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tv   Legal View With Ashleigh Banfield  CNN  October 30, 2013 8:00am-9:01am PDT

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americans just in the past few weeks. whether your statement was inaccurate or not precise enough, it does strike me that millions of individuals who by listening to speeches like yours voted believe one thing now found themselves without coverage and now scrambling to find coverage in a marketplace that offers more expensive plans with fewer options. in response to my constituents' calls for help, i created a portal on my website that allows those who have experienced problems to reach out and tell me about their personal experiences. in just the last few days my office has 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 premiums double, but she will also have to switch
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insurers to keep her doctors. can you imagine receiving notices like this i can tell you that just in my district, many more are ex-spenting this situation. madame secretary, this is aiken to telling seniors that in a few weeks their medicare coverage would be dropped or premiums would double. now i know that neither you nor the administration would ever advocate for such a policy. yet here your subjecting those 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 i'll 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 three and one half years after we passed this
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law. as of today, can an individual apply for hardship kpempexempti from the individual mandate or yes or no. >> i don't know, i -- >> i do. it's no. on october 14th, politico report the that if this is riktty, the system for getting out of the mandate doesn't even exist yet. hhs says it would take another month at least for the administration to finalize the forms for the hardship ex-ejs from the individual mandate. why has it taken that long to finalize a simple application form for the compensation from an individual mandate. >> sir, as you know, that's not in place until next year. we have made it clear that if somebody is medicaid eligible in a state that doesn't chose -- >> my last question.
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16 million people in the individual market have or will receive cancelation notices stating their health insurance coverage does not meet minimum coverage requirements of the affordable care act. the bill specifically grants you, madame secretary, the power to determine the criteria for a hardship exemption. will you provide all of these individuals a hardship compensation since the affordable care act has taken away their plan? >> no, sir. and i think the numbers are far from accurate. 95% of americans who have health insurance will be in a continuous plan, medicare, medicaid, employer base, v.a. 5%, a portion of those 5%, about 12 million people, a fraction shun of those 12 million, will have a plan that doesn't meet the criteria and has not been grandfathered in. they are indeed receiving
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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 banquet -- >> sounded like a hardship -- >> gentleman's time is expired. >> thank you, mr. chairman. and thank you madame secretary for being here and thank you for all that you and your staff at hhs has done and implementing the affordable care act to ensure that it will provide many benefits and to ensure security to those who have insurance as well as lower costs. of course the biggest complaint has been about the application and enrollment website. but we have heard over and over from you that those are being addressed. you would recall and i know my colleagues will recall, we've been concerned about those who
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do not have internet access, those who are uncomfortable using the internet and would not use it. i just wanted to 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's been circulating. many rumors about how the affordable care act has affected part-time workers. and 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 low wage workers will being affected. i understand why these claims are being made as just another part of the ongoing effort to undermine the law. would you take a few minutes to set the record straight on the part-time issue? >> certainly.
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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 employee -- employers who want to offer coverage to actually come into the marketplace. for the other businesses, the businesses hiring 50 for 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 full-time employee. what we know about the economic
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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. i'm sure that there maybe 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 effect of the law. >> true. and in fact, it's my understanding that part-time workers are at the lowest percentage of workers in many, many years right now. and -- >> well, and for the first time, as you know congresswoman, part-time workers will have options for affordable health coverage. they've never had that before. they've never had options in the marketplace. they've never had some help
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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, the last part of it, it would be fair to say that at every point along the way you expected this website to work based on everything that you had been told by the contractors up unto that point? >> i expected it to work and i desperately want to get it working. >> more than anyone else, i'm sure. >> and we are committed to fix it. and the only thing that i think builds back the confidence of the public is fixing it. >> thank you mr. chairman for holding the hearing and thank you secretary sebelius for being with us. last week when the contracts that built the system were here, i asked them 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
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that you contracted them to build? >> i don't think i can accurately answer that question. what we know is we have a system that doesn't function properly. as we fix things, we will know more about what is broengen along the way. >> so would someone in your office know, i mean somebody in your office oversaw this implementation and received the product and they either said this is the product we contracted or it wasn't. >> i think that we can say that the products testified individually va fied individually -- >> but clearly it was an integrated system. >> -- don't work well together. >> i used to write programs for a living. if you're developing an integrated system, it's irreal if one isolated part works by itself but if you plug it in together it doesn't work. one of the questions i had, somebody in your agency made a
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decision literally weeks to change the system. instead of going from a browser facility, so they can look at prices before they purchase, y'all made the decision to change it around and gather all of their information dpirs before you could let them see prices. was that you who made that decision? >> no, sir. >> was that mrs. tavenner. >> it was mrs. tavenner and a team who looked at -- >> did that team make the decision because they knew once people actually saw the prices and we're getting reports from all of our constituents of dramatically higher prices, did you make the decision that because when they saw the prices they may not want to buy the product so you wanted to gather the information first? >> sir, first i did not make the decision. i was informed about the decision. and clearly, they can see the product's note, there is no requirement -- >> i spent over two hours trying
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to get into the system. i never once got to a point i could see the price. i want to share stories with you from some of my constituents. we started a page on facebook and twitter we are collect. people are sends us stories. i want to read you a few of them. this one says my health care premium went up 30% to over $350 a month increase. another one, our insurance premiums are going up $400 a month and our deductible as increased. and then this one says my current plan from united health care is no longer being offered in 2014 due to obama care. i received a letter stating that that was indeed the reason for the removal of my current health care plan. what would you tell him who liked his plan and now has lost it and he was promised by you and the president that he would
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be able to keep that plan? >> i would tell him to shop in the marketplace -- >> do you think that's an acceptable answer to him? >> if shawn -- if united chose not to keep shawn's plan in effect of the -- >> because of the law. >> sir, the law said if you keep shawn's plan in place, if he liked his plan -- >> shawn likes his plan -- >> -- then the plan is still there. >> you and i may disagree who you work for. you work for shawn. shawn lost his plan that he liked. and there are thousands and millions of shawns throughout this country that lost the plan we like because someone in washington said we think your plan is not good enough even though you like it you're now not able to keep that plan. i think you deserve to give shawn a better answer -- >> gentleman's time is expired. >> thank you, mr. chairman.
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thank you madame secretary for coming today. i'm going to follow up on mr. doyle's line of questioning. one concern i have with the fallout of the website is that many users who tried to sign up and were discouraged because of the problems will now be too discouraged to come back once the site is fixed. what do you plan to could to get those folks to come back? >> we intend to invite them back formally by e-mail by message, but we don't want to do that until we're confident that they will have a different experience. 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 we're going to have to spend personal time and attentioning on young and healthy americans who don't start out thinking they need health insurance, aren't aware of the law, certainly don't want
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to use a failed or flawed site. we're going to have to spend particular attention on them. >> thank you. have the software specifications for the website and its related software em meants including the test specifications, has that change the since the initial rollout? >> i know that there are certainly some changes. because since october 1st? i'm sorry. >> since the rollout. >> the specifications haven't chang changeds. we are certainly fixing as i say speed and reliance is one of the issues we're taking a look at. that's the performance side. but there are also functionality sides that things do not work as they can including the enrollment past on to insurers. we are fixing functionality. and i don't think that's a change in the specs. i think it's actually making the system work the way it should. >> well, are you -- or is the
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department doing a prioritization on the problems? >> yes. >> could you describe that a little bit? >> yes. as of last week when jeff zientsed us for this 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 the fixes. and we are doing a daily tech briefing and blog to tell people what we have found, what we have fixed, what's coming next, what the funkalty is.
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and we intend to do that until it's fully functional. >> thank you. madame 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 shrunk -- >> we have had some success. i think the goal is to continue to achieve that fully insured population, arguably with preventive care, with 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 have may serious problems in managing those problems will reduce health costs. but i think the delivery system needs considerable help in paying or not number of procedures, number of tests, number of prescriptions, but
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paying for health outcomes. >> thank you very much, mr. chairman. and madame secretary, thanks much for being with us today. appreciate your testimony so far today. what i would like to do, i'll get ez these two. these are questions that we've received from our constituents back home specifically about what's going on with the website and for them. i would like to get those to you. but there's a lot of questions and a lot of thoughts have gone into a lot of these questions. if if i could start with last week's testimony when four of the contractors were here. and in one of the questions that i had posed to mrs. campbell from cgi, and her testimony, she had stated that they delivered the and also the federal and i asked at that time, were these sites more or less complicated than site we're
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talking about here today. and she said, of course the site today was more complicated. an in the questioning and from her testimony, we've been hearing about this end to end testing that wasn't happening that we had individuals out there saying about two weeks had been done. but i asked her about was there sufficient enough time when they did and the response that she gave me back was on which is a less complicated site. and she stated that we had sufficient time to test the system before it went live. and i asked her in a followup then, what was that sufficient time? and she said, we had a number of months before the system went live at that time. and then -- i just want to make sure, because again, you know, sometimes things don't get reported accurately. but in the u.s. news there was a report on october 18ed of this year, and it's questions going back and forth. i want to make sure that you
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were quoted properly. it said after two weeks of review, the hhs secretary con included we didn't have enough testing specifically for high volumes for a very complicated project. the online 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 don't know the quote. i never suggested that we needed five years. >> okay. well that's -- >> i don't know what that's fro. we clearly did not ever have five years. the law was signed in 2010. >> and last week when you were down in texas, you were being asked by a reporter about the system and the launch. and one of the parts of the question was at what point did you realize the system wasn't going to be working the way that you envisioned before the launch and why didn't we stop it before the launch? and again, this is what was reported. we knew that if we had another
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six months we would probably test further. but i don't think anyone fully realized both the volume caused such problems but also exposed some of the problems we had. now, going back to mrs. 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 be have been ideal to do it differently. medicare existed well before the website. medicare is a program that started 50 years ago. the website was an additional feature for consumer ease and comfort. they were not launching medicare. they were not delivering health benefits to seniors.
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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, didn't 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 amp time to do that. so the date that i was again required to select for open enrollment, that's again part of the statute. how long would open enrollment be? we picked that date. all of the contractors that began early in this process in the fall of 2010 when we i should -- i'm sorry -- 2011 when we issued the initial contracts to cgi and qssi new the october
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1st date. it wasn't changed or added to. as we got closer to the system, one of the reasons that we paired down what needed to launch on october 1st was an attempt to minimize the risk of the system, to get people to their ability to see clearly what they were entitled to and what the plans were and if it they chose to, to enroll. clearly the testing should have been longer and more sufficient. >> thank you mr. chairman. people who are watching this hearing might be under the assumption that there's some kind of political debate going on over the affordable care act. i think people in iowa don't care anything about who is winning the political debate. they want these problems fixed and they want them fixed now. i think that's 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
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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 you're registering online for anything and you have to put a date in, there will be a little prompt there that tells you what the format is you're 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 i.d. proving, which is a two-step process, one is that you give preliminary information and you set up a password. but the second, to ensure that your personal data can't be
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hacked. can't 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. in the first several days it was fixed only then to discover that there were system problems throughout the application. and that piece has been fix sd. but i would suggest it always was a function of trying to make sure we had the highest security standards, that we were not cavalier about someone's personal information being able to be addressed and attached. and it was a functionality that didn't perform properly but 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." and people went to see the
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wizard because of the wonderful things that he did. and the affordable care act is doing a lot of great things in iowa. it's increasing competition in our state. iowa consumers are able to choose from 40 health plans in the marketplace. you've mentioned the growth of health care spending is at the slowest rate in 50 years. 50,000 iowa seniors have received prescription drug reba rebates. bands on reexisting 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 don't 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
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have committed to that date because that is the assessment of both inside and outside experts have analyzed. and i think they kicked all the tires and looked at all the system. i know that there's no confidence in that date until we deliver on the date. i am well aware of that and that's on me. >> since americans were supposed to six months to sign up, would you support ensuring they still have six months by extending the hope enrollment period for two more months? >> at this point, congressman, they will have a fully four months of fully functional all ways to sign up. and again, there are alternate ways and the website right now that people are getting through. the open enrollment period is extraordinarily long. it's about six times as long as a typical generous open enrollment period. and it's important for the insurance partners to know who is in their pool. so again, they can stay in the
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market next year and know who they're insuring. we think that the time table will allow people four months' time to fully use the website. they can accuse oous it now. they can use the call center and go to navigators. >> gentleman's time has expired. mr. harper. >> thank you mr. chairman and thank you madame secretary for being here today. we welcome the punt to have this conversation. i'm going to ask the clerk to bring you a document for you to look at so i can ask you a couple of questions. if you can go to page 8 on that, i have highlighted an item there. but this is a copy of a cgi slide show from october 11 discussing technical issues that must be addressed within the website. on page 8 of what i've handed you, cgi recommended that cgi and cms have a review board to
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agree on which issues can technically be solved and which should politically be solved. was such a review board convened? >> i cannot tell you. i've never seen this document and not aware of this recommendation. >> but cgi is responsible for the website, correct? >> it's responsible for the application. >> does surprise you that in the slide show that they gave in october 11th, they acknowledged political reasons for -- >> sir, i've never seen this document. i have no idea what that means. did you ask cgi when they came -- >> 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, that question needs to go to cgi. but i can ask them to report to you. >> well, if you would do that. >> this is their document, if i understand. this is not our document.
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>> would you turn to page 9 of that document, please. and it states challenges on page 9 in this presentation by cgi. and it says under challenges, unable to determine at this time whether low enrollment counts are atribable to system issues or due to users choosing not to selector enroll in a plan. so those are two completely different issues, obviously. fw it is a system issue, that's something you have confidence at some point will be resolved, correct? >> yes, sir. >> and if it's a user selection issue, that's an entirely different story, is it not? >> yes, sir. >> okay. now, you know, when you used the phrase earlier about a punch list, that's like having somebody move into a house. someone's buying a new house and they go through and they've been told this house is going to be ready for you to move in on october 1st, they come in and get in and it's not finished. part of the pluming is not
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right, the wiring is wrong. this creates the situation where, you know, we -- health care shouldn't be a zero sum game. went to be fair to everyone. went to help people who are vulnerable. but at the same time we shouldn't have to hurt folks. we've got people in my district and my state who are getting notices of cancelation. they're being told of higher premiums that they're having. how do we work through that? and i want to say, i appreciate you accepting responsibility for these initial rollout failures that we've had. but who is ultimately responsible? is it the president, correct? >> for the website? >> the president is ultimately responsible for -- for the rollout, ultimately? >> no, sir. no, sir. we are responsible for the rollout. >> but who do you answer to? >> i answer to the president. >> is the president not ultimately responsible, like a
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company ceo would be? >> sir, he's 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. that's what he asked me to do and that's what i'll continue to do. >> so you're saying that the president is not responsible for hhs? >> sir, i didn't say that. >> okay. so the president ultimately is responsible. while i think that it's great that you're 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 as expired. >> gentleman's time has expired. >> mr. chairman, thank you very much. i would like to ask unanimous consent to submit into the record articles from new mexico publications the first entitled small business owner health insurance will save me $1,000 a month. >> without objection.
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>> i see my time did begin there. so i'll try to get through this. madame secretary, i was intrigued by a line of questioning by congressman green asking questions about the individual marketplace. how volatile was the individual marketplace before the affordable care act became law? >> i would say it wasn't a marketplace at all. it was unprotected, unregulated, and people were really on their own. >> madame secretary, the kiser family foundation reports that over 50% turn out of individuals that have coverage on the individual market turn out of coverage every year. is that consistent with what you're aware of? >> that's an accurate snapshot. about a third of the people are in for about six monthsment and over half are in for a year or less. >> so individuals that were in the individual marketplace before the package of the affordable care act did not have the same protections as those that were in group coverage? >> that's true. >> and would those individuals
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in the individual marketplace sometimes have higher copays? >> higher copays, unlimited out of pocket costs for often coverage that was medically underwritten or excluded whatever medical condition they had in the first place. >> these were typically one year contracted. if they used the plan, sometimes they would be thrown off their plans or their rates would go up? >> yes. >> i think that's important to note, madame secretary. and i'm intrigued as well that my understanding is last month hhs conducted an analysis and found that nearly 6 out of 10 uninsured americans getting coverage will pay less than $100 a month, is that correct? >> they will have a plan available for less than $100 if that's their choice, yes. >> and that number be would be higher and be better if more states chose the option to -- >> very definitely. that's just a marketplace
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snapshot. >> madame secretary, i don't think i've heard anyone from the other side of the aisle ask you how can congress work with you and support you in fixing this website and fiking this problem. i hope that we all agree went this website fixed. i would yield to anyone that would disagree. see no one accepting that. i'm glad to hear that we agree with this. now, what can congress do to work with you to fix this website? >> well, i'm not sure that there is hands-on work that you can do. maybe we have some technical expertise. but i would say getting accurate information to constituents is helpful. letting people know that they can check out the facts and the law. that they may be entitled to some financial support. that cancelation of policies means that the policy that they had may not exist but they have a lot of choices of new policies
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and a law that says they must be insured in a new policy. that they don't have to be insured by their company at a higher price. >> going back to the individual marketplace, did this congress in previous years before the affordable care act make it illegal for health insurance companies to raise rates on someone after they submitted a claim for going to the hospital or becoming sick or getting rid of preexisting conditions? >> no, sir. >> one last note here. it seems that we've received some horrible news that there are bad actors already taking place of fraudulent websites to imitate the health care exchange or misleading seniors to disclosing their personal information. i've signed on a letter to you to request that you prioritize fraud prevention efforts. what's the administration to prevent these acts to protect personal information? >> i can tell you that the president felt strongly that that needed to be part of our
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outreach effort. which is why the attorney general and i convened representatives much state attorneys, general insurance commissioners, u.s. attorneys and the justice department and federal trade commission, which has jurisdiction to make sure that we first got out ahead of some of this developing consumer outreach. no one should ever give personal health information. it's not needed for these policies any longer. that's a red flag. went to make sure that people turn over potential fraud atlanta acts. we have put training in place for navigators. we have our -- >> gentleman's name thyme as expired. immediate just note that we -- with the indulgence of the secretary, we're hoping that we can have all members ask questions. we know that with four minutes we're going to have trouble. i'm going to ask unanimous consent that we try to limit our questions and answers to no more
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than two minutes. and i've talked to mr. waxman. is that okay? otherwise we will -- they'll be a lot of folks who will not be allowed to ask questions at all. >> and i would submit that if the questions get submitted we would be happy to provide timely answers. >> with that, we'll try two minutes. >> i guess i won the lottery on the two minutes, madame secretary. >> time is expired. okay. >> 20 seconds, mr. chairman. on the weeb site, madame secretary, the contractors testified last week that they needed more than two weeks for end to end testing. why, in your opinion, was there not more than two weeks? >> again, we had products, insurance policies themselves by companies were loaded into the
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system. so we could test up until then. but it wasn't until september, mid-september, that that was done. and again, the contractors said we would have loved more testing time, but we think we're ready to go ahead. >> i believe that will ultimately be a dispute between cms and hhs and contractors. and if there's anything we can do regarding that, because obviously that didn't work. and i had thought given this as a the signature issue of the president that the website would be ready. in my judgment the president's statements were overstatements. there's a report in the new jersey newspapers this morning that 800,000 people in new jersey who purchased their policies in individual or small employer markets will be affected by this. in a previous question they mentioned the fact that in an individual market you would be able to keep your policy grandfathered. yet regulations issued by hhs
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say that grandfathered status would not be continued for so much as a $5 change in a copay. is that accurate and do you believe that that is a significant change? >> sir, we gave, i think, in the grandfather regulations a guide for how pricing could change. medical inflation and i think it was in most cases, plus 15%. there were some individual consumer outfacing issues that were more ridged than that. but i would say that in terms of having companies being able to collect a profit margin that was certainly build in to the grandfather status -- >> i think that's two little a change. >> gentleman's time has expired. >> thank you, mr. chair. and welcome honorable secretary.
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thank you for fielding our questions and for responding when you are extended the courtesy to offer a response. as a strong supporter of the affordable care act, i'm frustrated and i think it's fair to say that the american people are frustrated as well. and i heard you say many times this morning you're frustrated. i think by and large people want this law to work. when i talk to folks back home that i represent, even people who opposed the law initially aren't rooting for the failure of the affordable care act. instead, they want congress to come together to fix these problems so we can move on to real issues that matter. my home state of new york which also experienced website problems at outset has now completed enrollment on 150,000 new yorkers. with more than that signing up. given that many states have had
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success overcoming these initial issues, has hhs looked at what it's doing and getting solutions for fixing it? >> absolutely. we shared a lot of the information going in. i think that the hub feature that we have in our website that all stated are using, including the state of new york, is fully functional. and that's good news for the states running their own state websites. we are learning from them. we've shared information with them. and we are eager for all of the help and assistant moving forward. >> many stated made the choice of rejecting medicaid expansion that would help some of the poor steps get access to the health care. can you comment broadly on hhs's plan in the future to encourage more states to run their own marketplaces and expand medicaid so the law can function as it's
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designed? >> absolutely. most recently last week the state of ohio did move into the medicaid market. and we now have 30 governors, i think 27 states have fully completed the process. another three are in the process. republicans and democrats who some of who sued us about the constitutionality of the act who are now deciding for the citizens of their state, they want to be part of the expanding medicaid. and we will continue to have those conversations. it's not just about the marketplace. >> the gentleman's time is expired. dr. cassidy. >> you said that only if an individual policy is only canceled if it changes significantly. but to be cleerks after may 2010, if coinsurance went up by any amount, even by a dollar, according to your regulations,
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that would not qualified as a grandfathered clause. just to have that out there for the record. i gather even by a dollar. that said, i get a letter from someone in nigh district, she says that she lost her coverage. she lost her coverage because spousal coverage is gone. she's going on the exchange and doesn't qualify for a subsidiary. but her premium and out of pocket cost under any plan is $10,000 a year. she writes this, she feels betrayed by her government. she has to sit there asking herself is this fair. if you were she, do you think that this would be fair? >> dr. cassidy, i want to start by the amount that you gave is not accurate. ist told $5 not $1. >> that's for the copay not for the coinsurance. for the coinsurance it's any a. if you were she, do you think this is fair? losses her spousal coverage now
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it's 10w, no zub dairies? >> i can tell you that what we've seen in the market and in the plans, people will be getting full insurance for the first time -- >> again, this is what she ro rts. if what she reports is true, do you think it's fair? >> i can't answer fair or not fair. i don't know what she was paying or what -- did she have full insurance in. >> richard writes that his daughter received a note that the premium is going up because she being lumped with older costlier patients. now it's possible that only those that will sign up will be more costly. does hhs have plans on what to do if that happens and premiums rise for everybody? >> i think that's what we're trying to make sure that -- >> if only the costly sign up, do you have plans? >> that's of the importance of individual mandate that you've just out lined. getting rid of preexisting conditions -- >> but if only the more costly
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sign up, do you have backup plans? >> we will encourage -- >> is this to assume that -- >> gentleman's time has expired. >> thank you mr. chairman. i come to this hearing with a little bit different perspective. kentucky is doing a great job with our exchange. as of this morning we had 350,000 people who have explored the website. 59,000 started applications. 31,000 are fully enrolled in new coverage and 5,000 just in the last week. and i think very importantly more than 400 businesses have gun applying for their employees as well. the idea that somehow this is going to be bad for businesses is not born out in kentucky. would it be safe to say that if 36 states had done what kentucky and new york and california had done that the rollout would have been much smoother and the website would have been much
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easier to construct? >> i don't think there's any question that in january of 2013 we knew how many states were not running their own website. in, i think, mid-february, we learned about partnerships. so it was northwest until that point that we learned that 36 stated -- having said that, we should have anticipated and planned better. that's not an excuse. but we clearly are running a different vehicle for enrollment than we thought we were going to run in march of 2010. >> on the subject of cancelation of policies. isn't it true that the federal government can't require insurance companies to sell insurance? >> that they can't? >> the federal government can't require insurance companies to sell insurance? >> yes, sir. >> and in fact, insurance companies all over the country are making difficult decisions now about where they want to participate and where they don't. and in some markets they're trying to get out of the market
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canceling people because they want to play in other markets. >> and we know we have 25% more insurers in the individual market than we did prior to the law being passed. >> a lot of dynamics going on here that are not necessarily an indication that the president misled anybody. business decisions being made all over now? >> now in cancelation of policies again, the one-year contract notice is routine in the individual market. it has been in place for years. and for a lot of people, they are policies now, they're being canceled because they're being notified that you can no longer be underwritten. we can't charge you more because you're a woman. we won't ever have the kind of limitation on what your policy can pay out. those policies will cease to be offered in the marketplace. >> gentleman's time has expired. justice mr. guthrie. >> thank you for being here.
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last week i know the president has talked about the alternatives to the website, phone call or using paper application, and what he said, and i think you said it, they take the paper application but enter it into the same web portal. but also, there are still issues with data within the web portal. as you said, you can't get reliable data who has even signed up. he also said because of the surge in paper applications it's like six to eight weeks to process. if november 30th is when this will be ready, and somebody does lose their insurance so they're signing up to this and they get to january 1st, even though you have a march 31st open enrollment, is there a contingency plan for these people to continue their insurance? >> sir, i think that we have improvements every day on the speed of the site.
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they were giving you early snapshots of difficulty of accessing the site. i think that's greatly improved. >> they said just processing the paper, actually. >> i understand. but it is the site for dash they put the application into the site and get a determination. that's part of what the process is. so the site is part of the portal part paul the way through. this is an integrated insurance vehicle. and so that will improve. and we, again, with four months of continuous service which is far longer than most people had, some of these cancelation numbers, mr. garrity again pointed this out from florida bluecross, but it's true of everyone else. these are not january 1st numbers, they are year-long numbers. so over the course of 2014 when an individual's policy is due to expire -- >> but somebody's could expire january 1st and not be able to get coverage in the website -- and the vendors said they needed
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and liked to have months and months to test. if we're going to -- >> i would say we're testing as we go. this is beta testing going on right now. that's why we're fixing and how we can identify things. people are getting through every day. >> but the paper process, if it takes four weeks, november 30th and people canceling on january 1st, there needs to be contingency for that person. >> they will have two full months of signup. >> gentleman's time has expired. >> thank you madame secretary for bringing to millions of americans access to affordable, comprehensive health care coverage that's going to be there when they that's going to there i want to thank you especially as a woman. being a woman can no longer be considered a pre-existing condition. women can no longer be charged more than a man for coverage.
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women have access to prescription drugs, free preventive screenings and free maternity care which is often left out of coverage. and the days of complicated pregnancy or diabetes or domestic violence being a pre-existing conditions, those days are over. you know, i want to say to my colleagues after a 3 1/2 year campaign to repeal to discredit, to even shut down the government over obama care, i want to say get over it. we all agree that there are problems, but these are problems that i see being fixed. and so i want to ask one -- i want to say that what we did under medicare part d can be an example of how we can work together and in fact, chairman upton and i both sent a letter asking for more money for community-based groups to help
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implement the program and make it work. we can work together. so if you could just briefly say how are the navigators, how important are they in making this system work for the american people? >> well, what we know, congress woman, is that a lot of people are not web savvy and are not frustrated because they don't trust a computer, they need a live human being to ask questions, get questions answered, talk about the plan, talk about insurance. so the navigators play a hugely important role. we have about 2500 trained navigators on the ground right now, we have thousands more community assisters trained and ready to go. about 45,000 agents and brokers have gone through affordable care act training. but those individuals working with their clients, customers and in the case of navigators and community assisters is just the public at large, they are not paid by a company, they are
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not collecting a fee. they just want to help people get coverage. they're hugely important. >> be mr. olson. >> welcome, madame secretary. i'd like to open with a quote from an american icon and hold up a poster. it says, if the user is having a problem, it's our problem. i'm glad to hear that you embrace this is philosophy during your testimony today, ma'am. obama care was signed into law 1,000256 days ago. and since then, there's been user problem after user problem after user problem. regarding, your deputy administrator for consumer information, gary cohen, testified one month ago right where you're sitting that and this i quote, cms has worked hard to test the infrastructure that will allow americans to
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enroll in coverage confidently, simply, and securely end quote. yet, according to forbes, and "the wall street journal," you told them that you need five years of construction and one year of testing. the program has crashed and burned at least three times. and the user is still having problems. get up here, ma'am. it's been down the whole time you've been testifying. system is down at this moment. my question, ma'am, is very simple. when did you know the exchanges were going down, a month, a day, a quarter and did you tell the president what you knew? >> sir, i was informed that we were ready to launch on october 1st. the contractors who we had as our private partners told us and
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told this committee that have they had never suggested a delay, and that is accurate. our cms team felt we were ready to go. i told the president that we were ready to go. clearly, i was wrong. we were wrong. we knew that in any big new complicated system, there would be problems. no one ever imagined the volume of issues and problems that we've had. and we must fix it. >> yes, ma'am. credible journalists said you knew you needed six years. >> that quote has been repeated. i can guarantee i would have never stated that because the law was passed in march of 2010. i chose the open enrollment date. i don't know where that quote comes from, but that is not from me. >> the gentleman's time has expired. mr. barrow. >> thank you, mr. chairman. thanks for attending today, i suspect ha deep down most people on this committee accept the
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concept. we have disagreements about the means used to get to those ends which is why i voted against the affordable care act. it seems every day we're hearing of something new going wrong. i'm many concerned the long-term enrollment problems could be market problems. my students are losing confidence. the way to restore their trust is to delay the penalties till we're sure the system is going to work. it's not fair to penalize consumers. we also need to take the time to make sure fits and starts won't cause larger problems. i'm more concerned what went wrong and how to fix it and assure it doesn't happen again. nearly all of our constituents want and need health insurance. it would be a huge mistake that we miss opportunities to address its flaws. to the subject of technical problems becoming market problems. can problems of folks getting into the system snowball into risk pool problems where those
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who choose not tony roll can actually affect the cost of those who do choose to enroll? >> certainly a risk pool needs a balanced mark. so you need people who are older and sicker to be balanced with people who are younger and healthier. that's how a pool, would. >> at what point are we going to see a problem to the risk pool if the tech problems affect the folks entering? what are we going to use to decide something needs to be done? >> well, again, sir, we be monitoring during the six months of open enrollment as will our insurance partners who is coming into the pool. that's why we want to give this committee and others reliable, informed data about not only who it is but what the demographics are and where they live. >> if things aren't better by the end of this next month, at what point will we start thinking about further delays and imposing penalties? >> i think having a defined open enrollment period is one of the ways you make an assessment if
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you have a pool that, would or not. you can't have an unlimited open enrollment period with any insurance company because that really doesn't work. >> thank you. >> mr. mckinley. >> thank you, mr. chairman. last week, representative campbell said that she had met her contract obligations and specifications. and she said the only problem she had was was pace. but the pace wasn't part of the specification. and we asked her what you would testify to. david mccullough -- he said you would testify that she did complete her contract in accordance with the specifications. would you? >> sir, i don't think until the product is working the way it's designed to work that anybody has finished their job. that's really my -- >> i'm sorry. they've shortened our time. so if she hasn't met their
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specifications but yet we're still using her, is the american taxpayer still paying money to fix the problems that she didn't do and her company do appropriately in the first place. >> none of our contractors have been paid the amount of their. >> will she be paid for this work into the future as we correct this problem. >> we will make that determination as the work goes forward. i would tell you as we learn what needs to be fixed, we'll know more about whether they delivered. >> who owns the software now now that this has been developed with taxpayer money to develop the software to do this? >> it is owned by the centers for medicare, medicaid services. >> will they be able to use it by a license for other clients? >> not to my knowledge. i think it is specifically designed for the marketplace with these products in mind. >> then the last question. >> and the clients are the american public. >> under iv & v, and she testified that she thought that was something we should have
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done, under hhs, you recommend or the hhs recommends that for software development that they should you have an independent verification validation program, but it wasn't used in this case. can you share with us the time that's gone why we didn't use iv & v on something as crucial as this. >> i don't think that's accurate. at every point along the way, there is independent testing. >> independent. >> yes. >> you recommend independent testing and validation, not someone within your staff. >> pardon me. there is a level of company self-attested testing. there is a level of cns testing and then there is an independent test on each piece of the contracting. an independent not -- >> what she's done independently. >> gentleman's time -- >> it needs to be done independently. >> has expired. >> no, it isn't cms. i will get you the information. one of the three levels of testing is independent


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