Transcripts For CSPAN Key Capitol Hill Hearings 20131031

Can Work Together as we go through the Implementation Phase to find out what is wrong with the program and if we can make some changes to fix it. Let us do it and let us do it in a bipartisan fashion. It is too big a program and too important to too many people to do that. Having said that it does appear that it is working. Let us not keep beating a dead horse. My beloved friend who gave us the beginning of our efforts today. Madame secretary, i see reports that consumers receiving plan cancellation notices from their Insurance Companies saying that plans are no longer available. Does the aca require Insurance Companies to discontinue the plans that people had when the law was passed, yes or no . Not when the law was passed. No, sir. Thats the grandfather clause. Thats because the plans existed prior to passage of the law are grandfathered in as you have said . Thats correct. So if an Insurance Company is no longer offering a certain plan, thats because that Insurance Company made a decision to change their policies and that caused them to take away the grandfather status from their insurance purchasers, is that right . Thats correct. Now, madame secretary. I want you to submit for the record a statement of what it is we can do about Insurance Companies that run around canceling the policies of their people and i dont have time to get the answer but i want to get a very clear statement from you as to what you can do so we can take some skin off some folks that have it coming. Madame secretary, its my understanding that these decisions of a business character are most common in the individual Insurance Market and that much turnover already exists and existed prior to the enactment of the legislation. Thats correct. Is that correct . Yes, sir. Is it correct that 35 to 60 of the enrollees in individual market leave their plan after one year for Different Reasons . A third are in less than six months in the individual market and over 50 are in for less than a year, yes, sir. Now, in the cancellation letters which move around from the Insurance Companies, some Insurance Companies are suggesting an alternative plan at a higher price. Do they have a right to do that . They have a right to do that, sir, but consumers have a right to shop anywhere to compare plans and they have choices now that theyve never had before and some Financial Assistance coming their way for 50 of those people. No right to enforce that demand on the Insurance Company . No one is rolled over into a plan. Individuals for the First Time Ever will have the ability to compare plans, to shop, and to make a choice inside or outside the marketplace. Looks to me like the Insurance Companies are trying to inflict on their customers the view that this is their right and that this is the only option available to them, is that correct . I think that Insurance Companies would like to keep their customers. Having said that, customers for the first time have a lot of choices. The Insurance Companies have no right to enforce that view on customers . Theres no rule that says you have to stay with your company or be rolled over gentlemans time has expired. Gentlemans time has expired. Chair recognizes the gentleman from texas, mr. Barton. Before i ask my questions, we have a former member of the committee on the democrat side from the great state of kansas in the audience. We are glad to have you. Madame secretary, were glad to have you too. Thank you, sir. Theres a famous movie called the wizard of oz and in the wizard of oz theres a great line. Dorothy at some point in the movie turns to her dog toto and says were not in kansas anymore. Madame secretary, while youre from kansas, were not in kansas anymore. Some might say that we are actually in the wizard of oz land given the parallel universes we appear to be habitating. Mr. Waxman and most of those on the democrat side think things are great. You apparently although you did apologize and you have said its a debacle, you also seem to think that the Affordable Care act is great. Myself and others have a different view. Ultimately the American People will decide. Now, last week when the contractors were here, i focused my attention on the apparent lack of privacy in the website. If well put up the first slide that i had last week. If we can. This is what is public, madame secretary. Its basically a disclaimer that says any unauthorized attempt to upload information or change information on the website is prohibited. It really doesnt say anything about privacy. You do have to accept that in order to go forward with the application. The next slide shows whats not public. This is in the source code. We tried to determine this morning if it was still in the source code but pointed out the website is down. This is much more frightening to me. It says you have no reasonable expectation of privacy regarding any communication or data transiting or information stored on the system at any time or any lawful government purpose, the government may monitor and intercept, search and seize any communication or data transiting or stored on the Information System. Any communication or data transiting or stored on this Information System may be disclosed or used for any lawful government purpose. Cheryl campbell of cgi federal said she was aware of it but it wasnt her responsibility to put that in the source code. Were you a aware of it and was it your responsibility to put this in the source code . Mr. Barton, i did not put things in the source code. I can tell you that its my understanding that that is boilerplate language that should not have been in this particular contract because there are the highest Security Standards in place and people have every right to expect privacy. All right. Now, the last time we could check, this was still there. You are given almost Unlimited Authority under the Affordable Care act to administer it. Will you commit to the committee and to the American People that, one, you do want to protect their privacy and, two, you will take this out and fix it and make sure that it doesnt have bearing on people that try to apply through the website. Yes, sir. We have had those discussions with cgi. It is under way. I do absolutely commit to protecting the privacy of the American Public and we have asked them to remove that statement. It is there in error. It needs to be taken down and we should be held accountable for protecting privacy. Thank you, madame secretary. I sincerely appreciate that and im sure the American People do too. My last question or really a comment. I introduced hr3348 saying lets make this system voluntary for the first year since weve having so many problems and let the American People decide. What at that means is if People Choose not to participate, they will not be charged the penalty for nonparticipation. Would you support such a reasonable approach to this while we work out the problems in the system . No, sir. Okay. Thats an honest answer. Gentlemans time has expired. Chair would recognize gentleman from new jersey, mr. Pallone. Thank you, mr. Chairman. I know were not in kansas but i do believe increasingly were in oz because of what i see here. This wizard of oz comment by my colleague from texas i think is particularly aa pro given what we see on the other side. I dont know how you keep your cool with the gop trying to scare people and bring up red herrings. Im going to ask you a question about that. Before that, i want to say this whole idea brought up today that somehow policies are being canceled and people dont have alternativ alternatives, its just another red herring. What my colleagues on the other side forget is this is not socialized medicine. This is in fact private insurance in a competitive market. If im an Insurance Company and all of a sudden everyone else is selling a better policy with benefit benefits at a lower price, i cant continue to sell a lousy policy that doesnt provide benefits and cost more because ill be out of the market so thats whats happening here. Insurance companies are canceling lousy policies with high prices because they cant compete. Thats whats going to happen when you have a private Insurance Market, which is what we have here. We dont have a government controlled system. We have private markets. So i just want to make that point. I have to drill down on what mr. Barton said here. Before reform, the individual Insurance Market was dysfunctional, premiums would shoot up if people got sick, coverage could be canceled if they had a preexisting condition, and they did not have secure quality coverage. Now, i heard my republican colleagues say that Patient Health insurance will be at risk in this application process and this is flat out also. A giant leap forward for protecting Health Insurance by taking it out of the insurance application process and banning discrimination based on preexisting conditions. Mr. Barton again is raising this red herring just like the cancellation of insurance by talking about privacy. Madame secretary, prior to the aca when people applied for insurance coverage, did insurers make them provide an invasive medical history but because the law bans discrimination based on preexisting conditions, they do not need to provide this information in their applications. Please comment on the privacy issue and why its irrelevant. In the past, any individual american who was in an employer based coverage, in government coverage like we enjoy in medicare and medicaid and a variety of plans, thats about 95 of insured americans had no medical underwriting. Had group protections. Had consumer protections. The people who were outside that consumer protected space were individuals buying their own coverage in an individual market. Medical underwriting demanding Health Records and often going through extensive doctor interviews and getting Health Records were a standard for that market. Pricing could very widely dep d depending on gender and Health Condition, people could be denied coverage and were frequently. Thats the market that is currently being reformed with consumer protections. If a person had a policy in place in march of 2010 like that policy and the Insurance Company made no changes to disadvantage the consumer, those policies are in place. You keep the plan and that goes on. For people that had a medically underwritten policy, were paying more than their neighbor because they happened to be female, could not get their Health Condition for a fixed hip written into their Insurance Plan, theyll have a new day in a very competitive market. 25 of the insurers are brand new to the market offering competitive plans. Mr. Chairman, could i just ask that this document put it into the record without objection. Chair would recognize mr. Hall. Thank you, mr. Chairman. Madame secretary, i think congresswoman blackburn asked you about the federal government and how much they spent today and theyre spending some money as we speak, arent they . Its down right now, isnt it . You project ongoing problems . Im sorry, sir. Im having a hard time hearing. She asked you how much it had spent today and im asking what you expect to pay in addition to that on the repairs that the website is going to require and they require them as we speak here. So those are things you projected and you knew they would happen and they will happen. But you looked ahead and you have some estimate of what is going to happen. Yes, sir. And going to cost. For our two major contractors who are ussi, subsidiary of united and for cgi, there are obligated amounts. For cgi who is in charge of the entire application, there has been 197 million obligated and that is to last through march of 2014 and as i said before about 104 million has been expended in that obligated amount. Im going to try to be here in 2014 to make sure your testimony is correct, okay. Im just joking with you. Okay. And were you born in kansas . I was not. I was born in cincinnati, ohio. I married a kansan and went to kansas. I was in the third grade there. I thought i saw you on a tricycle one day. It was an illusion. Let me ask you a question, have you ever rejected a financial bail from one of the contractors . Have you ever . Have i ever rejected a financial bail from one of them . Sir, again, our i guess you can say yes or no. Our Accounting Office does a routine audit and review of every bill before they do it. I do not personally. I want to be very accurate that i dont personally pay contracts, negotiate contracts, by law and by precedent thats really illegal for someone who isnt a warranted contract officer to engage in the debate or discussion around federal contracts. How much has the Administration Spent on the exchanges in total . Not just healthcare. Gov but all of the exchanges . Sir how difficult is that figure to give me or if you cant give it to me, could you send it to me . I would like to get it to you in writing very quickly. Madame secretary i dont know how much time i have left but i would like to talk about a couple businesses in my district who are struggling with how to move forward. One is a manufacturing and one is pet boarding and training business and one has 85 employees and others have 46. This is another example of the government picking winners and losers. Were the losers. There is no way i can be competitive if i have to raise prices to cover 170,000. Do not pay penalty. Raise prices and go out of business. Layoff 35 employees and move more production from this country and heres a quote from the other. Since they are high labor low margin business cannot afford to pay insurance for employees were forced to close our business through bankruptcy because there are heavy financial obligations that continue whether we operate or not or five enough employees to get under 50 employees. Even if we close the location, we cannot escape many expenses such as rental agreements. What am i supposed to tell these people . Well, sir, i think that in the employer market, about 95 of all American American businesses are exempt from any kind of requirement to cover employer employee insurance, and they are outside the law. They continue to be outside the law, but they will have new options for those who want to cover their employees and some new tax credit possibilities. For large employers, about 96 of them already cover their employees, and as you know, the penalty that your constituents refer to is not a penalty that is imposed in 2014. It is being discussed with businesses about what kind of information will be exchanged hes going to use the gavel on me if you dont hush. Gentlemans time is expired. I yield back my time. Gentlemans time is expired. Gentle lady from california . Thank you, mr. Chairman. Welcome, madame secretary. Youre a distinguished woman. You have distinguished yourself and your state, the offices that youve held, and now working for the American People, and i salute you for it. I want to really congratulate my republican pals for being absolutely, 1,000 consistent. You love whats wrong with the website, and you detest whats working in the Affordable Care act. And i think that is on full display here. But lets get back to the website, because thats what the hearing is about. Its my understanding that november 31st is a hard date for having everything up and running. Do you have now hhs did testify in september that they were 100 confident that the site would be launched and fully functional on time on october 1st. Do you have full confidence in this new date . It will take until november for an optimally functioning website. The only way i can restore confidence to get it right is to get it right. So i have confidence, but i know that it isnt fair to ask the American Public to take our word for it. Ive got to fix this problem, and we are under way doing just that. But are you confident that i think i said november 31st, which is i thought which does not exist, but november 30th. You have confidence in november 30th . I do. Is there any penalty to qssi or cgi for not delivering on what they promised . Well, i think the, as you can see, we have a obligated funds for a contract. We certainly have not expended all those funds, and we expect not only the cms team, but our contractor partners, to fulfill their obligations. But if they fail to fulfill their obligations, i dont know whats in the contract, is there a penalty . There isnt a builtin penalty, but i can tell you that paying for work that isnt complete is not something that we will do. Qssi, as you know, has taken on a new role as integrate tor of the hub that they built and have in operation, is working extremely well, not only for the federal exchanges, but all the statebased markets are using the hub, and thats why we had confidence in their ability to actually take this next roll on and coordinate the activities moving forward, which have to be driven with a very clear set of outcomes, very accountable timelines and deadlines, and they will be helping to manage that process. On the issue of security, there was a Security Breach that arose recently that i read about, at any rate. And what i think is very important here, because the issue of privacy has been raised, and i think thats been answered, because very importantly there isnt any Health Information in these systems, but there is Financial Information. So my question to you is, has a security wall been built, and are you confident that it is there and that it will actually secure the Financial Information that applicants have to disclose . Yes, maam, i would tell you that there was not a breach. There was a blog by a sort of skilled hacker that if a certain series of incidents occurred, you could possibly get in and obtain somebodys personally identifiable isnt that telling . Isnt that telling . And we immediately corrected that problem. It was a theoretical problem that was immediately fixed. I would tell you, we are storing the minimum amount of data, because we think thats very important. The hub is not a data collector. It is actually using data centers at the irs, homeland security, social security, to verify information, but it stores none of that data, so we dont want to be thank you. Gentle ladys time is expired. Chair recognizes mr. Shimkus. Thank you, chairman. Welcome, madame secretary. Madame secretary, before i start my questions, the Washington Post gave the president and yourself four pinocchios on the debate of if you like this insurance you have, you can keep it. Would you recommend the president that he stop using that term . Wouldnt that be helpful in this debate . Sir, he used the term at the time the bill was passed september 26th also. Thats why we wrote the answer is, you dont believe the Washington Post well hand this down for you so you can see it. Have you ever shopped i know you have, but this is for a at a Grocery Store with a coupon . Ever used a coupon . Yes. So the coupon gives you the terms and conditions of when you go to the checkout to get whatevers off the price of the goods. When you all added the c plans now option, you, in essence, gave the searcher, in essence, a coupon based upon what they are seeing there. The desire was, let people know what the price is. However, as the news reported, and i followed up in last weeks hearing, was that if you are under 50 years old, you get quoted the price of someone whos 27. If youre older than 50, could be 64, you get quoted the price of someone whos 50 years old. Isnt that misleading . Sir, the learn site of the website, which has been out thats truthful, then, if you quote a price it is clearly a hypothetical situation that allows people on the see plans now option, is that a hypothetical . Thats not what it says on the site. It says this is the price when you put in your age, and if your age is 49, it quotes you as if youre 27. Sir, the only way someone can get an Accurate Information about their price is to get their let me ask you a question, when did you decide to use this below 50 at 27 and above 50 at 50 years old, when did you make that decision . That was decided by the team by who . Who made the problem with this whole debate is yall wont tell us who made the decisions. I can tell you, i did not design the site. Well who . Who made the decision on the 27yearold quote for someone whos 50 . I just said ill get you that information. Thank you. Thank you. Let me go to, because its misleading, and the white house insists it didnt mislead the public, and let me finish on this debate. Its another transparency issue. If someone, a constituent of mine or someone in this country, has strongly held prolife views, can you commit to us to make sure that the federal exchanges that offer that is clearly identified and so people can understand if they are going to buy a policy that has abortion coverage or not . Because right now, you cannot make that determination. Sir, i dont know. I know exactly the issue youre talking about. I will check and make sure that that is clearly identifiable. Heres our request. Can you provide for the committee the list of insurers in the federal exchange who do not offer as part of their package abortion coverage . I think we can do that, sir. Well, you should be able to do it. I just said. No, you said, if we can do it. I think we can do that. I think or i know . Sir, i cant tell you what i dont know firmly right now. I know that is the plan. I will get that information to you. Gentlemans time is expired. Chair recognizes mr. Rangel from new york. Thank you, mr. Chairman, mad madame secretary, i appreciate your taking time to come here today to answer questions about the Affordable Care act. This reminds me a story of when i was a little boy, the story of chicken little, who ran around yelling, the sky is falling, the sky is falling. But unlike chicken little, my republican colleagues are actually rooting for the sky to fall. Republicans are holding this hearing today under the auspices of an investigative hearing, as if they want to get to the bottom of what went wrong with the website in order to help fix it, but i dont think, madam secretary, theres one person in this room thats naive enough to think the republicans want to see this law work. They voted over 40 times to repeal the law, they shutdown the government and threatened a default in order to stop it. They are rooting for failure. Madam secretary, can you tell us what would be the impact on americans Health Insurance if republicans had been successful in their efforts to defund or repeal the Affordable Care act . Well, i think the estimates at the congressional budget office, it would have increased the deficit by 110 billion in the first decade and close to a trillion dollars in the second decade. We know we have 42 or 43 million americans without health care, some medicaid eligible and some over the medicaid eligibility. 30 governors so far, republicans and democrats, have declared their support with moving ahead with medicaid expansion, but absent the Affordable Care act, those folks would be without any kind of Health Security, and in the private market, what we know is it takes a real toll. But id say the Biggest Issue is not just the financial toll, not the community toll, not the country toll, which is significant. I have a good friend who runs the Cancer Center at the university of kansas. I was with him and cancer researchers recently, and he said if you get a cancer diagnosis, you are 60 more likely to live five years and beyond if you have insurance than if you dont. I think thats a pretty powerful statement for why we need Affordable Health care for all of our citizens. Well, thank you. The republicans have not been able to defund or repeal it, but they have denied requested funding, theyve raised arguments about death panels and socialized medicine, and theyve worked to intimidate groups that could help the implementation effort. Theres a spreading of misinformation about the cost of coverage. We hear some of that today, and to actively dissuade the uninsured from seeking coverage. So madam secretary, how are these tactics impacted your ability to implement the Affordable Care act . Well, i dont think theres any question that a lot of people need a lot of information. I think its one of the reasons we had millions visit the site, try to visit the site. Its why i am so frustrated and disappointed that the site is not fully functional and why im so committed to getting it functional, because clearly, there is a demand. We need to get information to people about the law. This is the law, this is not any longer a debate. It was a law passed by both houses of congress, signed by the president of the United States, upheld by the supreme court. The president was reelected. It is the law. And people have benefits and rights under that law, and weve got to get that information so they can make good choices for themselves and their families. Well, thank you. It is the law, and, frankly, i find it disconcerting that my republican colleagues have done nothing but root for this law to fail for the last three and a half years. And now theres a big show here of being upset at problems with the website and keeping people from signing up for coverage fast enough. So i would just say to my colleagues on the other side of the aisle, youre really on the wrong side of history here. The website will be fixed and millions of americans will be able to get quality affordable Health Insurance coverage through the Affordable Care act. And again, i thank you for being here today, madam. Mr. Pitts, chairman of the health committee. Thank you, mr. Chairman. Welcome, madam secretary. Have you personally tried to register or enroll on the website . Sir, i created an early light account so i would see the prompts that were coming to people who were interested. I did work my way to the application feature fairly early on, but frankly, i have Affordable Health care, so i i wondered if you have been through the process that millions of americans are having to go through. Madam secretary, the initial Website Crashes appear to be largely a result of the decision to prevent browsing of the plans. Cgi federal testified at our hearing last week that they had designed the website to allow users to browse and compare plans before having to create an account. Ms. Campbell told us that two weeks prior to the october 1st launch, they were told to turn off the browsing feature. Were you aware in september that this decision was made . Sir, i wasnt aware of that particular decision that was made by the cms team. I was aware that we were pearing back some features to not put additional risk on the website. And who made that decision . Who made that decision . Administrator tavenner made that decision. And do you know why that was made . Yes, sir, because we were anxious to get the website up and running and functional, which we clearly have failed to do to date, although i would suggest the website has never crashed. It is functional, but at a very slow speed and very low reliability and has continued to function. Having said that, they paired down some of the features, feeling that it would be better to load them in later. One was the shop and browse feature. Another was the spanish version of the website and the medicaid transfers. All three of those issues were paired down in september to not load the system. Thank you. Thank you. Last week, cgi federal and qssi testified that cms was responsible for endtoend testing and that they believe that months of testing would have been preferable to two weeks. Do you believe that two weeks was enough time to complete testing of the entire system . Clearly, not. And when were you made aware of the result of the test, now in the Washington Post on october 21st, there was an article that said about a month before the exchanged open, a Testing Group of ten insurers urged Agency Officials not to launch the site because it was riddled with problems. Were you aware in september that insurers recommended a delay in the launch of the exchange . I was not aware that they recommended delay. I know everyone was concerned that there were risks and there were likely to be problems with the brand new integrated insurance system. I dont think anyone ever estimated the degree to which weve had problems in the system, and certainly, the contracting partners did not. And did hhs respond to the insurers recommendation to delay the launch . Sir, i cant i wasnt in the meeting. I dont know what occurred in the meeting, and i dont know who they talked to. Can you find out and answer that question for us . Sure, i will get back to you. Thank you. Thank you, mr. Chairman. Mr. Green . Thank you, mr. Chair. Madam secretary, thank you for taking time to be here today. I represent parts of east and northeastern houston Harris County and our district has one of the highest uninsured rates in the country. Even worse, we have one of the highest rates of people that have jobs but dont receive their insurance through their employer. Its for this reason i believe houston would be a good place for you to come and spread the word about the benefits of the Affordable Care act, however, youre unable to attend because of scheduling conflicts. Hopefully, we can have agreement some time in the future youll come to the fourth largest city that probably has the highest number of uninsured in a metropolitan area and were in the area of texas with the highest uninsured in the country. Its important to me and our constituents to get it right, and thats why i share your and the president s disappointment the websites not working as planned. November 30th is not soon enough. Many of my constituents have been waiting for years to be able to purchase Health Insurance and we owe it to them to get the marketplaces up and running. The contractors have not served our country well and should fix it or not be paid. Now were hearing about the cancellation letters being sent by Insurance Companies to customers notifying them that their plans are no longer offered. Are these americans losing their Health Care Coverage because of the Affordable Care act, or is it because these plans were changed after the enactment of the act . I would say its the latter, sir. If a plan was in place since the enactment of the act, no one would have received a cancellation. If somebody in america had an Insurance Plan before the act and the president was correct, if you have if you like what you have, you can keep it. The plans were changed, so now they have to comply with the new law. They can either choose to be grandfathered and keep the same plan, which meant the same benefits and actually the regulation allows Insurance Companies to charge medical inflation, plus a trend line, so they didnt have to charge the same price. They could increase it, they could increase copays, they could increase coinsurance. What they couldnt do is cancel benefits that the policy holder relied on. They couldnt disadvantage the policy holder, but if that plan is in effect, absolutely, its still in effect. But some of these millions of letters were hearing about are probably because their plans changed . Absolutely. And again, in the individual market, plans change every year. Insurers design new products. Even in a Small Business market that happens. These plans are not allowed now because they are completely inadequate and dont offer the minimum essential benefits, is that correct . Thats correct. And having been a state legislator and i know as governor in kansas, i assume every state has some type of minimum mandated benefits that they have for their Health Insurance plans. They do, but it applies, again, sir, in the past usually to the group markets, where 90 of covered americans get their policies. This market has always been the wild west. The americans received those letters from their companies about cancellations, they are eligible to purchase plans on the exchange . Or out of the exchange. Individuals who dont arent interested in some kind of financial help can go outside the exchange, inside the exchange. Their insurer can offer them plans. They have choices theyve never had before. Because of the benefits of theca Affordable Care act, 80 their premium dollar will come back to them . Thats correct. I dont know any states that have that 80 requirement. No state had it, i would suggest, in that kind of broad base prior to the Affordable Care act, so its let me give you an example of one of the plans i found out during case work, a Large Company provided 25,000 maximum benefit for their employees during the year. Most of the employees didnt know about it, until this one constituent found out that she had cancer, and the bill ended up being 300,000. And so thats some of those plans that are not being allowed to be sold now, is that correct . Well, not only would the plan have a limit on out of pocket costs per year, it would have a limit on a lifetime out of costs, and it will take away the notion that you would run out of your coverage in the middle of a treatment, which a lot of plans do. I know im out of my time, but its like buying a car, if they look good, but if it doesnt have a motor, its no good to have that car. Save a lot of gas jebt lmans time has expired. Gentleman from oregon, mr. Walden. Thank you very much, mr. Chairman, governor, secretary, delighted to have you before the committee. You and i both know how important this issue is to all americans that we get it right. So i hope you can appreciate were trying to understand what we missed along the way, and one of the things that bothered me was the letter that was sent from your agency to the gao back in june 6th. And ill read in part, it said, were in the final stages of finalizing and testing the i. T. Infrastructure that will support the application enrollment process. Hhs is extremely confident that on october 1st, the marketplace will open on schedule and millions of americans will have access to affordable quality Health Insurance. Im just an average guy from a small town in oregon, but when i read that, it tells me you believed everything was good to go, the testing was in place, and we should have full confidence everything would work. Correct . Thats the letter i signed, yes, sir. Actually, it was signed by your assistant. Yes, yes. Same point. I went into this believing your response, your agencys response, things ready to go, we should have full confidence, when someone uses the word extremely confident, tells me youre extremely confident. Second piece, the witnesses last week, i asked about the endtoend testing and what the Industry Standard would be, and they said it will be should have been months, especially for a project of this magnitude, yet we heard it was only two weeks. Now in august, gci told cms in their report cgi. Im sorry, cgi, thank you. August 9th there was not enough time in the schedule to conduct adequate performance testing. Did that make its way all the way to you, and do you think there was adequate time . Sir, clearly, as ive said before, we did not adequately do endtoend testing. The products were not locked and loaded into the system until the third week in september. Each of the Component Parts was tested, validated, independently val validated. Im sorry. All those worked, they told us last week their individual modules were tested and met specification, do you concur with that analysis, based on what you know . I do concur with the testing, yes. It really was end to end, which is why some of us thought we should delay until it could be done right to avoid this very collapse that now is upon us. I realize not everybody agreed with that. The second piece gets back to the Washington Post, which you havent had a chance to read this morning, but the four pinocchios about the president repeatedly saying if you have a plan, youll keep your plan. We all heard that to mean, i have a plan with a company, i will continue to keep it if they make minor changes, when, in fact, no, thats really not whats going to happen. If minor changes are made, that means the plan changed, that means you dont get it. Sir, that isnt true. The rules did not say what you just suggested, and i think the estimate given that there would be turnover in the market was really an outside projection. It wasnt our rules. Its a snapshot of what happens in the market, that plans change so dramatically every year. Over time, that the estimate was not because of our rules, but because of Insurance Companies Business Decisions. You said those market rules looked like they had to comply with, correct . Only if they chose not to grandfather the policy. Thats that meant they couldnt make any changes. Any grandfather policy stayed in place, still would be in place. None of these rules apply. But if they made any change they could make changes in pricing, they could make changes in benefits. They couldnt dramatically disadvantage the consumer, but they could have trend lines, they had a wide corridor to make sure that a similar plan, so if a consumer liked the plan, the plan, if it stayed in place heres what the practical implication, i have letters from constituents all over my district who have letters from their insurers who say because of obama care, they are no longer going to be in the individual market, or at least with that plan in the individual market, and the result is this person from cove, oregon, i was paying 600 a month for a 3,000 deductible, now its 800 a month for a 5,000 deductible. Ive got others here ill put in the record. A woman whose job she had 40 hours, now down to 29, neither has Health Insurance, nor enough income to live on her own because of the way this law is getting implemented. I realize my times expired. Gentle lady from colorado. Thank you very much, mr. Chairman, and thank you, secretary, for being with us today. I want to follow up on a couple of those questions that mr. Walden was asking you about cgi. As you know, chairman issa last night released this document, monthly project status report from cgi last night, and it looks to me as sort of a technical document that has a punch list of outstanding open issues. And some of them do highlight items that upon first read seem to be alarming. For example, one of the entries said, due to the compressed schedule, theres not enough time built in to allow for adequate performance testing. And this certainly, in retrospect, sounds bad. But the date of the document that chairman issa released is september 6th, and then on september 10th, four days later, cgi came into this committee and testified under oath, quote, cgi federal is confident it will deliver the functionality that cms has directed. And were trying to figure out, at least im trying to figure out, how cgi is now coming in and saying, you know, we warned everybody that this wasnt going to be ready, when they came in and directly told me that they would be ready to launch on october 1st. So it kind of raises a question, how these statements can be reconci reconciled. One explanation is cgi was lying to this committee. I think thats unlikely. Another is that cgi thought that the items flagged in the report were like a punch list that could be addressed. So heres my question to you, madame secretary, was cgi telling your department the same thing that they told the committee on september 10th, that the company was confident that its programs would be ready . Congresswoman, all of the contractors testified here in september and again, i think, last week before this committee. And the testimony was fairly similar, that they were ready to go in september. They were asked in last week if they had suggested that we should delay the launch date. Each of them said, no. They never asked you to delay launch date . They did not. And frankly, i think it is not valuable at this point to do a lot of pointing blame, fixing the blame. What i want to do is fix the problem. I think we need the whole team to move ahead and we will report back regularly. But were relying on these contractors who fix this, so that goes to my last question, which is, mr. Zintz has now come in and he says the site is going to be up for the vast majority of users by the end of november, is that right . Thats correct. And given what cgi told us and the other vendors, do you believe that that is correct . Do you believe it will be pretty much ready to go by the end of november . I do. And i think that we are making improvements each and every day. It is easier to use now than it was two weeks ago. It is way from where we need it to be. So its not like its all going to be fine by the end of november, its beginning to improve already. Is that your testimony . It is a continuous process, as websites are. Patches are made, fixes are made on an ongoing basis, and as we find issues like congresswoman eshu talked about, were fixing them in realtime. And youre going to guarantee, yes or no, people are going to have privacy . Absolutely. Immateri i want to say one more thing, i was on max got a letter from his Insurance Company that his insurance was cancelled, so what he did was he went on to the website and he found a better plan, and now hes going to sign up. So i would hope that thats what everybody would be able to do. And i thank you, mr. Chairman. Mr. Terry. Thank you, mr. Chairman, and im pleased to hear that the website will be fully operational by the end of november, and would you be able to would you come back to our committee so we could see if thats actually accomplished and how it was accomplished . I will make every effort to do that. Okay. You were governor and state insurance commissioner in kansas, and i reached out to our state insurance commissioner and governor and found out that they have absolutely no data about nebraskaens who have either tried to enroll or enroll. As you know, nebraskas one of the states that opted not to do their own exchange and rely on the federal exchange. So its interesting to me that neither our insurance commissioner, nor the governors office, had any data about nebraskans and this enrolling in these plans. I also asked our insurance commissioner if any of the navigators, if they knew who the navigators were and whether they had to apply to be certified or licensed, in essence, like an Insurance Agent would be. And they told me they have no clue whos been authorized by hhs to be a navigator and work with people in nebraska. So this is concerning to me, so im going to ask you a few questions along this line. First of all, do you have data on how many people in general in the United States have tried to enroll in a plan through this website . No, sir. We do not have any reliable data around enrollment, which is why we havent given it to date. Or have any data on how many people have tried to enroll, but because of the problems, have not been able to accomplish that . No, sir. I can tell you i met with insurers last week, and one of the priority fixes is the socalled 834s, the document that sends an individuals name to a company and verifies it. That is one of the systems that is not working. I appreciate that. And the contractors i asked specifically about the information of how many people have tried to enroll and enroll, and they say they do have those numbers, but cant tell us that because of a contract with hhs saying that they are gagged on that information. I would suggest that the numbers are not reliable, according to the insurance my question is going to be, though, will you on the record right now authorize them to give us those numbers and let us determine whether those are reliable . No, sir. I want to give you reliable, confirmed data from every state and from the federal marketplace. We have said we will do that on a monthly basis by the middle of the month. You will have that data, but i dont want to turn over anything that is not confirmed and reliable, and thats what well do. But that data out there exists. Sir, i would tell you right now, it is not reliable data. According to the Insurance Companies who are eager to have customers, they are not getting reliable data all the way through the system. The number of people its one of the real problems we have. That have clicked on or tried to get enrolled, im not asking what they enrolled in or whether they came in and said they were 65 and were quoted something that they were 27 years old. That should be a pretty reliable number just on the surface. The system isnt functioning, so we are not getting that reliable data. Insurers, who i met with, said that that is the case. We know that theres 700,000 applications the reliability of that data certainly flies in the face of the testimony from the contractors. All right. I yield back. Ms. Capps. Thank you, mr. Chairman. Thank you, secretary sebelius for your presence here today and your testimony. While i, too, am frustrated with the flawed rollout of healthcare. Gov, i do appreciate your longstanding commitment to improving the Health Care Options for all americans. And fixing this website quickly. I think its important to note that in my home state of california, and other states, as well, the new exchange marketplace, we call it covered california, is working. And rates are as much as 29 less than those that they found on the marketplace last year. Im thankful my constituents now have this option, and as i look around to implementation nationwide, it seems clear to me that political decisions in individual states have really made the difference for consumers. The governors and legislators, state legislators, that embraced this law are delivering for their communities, but those elected who are trying to ignore the opportunities presented and continue to throw up roadblocks should not now seem surprised that there are significant bumps along the way. This seems, to me, to be completely disingenuous. Having embraced the law since open enrollment began october 1st, californians have started nearly 180,000 applications with more beginning every day. I know my time is limited, but i want to have a second to mention the conversation i had just last night with a telephone town hall to my district on the Central Coast of california. One of the first callers i heard from was a mother from santa barbara. Her names merrill, and she wanted to tell me the story of her son. Her son is 28 years old, and he had been paying 425 a month for his insurance before the Affordable Care act. She was happy to report that he has already applied through covered california and has found a policy that works better for him and has all the essential Health Benefits covered, which his former policy did not, and now will only cost him 109 a month. This is significant savings for merrills son, and this is a story thats being repeated at least in california often. So there are millions of residents in many states who have now set up their own websites and marketplaces, and those states, tens of thousands of people are now, as we speak, signing up for coverage, and this is demonstrating that the Affordable Care act is working. New york and washington, over 30,000 people have enrolled, in oregon, over 50,000 people have been enrolled, kentucky, 31,000 people have been enrolled. We could go on and on. The success of the data exchanges, which is where this is meant to be implemented, shows how badly this law is wanted and needed, how much it will be of help of people who want quality, Affordable Health care. My three quick questions to you are this, madame speaker, what is your assessment of how this first month has gone in the states that are running their own marketplaces, which this congress intended that the Affordable Care act work . Well, everything we hear from the statebased markets is that they are doing well. They have not submitted data yet. We, again, are working with them around a monthly schedule so that they will confirm medicaid data and enrollment data, and well see the real numbers at the end of the month and make sure that the they are available to the public, but everything we hear is that they see the same demand, they are eager to enroll folks, and that that is going smoothly. And what do you think this success shows about the demand and the interest for affordable Health Insurance on the part of constituents . Well, i dont think theres any question that in spite of a series of roadblocks and blockades, and a lot of misinformation driven by about a 400 Million Marketing Campaign last year, americans are eager to see what their benefits may be under the law, what their opportunities are, how to get Health Security for themselves and their families, and we want to make sure that they see those benefits. The website is one of the ways to do that. The call center, on the ground enrollment, personal outreach, are a variety of ways, and i would tell your colleague, mr. Congressman, id be happy to get you the list of the nebraska folks who are on the ground. Its available easily. Its public record, so id be happy to send it to you, so you could share it with your Health Insurance commissioner and governor. Gentleman from the great state of michigan, mr. Rogers. Thank you. Thank you, madame secretary for being here. Short time, get through some questions here, if i can. Is it your testimony that every night to try to increase the functionality of the system youre hot swapping codes . My understanding between 2 00 and 4 00, write new code, put it into the system, yes or no . Clearly, i am not hot swapping code. There is a Technical Team you are in charge of the operation that hot swaps code on functionality. Youre trying to improve the functionality, yes . That happens every night, yes . No, i dont think it does happen every night. It happens periodically during the hours of 1 00 and 5 00, but it is not a nightly feature. Great. Has each piece of that code thats been introduced in the system been security tested . Thats my understanding, yes, sir. And the testing each piece of that code has been tested . Yes or no . I dont know, but i can tell you that security thats a much safer answer, trust me. Security is an ongoing operation that as code is loaded, you need to retest over and over and over again. Whether its pretested, i cant tell you. You need to test the code. Is the endtoend security test been conducted since healthcare. Gov went live on october 1st, yes or no . My understanding is, theres continuous testing as the temporary authority to operate calls for. Yes or no, has an endtoend security test on healthcare. Gov went live, yes or no . I will find out exactly what testing they are doing. I know they are doing simultaneous testing as new code is loaded. Are there any endtoend security tests run after every new piece of code is put im not talking about testing the code, im talking about an endtoend security test. I can get you that information. I can tell you they are not, and id be interested why not. If you go to tab two quickly in your book what book, sir . You have a tab there. If you go to tab two, right there. While youre looking, ill read. Dated september 27th, and it is to marilyn tavenner. Let me just a couple of pieces here. There are inherent security risks with not having all code tested in a single environment. Finally, the system requires Rapid Development and release of hot fixes and patches so it is not always available or stable during the duration of the testing. Secondly, the security contractor has not been able to test all the Security Controls in one complete version of the system. And if you look in the first part, which is most troubling of all, it says, due to system readiness issues, the Security Control assessment was only partly completed. This constitutes a risk that must be accepted before the marketplace day one operations. And so let me tell you what you did. You allowed the system to go forward with no encryption on backup systems. They had no encryption on certain boundary crossings. You accepted a risk on behalf of every user of this computer that put their personal Financial Information at risk because you did not even have the most basic endtoend test on security of this system. Amazon would never do this. Pro flowers would never do this. Kayak would never do this. This is completely an unacceptable level of security, and heres the scary part, we found out after the contractors last week that an endtoend test hadnt been conducted on security, not functionality, because if its not functioning, you know its not secure. Your on going hot patches without endtoend tests. The private contractors told us it would take a very thorough two months just for an integrated endtoend security test, which hasnt happened, because youre constantly adding new code every night to protect the functionality of the system. You have exposed millions of americans because you all, according to your memo, believed it was an acceptable risk. Dont you think you had the obligation to tell the American People that were going to put you in this system, but beware, your information is likely to be vulnerable . Would you commit today, secretary, to shut down the system and do an endtoend security test so that these americans can have their information no, sir. If you read the memo, our testing, daily, weekly scans are going on. This is a temporary authority thats not what the memo says, number one, and number two, the contractors will tell you mr. Chairman, point of order. I think the witness ought to be allowed to answer what was a speech by the colleague, because hes raised a lot of issues. If the gentle lady will quickly answer. Does the secretary wish to respond briefly . Sir, i would just say this document is a document signed by administrator tavenner, which discusses mitigation strategies for security that are ongoing and upgraded and an authorization to operate on a permanent basis will not be signed until these mitigation strategies are satisfied. It is under way right now, but daily and weekly monitoring and testing is under way. Mr. Chairman, there are people using this system today and shes just admitted the system mr. Chairman, she didnt admit that. You said it, she didnt say it. Gentlemans time is expired. Mr. Doyle. Thank you, mr. Chairman. Madame secretary, welcome. Those of us who fought for this law, who voted for this law, have a vested interest in its success, and the concerns that you here expressed on this side of the panel are real, because we want to see americans get health care. I think its somewhat disingenuous for my colleagues on the other side of the podium here to have this faux anger and this faux concern over a bill that they absolutely want to fail and have rooted for its failure and have voted over 40some times to repeal this bill, never putting an alternative plan on the floor for the American People, but just to simply say they want to make sure this plan doesnt succeed. And i think the real fear is, that the plan will succeed and the American People will learn of the real benefits of this plan, not the Propaganda Campaign thats gone on by the republicans for the last three years. Madame secretary, i think one of the keys to success of this plan is that we get young people to enroll in this plan. And i have some questions about some enrollment concerns that i have. Now i understand that youve said approximately 700,000 people have applied for coverage via the healthcare. Gov and the state exchanges, is that theyve completed an application. Right. Which is different from enrollment. Thats correct. So my question is, are you expecting i know you dont have exact numbers yet, but are you expecting a large number or a small number of enrollments during the first month . What is your thoughts on that . Well, our projections prior to launch were always that there would be a very small number at the beginning. We watch the massachusetts trend, which started slowly and built. I think theres no question that given our flawed launch of healthcare. Gov, it will be a very small number. Yeah, i mean, in the massachusetts plan, i think the first month it was 123 people signed up, less than 1 of the overall firstyear enrollment in the first month. And we saw the same kind of numbers in Medicare Part d the first month of open enrollment back in 2006. Madame secretary, Young Americans are the most likely age group to be uninsured, and a lot of us are concerned because of the problems that weve been having with the website, that a lot of these young folks may not come back on, you know, they have very short attention spans. Ive got four kids that all work on the internet, and if they cant get something in five minutes, they are on to Something Else. What do we do, and what plans are in place by your department to encourage young people to go back and revisit that site and to make sure that were getting young people looking at that site and accessing it . Well, step number one is fix the site, because we dont want people to be invited back and then have a bad experience a second time around. I think thats absolutely right. The site is particularly important to tech savvy Younger Generation folks who we need to enroll. I think that we have so fixing the site is step one, and step number two is getting information to folks that the law even exists. A lot of young people havent followed this dialogue for the last three and a half years. Yeah, i think we need a Real Marketing campaign, and we really need to reach out to young people. We intend to do that. Especially at the end of november when you say this site is going to be working a lot better, to make sure they are checking that site out. You bet. One of my four kids is self employed, 33 years old, paying about 140 a month for a blue cross plan, hes eligible for a subsidy. We browsed that site. Hes able to get coverage for about half of what hes paying right now, and thats good news for us, because i think my wife is paying his premium, so i think were going to save the money. So i think its important we had to prod him to go on that site and enroll, and i think for a lot of young people, they are not going to do it unless its easy, so its important we get that fixed. Thank you. I agree. Dr. Murphy, chairman of the oversight subcommittee. Thank you, madame secretary, and welcome. You had mentioned that the people who did the technology on the website made a number of mistakes, you mentioned verizon. Last week they said it wasnt their fault they were told within hhs there was some problems there. Sir, verizon wasnt involved in the website. With the data, i understand, im sorry. But they had a role, cgi had a role, other companies, et cetera. Im just curious in this process, what decisions did you make that affected this for better or worse in terms of the data, the ease, or problems with the implement and being able to track how many people are actually enrolled . My decisions specifically to design the website, i was not involved. I am prohibited to choose contractors. We go by the federal procurement, and i got regular reports on exactly what was done. What about the part with regard to getting data in terms of how many people are enrolled or trying to roll, did you have any decisions in that process . The application process, to this point, does not work end to end very well. I understand it doesnt work. We do not have reliable data about the end of if you had asked them, look, im in charge of this, im going to want a regular report, how many people have tried to enroll, how many people have enrolled, did you ask that question . We have prioritized for our contractors that specific fix, and believe me, the Insurance Companies are eager for us to get reliable data to make sure their data matches ours, and that is not there yet. I appreciate that. Im trying to find out if you told them that was part of the plan. Real quick, were hearing from thousands of people who have had their policies cancel, in fact, i heard from one insurer in pittsburgh that just cancelled 30,000 individual policies. They said they expect 50,000 to 30,000 to enroll in the exchange plans. Just so you know, to date, so far, the number of people who have signed up for their plan is ten. Ten. Now im concerned a lot of these individuals and families arent going to be able to make it by january 1st, so im wondering, do you know how many families will not have been able to keep their insurance by january 1st, do you have any matrix to help you understand what that is going to be . That has been in place at the state level, Insurance Companies must give their customers a 90day notice about a policy change or a plan cancellation. Im wondering if you have a mechanism whereby you will know if something built in this system i know if your constituents signed up for an individual plan, no. People across america. And do we know how many policies will be cancelled . Is it 1,000, 10,000, 1 million, 5 million, do we know . We know that in the individual market, a number of of the plans having sold are not grandfathered and are not currently meeting the law. Those notices have gone out. We know there are about 12 Million People in the individual market. A number of them have grandfathered plans, a number of them have plans which meet the essential Health Benefits. Let me put a face on that. Person named paul wrote to me, im supposedly one of the families this act is supposed to help, but, in fact, is hurting more. Well have less money for food and other essential items. I have a wife and four children to take care of. Another person wrote, i received i had a 2013 plan which if you include the premium, total liability was 5,300. For 2014, the same Program Liability is 9,000. Single mom writes, im one of the millions having their Health Insurance cancelled because it does not meet the standards of obama care. I liked my insurance, now im being forced to sign up for something that will be way more expensive. As a single mom self employed, im worried about how im going to pay my bills. I hope you have a mechanism to track who these people are. Shes not eligible for other subsidies, but the costs are going to be driving her down. Sir, again, i would suggest there is no requirement that any of those consumers sign up for a Plan Suggested by their company at a higher price. They have now options. But if a plan changes health underwriting, without preexisting conditions, with some guarantees around shes searching around and she cant find a plan she could afford. She cant find a plan she can afford. Gentlemans time expired. Gentleman from north carolina, mr. Butterfield. Mr. Chairman, before my time begins, i have a parliamentary inquiry. Go ahead. Mr. Chairman, im always sympathetic to committee decorum and i want to ask unanimous consent to display the democratic twitter handle. Go ahead. Hear no objection, thank you. Secretary sebelius, thank you so very much for coming today. I would like to ask you about the document that my republican colleagues have just released. This document is an authority to operate memorandum to operate the federally facilitated marketplace for six months and implement a security mitigation plan. This document, as i understand it, describes security testing for healthcare. Gov. It says that security testing of the marketplace was ongoing since its inception, and into september of this year. In fact, it says that, throughout the three rounds of Security Control assessment testing, all of the Security Controls have been tested on different versions of the system. Thats good news. But the bad news is, that it goes on to say because of system readiness, a complete security assessment of all the Security Controls in one complete version of the system were not tested. This document indicates that cms postponed a final security assessment screening, but in its place, cms did put in place a number of mitigation measures, and it concluded that these measures would mitigate any security risk. Question, are you familiar with this document . Yes, sir. Is it correct that this document recommends implementing a dedicated Security Team to monitor, track, and ensure the mitigation plan activities are completed . Yes, it does. Now is it correct that this document recommends monitoring and performing weekly testing on all devices, including internetfacing web servers . More than recommended, its under way. Is it correct this document recommends conducting daily and weekly scans . Yes, sir. Does this document recommend conducting a full sea test on the marketplace in a stable environment . Yes, sir. Is it correct that this document recommends migrating the marketplace to cmss Virtual Data Center environment in the First Quarter of next year . Yes, it does. My understanding is that an independent security expert, the miter corporation, is performing security testing on the code that powers the website on an ongoing basis, is that correct . That is correct, and mitor did an assessment of the system, gave us a preliminary report, they are in the process of posting their final report. That did not raise flags about going ahead, and the Mitigation Strategy was put in place to make sure that we had a temporary authority to operate in place while the mitigation was going on, and then a Permanent Authority to operate will be signed. Finally, do you have confidence in these and other measures you are taking to protect the security of americans personal information . I do, sir. Thank you. This is the third time youve said it during the hearing, and we believe you. Thank you. What youre telling us is that these remedial actions and the ongoing security testing from mitor are protecting the security of the website. Thats a message that its important for the public to hear. My republican colleagues do not want this website to work. I am convinced of that. They want to block the aca at all costs and even shut down the government to stop the law. For the last four years, they have taken every glitch, every simple glitch, and hiccup in the law and tried to exaggerate its significance, and thats happening today and its so disappointing. Thank you, mr. Chairman, i yield back. Dr. Burgess. Mr. Chairman, i wonder if i may make a unanimous consent request also . Yes, go ahead. I would like to request unanimous consent my opening statement, which we were not allowed to be given could be made part of the record to this hearing. No objection. Further, i do have a number of questions, many have come from constituents, i would also like to submit those for the record and ask the secretary for her attention to those so we can get answers, because they are, after all, important questions. Okay, thank you, mr. Chairman. It just came to my attention that on cnn, the cnns website, that the site was hacked just last week, and i will be happy to make this available to you. I dont think the cnn website . The cnn website . Cnn ran a story that the healthcare. Gov website was hacked last week. I would appreciate your response to that. Mr. Terry asked a question about he wanted to get the information about the number of people that signed up. You said you wouldnt provide that because it wasnt accurate woch. Would you provide us with the number of people that have been able to enroll on the telephone . The president gave an 800 number during the speech. Can we get a number of people that enrolled on the telephone . No, sir. We do not have reliable enrollment data. Well have that you to by the middle of november as we committed to. We are collecting state data and telephone data. Were collecting paper data. Were collecting website data. We want it to be reliable. Reclaiming my time, telephone doesnt seem like it would be that difficult to compile since the number is likely quite low. The telephone goes through the system. You have the president designated, i call it a glitch czar. Youre familiar with his pintment to the i asked him to serve in this capacity, yes. Many of ounce the subcommittee of oversight investigation were not as comforted as you by that selection. His history with this subcommittee is not great. He was involved with solyndra. We asked him to testify in 2011 and he refused requiring a subpoena. Will you commit to making him available to our subcommittee for our questions . Congressman, youre welcome to ask him to come before the committee. He is volunteering his services to us for a period of time. He has been appointed by the president to start in january as the head of the National Economic council. He was the Deputy Director at omb for management and performance. Im thrilled he is willing to take on this assignment and help us drive the management. Again, his appearance here will be important. Now, a lot of people are asking if the president s words leading up to this law if they matter. And the statement in the Washington Post today edited the president s statement, if you like your health care plan, youll be able to keep your health care plan. If we deem it adequate. That seems like a more operational statement. Especially if you go back just a few years into the federal register and im quoting from the federal register from july 23rd of 2010, just a few months after the law was signed, the rule the interrim rule for the dealing with the grandfathering written in the federal record because newly purchased individual policies are not grandfathered, the department expects a Large Population of individual policies will not be grandfathered covering up to and perhaps exceeding 10 Million People. I hope the president was apprised of that before he made the statements. Clearly his statement wasnt operational . Again, thats an Insurance Company choice. That was a snapshot whast marof market looks like. It was employerbased coverage and individual coverage. But those were the comments that were recorded. Now this isnt a government takeover of anything. These are private Insurance Plans. I do have to ask you this. You served at the pleasure of the president. Were all aware of. That but weve had many of your employees here in front of this committee. And do you have to ask yourself, are they being purposely misleading or are they really not that smart . So im going to ask you this morning for the sake of the future of health care in this country, will you please ask for the resignation of gary cullen because he misled us. I will not, sir. The gentlemans time expired. A point of personal privilege. I think the record ought to be clear about jeffrey science. He was invited with less than a weeks notice to come before this committee. He couldnt make it that day. He asked for some other day. He went to omb and had nothing to do with the solyndra contract. Did he come before us and talk about it. The sole role is to represent omb. I dont think he ought there ought to be any disparagement of him. He is a very wealth regarded public servant. The gentlemans public will stand. Thank you, mr. Chairman. Welcome madam secretary. Now we all agree the website problems must be resolved. This country invented and developed internet and the concept of the web sites. So there are high expectations. The fact that the hired private contractors didnt build the website in three years is inexcusable. I hope those at fault will be held accountable. We cant lose sight of the big picture that, when this is all said and done every american will have affordable quality Health Insurance and health care. This is a goalie believe of all democrats and republicans. The aca is working in california and is working in my district in sacramento. I just want to tell you about a letter i got from the constituents. Dear congressman, as a selfemployed contract employee ive had individually purchased Health Insurance for 11 years now. Insurance that has gone up every year, sometimes more than once. Insurance that wouldnt let me add my daughter when my sex husband stopped his insurance policy that covered them both. Insurance that i underused for fear they would drop me. Insurance that just dropped me anyway because they decided they will no longer offer individual plans. This could have happened to me at any time. Im so grateful that the Affordable Care act provisions make it possible to get Health Insurance beginning in january for me and my daughter. As all this is happening, i have finished graduate school and started my own business. Slowly but surely things are happening and i will be hiring my first employees in the next six months. The provisions of the aca are helping me in this, too. I can clearly see what would cost me to provide Health Benefits for my future employees, understand the costs and build my Business Plan accordingly. And that is just one of the letters i received. Now, ive also heard from my colleagues on the other side of the aisle complain again and again about how Health Care Reform is increasing Health Care Costs. But the empirical evidence shows something quite different. The recent trends in medicare spending growth are really quite remarkable. Medicare spending growth is at historically low levels growing by less than. 5 in fiscal year 2012 following slow growth in 2010 and 2011. The same is true on the private side of health care. Personal consumption expenditures on health care, everything from Health Insurance to drugs to hospital care rose by just over 1 in the past year. This is the slowest increase in nearly 50 years. Madam secretary, what does this data tell us about what has happened to Health Care Costs since the aca became law . Well, youre absolutely right. In the last 3 1 2 years since the president signed at fordable care act, we have seen a great slowdown in the extraordinary Cost Increases year in and year out for health care, in the medicare plan and medicaid plan and in private insurance and in underlying Health Care Costs which affect every american. Some of that is to do with some of the features that are currently in place around different care delivery and different Payment Systems that we are helping to draw and given the tools we have with the Affordable Care act. More quality outcomes, trying to prevent hospital readmissions, looking at hospital acquired infections, medical homes that prevent people in the first place or help them stay healthy in their own homes and in their own places. So its true that private insurance costs are growing at the slowest rate in decades. Thats true. Am i also correct that the aca premiums are coming in lower than predict by experts like the cbo . Well, theyre about on average about 16 lower than was estimated that those premiums would be and thats the premium, not accounting for the number of uninsured or underinsured americans who will then qualify for financial help since they dont have employer coverage, they get some help from the taxpayers paying for that coverage. Thank you, madam secretary. Thank you, mr. Chairman. Madam secretary, when you spoke at the Democratic National convention in charlotte last september, one of first statements you made about the Affordable Care act was, but for us democrats, obama care is a bad drama because no matter who you are, what stage of life youre in, this law is a good thing. First, if you already have insurance you like, you can keep it. Id call this a red herring that misled voters intentional or not. Now perhaps had you known that millions would lose their coverage, families would face financial disaster as one constituent recently told me. Or that exchange rollout would be plagued by multiple delays weve seen. You would not consider it such a badge of honor. The fact is your words and those of the president as he came pained last year that if campaigned last year that if you already have insurance you have you can keep it seemed to be refuted by the millions of cancellation notices already sent to americans just in the past few weeks. Whether your statement was inaccurate or as mr. Hoyer said yesterday, not precise enough, it does strike me that millions of individuals who by listening to speeches like yours voted believing one thing now find themselves without coverage and are now scrambling to find coverage in a marketplace that offers more expensive plans with fewer options. In response to my constituents calls for herngslp, i created a portal on my website, no patches forris or fixes needed. It allows them to tell me about their personal experiences. My office received dozens of complaints regarding increases in their monthly premiums. I received one such notice from a mother in her early 50s who just received a notice that not only will her Insurance Premiums double but she will also have to switch insurance to insurers to keep her doctors due to the fact of at fo of the Affordable Care act. I can tell you just in my district many more are experiencing this situation. Madam secretary, this is akin to telling seniors that in a few weeks theyre Medicare Coverage will be dropped. Or their premiums will double. I know that neither you nor the administration would ever advocate for such a policy. Yet, here you are subjecting those currently in the individual market to such government intervention. And i would hope that you would agree with me in recognizing that these increases are a heavy hardship on my constituents on all of our constituents, republican or democrat. Now get to my questions. You know the Health Care Law included a hardship exemption from the individual mandate. Yet, the administration has failed to finalize the Application Form for the hardship exemption 3 1 2 years after we passed this law. As of today, can an individual apply for hardship exemption from the individual mandate on heal heal healthcare. Gov. Yes or no . I dont know. I do. Its no. On october 15th, politico reporting that if the on line system for getting into obama care is rickety, the system for getting out of the mandate doesnt even exist yet. Hhs says it will take another month at least for the administration to finalize the forms for the hardship exemption from the individual mandate. Why has it taken 3 1 2 years to finalize a simple Application Form for an exemption from the individual mandate . Sir, as you know, the individual mandate is not in place until next year. We have made it very clear that if somebody is medicaid eligible in a state that doesnt choose my last question and my last second. 16 Million People in the individual market have or will receive cancellation notices stating their Health Insurance coverage does not meet minimum coverage requirements of the Affordable Care act. It grants you the power to determine the criteria for hardship exemption. Will you provide all of these individuals a hardship exemption since the Affordable Care act is taking away their plan . Will do you that . No, sir. And i think those numbers are far from accurate. 95 of americans who have Health Insurance will be in a continuous plan, medicare, medicaid, employer based, va. 95 . 5 who are in the individual market, a portion of those 5 , a portion of them, about 12 Million People, a fraction of those 12 million will have a plan that doesnt meet the criteria and has not been grandfathered in. They are indeed receiving notices. Many of those individuals, half of them, will be eligible for financial help getting a new plan and they have many more choices in the marketplace. So we will not have a blanket exemption. Sounds like a hardship to me, madam secretary. The gentlemans time expired. Mrs. Christianson. Thank you, mr. Chairman. And thank you madam secretary for being here and thank you for all that you and your staff at hhs has done in implementing at fordable care act to insure it provides the many benefits to children, women, to Medicare Beneficiaries and to ensure security to those who already have insurance as well as lower costs. Of course, the biggest complaint has been about the application and the enrollment website. We have heard over and over from you that those are being addressed. But you would recall and i know my colleagues would recall that congressman rush and i have always been concerned about those who do not have internet access, those who are uncomfortable using the internet and would not use it. So i just wanted to just remind everyone that there are other avenues for enrolling either by telephone or by paper either alone or with the help of a certified application assistant. But my question goes to one of the rumors that is circulating. There many resume norz about how the Affordable Care act affected part time workers. Some of my colleagues on the other side claim that the companies are moving workers to part time jobs because of the Health Care Reform law and that low wage workers are being detrimentally affected. And i understand why these claims are being made as just another part of the on going effort to undermine the law. Would you take a few minutes and just set the record straight on the part time issue . Certainly. 95 of businesses in this country are Small Businesses, under 50 full Time Employees. And there is no responsibility that any of those employers have to provide Health Coverage for their employees. On the other hand, there are now tax credits available for some of the smaller employers who want to offer coverage to actually come into the marketplace. For the other businesses, the businesses hiring 50 or more, there is a standard that says an employee is considered full time if he or she works 30 hours a week. And that really came from a market snapshot with help from the Small Business administration of where Employee Benefits were in the private market based on hours of work. What was a part time or a full Time Employee . What we know about the Economic Data is the high point of part time workers was in 2008 and 2009 at the height of the last recession. It has been decreasing each and every year. There is no data to support the fact that there is an uptick based on the impending Affordable Care act. Im sure that there may be some individual employers making some Business Decisions about how many workers they want full time and how many part time. But i can tell you there is no Economic Data or Employment Data that supports the notion that this is an effective law. In fact, its my understanding, that parttime workers are at the lowest percentage of workers in many, many years right now. Well, for the if i ever tifi parttime workers have options for Affordable Health care. They never had that before. Theyve never had options in the marketplace. They never had some health purchasing coverage for themselves and their families. Their full time colleagues have but they have not. So they will have options. And just to be clear, i had another really long question. The last part of it, it would be fair to say that the every point along the way you expected this website to work based on everything that you have been told by the contractors up until that point. I expected it to work and i desperately want to get it working. More than anyone else, i am sure. And we are committed to fixing it. The only thing that i think builds back the confidence of the public is fixing it. Thank you. Gentle ladys time expired. Thank you, mr. Chairman for holding the hearing and thank you for being with us. Last week when the contractors built the system were here, i asked them all under oath if they had actually delivered the system they were contracted to build. And all four of them answered yes. I want to ask you, did the contractors deliver the system that you contracted them to build . I dont think i can accurately answer that question. What we know is weve a system that doesnt function properly. We definitely know that. As we fix things, well know more about what is broken along the way. And ill be able to so would someone in your office know someone oversaw the implementation and they said this is the product we contracted and paid hundreds of millions of dollars to build or wasnt. Does somebody have the ability to get that information . We can say that products tested individually verified individually. But clearly was an integrated system. And dont work well together. But, you know, i used to write programs for a living. I develop Software Products for a living f youre developing a system, its irrelevant if one Component Works by itself. But when you plug it in together it doesnt work, thats a system that doesnt work. One question i had and others had, somebody in your agency made a decision to change the system. Instead of grog a browse area built where somebody on kayak or just like on amazon. Com could go shop for products, look at prices before they purchase, which is how consumers are used to doing this yall made the decision to change it around and gather all the information first before you could let them see prices. Was that you who made that decision . No, sir. Was that miss taverner . Yes. And a team that looked at did that team make that decision because once they saw the prices, and were getting reports from all our constituents of dramatically higher prices than what they were expecting. Did you make the decision because you knew that when they saw the prices they may not want to bite product so you wanted to gather the information first . Sir, first i did not make the decision. I was informed about the decision. We didnt do you agree with the decision . It rolled off a number of features. They can see the products. There is no requirement to buy anything. I spent two hours to get into a system. I never once did get to a point where i can see the price and got the blank screen thats other people got. I want to share stories from some of my constituents. I we started a page on our on facebook and twitter and were collecting share our stories. Were getting lots of stories from my constituents. I want to read a few of them. Randal said my Health Care Premium went up 30 to over 350 a month increase. We have michelle, our Insurance Premiums are going up 400 a month and our deductible increased. Then you have shawn from could having ton, my current plan through United Health scare no longer being offered in 2014 due to obama care. In fact, i received a letter stating that the new Health Care Law was indeed the reason for the removal of my Current Health care plan. Madam secretary, what you would tell shawn who liked his plan and now lost it . He was promised by you and the president hed be able to keep that plan. What would you tell shawn now that he lost his plan . I would tell him to shop in the marketplace and out of the marketplace. Do you really think thats acceptable answer to shawn. If united chose not to keep shawns plan in effect for shawn because of the law. Sir, the law said if you keep shawns plan in place, if he liked his plan, if you only then the plan is still there. You and i may disagree over who you work for. I work for shawn. You work for shawn, madam secretary. Shawn lost his plan that he liked. And there are thousands and millions of shawns throughout this country that lost the plan they liked because some bureaucrat in washington said we think your plan is not good enough even though you like it, even though you were promised can you keep it, youre now not able to keep that plan. I think you deserve to give shawn a better answer than you just have to go shop for Something Else even though you like your plan. The gentlemans time expired. Thank you, mr. Chairman. Thank you, madam secretary for coming to day. Im going to follow up on mr. Doyles line of questioning. One concern i have with the fallout from the website is that many users who tried to sign up and discouraged becausest proble of the problems will be too discouraged to come back once the site is fixed. What do you plan to do to get those folks to come back . Sir, we intend to invite them back. Formally by email, by message. But we dont want to do that until were confident that they will have a different experience. So fixing the site is step one. And then inviting people back to the site to make it clear that when our timetable is fulfilled, they have four months to shop for Affordable Health coverage on a fully functioning site. We know were going to have to spend special time on young and healthy merns wamericans who thy dont need insurance, arent aware of the law, dont want to use a failed or flawed site. We have to spend some particular attention on them. Thank you. Have the software spes infectioinfectio specifications including the test specifications, has that changed since the initial rollout . I know that there certainly are some changes because since october 1st im sorry. Yes, since the rollout. The specifications havent changed. We are certainly fixing, as i say, speed and reliance is one of the issues were taking a look at. Thats the performance side. But there also are some functionality sides that things do not work as they can including the enrollment passed on to insurers. So were fixing functionality. I dont think thats a change in the specs. I think it is actually making the system work the way it should. Well, are you is the department doing a prioritization on the problems . Yes. Can you describe that a little bit . Yes, as of last week when jeff signs joined us for the short term project, we asked him to lead a sort of management team. We have pulled in all of our contractors as well as additional talent that they may have available. We have talked to tech folks in and out of the private sector and insurance, some of their tech experts to get all eyes and ears, made a full assessment, developed a plan for fixes along the way, have a punch list for going after those fixes and we are doing a daily tech briefing and blog to tell people what we have found, what we have fixed, whats coming next, what the functionality is and we intend to do that until its fully functional. Thank you. Madam secretary, looking past the initial problems with the aca rollout, do you think that the Affordable Care act will be successful in bending the Health Care Cost curve and reducing the fraction of our National Economy that goes for health care . Well, i think that we have already had some success. I think the goal is to continue to achieve that, fully insured population arguably with preventative care, an opportunity to see a primary care doctor and not go through the emergency room will in and of itself reduce costs. Having people identified earlier who may have Serious Problems and managing those problems will reduce health costs. I think the Delivery System also needs some considerable help in paying for a number of procedures, number of tests, number of prescriptions but paying for health outcomes. Thank you, mr. Chairman. Thank you very much, mr. Chairman and madam secretary, thanks for being with us today. Appreciate your testimony so far today. What id like to do is ill get these two you. There are so many these are questions that weve received from our constituents back home specifically about whats going on with the website and for them. So what ill do, id like to get those two you. But there is a lot of questions here. A lot of thoughts gone into a lot of the questions. But if i could start with last weeks testimony when our four of the contractors were here. And in one of the questions that i had posed to miss campbell from cgi and her testimony she stated that they delivered the medicare. Gov and federalreporting. Gov. Were the sites more or less complicated than the site that we were talking about here today . And she said, of course, the site today was more complicated. And in the questioning and from her testimony, and weve been hearing about this testing that wasnt happening that we had individuals out there saying that about two weeks had been done, but i ask her about was there sufficient enough time when they did medicare. Gov . And the response she gave me back was on medicare. Gov which is a less complicated site and she stated we had sufficient time to test the system before it went live. And i asked her in a follow up then, what was that sufficient time . And she said we had a number of months before the system went live at that time. And i just want to make sure because again, you know, sometimes things dont get reported accurately. And the u. S. News and world report on october 18th of this year and there is some questions going back and forth. I want to make sure that you were quoted properly. After two weeks of review, the hhs secretary concluded we didnt have enough testing specifically for high volume for very complicated project. The on line Insurance Marketplace needed five years of construction and a year of testing, she said, we had two years and almost no testing. Is that correct . I dont know the quote. I never suggested that we needed five years. I dont know where that is from. Thats one of the things were going to check. We clearly ever didnt have five years. The law was signed in 2010. And then last week you when you were down in texas you were being asked by a report bert system and the launch. And one of the parts of the question was that at what point did you realize the system wasnt going to be working the way that you envisioned before the launch and why didnt we stop it before the launch . And, again, this is what was reported. We knew that we had another six months we would probably test further. But i dont think anyone fully realized both the volume caused such problems but volumes also exposed some of the problems we had. Now going back though to miss campbells statement that they tested more extensively on a system that was not as complicated but hhs, cms decided to go forward with only a very short period of testing. Do you think that was acceptable . Clearly looking back, it would have been ideal to do it differently. We had a product that, frankly, people have been waiting decades to have access Affordable Care. Medicare existed well before the website. Its a program that started 50 years ago. The website was an additional feature for consumer ease and comfort. And so they were not launching medicare. They were not delivering Health Benefits to seniors. They were putting together an additional way to enroll in medicare. I would suggest, sir that, we had deadlines in the law that people had benefits starting january 1st. We wanted a extensive open Enrollment Period so that a lot of people who were not familiar with insurance didnt know how to choose a doctor or choose a plan had never been in this marketplace or people who needed to understand fully what the law offered had ample time to do that. So the date that i was required to select for open enrollment, thats again part of the statute, how long would open enrollment be . We picked that date. All the contractors that began early in this process in the fall of 2010 when we issued im sorry, 2011 when we issued the initial contracts to cgi and qssi new the october 1st date. That was not changed. It wasnt added to as we got closer to system, one of the reasons again that we paeared down what needed to launch is an attempt to minimize the risk to the system to get people to their ability to see clearly what they were entitled to, what the plans were and if they chose to to enroll. Clearly, the testing should have been longer, should have been more sufficient. Gentlemans time expired. Thank you, mr. Chairman. Madam secretary, people who are watching this hearing might be under the sum that is there is some kind of political debate going on over the Affordable Care act. I think people in iowa dont care anything about whos winning the political debate. They want these problems fixed and they want them fixed now. I think thats the responsibility of everyone in this room to make sure that that happens. I tried to go into the marketplace on october 7th and i encountered problems immediately dealing with the Security Code questions which required you to select dates. One of them was type a significant date in your life. Today is my birthday. So i put that in. I tried three different ways of entering that date and got a message each time, important this is not a valid answer. Same thing for the third date entry. And a lot of times when youre registering online for anything and you have to put a date in, there will be a little prompt that tells you what the format is youre required to enter. Do you know, have we solved this problem in the Security Code area . Yes, sir, one of the initial issues was just getting people into the site and the id proof clg is a twostep process, one is that you give some preliminary information and you set up a pass word. But the second to insure that your personal data cant be hacked, cant be interfered with is the second step where some personalized questions which only can be verified by you are indeed part of that. Again, that was a an initial holdup in the system. We focused a lot of attention on that. The first several days it was fixed only to then discover that there were system problems throughout the application. And that piece has been fixed. I would suggest it also was a function of trying to make sure we had the highest Security Standards, that we were not cavalier about someones personal information being able to be addressed and attached. It was a functionality that didnt perform properly. But it does now. One of the things that keeps coming up in this hearing because you are from kansas is references to the wizard of oz. People went to see the wizard because of the wonderful things did he. The Affordable Care act is doing a lot of great things in iowa. The Des Moines Register said that iowans buying Health Insurance will face the lowest premiums in the country. Increasing competition in our state. Iowa consumers are able to choose from 40 health plans in the marketplace. Youve mentioned the growth of Health Care Spending is at the slowest rate in 50 years. 50,000 iowa seniors received Prescription Drug rebates. Bans on preexisting conditions are allowing people to get coverage and switch carriers. And now Insurance Premium increases are subject to review and can be rejected by the people reviewing those plans. But all of these good things dont mean anything unless we solve these problems. And what i need to know is how confident are you that the problems will be fixed by december 1st . Well, again, congressman, i have committed to that date because that is the assessment of both inside and outside experts have analyzed. I think they kicked all the tires and looked at all the system. I know that theres no confidence in that date until we deliver on the date. Im well aware of that. And thats on me. Since americans were supposed to have six months to sign up, would you support insuring they still have six months by extending the open Enrollment Period for two more months . At this point they would have a fully four months of fully functional always to sign up. Again, there are alternate ways and the website right now that people are getting through. The open Enrollment Period is extraordinarily long. Its about six times as long as a typical generous open Enrollment Period. And its important for the Insurance Partners to know who is in their pool so again they can stay in the market next year and know who theyre insuring. So we think that the timetable will allow people four months time to fully use the website. They can use it right now. They can use call center. They can go to navigateors and enroll. The gentlemans time expired. Thank you, mr. Chairman. Thank you for being theer day. Im sure there are other things youd rather be doing. But we welcome the opportunity to have this conversation. Im going to ask the clerk to bring you a document for you to look at so i can ask you a couple questions. If can you go to page 8 on that, i have highlighted an item there. But this is a copy of a cgi slide show from october 11th discussing technical issues that must be addressed within the website. And on page 8 what ive handed you, cgi recommended that cgi and cms have a review board to agree on which issues can technically be solved and which should politically be solved. Was such a review board convened . Sir, i cannot tell you. Ive never seen this document and im not aware of this recommendation. And cgi is responsible for the website, correct . Cgi is responsible for the application. For the application. Yes, sir. Does it surprise you that in a slide show that they gave in october 11th they acknowledged political reasons for again, ive never seen this document. I have no idea what that means. Did ask you cgi when they came last week . Can you find out for us if such a review board was done and if any decisions were made on political reasons or on the other reasons and find that out for us . Sir, i that question needs to go to cgi. I can ask them to report to you. This is their document . This is not our document. You would turn to page 9 of that document, please. It states challenges on page 9 that says under challenges, unable to determine at this time whether low enrollment counts are attributable to system issues or due to users choosing not to select or enroll in a plan. So those are two completely different issues, obviously. If it is the system issue, thats something you have confidence that at some point will be resolved, correct . Yes, sir. And if its a user selection issue, thats an entirely different story, is it not . Yes, sir. Okay. Now, you know, when you use the phrase earlier about a punch list, thats like having somebody move into a house. Someones buying a new house and they go through and they have been told this house is going to be ready on october 1st. They load up the van, they come in and they get in and its not finished. Part of the plumbing is not right. The wiring is wrong. And they go in. This creates the situation where we health care shouldnt be a zero sum game. I mean we want to be fair to everyone. We want to help people who are vulnerable. But at the same time, we shouldnt have to hurt folks. Weve got people in my district, in my state who are getting notices of cancellation. Theyre being told of higher premiums that theyre having. And these are great concerns that we have. And how do we work through that . And i want to say i appreciate you accepting responsibility for these initial rollout failures that weve had. But who is ultimately responsible . It is the president , correct . For the website . The president is ultimately responsible for the rollout, ultimately. No, sir. We are responsible for the rollout. But who do you answer to . I answer to the president. All right. So is the president not ultimately responsible like a company ceo would be . Sir, hes the president of the United States. I have given him regular reports and those i am responsible for the implementation of the Affordable Care act. Thats what he asked me to do. Thats what ill continue to do. So youre saying the president is not responsible for hhs . Sir, i didnt say that. So the president ultimately is responsible. I think its great that youre a team player and taking responsibility, it is the president s ultimate responsibility, correct . You clearly whatever. Yes, he is the president. He is responsible for government programs. My time expired. The gentlemans time expired. Mr. Chairman, thank you very much. Bring begin, id like to ask unanimous consent to submit into the record some articles from new mexico publications, first entitled Small Business owner Health Exchange will save me 1,000 a month. Without objection. I see my time did begin there. So ill try to get through this, mr. Chairman. Madam secretary, i was inkritrid by a line of questioning asking about the individual marketplace. How volatile was the individual marketplace before the Affordable Care act became law . I would say it wasnt a mark marketplace at all. It was unprotected, unregulated, and people were really on their own. Madam secretary, the Kaiser Family Foundation Reports have over 50 turnout of individuals that have coverage and individual market churn out coverage every year. They either lose coverage, priced out or drop it s that consistent with what youre aware snf. Thats an accurate snapshot. About a third of the people are in for about six months. And over half are in for a year or less. So individuals that were in the individual marketplace before the passage of the Affordable Care act did not have the same protections as those in Group Coverage . Thats true. And would those individuals in the individual marketplace sometimes have higher copays . Higher copays, unlimited out of pocket costs for often