 421,000 people had never had coverage in their lifetimes. Folks, thats a lifechanging experience for them. Its transformative for our state. Because 421,000 represents about 10 of kentuckys population. Thats an impressive number in anybodys book. And its due not only to my aggressive approach but also to people like you in kentucky who did the hard work, building a website, creating an application process and working with families, facetoface, help them enroll. Last october, about a month into our Enrollment Period, steven brill from Time Magazine came to kentucky. I took him other to the office of our Health Benefit exchange. And quite honestly, he was shocked and somewhat amused. He looked at me and said, this looks like a warehouse. Well, he was right. He was right. Our exchange started in an Office Building that looked exactly like a warehouse. We filled it with surplus furniture. Rows of folding chairs. Cheap tables. And some computers and telephones. But heres the thing. It didnt look like much, but people noticed that its open air, stripped down atmosphere created the feeling of a startup. A new company. Where creativity abounded. Collaboration was expected. And determination to succeed prevailed. And that sense of mission was contagious. When providers, insurance officials, i. T. People and sign up agents we call connectors connectors came in for meetings, everybody felt the excitement. This aura provided the context for decisions that we made that contributed to our success. And let me talk about a few of those. We kept the website simple. We knew we didnt have much time, so we left off the bells and whistles. But an important feature of the site is that it allowed you to browse and plug in numbers without actually signing up. This gave people a no risk way to get an estimate of their premium or to find out whether they qualified for medicaid. I told people, you dont have to like me. You dont have to like president obama. Because this is not about me, and its not about the president. Its about you. Its about your family. [applause] and i said, you owe it to your families to go see what you might be able to get. Well they went. And they found out. And they were sold, so to speak. And yes, many of them still dont like the president or still dont like me. But thats ok. We also built a single system to determine eligibility for both the exchanges exchanges private insurance subsidies and medicaid. To institutionalize collaboration and eliminate barriers we put the exchange in our cabinet for health and Family Services which also houses medicaid and the Community Based services. Under the same roof, then, were both i. T. Experts who knew how to build complex systems in the health care universe, and people who knew how to determine eligibility. We also tested our system, early and often. We worked closely with all of our partners, h. H. S. , local health care experts, Insurance Companies, to be ready to test connect at the earliest available time. Three months out, we tested the whole system, top to bottom. So day one, despite overwhelming activity, our site remained available throughout the day for browsing and preliminary screening for eligibility. And when i say overwhelming, i mean that by 7 00 p. M. On the first day, we had over 70,000 prescreenings, almost 4,700 applications and some 940,000 unique page views. I also picked strong leaders. Audrey, my secretary for health and family service, is a former Deputy Assistant to president clinton and chief of staff to tipper gore. Carrie has extensive experience in medicaid, Health Policy and insurance regulation. We also had an open door policy that encouraged communication. Some other governors around the country were caught by surprise, by events surrounding their exchanges. Haynes kept me apprised of the challenges and we made decisions together every step of the way. We also built a huge network of people to publicize connect and to identify and enroll the uninsured. We formally engaged all the sister agencies within the cabinet to educate their clients about connect. And we hired local health departments, communitybased agencies, to act as connectors. These people were already on the front lines, many of them were, especially in our impoverished communities. You know a lot of people dont trust State Government. So we went out and found the people that they do trust. Our connectors were available everywhere. And i mean everywhere. Kentucky has a lot of small towns. They host a lot of festivals. The connect mobile tour visited them all. The bourbon festival. The woolly worm festival. The apple festival. The world fest. Festival latino. September fest. And on and on. Not to mention College Football games, ironman competitions and Minor League Baseball games. At every place, connectors sold the benefits of the exchange while passing out those colorful and reusable connect tote bags. We have handed out over 64,000 tote bags, and people love them. We also had an accessible ad campaign with a catchy tune that featured cartoon figures, with which any Demographic Group in kentucky could identify, black, white, male, female. Someone in a wheelchair. A single mom. A twoparent family. A young professional. Another thing we did was carefully separate the politics of the Affordable Care act from the Health Care Impact of connect. That was a very fine line to walk, and im still walking it. Nationally, ive become the face of obamacare to many. Calling out senator Mitch Mcconnel and others who continue to try to dismantle the Affordable Care act for being disingenuous now when they talk about it. [applause] now that we have 421,000 potential voters in kentucky signed up for health care, our senators and others seem to be looking at it a little differently and trying to talk about it a little differently. At home in kentucky, though, my emphasis is not on politics, its on people. Look, i had the authority under kentucky law, thank goodness, to expand medicaid and to create our exchange. So i didnt ask anybodys permission, i just did it. [applause] and i was sued. And i won. No, let me rephrase that. I didnt win, the people of kentucky won. [applause] before the a. C. A. Was implemented, we had 640,000 uninsured people in kentucky. Thats almost one in seven kentuckians. Helping them is morally the right thing to do. And we all know that. But economically, its also the smart thing to do. For the future of kentucky. As increased access to health care slowly reins in cost and improves health, all of us in kentucky, State Government, providers, policy experts and families, are taking a more holistic, longrange view. Were using that ready access to health care as the foundation for a Larger Initiative called Kentucky Health now. Folks, kentucky historically suffers from some of the worst Health Statistics in the country. Kentucky health now is taking aim at the problems that are really holding us back, such as our tobacco use, obesity, heart disease, cancer, and behavioral and oral health. The Affordable Care act is an enormous opportunity to change the lives of the next generation of kentuckians. And through Kentucky Health now, were going to be more economically competitive as a place to do business and more attractive as a place to settle and raise a family. In the end, people across the political spectrum walk want the same thing. A better life for themselves and for their children. Now, we have a lot of work ahead to make connect as successful as it can be. To improve our performance on the next Enrollment Period, weve been holding weeklong workshops with stake holder groups. We need to better reach populations that are illiterate or who dont speak english. We also need to improve our Small Business portal. But having finished the first Enrollment Period on such a high note, we are excited and looking forward to the next one. Ive had dozens of folks come up to me on the street with tears in their eyes, thanking us and saying for the first time in their lives theyve taken a kid to the doctor. Ive gotten letters every week from grateful families describing how obtaining Health Insurance has given them Better Health and a real hope for the first time in their lives. Obviously thats rewarding and i know that you feel the same way. So, to you i say, keep it up. Were going to change the world. [applause] thank you so much, governor. Thank you, governor, for being here and for your leadership. I think youve taught all of us a lot about successful implementation of the a. C. A. Now its a real honor to introduce our next guest, she is the leader who presided over one of the largest expansions of Health Insurance coverage in our nations history. And im going to ask all of you to help me give a warm welcome, thank her not only for being here with us this morning, but all she did to help get over 14 million americans covered. Secretary kathleen sebelius. [applause] thank you. Good morning. Thank you. Its great to see all of you here in washington and i want to start, as my colleagues did, with thanking anne and also thanking all of you. Enroll america did an amazing job. Ive seen a lot of political campaigns in my day and efforts to find and educate people and turn them out. This was one of the most amazing efforts, built from scratch, that i have ever seen in my life, and i think that anybody has seen in the country. Give anne and yourselves a big round of applause. [applause] im so glad to be here with great partners, drew altman and the Kaiser Family fund has been terrific in this effort from decades ago. Moving the country toward comprehensive health care. Dan and the blues that he represents but really the blue crossblue shield plans across the country and lots and lots of Insurance Partners did an amazing job coordinating and collaborating on how best to reach out to potential customers, how do educate people about the benefits of Health Insurance and how to work sidebyside with all of you. And isnt Steve Beshear pretty swell . [applause] i had the great opportunity, when i was chairman of the democratic governors association, steve was one of our candidates that year and a big win in kentucky. So i have known steve for a long time and i wasnt surprised but thrilled with his incredible leadership and promotion of health care in his state, knowing, having grown up in cincinnati, knowing a lot about the Health Status in kentucky, i can tell you he has done a lot of wonderful things but the best legacy project that he will leave behind is a far healthier and more financially secure infrastructure for hundreds of thousands of people in kentucky and thats something that will go down in the history books. Now, i saw a lot of you around the country as i traveled. We went back and i was in about 47 cities just during open enrollment. Enroll america was always there. You always were part of these amazing coalitions. And what i know is, you didnt have the easiest job. The work that you did was very tough. It was perhaps easier in a state like kentucky with supportive governors and statewide Office Holders and coalitions being pushed in a constant message. It was hardener states where you were facing unbelievable odds. Political environment where people were working not only to push back on the law but really intimidate you. Push back on you. Make it more difficult for you to do these very important jobs of getting to people who desperately needed it. As we approached open enrollment, the opponents of the Affordable Care act had already outspent what was our small federal outreach budget 41. Theyd already spent directly, and this isnt all the adds and political campaigns, its direct expenditures against the Affordable Care act, 400 million had been spent. We had a total of 70 million in the entire federal budget for outreach and education across the country. People shut down the government trying to stop this law from ever happening, before our wellknown issues with the website, which made it very difficult for people who were eager to sign up to actually get enrolled in those first eight weeks. And its before we had this amazing opportunity. So we knew we were facing very daunting odds. We had right wing media, leadership in congress who was determined on the house side to stop this law at any cost, shadow political organizations, hostile legislators, all working to make sure you couldnt do the job that was so important. But the people who needed health care and the people who had been waiting for years, actually decades, some of them, for this opportunity needed you. And you absolutely stepped up to the plate. Let me just give you a little snapshot of what we were watching at the federal level. Just before christmas, and these are national numbers, not just 34 states in the federal marketplace, but just before christmas and most of this came in december because by december 1, the website was fully functioning. Just before christmas, there were about a Million People who had signed up. On january 24, we announced that we jumped to three Million People. So another two million in that second month of good operation. February 25, four million. March 16, five million. March 27, only 11 days later, an additional Million People had come into the system to get to six Million People. You can feel this momentum building. Deadlines really do matter and you all were doing these amazing rallies and work and outreach across the country. April 1, five days after that, seven Million People had enrolled and then we allowed for two weeks for people actually in the system and an additional million folks signed up by the end. So eight Million People across this country now have Financial Security and Health Security because of the work that you did in the marketplace. At the same time, that effort also, in states that expanded medicaid, like kentucky, brought in an additional six Million People into the medicaid system over the enrollment preoctober 1. Thats an amazing number of folks. Again a lot of the medicaid outreach was based on the kinds of outreach efforts that you all were doing. I know it was heartbreaking because it was heartbreaking for me, to be in states where governors are still playing politics with medicaid and having to tell someone actually, you dont have enough resources to have Affordable Health care. Theres something so fundamentally wrong with that message and thats something that has to be worked on as we move forward. That is unacceptable. [applause] and the coalition, i think, is there to do that. So the original c. B. O. Projection was seven Million People would sign up and the way they predicted this would happen was four Million People would come in into the federal marketplace and an additional three million would come through the statebased marketplaces. In the end, about 5. 45 million of the enrollees came in through the f. F. M. States. And i can tell you, and you know this, any of you who worked in some of these states know just how difficult that was. And thanks to your efforts on the ground, which really combated relentless, not only misinformation but relentless obstruction, people who were told they couldnt come on to city or county property in order to do your job. People who were forced with getting fingerprints and paying a fee in order to help people access Health Insurance. Answering questions in multiple languages. Trying to figure out how to get information to people who, as Governor Beshear said, has never had Health Insurance before. They didnt know how to start the process, much less what a deductible was or how to figure out who should be in your network. If youve never had a doctor, how to you figure out a network . How do you figure out that process . Thats where you all came in and what we know is that this will change the country. We have had a snapshot in the United States of america, spending 2. 5 times what any country on earth spends per capita on health care and frankly having very mediocre health results. It would be one thing if we were spending a lot more and had these dazzling, healthy populations but thats not the case. We also have one of the largest blocks of uninsured in any developed country. So the combination of any of more money, lousy results and a lot of uninsured was a recipe for disaster not only for individuals ander that family, not only for communities but for this country. That is a look of a country that has some serious economic challenges. So when the president said early on on the campaign trail if you dont fix health care, you cant fix the economy, hes absolutely right. Governor beshear has talked about people with tears in their in their eyes. I always had somebody with me at the events i would do who was found and scripted and they had signed up for health care and willing to tell their story and come forward and that was always very impressive. But more impressive to me was getting off an airplane and having somebody stop me as i walked down the corridor of an airport and tap me on the shoulder and tell me about their grandson or their aunt or their mom or themselves. Stewardesses who gave me notes on cocktail napkins saying can you help me . Can you help my child . I live in texas. What can you do for us . And we would follow up with those individuals one a time. One guy who knelt on the seat in front of me on a tiny regional plane who handed me his cell phone and said, i hate to bother you but would you talk to my wife as passengers were boarding. I said ok. And she said my husband told me you got on the plane and you saved my best friends life. She got Health Insurance for the first time in six years and discovered a tumor and doctors said she had about four months and she said i had to say thank you and he is on the back of his seat saying [laughter] im not sorry. Im not sorry at all. [applause] so i look forward to watching your great work as we continue forward. I can tell you, you have a terrific partner in the new h. H. S. Secretary. She is totally committed to making sure our efforts continue on in the strongest way possible. But im always reminded as i think about this effort dr. Kings famous words at the arc, but it bends towards justice and you all have done an amazing job bending that arc better than ever before in the history of this country. No one has had a chance to do it before. You have not only worked to pass comprehensive Health Coverage, but youve now connected people with comprehensive Health Coverage and Financial Security. You are on the front lines of history. And you are making a huge difference for individuals, for communities and for this country. And for that, thank you very, very much. [applause] thank you. [applause] thank you all for being here and lets get the entire panel a round of applause. [applause] Important Group of leaders. We have about 25 minutes to have a conversation which im looking forward to. And want to start with you, secretary. People often talk about the Enrollment Period in two distinct moments, the dark days of october and november when the web site wasnt working and the bright days in the end when we saw this incredible surge that you described. But im a real believer that the surge we saw at the end was made possible by work and decisions that were made last summer. And in october and november when we were dealing with those issues. A great example is the work that folks in this room did. They didnt sit back and wait for the web site to be fixed. They continued to do education and continued to do outreach. As you look back, what was something you did last summer or in october and november that you think helped facilitate that surge in march and what is something you might have done differently looking back . Well, i think there is no question having, first of all, a sixmonth openEnrollment Period and that was a decision that we made early on, the law said that benefits started on january 1 and that i was to choose a date for open enrollment. So we knew it was a brand new program. We knew that a lot of the people who were uninsured would need a lot of education and a lot of help and intentionally looked at a long period. I think that was an important strategic decision. And what we heard from not only you all that had enrolled, but navigateors on the ground but a lot of people going to need four, five six touches because they werent ready at all to sign up at the first blush. They needed information. They needed to bring their family members. Needed someone to bring with them and talk to families and friends. Having that long period and deadlines in the period about coverage starting, that combination, i think, was a very good strategic move, which also gave you all an opportunity. And i say the second thing was part of the critical part of the ground game was working with our partners throughout the federal government and throughout the campaign effort, anne and her team were part of that but putting specific targets down, looking at the number of uninsured, trying to target our relatively limited resources to where there were big opportunities for enrollment, large numbers of uninsured in states that we were actually running the federal marketplace and then having that communicated to the folks on the ground so they had some idea, like a campaign, what actually was going on, who was coming in the door, how that was working. You could measure sharing information about success. Certainly, i think better what has been a web site that was fully functional, they won. I would trade those eight weeks in october and november in a heartbeat. Someone said to me would you like a smooth web site and four million enrollees or the eight million . I will take the eight million any day. [applause] and ironically, i think there is something to be said about we said to people, we will get it fixed. We did a lot of analytics and said it would be fixed by december 1. The most terrifying couple of days in that period was november 30 and november 29 and thinking, i really hope this is going to work and on december 1 when millions and millions of people came back to the site knowing that it was smoothly operating was a great validation and we saw people take advantage. We had to go back and invite people and partners back. We did a pretty good job and dan knows this well and others, Insurance Partners, we were able to go back and reach out to people individually and say Steve Beshear, you came in in october, you stopped somewhere along the way, come on back. You have plenty of time. Heres how long open enrollment lasts and try the process again and that, i think, was helpful. Dan, bring us behind the scenes a little bit of the Insurance Industry. You had something that the majority of the folks did not have, which is the realtime view of how many folks were enrolling in your plans. Im curious if we could think of a few different moments along the way. Last summer as we were gearing up and october first, that period in october and november and then the final surge and you described that numbers did at the end of the day far exceed what you were expecting. Tell us about the experience you were having and what you were hearing from your colleagues and how you approached these different times. Panic. [laughter] and from our perspective and i think the Insurance Industry as a whole and we did have ongoing conversations with the secretary and with h. H. S. And c. M. S. , we felt very good about the tools we were developing as a company, as an industry to meet individuals where they were. And we have all referenced it, whether it was churches, Community Centers or everything known to humankind in kentucky, we felt very good about that. What we were most concerned about, frankly, and this is before the glitches with the website, we were concerned about the case mix of the members and im speaking to you as a business person. We were concerned about the case mix of the folks coming in. If we werent able collectively to get the young invincibles into the program, we were fearful it would break the bank on the program. And federal government did a terrific job. We refer to the three rs, the risk adjusters, they were in place, we werent sure if they would be enough to sustain the program. I would say that we were less panicked when all the outcry over the problems with the website, because we were in constant dialogue and we knew over a period of time, any program of this magnitude was going to run into problems and we knew if we were successful and kept our heads down working in collaboration with you and with government, that we would be able to enroll the numbers of people that we needed to. Again, the fear was the young people. We reuped our efforts in social media and going out to ball games, the professional teams, the schools to educate, educate, educate. So i would say it went from, ok, we feel like we are ready to are we ready, are we going to get the types of mix to make this work financially and ultimately feeling real good about our collective efforts and our efforts as an individual entity to bring people in. Just in closing and the other speakers referenced medicaid, i have to say, folks, Medicaid Managed Care works. In every state where it has been implemented, the significant reduction in the growth of expenditure is pal atable, number one. Number two, people move from accessing care in Emergency Rooms and clinics to having a primary care physician and beginning to understand that they have a vested interest and pride in knowing that you can access care. Heres my fear. The effort to expand medicaid was the right effort. The issue is this. At some point, the money runs out and states will be left holding the bag. And the reason i say this, its not a political statement. I dont care what your political persuasion is, what it is, it is incumbent that the next step of Health Care Reform is making sure that we focus on the individual, that we focus on populations of individuals to get them access at the lowest possible cost care yet the highest quality of care possible, because unless we attack this cost curve and show real Outcomes Using Realtime Data in the hands of clinicians and other professionals to drive down costs, it is all for nauth. The only thing i would say, i dont disagree with anything that dan has said, but the other piece of information that i think is so important to get into peoples hands as this dialogue goes forward is the untold story of what has happened to costs since the Affordable Care act was passed. We are on the lowest cost increase ever in the history of this country on Overall Health costs, the lowest Cost Increases in medicare costs. They have been cut in half. The trend line is cut in half. If we can sustain where we are right now, medicare will be solvent for a long time. Medicaid costs per capita last year actually went down, a cost decrease, again never seen before and private insurance costs are down. So we have had not one, but four straight years of lowest cost trends in health care ever in the history of the United States of america. And we are now health costs are below overall inflation costs, which again, has never happened. So it is an important piece of the puzzle. Its a start. And there are a are a lot of tools in the Affordable Care act that will move us further in that direction with major Delivery System reforms, focusing on keeping people in the first place, as opposed to waiting until they get sick and doing more sufficient. Healthy populations, Healthy People will help lower those costs but that gets tied in with people having access to medical homes, people having a primary care doctor, people having Preventive Care with no copays or barriers. That trend can continue again. Again, these are very linked together. The secretary didnt always love the polls. Oh, really . [laughter] the most amazing thing about the polls really is that they never changed from just before when the law passed until after passage and even until today. And thats because opinions are widely distributed. Its distributed almost perfectly along partisan lines. At this point, i think we could ask the American People will the Affordable Care act take us to mars or solvet the Energy Crisis in america or turn the season around from my beloved Boston Red Sox and get a perfect partisan slip and thats because we arent having the debate about the a. C. A. Or substance. Its because in the political debate, the a. C. A. Has become the poster child for a larger debate between left and right of government and other things and in the country. And what that means and it may or may not remain the lightning round so we will see how that plays out over the next several years. The big question in my mind is, as more people get coverage, as this becomes more real for the American People and no longer just the political symbol, does the judgment about the law and the discussion of the law focus more on the reality and less on the laws of political symbol. And thats what well find out. A great transition to you, governor, you spoke in your remarks about the experience of implementing this and what washington, d. C. Considers a red state and you have captured the National Attention for many reasons for your leadership, but i think not the least of which is this experience that drew described of this highly politicized issue and implementing it in a state that a lot of folks started thinking of this as red state versus blue state and you have proven something that goes beyond that. What role do you think that Public Opinion and Public Perception that drew just described of quote, unquote, obamacare, what role did that play or not play . The phrase obamacare has been demonized and creates the partisan reaction one way or the other. What we did in kentucky, we sort of anticipated that and when the Affordable Care act passed and while it was in front of the Supreme Court, we accepted every dollar that the secretary would give us to plan and to get ready. And we were very quiet about it. We did all of our planning. And as soon as the Supreme Court said it was constitutional, then we announced that we were going to expand medicaid and to create our own exchange. What i did leading up to that was number one, i went to all of our stakeholders in the state. Chamber of commerce, doctors, and every one of them said, we are going to have an exchange one way or the other, lets have our own exchange. That gave me a great Political Foundation to be able to say we are going to do our own exchange. We know how to devise something for the people of kentucky than take a cookiecutter approach from the national standpoint. The tougher decision was the medicaid decision because its money. Eventually its money for the states and you know the details. I wont go into that. But i asked price water house coopers, i said tell me what this is going to to us or for us. Can we afford to do this . They came back in six months and said governor, you cant afford not to do this. [applause] they said this is going to infuse about 15 billion into your economy over eight years and create 17,000 new jobs. You are going to have a positive impact on your operating budget over the next eight years. And obviously, i took that and announced, you know, this is a great business decision. [laughter] it was also a moral decision and we all know that. It was the right thing to do. And i just had to make sure i had an answer for the economics of it. Once we did that, we started out in the summer after we got our web site kind of all together and we started an education campaign. And ill just use one story to illustrate what we started with on obamacare. We are at our state fair. Thousands of people from across the state come to our state fair every august. We are leading up to october. We have a big booth and educating people and we called ours kynect. There was a guy being briefed by one our connectors and she goes through the whole thing and he looked at her and said man, oh, man, that sounds great. That is a lot better than that obamacare. [laughter] and when of you as connectors thought as she did, do i tell him . [laughter] and only took a moment and said, nah [laughter] we just kept pushing and getting ready and really what we ended up doing is convincing the people of kentucky saying, i dont like the president but i have to find out what that is about. We separated that as much as we could and they did. They ended up deciding im going to end up deciding for myself. When they went on there and found out and it wasnt the web site as much, but it was you. We really pushed personal connectors all over the state because, look, most of these people, the reason our web site worked pretty well, there is no bells or whistles, we looked who we were going to be dealing with. A lot of those folks didnt know much about computers. So you had to make it simple. And we knew these are folks that never had insurance in their lives most of them. And you Start Talking about copays and all of these kinds of things, i have had insurance all of my life and i dont understand all of that stuff. I knew what we were facing and so you folks were the most important link to making it successful in kentucky because they sat down across the table from you. We got Insurance Agents qualified and they trusted their insurance agent. It was people they developed a trust in and sat down and explained to them what was going on. And that ended up really making it successful and sort of taking it out of the political realm. Last november, i was asked to come up and meet with the House Democratic caucus and they were moaning and growning about what was happening and they were getting hammered. I said, look, this is a process. Ill guarantee you that next november, the discussion is going to be a lot different than it is this november. And thats what you are seeing now. You are seeing that transition, you are seeing some of the worst critics, all at once, they are still trying to be against obamacare but still be for kynect. I want to tell you something, this ladys a hero. [applause] she is. Im going to tell you, i never saw anybody take any more abuse and undeserved abuse and she took it and made this darn thing work. And quite honestly, i would like to say thats what governors are all about. She was a governor. In a really red state. They get things done. You make things happen, and you dont have a lot of time to argue about ideology, you have thousands of people depending upon you every day. When things didnt go exactly right, she could have pointed fingers. She and the president said, look, we are going to fix it. Im so proud of this lady. Thank you. One of your comments sets up the next question because you talked about your conversation with Price Waterhouse coopers and you are the leaders that implemented and we all turned to for advice. Im curious as you were undertaking this enormous implementation project and this is a jumpball question, who did you turn to for advice . What past experiences did you look at to inform the decisions you made both in your planning stages but also as a moment when things didnt go according to plan . Ill jump in on that. It starts with we as an organization have had a great deal of experience in the medicare, managed care area working closely with government. We are in several states in medicare managed care. We looked at our experiences in developing programs for special needs populations or different populations, not traditional commercial populations in building our products and building our average. We looked at our team to make sure that we left no stone unturned in understanding the makeup of the population. But we started from a point that even though a great number of people across the country signed, it is only about 5 to 6 of our business. We felt that we err on the side of pricing our products to attract people, err on the side of putting proactive programs in place to make people understand that there are ways to stay healthy and access high quality care at a lower cost. We felt good about that. But it was really banking on our experience that we had in the past in really high quality effective government programs. Understanding the potential risk and partnering with government and with the Provider Community to set up products and programs that would really educate people and access the quality of health care they needed. Anyone in particular you turned to for advice . I basically turned to everybody. And i mean that seriously. The Affordable Care act is is much more comprehensive than the slice of marketplace enrollment. It is a very comprehensive health bill from expanding Community Health centers, workforce issues, Electronic Medical records, a lot of Delivery System possibility, the first ever Innovation Center at the centers for medicare and medicaid, our own r d operation and look at what works. So it is a massive look at the Health Care System. Providers were a key part of those discussions. You know, what were the best Hospital Systems doing, how could we drive that further. I did have the experience of being the elected insurance commissioner in kansas for eight years. My former colleagues were critical inputting together the framework for the new plans that were going to come into the marketplace. I spent a lot of time with them. Governors we knew were going to be hugely important. And again, i had one of my former lines was a governor. So i had that opportunity. Members of congress, both as advocates and opponents were staying in touch. Some i had a little too much touch with, i would say. [laughter] that was an important constituency. But then trying to look across the spectrum of who at the state and local level, because we knew at the end of the day, this effort would really be about personal outreach, personal touches, personal connections. And again, i cannot underestimate this amazing enrolled america role, because you were at the table from the outset. You were building an organization specifically designed where other organizations were in place but this wasnt their mission. They had to go to Church Groups and Health Leaders and others saying could you add to your mission this piece of the puzzle . Will you spend some time in energy . Will you help recruit . But enroll americas function was to do this across the country and that became an amazing asset. And what you are learning, the team did a great job of feeding back in so we could make decisions out in the field, what worked, what didnt work, how you operated. I would say it was really everybody in an ongoing fashion. Listening to what the critics said, trying to make improvements. We also the rules and regulations are substantial in a law like this. We had to write them the way the framework is. There are three departments, department of h. H. S. , department of labor and department of treasury and the fact that we got them out the door in a timely fashion is somewhat remarkable if any of you know about government regulations and government time. There were a lot of the pieces of the puzzle. It was an allhandsondeck approach. And reaching across the cabinet which the president did effectively in saying to a lot of our colleagues when you travel to the states, do not lose that opportunity to also look at ways you can help spread the word. So it became a mission that people adopted, happily were eager to participate and worked very well across government. You know, i just had a great team of folks. When you get down to it, i mentioned secretary haynes and others. There were hundreds of folks. I went over to our warehouse that first day and they had been up all night and blurryeyed but had smiles on their faces. Because we had worked so hard and approached midnight leading up to october 1, we crossed our fingers and said a prayer. It worked. These people were invested in. They are real believers. We are all believers. And so we were going to make it work. And we did. Governor, that will be the last word. Hard to believe it, but our time is up. Thank you to our incredible panel for being here today. [applause] Martin Omalley was that the Iowa State Democratic Convention in des moines. One of several stops he made on a twoday trip. He has been mentioned as a potential president ial candidate in 2016. Here is some of what he said at the convention. The patriots who made america great, they did not pray for their president to fail. They prayed for their president to succeed. [applause] our founders did not belittle science, belittle learning, they aspire to it. They would never, ever abandon the world the war on poverty in order to declare a war on women, workers, immigrants, a war on the sick or a war on hungry children. [applause] what was true for our parents and grandparents remains true today. America is the greatest job generating, opportunity expanding nation ever created in the history of the free world. Serve oura can not childrens needs, cannot serve our childrens future well if our republican brothers and sisters in Congress Keep shutting us down and selling our country short. [applause] more from governor omalley tonight at 8 00. Part of cspans road to the white house coverage. Over 35 years, cspan brings Public Affairs offense from washington directly to you, putting you in the rim at congressional Public Affairs is thence from washington directly to you. We are cspan, created by the cable tv industry 35 years ago and brought to you as a Public Service by your local cable or satellite provider. Like us on facebook and follow us on twitter. Appeared on a panel before a Senate Subcommittee to defend the promotion of diet products on a show. The subcommittee deals with Consumer Protection and product safety. A memberhis panel was of the ftcs advertising division