Policy, can you keep it. There were a lot of people that wanted to buy policies that cost less and that didnt have lifetime caps lifted. There are a lot of people that wanted to buy that didnt cover their 26yearold. You didnt let us do that. And that is the problem. We are smart people. We can make our own decisions. We dont need the government telling us what we have to have. And that is the biggest complaint i get from idahoans, from americans saying why are you politicians and washington, d. C. Constantly telling us what we should do for ourselves . And thats the basic problem of all of this. Whenever you try to socialize in the industry, nationalize an industry like its been done here, its never worked. Its been in tried in all sorts of countries and it never works. Its not going to work here. Well, let me go over a couple other points. First of all, i want to ask mr. Knoll, im told that there are have been 150,000 small group plans that have been canceled in your state. Is that true . Sir, im not familiar with the number there. The department of insurance is the agency that handles the mechanisms for that. Ill be glad to provide that information to you. I got it. They said there is 150,000 small group plans that have been canceled. On the other side of the ledger, through november 8th, 309 have signed up again. Thats a big problem it seems to me. We have 150,000 canceled and 309 signed up. Certainly with the small group, its to note that the open Enrollment Period that affects individuals is not the same with small groups. There is a continuous open Enrollment Period available to small groups. They can sign up any time during the year. Its really encouraging to hear you were one of five that made the rollout work on october 1st. In the morning of october 1st, Bloomberg News was reported we were one of four jurisdictions. Four . That went live without a glitch. That is really good to hear that they were able to sign up. They were able to get on and do what they wanted to do. That is a really good thing. What is the population of the district . We are a small population jurisdiction. About 640,000. Im told that in the first month with you up and running, no glitches, everything is working good and that kind of population you had five enro enrollees in the first month. Is that true . No, thats not true. What is the number . I can provide your office with the exact numbers. We did issue most recent numbers as of november 13th. We had close to 700 employer accounts created. In terms of individual whos completed their applications, both for premium reductions and full premiums, we were at about 1,350 for full price applications. And close to 2,000 for reduced price. Each application could be a familiar live ten. We only count applications. In terms of account holders who collected a plan, over 1100 account holders selected a health plan. And 565 account holders said they wanted to be invoiced to pay. Now theyre not required to pay until december 15th. So i just want to make sure that people who are residents of the district are reminded of that. Were not asking for people to pay early. Were just if they want coverage to be effective january 1st, they do have to make their payment by december 15th. So my calculations then is youre a little under 1 signed up of the population of the district. Would that be fair . I can provide you better numbers. Right now folks who are shopping and making decisions, theres a lot of activity through dchealthlink. Com. Im encouraging Small Businesses to take their time selecting Health Insurance. It is not an easy decision. And if youre not not working with a broker who can help you through it, you really do have to take your time. I can tell you as a former insurance regulator myself, insurance is very complicated. Consumers who get 150page document which is their insurance contract which has the exclusions and what is included is very complicated. So although weve made it much easier through our web page to shop and compare apples to apples, we provide fourpage coverage summaries that make it much easier than before. It is still not a quick decision. We encourage everyone to take their time. Thank you. Senator booker, let me welcome you to this committee. Let me welcome you to the United States senate. I look forward to your leadership. Youve already been a champion of Small Business. Youre a perfect person to join us in our effort to help them. Thank you very much. Thank you. This is such an important issue for the state of new jersey that im very grateful to have the opportunity. I want to thank all the panelists. I wish we had more time. I look forward to reading more of your testimony submitted into the record. Mr. Greenblatt, first of all, i appreciate your jersey connection, a guy who vacations in jersey and you have some jersey boy aura to you. I want to say to you first and foremost as the geologists say, you rock. And you rock not because of your jersey connections, i feel the kinship of you and any the last month have come to washington. You goat go home, i think. Im going to stick it out here and battle it out. You deal with prague in a tichl that i have to deal w i cut 25 of my employees as a mayor. The reason i had to cut so much is because health costs were going up, my taxpayers couldnt afford it. I have to balance a budget every year. So do you. The challenge that you have which ive seen working with local manufacturers in my city that i want to expand is that you said you export products to china, right . Youre competing globally, right . I like you a lot. And when you compete globally, youre competing against countries in europe and asia and across the globe, right . And many of those countries have Different Health care systems and most of those countries, most of our competitor nations have much Lower Health Care costs, right . Its parts of the system. Their taxes are 15 . Our taxes are 40 . It makes it challenging to compete with canada. I want to compete with canada in every way except in toronto. Their mayor has challenges there. So my point to you is that your pragmatism i love. Because this is not about politics. Its not about the pugilism that is row found in washingtonment its about solving problems, lowering costs, giving access and Small Business people like you want to keet with the big boys, right . Absolutely. And what i see in my city is many folks have a hard time keeping employees who could hes gloi to other companies and have better insurance plans. You probably know of people that will go to companies and get less salary for Better Health insurance. I think that is one of our positive attribute thats we have such a good plan. So the key here, the goal here is to make sure that we take this variable which has made Small Businesses get so crushed in the past and helps them be more competitive not only in keeping employees locally but also competing against other countries that have Lower Health Care costs. They have Lower Health Care costs. And youre competing against them because you internalize the costs and manufacture the companies dont. Right . Right. So thats the flag ma ticpra. I dont care about the next election, i care about solving the problems. They may not like politicians, but most people are saying fix this thing. So mr. Hickey, who has no new jersey connection, im sorry you do, sir. In my last 90 seconds, sir, would you please youre well down the field. You have a functioning exchange. You heard the good jersey boy mr. Greenblatt and mr. Allens problems. You could please tell us what the future could look like for them and how to solve the very real problems they brought up . Number one, put together an Exchange Board that is from both sides of the aisle. But as you say, they care about the people of new jersey. Our board has people i dont know sorry to interrupt you, i dont know if you heard about my governor, he is quiet he and soft spoken, but did he not participate in the exchanges. We have one of the best local insurance based knowledge there is and we didnt engage in that, new jersey. We left it to the federal government. So were way behind new kentucky. Not a place we want to be in new jersey. But continue. And that board being made up of people even though they were vitriolic against the aca, once they got on that board, they said we have an obligation, a duty to the people of new mexico and we are going to make this work. Right and left coming together. Right. And we all came together. We have a great chairman. He is also a doctor. We all came together and we met and we met and we met and we resolved the issues. And we hired an excellent ceo and we hired a company of previous private exchange ven r vendor, a shop in the box is what we call it. And it already works. And we knew it would work. And so that was and my time expired. People are hurting now. We have to fix this before the next election. I appreciate you showing us a way forward. Thank you, mr. Chairman dr. Hickey. Senator enzy . I didnt anticipate getting into my Congressional Review Act, but since its been brought up several times. I will. One of the reasons that it included some things that you would prefer not to have in it is when the federal register is published and says that theres going to be this huge kst and people losing their insurance even though the president promised that if they like their insurance they can keep it, your choice isnt to pick from the things in there. You have to reverse the whole regulation, the whole regulation would have made it possible for people to keep their insurance if they liked it. So you had also have a very limited time to be able to bring up a Congressional Review Act and have that kind of a forced eighthour debate and up or down vote on regulation. They could have made it so that people could keep their insurance if they liked it provided it didnt have the two things. Thats not how it works. There hasnt been any effort in the meantime to do that. Now that its been exposed. There is a tremendous effort and interest and senator johnson has a bill that would comply with what i think the chairman said would be acceptable to go ahead and fix it so that people who like their insurance could keep it. Although, it should have been done three years ago. So the Insurance Companies would have had the opportunity to adjust to the time. To have their stuff together for this particular time. I think it would have helped out businesses. There are three change thats id like to make in obama care and if we made those three changes, it would make more of a difference in jobs in the economy than the stimulus package did. One of those is to change the hours for part time from 30 to 40. And that is the standard by the Small Business administration. And this is the Small Business committee. So i would hope that we would do that. I had a ten step plan for fixing Health Insurance before the president ever became a senator. And one of the things is Small Business health plans. We had an opportunity to do that. That would allow Small Businesses to group together through their association, any association across state lines, nationwide so theyd have a big enough group they could infectively negotiate with any Insurance Company. There is another proposal that would have allowed them to selfinsure on those big groups. Those would have provided a lot of advantages for Small Business. Those are not available. Small Business Owners of wyoming are asking me what can be done . Wyoming didnt do an exchange. Its less populated than the district of colombia alom colum. We only have two Insurance Companies that are interested in serving there. We only had two provides providing prescriptions until we bid prescription part d. One of the things that surprised us, 48 companies wanted the business in wyoming. Even though it is a small populated state. And what was the effect . Before the law even went into effect it dropped prices by 25 and gave people choices. We could have had that same thing here. But we dont. I want to thank you all for the testimony you had. I had some pretty specific questions that i would ask. Just quickly, mr. Allen, you mentioned that drugs cost 52 more because of the name brand requirement . Could you give expand on that a little more . Yes. The difference in premiums to go to the new policy that includes brand name drugs, the difference in the premium is 52. 3 . And none of your employees are using brand new drugs . Yes, i did a poll among my employees and not one Single Person is presently taking or plans to nay any pharmaceuticals that are available only as a brad name product. Thank you. I think there are a number of great examples there. I appreciated mr. Greenblatt. Sometimes can you use a little stability in what the prices are going to be. Hes not getting that under the exchange. I thank the chair. And i thank the senator from wyoming. Senator shaheen just to put for the record and the senator knows, there are 576,000 people in wyoming, less than in the District Of Columbia. One chose the exchange, one chose not. Senator . Thank you very much thank you for holding the hearing. Thank you all for being here. Im sorry i missed your spoken testimony this morning. But i do think its very important for all of us to hear from Small Businesses and in New Hampshire, 96 of our employers are Small Businesses. It is a foundation of our economy. And the frustrations that you have shared are ones that i think everybody on this panel appreciates and shares in terms of how to make this law work and what we can do better. You know, one of the biggest concerns that i have heard from New HampshireSmall Businesses is about the costs of health care and mr. Greenblatt, you and senator booker engaged in a back and forth on that this morning. But Small Businesses currently in New Hampshire pay 18 more than Large Businesses because of administrative costs. So finding a way to address the challenges that you face is going to be critical. And, you know, looking at what we can do to fix this legislation, i think, is very important. And in that vain, i offered a bill that would delay open enrollment in the individual market because that is the immediate problem that were facing in New Hampshire. And i did that because we want to make sure that people have time to enroll. Now fortunately with the shop exchanges, thats an on going opportunity. But New Hampshire, like wyoming, like a number of other states, also has not chosen to do a state exchange. And so we are very much struggling with whats happening at the federal level. I wonder for mr. Knoll and miss kaufman as you have participated in state exchanges that are working, if you could talk about the reaction of those businesses that have enrolled in the shop exchanges and the District Of Columbia and in kentucky. And how theyre feeling at this point about the product that theyre getting. Mr. Knoll, maybe you would go first. Sure. As youre aware, the enrollment process in the small group exchange, the shop exchange, is really a twostep process. The first step is the employer themselves will come to the exchange and shop and try to determine which plans they want to offer to their employees. Once they go through that process and pick the plans that they want to offer, then the employees are given a 30day open Enrollment Opportunity to go online and pick the one they want. So the it takes a little longer in the shop to really get to the point where you actually are enrolling. So that process has to be completed. That is the open Enrollment Period for the employees has to be completed. We had a participation requirement in kentucky that says that 75 of the employees have to participate. If they dont, then the employer so that takes time. Weve gotten to the point where now employers have selected plans and the open Enrollment Period is on going. Employees can come in and choose. And then, you know, so what im trying to say is its difficult to say how thats all going to happen. Its predicting the future. So we are very, very encouraged about the numbers. I mean weve had over 93 employers that have gotten to the point where their employees are now picking plans. Great. Thank you. Thank you. [ no audio ] so this is the first time they can offer coverage to their workers and themselves because if the workers arent covered, its likely the owner isnt covered either. So one Small Business was very excited about that. Another small busy spoke to on october 1st said the owner said based on his quick review of all the products, hell save 12 , at least 12 . At that point in time he has not made a decision of the products he wanted to offer. Another small busy spoke to said they were very happy not to be paternalist paternalistic. They can let their employees decide which hmo or ppo or Insurance Company to select. Anecdotally, Small Businesses i have been talked to have been very, very pleased with the product offerings, the range of offerings and the prices. Thank you. Thank you very much. Senator johnson, thank you for joining us. Thank you, madam chair. In solving any problem in negotiation, first thing yo