On behalf of our member companies. Our agenda looks a little different from what you all expected. We had a little lastminute change. Jennifer cannot be with us. She is in the premises. Her luggage is not. She sends her apologies. She would have provided a stellar update on what is going on in illinois. We wish her well. With that, i am going to turn it over it to representative greg cromer who will kick us off. Thank you. It is good to be with you folks this morning. Greetings from the state of louisiana. Home of the new Orleans Saints and health cooperative. Thats a cheap plug but i had to do it. A little history. I was in the Space Business for 31 years building tanks. Then, working with the boeing corp. Big, big rocket. Ive been elected to legislature for six years. I was brought an opportunity to change career paths at age 55. We are a nonprofit Government Insurance company. The newest in the state of louisiana. Some of you may question the wisdom of that choice or decision to go from a profitable, successful airspace career into insurance. Do not feel like you are alone because sometimes i do the same thing. With my background, i can tell you our industry is not Rocket Science. I can say that with a little bit of authority because ive been in Rocket Science for a long time. The only exception may be the actuarials that we use. Any actuaries in here . Raise your hand. Good. When i compare it to Rocket Science, we look at projections, it may be more like Science Fiction than Rocket Science. We have gone to market but we have not set the world on fire with what wouldve established so far. That is coming toward the end of this year. There was a question posed yesterday, how can we partner with state officials. Whenever i was appointed to this position as ceo, Louisiana Association of health plans came to me and jeff and company in the front row. Immediately before i was active in the position and started talking to talk to me, i know what a fine job they do in advocacy and education of my members and committee. It was an easy choice to engage with that association. And further with the agency as a whole. What do we face as a startup . The first hurdle we have faced as a coop, as most of you know, has spun out of funding through the aca, is an education process. Most the folks look at us and think we are the exchange, we are the mechanism that people enroll into insurance plans and we run it which is actually incorrect. We are in the exchange. We are in the private marketplace. That is one hurdle we had to overcome. The next one is some of our competitors have felt that we could mandate costs and rates with our providers and that is absolutely incorrect. We have to go in and negotiate contracts with providers like anybody else. The folks who sponsored us, which is a Big Health Care system in louisiana, are the hardest people to negotiate with that i have dealt with. And we signed the last contract before went to market on october 1. Believe me, i did not get any favorable consideration from them. We were finally operational on october 1 on the federal marketplace. We opened our internal exchange, it was ready, the federal marketplace was supposedly ready. We spun up and down very quickly. There were glitches. We had them fixed before the end of the week. The federal government continues to have glitches in their system. We are not sure, depending on who you talk to, when all of the pieces will get fixed. We talked to folks in washington about three weeks ago and we were told it absolutely would not be working this year and our Customer Service representative was in our office the next week and we asked her the next question. She came back and said it will be running on october 1. Coming from the same agency, two different answers did not give us a lot of confidence. Therefore, when october rolled around, the piece we worried about was not up and running. One of the good things about the first week we were open was a friend of mine, a ceo of the biggest competitor that i have in the state of louisiana, theres a group of us that play golf. We were sitting around after a round of golf talking about our numbers and whenever we started talking to mike about his numbers and mine, low and behold i found out i should be optimistic because i was ahead of him 2 to 1. That is not a ratio, that is in rowleys. Enrollees. He was the 800 pound gorilla and i was taking him to his knees. One of the encouraging things that we are getting is that some of our early enrollees have been young people under 30 which was a concern which we would get all of the high risk business and not get any young folks to offset the high risk. We have had a fair amount of younger folks which give me reason to be optimistic that maybe there will be chance for success. Most of the interest in our plans have been coming from folks that are calling us directly instead of going to the federal marketplace. There seems to be two reasons. One is that there is a significant amount of frustration with the ability to get into the federal marketplace. The folks who have been able to get on and do transactions have all occurred between the hours of 11 00 at night and 4 00 in the morning. Some of that not without long waits of two hours to make a single transaction. Theres a lot of frustration. And a lot of folks looking at the marketplace have either had a coverage or no coverage at all and do not have any real idea about what they need or what is available to them. They are calling us directly and looking for education and what they can get and what they may need. And what types of subsidies are available. We will therefore walk them through the process to enroll they are subsidy eligible or through the process to enroll with our company. They are calling us directly to get into the programs. Due to the problems with the ffm, we are taking information manually from customers who called. And calling them back, hopefully within a week in most instances as we are able to access the system. With all of the issues that are going on with the federal marketplace, we are actively seeking on a daily basis and putting into place and the word came out that the federal government is going to start looking at manual applications. We were already looking at manual applications to facilitate people to get on board. We are trying to stay ahead of the curve. All of the problems that we are seeing seem to come down to one key issue and that is with all the planning that has gone into this, the inadequacy of the amount of time of testing in the federal marketplace and resulting in our testing of our systems as we have been able to integrate has been sorely inadequate. We are putting things live on the web without good knowledge if they are actually going to work. You have seen that in the federal marketplace and they are doing upgrades just about every evening. Take the system down on the weekends to make changes. One of the big things in developing software is the testing and implementation and that piece of the puzzle seems to have been i am not going to say overlooked, but the drive to get to market in a timely fashion was not allocated. I see one big problem for our company in the near future and maybe some of you will see the same with the slowness of enrollees and enabling of getting into the system. I have a small team that works for us. I see there will be frustration setting in with those folks. My biggest problem is not getting the members enrolled, keeping my team motivated and engaged. Theyve got to have a positive attitude when they talk to consumers. There cannot be any frustration in their voice. They have to be positive and that is where i see one of my bigger problems. I look at my team as a football team. We are projecting out how we are going to grow and be prepared to win in the next three to five years. This year we have a onegame season. We are in the First Quarter. The referees have blown some calls. Thats a kind way of putting it. It has prevented my offense from being able to move the ball down the field. We are looking for a strong secondquarter if you will between midnovember and in the end of the year when you expect to see a big push and we are hoping the systems are up and running more smoothly. We are hoping for a very strong Second Quarter so we can score a couple of times and get points on the board. And midyear, halftime, everybody will make adjustments. It will be the enrollment period. If we can score points in the Second Quarter, we can maintain and hold on in the third and fourth quarters and we will have a successful season and be able to compete next year. That is the goal to get past this year and next year. We hope to be super bowl winners. That is what i would use to motivate my team and keep them on track and on point. That is about all i have to offer you. I will take questions directly in a minute when time allows. Thank you. Thank you. That was fantastic. We will do q and a. I am not into sports. I am from a place where the women are strong and the men are goodlooking and the children are above average. My story is going to be pretty similar. From a little bit different perspective. Set the stage a little bit for minnesota we all get along and we smiled and we try really hard. [laughter] it has been tough. It is been a tough couple of years. Minnesota, we have over 5 million people, 5. 5 million people. We have an uninsured rate at 8 . We have the largest high risk pool in the country. 26 years old. We have a pretty good idea as we phase that out what the risk is. We do not know where its going. Everybody is watching. We have seven health plans in minnesota. In order to hold an hmo license, you must be nonprofit. We have a large forprofit company that is housed in minnetonka. It is for profit. We have a little bit different environment that we operate in. Five of the health plans chose to go on the Minnesota Exchange. Two of the health plans are not on the Minnesota Exchange, another is on is in the exchange in three other states but not in minnesota. That is where we are starting out. The projection for the numbers of individuals which we call our exchange, i doubt we will be drinking this stuff. It tastes awful. In any case, it is about 1. 3 million, the optimum number that will be shooting for. Give you a little bit of a history of how we got to our statebased exchange. It really was launched by the governor with an executive order in 2011. That was because the first two years of our current democrat governors term, the legislature, both the house and senate was republican and they were not interested in passing exchange legislature. We worked very hard, a coalition of business providers, very hard to convince the legislature that we should move toward a state based exchange in minnesota. Were not able to get that traction. When the election happen in 2012, both houses went democrat. The first thing, the first day of the 2012 session, governor assigned the Medicaid Expansion and the senate was exchange legislature that moved through 20 committee hearings. By the end of march, we had our legislation passed this year. It is an active purchaser starting in 2014. The first year, any company that was able to meet the requirements and get the products approved can be on the exchange. We have had mlr in minnesota for a while. We are highly regulated market. Weve had rate review forever. Some of those pills that people had to swallow for the first time, we were able to roll through some of that. Two of the five companies that are on the Minnesota Exchange are only doing individual business. Three of them are doing individual and small group. We have a very strict conflict of interest that constitutes who can be on and off the board. The Exchange Board in minnesota so there are no brokers, no insurers, no providers. It is frustrating for the stakeholders who have been active in moving this forward. Fortunately, the board that was appointed appears to understand that working with stakeholders who are really involved in this is going to be essential in having a successful exchange. We have done a lot of work with them. I wanted to give you some numbers, the first numbers out of the gate which were announced on wednesday. And i will talk about the communication strategy that we adopted in my organization. As of wednesday, about 12,000 accounts have been created. I think that is a really small number when you think we are moving toward almost november. We have a long way to go before march. The Exchange Officials are saying, we are really pleased, it is meeting our expectations. I think its a theme they have struck. The message is positive. Of the 12,000, 5500 completed applications to determine whether or not an individual is eligible for credits or so forth has been completed. We are going from 12,000 to 5500. It will get better. About 3900 have started the enrollment process. Really mining down into it. 406 commercial applications have been completed. I will talk about the medicaid. The balance of all of those will be medicaid enrollees and we have a state subsidized program called minnesota cares. 3,500 are those. That system is not yet automated. It is not operating. Itll be the portal that people go into. It is not working. We knew that is what the status was going to be. At this point there has not been one successful 834 filed translated to a health plan. That is the point we are at right now on a daily basis. Talking with Exchange Officials so that plans at this point, we know there are 406 names somewhere but not one of the companies at this point knows who the enrollees are. The plans and did receive a call a couple of days ago telling them of the 406, you have 10 and you have 9 and you have 30 . The numbers are pretty small. We have daily i convene a Daily Exchange call with all of my members to keep information flowing. It has been very useful because we are able to turn around and communicate back to the officials exactly what is going on. We expect a productionready 834 any day. We thought it was going to be yesterday, i had my call this morning at 7 30 a. M. And now we expect it today. It is imminent. It is coming. We are seeing very positive and on message with exchange so far. We also have not gotten the navigator and assistor function. That is one of the problems. Once we can get the 834 and 820 solved, the next is to get the navigator and assistor working to get people enrolled. My Companies Want the exchange to work in minnesota. We think it is important. 110 million have been spent on this. That is something we want it to work and to be easy for folks to find, compare, make choices, and get coverage. The biggest challenge and i will talk a minute or so about communication strategy. We started working on a communication strategy about two years ago. From my perspective, the biggest challenge that the health plans have is managing the expectations that people have that once i go on the website and enter information, i am in a health plan. That is just not true. People are calling health plans in minnesota saying i enrolled in you yesterday and i need to schedule surgery in january. Can you tell me if my physician is in the network . This is happening. We have been doing a lot of communication with the media, a lot of education with the media trying to help the media understand how those promises that were made as a part of the passage of the Affordable Care act that you can keep your coverage and etc. , how that is basically true. But everything is going to be individual, it is all individual and how you are impacted is going to depend on how it hits you personally or your family. One of the things we did early in the year was a website called myhealthcarefuture. Org, it was a quiz you can take that helped you understand where you might fit into this new world of health care. Where you might be eligible for a subsidy, for a public program, probably not going to receive a subsidy but you would have a choice. Very quick, we got a lot of hits. We got a lot of nice media coverage. What we found is we started to manage toward the public understanding of this is going to be complicated. It was not going to be a Straight Line to get your insurance and that was one of our objectives. We did a lot of media pieces. I did an opinion piece that a twin citis major paper picked up which had a great graphic. It was a pie chart. It sort of laid out in minnesota where people get their coverage. We were able in that piece show that a very small part of the pie was going to be impacted by the insurance exchange. We have done a lot to really manage. And of course, we talk with the exchange at least two times a week. We do Conference Calls with them. We worked really hard and have absolute agreement that we are trying to stay on the same message as them. We are trying not to let the public walk away from this. One of our biggest concerns in terms of the plans that i work with is that we are going to lose a lot of medicaid enrollees in the process. We are going to have people falling through the cracks which is a great concern to us. We want it to work. It is very complicated. The message we have really stuck to with the Exchange Organization at this point is that this is proceeding as we had basically expected. We did not expect to have a fast start out of the gate. Doing it right and having secure data transferred is the most important thing. One of the things that has worked to our advantage in this, not so much through the Exchange Organization, they had a Security Breach by their staff. In the grand scheme, it was a little Security Breach. They sent an encrypted file to a broker at a list of other broker names and there were Social Security numbers. Thats a breach and in violation of our data practices. It was not client specific information. They got a lot of media attention. It heightened for this to be done right. We have done the secure transfer of uncorrupted information is the most important that we can do for you as a consumer. We are not off the runway yet. As i like to say, it is going to fly, orville, but i am not sure. We have a communication plan. Our next plan is really focus on 1 1 14. How do you explain to people what they had how does it fit to these levels . Things are not exactly the same. You are able to get more benefits for young folks. I may not have to purchase maternity or Mental Health services. Everybody is going to be doing this now. That is really hard for the public to understand. We do think we have our media there. We think the media can help us with that. I will stop there. Thank you so much. Leslie. I know we are running i could say what julie said. Same for new york. We have a lot of shared experiences. For those of you who were here yesterday, i will not repeat everything that paul said. I want to give a little bit of history. 2011, new york wanted to build its own exchange with andrew cuomo. He made it a top priority for his legislative authority this year to pass to set up an exchange. Another top priority was to pass gay marriage. They passed the gay marriage bill but only after a handful of republicans agreed to vote for the bill. As a result of that, as tremendous backlash against the republicans. You are looking much more like a democrat and we do not like that. Even though we are in a very blue state, even though we had an agreedupon bill to create an exchange, the gop said we cannot get behind obama care right now. We are waiting for the Supreme Court to strike it down and we know it will happen and they said we are not doing this. Nothing stops andrew cuomo. He said, fine, i will create an executive order. That is what he did. We got a lot of the federal dollars that wouldve gone to other states. We gladly took those dollars. The good news about the new York Exchange is when they started staffing, they grabbed a lot of good people from the health plans to staff the exchange. We have some plan expertise. That was the good thing. As a result, we have had a good ongoing dialogue with the implementation. The bad news is in 2012, the governor, when he talked about building this change set expectations very high about how it would lower premiums. The number that was thrown out there was premiums would be 70 lower than they are currently. Theres a little asterisk to that. That is for a small percentage who purchases individual coverage, that is about 17,000 people. You talk about your pie charts. Now they have set the bar. 70 lower premiums. We of course folks, your setting the expectations so high you are going to be eating crow. We cautioned them about managing those expectations. And we were significantly that were to drive the premium to meet that expectation. We have some good and bad news. When the rates did come out, they were not 70 lower. They were 53 lower. Again, for a very small percentage. We spent a lot of time at the Health Care Plan association reminding the media, lawmakers, it was for a very small percentage and some people were going to see the premium go up. People are beginning to find out as they shop on the exchange. We have about 16 plans that are participating including the three brandnew health plans, the Hospital System put an insurance company. Two new Insurance Companies that wanted to do business on the exchange. It also includes a number of our medicaid and Government Programs that decided to shift. In addition to the promise of these greatly reduced premiums, another concern was capability of the i. T. System. State spending a tremendous amount to build this brandnew data system, brandnew portal. We had three plans that were chosen. Most of the testing involved, transferring files and make sure the protocols and when not have Security Breaches. A lot of plans were invited to test. Because of the way the portal is setup, you cannot do anonymous shopping on the individual exchange. They were giving plans screenshots. They said we would really like to test it. That has been a bit of a problem and a concern. Fast forward to october 1 and the exchange opens its doors, great fanfare. Within two hours, nobody can log on and there was a thing that came up that said it due to overwhelming interest in the exchange, the system is down. The Exchange Staff worked to increase capability of the portal overnight. And the next day the exchange came out and, we like to go big in new york. Came out and said we had 30 million hits. Everybody said, there are 2. 7 million uninsured. The media was skeptical. Then they backed off and little bit and said, we have 30 million hits, individual page hits. We really had 250,000 unique visitors. People want to know, how many people enrolled . They said 250,000 unique visitors and 40,000 shoppers deemed for the exchanges with the how many people enrolled . Last week, the officials told us about 600 applications had been processed. Again, we said how many people have enrolled . The bottom line is we still do not have a number of enrollees. Like minnesota, that been no 834s transmitted. We were told there were 2700 834s ready, but there is a significant error in many. I feel like annie, tomorrow. We still do not have any 834s. Bill just reminded us about the president s promise if you like your Health Care Nobody will take it away. The New York Post ran a story and they found a selfemployed woman who does not qualify for any subsidies and she was a Sole Proprietor so she was buying a Group Program as an individual. She found out her coverage of the exchange because the Sole Proprietor product is going away, her coverage will be 250 more expensive than her current. I do a newsletter every week and my to have this quote. The president said i could keep my coverage, he lied and i will never forgive him for that. We are working very closely with the exchange and we do not want to publicly say we told you so. We are saying to them, we would like you to remember there are winners and losers here. While there are some people for going to see their premiums decrease, there are probably more people or going to see them increase. We do not like to promote that too much. We are working with the exchange to make sure it is a success. We are still waiting for tomorrow. Thank you very much. I think we have time for a couple of questions. Right here in the middle of the room. Hi. Do we have any concrete numbers . Same sort of thing, how many people have enrolled . We have received a few 834s. Does anybody have numbers nationally . We are not getting any feedback on that. That is part of the federal marketplace in louisiana and we have received some 834s for processing. We know there are others that were held up in the system. We filed several tickets to get problems resolved. We had a couple of folks who called us wanting to know about premiums. We know that 834s are out there being processed. They are not really seeing any numbers. That speaks to where we are at. If the numbers were big, you would be hearing about them in the media. Other questions . We have time for one more. Somebody in the back. Way in the back. Being a consumer, i were present Nurse Practitioners. One thing that strikes me when you are trying to shop for something, you are going to go on the site and Everybody Knows they have more time. I think we are dealing with our concern that we know there is misleading information in terms of how much money you will save. The sooner that somebody will go online and look at this and sign up the same day, i think it expecting a great deal of the public. I think we need to give a bit of time to see how people do. Our concern is to make sure the patients that see Nurse Practitioners are able to see them. That is what we are trying to keep a finger on the pulse. I do think we need to be patient. I would echo what you say. That is one of the things ive been telling the media. Look, nobody expected people to go on and sign up the first day. One of the reasons we have this prolonged open enrollment is so people can shop. We want them to be responsible and actually do their homework and make sure that when they are ready to push that button and select a plan, they are picking the right plan and they have done their due diligence. I totally echo that. We assumed people would register, shop, make comparisons, talk with family and friends, and go back. The big concern was the ability in such a short timeframe to do this i. T. Bill and we all knew, everybody in this room knew it was not going to be possible to get it perfect. It is really a matter of acknowledging that it is going to take some time to ramp up. But i totally agree with the comment. Ditto. The first day, the first week there was a huge volume. That was curiosity seekers. A lot of folks that i know, members of my staff who had no intention of buying Health Insurance on the marketplace but wanting to see if it was working and what it looked like and what was out there. You have seen a lot of people doing that. That is why we are hoping for a big Second Quarter. People are going to want to get enrolled before december 15 so they will have coverage for january 1. That is why we are hoping that folks are sitting around their thanksgiving tables talking about this. And we are going to have our internal portal open the afternoon of thanksgiving day so if folks want to look at what is out there in our program, it will be available. Thatll be our big push to get enrollees. We hope in our Second Quarter, the second half before december 15. Thank you so much. We are the First Quarter with our eyes on the super bowl. We are not off the runway yet. Communication is king. Manage expectations and testing is important. Doing the right is the most important. And tomorrow is only a day away. [laughter] will you help me thank these guys . [applause] [captions Copyright National cable satellite corp. 2013] [captioning performed by national captioning institute] span, a series on gridlock in washington. Then, United Nations deputy secretarygeneral talks about the u. N. s agenda. Theyd are, the former president of the Brady Campaign to prevent gun violence. On the next washington journal, the week ahead in washington. The 2014 midterm elections and the budget. Our guests are democratic strategist Steve Mcmahon and republican strategist ryan walsh. Followed by a look at the new Health Insurance exchanges and how the Health Care Law impacts Insurance Coverage with a Kaiser Health news correspondent. It are, a discussion on how the fbi tends plans to deal with budget cuts under sequestration. Washington journal, live at 7 a. M. Eastern on cspan. Host our sunday roundtable with patrick rory will speak monday. Before becoming governor this year, mccrory was a governor mayor for 14 years. Init was not that important 95. It is critical now. Certain occasions of mobile devices because all these devices, literally hundreds of millions of americans have, we have to ensure that they dont interfere with each other. In 1995, there werent that many mobile phones going through the process. Now, it is really important to battle between apple and samsung and motorola and others. They need that certification. They make these plans. They have billions of dollars in advertising. Suddenly, whenever the plans get delayed one of the plans gets delayed. That is a real cost. We have had several budget disputes. They stem from the budget control act of 1974. This occurs almost every year. This, wer 40 years of still arent very good at figuring out how to operate a government. The effects of the Government Shutdown on the fcc monday on the communicators. This is Eleanor Roosevelts typewriter. It is on this typewriter that mrs. Roosevelt wrote her my day column. One is Eleanor Roosevelt first my day column. It sets the tone for the columns to follow. She is talking about the comings and goings in the white house, getting back to the regular schedule after the holloway season. Holiday season. Midnight about how at a larger crowd than usual came in from hyde park. The president went out to greet them. This was a tradition on election night. Roosevelts would come to hyde park, gather family around and only the election results. When they were announced, folks would march down and the president would greet them. First lady Eleanor Roosevelt, monday night live at 9 00 eastern on cspan. Our sunday roundtable with two veterans of the boston globe. Michael kranish, matt viser, thank you for being with us. We should point out that a baseball game got higher played in your book this morning in the boston globe, that this is what the front page looks like, improbable dream soaring into the world series. We will talk about your book out this morning, and it you say what is behind the gridlock with reference to behind the last two weeks . When the system seems to be perpetually in crisis even the host Michael Kranish . Guest that is right. We have a city where we only just briefly gotten over the last crisis, but as everyone knows it will happen again. Even if they do not default in a few months, the underlying issues and framework on which the city is based, a lot of people are concerned that the system is broken. This is based on a series of stories this year from the boston globe, we try to tell a series of stories in a compelling and readable way to give you a sense of what is behind the broken nature of the city. Not just the day today, but the deeper stories that tell us what the deeper problems are and what we might do to fix them. Host how . Guest that is the big question. We are at historical levels of partisanship in congress. Things are not working the way that they probably should in a better atmosphere. Next step is where we are turning next in terms of where we what we can be done differently. Host to get things done we learned that you have to have personality. In the book, broken city, you write Speaker Boehner has turned down and declined invitations to all six state dinners guest this is a story that matt wrote, let him talk about it a little bit. Guest it is amazing, their relationship or lack thereof at this point. President obama has met alone with Mitch Mcconnell twice and it took them two years for him to meet oneonone with john boehner. I think that there is a lack of cooperation and a lack of personal relationships that do affect the legislation that gets done and the conflicts that we have seen, just this past time with the debt ceiling crisis. Host we should point out that there were a series of contributors to this, but the president has taken more trips to self korea then to south carolina, having visited the citizens of denmark twice, gone to kentucky wants your cois that important . Guest we wrote about john boehner and obama in this story to give you this balance, really trying to show that the problem goes all around for why things have this underlying broken nature. People probably remember that obama in 2004 at the Democratic Convention in boston said that there was one america and he has not really been able to fulfill that as far as bringing the country together. That story, talking about his inability to do that. We are clearly more divided today than he hoped we would be when he took office. Host what was your one take away from broken city . Guest that things are worse than we thought in a new creative ways. That things got really bad. Things are worse than we thought heading into this. Host there is a quote from john boehner who said that we got rolled by the tea party and the circumstances that led to the shutdown. Were the republicans rolled . Guest the Republican Party really is in the midst of a civil war, some would say. John mccain said that they are trying to define themselves. There is the isolationist wing, the tea party, the more traditional members. The party is trying to figure out exactly what it is, that is something the Republican Party themselves having trying to deal with. They have this report about resetting and redefining themselves. Host the speakers comments this past week, as it appeared on the radio show from Bill Cunningham about what happened and where they are going next. [video clip] john boehner, thank you, how are you . How are you doing good . We have been locked in a fight over here, trying to bring government down to size and do our best to stop obamacare. We fought the good fight and we did not win. When they come together to do this deal . I would hope so, we will see. Every time i have gotten into a discussion with the president , the Vice President , talking about title changes and making these programs sustainable, it was all we cannot do that unless you raise taxes. If they hold onto that position, we will not come to that position. Host Michael Kranish, based on the comments from john boehner, what is the likelihood of returning to this . Guest very likely in the sense that they are trying to come up with a grand bargain and they have not succeeded after trying many times before. How they will get to this new agreement is hard to see. There were some taxes that were raised, not as much as the democrats wanted. It is going to be quite a battle coming on and it is hard to see how in a few weeks they will simply come to an agreement. Maybe they will come up with something. Host this is a quote from Mitch Mcconnell, interviewed by a number of organizations, one of my favorite kentucky sayings is that there is no education in the second kick of a mule. The first is when we shut it down in the 1990s, the second was in the last 16 days. There is no second education. I think we have now fully acquainted our new members with what a losing strategy that is. Guest i think that is the hope of many in the leadership. The challenge certainly in the house and in the senate is that that will be the big text next and there are no signs of the tea party letting up either on health care or sticking to their guns on these issues. Host there had been stories that Speaker Boehner might be challenged within his own caucus and those stories dissipated. Guest a lot of republicans that we talked to in the tea party, they do not really blame john boehner, they realize what an extraordinarily difficult position he is in. It really is a tough position. When he first came to congress, he was a rebel himself. It is a very tough position that he finds himself in, constantly trying to bring the party together. He has not been successful in trying to get this agreement last week with democratic votes, not something he wanted to do. Host the new ebook, out today, broken city. With us today, Michael Kranish and matt viser, two of the many contributors to this boston globe ebook. We will get comments and then get your calls and emails. [video clip] we know the American Peoples frustration with what goes on in this town has never been higher. That is not a surprise. The American People are completely fed up with washington. At the moment when our economic recovery demands more jobs, more momentum, we have got yet another selfinflicted crisis that set our economy back. And for what . There is no economic rationale for all of this. Host that was the president on friday speaking to his staff in the state dining room. What was the shutdown all about, matt . Guest it was a battle with republicans over health care that they fought. A battle that some of the Republican Leaders did not want to fight. I think it began over health care, eventually. They realized obama would not yield on that. They try to find a way out, which is where we are now. Host Michael Kranish , we have been talking about this new poll from nbc news, and there has been a lot of talk about whether we could have a thirdparty challenge