Transcripts For CSPAN3 Key Capitol Hill Hearings 20151210

Support. I want to give the congressman a chance to respond. The American People are ned concerned. I think when incidents like what happened in San Bernardino, americans are frightened and they like to their leaders for answers. Ane i think the initial response, my republican colleagues was to go after the refugee program. Thats the panacea, denyingun women and children and old men i and women fromng coming to the United States, who are looking for refuge. That really is not addressing the issue. Getg i think what democrats are focusing on and we had from the get go is a visa waiver program, which weve taken action on in a bipartisan way, a more he thoughtful way and i think also the issue of addressing the issue of access to weapons by terrorists. Weapo by keeping them from getting those weapons the terrorism watch list by a means as to who can purchase weapons. People i recognize the feelings there. The first reasonability of the president and congress is to protect the American People fron foreign attack. That type of violence. A good time to bring up this front page today in the new york daily news. T beco when trump came for the mexicans, i did not speak out ae mexican. A when he came for the muslims, i did not speak out as i was not a muslim, then he came for me. I you can see the picture. Your thoughts. I think its remarkable, the hateful rhetoric hes been speeing. Its not enough to say i disagree with him. Thinking about what they would do if hes their nominee. I think theyd have to support t him. I think its not enough to say i disagree with him when he makes statements about mexicans or ths speaksla about women and in this case, how he speaks about people of the islamic faith and that all should be barred from coming to the United States. That itsy being resoundingly condemned by the new york dailyp news. I think evene speaker ryan yesterday finally came out and had some strong words for mr. Trump and that he does not that language is not representative of the gop. Gre the grand ole party, the republican party. Its about attime. I th it may be a littlein late. Incredible damage has been done. People around the world have condemned what mr. Trump has said. Josh earnest as well, one ofi those voices condemning trumpsr comments. Heres a bit from his press conference yesterday. The fact is, the first thingw a president does when he or she takes the oath of office is to swear an oath to preserve, protect and defend the constitution of the United States. F what trump said yesterday disqualifies him from serving as president. And for republican candidates ls for president , to stand by their pledge to support mr. Trump, that in and out of itself is disqualifying. D we have about 15 minutes left in this segment of the washington journal. Rning, g kens been waiting in ohio. Ken, good morning. Good morning. I just wanted to couple of moments of your time. O ans poll from world republican opinions that states that 61 o, egyptians approve a tax in america. 41 pakistan. 38 morocco, 42 turks and being that muslim religion is the ng t second largest in the world now, i mean, those numbers could beo staggering. If we have people trying to penetrate our borders to commitb acts of terrorism on our own land. Oush theres a lot of talk about whether or not we should shut ,u down thet borders and the syris and everything. Issue i think weve spent enough time, not thinking about whats going on with our own people and our. Homeland. Theres a lot of issues here we need to address as opposed to baby sit the bir world. And you have to understand the skepticism of the American People. Rethere ha theres been deceit, lie, many reasons for distrust for our sof government fromor the things th have happened over the course of history. Our g weve got to start establishing, reconcilingrt a bond between ou people and government before we can start making anything better. I think a lot of what ken said was true. Th i think there is a lot of sense of commonality. Its reflected here in the congress today. Et i think the president would agree with the notion we cant be baby sitting all over the world. I call them daish. This needs to be a worldwide effort that cannot be the United States effort to eliminate them. They need to be eliminated. We will eliminate them. Our country will work in con vungs with other nations of the world, especially in the region to destroy daieh and eliminate them. We need to get our president and Congress Working together. Thats why im in favor for are new use of military force the. Were working on one thats 12 or 13 years old. We need to pass a new one to give the president the authorization he needs to work in con jux to eradicate daish. I dont necessarily disagree with ken. Host the independent. Nevadas next. Petes waiting on our lip for p republicans. Good morning. Good morning, ougentlemen. First of all, you democrats are very sneaky on how you use u your language. For example, you talk about common sense any kind of reform, its automatically shuts down the bait because if you have an opposite view, it means you have no common sense. Nd it its very slick the way you guys play this game. O throug you always use the term, t semiautomatic and automatic weapons arebackgr illegal unles go to a significant background investigation. Publ illegal weapons at one point, you talk about how the American People is fearful. Im not fearful. Im angry. Im frustrated with our government. You guys cant vet people coming in here, you cant and dont. Clearly, thats evidenced by whats happening. Nobody knows anything about it. A with the refugees we bring in. And defend my own family. I dont think thats right. The terrorist watch list is garbage. Theres tons of names on there. I that shouldnt be on there. Theres no due process. We dont want the terrorist to know hes on the watch list, so, now, all he has to do, try to buy a gun, hes denied, i know im on watch list. Its ridiculous. You guys pete, let the congressman g b jump in here. I appreciatee petes commen i dont want to be sneaky, i want to be very direct. 2,000 people who are on the terrorism watch list have successfully over the last on te decade, purchased weapons legally. T here in the United States. 2,000 people on the no fly list on the terrorism watch list, have purchased weapons. Thats not sneaky. Thats a fact. Just letting you know that. Is the first responsibility of our government is protect the american citizens. The no fly list is in place h because it is believed that the greater threat and the duty that we have to prevent another attack like 9 11 for the flying public as well as for as i said, the citizens of our country, is to create a no fly list. It is an inconveniencnconvenien. No question about it. Life is inconvenient in trying to protect the American People and so, as well, with er using the terrorism watch list for the purchaposes of identify whether someone should have access to legally purchase a gun. Pete, i think you know, guns can be modified. You can buy one, modify it into a different tostyle. This is not a panacea either. Ooip not saying this is the onl. Thing we can or should do. But its something logical. We may disagree. Our logic may be different this seems pretty logical to me. Washington, d. C. Is next. Randall is here on our line. For democratics. Good morning. D i th i think one thing i never hear mention School District the guns. S of and i think thats the real, thats what republicans are really about. Is business. And i think thats really purpose of the nra. As a cover in show thag the business of guns in any way is h not affected. On one hand,nu if you never lai another gun in america, a nump guns for everybody, i believe we have one and i think thats lefi and probably the real purpose and drive of the republicans and the nra and its never, ever discussed, i dont know if it can be, but i think thats the real concern and i think thats the real drive and theyre using the Second Amendment as a tool to assist in that purpose. I dont necessarily disagree with you. It doesnt need more further comment. I think youre ws right. Te on h want to talk about an issue thats personal to you. The 9 11 Health Responders bill. Bring folks up to date on where that is and when the men runs out for that bill. Abou look fo these are men and women who r went down to the pile, ground zero, to look for their brotherb and sisters, to try to save their lives. To recover their bodies. Business to restore Lower Manhattan to some resemblance of commerce and of business. As i know many of my colleagues were told the air was clean. I dont think it mattered. Today, theyre suffering because of that. They have cancers, i know people with stage four cancers. People who may not live another respond to 9 11. We have an obligation not to forget them. They didnt say ill go in only if you tell me 14, 15 years from now, my government wont forget me or my family. They went in any way. We cant forget them. The law we passed five years agd expired and without s reauthorization and additional e funds, these men and women were facing death, certainwi cancers that are linked directly to the attack of 9 11. They will die. And they need to Health Care Coverage. They need tot know their government will be there for them. D in 2 the logic behind that fiveyear sunset for the law passed in 2010 was to allow forf a reviewor to see if theres an waste or fraud in this program. Has that review been done . S def theres been review after review. No one is defrauding the government here. If there is fraud,rn not suggesting there cant be, if there is, those individuals should be held accountable to the inth degree. They should be put in jail forever, quite frankly, but vere thatsnt not happening. Because of that, people are suffering. Without certainty,kn without knowing the government will be there for them and their families, as they fight these horrific cancers, it actually adds further burden to their health. And that makes them sicker. So, wheres the hold up right now . We were told that we are thed ledge islators who care about this. We were told this would be in the transportation bill and at the last moment, it was pulled thed bill and then we were told it would be in the tax extenders, then told maybe not,h well put it into theat omnibusl bill. Theres such uncertainty, what bill this willwe be used for as political fodder. Which i think is disgusting, that we would use the 9 11 bill, hero hero of our country, to delivern for them is being used in an openly political way to pass other trst legislation, i thinko wrong and not in the spirit of our country. Sheila is waiting, go ahead. G i just wanted to tell you that i had a different idea on n the subject of guns, how we e might bring this, i dont know if it will ntwork, but i see on of the greatest men in country music, johnny cash, the man in black, with his guitar strapped on his back with a words in bigs bold letters stating, dont take your guns to town, son, leave your guns at home, son, portrayed on billboards throughout every state in the ff usa. Now, my idea on this was he went to prison, performed for the inmates with his meaningful songs and when they got out, they choose maybe hopefully, they chose to live out the rest of their lives when they served their time and were welcomed back into society. As after they were released and ie thinking that you know, just maybe, the picture of johnny rc cash would flash across the memories stopping people from thinkinging about becoming radicalized or already will erase the desire to kill and as themselves, what am i thinking . This is not what johnny would do and i choose to follow his footsteps than take the chance of ever being ever able to rest in peace. Our minds are, our brains are like sponges. And they absorb goodness as for developing from birth and that o goodness says in a persons sub conscious throughout the rest of their life. T maybe, just maybe, in that eaveu instance, they would stop and think. Im hoping. And b a great idea. Leave your guns and boys home. Quoting johnny cash. Grea one of my heroes as well. I love johnny cash. Wonderful. Great thought, thank you. Congressman joe crowley, democrat from new york. Appreciate the time. Thank you. Great to be here. On thursdays, washington journal kentucky congressman Thomas Massey on fridays deadline for passing a spending bill to avoid a Government Shutdown and we talk to congressman robin kelly of illinois about the gun control debate following the San Bernardino shootings. Washington is journal is live. We take a moment to spotlight a recent article and this week,h were joined by elizabeth grossman, who us,cowrote this piece. What we didnt know is killing us t. Result of a six month investigation into the science of regulating toxic substances. Why did you conduct the investigation in the first place brought you to this topic . Thanks for having me on and what we wanted to know was why so many studies, scientific studies about chemicals that were done by researchers with e industry support were coming to such different conclusions than studies about the same chemicals by resernlers without industry support. We discovered a 30 plus year history and pattern that goes back to the r early 1980ss and i researchers at the department of defense and and c long pattern industry influence of the le Science Behind chemical regulation. Zbr as we say, it was a six month investigation. Lets set up the two stids of this debate. On one side are researchers who are in a field, regulatory toxicology, that look at the toxicity of chemicals and a lotr of thesenm researchers over the years have worked both for industry and government. And on the other side of the debate, our scientists who are biologist biologists, health affect researcher, scientists who relya on observation al experiments, i who look at how chemicals affect human health and the health of other living animals and the environment and on the other side, are the toxicologists, who are relying largely on computere modeling. Thats the crux of the difference here. The modeling thats done to try to understand how chemicals un are affecting our body. Explain what this term is. Fizz logically based of pharmacokinetic. What it boils down to is a kind of modeling that was r the pioneered by a group of resea h researchers working in the 1980s and the time when desktop Computer Technology was coming into play and all of a sudden, g it wasy possible to do these studies. What those do is toll low the path of the chemical through the human or other animal body. How look at where it goes. Froms what it doesnt tell you. Is what those chemicals are doing to those parts of the body and what happened was that these models, it turns out, they can be extremely useful, but they depend on the data and assumptions you put into them so itud turns out you can design those studies to influence their results. A few we look at in the stories of people who might be familia familiar, probably familiar with the problem, exposure from Hurricane Katrina when discovered from the plywood of the fema trailers. Of orns out those typesf models were very, very narrowly at a certain type of Health Effect when a single chemical bl can produceoo a range of Health Effects. By looking narrowly as a certai effect, you can down play the chemical hazard, the risk of the exposure and what has effectively happened is that nu theseme studies have been used delay the regulation of numerous chemicals. Doeso, what is a pbk study r formaldehyde show, liveim animae testing and other sorts of experience. It could show you there are different type of conferences that have been associated with formaldehyde. Different types of respiratory effects. But if you look more narrowly, at these studies, you could look at one type of cancer and not the other and come out with some conclusions that could say well, were not seeing the association between formaldehyde and leukemia, for example, when in fact you may have lots of people who are suffering from leukemiar who had a formaldehyde exposure. That could lead to down playing that Health Effect. Es this weeks story coming from in these times magazine. The Chemical Industry is using its sizable resources often with Financial Support from federal agencies to control the Science Behind chemical regulation, the result has been decades of delay in restricting hazardous and deadly chemicals. Ant its in theseto times, if you w to call in and ask questions. Elizabeth spangrossman is our g. Well start with bill from on h pittsburgh, pennsylvania. Line for republicans. Bill, good morning. G thanks for calling. Bringing up a subject, i wish i has been chosen later in the order because im not sure but the things that have ical m concerned me from the beginning is that there is a political movement. That says a correlation, if theres exposure followed by a Health Effect, therefore, the Health Effect was caused by the exposure. That seems to be the beginning. That opens the question of , ether there is causation and until you can show direct, having the government step in and ban the use of otherwise useful substances, it a situ essentially creates a situation where were in a bubble, a baggy, where we dont touch anything that hasnt proven not to be safe. Somebod you have hit the nail on the head of one of the biggest questions which is at what point does somebody decide to regulat or restrict the use of a hazardous chemical when so many chemical Health Effects do not result in an immediate and acute effect. But what we discovered in our working on our story was that chemicals even with direct acute immediate effects, one we looked at was meth lean chloride, used in paint and varnish strippers and the Occupational Health fati administration hasti counted numerous fatalities as a result ofev theseen products being use. Even dow chemical has not been effectively restricted or taken off the market in any way. You can go to your Hardware Store and buy products. Containing it even though theyve been connect ed with immediate fatalities and what we discovered was as a result of using this kind of computer modelinging, these studies and it is a perfect example, that we were able to find pap rs that said wow, as a result of the study, we have been able to effectively delay the Protection Agency regulating this chemical, which means keeping these protects on the market. So, yes, for numerous chemicals, its sometimes hard c to say this particular exposure immediately causes disease, but even for chemicals with acute ey effects, these studies have been used to delay regulation for 30 years. But isnt epa and the other regulatory agencies, arent they there to be able to sort through the data and studies and find the ones that are harmful . Anothe yes, thats what theyre supposed to be, but another thing we discovered is that as a result of 30 plus years of a revolving door tweep industry and government and industry ties, enormous numbers of that contracts. Select not only the scientific literature that goes into the e decision making, who, which hese people and the Chemical Industry has successfully promoted those studies. Ak and delay the regulation. They take on that topic in the story that goes along with x this. Big kemps tangled web of influence, the research group, the agencies themselves, the trade associations and trying to find the connections between them. If you want to read the story in the november issue of in these times. Shes with us to talk about hera story. Ted is waiting in new hampshire. Line four independent. Good morning. Oncern good morning. My concern is the chemicals thad in r in the food. W if you look at the chemicals in a bag of doritos, youll see ths yellow number 5 and all w this. They dont seem to regulate these things that were feeding our children. Im a food junkie from a baby boomer. This has been in my system for years and i feel more like a lab rat than a consumer and i think the food and drug needs to steph up andat make these politicians get a hand on lobbyists that want to change it the way they d want it. Because i think a lot of these f cancers we gotor can be prevent. Yes, thanks for that comment. And yes, one of the things thatt we realized and discovered looking back to this history iss this manipulation and promotion for a certain kind of science that favors Chemical Industry favor, whether its chemicals used in Food Production or that go into Consumer Products or industrial production. Wh history of influence, of the science, not just of the political process, goes back to the 1980s. Back to exactly the point in time when this countrys major environmental laws went into effect. Some of the food laws that youre thinking about go back even further. But the big environmental la protectionrol laws, clean air a clean water act, toxic substanca act, the laws that set up superfund and things like that, all those came into effect in the 1970s and 80s and it was a that time that this corporate influence of the science really got going. We found details from thats whats happened and thats how we end up with a lot of has down chemicals. Is this something that breaks down along party lines, along a whichge modeling is best here o . Stay within the regulatory agencies themselves . What we looked at is well behind the scenes of the political lobby iing that gets lot of attention. Ways t one of the thipgs we did do is look back at this historical revolving darr and in terms of history, the epa because it goes back to the erarly days of the epa. Both republican and democratic. Founded in a republican administration. It exactly, so, its not necessarily a partisan issue, but i would agree that at this point ins time, acceptance of l science has broken town on partisans lines. Vernon, good morning. Good morning. Im finding that chemicals as nuclear, the thipg about humanity and its nuclear aspect, it seems like when we created this stuff, we had a way of. Getting rid of this stuff and it seems like thats not going anywhere. I am a democrat. Seeing the reagans put a bomb on holy soil, im wondering, where are they putting the waste. Theyve got to be putting the waste in the soil. Of our most holiest land and i dont understand why. The issue of waste, pollut n pollution, leaving the environmental impacts, the Health Impacts to the end of the pipe so to speak, is an enormous issue. Reviou the system was set up to allow chemicals to be used until they are proven harmful and as g previous caller alluded to, proving absolute causation and harm is extremely hard and the e laws we have in place have set an extremely high bar. To look way upstream and ask the question ahead of time, what th kind ofth impacts might this hae before we let these things out into the world andth products a out, smokestack, anywhere else. E are there chemicals aloud under the current regulation in the United States that other o e country, other bodies, who perhaps have different modeling have banned and dont allow in their countries . Well, the answer is yes. Whether it depends on the modeling, not necessarily. But it depends on how the science is read. Fd we didnt necessarily talk about it in our oopiece, but th caller who asked about food colorings, thats a wonderful example. In eur they look at the those,s particularly the red and yellow. In europe, they said based on what weve seen, particularly for the effects on chirps health, we should think these should be used, so theyre not. Regulators in the u. S. , read them and said, oh, were not so sure and we think theres some e wiggle room for tdoubt, so, wel let them be used. And thats where it boils down. Whether youre, what youre going to look at in the science, and what youre going to decidet to do as a result, whereim you t the bar on when its time to protect you. Deborah is in lubbock, texas. You with us . Raffle is in washington, d. C. Line for democrats. Good morning. Un good morning. I think this is a greatde topic. One thing people underestimate is a total damage this stuff has donetou to us. In the 50e 50z, a scientist discovered lead was being spread via the exhaust of gasoline. Coy it led to neurotoxin. About 15, 16 years later, crime began to spike. Not just this country. It was every other country where they introduced lead. What we did was passing a three strikes youre out law. There was huge violent in the city. Ing th people moved, we lost take that back. An extra million to two Million People. We ruined lives and they kept gasoline into the mid70s, so, e the s. Epa was supposed to enfoc the law. They didnt do it. Basically, theyre a bought and paid for entity and the destruction to this country can be measure nd the hundredses of billions of dollars. If you look at the millions of lives lost. Thank you. For bringing up extremely important point. Eff thats delayed effects and that gets to heart of another really big issue that another big issue, that is there are a lot of kchemicals and science that has emerged over the past now even 20 or more years, that shows us that lots and lots of kem kag expo shoours can result in not immediate effects, but w chemical exposures that can for example, upset how hormones work and set the stage for chronic diseases, Health Problems that k show up years later, whether theyre Metabolic Diseases like diabetes and obesity or infertility problems or neurological problems and these delayed effects are difficult to deal with in regulation, but theyre real, well recognized. Oe so, yes, you bring up a difficult point about making sure we Pay Attention to the delayed effect. Still an individual is watching and tweeting still ar a individuals thoughts, its clea that the eps isnt the answer e after the release in colorado. The clean up should be paid by those who own stock during the pollution is still an individual. You can join the conversation at cspan wg or call in like mike did in charlotte, north carolina. Line for independents. Mike, good morning. Good morning. Im concerned about the amount of called for fund raising to findof a cure for cancer and it seems there could be a lot of prevention by eliminating chemical exposure. E thats my coulthought. T that is a point thats been very well researched. In fact, the president s council on cancer, president s panel ont cancer and maybe getting the name exactly, not exactly righta but they did a report a few ntru years ago that looked at environment alal exposure contributions to cancer and thar was the conclusion they came tol that, yes, research for cures, absolutely essential. At the same time, we could the be doing a lot more in prevention, pesticides, exposing Agricultural Workers and their families or many chemicals that paying attention to this and preventive basis would be an llv enormous Public Health benefit and in fact, theyve all come out and said we need to do moree prevention and getting these chemicals out of our environment on a daily basis for health n tn benefits. Glenn is in tennessee for democrats. Good morning. About i have a concern about plain Household Goods we use from al daytoday. How folks get away with not putting out any information to a the public . Yeah, thatst a very good point. Mical in its got a complicated history like so many things. Why it is that household products dont have chemical onr ingreend yent labels the way Food Products now do. Or personal Care Products now et do. In fact, tlas move afoot to get a lot more of this information out there and and this isnt necessarily what we looked at in our piece, but one of the things that a lot of the scientists wes did speak to who are biologists really concerned about Health Effects, pointed out it is concerns like yours from citizens its that concern of consumers who are reading about this science because its more ak siszto successable than ever who are starting to ask questions and putting pressure on their elections ange. Representatives and the companies they buy things from and this is starting to change. Wants us to follow the money. Who funds this study, what private funds as were talk at the studies here. Thats something we did look into rather extensively and one of the things we discovered, whichof seemed to us a little bc disturbing in terms of conflictf of interest is that a lot of the these studies are funded by , oi millions of dollars from chemical corporations who themselves, b obviously have an interest in these because they make them. With millions of government funding have gone into this research. Some its a very curious wrinkle in this revolving door of influence that some of these peresearch institutes have been set up in a way that they can compete and get millions of dollars that benefit industry. The story were focusing on is the cover story from novembers in these times magazine. Its what we dont know is killing us. By Valerie Brown and elizabeth grossmann. Here with us to talk your fort m questions andye comments. Icans. Youre up next from florida. Line for republicans. Situat id like mention what happened in 70s and the botul governments solution. There were outbreaks of salmonella, botchulism and what the fda decided to do was to incorporate in multiple forms and everything that is in a bottle or a jar. Which continues to this day. Unfortunately, what occurred as a result is everyone has in these foods, so, and they have alleviated an issue, but it created an epidemic. We did loot knot lonot look score, but acid into food, i think one of the points youre bringing up is making sure we have a thorough knowledge of what goes into our pruktss andid one of the problems with how we regulate chemicals in this country is that we dont in fact know very much about the Health Effects, the environmental effects of vast numbers of prou chemicals that are on the market and in products today. so, that does raise an important point, so thanks for that. Indepe out to wisconsin where paul is waiting. Line for independents. Good morning. Hi. Good morning. Bear with me a moment, take me a minute to get through this. You just hinting at it, my concern is about the lack of research and then therefore, the understanding of the combined d effect w of the every day exposures of chemicals and erydy carcinogens. Because of the current world we live in, every day experience ed lifestyles and the food and all the you know, air products and erthings. Everything. Our basic every day living. Thesh theres such a lack of understanding of how all of these chemicals together combine to have an effect in our s into biology. Because obviously, it changes when it comes into our body because our body itself is a chemical lab and essentially, so, the lack of understanding of what that effect actually is is a concern. Us does that, as you said, the Research Direction isre so cal focused, the models are so limited and focused on one chemical and aspect, theres another dynamic thats occurring here. You raised an extremely important point. Our chemical regulatory system,a the system we werete in fac investigating, does indeed regulate one chemical at a time. When in fact were all exposed i toca mixtures of many, many chemicals in fact before the d time we werety born. And the type of study we were looking at in our piece, these pbpk models are indeed very, very narrowly focused and one of the big criticisms, we heard tai about them, from biologists, is is that they completely fail to take into account the full rangi of different Health Effects that a single chemical could cause and also the fact that not every individual will respond are now similarly, so, that is a huge research gap. A huge gap in information. That scientists are now rapidly trying to fill. About ten minutes left befor. The house is scheduled to gavel in. Well be going there when that s happens, but until then, were talking withman elizabeth gros. Contributor to in these times magazine about our cover piece for the november issue, bad science is what is written on the cover. How the Chemical Industry has captured toxicology. Stopped regulation and put us all at great risk. Ing. Gerald is in new hampshire. Line for democrats. Good morning. Good morning. Thank you very much for taking my call and thank you for your research. And thank you for you research. Y. My comment today is about the corruption and greed in this particular industry. Er one if ms. Grossman could comment on this and also if the united. States is the number one chemical producer in the world. O we are the number one producer of the arms in the world, and i think thats why we haveth a lo of the problems with guns and gun control. We have been the number one arme country in the world. It seems like every time we are always having to take guns away from Different Countries that we give them to. Isis is a big example, but i dont want to get off track. I really appreciate your research because ive had people in my family of die of oxic everything from agent orange tof toxicor you chemicals and rtant hydrofracking. Go ahead. Thanks. I was going to say thanks for n your call. You raise a lot of points in that question, and one of the things that we can say for sure is that our political system ann our system for regulating chemicals has allowed political influence to enter into the system of regulation far more effectively than it does in chec otheral countries. Whether were the number one chemical producer at this point in time is a little bit hard to say. Theres an enormous lack of transparency about those kind of numbers and one of the things that has happened in part of as a result of chemical regulation is some of this manufacturing has moved to over places in the world where environmental oversight is far more lenient. Laws are enforced less stringently than they are here,l but its a global problem. How or you raise a couple of really important points about how our system allows political influence and also alludes to this global problem weve been t pushing o other places. The caller brings up the department of defense, but theres some history here with the pvpvk argument and the history of the department of defense. We traced it to a group of se researcherst at an air force be in dayton, ohio. Th at the time, there wase divisiof there that was y entirely set u to look at the toxicity of chemicals that were used by the military. As you can imagine, thera mility uses lots and lots of chemicals in everything from maintaining aircrafts and vehicles to making new materials for that is. Equipment, so they have a huge o interest in this. It just happened that they had a bunch of researchers there who c essentially developed this typer of t computer modelling and then went on over the next several decades to work at research institutes, to work in government agencies, and to fan out into industry as well doinge this type of research. So it may be coincidental, but there was a lot of effort atof e department of defense at the time into looking into chemical toxicity. Part of that coincided with the Clean Air Act and the clean water act. The government for the first ur time saying to anybody who uses fected chemicals were going to be keeping an eye on your toxic lie emissions. Lets go to sparks, nevada, where brett is waiting. O know w good morning. El caller good morning. Thank you for taking my call. I would be curious to know what elizabeths view is on geoengineering. All you have to do is look out your window and see whats happening g in our air and that not fog. Dropp thats geo engineering pollution. Do you have anything about what they are dropping on us daily iy our environment that were existing with their defecated red blood cells and aluminum and barium andno stromium . We did not look at geo tists a ineering in our story, but number of the scientists that we talked to have on many occasiony pointed out that the environment in which all of us live is now chemically different than it was at any other point in time and as a result we are experiencing chronic Health Problems that are again really hard to link directly to a specific cause a specific exposure, but there i lots and lots of associations that paint a very , convincing picture that we are pushing human health in a certain direction and in fact i one biologist that we talked ton said if we actually wait for the human data to come out like thee animal data are, we may not be. Reproducing as a species, she feels so strongly about it. Good morning. Caller yes. How are you doing, ms. Grossman . I love cspan because you get a lot of information. Out i i was over in vietnam. I came back and found out i had some of the agent orange that was in my system, but anyhow, they banned that here in america and then turned around and sold it to mexico and used it in vietnam. The republicans have no common sense because i believe theyre being paid by the Oil Companies and fracking. They use all different kind of chemicals. I believe americans need to know what kinds of chemicals they us, in fracking. They want to get rid of the epa, the republicans do, but theyvee shown who isan lobbying them. Maybe all the americans can see. If we get a republican in there, they dont care nothing about clean water. They dont care nothing about the environment and dont believe about climate change, so were in trouble. Go ahead. Thanks for those thoughts. Im sorry to hear about your experience with agent orange. One of the points that you rais is something we grappled with ih our research, which was an enormous lack of transparency, whether it is in who is doing the research, making decisions f aboutor regulation. Theres a terrible lack of transparency, and that makes it very difficult for people to understand whats going into products, whats being used, and again what kind of science is ny behind making these decisions. One of the points you raised a, about the transparency is an enormous problem. Lets go to montgomery, alabama. Alfred, good morning. Youre on the washington who journal. Or t caller there was ahe f book written by a biologist who worked for the food and drug Se Administration around the late w president kennedy administration. She wrote a book called a silent spring referring to the environment. In other words, she was trying to say were in a vicious circle. She called it environmental oh, my goodness. I forgot the title, but the book was written by rachel carson. It was titled the silent spring. Were talking about environmental poisoning. I read an article sometime ago about dow chemical and one of the largest Seed Producers for farming. They chemically treat seeds to discourage weed growth and produce an abundant harvest. I hope you can talk about that. Rachel carsons book called t silent spring concerning environmental we got it, alfred. Well try to get it in before the house comes in. Yeah, i will try to pull that all together. Yes. Rachel carsons silent spring was published slightly more than 50 years ago is considered a watershed landmark event in raising Public Awareness and in fact legislators, politicians, awareness of the effects of ven. Toxic chemicals. And she was wayea ahead of her time, pointing to hormonal dmarn effects. That set off and is credited acs with pushinget the federal government to enact some of our landmark environmental laws, so that in fact set off a whole log of scientists and a lot of research that has been absolutely instrumental in protecting human health. I want to thank elizabeth grossman. Its in the november edition of in these times. Appreciate your time this morning. Thanks so much for having me. Coming up tonight on cspan 3, samantha power, the u. S. Ambassador to the United Nations. And a look at the u. S. Health care exchanges under the Affordable Care act. Next, samantha power, the u. S. Ambassador to the United Nations, testifies at a Senate Foreign Relations Committee hearing on u. N. Peacekeeping efforts. Members also hear from former Bush Administration diplomat johnn negroponte. The Foreign Relations committee has come to order. I want to thank our witness [ inaudible ] significant responde responsibilities right now at the u. N. Security council. Quite educational, i hope, on both sides. We certainly appreciate you being here and certainly ill introduce you in just a moment, but todays hearing will review United Nations peacekeeping operations and explore opportunities for reform to make u. N. Peacekeeping work better in the u. S. National interest. As a permanent member of the Security Council and the largest contributor by far to the u. N. Peacekeeping budget, the u. S. Has a particular interest in how u. N. Peacekeeping mandates are set and operations are carried out. The United States cannot be everywhere all the time. Theres an Important Role for u. N. Peacekeeping and supporting u. S. Interests for security and stability around the world. Todays u. N. Peacekeeping is evolving in many ways. U. N. Peacekeepers now are being asked to take on new and difficult responsibilities such as civilian protection, disarming active combatants, or developing the capacity to engage on the antiterrorism front. These new missions and mandates raise many questions, which we certainly will be exploring today. What are the risks when u. N. Peacekeepers actively engage combatants in a war zone . The u. N. Peacekeepers forego their neutrally in these situations. If u. N. Peacekeepers are asked to provide Logistic Support in humanitarian crisis such as the ebola fight, what challenges does that raise . I am particularly concerned with recent disturbing reports of Sexual Exploitation by certain u. N. Peacekeeping troops. The current u. N. Peacekeeping policy is zero tolerance. So its our hope to find some common sense ways to address these issues and explore these and other topics such as u. S. Peacekeeping assessment. I want to thank our distinguished witness for being here, and ill turn it over to our Ranking Member for his comments. Thank you, chairman corker. I appreciate you convening this hearing on an important topic. And i want to thank all of our distinguished panelists today. Extraordinary individuals who have given so much to our country. We thank you all for your participation and your continued service to our country, particularly ambassador powers. Good to see you here. I have long believed the United Nations at its best can be a powerful partner of the use advancing global peace and security with far less cost and more effectively than if we act alone. When you add the u. N. Presence, its a Global Presence and thats far preferable than having a u. S. And sole one country presence. The u. N. Assists more than 60 million refugees and displaced people fleeing conflict and persecution with lifesaving assistance. It vaccinates 58 of the worlds children. Recently it launched the Sustainable Development goals, which if fully embraced could have a powerful impact globally on reducing corruption. In short, the u. N. Is capable and has already done a great deal of good in the world, but i believe the u. N. Could be stronger and much more effective if there were Greater Transparency and more accountability across the organization. In the case of syria, the assad regime continues its barrel bombing and slaughter of civilians and those responsible for war crimes have yet to be held accountable, but lets be clear. The United States could not ensure International Security alone or should it have to. The United Nations and u. N. Peacekeeping is one of the best burden sharing tools we have to protect the civilian population and secure territory. By drawing upon the financial and human capacities, the u. N. Peacekeeping helps the United States share responsibility for promoting global peace. Unio u. N. Peacekeepers now represent the largest deployed military force in the world. There are more u. N. Peacekeeping missions today because peacekeepers are being asked to do more in deadly environments. We need to recognize this and make sure that the United Nations and the troops and contributing countries are giving peacekeepers, who are placed in harms way, the protect of equipment, training, and support they deserve. Peacekeepers themselves are often seen as legitimate targets of attack by extremist groups. We saw that in recent attacks in mali. U. N. Peacekeeping mission in mali has suffered 42 fatalities at the hands of the militants since january 2013. We know that the u. N. Peacekeeping is a costeffective tool when compared to other military options. The budget makes up only about 0. 5 of the worlds total military expenditures. I think this is a particularly important moment in debating trying to balance our budgets. The u. N. Mission, the cost per peacekeeper per year is about 16,000. In 2014, each u. S. Soldier in afghanistan cost 2. 1 million. Moreover according to the study by the gao, u. N. Peacekeeping operations are eight times as expensive than funding a u. S. Comparable force. The scale of the assessment should be reworked, and im confident that ambassador power and her u. N. Team are focused on that goal as wel i have long been concerned about these reports of Sexual Exploitation and abuse. As the permanent member of the u. N. Security council the United States has the responsibility to make sure the u. N. The failure by the United Nations to hold individual peacekeepers, they command their commanders and troops, accountable for these abuses is unacceptable. The represe thats only a start. More must be done by both the United Nations and the member states, and i look forward to hearing about how the United States can continue to push for these effective reforms. I look forward to hearing from our witnesses and having a robust discussion. Thank you, senator carden. We have two distinguished panelists today. We want to thank all who are here to share their wisdom. Our first person is the permanent representative to the United Nations, samantha power. We thank you for being here today with a very tight schedule. We thank you for bringing hailey back, who served so well with senator coons here and was one of the bright people we had here on the committee amongst many, but we thank you both for being here. If you could keep your comments to about five minutes or so, wed appreciate it. Then we look forward to q a. Thank you so much, mr. Chairman, Ranking Member cardin, for convening this hearing and members of the committee for making the time to be here for this meeting. Weve seen time and again how conflicts with displace millions of people, up end markets, and destabilize entire regions. All too recently and all too frequently, weve seen how such instability can attract violent extremist groups to recruit new members and plan, launch, or inspire attacks. U. N. Peacekeepers play a vital role. As president obama said in september, we know that peace operations are not the solution to every problem, but they do remain one of the worlds most important tools to address armed conflict. Peacekeepers can deny safe harbor to extremists and protect civilians from atrocities, all of which reflect deep American Values by ensuring greater burden sharing by the International Community. This organization has been working aggressive to ensure u. S. Peacekeeping operations are better able to meet the demands of International Peace and security, which has been noted by both the chairman and the Ranking Member, those requirements have changed considerably over just the last 20 years. Peacekeepers today are undertaking more missions. The number of uniformed personnel has risen from 20,0 20,020,00 20,000 15 years ago to 1,000 today. They are assigned broad and increasingly complex responsibilities ranging from disarming armed groups to protecting civilians from those who wish them harm. Today 98 of uniformed personal in u. N. Missions around the world are under orders to protect civilians as part of their mandate. This is not your mothers peacekeeping, your fathers peacekeeping. While peacekeeping has never been more important to american interests, its also never been more demanding. Thats why in september president obama issued the first president ial memorandum on multilateral peacekeeping operations to strengthen and modernize operations by providing u. S. Support and leading reform of u. N. Peacekeeping. I want to briefly, mr. Chairman, touch on a few key lines of effort we have pursued. First, we are working to ensure that countries with the will to perform 21st century peacekeeping, that they have the capacity to do. One way were doing this is there aprep. Through aprep, the United States is investing in six african countries. It will help ensure that more soldiers deployed for peacekeeping missions will be fully prepared. I hope that the senate and house will fully fund this Important Initiative in future years. Second, we are expanded the pool of troupe and Police Contributing countries and bringing advanced militaries back into peacekeeping. There was a summit at the u. N. To rally new commitments to peacekeeping, marking the culmination of a yearlong effort initiated by Vice President biden. 49 countries participated and pledged nearly 50,000 additional troops and police. Not only that. More of these troops will now come from advanced military to bring with them equipment and expertise that is critically needed on the ground. We saw this in mali in january this year when dutch attack helicopters helped repel fighters on their camp. The United States is making contributions in this respect as well. Looking specifically for ways to leverage our militarys abilities to support peacekeeping operations, including faster deployment by others. Third, were working to ensure a higher standard of performance and conduct once peacekeeping contingents are deployed specifically in two critical areas. The complete fulfillment of their mandates and the combatting of Sexual Exploitation and abuse. It will allow the u. N. To be more selective as to which troops it deploys and giving it the leverage to repatriate troops and police when necessary, especially in instances where there are allegations of sexual abuse. They have to use force to defend themselves, to protect civilians. Too often, in the past peacekeepers have shied away even when atrocities are being perpetra perpetrated. A report last year found that in 507 attacks against civilians from 2010 to 2013 peacekeepers never used force to protect those coming under attack. Thousands of civilians lost their lives as a result. This cannot continue. The 50,000 additional troops and police should enable more police to staff these missions. The same is true on Sexual Exploitation and violence. We share the outrage of everyone on the committee, all the American People who are focused on this issue. Peacekeepers must not abuse civilians. Sexual abuse and exploitation have no place. It goes without saying in any society it is especially abhorrent when committed by those who take advantage of the trust that communities are placing in the United Nations and those responsible must be held accountable. Addressing this scourge will require continuing the important efforts to strengthen the implementation of a zero tolerance policy, including pledging to set up an Immediate Response team to investigate certain cases. It will also require more vigilance and follow through. There must also be far more transparency in these investigations to ensure that justice is served. The u. N. Should be able to take advantage now of this newly expanded pool of soldiers and police by suspending from peacekeeping any country that does not take seriously the responsibility to investigate and if necessary prosecute allegations. The fourth priority is to press for bold Institutional Reforms within the u. N. Itself. We have seen the u. N. Secretary make profound changes to peacekeeping from logistics and sustainability to military police, but much more needs to be done. We have spearheaded efforts for penalty for troops who show up without the necessary equipment to perform their duties. We will continue to work aggressively to cut costs. The u. N. Has already cut the peacekeeper cost by roughly 17 since 2008. We are also working to advance the reforms proposed by the secretary generals High Level Independent Panel on u. N. Peace operations, which are intended to address inadequate planning and a current set of rules around people in all of the areas i have just described, weve seen improvements and the United States has played an instrumental role in making them possible, but theres much more to be done. Were not satisfied with peacekeepers fulfilling a ining but not all of their mandates. The role played by peacekeepers today is too important for the sake of our own interest and security as well as for the millions of innocent people around the world. Well continue to work to strengthen peacekeeping. We appreciate your interest and support and continued dialogue on these matters. Thank you. Thank you very much for those comments. Senator isakson and i were four years ago infuriated by the caveats the u. S. Peacekeepers had. They could only fire at people when they were fired upon. People abused. People being murdered. And yet those caveats existed. Weve evolved. That is not our fathers peacekeeping mission anymore. As we have evolved these missions and people are placing themselves as peacekeepers more in the center of conflicts, in some cases taking sides, how has this changed the way the u. N. Is viewed in these peacekeeping missions . I assume you believe this is International Interest for us to be in this. Certainly i do. But how has this changed the way these blue hats are viewed in these areas . Thank you, senator corker. Its an excellent question. I think one of the lines that the u. N. Struggles to walk is that it has on the one hand peacekeepers that are charged with an aggressive enforcement of mandates, which entail protecting civilians not just protecting peacekeepers themselves as was once the case. You have that on the one hand. Then you have them all driving around in white vehicles, unarmed, passing out food, providing shelter, trying to provide counseling to those who have been victimized by sexual abuse. So its been challenging. The blurring of functions across these missions. But the only thing worse than confronting that challenge of having people in society distinguish who does what is actually having people in these societies rely on peacekeepers, know that the mandate says protect civilians and have those peacekeepers bunkered and more interested again in collecting a paycheck and then going home than actually being out and about and delivering on the promise of that blue taflag. The statistics are not inspiring. There are still many troop contributing countries who send their troops in without the very strict guidance you will be sent home if you dont enforce the mandate youve been given. As i understand it for some of these countries, even though the cost to us is far less than having u. S. Soldiers there, its still the pay for these soldiers thats far greater than they would otherwise receive in their own countries. That money goes to the countries. And so theyre benefitting financially, these countries, in sending these troops there. Is that correct . In some of the lower income countries. Is that feeding the situation of actually having troops there that are not, if you will, carrying out their mandates in an appropriate way, not qualified, not equipped . Talk to us about what is driving having folks in the peacekeeping mission that are not conducting themselves in a professional manner. Thank you again, mr. Chairman. It reflects a real understanding in the dynamics of some of these missions. Again, the performances are uneven. The motivation is uneven. If you take rwandan peacekeepers, they are totally driven by what happened in their country 21 years ago and actually view protecting civilians as a way of showing the world what should have been done when the genocide unfolded in rwanda. Contrast that with other troops who institutionally are not given the guidance from capital that they need to be out and about, that, yes, there are risks entailed with patrolling, but there are risks by being bunkered. On the specific question of the stipend, this is a very good deal for the american taxpayer. These are extremely difficult environments not only because of the risk of militia and Government Forces targeting peacekeepers but the conditions in terms of logistics, access to water. I mean, these are missions that are not expending resources in the manner that our missions do when they deploy internationally. The logistic tale is not nearly as fulsome. Some countries are doing it because theyre able, again, to secure Additional Resources that they are investing in ways that sometimes we dont have full visibility into. Sometimes into professionalizing their militaries. Sometimes in other parts of their government. But we are getting a lot out of the 100,000 plus troops that are active in these conflict areas. If you look at mali and lebanon, places that are cuttingedge theaters in terms of terrorism and extremism, if it werent u. N. Peacekeepers that were there putting their lives at risk, it would come to the United States at some point to advance our security. As it relates to the issues of the abuse thats taken place thats obviously abhorrent, i think people on both sides of the aisle have concerns about the u. N. s ability to put reforms in place. I know you talked about the leaders desire to create reforms. We sent a letter suggesting that we have on site courtmartials by the way these particular soldiers actually report too, not by the u. N. Itself. We also made some other suggestions. What is your sense that those types of reforms can be implemented relative to peacekeeping . Through the life of the u. N. , you have a challenge always on reform in the sense that there are two places you have to secure will and follow through. The first is with the countries that comprise the u. N. Every troop contributing country to peacekeeping has to be prepared and implement in their own military changes to ensure follow through, oversight in the first instance, follow through on investigation, and accountability whether a courtmartial or some type of prosecution. Every country has it own set of procedures, again, for following up on abuse of any kind. Then theres the u. N. Itself, which has to be much more aggressive in shining the spotlight on the countries that are not taking the steps that are needed. I think weve seen improvements. This is, again, not something one should cite as an improvement. But those individuals who were alleged to be involved in sexual abuse are not being paid by the u. N. Theyre being recalled to their capital. Training and vetting now is changing so there is training on preventing sexual abuse and exploitati exploitation. You had an idea in your letter about a claims kind of commission. The u. N. Is looking at creating a victims support trust fund, which is something we would wish to support as well. Maybe some of the docked pay of those against whom their allegations could be used in service of such a fund and then i think having more aggressive on Site Investigative capacity so that less time passes between an allegation and actual follow through. Lastly, the two aspects of reform come together in order to secure reform, meaningful reform, there has to be more transparency between whats actually going on in the field and what were made aware of in new york. Too often we hear about sexual abuse and exploitation rather than from the u. N. Itself. If were going to go to a developing country and try to enhance their capacity, their training on the front end, we have to know whos been accused of doing what in what period in order to be able to offer support. We have to know so we can look at our bilateral leverage. Thank you. My time is up. As a courtesy, i want to move on. I do hope through questioning at some point i know the president had made additional pledges to the u. N. Beyond our normal peacekeeping budgeting, and i hope at some point itll come to light as to where those resources are planning to come from. Thank you again for being here. Senator cardin . Thank you. As i said in my opening statement, im a strong supporter of the mission of the United Nations and the incredible progress it has made in global issues. I want to talk about tr transparency and accountability. One of the, i think, clearest ways to try to help the safety of civilians is to hold president assad of syria accountable for violating International War crime type activities. So do we have your commitment as our ambassador in the United Nations that we will seek full accountability by president assad for the war crimes hes committed in regards to the resolution of syria . Thank you, senator. Let me say one of my more unsuccessful days in my office since this body was good enough to confirm me for my job was pursuing a referral of the war crimes and crimes against humanity carried out in syria to the International Criminal court. That was a resolution we brought to the u. N. Security council, not wiwithstanding our own participation. Of course that effort at a referral was vetoed by russia and a veto supported by china. I do understand theres going to be negotiations that will involve the United States and the United States is going to have to sign off on those negotiations. Do i have your commitment that your position at the United Nations will be to hold president assad accountable for the type of activities you just described . The ultimate settlement in syria is going to be between the opposition and the Syrian Government. The United States position on accountability, i hope, is well known. We are absolutely supportive and have been aggressive supportive in building and evidentiary base. Its not up to the government and opposition to determine whether a person has violated International Standards on conduct of war. War crimes are global. Its a global accountability. Two separate issues. One is what is the standard of the threshold question for where accountability should be provided or whether prosecution there are a whole set of tactical questions on how accountability should be pursued. Theres a related overlapping question of what the terms of a political settlement would be. This is not something that is on the verge of happening, so i think the details on accountability have not yet been fleshed out. And its something we should consult on, but i want to underscore the final agreement has to be something that both the opposition and the government can get behind. I understand that. That doesnt quite answer my question. Let me make my position clear and i think the members of this committee. If president assad is not held accountable, there will not be support for any solution in regards to syria. I want to make that clear from the very beginning. Let me talk to issue number two in transparency and accountability. If this is not done in an open manner where there is complete understanding and disclosure of what is taking place, the confidence factor of those being held accountable will not be there. I agree completely. Im not sure what to add. As i said, there has been insufficient reporting back to the Security Council. We have now taken sexual abuse and exploitation made it an issue to be discussed in the Security Council. Ive seen the specific recommendations and theyre good, but they have to be followed through. It has to be done in a way that the International Community, the activists, can be confident that those who are responsible have truly been held accountable so this will not happen in the future. That i think is the important point. Its not just a closed investigation, but that we have an open closure of this issue and a commitment on how to go forward in how these matters will be handled. Its fair to say that victims who come forward do so at their own peril and dont do so with confidence. Having taken that risk, theres even going to be accountability on the back end, and that has to change entirely. If it does change, you may well see more people coming forward. Let me get to my third point on transparency and accountability and that is the Budget System at the United Nations. Its anything but open and clear and transparent. Thats nothing new. Its been that way for a long time. Its hard for me to understand why our assessment on the peacekeeping is 28. 36 , if im correct, which is almost three times higher than the next country and is significantly higher than our general allocation for the u. N. Budget. That doesnt seem to be to me a transparent way to budget. Can you briefly inform us as to the u. S. Position of a fair allocation of budget . The formula on which the u. S. Share of the peacekeeping budget is a very complex formula. Let me say in brief that its some combination of our share of the Global Economy, plus a premium we play by being a permanent member of the Security Council and getting to dictate whether a Mission Comes into existence and whether it doesnt along with the other permanent members, so we pay a premium for being a permanent member. We were able to secure the cap on our regular budget. The formula would have us pay at a higher right if not for the 22 cap that ambassador holbrook secured going on 15 years ago. The one thing i want to stress is our emphasis is on ensuring that countries that are contributing more to the Global Economy are paying more of their share. We are in the midst of scales negotiations now on our share of the peacekeeping budget. Our emphasis has been on ensuring countries where you can see their economic growth, but you dont see a correlation in terms of their contribution. The chinese contribution to peacekeeping has more than doubled in the last ten years, and i think we can anticipate that the chinese share is going to be up around 10 , which would be a triple. The russian contribution has doubled. We should point out china is still less 1 4 of the United States and russia is 1 8 of the United States. The 22 cap, we understand that. That was well deserved the way that came out. It looks like that the United Nations is equalizing through the peacekeeping percentage and that the 22 cap is being violated because of our higher contributions to the peacekeeping efforts. I just urge you the more transparent this process, the better its going to be, i think, received politically in our country. And we do think the 22 is a fair number, and we think it should be honored and it should be honored in the peacekeeping. I want to underscore when the agreement was secured on the 22 cap no similar agreement was secured as it related to peacekeeping. In fact having the 22 cap actually helps us in the peacekeeping realm because 22 becomes a baseline on which these premiums are agreed to. I want to stress we share the same objective. We want to get other countries to step up and pay their share. If you look again at what this means for u. S. National security, i think this is a version of the argument you made at the beginning, that having the even when you compare it to nato where the United States bears the lions share of defense investments, that having the rest of the world paying 72 of the peacekeeping budget is a good deal for the american taxpayer. My last point, the safety of civilians is critically important. You stressed the increased number in the commitment in the meeting in september. Its not matter of numbers of personnel. Do they have the will to go in and stand in front of civilians to protect them . We havent seen that. Im not sure i was comforted by your reply that we have a greater capacity by number. If we dont have greater capacity by will, the civilian population is going to be at great risk. The point that i emphasized in my testimony is we have succeeded now in getting contributions commitments i should say from advanced militaries. Europe had gotten out of peacekeeping by and large over the large last 20 years. We think, again, giving the u. N. The choice now it has a pool from which it can choose. If there are people who show insufficient will and want to spend more time in their bases, we think having this pool of forces, which include more professional and advanced militaries and better aviation and engineering and infantry capabilities, giving the u. N. That selectivity is going to mean over time the performance of these peacekeepers is going to improve. Numbers alone dont mean anything if you have 50,000 commitments of people with no political will. But we see sustainable commitments from those who we think do have that will. I want to thank the Ranking Member for bringing up an issue that is brought up consistently certainly on our side of the aisle also. I want to thank him for that. With nato, which i know is not within your jurisdiction, we have become the provider of Security Services. And our nato allies, generally speaking, the consumer of Security Services. The same thing is happening with the peacekeeping at the u. N. I know its a different set of actors, but the very people that stymy our efforts to enforce china for instance is taking advantage of us. But i think we continue to be not as good as we should be at forcing other nations to be responsible, so i want to thank senator cardin for bringing this up. It is infuriating, infuriating, to have the lack of transparency that does exist at the u. N. I think over time it will erode support. Its not particularly high because of the many issues that we see going unattended like not dealing with the Ballistic Missiles that are being fired in iran. Im glad theres bipartisan concern. I hope you can address it. Senator perdue . Thank you, mr. Chairman. Let me echo that too. I want to compliment the Ranking Member for continuing to bring this up. I want to talk about that in just a second. Right now, were spending about 2 billion just in the peacekeeping force in the United States. I think thats our contribution. Because of the assessment, were some 345 million in arrears in terms of what the u. N. Says we owe them. Id like to point out also, mr. Chairman, its not just the percentages here in relation to the size of the gdp. Its also, i think, should be taken into account the percentage of the gdps in this countries that spend on their own military. That also bears to the Global Security situation. I think given the situation we have in the United States 35 to 45 of what weve been spending is borrowed. I have two quick questions. First, i want to thank you for what youre doing. Given your High School Years in georgia, we claim you and were proud of what youre doing. I want to talk about hezbollah and lebanon. Some 12,000 troops are there of the u. N. Resolution in 2006 strengthened the mandate there to preclude the illegal transport of weapons into lebanon and yet we know today they have an estimated 120,000, 150,000 rockets, some of these guided weapons, and it is very troubling. It looks to me like if that mandate were directed to keep weapons out of lebanon, theyre faili ining against that mandat. Weve had reports that there reprisals if they report violations. What can we do to strengthen there and preclude the transport of these dangerous weapons . Unifil has played a role since 2006 in calming the situation, but theres no question that hezbollah has been able to maintain and expand an arsenal. We have and continue to urge uni fil to be more aggressive in patrolling and monitoring about violation of the unifil mandate. Youve seen more transparency on the part of unifil. Part of the problem is when you have when youre not at war with those terrorist organizations, youre using political pressure particularly by lebanons own sovereign institutions, which are themselves very weak, youre shining a spotlight. Youre trying to ensure interdiction of weapons before they even get into the theater in question. So unifil is not a perfect fiction for everything that ails lebanon or for the threat posed by hezbollah, but it has a responsibility to be vocal and to take very seriously its reporting mandate so doesncount in the region, including our friends, know whats happening in an area from which threats have come routinely in recent decades. Let me ask you to add a comment or two about syria. Can you speak to their role now and how are they interacting with idf . I have one last question. Thank you. Youre right that theres been a reconfigure ration. This is something idof has done in israel. Given the stakes here, it is a response to nustra made advances on one side of the line. Actually kidnapped some of the u. N. Forces. Exactly, senator. They did and the release of those forces had to be negotiated. I say even that incident showed its not the same as civilian protection, but an unevenness in how the different units responded which is life in the u. N. , some holding onto their weapons, refusing to be cowed, others handing over their weapons, unfortunately in a manner that left idof weaker. We again view this as a temporary relocation. We still believe the prior configuration is the stabilizing configuration, but i think the israelis are aware that the circumstances dont lend themselves to putting the observers on the other side of the line. The last question i have with the time remaining, ambassador, is the chairman mentioned it, but the violations of iran, weve been concerned that iran would violate our agreement incrementally. Theyre violating the u. N. Agreement with the launch in october. Then we have reports in the last week or so of a second launch. Whats the u. N. Doing in relation to the violations and the sanctions that back them up . This is something ive had occasion to talk to the chairman about. Its music to an u. N. Ambassadors ears when resolutions just roll off the tongue of members of congress. Resolution 1929 has been an incredibly Important Foundation to the sanctions regime. As soon as we confirm the launch, we brought it to the Security Council. We now are going to be discussing it on tuesday, the u. N. Machinery always works slowly. The panel of experts is looking at it. We provided all the information we have on it. In a way, the Security Council is an important venue for increasing the political costs on iran when they violate resolution 1929. I would note, of course, that the jcpoa is aimed at dismantling Irans Nuclear Weapon Program so that the threat iran poses in any aspect of its military is much diminished. The Security Council sanctions body operates by consensus. This is something that over time benefits the United States, but on Something Like that it means we have to convince all members of the committee to support our desire, designations, or any further form of accountability. What is the u. S. Moving forward . Were going to get the report back from the panel of experts. Well discuss it in the committee. Then well look at what the right tool is. I think it is important to look at the bilateral tools we have. We have sanctions on ballistic missil missiles. So trying to secure a nexus between this launch and any particular individual and entity is a challenge we need to take on. Looking at the Security Council and our bilateral tools complementary is important in this record. Thank you. We both everyomphasized with th Security Council, we thought they might got a dminus. An f. Total hoax. Nonaction here is just going to empower them to continue to violate. I think what the ambassador just said is the u. N. Is going to do nothing. Nothing because china and russia will block that from theyre p their bilateral efforts. Its disappointing. We provide the resources that we do and, yet, we have countries that will not cause other countries to live up to their obligations. So for disappointing. Senator . Thank you, chairman and Ranking Members. Thank you for your tireless and dedicated service. And for your passion on behalf of our nation. And on going work. Im pleased to here that theres not immediate finance ministers around the un council and look forward to continue to work closely with you and secretary lu and others of the administration to make sure that we are using all the tools that we can to enforce the sanctions that remain in place. And to impose sanctions should we deem so. Ive had the opportunity to visit u. N. In the field in a number of countries and have seen both the positive that they can accomplish and particularly where as you noted in your opening testimony, the disconnect with the trained equipment leaders. I just spoke with whether theres a mismatch whether Security Councilman dates and what countries are trained. For the president s leadership in revamping militaries and not just logistics and intelligence but troops. How do we connect mandates and the capacity to deliver in the field. . This is something senator mentioned before, which is the contracts with nato. I just want to underscore this. This really is an example where we have National Security interests in peace keepers in troops from other countries performing ably. This is not a nato situation where we are carrying a disproportionate share of the trooper. Were carrying a large share of the finance burden, and u again, thats something were working to ensure is al kated more fairly. I think on the mandate troop contributor disconnect, which is real, and i think its written across the board, something you have to do is get more quality groups. It has been, as you know well, a supplydriven market, as far as the un basically goes with Different Countries, you know, standing army, you know, that exists in new york, the secretary general doesnt have anything beyond he can extract from un member states. And that process. And theres going to been an effect on the ability to perform the man dates. There needs to be more prioritization. Its hard in the real world to prioritize because you look at a situation like that in south sudan or that in congo. And what a task those peace keepers are slated to perform. Would you give up . Would you give up demobilization . Would you give up human rights monitoring . Would you give up attention to child soldiers . Of course not. And so you need to make sure that the missions are rightsized. You need maybe to do some sequencing in terms of building out some of those capableties over time. And the u. N. Country and their own Bilateral Assistance Needs to be involved in state institutions. I would challenge all of us to imagine what any one of those countries would be like without this somewhat stabilizing presence. But its not going to be a cure all for leader that is are krupt. Gld i continue as an appropriate xx to advocate for funding Peace Keeping and for dealing with some of these challenges. Its very encouraging for me to see your engagement and hard work. For this to be Cost Effective an, yet, refleblgt our values, we need to make some Real Progress in the areas around accountability. Let me just ask sort of the last question and then take what time we have left to answer. Im concerned about the peace keepers both in africa and globally. China made a pledge of 8,000 peace keepers. And im concerned about how you see that planning on Going Forward and how we can sustain that investment. Thank you. Basically, told us anything he can do to ensure that these commitments are followed through on, hes prepared to invest his own time. So we are dealing with the set of challenges at a level that i dont think weve seen before with the aggressiveness that we vrnt seen before from the United States, notwithstanding the fact that successive administrations have seen the value of this tool. I any the china question comes together a little bit. We have a major issue in terms of the delay between the time a mandate is given to u. N. Peace keeping force. Aprep is designed to take six militaries, and having plit k58 will to go to dangerous places. And we ape to ensure deepening provision and the particular forms of training we offer that they can get into the theater more quickly than they happen up until this point. Sometimes we have to swoop in and carry people into harms way. But they need to acquire over time to lift and self sustain and, again, this ability to if not be formally on standby, to be ready to go when the 911 comes. Chinas commitment offal e 8,000 troops is a very large piece of business. Of how they imagine that set of forces over time. Right now, theyve just deployed their first Infantry Battalion ever. Their reports are quite promising. So, you know, we need to look and see how the umt n. Chooses to use that commitment. Rapid response, if that were something that china could put on offer, you could actually use less time. In south sudan, were still two years after the original employment. Thats occurring in a pattern across. So we welcome Rapid Response and, of course, we also have to make sure that were willing to protect civilians and put themselves at risk for the sake of the mandate. Thank you. Thank you, mr. Chairman. And thank you madame ambassador for your time and testimony today. Thank you, as well, for your service to this country. This is a clear violation of these rez luxs. After first launched in october, we first, as you said, called on it to review this quickly and recommend appropriate action. On october 22nd, i believe you stated the United States will continue to press the Security Council to respond effectively to any future violations to u. N. Solutions. So, as of today, as the ewe nielted nations Security Council taken any action in response to the missile test . And i think the response is no. Theyre meeting tuesday. Is that correct . Yeah, beyond discussions of the matter, theres no follow up action discussions are a form of u. N. Action. Its a little bit like a hearing as a form of congressional action. So, you know, weve had multiple discussions. The tuesday meeting. Can you describe the actions that will be taken at that tuesday meeting . We will be in a position to launch. Were not yet in a position to confirm. Again, we have taken action. We confirmed the u. N. Security council and weve launched the panel of experts investigating in the matter. So what other Administration Actions other than taking to the panel, talking about it and having a meeting. Were looking, as i mentioned earlier, looking at the bilateral tools that we have at our disposal. What unilateral measures have we been considering . I believe sanctions designations, bearing in mind that most actors i shouldnt say most, many of the actors involved in Ballistic Missile launches and the program itself are already sanctioned under ugs law. And are we considering stopping or rescinding any previous relief as a result of these actions . The jcpoa i want to underscore, again, that the jcpoa, the point is to dismantle Nuclear Weapons program. Thats a really important area of emphasis for us. So more important than the Ballistic Missile concerns. Taking away i dont want to talk about relative importance, but taking away irans i think its something we can agree upon, actually ensuring that iran doesnt agree upon a huge priority. In your opening statement, you said, and i quote factors in the middle ooegs and other terrorists. By not imposing sanctions, by not doing anything that im talking about, are we allowing exploitati exploitations . We have at this administration put in place in the case of the iran sanctions the first instance and then amplified by what weve done. The most devastating in the history. Iran has seen the con kwens of violating the national norms. We also have a sanctions fact provision that i think few around the world would be part of this deal which would allow snap back in the event of significant noncompliance with the deal. So sanctions are a really important tool. The sanctions that are put in place is one reason were ensuring that iran did not develop Nuclear Weapons. But nothing has been done, other than a meeting on a Ballistic Missile violation. We have increased and will continue to increase the political of iran. The work that iran does to ensure that the u. N. Security council does not discuss Ballistic Missile launches i assure you is a testament. The stigma they associate with our bringing these issues to the Security Council. Same with the panel of experts discussing this and documenting any violation. This is something that iran increases the political costs. In october, this Committee Members sent a letter to the secretary of state talking about iran. And the letter talks about a range of unilateral, multilateral activities presented domestic authorities and engage in proliferation activities. But weve done nothing theres no penalties under foreign entities as a result. Its also a defense response. Its also the proliferation security initiative. Its everything thats come out of camp david in our engagement with countries to ensure interoperability. Its the iron dome and all of the bilateral defense arrangements that we had, many of which are getting deepened, as you know. One has to take measures to make sure that you have the tools to defend themselves. Even if you have a designation, the number one deterrence and preventive measure is going to be regional defense. If i were here and we had designated another actor, bil bilater bilaterally, lets say we find one that has not already been designa designated, i dont think that would address your concern about iran. Security Council Resolutions over the life of the entire international Security Council regime. The sanctions were in the system and would be sanctioned if they were engaged in iran. This systematic ignoring of the solutions, doesnt that give you concern about their willingness to comply. Thats why we have snap back. Its pred kated on trust. O i just want to reiterate what ben and i did the other day right now with iran. And on both sides of the aisle, regardless of how people voted, we want to make sure the agreement is implemented in the way that it was laid out. And i think theres been a concern on both sides of the aisle that theres an heir of permissiveness thats being developed. That calls the likelihood of any pushback over time. And i think thats what shes getting at. And i think people on both sides of the aisle have been concerned about. 1929 says they shall not undertake any bligsic activity. And wha were seeing is, again, not barely individual lent steps in taking and setting with the future with it senator cane. Thank you, mr. Chair. And thank ambassador power. If you gave a pbs news hour on december 4 and you know that more progress needs to be made in ewe nieunitedinewuniting the coalition, what is it to be clear if congress is willing to finally debate and vote on this matter after 16 months of war . Yes, i think people are puzzled as given the priority for the u. N. And on a bipartisan basis, both houses of congress attach to the struggle and all of the attention to it that, you know, has come over the course of the last two years as to how we cant arrive at consensus in order to be able to enshrine legislation that would be bipartisan backing of the American People. I think it would be really important to get that done. That is my understanding as we know it. And i think other countries who were part of the go ligs, but not on the Security Council, also. Germany, for example. Last week, senator mccain said this. He did not say this approvingly. But when he was asked for an authorization, it may require an attack on the United States of merit. In terms of you being able to do your job well, would it be a good idea for congress to waive that . No, it would not be a good idea for congress to wait. This should be one issue that everyone should agree upon, even those with differences over tactics over the number of the difference of tactics showing the world that this is something that is backed by the congress. It is a long struggle. The president started this war against isil on august 8, which was 16 months ago. A year ago friday, an authorization before no action was taken on it. Legal gymnastics that were not helpful and urged congress to take action. Let me ask you this, you talked about european nations having scaled back. Columbia is stepping up in september saying they want to devote 5,000 troops. Talk about columbia coming in to Peace Keeping forces for the first time and a period in which you encourage that is. Thank you, snats xx. We view that very much the same way. A reflection of however the Peace Process is, theres a lot left to do. But their confidence and where they need to get. Latin america has a huge contribution to make one of the significant pictures of the president s summit. A lot of latin american countries with haiti, i want to particularly commend uruguay because of the contributions working with the columbiaens, working for us, this is how it works for you. Also, mexico, which i visited recently, which has announced it will be breaking ground involving Peace Keeping for the first time its in the mids. If i could just touch upon, because i think its such an important point, the larger point of pulling up latin america, which is the dividend for us in terms of conflict resolution. Im just back from sri lanka, a place in the wake of its defeat, the lte people in effect coined the suicide bomb, fairly regressed in terms of aauthoritarianism and carrying out on detail of the war. Now theres been a change in government. How often do we see that taking on issues of capability, trying to reconciliation. We also see the behavior of International Institutions transformed. Also making a substantial commitment to Peace Keeping. A resolution on syria, north korea, et cetera, shifting. I want to just dwell on this. They become more at peace within themselves and we see a pay off, again, in terms of the Critical Mass of countries that we have as partners to work with. Right now, more than half the countries in the u. N. Are not democratic. An effect to which the u. N. Is going to be with enforcement, et cetera. Thank you. Senator isaacson is next, after him, senator menendez. Im going to ask if you would chair the meeting while youre asking questions. Very brief. Okay. Okay. Then senator murphy is next. If we could just keep it going. Im going to bolt and come back and thank you both very much. If menendez is not back. Thank you for calling this hearing. Im going to be very brief. Your required at every meeting of congress, every ambassador of the United Nations ought to be fw that book had been read, a lot of the problems were talking today with Peace Keeping missions and military tactics and things like that, wed be a lot further along. The senator and i went to ruwanda. Thats my first question to you. Are we, as a country, the United States of america . As you know, were not a substantial contributor to Peace Keeping. So these principles, so far, have been embraced by big countries putting thousands away, 40 Police Officers and 40 military officers when i read your speech last night, you talked about the learning lesson from your point out in the problems of how you do it. The rules, as i understand it is, the peace keepers need their countries need to affirm that their troops have the authorization to use force. Is that correct . Correct, sir. Thats our problem in the middle east right now. In terms of the United States. Authorization for the rules of engagement of our own troops. I commend you for raising it on this question. But i think its a bigger question of being effective. The troops you have deployed for Peace Keeping or for war, if youre at war, to have the actual authority. It kind of struck me that we were congratulating a lo of people who are korean yet we, as a country, have the practice right now in our own country. Thats the point im bringing up. If i may just respond quickly, senator, while youre here, you know, my impression is not that. I think that what president obama has convey ed is a desire to offer strategic guidance and any big shifts in strategy at a senior level to make sure everyone is on the same page. But theres a huge amount of tactical flexibility these commanders have. And i think youve seen publicly which hes conveyed many times in a private situation room is if there are ideas for how we can pursue this campaign more expeditiously in ways that increase the security dividend for the American People sooner, i want to see those ideas. And so, you know, im in these meetings and i, again, have not guilty heard the commanders. My last question is not a question, but a statement. I would underscore as i leave senators remarks and the chairman. More transparency, the better for the u. N. Theres a lot of suspicious and a lot of misunderstanding and a lot of lack of trust out there in the general public. It would be helpful to the union to carry out its intent. Senator, that gives me a chance to invite you to new york so you can get the budget numbers first hand. But we would really welcome visits by members of this body and we give you a good, deep tour of the u. N. And so many of the africarelated issues. Invitation accepted. Okay, great. Thank you, senator isaacson. Good morning. The evening of sunday nights speech, there was periods of social media spotted very wonderful report from the New York Times. Those observations was u. S. Strategy seeks to avoid isis prophesy. And the idea, if you understand the fundamental Building Blocks of the religious perversion, it is built upon a military belief on the ground. And i suspected that acknowledgment is part of what made the president talk not only about the things we shouldnt do but the things we should do. From a broader fer spective, as we try to confront organizes that are trying to have Peace Keeping forces that are trying to go in particular the United States, why multinational and multiethnic forces are going the be much better positions than a majority of the u. S. Force to try to have peace and order could or should make in the future if that is amongst what should be had. Thank you, senator murphy. Thats a complex question and several ideas within it. I think the key to effective deployments is legitimacy. And one of the things that multinational dploimts can offer and can amgs forfeit is a perception of legitimacy. The whole world is behind a Peace Keeping mission. You know, which i think having the colix also enhances legitimacy and the fact that countries from the region are part of that council. The one thing that i would note in areas where terrorists are active, 44 deaths of peace keepers just over the life has only been in place a few years, there can be a mismatch between u. N. And even and other kinds of environment where extremists and terrorists are, yes, they may make the United States number one target if they have that opportunity. But if theres no americans around so i agree with the logic of the article that you described and founded very powerful. I will use to how the extent to which Peace Keeping is being increasingly for terrorists and extremists in those environments that they inhabit. And just to give you one example, were now doing more and more counter ied training for peace keepers. If anybody would have imagined that people had to train against ieds that were presumably targeting the peace keepers themselves, im not sure peace keepers would have gotten off the ground. Having, you know, countries who know the language, i think thats a critical component to have cultural overlap with those countries is really important. The other challenge is sometimes countries can be foo familiar. Trying to inject more distance perception of independence. To all of these need to be taken into account. Thank you. And my thanks to the senator. Thank you for your time, senator. Thank you. Im not going to ask for unanimous consent right now since im here alone. Let me, first of all, ambassador, say i appreciate your service to our country. And i have a high regard for you. My own personal view is left to your own devices, on some issues you may be more forward leaning. You dont have to respond. Let me enlarge this conversation for Peace Keeping. Peace keeping is, yes, very important. But part of the way we can keep the peace is to make sure that the will of the International Community isnt violated. There are consequences that continue which doesnt lead to the outbreak of war and therefore what flows from that. So i point to the issue of i noticed several of my colleagues. First, i want to ask you, would you agree that for a decade, iran, as you have said and some of my colleagues questioned, did not recognize u. N. Security Council Resolutions and moved their Nuclear Program forward to a point in which it got so big, almost too big to fail and too big to actually end. And in doing so were able to get to a point that they large way wanted to. Would that be a fair observation . But the point is they violated International Resolutions for the better part of a decade. For a good period of time, and so look at that and i look at your acknowledgment that they recognize Security Council rez luxs. And i say to myself. Theres a history here and a pattern. If you go visit the archives building, it says what is past is prologue. And i have a real concern that what we have here is a lack of will by the United States and as a leader in this regard by our parter ins in goimpk ahead and making sure that iran understands that you cannot violate the International Rule without consequence and i consider that to the extent the greemt is going to produce any benefi benefits, iran must clearly understand there will be consequences for not following that agreement. And the message seems to me that we are sending, and that we have sent as a country in various iterations. So we basically have no real action. I heard your responses about now they have a second test. Wed like to see the multilat ral but we hear nothing in the interim about an individual consequence. I predicted as well as a whole host of others, that we are bagsically going to sweep this under the rug. Its presently being circulated at the iaea. We want something bad enough, we are willing to go ahead and overlook and in doing so, we make a great mistake. We did so with cuba. They violate the Security Council resolutions, knock happened to them. So when we want something bad enough, and i say we as the administration wants something bad enough, they are willing to overlook. And that is a dangerous proposition. So what is it we are going to do to send a real, clear, une kwif cab, unambiguous message to the iran yans that notwithstanding the Nuclear Portfolio that we could be robustly active and take actions on nonnuclear issues. Well, this is a nonnuclear issue. And conversations is an action. Thank you, senator. So let me use this also as an occasion to sort of to address a comment he made earlier, which is in keeping with what youre saying, k4 is his impression of a greater permissiveness in terms of your statement that somehow if you want it bad enough, youre willing to overlook. The way that this Administration Responded in new york to prior occurrence as it happened in the life of the regime, violations of the u. N. Security Council Resolution hant changed. Theres no difference in the way we go through this procedure what we seek to do in new york at the u. N. Security council. And frankly, theres not even much difference in terms of what we face from predictable quarters. The Security Council regime, as you well know, built out and put in place and its that regime that caused iran concessions that, you know, three of you here deemed satisfactory, but went well beyond would have been achievable without the sanctions regime and givers us the confidence again that this is a good deal and one that will dismantle Irans Nuclear weapons program. We have a vested interest in seeing this deal implemented because we dont want iran to ever obtain a nuclear weapon. That is our objective. We have put in place measures, whether its the expanded monitoring and for all the dissatisfaction thats been expressed about the report and our approach to it, understood famtly, the ie was able to get approached than it hadnt been able to get approached in the past. The snap back of the sanctions regime is incredibly important. The senator said the other day to the Security Council we will have given up all of our leverage on the front end. Thats just not true. We will have that hanging over violations Going Forward. And we will have it the way of responding to lesser incidence of noncompliance. So, again, the u. N. Security council is one venue. And we will do, as weve been doing for a decade, bring forward violation increase, ensure that iran is isolated for its violations of 1929 now but we also have a set of tools i appreciate your answer. Youre very good at answering but not answering. So let me just say you talk about snap back. Those sanctions that you admit, and the administration has increasingly admitted, brought iran to the table. They expire this coming year. And you all negotiated away, at least as i read, the abilities to export. And the Administration Just wont talk about that reauthorization. They dont have the where with all to reauthorization. They gave it away. And then, last point, you know, another example. Enforcing resolution 1701. During the iran nuclear agreement, the administration repeatedly emphasizes that u. N. Security council 1701 is in place and that pertains to weapons of hersbolah. Hesbollah has continued to receive arms. So what steps have you to stop the transfer of arms . What steps have we taken . Thank you, senator. I addressed this question earlier for senator perdue. Its a very important question. I think the point that was made over the course of the discussion about the jcpoa is that the authorities, as we understandably concern would go away at some point under the jcpoa. As i said earlier, do everything in its power to call them out when they are. To alert us and other stake holders to anything to their attention that, again, is alarming in this regard. As you know, a constructive effect of events on the ground. I dont think the government would have supported its perpetuation if it hant. It wont be. We have really pressed the u. N. To step up its reporting and sound the spotlight and do the things that it can do. But, you know, in terms of armed confrontati confrontation, thats not something we feel is pursuant. Were also trying to enhance the capableties of troops with that bill. And were hopeful again that the Peace Keeping summit will give us a broader pool of troops to draw from. Okay. I just have no consequences is a green light for violation. Thank you. Its true that its highly unlike unlikely the answer is yes. Brought the issue to the council. But not as far as sanctions, penalties. I would not assess that. Relative to the administration were permissive. Is that what youre saying . The leverage shifts to iran. So that they get the sanctions related there after, which we would expect. Now people believe that january, february, they get all of this. And for you to say that snap back implementing back those sanctions and we have countries like russia and china which would probably, likely, know are not going to push back against this issue if there are incremental vie lagtss. All of the leverage is with iran. That is a fact. Its not anything but a fact. All you have to do is step out. And they know that russia and china and probably our western friends in europe, are not really with them to comply. True statement. It entz up with them because they have what they want. Weve given it up. We have pursuant to Security Council. Senator martin . For one second, i apologize to senator martin. We all hear the frustration that youre unlikely to be sanctioned by the Security Council. But if you demonstrate action with our european partners, particularly in the signal to iran that these types of activities arent going to go changed. I want to underscore to the council what further tangible outcome. Mr. Chairman, the one thing i feel compelled to say is that when you were going to dismantle, its very important to remember that thats a good thing. Thats what we want. Understanding, again, that there is pay for performance as part of the deal. Like the way that weve incentivized. Wu sometime but sometimes, in the way that this is discussed, you would think that that is not a good thing. I understand that. And, look, again, i dont want to redebate the agreement. What i think were focused on right now is that the International Community knows that they violated, 1929, and, in essence, theyre violating the spirit where theyre called upon. And we all know that their influence was not going to take action for us. We believe that after they get sanctions that theyre going to be there and taking you are correct. We like you and respect you. We have a policy difference here. This is not directed at you. Its directed at the defense council. Thank you so much. Thank you for all of your great work. You serve serve our country so well. Thank you. If we can come back for a second, when i look at inside of the creativeness, upwards of 30 of the suni soldiers who have soldiers trying to depose. And similarly, fighting for him, theyll be looking for him. And i thi secretary kerry will have to attach for these people. What happens and that kind of looks to the u. N. , the soldier. They lay douchb their guns. Otherwise, i dont see a resolution. I see trying to ne gauchuate an evercontinuing conflict. So can you talk about that a little bit . The u. N. Peace keepers could play . Again, the postpeace agreemen . I understand that were far from that. But just looking at that and anticipating a potential call for the u. N. And to assume no guarantees. Otherwise, i dont think asad is ever leaving. Otherwise the fact of human nature and looking at whats happening with all of these countries. Theyll be dead. The revenge mode will be so high given the tragedy thats affected the families. So how could we play a con instructive role . Theres no tour to very complex dimensions of imagining to syria. But you put your finger on, i think, one of the hardest issues involved with the emotional reinspiration of syrian modern Opposition Forces with Syrian Government troops who have been the air force which have been involved in barrel bombing, chemical weapons or the infantry and it is going to be vetble, i think that, and, as you say, were not at this point of the discussions. But in order for there to be an agreement on a political con sen, which is the catch phrase is the operative principle, ask in the other direction, as well. When moderate Opposition Forces go back, what happens to them if the forces in control or remain, you know, in large, you know, Government Forces. So, where that confidence building comes from, who the guarantors are of any kind of e reintegration and back to senator cardins question earlier, what the accountability mechanism whereby there can be some healing or, you know, truth telling and punishment for those who committed the worst violations, all of those modalities have to be worked through. On both sides. On both sides. Again, yes, absolutely. Now, in terms of the new term, you know, we have an isil with a you know, very extensive presence in syria that is shrinking but nonetheless would be a significant consideration for any outside country thinking about deploying troops to syria. We have al qaedas affiliate nusra, as well. Part of whats being worked through is definitions of whos a terrorist and who isnt so theres an idea that everybody could go against these forces together. But i think what you would need if, you know, if one wouz going with a troop presence from the outside would you would have to make a judgment that a troop presence would do more good than harm. That it would invite and create more confidence to have that confidence those alawite and sunni soldiers don government side and then sunni moderates on the other side have to believe that the troops protect them if they get attacked f. You look at u. M. Peacekeeping missions, thiss not always the case around the world, right . Some troop contributors, thats not a role they play eagerly. You could look at a force of some kind. You would ask that question. Are troop contributors ready to invest themselves in enforcing this agreement . Is that something that, you know, some of our allies would be a part of . And the only caution i would give in terms of a Regional Force which is something that i think is being looked at and, again, all the costs and benefits of these per miations have to be thought through. On one hand, the language, the cultural affinities but in the case of many of the regional players they have been stakeholders in this conflict so the idea they would be then seen as impossibartial so finding confidencebuilding mechanism that doesnt run afoul of being seen as a party of the conflict and where they would be willing to put their troops in harms way on behalf of this agreement is going to be one of the challenges we have to think through if the parties deem an outside force a necessary part of this political agreement. Yeah. I dont see how you can avoid it. I just think that the recrimination coefficient is going to be historically high. The carnage is just been so great on both sides. And bitterness. The okay ri mony wont setting out for decades and we needs a period of reconciliation, healing. In the absence of a very well thought out plan that is put together and i think it should be put together sooner rather than later. Just as a concept that could move in to assuage the concerns that all parties are going to have, that the removal of assad doesnt lead ultimately to a repetition syndrome breaking out inside of the country and yet a different cycle that seeks to extract a revenge against those who they have grievances. So i just think the sooner we kind of think that through and what were going to put in there, i think the better the conversations we can have to give some assurances to the more responsible parties who want to end this war that the death toll isnt just going to continue to mount so removing assad is just one step. I think the next i think but it has to be accompanied by a set of guarantees. I feel very good knowing that youre there, secretary kerry is there and thinking all these issues through. Thank you so much. Well, thank you for being with us. I think you can see were getting close to the end here. I do want to chase for a moment the conversation you had with senator kaine. I guess do your colleagues at the United Nations think that somehow congress and the American People do not want to defeat isis . I dont think they would have that impression. My response was that theyre puzzled as to why we cant come up with an authorization are they puzzled by the fact that the administration told us over and over and over again here at this committee, secretary kerry, secretary carter, the white house, sending over notes that they have all the authorities they need to continue the fight against terrorism, is that confusing to them . Again, i was not speaking if i may, i wasnt speaking to the legal authorities question. I dont think anybody questions whether or not the United States has the authority to carry out the campaign were carrying out. I think the question is as a political symbol aez reinforcement of the effort were making an ability to get consensus. There is consensus. I mean, the president im sorry. My response was on a consensus the game thats being played. Its dflt for me to understand. On one hand, witness after witness after witness comes up here and tells us they have all the authorities they need. And then, people like you and others come up and talk about how it would be nice i guess i dont get it. I voted for an authorization in 2013. Help craft it. To go against assad. And we turned away from that so certainly this committee is willing to take up tough issues when a declaration of war is occurring. And has the president declared war on isis . Has he declared war on isis . Has he laid out a strategy publicly to defeat isis . So i just want to say, im sorry that cute sy thats been occurring recently, especially over the last two weeks, im having difficulty understanding when i agree with the administration. They have every authority that they need to defeat and destroy isis. So, i dont know whats up. Maybe the president s receiving criticism an hes trying to deflect that to congress somehow. I dont know whats occurring. But all i can say with you, im in full agreement with the administration that the 01 authorization while certainly on the edges gives them the authority to do everything they could possibly want to do to destroy isis and everyone in the world, everyone in the world understands that Congress Wants to see that happen. Let me be clear. The president has himself as you made clear he has the authority to prosecute this campaign effectively. I was responding to senator kaines comment that a number of the other countries in the coalition have gone through a domestic legislative process as of late they didnt have the authorities to do what they were doing. Is that correct . Id have to go case by case ooshdy Great Britain or uks unwillingness they have to go through the exercise they have gone through. I think this is a reason, though, that the question is a little bit more in the air than it has been over the last six months up in new york. I think its in the air for but the president has said he has the authorities he needs. Theres no resurrecting or surfacing this issue for any other reason. You agree 100 the president has the authority absolutely. Has the president declared war on isis, by the way . I believe he has said were going to defeat and destroy isis. Isil. We thank you for being here today and certainly respect the job that you have here. Youre very bright and intelligent. Sometimes i, you know, take issue with you when i feel like youre carrying too much, the administrations line but i understand sometimes you feel compelled to do so. I thank you for being here and wish you well as you take demon straitive action against 1929 being violated over the next week or so. Thank you. So our next panel will consist of two more outstanding witnesses. The first witness is the honorable John Negroponte and former United States permanent representative to the u. S. Mission in the United Nations, same job our former witness is occupying our second witness is dr. Bruce jones, Vice President of the program at the brookings institute. Again, we thank ambassador power for being here. Both of you have witnessed what just happened. We hope you can summarize your thoughts in about five minutes and we look forward to questions. Again, thank you for being here. And, john, why dont you start . Yes, sir. Thank you, chairman corker, Ranking Member cardin. Its a pleasure to appear before you this morning to discuss United Nations peacekeeping, a subject of importance to the United States security. When i was ambassador to the United Nations, this subject was frequently on the agenda of the u. N. Security council and during my tenure the peacekeeping operations were stood up in sierra leone and liberia, of course. And operations that continue to this day such as in the democratic republic of congo, Western Sahara and so far. I want to state categorically at the outset my conviction that United States support for u. N. Peacekeeping operations is in the overwhelming National Security interest of our country. There are three major reasons for which i hold this view. I call these three arguments, first, cost. Second, the boots on the ground argument. And number three, legitimacy. I will explain each of these thoughts further. First, with respect to cost, United Nations has more than 100,000 troops deployed in peacekeeping operations around the world. Today. The approximate cost of deploying these forces is 8 billion per year. Which, of course, is a a small fraction of what we spend in our own National Defense budget. Our share of these costs is less than 3 billion. A small fraction, again, and some ill lus strous figures were cited by senator cardin. A small fraction of what it would cost to deploy United States forces on similar missions. This is not a trivial argument. In todays world and with the high cost of deploying u. S. Forces to overseas missions clearly it is an important advantage for us to know that we are considerably less expensive options available to us regarding whose forces might be available to carry out an intervention we deem to be in our interest. Second, the boots on the ground argument. This, of course, is an argument related to financial costs just as we benefit from the lower cost of u. N. Peacekeeping budgets as compared to our own defense spending we also do not deploy our own combat forces to these situations. This is a huge benefit. It is hard to imagine sustained public support for a hypothetical situation wherein u. S. Combat units deployed to five or ten peacekeeping operations abroad. The cost in u. S. Blood and treasure would be high and the expectations of u. S. Forces involved could undermine the kind of support and patience required in some of these very difficult situations. So support for u. N. Pko saves us from having to contemplate these possibilities. It also enables us to think about choices other than a stark selection between u. S. Boots on the ground on the one hand or nothing at all. And third, legitimacy. How many times have we undertaken or contemplated sbe vengs without the United Nations Security Council resolution . In early 2003, i was in the well of the Security Council arguing for a chapter 7 Security Council resolution permitting the use of force against iraq. We failed to achieve that resolution and soon thereafter intervened in iraq with a coalition of the willing. Im not saying that a pko would have been appropriate at that point in time in iraq but what i do want to highlight is that we subsequently paid a high domestic and International Price for intervening in iraq without the support and blessing of a u. N. Security Council Resolution. By definition, a u. N. Peacekeeping operation has consensus support within the p5 and a blessing and the blessing of a Security Council resolution. This is an important political and Legal Advantage which should not be dismissed lightly. Senator corker, Ranking Member cardin, i know there are issues regarding the effectiveness, comportment and leadership of some pkos and these are issues that will require continued attention and effort from troop contributing and other u. N. Members alike. And given our leadership role in the world and our status as the u. N. s largest single financial contributor, we have a special responsibility in this regard. But whatever imperfections or blemishes might exist in the u. N. Peacekeeping setup, it is our responsibility to help address these issues in a constructive way with steady engagement from the u. S. And others, i foresee continued improvement in the performance and utility of pkos and even their more creative use in addressing some of the very difficult security challenging around the globe. So thank you for the opportunity to appear before the committee on such an important topic. And id be pleased the try to answer any questions. Thank you so much. Dr. Jones . Thank you very much, chairman corker, Ranking Member cardin. Thank you for having me appear before the body an your leadership in sustaining attention to this issue. We have covered a lot of ground so ill be brief and try to raise a couple of points, reinforce and raise a couple more. I think you understand the purpose of peacekeeping is to give the United States as a tool for burden sharing and conflicts where we have interests but we dont want to have to deploy u. S. Forces. I think that is well understood in this body. I think its important to remember that in the majority of the cases where the u. N. Deployed it is not deployed alone. Its often a Regional Organization and the u. N. Codeployed in a hybrid operation and we dont focus on that enough. The u. N. Is an important part of the equation and we need to sustain attention to the way that Regional Organizations expand the reach of theu. N. And reinforce what the u. N. Can do. That being said, of course, the u. N. As you both highlighted as a burden sharing tool, a global burden sharing tool allows us to reach across the globe. European forces working with news haiti that Regional Organizations cant perform and so for of its flaws and weaknesses the u. only genuinely global burden sharing tool we have and extremely important at a time when senator murphy i think mentioned colombia and others like korea and indonesia and brazil, rising democracies who want to do more on the international stage, and the u. the only tool that they have to do that. So how do we improve the u. N. S Performance . This is four dimensions, effectiveness, efficiency and leadership. Effectiveness, i want to reinforce something that ambassador power said which is important which is bringing countries with advanced military capabilities sbak into the u. N. A number of you stressed the complexi complexities. We have to be clear eyed about the fact that in a number of cases the u. N. Operating in theaters and not challenges of troops with low order troops with low ordeyu look at the situation in mali, we have to see peacekeeping have within it troops with countries with advanced military capabilities to perform the functions or protections of civilians and implementation of mandates and very supportive of the Administration Efforts to bring european and rising states back into peacekeeping. An additional point that i would make, again, senator murphy touched on it, there are different way that is the u. N. Can structure their actions. Theres Multinational Force operations an ena Single Member state takes the command and thats sometimes a effen effect tool because theres members who have a far higher degree of capability in command and control and intelligence than the u. N. Secretary at the disposal and that variation of using a u. N. Authorized Multinational Force is something i think we should be thinking about more than we sometimes do. Quickly on efficiency, nobody accuses the u. N. Of being an Efficient Organization but its made an important step forward with the creation of department of Field Support, a tool to structure the field operations. The absurdity is the politics means that the Department Still has to run all of its decisions past the department of management, the headquarters tool and the same tool that manages workshops and conferences in new york to approve all the decisions of a more nimble tool and something the United States could do is work to change that so the department of Field Support has more direct authority to oversee and implement peacekeeping operations without that kind of extra layer of kind of dual key system which is inefficient and keep working on the scale of assessments issues. Third, the things that have been said, i think the u. N. Makes a mistake not recognizing that even though this is an issue of a minority of troops and missions, its severely erodes the legislation macy of the u. N. On the ground and in capitals. You have said a number of things about the United States putting the right kind of pressure on the u. N. To live up to a zero tolerance policy and ban kimoon came to. And that goes to my last point and ill end here. This is also about leadership. Were coming the end of ban kimoons term and i think it should be a matter of priority for the United States when we get into the business of selecting a new secretarygeneral to be paying attention to the question of whether theyre focused on the effectiveness and efficiency of the u. N. And contributing to International Peace and security and working closely with the secretarygeneral when he or she is selected and other members of the p5 to have available a deep roster of talent on which to draw and selecting top officials for the management of peacekeeping and humanitarian operations. Ill end there. Well, thank you both. We got off on on a lot of different topics in the last panel and rare to have the opportunity to talk to the ambassador. We thank you both. We know youre both friends and we just been here and this will all be part of the record and appreciated, this is more of a conversation. As we have moved i mean, you know, you both have experienced a frustration of seeing peacekeeping operations where people are being abused and brutdallized and yet the caveats that existed kept peacekeepers from really being able to intervene so we have moved in a more forward manner which from my standpoint is welcomed. As we have seen helpless people be brutalized in certain areas. What are, though, some of the challenges that from your perspective we most need to think about relative to that . I mean, in essence, as an extension of some cases carrying out semikinetic activities, right . So what are some things we as a body should think about as we progress down that path . Thank you very much. Its an excellent question. And i think its extremely well put. Its interesting to observe at the u. N. I think you face two challenges. One over time as countries with more advanced capabilities, europeans and others, have not been participating in peacekeeping and the practice sort of lowered to the capability of the troops. And so, the willingness to go out and undertakeaki nettic activity, to defeat rebel forces diminished. Getting troops into peacekeeping is the first necessary step. I think an important question is what can the United States do to stiffen their will or ensure that they will have will or support . One things to put on the table is that by the way, i would say that im not among those who thinks that the United States has to put troops into peacekeeping to ensure. I dont think thats the correct approach. I think the United States hads a unique capabilities of air lift and intelligence that are more important and i would add to it over the horizon extraction. If we ask countries to put troops on the line and take risks, first of all, its helpful if theyre more capable troops and if were willing to provide defense capabilities, the risk theyre taking is lessened and we can be in a stronger position encouraging people to take those risks and take those fights if were willing to help them if they get stuck. If i could add, first of all, i would definitely agree with dr. Jones that Capacity Building and i think thats what he was talking about in the first instances, really, one of the most important challenges if not the most important challenge we face with respect to u. N. Peacekeeping. There was also mention earlier in the testimony this morning about the problem the time it takes sometimes to mobilize some of these missions and i think the Security Council and the peacekeeping department has become more effective at that. I would add with respect to Capacity Building the challenge we have in ensuring that theres sort of a uniform level of capacity amongst the officers that are leading these Different Missions around the world, and im not aware that the u. N. Has any kind of peacekeeping academy. It would seem to me if you have a military deployments in excess of 100,000 people around the world, i mean, we have we have an academy for each of our four Uniformed Services in the United States. And i wonder if some kind of Training Institution where you would cycle current and potential leaders, future peacekeeping missions, whether that wouldnt be an idea worth consideration. I mean, we wont have to sit down at the drawing boards and think about how you do that, but anyway, thats one idea i would like to leave for your consideration. Dr. Jones, you mentioned that you dont think its appropriate for the u. S. To have Ground Troops, if you will, involved. You know, as it relates to our nato efforts, we obviously have everything involved. Money, equipment, personnel. Again, we are provider of Security Services and unfortunately most of the members of nato are consumers of Security Services. Here were the largest provider of monetary resources and as i understand it we have committed 42 officers to be part of peacekeeping. But just for the record, so that you tease out why it is you said what you just said, you say we shouldnt be involved with Ground Troops because thank you. Yeah. It comes up a lot. Its come up a lot in the last year as the administration is pushing the europeans and other states to do more. One of the resources is are you going to . Are you going to put troops in . As i said, i think the things that only the United States can do include airlift, signals intelligence and some of the command and control functions you just referred to. I wouldnt be doctrinal about it. I dont think theres no circumstance for the United States to put troops in. We have historically in 1995 the United States had troops under the command of a canadienled Multinational Force. We have done it. Its not impossible to do. But by and large, it seems to me that we are better off when other troops are willing to be in the front lines of this. Senator murphy talked about the motion of having multiethnic and Multinational Forces. And the simple reality is that the United States is going to attract attraction and people to want to fight the United States and simply raising a red flag to a bull putting u. S. Forces on the ground in these situations and much better off performing the functions that only we can perform as well as as i mentioned over the horizon rescue and support operations and ask others to be on the front lines. Generally the same approach as has been discussed by most and that is in syria we would like to have arab faces on the ground. More predominantly than western faces. Right . I mean, it just helps ensure that theres more cohesive nature, if you will, relative to whens happening on the ground. Typically we have had a policy, have we not, that u. S. Troops are not going to be commanded by people other than u. S. Officers, too, is that correct . We have had that policy as i said. We have occasionally violated it. U. S. Forces were under canadian command in Multinational Force operations in east zaire and as i said theres simply too many occasions in which participation in the United States changes the Political Force of the force in ways to amplify resistance rather than the opposite. Whereas the enablers dont necessarily have that same kind of a profile and yet no other country as capable as we are of producing the vital enablers to these missions. Ambassador, you have had this role, you have been at the yipts. Senator cardin which i appreciate deeply raised the issue of just our payments, the amount that we, you know, we have 22 of the worlds gross domestic product. And yet, we obviously contribute 28. 5 of the budget here. Our other, quote, associates if you will, at the United Nations, obviously are not doing their part otherwise our amount would not be 28. 5. We find this saying to be the case. Nato, its where we desire for things to happen more so than others and were financial exposed more than others much you have been in this role. Tell us from your perspective what we as a country can do to seek equilibrium and calls other countries to play their appropriate roles. It is frustratinfrustrating. And i think you were right, senator, to talk about the kind of Mysterious Ways in which the budget is negotiated and very often right at the end of the year just before christmas before everybodys in a rush to get out of there and somehow at 3 00 in the morning the u. N. Budget gets agreed upon and so you sometimes get some rather anomalous situations to arise and i think we have to keep working on that. I recognize that we have not been as successful as we ought to have been in keeping the peacekeeping assessments down. But again, in proportion to what it would cost to field other kinds of forces or our own military expenditures for our own defense establishment, we are talking about relatively small amounts of money and therefore i just think we need to do our best but recognize that we may not achieve everything we hope to achieve in those negotiations but im also reassured that some countries putting up more resources than before. Im glad to hear china is assessed Something Like 10 for peacekeeping and a significant departure from 10 or 15 years ago when the contribution was a fraction of that. Senator cardin . Mr. Ambassador, as you were describing the u. N. Budget process, i thought you were describing the u. S. Budget process. I dont know where they learned those lessons, sir. Dr. Jones, thank you very much for your service and you come here with a great deal of expertise on the United Nations having worked as adviser to secretarygeneral and ambassador negroponte you served in that position and so many others so i want to follow up on the reform issues and ill tell you why. But first, let me suggest to the chairman, your suggestion on training is a very important suggestion. I serve on the board of visitors in the u. S. Naval academy and see firsthand the availability of training at the u. S. Naval academy for some of our allied countries. We do train at our Service Academies foreign students. I think an arrangement with the United Nations in regards to their peacekeeping command may very well be a viable option to get greater capacity and i would ask our staffs to take a look at this to see whether or not we can look at how our Service Academies could assist in this regardment it also helps us with a more diversified student body at the academies prepares us for the Global Missions our military command needs to be aware of so i thought that would a good suggestion and if our staffs could follow up on that and see if thats a viable option. But i want to talk about the absolute scales and assessment and how these numbers come about but i put it in context of a senator that strongly supports the United Nations and its mission and its budget, but if we were to put a u. N. Reform bill on the floor of the United States senate, the type of amendments that would be offered an enthe types of potential restrictions on the u. S. Participation in the United Nations, getting a majority vote, perhaps even a 60 vote threshold is real. And the reason for that is because the lack of transparency in the United Nations and the illogical way they go about their budgeting. We talk about burden sharing and we recognize that its disproportionate. That the u. S. Taxpayers have been asked to take on a much stronger commitment than the developed countries, those who have the capacity could do a lot morement its true in nato. Its true in our coalitions. Its true in individual participation globally. And its certainly true in the United Nations. So, i understand that were getting a good value for our contribution to the i never doubt that. I adpree with you completely an its the peacekeeping missions are critically important to the u. S. But it seems to me we have not been as so in the transparency issue and if we dont deal with it in a way thats understandable to the u. S. Political system then there could be negative consequences to the u. S. Participation at the United Nations and for that reason i cant justify a 22 budget aloe case and then 28. 5 on peacekeeping. Particularly in light of all the other commitments that u. S. Taxpayers are making to International Security issues. And i just would like to get your advice as to hows the most effective way for this senator and for the congress to weigh in in a constructive way so that we can get the type of reforms we need in the United Nations. Well, you know, im not as current on these issues as i was when i was serving in that position but i inherited, i was the beneficiary of Richard Holbrookes successful negotiation with respect to the last big arrears situation that we and it took incredible work on his part. As the kind of work that only Richard Holbrooke was capable of. Jawboning with the membership with the secretariat, working hard with the congress, like ms. Power bringing the Security Council down to visit the senate which i think was a very, very good idea and im sure you imparted this message to them when you met with them. Those are the right people to pass that message to. I think it just requires an intensive diplomatic effort with these countries to try and correct that situation. Im pleased we have a 22 assessment for the general assessment for the u. N. Holbrooke left that issue somewhat unresolved. Its gone up a percentage point or two since he reached his agreement. But i think we have just got to work that one really hard. And what id hate to see happen is that the arrears become so large that then it becomes some kind of a crisis situation with regard to whether or not were going to continue our support or which would undermine support for United Nations and thats the danger that i think youre describing. Absolutely. I dont have much to add. I would just add one point of context which is sort of ironical. We spend a lot of few years talking about a United States in the decline, you know, relative decline in the United States, all this kind of stuff, the rising powers. I profoundly disagree with that underlying notion and in this case looking at the scales of assessment it was about 30 in the height and decaylee anthonied to 25 as we made continual progress to bring the scale of assessment in line with the world gdp and gone up over three years to 28 since the Global Financial crisis because we have done much better in recovering from the Global Financial crisis. A number of allies and partners in europe and others and irony of the moment and people talk about u. S. Decline as i understand, the difference between 22 and 28 is not our share in the Global Economy. Its justified by the seat on the Security Council which many of us interpret as bust the 22 cap. Its both. Because the formula starts with what is the share of gdp. You pay a premium by being rich and rich countries pay more per share of gdp and then additional premium by virtue and it was going down as our global share of gdp pent down and gone back up a little bit and worth remembering the irony. I dont disagree with anything that ambassador negroponte said and its an issue to be made an important priority with the incoming secretarygeneral. They have to make it clear to the incoming secretarygeneral to sustain support for the United Nations its impossible to explain to the American Public why we pay a joult sized share of this bill. It is true that we have an outside interest, an outsized interest in the performance. We have interests in the every region of the world and an outsized interest here as well and that reduces the leverage. Everybody knows that we have an outsized interest in these things. Because we have assumed greater burdens, we have even greater burdens. Correct. I want to ask one last question if i might. Ambassador power was pretty firm and optimistic about the september 28th meeting of the countries that are contributing resources to the u. N. Peacekeeping. The commitments she over she continues to state are just that, commitments. They have not been delivered yet. Have you had a chance to review the september 28th results and are you optimistic that, in fact, this will have greater participation by the country that is are capable of doing more . Whens your prognosis on this . Well, i was had the honor of being invited to that meeting by the administration and involved and helping the administration think through the preparation for it. Im semi optimistic. I think that the europeans in particular as they have down down in afghanistan, they have capabilities theyre not using in that context. They can contribute. Dutch in mali most important example of what we have seen so far. I think they recognize, they have a deep interest that if theyre going to come to terms with the migration and refugee problem they have to solve it in the places where they originate and they have an interest in helping to stabilize conflicts in africa and beyond. So im somewhat optimistic. I would be very optimistic were it not for a very different reality which is rush why and ukraine causing european governments to reprioritize back to some older kinds of concerns about nato, the containment of russia, et cetera and put pressure on budgets and pressure on european militaries worried about other things than conflicts in africa and so the two things happening at the same time. Theres a genuine will from the europeans and korea that i mentioned to participate in u. N. Peacekeeping and facing new challenges of china, russia and putting different kind of pressures and right to push the argument. The administration right to pursue that initiative and other challenges to confront at the same time to diminish the full impact that it might have had otherwise unfortunately. Thank you. I think we need to keep the spotlight on it. I think that was a Great Initiative by the president and have to be followed up. The other thing i might add with respect contributing countries is one encouraging region of the world in that regard is the willingness of certain latin american countries to contribute to peacekeeping, global peacekeeping which they have been reluctant to do in the past. This mention of colombia, for example. Brazil, too. So i thought that was encouraging and i think its something that the u. N. Needs to avail itself of. Thank you. Thank you both for your service. Thank you. One of the great privileges we have around here is the access to people like you who are so respected and have the ability to share wisdom with us and experiences and we know that every day when we come to work so we want to thank you for your continued involvement and issues of importance to our country. For being here today. As you can see, a lot of members are present by asking questions later. If you would, without objection, first of all, the record will be open until the close of business friday but if you could respond in a fairly timely manner, that would also be responsibilitied but we thank you for your service to our country, we thank you for being here today and with that, the meeting is adjou adjourned. Okay. Thank you. Thank you for the invitation. On thursdays washington journal, kentucky congressman massie on the friday deadline for passing a spending bill to avoid a Government Shutdown. And we talk to congresswoman kelly of illinois about the gun control debate following the San Bernardino shootings. Washington journal is live with your phone calls, tweets and Facebook Comments at 7 00 a. M. Eastern on cspan. Thursday a hearing on terrorism and its impact on global oil markets. Well join the Senate Energy and Natural Resources committee starting at 10 00 a. M. Eastern here on cspan3. Book tv has 48 hours of nonfiction books and authors every weekend on cspan2. Saturday night at 10 00 p. M. Eastern, on after words, nurse and the New York Times columnist Theresa Brown discusses the shift. Which gives readers a firsthand account of her experience in patient care and safety. She is interviewed by deborah hatmaker, executive director of the American Nurses association. Health care is only going to get more and more complex. Right. And were just going to need better and better nurses than to meet all of those complex needs. So thinking about how to keep us strong and healthy and encouraging that is huge. I dont think we sort of give lip service to that but we dont really emphasize it. On sunday afternoon, at 1 30 p. M. Eastern politics which i had been part of all my life was not so different from the world of petty criminals, robbers and racketeers but it was disguised and therefore less obvious to see. In fact, for 25 years in my career, i have looked at america as an idea. Ive defended american principles, the american dream, the american founding. And ive looked at american politics as a debate. The republicans believe in liberty. The democrats believe in equality. Republicans want equality of rights. Democrats want equality of outcomes. Now, it is the point of view of the criminal underclass that this way of looking at american politics is complete and total nonsense. Dinesh examines america and american politics in stealing america. And sunday night at 7 30 p. M. Eastern, former democratic president ial candidate and author Lawrence Lessig talking about his experience running for president and campaign finance. The central theme of the book republic lost. Were supposed to have a democracy where we as citizens e quantity participants but you have a system where members of congress spend 30 to 70 of the time raising money. They cant help but be more focused and concerned with the interests of that tiny fraction of the 1 . So thats a system where this basic equality is denied. Watch book tv all weekend, every weekend on cspan2. Now, a hearing examining state Health Insurance exchanges under the Affordable Care act. The house energy and commerce subcommittee on overnight and investigations heard from the acting administrator on the issue. Its about two hours. Good morning. This subcommittee will now convene. The overnight investigation subcommittee to continue the examination of the marketplace under the aca. On september 29th, Committee Heard from a panel of witnesses representing six state exchanges. While attempting to paint a rosy picture, theyre serious long term and short term problems with the exchanges. One of the main concerns is how services or cms is conducting oversight over the billions of taxpayer dollars in the exchanges. We expect direct and honest questions of andy slaf it. Welcome back, sir. Cms handed out 5. 51 billion to the states to help them establish the exchanges. Despite the investment of taxpayer dollars, four states exchanges turned over to the federal exchange and countless others are struggling to become self sustaining. As the federal dollars run dry and enrollment numbers appear far below projections, all state exchanges face significant budget shortfalls. By law, state exchanges were supposed to be self sustaining by january 1st of 2015. At which point federal establishment grant money could not be used to operate the exchanges. Not be used. Yet cms is issuing nocost extensions allowing them to use the remainder of the federal grants through 2015 and 2016 against intent and letter of the law. Federal funds still cannot be used for operational costs. But because of lax oversight and weak guidance, we dont know whether or not state exchanges have actually spent the federal money appropriately. We intend to get clear answers today. In the over five years, cms issued two guidance documents to inform exchanges on the way to spend federal establishment funds. The first guidance in 2014 less then a page. The second guidance came only after the hhs office of Inspector General issued an alert to acting administrator an andy slavitt and using grant funds for operational expenses which is not allowed. In fact, the oig discovered based on budget documents that washington Health Benefit exchange might have used 10 million in establishment grant funds to support operations such adds printing, postage and bank fees. Again, not allowed. Hhs, oig urged the acting add min stray forfor a clear guidance on the appropriate use of establishment grant funds. What followed was a vague document bereft of concrete examples. Based on these quote guidances unquote one wonders if cms is encouraging them to spend federal dollars in any way possible against the stated purposes of the law to keep these state exchanges limping along. To the committees investigation we have learned of instances of state exchanges may have used establishment grant dollars to cover operational costs or transition costs when a state exchange shuts down and moves to the federal platforment it hasnt been always easy to discern because theyre comingled and expensions and costs redefined. For example, rent, which is an operational cost by any definition, suddenly becomes Business Development costs. The system seems to be convol e convoluted by design. In spite of or perhaps because of cms hands off approach, theyre struggling to become self sustaining. They cannot to face i. T. Problems, growing maintenance costs and as the hhs oig pointed out in the alert, theyre facing uncertainty in revenue. Four shut down their state exchanges and these four states alone received 733 million in federal establishment grants. The taxpayers return on investment appears to be minimal at best. Further, little indication that cms attempted to recoupe any of this money. It is our that hope the slavitt has a blueprint for recouping the lost millions of dollars. To better understand the challenges these state exchanges face, to ensure more tax dollars arent wasted, we have a number of questions. Especially given the extraordinary taxpayer investment, a lack of accountability or oversight . Cms encouraging fiscal restraint or taking a hands off approach allowed money to be spent unwisely and maybe imper miss bring . Where an exchange has shut down has cms sought to recoupe any of the dollars . Are they doomed to fail . In my estimation, cms oversight is sloppy at best and ignorant at worst at costing taxpayers millions and counting from the states. We hope that cms is forthright in answering the questions on the failure and overseeing the aca state exchanges and provide members a blueprint of how the administration recoupe lost taxpayer dollars. It is a mess and taxpayers on the losing side and unacceptable. This hearing comes when premiums are on the rise, major insurers questioning the decision to join the exchanges and expressing doubts about the ability to exist long term. Evidence suggests the aca problems of 2016 and today we have an opportunity to ask cms top official if and when the administration will finally address the concerns. So i thank andy slavitt for testifying today. I now recognize Ranking Member ms. Degette for five minutes. Thank you railroad much, mr. Chairman. Yet another hearing on Affordable Care act, as usual, mr. Chairman, im disappointed that here we are on having another hearing focused on undermining the law rather than focusing our efforts on trying to make the law work better. I know with respect to the topic of this hearing today cms is trying to implement efforts to make the law work better and i think that we should be using our time today to see how we can partner to make that happen. Since the aca was passed over five years ago, this committee has held dozens of oversight hearings on the law. Not one of them has been focused on ways to make the law work better. Not one of them has presented a balanced view of the laws benefits but despite that, we have gotten a lot of good news out of the hearings about the number of americans that the law is helping and about what the agencies are trying to do to improve coverage despite some of the bumps in the road. But, you know, even more disturbingly to me, though, its been its been really an uphill climb to try to implement this legislation because some of our colleagues, both here in congress and around the country, have intentionally placed roadblocks to implementation that make it harder for their own constituents to access carement some of the governors refused to give Health Care Coverage to millions of lower income americans. A republican president ial candidate who also happens to be a u. S. Senator recently bragged that he killed obamacare limiting risk quarter payments. I have two things to say in response to that. First, i think its really disatonighting that members of congress would brag about taking Health Care Away from vulnerable americans. Secondly, i think people are wrong on the facts. The Affordable Care act is not going anywhere. Despite countless attempts to repeal, undermine, defund and defame the law, its making comprehensive Health Care Reality for American Families. Its saving lives. Since passage of the law more than five years ago estimated 17. 6 million americans have gained Health Coverage through the acas various provisions. According to the recent cdc data uninsured rate dropped to historic low of 9 , down from 16 in 2010. I just ran into my colorado folks yesterday at the airport coming out here and they told me despite the failure of the colorado coop a month or two ago, theyre expecting because of the revisions and innovations theyre making in colorado they may be up to 95 coverage in colorado pretty soon. Thats extraordinary for the health care of our constituents and thats what we should be working to achieve. I have an article of the New York Times entitled rise in Cervical Cancer detection is linked to Affordable Health care, mr. Chairman. According to researchers from the american cancer society, more women are receiving an early diagnosis of Cervical Cancer due to an increase in Health Insurance coverage rnd the aca and ask unanimous consent to be put in the record. Without objection. Womens prospects for survival of the disease and it also bull stores their hope to preserve fertile if i in treatment and far more likely to get a screening that can identity Cervical Cancer early. You know, i know i know that its hard to make this specific about constituents. Its hard sometimes for my colleagues on the other side of the aisle to acknowledge that actual people are being helped by this law but millions of americans are benefiting from it and a lot of people like me think we could be making it even better. The reason im talking about this this morning is because on the house floor well be likely voting on a recon sail yags bill to repeal key parts of the Affordable Care act, the 62nd attempt to eliminate key provisions. If enacted, virtually all of the gains in five years would be lost. This would be a tragedy for the American People. And a gross failure of leadership. You know, we have done so much good this year in this subcommittee. We did bipartisan work on pandemic flu. We did bipartisan work on the volkswagen invest and many other things. I think this could be the committee where we had these hearings and then we sat down to think about how to improve rather than to undermine the Affordable Care act. I hope thats what well do in the next year but frankly i dont hold out a lot of hope. I yield back. Before the next i want to welcome today several members here from the National Democrat ins newt support of the house democracy partnership, this is a peer to Peer Exchange by peter ross and david price an we have guests with us from kenya and peru. Is that welcome here. Welcome. Just let you know, we this is a love fest among us. We all like each other. So take back to your countries sometimes we argue but we still are in here for the same cause. If the chairman will yield. Yes. We disagree in a civil way. Watch this. Thats going too far. Thank you. Now recognize mr. Upton for five minutes. I thank the good chairman. Today we continue our oversight into the obama state exchanges. Taxpayers some 5. 5 billion in these exchanges, yet they still continue to struggle as we know. They are struggling to sign up new customers, struggling with operational costs, i. T. Systems and selfsustaining. We welcome mr. Slavitt today, and we appreciate his testimony on this very important issue. As the state exchanges struggle to survive, we seek to understand cmss role in overseeing them. The governments robust investment of federal funds in the state exchanges should be accompanied by equally robust accountability by these stewards of taxpayer dollars, yet the committees oversight is revealed that cms took a handsoff approach to the state exchanges. For example, cms rubber stamped no cost extension requests issued pervasive guidelines with no questions asked. This is not acceptable. We want to hear directly how cms plans to improve its oversight over the state exchanges to ensure that they are spending some grant dollars legally, actually all grant dollars legally, and wisely. We also must understand the longterm sustainability of the exchanges, especially against the backdrop of rising premiums, failing coops and Insurance Companies doubting their participation in the exchanges next year. The writing is on the wall that we very well could see yet another big taxpayer investment spiral down the drain. So its critical that we all understand the short and longterm challenges that state exchanges are facing as well as what cms is doing to help the exchanges confront the challenges. Regardless of ones views of the president s health law, the law and its implementation demand oversight. As we see today, billions of dollars are certainly at stake, and i yield the balance of my time vice chair blackburn. Shopping for insurance was supposed to be as simple as shopping on kayak or esurance. And that is not what happened. And what we continue to hear from our constituents is that this insurance, the obamacare insurance product is too expensive to use once they do get it because of the copays, the deductibles and the premiums that are there. Its a very expensive product. We want to look at the gao report from september. Today we want to go through this with you as both chairman upton, chairman murphy have said, it is very difficult for our constituents. And basically, what it appears is that this has been a false promise that was given to people, that they would have health care access, because they were going to have insurance. And that has not come about. So we are very concerned about the dollars that have been spent on these state exchanges. Were concerned about the quality of the product, and i yield the balance of my time to dr. Burgess. Well, thank you for yielding. Look, the administration has invested billions of dollars in an experiment. An experiment that did not include the necessary safeguards and in fact ignored success models in the private market. The Health Benefit exchanges are one such experiment. Billions of taxpayer dollars have been pumped into reinventing the wheel, and billions have been forced to rely on exchanges to purchase Health Care Coverage. My experience as a consumer on health care. Gov has been extremely frustrating, and my experience as a member of congress and a member of this committee and Sub Committee has been just as frustrating. I know there are those who want to accuse us of trying to undermine the law. That is not the case. The law should work. We as members of this Sub Committee, members of this full committee, we as members of congress have a responsibility for oversight on how those dollars are spent. It is extremely difficult getting questions answered, extremely difficult getting information. That needs to change. And i hope in this last year of the administration we perhaps can at least now admit to each other that there are Serious Problems with the law as it stands. And there are serious actions that we could take to fix those. Thank you, mr. Chair. I yield back the time. I recognize the gentleman from new jersey, mr. Pallone. Thank you, mr. Chairman. Were here today for yet another hearing to attack the Affordable Care act. Since the august recess, the majority of the Sub Committees hearings have been dedicated to undermining the law. The majority has called in the state exchanges and cms to criticize them, and they have burdened them with massive document requests in the middle of the open enrollment. I do not mean to suggest that we should not be doing oversight of the implementation of the aca, but what were seeing from my republican colleagues is not balanced oversight. Instead, the majoritys efforts are designed to hamper implementation and undermine the Affordable Care act regardless of the facts. Frankly, its incredibly frustrating to sit here time and team again, listening to my republican colleagues lay into the administrations witnesses, criticize the efforts of their departments without any sense of perspective on the historic gains in coverage that have been achieved. I would have hoped that by this point nearly six years after the passage of the law we could add a balanced perspective on where implementation of the law faces challenges. But just as importantly, where it is helping americans lead better lives and become more productive citizens. We should be talking about ideas to advance the mission of the law to provide quality Affordable Care to all of our constituents or even make key focuses whe fixes where appropriate. As cms will testify today, the acas making a difference in the lives of millions of americans, making familiar lils stronger, states stronger, making america stronger. The law has faced challenges, but weve had many more successes than youd ever hear from my colleagues on the other side of the aisle. So im going to take a moment to make shush we hear some of the successes in todays hearing. 17. 6 Million People have gained coverage. Since the start of this years open Enrollment Period on november 1st, 2 million americans have selected plans through the federally facilitated exchange. More are making the right decision on Medicaid Expansion which is saving billions of dollars. Preexisting conditions can no longer preclude individuals from gaining Health Insurance. Consumers do not have to worry about losing coverage if their employment changes. Reductions in the uninsured rate mean doctors and hospitals provide less uncompensated care which means fewer costs are being passed along to consumers and employers. Instead of acknowledging any of these successes, my republican colleagues insist on holding more hearings and debating bills to undermine the law. This week the house may be voting on a reconciliation bill to repeal key parts of the Affordable Care act. This is the 66th attempt. The republican bill eliminates subsidies for individuals purchasing coverage through the exchanges. And according to the congressional budget office, the gop bill would increase the number of uninsured americans by 22 million by 2018. It would undo many of the historic gains weve made in the past five years while doing nothing to make health care more affordable and available for all americans. As for a viable republican alternative, which republicans said they would offer for several years now, let me just say this. Ill believe it when i see it, because i havent seen it. Lets actually work in a productive bipartisan way to make the Affordable Care act work better instead of taking empty, meaningless votes to repeal it and take Insurance Coverage away from our constituents, and i yield back. I ask that written Opening Statements be entered into the record and without objection the documents will be entered into the record. We are holding a hearing and have a practice of taking testimony under oath. Do you have any objections to taking testimony under oath . I do not. Youre entitled to be advised by counsel. Do you desire to be advised by counsel during the hearing today . No, i do not. Do you swear the testimony you are about to give is the truth, the whole truth and nothing but the truth . The witness said yes. You may now give a fiveminute summary of your written statement. Thank you. Chairman murphy, Ranking Member degette and Ranking Members of the Sub Committee. Thank you for the invitation to discuss statebased health care exchanges. Cms is working hard to provide access to Affordable Care coverage. Allow individuals and families access to information, tools, personal help, Consumer Protections and an array of options from private Sector Health plans, setting up and managing a state marketplace is a significant task and id like to talk now about how we provide oversight and assistance to the marketplaces but also watch over the american taxpayers dollars. In considering our oversight role, its important to understand all the responsibilities of a statebased marketplace. States must establish the infrastructure to review and qualify health plan offerings, develop call lines, interface with state medicaid systems. Develop Cyber Security capabilities, outreach and education functions and dozens of other functions. They are successfully ensuring millions of people. Every state has had its share of challenges, including five who have had more significant i. T. Challenges. And i. T. Typically represents 30 to 50 of a states budget. In discussing our three key oversight priorities, i want to focus in particular on those situations where states have had more significant challenges. Our First Priority is to be good stewards of the federal taxpayers dollars. This means returning unspent dollars to the treasury and closing grants, collecting improperly spent dollars and preventing more from going out the door. Over 200 million of the original grant awards have already been returned to the federal government, and were now in the process of collecting and returning more. This also means no new money fix i. T. Problems was given or will be given to any of the five states or any of the other states that may run into difficulties. We should not pay twice for the same result. Second, our job is to manage every dollar tightly. Ive always been a big believer in preventing problems so we can spend less time recovering from them. Every statebased marketplace has external funding sufficient to run their operations. Federal money may not be used for regular operations. We do a lineitem review of the expenditures a state proposes to ensure it complies with the law and conduct audits to ensure there is a full accounting of all federal dollars. Important to our approach we maintain control of the Purse Strings in 69 times this year weve denied use of federal funds. We also make adjustments through readiness reviews, detailed reporting of regular audits. Third and perhaps most important we assist a state on getting a return on their investment as measured by the value they provide to their state. For all the challenges theyve had, their ingenuity, their persistence has paid off for millions of americans. S after june 30, statebased marketplaces provided coverage to 2. 9 Million People, has helped millions access medicaid and the uninsured have declined an average of 47 since 2013 to under 10 . Now ive worked in health care in the private sector since the early 1990s and joined the government only last year. Among other things, i founded a company that assisted people who were unand underinsured. And ran an Analytics Organization touching virtually every part of the health care system. I can tell you from my perspective what a significant advancement has been made to American Families in a short time by giving access to care and eliminate the worries that come from not being able to protect one as own family. I can tell you how difficult it can be to launch and operate any New Enterprise of this scale. In conclusion, i have the privilege of serving as active administrator as we are celebrating the 50th anniversary of medicare and medicaid. The perspective it offers is that at this early stage of the marketplace there are millions still to educate and enroll and leaders are continuing to find the best, most efficient ways of meeting the needs of these populations. Cmss oversight responsibilities are critical in this equation. Cms must not only be accountable for these responsibilities but we must take every opportunity to find ways to improve how we do our job, including taking outside input so we can best provide affordable coverage for consumers and presenting the investment by taxpayers. We do appreciate the Sub Committees interest this this area, and i am happy to answer your questions. I recognize myself for five minutes of questions. The office of Inspector General found that Washington State budgeted 10 million federal dollars for expenses including printing and postage fees from july through december 31st of this year. These expenses are prohibited, but cms had approved them in washingtons grant application. I know you said you disprove them but how do you explain that . The early alert stated that there was a potential that there may have been misspent funds, but i dont think oig made that conclusion, and we conducted an investigation and looked through all their funds, i think there were a pewfew adjustments made, state of washington by and large is spending its money and categorized it properly. We do have one small collection that we are undertaking with the state of washington, but thats in process. But the oig did say that was occurring, but you said there has been an adjustment made . Theres been plenty of adjustments, we have by background hundreds of interactions with the states. We rely all their line items and budgets monthly. So at any point in time they may have found something that they thought was classified improperly. We take advantage of the work of the oig and go conduct further the investigation ourselves. I dont believe we think all those 10 million were unclassified. Would you have found these if the oig had not pointed these out . I wouldnt represent that our team finds everything. I would say that we have multiple pieces of the process, most important being prevention. Once the dollar goes out the door, you have to spend an effort to collect it. So we spend a lot of effort preventing things from being misclassified. We do find things and collect them. And i think oig also finds things that we dont find, and when we do, we have a period of time that extends three years past when the time periods end, and the clock hasnt started ticking yet, so we will make sure we collect anything that gets uncovered. Will you then post what your findings are in the oig to show this is an inappropriate category and notify states that if you have spent money in these categories you will be asked to return that money . Yes, states are all aware. Is it appropriate for state exchanges to transition healthcare. Gov after spending hundreds of millions of tax dollars on their own sites, and shouldnt there be other consequences . They failed and later they said sorry, it didnt work out. Does that seem appropriate . I think its important for us to recognize, states have the right under the law to decide whether they want to be a statebased exchange or federal exchange or to be a statebased exchange and use our platform. They have the right to change their mind for a variety of means including technical and otherwise. We think thats important. What also is important is if we find any money has been misspent or granted money we believe the state no longer needs, we control the purse springtrings. We have collected money from the state of maryland. With regard to the states trying to get into the Insurance Business and didnt work out for many states, but theres no real consequence if they were able to take the money, say, toss their hands up and say well, turns out it didnt work out, well just go to the federal exchange. Many of us have a concern, if there are no consequences then thats hardly a lesson. This is what i want to know. Do you have any plan or intention to gather back, to recoup the federal funds that have been provided to states to set up their exchanges only to shift into healthcare. Gov . Theres five states that have had most significant i. T. Challenges. Two of them maintained the role as state exchanges. Three of them are using the federal platform but are still statebased exchanges. In each of those cases its slightly different. In one of those cases we have recovered money. In another case, the state, two of the other case, states in processes of trying to recover money, after which wlee try to go after our federal share. One of the other states we in the process of closing down and collecting some money. It varies by state. But even states that had challenges, they were, by every measure, able to enroll people, they had contingency plans and eventually able to set up a system that worked, which extends, as he said earlier i understand that, but it was after a lot of failure and waste of money. And i would love if you could give us something in writing of what your specific plan is with recouping these federal tax dollars. Mr. Chairman, im assuming that youre referring to this gao report from september 2015 to congress . Yes. In these questions . Id askew nan muss consent to make that part of the record as well. Yes. Have you also reviewed this gao report . Yes, i have. That the chairman was asking you about . And one of the things that they said is that it was their finding that cms that, had established a framework for oversight, but it wasnt always effectively executed. Did you see that finding . Yes, i did. And what, whats cmss response to that, to that finding . Yeah, i believe we concurred with that finding. You know, from our perspective, we are overseeing a lot of grants, so engaging the oig, which we have worked in partnership with as well as gao are very helpful to us. And we take action when we get those findings. So did you take action as a result of that concurrence . Yes, we did. What did you do, briefly. We built a tool which allows and monitors all of the funding before it occurs, so were able to collect money, to stop money from going out the door that shouldnt. I think this hooks onto the question the chairman was asking you. If could you supplement your answers by letting us know the policies that youve implemented, i think that would be great. Yes. Now, can you tell me about cmss interactions with sbm officials like weekly checkin calls and site visits . Yes, i think we have dozens if not hundreds of interactions that relate to issues such as weekly checkin calls to site visits to audits. There. Administrator, what types of reporting are required from cms establishment grant recipients, and how are they used by cms . So, you know, we conducted at omb a one, two, three financial audit. We have a Smart Program audit, an externts security audit. The states have their own audits, legislature audits. So these numbers get pored over. And then how do you use them . Well, if we find that moneys been improperly classified either as a Cost Allocation or as an operating expense when it wasnt, we go collect it. And what types of independent assessments and audits are required . Well, theres the omb audit. Mmhm. Theres a large variety of audits that follow these. Sometimes i think as you said before states do misclassify or misuse the grants. So what steps does cms take then to bring the state back into compliance . To give you an example, we found that in the case of arkansas, roughly 1 million and weve notified them. And were in the process of collecting that. Theres three other states that have amounts of money that we thought were misclassified but also emphasized, congresswoman, we do a lot more to prevent these from happening. That was my next question, yeah. Go ahead. I think 69 times this year we have caught in a request something to be used for generally an operating purpose that we didnt believe was an operating purpose, we believed, im sorry, for a development process, and we denied the funding. In reviewing the original app. Reviewing the original request. And what types of evaluation can cms conduct on nocost extension requests. Pretty extensive. It needs to be to fulfill whats part of their work plan that three have set up and that they just need more time to establish. We all know that these things are taking a little more time to implement than people originally thought. Now i just want to shift, shift my questioning for a second. To talk about some of the things the aca is doing. The most recent data from the cdc and Census Bureau found that the uninsured rate has fallen to 9 from 16 in 2010. Im wondering, is this a new historic low in the uninsured rate . I believe it is. Do you believe that the Medicaid Expansion has played a significant role in these reductions . It has. Why do you say that . Because we see millions of people in the states that have expanded medicaid who now have access to coverage largely for the first time. They didnt have insurance before. They didnt have insurance before. And for these vulnerable citizens, can you talk about how the Medicaid Expansion has impacted them . Yeah, certainly. I think very briefly, congresswoman, when these families get access to health care for the first time, it changes their participation in the community and in many profound ways, but it keeps them healthier and i think it reduces costs for the long term. Thank you very much. We now recognize ms. Blackburn for five minutes. Thank you, mr. Chairman. Mr. Slavitt, lets go to page 886 of the dao report. I dont have it in front of me. On page 86, what you find is the grants that have gone out, and the pool of money, which was 4. 5 billion. And youve sent about 1. 3 billion out the door. So what we want to know is, wheres the balance of the money . Wheres it currently sitting . Yeah. Do you have a proper accounting of that . We do. We, in fact, we can provide you with an accounting of every dollar thats been spent, every dollar that hasnt been spent but we still have control of, and were in the process in many cases of pulling that money back. Okay. Then do provide us we will. With that accounting, because we will need to see that. And, you know, if there is money that you are, lets go to the arkansas situation. Okay. I know you had said there was a Million Dollars there unallowable. So tying back in to what the chairman was asking you, when you have a situation, do you give them a plan of action and a timeline for returning that money to the treasury . Yes. Sometimes theres a little negotiation at first, but then we do that, yes. Okay. It seems interesting there would be negotiation if they used it for something that was not allowed. Well, i think really this is all a matter of us explaining to them why we believe it was unallowable. Theyre reviewing it, reviewing with their lawyers. It takes a little bit of time. All right. How many other states have utilized funds for unalouables . For unallowables . I can think of at least three. And you plan to get all that money back . We do. Excellent. That sounds good. I, also in the gao report, one of the things that is of concern to me is they say none, zero, nobody, not a one of these exchanges are meeting the desired operational outcomes in all functional categories envisioned by cms. So at this stage of the process, doesnt this demonstrate that the systems are incomplete and incapable of functioning properly . What i could tell you today is that all of the exchanges are functioning, serving the members in their states and their communities. And some of, all of them have run into their share of challenges. None of this was easy. Some of them bigger challenges than others. But there have been some that are very successful, and i think the experimentation level of states then how do you answer the gaos assessment that none are meeting the desired functional outcomes . I think at any given point in time there have been challenges, things that have been delayed, have been in the contingency plans. But nobody is meeting the desired outcomes. We continue to get complaints about these exchanges. We hear from people that, you know, the dissatisfaction is rampant. It costs too much, its too expensive to use. The exchanges dont work, and then you get a gao report that says nobody is hitting the metrics. So why do you continue to put money in on this, if theyre not meeting the functional outcomes, the desired outcomes . Why are you continuing to put money into this is this so i understand the question. And its an important question. Of course, 2. 9 Million People have been covered. Thats the point of these coverages. They are reaching the needs of populations that have never been meant before. So weve spent or could spend 4. 5 billion to get access to 2. 9 Million People. Thats what youre saying. Im saying the states have reduced their uninsured rate, the states that have statebased marketplaces to under 10 . And theyre still in the establishment phase. Its still early on. If theres money thats improperly spent or money part of a grant thats no longer needed we have every ability to collect that money, and well bring it back. So if you were in the private sector and you were five years into a rollout and you werent functional, would you give yourself an a or an f . I wouldnt agree with characteristic that they are not functional. The gao says they are not, so you are disagreeing with the gao report . I would say at this point the states are all functional. So you disagree. The gao says not any of them have hit the desired operational outcomes in all functional categories. Mr. Slavitt, it means, it aint workin. Let me take a look at the language they used and let me get back to you on the well, i would think that you would have known that answer if youre functional or not before you came to us. Yield back. Now recognize mr. Pallone for five minutes. Thank you, mr. Chairman. Despite countless attempts by the republicans to repeal and undermine and defund the Affordable Care act, it is making affordable, comprehensive coverage a reality for American Families. According to recent cdc data, the uninsured rate has dropped to a historic low of 9 down from 16 . So i want to ask administrator slavitt, can you put this in historic perspective . How significant is this drop in the uninsured rate, and can you comment on how the different coverage provisions of the aca have operated to result in these gains in Insurance Coverage . Well, since at least ive been in health care in the early 199 1990s theres been very little progress. So these strike me as fairly significant improvements. I think theyve come both from Medicaid Expansion as well as the offering of qualified health plans through the exchange. And you said, of course, that these gains really are historic, and i want to thank you for your contributions to making Health Insurance more affordable and available to millions of americans, but looking to the ut into, its my understanding that this open enrollment and future seasons are more challenging, because there are some that are hard to reach. Thats correct. Many of the uninsured are actually still unaware or confused about how federal what is cms doing to communicate so that they understand that they may be eligible for the subsidies . I dont know if you answered that, but id like to know more specifically, if you could. For us, its really a function as you said congressman, making sure people are aware that there are subsidies, that there are plenty of choices available. These are people many of whom didnt have Health Insurance for a long time. So theyre not as connected to the process as the people who have been engaged so far. Ply own experience, when you began the open enrollment, i guess, was what, in the early part of november . Is that when it began . November 1st. And we had a couple of events at, you know, the centers that were being set up. And there was a lot of, you know, outreach that was done, not so much in the traditional way, you know, with ads or media type things, but more, you know, just with people going around, you know, fliers and, you know, knocking on doors and that type of thing. And we did get a lot of people actually show up. You know, even that first day, and you know, its hard, a lot of times you have to, you know, figure out exactly where your Placement Center is. You know, operate on weekends, you know, do things that are not easy, to be honest, just to get people, and i just think that, you know, i know that a very good job is being done right now, you know, during this period to try to get to the people, but it is hard, and i, i just, you know, even when i talk to people one on one and i explain to them, you know, that they can get help with their premium, theyre kind of shocked by it, which, to me, is surprising six years after, you know, we voted on this that people still dont understand that they can get help with their premium, but thats the reality. This is one of the successes of statebased marketplaces because they understand their local populations better than anyone could here in washington, d. C. , and i think they do a nice job of that. Thank you. The chair will recognize mr. Mckinley for five minutes. Thank you, mr. Chairman, and thank you for appearing for us, mr. Slavitt. Several comments. One, i think, when your opening remarks you touched on some of your Mission Statement of providing oversight and assistance, but what was missing, i thought, maybe i because my hearing loss, i might have missed something, but i didnt hear about accountability. Trying to give us, give some guidance to the people, not only your own staff, but those affected parties with it. And the chairman talked a little bit about accountability. And i know coming from the private sector, there is accountability. We, just a quick grab this morning of things here with a person that, because he had committed fraud, hes going to spend 30 months in prison. Here was another one that paid 7 million in restitution to nih. Heres another individual, 27 months for 335,000. In fraudulent documentation. And heres another one. Person is going to spend 3364 days for inappropriate expenditures. What are we doing . Just checking the box that youre providing guidance . Or are you Holding People accountability . Either in your department or, like arkansas, is anyone going to be held accountable . We are accountable for making sure that the federal tax dollars are getting spent properly and we are accountable and have been collecting federal tax dollars when theyve been misused or not. Has anyone lost their job . At a state, in the state . In the state or in your own department, if youve, if you, theyve given inappropriate advice. These people all have gone to prison as a result of doing something wrong. I cant speak to whats happening in the states. But i would tell you that just because a state misclassified information doesnt necessarily mean that they did it with intent, and each case, as you now, it know, its case by case. I keep looking for a good analogy and a quick term. You seem to be like a policeman or a state trooper along the road trying to people guided and under control, but when they speed, theyre ticketed, theyre fined. Im just wondering what youre doing for accountability after that, if they abuse it, then they should be paying for it. Well, were certainly willing to make all these things a matter of Public Record as we have. But you dont have anyone has been held accountable for anything going on. Im sure there have been people throughout the exchanges who have lost their jobs. Could you share that back with me and the names of any just give me a handful of names. Because surelily during this process as convoluted as its been, theres someone that should be held accountable for it. And just in closing, you had mentioned about the affordability. I would, with all due respect i have a little problem because in West Virginia we only have one exchange representing the majority of the state. And there, their costs are going to be increasing 19. 7 if their rate is approved. Thats, thats not affordable. What should be done . What can we do in West Virginia . Almost a 20 hike in premiums. Yes, i believe West Virginia has seen an uninsured rate from 17. 6 to 8 . Thats not high question. The question is affordability. Thats part of the title of this bill is the Affordable Care act. But under the entitlement, they cant afford it. Ill be happy to get back with you with specifics around the state of West Virginia. What i can tell you is that for the majority of the residents, they still have opportunities to get covered for less than 100 per month. No doubt we take accountability seriously and im happy toe wy with you on the state specifically. I want accountability. Thats what we started with. Who is going to be responsible for whats happening out here . All in federal government, but in yours right now is over this Affordable Care act. Whos being held accountable . I look forward to talking to you. Yield back. Mr. Mckinley, when you referred to the affordability, are you referring to the premiums . Deductibles . All of this together. The premiums themselves are 19. 7 increase. I think theres laalso conce for the deductibles. Now from florida ms. Castor. Survey after survey over the past year all confirm that the percentage of uninsured americans has declined substantially. Due to both the Affordable Care act exchanges in marketplaces and also due to the expansion of medicaid in many states. In fact, the census data from september found that the uninsured rate dropped in each and every state. And this is a wonderful accomplishment. It was one of the overriding goals to ensure that our neighbors have that very basic, fundamental access to Affordable Health care. Although all states saw a reduction in the uninsured rate, states that set up their own statebased marketplaces and expanded medicaid saw the greatest gains. For example according to the census data and mr. Yarmuth will like this, from 2013 to 2014, kentucky showed an over 40 drop in the uninsured rate. Oregons rate dropped 34 , and minnesotas rate dropped 28 , and further declines in uninsured rates are likely to continue into the next year. Now florida, my home state doesnt have a statebased marketplace, but were going gangbusters on the number of my neighbors now, that have access to an affordable plan. And it was announced just last week that as my neighbors enroll and renew coverage, were approaching over 500,000 so far, just over the past four weeks, thats out of the 2 million all across the country that are renewing in the federal marketplaces. And if you all are looking for a holiday gift for a loved one, for your son or daughter or niece or nephew, be sure to get them enrolled by december 15th. Because then they can start their coverage on january 1st. Were very fortunate in the tampa bay area, the average cost of our standard of Exchange Insurance plan is actually dropping this year. And so it is very helpful to have that competition in the areas where we have that competition costs and the costs of plans are going down. But back to the statebased exchanges is that right slavitt, what do the declines tell us about the statebased marketplaces . Do you think they are succeeding overall . Yes, congresswoman, i think they are. I think the statebased marketplaces are on arm doing even better than the federal marketplaces. And do you have a sense of how many people have enrolled in coverage through the statebased marketplaces so far . Ago of june 30th, the numbers with roughly 2. 9 Million People. And what role has the premium support played in that . And who receives the premium support . Whos it available to . Sure. So the cost sharing reductions and the tax credits that are available through the Affordable Care act really are allowing people to afford their coverage for the first time in many of these places, so its been a big impact. And what weve found in florida is its kind of complicated for folks whove never had the ability to afford health care before, the navigators are playing a very Important Role, because theyll sit down with you and go through all of the options and what makes sense for you or your family. And youve seen this same thing across the country . Absolutely. Absolutely. I was just at a Community Center and saw the exact same thing. And what more can we do to continue to lower the uninsured rates even further . So we are willing to work with any state that hasnt yet expanded medicaid that is interested in having a conversation. Yeah, thats my state. Boy, we have thousands and thousands of my neighbors. And its just been, governor scotts been so intransigent, while it shows that it would lower costs, the chamber of businesses, hospital, okay, youre willing to work, but what happens when you run into this wall of unreasonableness and unwillingness to expand medicaid . Year willing to work with any state. We know the states have their local concerns and were willing to entertain them on their terms. We open for business for states that are interested. I know youre still willing to talk to florida. I hope we can put the coalition together again to do it. And even though we have those challenges in certain states on medicaid, and there are going to be glitches and audit reports that are not so favorable in some ways, its still important to remember the purpose of these exchanges and the grants that support them is to provide affordable Health Coverage. And its great to see that the Affordable Care act is providing that lifeline to affordable coverage and Consumer Protections and that the state and federal exchanges are achieving those goals, so thank you very much. Gentleman yields back, recognize dr. Burgess for five minutes. Thank you, mr. Chairman. Mr. Slavitt, im going to depart a little bit from the stated purpose of the hearing. Its so rare that we get the cms administrator in here, i think its two or three years, so theres some things that i feel that i need to ask you since i have the opportunity to do so. But first, i want to offer to colleagues on the other side of the dais complaints that no one on the republican side is trying to improve anything in health care, i have had a bill out there hr 1196 which would al lou the bronze and silver level plans to be each considered as a an hsa compliant plan. You have high deductible insurance. When i had an hsa i had a higher deductible. And i could put some of that money away to use toward that high deductible. Weve made it very, very difficult for people who have these high deductible policies, but, again, id encourage people on the other side of the dails to look at hr 1196. If you can suggest improvements we have something to talk about. But it says every silver and bronze plan would be hsa compatible. You wouldnt have to look to find one thats hsa compatible. They would be. And another thing thats straightforward, currently i have a Health Savings account. Im capped at 3400 a year that i can contribute, but my deductible is 6,000 on a bronze plan in the ppo, so why not make those two amounts equal . And if the deductible is 6,000 in a bronze or silver level plan, let that be the cap on the amount they put away into the Health Savings account. Now, as i sit here and listen to the discussion on both sides of the dais, i feel like im stuck in a dickens novel. Its the best of times. Its worst of times. So i think the fair observation is that the Affordable Care act has never had, never had even a plurality of positivity. Its about a 52 to 53 negative right now, when you look at the polling numbers. You have to ask yourself, youre giving something away, why arent people liking it more. And the answer is because even though youre giving something away, its still really expensive to live under the Affordable Care act. Now my personal experience, i rejected the special deal for member of congress, and i just took a bronze plan at healthcare. Gov, one of the most miserable experiences ive ever been through trying to get signed up for that darn thing, but look, ive got an Insurance Premium thats higher than ive ever paid in my life. I have a deductible that quite honestly leaves me, at least in my consideration functionally uninsured. People have asked me, is your doctor on the list of providers you can go to . I dont know, because im not going to look, because im not going to go to the doctor. If i cant fix it myself, thats that. But im not going to spend 6,000 on an office call or e. R. Visit. And most people actually fall into that katz gore. So once again, even though you have people with that insurance you have people financing a lot of their day to Day Health Care needs out of cash flow, which is exactly the way it was before, the only difference was you could in fact buy an affordable policy before, now you simply cannot, and oh, by the way, were going to fine you if you dont do that. I also have a question about some of the implementation on the Affordable Care act, and i apologize for doing this to you without warning you before. But section 1311 h, sub section b, which deals with hs, were talking about the exchanges. H deals with quality improvement, enhancing patient safety, a hospital greater than 50 beds. Next paragraph is b, a health care provider. And here are Health Care Providers that can work in the exchange only if a provider implements such mechanisms to improve Health Care Quality as the secretary by regulation may require. And the start date for that was january of this year. So my question to you is have the rules been written on 1311 h when my provider friends ask me where, where is this in the rule making process, has that in fact happened . Are people going to be excluded from the exchanges because they dont meet the secretarys definition of quality, and has the secretary defined quality, and are those definitions likely to change . Thanks. So i think your question was relative to how were implementing the quality provisions in the Affordable Care act relative to exchanges. And i could spend more time with you, either here or in another setting, kind of taking you through the quality steps were introducing a whole series of quality reporting measures that are going to be coming with the exchange shortly. I think i understood have you excluded a provider based on quality . Im not sure i understand your question correctly. I want to make sure that i said it at particular sub section. We do reviews, and i think we do reviews based upon the Network Adequacy. Im not sure weve yet excluded any provider for quality purposes at this point, but i will get back to you. Chair recognizes mr. Tonko for five minutes. Thaurngs and welcome administrator. As you mentioned in your opening testimony we need to keep in perspective that the Affordable Care act is working. And it is working best in states that have embraced the law and taken advantage of the tools that the Affordable Care act provides. When states take ownership of the law and its benefits, the residents of that state see better outcomes. And let he use as an example my home state of new york. We expanded medicaid. We set up our own exchange, the new york state of health. And this year we are one of the first states to utilized basic Health Plan Option known in new york as the essential plan. The essential plan will help people toward the lower end of the income spectrum but above the Medicaid Eligibility line to gain access to quality Health Insurance for as little as 20 per month. Because new york has taken a proactive approach to health care reform, the citizens in our state have reaped the benefits. More than 2 million new yorkers have enrolled in coverage because of the Affordable Care act. Certainly, with that in mind and across the board, states have been have pursued the statebased marketplace models. And theyre serving as laboratories for innovation, testing new roles for enrollment and Consumer Protection and they are tailoring the aca to their own given citizens. With that in mind, administrator, california has been a leader in the active purchaser model. Can you explain what this is and how this has helped covered california ensure access to highquality, affordable Health Insurance coverage . Thank you for the question. I think this is an example of a state innovation where california has really been, as the description says, actively involved in defining the benefit offerings for the residents of their state. I think quite successfully given both the number of people that have been covered, but also the management of the rate of cost has been, i think done a very nice job. Now are other states taking steps that you know of to qualified health plans . I believe there are several others, yes. Any number that you have in mind of how many states . Let me get back to you on the exact number. Thank you. And what are the steps are the sbms taking to improve the quality of care to transform the Health Care Delivery system . I got back from a tour of several states. And theyre each doing unique, innovative things. Some are reaching out into communities where theyve got specific needs. But, again, i think this is a benefit of the model of the state having their own, operating their own exchange. It gives them more control to be able to taylor things to the needs of their population. And as we move forward, does cms plan to encourage states to set up and operate their own exchanges . What federal support will exist out there . Will remain for our other states to plan to ten continue their o exchanges . The law provides every state the flexibility to make their own decision, but we will of course support any state that wants to set up a statebased marketplace. Today if the state wants to do this, they get the benefit of all the best practices and Lessons Learned that the states that originally did it didnt have access to. Did we hear, do you hear from residents of these given states that have not expanded medicaid, for example, or established their own exchanges . Do you hear from any of the consumers . We do. We do frequently. And whats the, whats that dialog like . Is it one of concern . Frustration . You know, i think anybody who doesnt have coverage has to manage their own personal family situation very differently than the rest of us do. They have to be, they dont, you know, they dont do things, typically like let their kids play sport in school, because they might get hurt or injured. So theres a whole set of things that are in the insecurity of peoples lives that those of us who have insurance dont have to deal with every day. Well, i certainly appreciate the work that youre doing. I know that it takes a lot of focus and concerted effort to move us into, transition us into a new era of Health Care Delivery, and we thank you for the work that youre doing at the agency. With that, mr. Chair, he yield back. Yeah yields back, and i recognize the gentleman from texas, mr. Flores, for five minutes. Thank you, chairman. The aca wanted the state exchanges to be selfsustaining after january 2015. And yet, as you heard earlier today, according to the gao report, the greatest challenges that stating with statebased marketplaces face are one inadequate staff and two, inadequate funding. And you answered a question earlier. And in that question, you said this. You said statebased exchanges are doing better than federal exchanges. So given that the gao report says that the statebased exchanges are having a problem, it doesnt foretell good news for the federal exchange. None of the statebased exchanges were fully operational in all the required functional katz goers as of february 2013. Y you heard that from ms. Blackburns presentation. They failed to be selfsustaining. My question is this. How many more state exchanges do you expect to fail to make the transition to the federal exchange . I believe what i said earlier that the states have been even more successful at reducing uninsured rate. The National Average has been 45 . Statebased exchanges have done about 47 . I think both successful, states even more so. Lets go to my question. Do you expect more state exchanges to fail to make the transition to the federal exchange . All the states have access to a source of their own funding, either through an assessment that they have on the Health Insurers in their state. So are you saying no state exchanges are going to fail . Im saying all have funding. Its a dynamic world. We do an evaluation at least twice a year. Based on those evaluations, how many state exchanges do you expect to fail and move to the federal the system . I cant predict, because there are a lot of factors, including their own decision about given this trend, do you think the selfsustainability is and always has been a serious situation facing these exchanges . The state exchanges . So, as i said, as of today all the states are sustainable. Whether they will be in the future, im not willing to predict. But as of today they are. The underlying economics of the aca have not changed since its inception. Was there any work that cms did that could have predicted that these state exchanges would fail . I mean, did you know in advance that any of the state exchanges would fail because of sustainability . A lot of this comes before my time, but i wouldnt classify a challenge as a failure. I think every state has had challenges. But every state today is successfully enrolling individuals in their state, and every state has sources of funds sufficient too run the run thei operations, so i would measure that as a success. Whether cms mchlt schlms grs to set of exchanges, how did states like hawaii set up their exchanges. These are decisions made before my time. So i cannot speak to what was being thought of at the time. Its an ongoing process for states to make that evaluation, and as i think youre aware, the stating of nevada and hawaii have decided it would be more efficient to maintain the statebased exchange but use our platform. Theyre broke and couldnt sustain themselves. How much has been recovered, i would ask for granularity from that and each state how much each state still owes that they have not repaid back to the federal government. And the last question, how would you ensure the states have not used and will not use grant funds for improper expenses after january 1st, 2015. Yes, i will provide that information that you requested. And we do this through several steps. Most importantly is to prevent them from spending the money improperly in the first place, this year, 2015, 69 occasions we have rejected a states request to spend the money improperly. If it turns out that they have, for some reason, we conduct an audit, and we go back, and then we go through a collection process as ive said. We have the first several states that weve begun the process for have begun to refund money, and we take that very seriously. Thank you. I yield back my time. The chair recognizes another gentleman from texas, mr. Green. Thank cms for working with us on something other than the gao report. Blue cross blue shield recently announced that they will no longer be offering a ppo plan in the National Exchange in texas and also in the individual market. This means theres no ppo plans on the individual and exchanges policies as a result specialty like md anderson and Houston Texas Childrens Hospital would be out of network. Group plans are not under the same decision, so they will still have ppos, blue cross and blue shield texas pulled the plan saying it is no longer financially feasible, that they could not raise rates for ppos without raising rates for all the plans. This is not limited to the texas example, because we are a National Exchange and not a state exchange, but was reported as an issue in other exchanges across the country. What can cms do to address the issue of Network Adequacy that would ensure that plans with premiere and hospital in network are available to consumers in the original market . Thank you for the question. We have just released a proposed rule around Network Adequacy. The National Association of Insurance Commissioners has also done some work in this area. But let me also say that this is an early stage of a market. And consumers are in the process of communicating through what plans they choose what things theyre willing to pay for, what things they value and what things they dont. And theyre trying to figure out offerings that are affordable and meet the needs of individuals. I think we need to recognize this is still in year three of an early set of offerings, and i think if consumers suggest that they will want certain things in their networks, my suspicion is that the health plans in those states will begin to make those things available. The houston market, if you dont have texas childrens or md anderson or a major full purpose hospital in our system, its going to limit using. From your perspective, is there any actions that congress can take to address this issue . I think we should just continue to listen to, all of us continue to listen to residents and make sure we adjust and adapt whatever our regulations are or however we are viewing this in the context of making sure that people are getting their basic needs met, and we make sure that sh sufficient Network Adequacy, and we do a review prior to allowing a state to go on the exchange, and if we hear problems wed like your office to let us know of specific instances. Let me talk about the open enrollment for 2016. November 1st marked the beginning. I heard mentions of how things are going. I realize you may not be able to speak to the federal marketplace in terms of early data, but how are things going with the open Enrollment Period and how many po folks are shopping . I think weve had 3. 5 million applications and 2 million plan selections of i believe 1. 3 million have been to renew coverage and 700,000 have been to get new coverage. And of course, we are now just beginning a, what has been a very big ramp up period between now and december 15th. People tend to be deadline driven, and this week we are seeing that acceleration we expect to see through the middle of december. In our area in houston, both with the original signup and the second time, youre right, we all procrastinate. What types of indications are you receiving from the states on their enrollment . Any information on how enrollments going in states that have their own plan . Ive seen some preliminary data. It looks to be pretty well on track to what they expected so far. I understand statebased marketplaces as well as health ca care. Gov are ofteningen hanced shopping and tools to help consumers make better choices. Can you elaborate on what things are being offered to consumers and why are such innovations important . I think one thing thats very important for consumers to know is 80 of consumers i believe is the right number have access to plans that offer Services Like primary care visits, prescription drugs outside of the deductible. They dont need to meet the deductible before they hit them. And the tools youre describing allow people to understand whether a physician is in their network, whether a drug is in their specific plan and how to make the tradeoffs exist between coinsurance and premium levels which i think is a complicated thing for people. So statebased exchanges as well as the federal exchange all have those types of tools i shouldnt say all. Many of them and certainly the federal market place has those tools available. Thank you. Now recognize the gentleman from oklahoma, mr. Mullin, from for five minutes. Thanks for being here today. I, i know sometimes that seat must get uncomfortable. But theres real questions and real concerns, and i dont want people to get caught up thinking this is a partisan issue, because really, this is about taxpayer dollars, and whats been going on with it and if theyre being misused. If we remember back, this was supposed to be budget neutral, and that hasnt taken place, and so now the american taxpayers are on the hook for it. And whats happening with the dollars . Where are they going . Whats the accountability process . And so i kind of want to maybe go down a different path with you. My understanding is that stating operate on the federal exchange receive a 3. 5 user fee . For the platform, is that correct . The health plans for the states. The health plan does . What happens to the 3. 5 user fee . It going to Fund Exchange operations. Who pays that . Does the state pay that . Or the Health Insurance company. The company does . So the user, the insurer. The insurer, yes. So it gets passed down to them. If the state closes its market place and transitions into the healthcare. Gov, is it required, is it required to charge the 3. 5 . If a state continues to operate as a statebased marketplace. Right. But uses the federal platform, we just have a rule that was proposed last month thats proposed, so its still open for Comment Period on what the fee would be and the fee thats proposed is 3 . The states that are currently on it, though, do they pay it . Do the insurers that participate in the fee states such as oklahoma . The states that are well, we have some states that have obviously closed down, and theyve wednesdnt now, if it mistaken here, theyve went into the marketplace or transitioned into healthcare. Gov, are they currently having to pay the 3. 5 to participate in healthcare. Gov such as other states that were already in it. Again, the states dont make the payment, the plans do. The plans do, but theyre operating inside the state. Yes, and the proposed rule is for 2017. So oregon, nevada and hawaii that recently came out. Yes. Theyre not, theyre users inside the state, their insurers inside the state, are they required to pay the 3. 5 . No, they make the payment to the state