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tv   Key Capitol Hill Hearings  CSPAN  November 5, 2013 10:00am-12:01pm EST

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are more votes taken away from third-party candidates by virtue of the idea that the third-party cannot win, then are taken away from a major party candidate. ralph nader has said it is a travesty to think that -- host: we may have problems with our signal, we want to thank david gillespie, author of "challenges to duopoly" for being our guest. this was a few are recommended segment. thomas smith, we thank you. we go now to the senate committee where marilyn tavenner , cms administrator, will talk about the status of the health insurance marketplaces. we go to that now. [laughter] -- [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2013]
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>> the senate committee on health, education, labor and
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pensions will please come to order. ago, richardars streeter, a 47-year-old truck driver from oregon was frustrated and worried. as new york times columnist nicholas kristof described this weekend, mr. schrader could not find insurance in the individual market. no insurance company would cover him. he did what people locked out of the market do, he went without care. after months of ignoring care, for areeter went in colonoscopy, he could not afford one. the only one -- the only way he could get it was from a doctor who agreed to take half payment now and half when he could afford it. he had advanced: cancer -- advanced colon cancer. his doctor said this "it was heartbreaking to see the paint
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on his face, the real train wreck is what people are experiencing every day because they cannot afford care." mr. streeter is the second patient the doctor had put off seeing because of a lack of health insurance and now has advanced colon cancer. he has a tough road ahead of him, but now he does not have to worry about paying for treatment. he signed up for health insurance starting january 1, which cannot turn him down because of his pre-existing condition. we passed to the affordable care act so that this would never happen to another family. millions of americans are shopping on new health insurance marketplaces for coverage that starts next year. 700,000 people have filed applications. why is there a surge in interest? for the first time in history, their health, whether or not
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they have a chronic illness or had a back operation 10 years ago, will not prevent them from getting insurance. these reforms will deliver on a long-overdue promise to all americans. if you work hard and play by the rules and pay your fair share, you will never have to stay awake at night worried that you cannot afford to see a doctor or pay medical bills. it is a promise i wish we could have kept sumer -- sooner for mr. streeter. onwill hear a status report the implementation of these reforms. the rollout of the federal -- of the federal health insurance marketplace has been bumpy to put it mildly. consumers have run into roadblocks, the site has been functional one day, unresponsive the next. americans who have been waiting for years deserve better. secretaryent, sebelius, and our witness today have taken full responsibility for the technical flaws and the website and have said that no resource will be spared to fix
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the problem. i look forward to hearing an update today on those efforts. republican colleagues' concern about the technical flaws and the rollout. i look forward to a discussion about how we can move forward. but i want to be very clear. i hope we are clear for a discussion. i am as upset with anyone with the difficulties individuals on the federal marketplace are experiencing. i want to learn how those problems will be fixed. it may be a difference. i want it fixed so the affordable care act will succeed. down.ucceed, not be torn there are many who have spent the last three years doing nothing but trying to tear the slowdown. -- this law down. i feel they have surrendered
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their right to express indignation that they -- it is not working flawlessly. they had voted 32 times to repeal or defund the law. as an appropriator and chairs of the appropriations committee that funds the implementation of this law, my colleagues have denied implementation funds at every turn. they have try to stop navigators from set -- from spreading the word, sent letters to the national football league warning against reaching out to fans. governors and legislatures who ran on platforms of states rights handed over the responsibility of running the marketplace to the federal government. before we get into the details, everyone should take a deep breath. this is a website. this is a machine that will be fixed.
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americans have until the end of march next year to sign up. as the president said, the promise of the affordable care act is far more than just a website. to 105mise is a benefit million americans who have been 2010 againstce lifetime limits. for more than 3 million young people who can stay on a parents' policies until age 26. it is a benefit to seniors who have saved $8 million on prescription drugs -- $8 billion. it is a benefit to the 71 million people in private insurance that have used preventative services at no cost, which mr. streeter could have used. hi this law then in effect to benefit. to the elderly americans with pre-existing conditions who cannot longer be denied or discriminated against by
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insurance companies. that is the big picture, and we should not forget it. health reform is the promise of the health and financial security that insurance companies bring. i can tell you that in iowa, iowa's premiums are among the lowest nationwide. a family of four making $50,000 will be able to get prompt level covers for $103 a month. toy $5,000ld making will be able to get a plan for less than $100. that is real choice, real affordability. let's get the website fixed as fast as possible so that every american can shop and and roll smoothly. but let's not forget the big -- that because of a obamacare, the affordable care act, millions of americans will not be in the same situation as mr. streeter found himself.
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about. what it is slowly but surely, americans who have waited years to get covered are enrolling in health insurance for the first time. we owe them our best efforts to move forward. closely whentening questions are asked of our witness. to help and fix the system so we can move forward to make this affordable care act work? to try tonother means tear it down and discourage participation? witness, thank our commissioner tavenner, for her leadership of the center for the care and medicaid services and for her dedication to making sure our health care system in america works for all. we will have some tough questions, that is fine. i do want to know why this problem cannot. -- came up.
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but i want to keep the big picture in mind as to what we're are doing here, that is to make the system work. i have one administrative this bei restrict that open for 10 days for statements to be submitted to the record. i turned to ranking member alexander. welcome ms., tavenner. i used to testify from that seat and i thought that the senators to literally put the chair down low so they could be of high -- deliberately. kellye friend used to say story instead of making a speech. here is a story, 16,000 have coverage from a state program. obamacare is canceling their policies. example of what president obama calls bad
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apples, an insurance plan that is not good enough for you. i recently heard from one of those tennesseans whose policy will be canceled on january 1, her name is emily. she is 39 years old. she has lupus. she told me i cannot keep my current plan because it does not meet the standards of coverage. has is a travesty, coverten been a lifeline. with the discontinuation, i am being forced to purchase a plan to the exchange. i premiums alone will increase 410%. i out-of-pocket expense will increase by more than $6,000 a year, including subsidies. please help me understand how this is affordable, says emily. i were health care system makes up nearly 20% of our economy, touching the lives of every american. obamacare is pushing that 20% of our economy in the wrong direction. saidresident has
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repeatedly, i looked up the white house website this morning, "if you like your plan, you can keep it and you do not have to change due to the health-care law." that is the white house website that i -- today. as the president said, it is a law transforming our health care delivery system in the wrong more than a it is website, as the president said. it is a law transforming our health care delivery system in the wrong direction, we believe, by increasing premiums, canceling plans, strong relationships with doctors, raising taxes, forcing people $.5 medicaid, spending trillion on new programs instead of making medicare solvent and encouraging employers to reduce their employees catch three hours. then having the irs fine americans for failing to sign up
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on a website that does not work. the president promised you can keep your health care, but the ofn cancels millions individual policies. for millions of others, employees are -- employers are dropping insurance programs. the new promise is, if you want health care, go find it. on a website that the administration says will not be working properly until the end of november, that is an unlock him christmas present. two weeks to shop for insurance by december 15 senate you are covered next year when obamacare outlaws your policy. the president put secretary sebelius in charge of this law. i have called on her to resign. ca couldhe internet, r tell you every day how many records elvis was selling, mcdonald's could tell you how many hamburgers were sold. , resident issa -- congressman
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issa posted notes are you are telling each other how many people are enrolling in obamacare, why won't you tell the american people? thisenator has described law as an approaching train wreck. my grandfather was a record engineer in kansas -- a railroad engineer and kansas. he drove the locomotive and headed into the right direction, that is what our country needs to do. turn the law around and headed in the right direction. obamacare is the wrong direction, it expands a delivery system that we already knew costs too much. the right direction is more choices, more competition that lowers cost so americans can afford to buy insurance. expect republicans to show up with our version of a 3000 page bill to move the delivery system in the direction we wanted to go.
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we do not believe in that approach. we believe in moving step by step in the right direction. make medicare solvent, reform medicare advantaged to compete with medicare. make medicaid flexible. encourage employee wellness plans. spall this is plans -- small business plans, expand health savings accounts, change 30 hour work weeks to 40 hours. the tennessee woman i told you hert, emily, losing insurance because obamacare has decided it is not good enough for her, she finished her story with these words. the biggestof betrayals our government has committed on its citizens. i beg you to fight for those like me. we only asked to continue to have what we already enjoy, a fair health insurance plan at a fair price. return tod a way to affordable health care. my message to emily is that we
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will do our best to turn this train around and headed our delivery system in the right direction so you can buy and keep health care that you can afford. on behalf of the committee, i welcome our witness, marilyn tavenner, administrator for center for medicare and medicaid services. she was confirmed by the senate. she was principal administrator for cms and served for four secretaryim kaine's of health and human services in virginia. ms. tavenner spent 25 years working for the hospital corporation of america and began her career as a nurse in richmond. she holds a bachelors of science degree in nursing and a masters in health administration from the virginia commonwealth university. i know you are very busy these days, thank you for coming here
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to share your experience and answer questions today. -- tavenner, i would like to ct,s is an intricate subje we usually give the witness five minutes. i would like to give you up to 10 minutes to make your opening statement, then we have our questions. welcome, your statement will be made a part of the record in its entirety. please proceed. >> thank you, chairman harkin. ranking member alexander, and members of the committee. launched one of the key provisions of the affordable care act, the marketplace where people without health insurance, including those who could not afford health insurance and those who were not part of a group land -- plan, could get health care coverage. we know that some consumers are having difficulties enrolling website,arket place and we are focused on identifying and solving those problems quickly.
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it is important to remember that the affordable care act is more than just a website. it has created a new market which allows people access to quality, affordable health insurance options. it does this by pulling consumers into statewide group risk betweenpread sick people and healthy people, young and old, and then bark up their behalf for the best deal argainsth insurance -- b on their behalf for the best deal. by creating competition, insurers have created new plants with more choices. the premiums for coverage are lower than expected, billions of americans will also qualify for tax credits to make this coverage more affordable. people will have comprehensive coverage that cannot be taken away, even if they get sick. we know that consumers are eager to purchase this coverage. i want to show you that can and will be
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fixed quickly, we are working literally around the crop -- the clock. we have made progress in improving the website, we expect the user experience to continue to improve. over the past month, millions of americans have visited to look at their new health coverage options under the affordable care act. 700,000time, nearly applications have been submitted from across the nation. more than half in the federal marketplace alone. this tremendous interest confirms that the american people are looking for quality, affordable health care coverage. that the initial consumer experience on has been very frustrating for many americans. some have had trouble creating accounts and logging into the site, others have received confusing messages or had to wait for slow-paced loads or forms that fail to respond.
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in the first few days that we went live, few consumers could create an account. we have now resolved that issue. users can create an account and go through the enrollment process. we are able to process nearly 17,000 restaurants for our -- with almostper hour no errors. we have updated the site several added moreave capacity and doubled number of servers to meet demand. we reconfigured various system components to improve responsiveness, this has increased performance across the site, but in particular the viewing and filtering of health plans during the shopping experience. in just response seconds, whereas it was taking minutes before. this now response in just
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seconds. we have resolved issues at the eligibility notices display at the end of the process. consumers can compare plants without registering for an account, this was not working well in the days leading up to worker 1, so we prioritize on the application process and stead. one of our highest priorities was insuring that consumer information was transmitted correctly. our team has worked with issuers to resolve outstanding issues and all necessary consumer information will be sent to issuers after they have enrolled in the plan of the choice. we will work closely with issuers to identify and solve problems quickly. we have also seen success in the -- improving response time. for the first few weeks, we estimate that users are waiting 8 seconds for pages to load. we have lower that time to less than one second, we will take aggressive steps to bring
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response times down further. we are pleased with these improvements and parts of the system that are already working well. the routing told that provides an efficient way to verify information submitted by consumers is sending determination to the marketplace seconds.than 1.2 the social security administration has reported 4.2 million transactions with the has responded to one point three billion requests. consumers can trust that the information they are providing tected and-- is pro that the technology underlying the process has been tested and is secure. at has decades of experience collecting personal information in medicare, we are extending that commitment for the marketplace. any system that is this large is
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inherently risky. we monitor the security of the as envisioned in the plan and have no serious issues. forrity testing never ends any large system. we continue to improve, it is important to remember that the website is working, more people are applying and is rolling each week. in addition to the website, there are other ways for consumers to approach can apply by phone on a toll-free number. a representative will work with a consumer to make sure they can complete the process. people can find in person health in their -- in person help in their community to help them understand their options.
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consumers can fill out a paper application and mail it in, they will find out whether they are eligible for private insurance, medicaid, or chip, then they can go online or contact the call center if they prefer. out of everyee four americans get insurance from an employer, from medicare, medicaid, or the pa system. -- the va system. american to purchase on their on thecoverage individual market. before the aca, coverage was on orordable, had high co-pays, lacked basic benefits like maternity care, mental health, and prescription drug coverage. these plans had high tenor rates, greater than -- high turnover rates and were not renewed at the end of the year. the health-care law is creating protections for people in the
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individual market, as well as strengthening employer-based coverage. in the health insurance marketplace, consumers will not be charged more because of their gender or pre-existing condition. beventative services will covered at no additional out-of- pocket costs, there will be caps on out-of-pocket cost, plans will have to offer 10 essential benefits. plans in place before the affordable care act past and have not been changed are fromfathered in and exempt consumer protections. they must notify their role -- enrolees that they are llees thatred -- enro they are grandfathered. for these enrollees, nothing has to change. receivedls have indications from companies that their plans will no longer
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exist. they can choose a different plan being offered by their insurer or they can shop for coverage in the market is or outside the marketplace. insurance companies are not shopping consumers, they are improving options, often offering better value plants with additional benefits. the majority of people and the individual market today will qualify for discounted or free health care coverage and signing up for coverage to the marketplace. one study found that not counting the one million who qualify for medicaid, 48% of people who buy insurance through the individual market will have thatdit -- a tax credit averages over $5,500. the aca is over four years old, we have seen improvements. the opening of the marketplace on october one is the latest step in the implementation of the law, we acknowledge that we have a lot more to do and are
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ready to do it. thank you, mr. chairman. you, commissioner tavenner. we will start a series of five- minute questions. everyoneld myself and else to five minutes. you might only get one question, that way we can go around once, twice, three times, as long as it takes so people can get questions asked. i hope we will keep within five minutes so everyone gets to ask questions. we'll start now. evaluate the as we problems with the website, it is important to get the facts straight. some have said that fixing the website could take six months to one year, others state that there are 5 million lines of code to rewrite, others urge you to start from scratch. wring some facts to this overheated debate. -- bring some facts to this overheated debate. i understand this can get you anal, i want to give
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opportunity to explain in plain --. what is the plan for fixing the website, who is leading, and what is your role? what is the expected timetable for the process? >> let me start with the plan, generaled qssi as the contractor. they were engaged last week. they will be leading the effort, working with me directly. they will be responsible for correlating contracts. -- coordinating contracts. the problems are into categories, the first problem had to do with performance and speed. added capacity and made system performance improvements, that has to do with the hardware side of the equation. that work was done immediately. we have projected demand for the website, we obviously underestimated that demand.
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we had to go back and catch up and at capacity and improve performance. that is some of what i was referring to in my comment about the slowness of the system. the second issue has to do with software improvements. the first big one was the ability to establish an e-mail account. that was a problem that was solved in the first week. we have had success there, there is not a problem with establishing an e-mail account or going on to identity proof. now we are into the internal piece of the architecture. i will remind you that this website is covering 34 states. and 50 medicaid programs, also raiseds the state exchanges. it is pretty, located. we knew we would have bugs in
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the system. we obviously have more bugs, particularly around the application. eriese doing serious -- s of software upgrades seven times a week, we will continue that. you will see improvement week by week. ou address security? there are reports that you had concerns about the site's security protections. what efforts are we making to ensure that consumers' information is secure? >> that may put it in a couple of different all caps, because there has been a lot of confusion about security. summer,earings over the and lot of the questions i answered and others answered had to do with the security of the
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hub. the contract you're there is qss i, that serves the federal marketplace and the state as well and has been a smooth operating system. completed by was september, and there was signed off on the hub. the it comes to the ffm, actual exchange, there was testing a component, and then we get a short term operated should to operate. we had announced proper to october 1 that we would not bring the spanish website up right away. we did a temporary or short-term authorization to operate because we knew we would have to do continuous security testing while those programs were being installed and while software was being updated.
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there is confusion but what was tested and what was not tested. we need to separate this. >> 527 seconds only. will theyne comes on, be assured their social security number will be kept secure, that no one can hack in and take their number? hubes, and remember the does not secure any information. it is a router. if you fill an application, it irs, butial security, that is not stored. what is stored is in your individual application, which is secure, and that was part of the front end, which is complicated as we had taken additional steps to make sure that individual applications are secure. we have continuing monitoring of all systems, which we do for medicare as well. >> thank you. >> thanks, mr. chairman.
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let me go back to the president's words. i am sure you will be able to fix the website, and i am not as concerned about the irs fix that will come next year. what i'm concerned about are the canceled policies and the inability of people to have time after you presumably six the website by the end of november to replace their policies by january 1 so they will have health insurance. i'm concerned about the kind of health insurance they get because of the large number of cancellation letters that are coming into our office from tennessee. so let me suggest that a way to fix this problem of canceled policies in the individual market is to go to a website that does work pretty well, but still says if you like your
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plan, you can keep it and you do not have to change a thing to to the health care law. that is the white house website. those are the president's words in 2009. why don't we put those words into law? why don't we solve the problem of emily from tennessee who is losing her coverage in tennessee am a, and finding to replace it more.l cost 410% senator ron johnson has introduced a bill that he calls, if you like your health care plan, you can keep it. it would put the president's words into law and i sure those millions of americans like emily that they will be able to keep a , andlike covered tennessee she will not be out of insurance on april 1. where talking about millions of americans, so my question is would the administration support senator johnson's bill, which would foot the president's words into law by saying to americans
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that if you had a plan before the law was passed on march 20 3, 2010, or a plan all the way up to the end of this year that you could keep it? wouldn't that solve a lot of problems and reassure americans that they could have affordable health care? alexander, when we wrote the regulation back in 2010, that is exactly what he did. we grandfathered in existing plans, both in the employer market and in the individual market. there was a lot of back-and- forth about that regulation, what was the phase-in time, and that is why we delayed it until plans could be grandfathered over this time and we allowed the grandfathering to continue as long as it did not reduce benefits significantly. there were some things put in place. i do think we have put in steps, the ability to keep plans.
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in these cancellation letters, these cancellation letters are also followed by statement, that says-- >> i want to give a chance to answer, but will you support senator johnson's bill? >> i have not even look at his bill. i would be happy to look at -- >> i will get a copy to you. we know about the relations written in 2010. -- the regulations written in 2010. they made it impossible to grandfather a lot of the plans that people had. according to your regulations, 40%as estimated that up to of plans would not be able to the grandfather, so didn't you know that there would be a big of these policies and it was wrong to say that if you like your plan you can keep it without having to change a thing? >> i do not think the regulation assumed that it was because of the grandfathering that these
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plans would change. these plans routinely change. over than 50% a year. this is part of what the affordable care act was designed to do, to try to stabilize the market and get individual some protection. >> but your regulations said if you increased cost sharing, co- pays, change the extent outcome and change the elephants, all those would mean those plans did not continue, and basically washington saying to people like the 16,000 whose their coverage in tennessee, we know better than you do what is a good plan for you. we want you to buy a better plan even though you like a plan you keep. words put the president's into law and simply say if you like the plan you have -- we will not decipher you, you can decide it -- if you like the plan you have, you can keep it without having to change a thing. that is what was on the white house website today. individuals 16,000
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that you listed, they were also given the option of renewing with the new plan. yes, maybe some of those plans were more expensive, but i would encourage those individuals to go on the website, take a look at what is available in the individual market in tennessee. you will see the pricing in the individual market came in about 18% lower. some of these individuals may qualify for a subsidy. i would encourage them to look at their current issue work, but also go on the website, look at plans available in tennessee, and also check to see if they qualify for subsidies. >> thank you, mr. chairman. >> thank you, senator alexander. senator mikulski? >> good morning, administrator tavener. i'm glad to see you. we are very proud of the fact that cms is headquartered in maryland, and there are thousands of people who work there every day in every way try
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to make sure that nettie care, -- medicare, medicaid, and obamacare is administered efficiently. you have been battered around in the failure to confirm permanent ministry just. we will put that aside for this conversation. the launching of the affordable been more than bumpy. i believe there has been a crisis of confidence created in the dysfunctional nature of the website, the canceling of policies, and sticker shock from some people. in my state of maryland, it was also happy. sun"ad in "the baltimore that 73,000 marylanders' policies will be canceled. let me get to where i am. it is not to finger point. it is to pinpoint. what i worry about is there is such a crisis of confidence people will not enroll, and the
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people we need to and role, particularly young people, to make this whole system work will not happen, that people who are most desperate. -- senatorwan xander' letters. alexander's me what you are doing in terms of the crisis of confidence, but also how are we going to get young people back to looking at how they are going to apply to make it attractive, to give them confidence, and also to make the whole system more affordable? >> let me start with the affordability, and i will talk about those from the state-based exchanges --
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46i have two minutes and seconds. do you have a plan to get young people back? >> yes, we do. we have a plan to stabilize the website this month, and we have a targeted plan that includes not only young people, but the large populations of the uninsured in markets, so yes, there is a plan. >> what kind of plan? of media, bothn television, radio, and some print. it is identified by top markets, and i will be happy to share that plan with you. >> do you think you will restore the confidence in this plan? >> yes. >> how? >> by the improvements in the website, which we are already seeing, and i would encourage folks who have not been on the website to go on the website. it has improved. we are seeing more folks being able to complete applications. we are getting more positive feedback. there is a tremendous
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amount of interest in this plan. there's over 700,000 completed applications. we have seen over 13 million visitors to the website. the information is out there, which is needed to ensure that this site is working. >> i would like to go to going to the website, which goes to many of my laurel constituents. we talk a lot about the robust baltimore-washington car door, but not everybody has access to a computer and that everybody knows how to use a computer. is includes young people. we worry in maryland about the digital divide. o'malley, ben cardin. my question is you say you can go to the phone, are you publicizing this number? if you want to pay for applications or you want to be able to talk to someone in person, as you said, where do you go and where do you get this?
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are there designated sites? offices,o this in post libraries? where will we do this where people can be able to do this if they are not going to go to a computer or a computer is not available or their friend? >> is a great question. we do advertise the one 800 advertise you can call their if you do not want to use a computer. we advertise who in the community we have currently over 70,000 broker agents who have been trained to assist people. we have navigators in every state, and they are covering the entire state. he advertise that. he also have many hospitals, including libraries, who are offering to help. >> i'm going to be blunt, because i really want this to be a success, and my job is to pinpoint solutions, not finger
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way., looking at a retro i think it is very confusing. i know my time is up, but i think it is very confusing about where you go. you hear about the navigators and this and that, but i can tell you people really do not know. they really, really do not know. >> senator, i'm sorry, senator isaacson? mr. chairman. thanks very much for coming today. qssiaid that 10 days ago was put in charge of coordinating the website, is that right? were you aware in june of this year the inspector general thatd a report on qssi said quality software services do not successfully implement risking exposure to personal information for over 6
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million medicare beneficiaries? were you aware of that? >> yes, sir. >> i would like to put into the fromd that the i.g. report june, because of their lack of discipline, they exposed over 6 million medicare beneficiaries their information. the reason i bring that up, and i do not believe everything i see on television. i tried to check everything out. this morning, what seemed to be a pretty credible claim that a lawyer in south carolina who have gone on the website and gotten access to set up an account was called by a man from north carolina, telling him, and he got that man's information. this information security is extremely important. made the-- mike rogers point that it is extremely part -- import. i would ask that you make sure that qssi is in compliance.
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>> i will follow up on a report. securityactor who does in the marketplace, and we are working with them in this incident in south carolina. we were made aware of that yesterday, and we implemented a software fixed yesterday to fix that. as awill be treated personal identification issue, and we will do a complete follow-up on that. >> you said this was going to be ongoing, because we know cybersecurity is an ongoing challenge. it is critically important to tell whoever you said the person in charge of security was to deal with qssi and make sure they met compliance. >> i will do so. aboutone who has had about a thousand independent contractors working for me, most of the people who are uninsured or had lack of access were independent contractors because
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their employer cannot provide it to them. what the unintended consequence i was begin to them, but i had three come up to me, one, and mrs. russell who had the insurance shift she had bought as a contractor who had just received a cancellation notice, had tried to go to the website, could not, had called the toll-free number and gotten help from a human being who said they would send them the information, but they cannot not guarantee them when it would come. i point in this is when we passed the affordable care act, it precluded insurance agents for being navigators and put in a ratio so high that you could not pay a commission to a salesperson. the only access to the human beings that could be incentivized to tell somebody what is in the plan is either to call the website am ago on the website, or find a navigator. considerms should rethinking appropriations for the medical loss ratio and the unintended consequences of not allowing health insurance agents to be navigators, because that
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limits access to the information that you want them to have. that is just an janitorial comment. my last segment, if you would put up the chart on the iceberg -- georgia, ihinks of think of ollanta, but there's a lot more of georgia than atlanta . in southwest georgia, remains are doubling. more than doubling in many cases. health insurance costs are going to the roof. when you said the website was only the tip of the iceberg, you were right, because you have tremendous problems and tremendous challenges, but the biggest one of all are the premium increases to the people who can least afford them. in rural southwest georgia, that is by far the case. on behalf of those georgians, we are seeing a doubling of the premiums, and we need to address that and we need to make sure the unintended consequences of requiring so much coverage is not running people out of coverage rather than providing
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what the coverage they need. >do you know what is contributed to the cost of role herald -- rural health care going up so much? >> we are not the experts, but the more competition, the better the prices. there was not enough competition to raise -- to lower the rates. -- rates were higher for before the implementation of the aca. andve seen new entrants, we hope that it will continue to press the pricing downward. >> thank you for your testimony. my time is up. >> senator murray? >> thank you, and thank you for being here and all the work you're putting into this. when we passed the affordable care act we designed it to have states lead the way and drive
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market reforms by building their own marketplaces. states like kentucky and washington planned and designed and created their own marketplaces, and many states declined the opportunity to build their own marketplace and rely on the federal government to do the work for them. washington state's health plan finder has been a leader on the launch of their new marketplaces, and in its first month enrolled nearly 55,000 people from my state for new health insurance coverage, including 10,000 kids. i'm very proud of the work that has been done in my state to provide access to quality, affordable coverage, and i wanted to ask you to tell us about what you are seeing in the states, like mine, that develop their own workplaces. i elicit some of the top -- will list a few. all the states are working hard. we have 17 partners at the state level, including d.c., and i
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would say that what we're seeing in washington and kentucky is probably some of the strongest performance, which is great. have had lots of application interest. the other areas that i would say we are pleased with because of the size of the states is new york and california, where we are seeing good progress. each of the states are moving along, and part of what we will be submitting in mid november, as i have talked about in previous hearings, is information about applications and enrollments that will look at the state and what is inside the state as well as the federal marketplace. we will have more data for you. >> we want some of those states use best practices? >> we are indeed. we meet with them regularly. >> ok, and i wanted to ask you about the next round of outreach to americans and what it will look like. everybody has focused on the website and we know it is improving, and those will be
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solved. obviously, a lot of americans are frustrated by their initial applications, and we have got to get them to return to the site. the crisis of confidence that senator mikulski talked about. in addition to those people, i want to know about the administration's plan to reach out to those americans who individually purchased lands are being canceled by the companies. there is a story in our people a 56-year-tle about old woman who received one of those cancellation notices and like a lot of other people who was told to blame the affordable care act in that letter. of course, she was not told that if she accessed the aca marketplace it could save her and her family thousands of dollars and provide her with upgraded, more comprehensive health-care coverage. a similar story, and that is an important reminder that it will be an uphill battle against some political and industry interests
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to get those individuals good information, that have received those letters, and i wanted to know what you are doing to get information out of those people whose policies have been canceled. >> this is actually a conversation we are having today we have ato we -- consumer assistance program within cms, and is there a way we can actively engage to reach out to people who have been canceled? although they are canceled, they are offered another policy, but what is important for them to understand it is not just that policy. it is also the ability to go on exchange. in washington they do not even have to apply. they can look at what the rates are. they can do that on the federal exchange as well. they're working on a plan and i will be happy to get back with you, but give back to the street. >> that is important because a lot of them are seeing their
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policies have been canceled by about care and not being told there is what your options are. we have to work on that. thank you, mr. chairman. enzie?tor >> thank you. i am from a low population states, and we do recognize that the problems of the website are just the tip of the iceberg him much as this chart demonstrates back here. saturday, 2600 people in wyoming had their policies canceled. fortunately, three years ago i noticed that the roles were changing -- rules were changing and people were not be able to keep what they were promised. we have a method of petitioning that, called the congressional review act to my we had a debate about repealing the rule that would've kept them from keeping the policy that they like. own onas voted d
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straight party lines and people will be paying for that in the next election. on the accountants, i will go to the more technical questions with this website. it is my understanding thatt cgi's contract is a cost plus contract where the company will be paid for their work while they straighten out problems that they maybe even cause. how much moral the cost to fix -- how much more will it cost to fix the website, and if it is their fault for delivering a product that did not meet specifications, do you intend to recover payments and what recourse is available? >> you're correct. contract is a cost plus contract. there is not additional funding being c provided togi. they will make these repairs within the contract. i meet regularly with not only
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global, including one at a: 30 this morning. they expect work to be completed. there is a recovery process in a cost plus contract, but i will have to get you that information. i would not want to rely on my brain for that one, but i will work with the contracting people. >> i would like to get a copy of the contract as well, and there must be a contract with qssi as well. is that cost plus as well? >> i will have to get you the details on the qssi, but i thought we had -- and we can certainly get you the information you requested. >> where is cgi headquartered? >> in virginia. >> jok. and qssi? >> a good question -- minnesota?
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i'm guessing on that one. also offices in virginia. we are working with both the national and local there in virginia, and they are also in maryland. >> i also served on the finance committee, and in the finance committee, cms testified on doing the testing on this website. we were assured that it had all been done. it is my understanding there was testing still going on the day before the website opened and that there had not been the either wassting that called for or was not called for. how much security testing was done as part of the data testing? >> this is what i was trying to explain earlier. there are two components to the
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federal exchange. one is the hub, and that was completely tested, security testing, signed off, and in the ffm, or the actual exchange itself, each component was tested by us independently come a verified, security tested, and it was night -- not signed off in a so we signed ae, short-term authorization to operate, which would be customary if you were continuing to do work on the project. also mention this information that goes in there there and not in stored. how do you identify the person later if there is not any of that information kept. >> the social security number is not stored in the data hub. completed an
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application, it has this information in an an individual can store that online. that is part of the proofing that an individual can do to store their application. we also have some storage in what i will call the enrollment eligibility russes in case there is an appeal. what i was trying to say there's no data stored in the hub. we have information on record. are do not think people cared where it is stored. they are cared about -- they care about their privacy. my time is almost up. thank you. i. thank you, senator enz senator bennett? >> thank you, mr. chairman. take you for being here today. approach tohis local and state and government here, i hope as we go forward we do not lose sight of the fact that government does not do a
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great job with procurement, with .t., or with customer service, and we're seeing that in spades. as ane is we use it occasion not just to point fingers but to improve -- things for the american people. in the short term, i think that customer service element is an enormously important so we do not face the crisis of confidence senator mikulski talked about. that should be job number one, to figure out that people -- but the politics aside. whether people sitting at their kitchen table can decide and evaluate for themselves whether this is a better deal or not for them. in colorado, as you know, we set up our own exchange. one of the things i have been told is that people have to go through 20 pages to have a determination made about the medicaid eligibility before they can actually get access to the private marketplace.
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and there has been some suggestion that that has been required by the federal government. i don't know whether that is true or not, but i wonder whether you can enlighten me on that or shed some light on it and whether we can figure out how to work together to make that less of a burden to people. he cause it seems to me that customer service friendly website would say -- if you think you might be eligible for medicaid, click here. take me through that. but for somebody he knows they are not eligible, to skip the 20 pages, means they get to the private exchange. think -- >> i am sorry, as you talk about that, can you broadly address the question of customer service part of this? the changes that you have made to try to give people the opportunity on the federal exchange to make their own decision. it is me start by saying, a common application, whether you are going on to shop without a subsidy or to see if you qualify for a subsidy or for
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medicaid. and i think that is what you are referring to, the common application. but whether you are medicaid areible or whether you applying for subsidies, it is a single application. so, medicaid doesn't add any additional steps to that process. my understanding -- and again, this is the colorado exchange and not the federal. my understanding is a you need to be denied by medicaid before to shop ine access the private marketplace. >> so, i would need to check with colorado. >> let's do that. can we do that today? >> yes. the customer service issue is very important to us. as we stabilize the site, we will go back and deal with those individuals that we think may have had a bad experience am a such as a establishment of an e- mail account.
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--have individuals' in the information so we will reach out and invite them to come back. some may have gone ahead and created a separate account or maybe they were just on their out of curiosity. but at least we will make an effort to go back and get in touch with individuals and say if you had trouble in the first week am a leave, come back and try to establish your account again, because we solved the problem. that is the first step. the second step is how we handle it in the media and the market. -- what i was talking about before -- a campaign to reach out to consumers, but we will not start us -- campaign until we stabilize the site the next few weeks. december, january, february, march, reaching out to individuals. if you are on a state-based exchange, they are responsible. if you are on a federal exchange, we have that opportunity. so, we identified key markets based on the number of young
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uninsured, the number of uninsured in general and the population. so, we do have a targeted campaign for the next four months. >> what are the implications for your timelines with respect to eligibility, sign up, and all the rest? if you don't get the website fully functional by the end of the month -- or by the end -- >> november. based on our analysis we will have it fully functioning by the end of november. there will always be people who don't want to use the website, who want to do paper, who want to call in. that is fine. we will support that. but i think we always assumed that, based on massachusetts' experience, the initial sign up will be very slow. and in fact, no payments have to be made until december 15 for coverage on january 1. so, while we don't like the problems we had in october and fixing it in november, we do not think it will impact the
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timeline because we have a six- month enrollment, so we still have four months left and individuals can apply up until march. >> thank you. thank you, mr. chairman. >> now to senator robert. -- senator roberts. senator robert? >> thank you, mr. chairman. 'm going to focus, if i can, on the concerns raised by senator isakson, alexander, and the chairman, on security and privacy. we have a law, the federal information security management .ct, his mother --fisma everything has to have an acronym. it requires each agency to a point a chief security officer to ensure americans private financial and identifying information is protected. and that is a big issue. secretary civilians revealed last week exchanges operating on temporary authority to operate.
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there is a 2012 12 memo from zyonts, the man appointed to fix the affordable care act. as head of omb he stated clearly omb does not recognize interim authority to operate for security authorizations. i first question is, why was the exchange allowed to go operational without the apparent parents required by the office of management and budget? on -- justto go think about any minute. i don't like to do this, but time is limited. again, as part of the fisma assessment, an independent testing organization must perform a risk analysis of the security of the system. my second question -- did an independent testing organization ever test the whole integrated system end to end?
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ask you to bank questions. >> that's all right. the first question -- omb does approve of short-term authorization. we are following rules outlined by omb, and i double checked that. the second one is -- yes, we are nist compliant and we did use an independent security firm that did the work in testing. the only piece that was not -- what i talked about before, we could not test and a live environment until october 1. because the testing will continue this month and next the softwareo upgrades, and it will be tested in a live environment. >> without revealing publicly -- which obviously you cannot do -- will use them in confidentially the results of the independent testing?
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>> i will submit everything i can within the security guidelines. yes, sir. >> all right. a september 27 memo addressed to you state that due to system readiness issues, the required security assessment was only partly completed. notes that untested parts of the system pose a high security risk and the contractor was not able to test all parts of the system in one complete version of the system. cbs news analysis that i would like to include in the record. that found that the deadline for final security land slipped three times from may 6 until july 16, security assessment to be completed in june was lit to august. the required top to bottom security test never got done. agency head marylin tavenner, according to this analysis, accepted the risk and mitigation measures like frequent testing and dedicated security team -- but three other officials signed a statement saying that it does
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not reduce the risk of launching as of october 1. that september 27 memo recommends a mitigation plan to address these risks and recommends a six-month authority to operate. that recommendation was signed by you. are you the official as cms responsible for making the security authorization decisions? the case, because of the visibility of the exchange, the chief information officer wanted to make me aware of it, and i agreed to sign it with their recommendation to proceed. >> does anybody else approve that decision before it is final? >> no, sir. >> like secretary civilians? >> and no, sir, it is my decision. >> i appreciate that. thank you very much. >> i will take the remaining 30 seconds of the senators time and just say, again, i think -- as i
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talked to my fellow senators on both sides of the aisle, this is a paramount concern. consumers have to be absolutely certain that when they go on and fill out the application and give all of that information, that at a secure, that no one can hack into that and steal social security numbers or identity and other things. i just think this is an issue that really has to be focused on thoroughly so that there is absolute assurance that that is secured. thank you. mr. chairman, can i get my 30 seconds back? >> you give it up already. >> you took it. i sort of given up. i just want to reflect on what you said, sir. there is a lady named margaret from kansas who i promised i would bring this issue up. exchange to get on the and then she tried to call the times.about 3, 6, 7, 8 finally got somebody and she
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said if i selected that plan, would it be secure? the answer was -- well, you know, pretty sure. that is a direct quote. she said, if you are pretty sure, i want to be sure. she hung up and call the office. that is an example a concern. >> appreciate that. i do share the concern. baldwin? >> thank you, mr. chairman. i want to thank you and the ranking member for convening us , and administrator tavenner, thank you for being here. esther chairman, i appreciated your opening remarks and setting are with for where we real and significant challenges. of the earliery implementation of the affordable helpact that has proven to very many.
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ofhink about the parents children with pre-existing health conditions who can now secure insurance for their children, and the peace of mind that for wide. i think about the 6.6 million young adults covered on their parents' health insurance and i take personal pride on that because i worked on that amendment as a house member as we were marking the bill up in energy and commerce. i think about the $6 billion in prescription drug savings that seniors have the advantage of since the passage of this bill. and then i think about the rough implementation of this next phase of the affordable care act. and even with the significant technical issues around the , i have heard from families in wisconsin that are already recognizing some of the new insurance options that are available. as you said in context of your
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opening remarks, that is what this is about. and new marketplace especially for those who are shut out. karl and bonnie who own a farm in hayward, wisconsin, in the north woods of our state. struggleed about their to find health insurance prior to the passage of the affordable care act. they were both dropped from their plan after health tests risk ofarl was at prostate cancer. they had to buy a new plan. they were lucky they could find one. $10,000 deductible and $800 premium, but it had a said it would not cover prostate cancer if karl ever got sick. due to the affordable care act, they are not comparing and shopping for new coverage in the marketplace. he contacted me to share that they are thankful and very
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findted to be able to health care plans that are not only affordable but actually cover cancer. quality health insurance options available in the marketplace, we need all of the doors to that marketplace to be wide open. and the ongoing technical andlems are unacceptable they must be fixed as soon as possible. and i am glad to hear your update on the progress. they should have been fixed yesterday. but the need for a well functioning is particularly acute in a state like the one i represent. because our governor chose not a wisconsin-made state- based arco place for individuals and small businesses. failed to seize the opportunity that the affordable
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care act presented to strengthen what we call badger care in wisconsin. to expandcided not medicaid under the affordable care act. walker decidedor to kick off as many as what we think would be around 90 -- 90,000-92,000 off their current medicaid coverage. i think of our discussion about, if you like your health care plan, you can keep it. well, there's tens of thousands like theirnites who badger care and the reason why they can't keep it is because of our governor's decision. to ask you, administrator tavenner, to start off, can you confirm that wisconsin is one of the only states in the nation poised to a large number of individuals from the current medicaid coverage in 2014? -- right now,dwin
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and we are in discussion with the wisconsin. the two maine are states of looking at this idea. other states have talked about it, but these are the two who put the proposals forward. you are right, 92,000 people. and we are working with --consin, are medicaid and to make sure those individuals are aware of the marketplace. >> i want to ask you a little bit more about that. a significant number of people in my state. and in order to avoid a lapse in coverage, individuals losing badger care must enroll by december 15 -- >> i am sorry, the senators time -- i am trying to hold to five minutes. everybody has been very good about this. senator scott? >> i want her to continue to talk so i would have more time.
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are tied to keep it at five that you will get a second round. are notlican jokes funny. i apologize. thank you, mr. chairman. [laughter] >> southern drawl. let's get back to the topic. ms. tavenner, thank you very much for being here. frome more than 30 days -- one of the greatest website disasters in history. after nearly 400 million dollars is synonymous with failure. the public's trust has been broken in the report i am hearing reinforces why. one in particular we have already heard discussion on -- the south carolina man, it is so painful, that i want to dedicate my time in question to try to resolve his issues. fromase starts with justin north carolina attempting on october 1 to get obamacare through the health by halloween, just four or five days ago, he was still unable to sign up for obamacare.
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however, mr. hadley from north twolina immediately saw download links. an eligibility notice from mr. dougal from south carolina, including his name, address, and eligibility for subsidies. dougal ise -- mr. requesting the personal information from all of his family be removed from because he cannot remove it himself because there is no delte option for consumers. of course now mr. dougal nor mr. hatley will use the website to purchase insurance. making matters worse, when my office was contacted with assistance we called the help one 800 number and asked a specific question -- can you remove mr. dougal's personal information? the response was silence. not a yes, not a no, not a maybe, not let me check with my
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supervisor. they just simply refused to have an audible word in response to our question. it is hard to believe that your account managers really do not know if they can delete accounts internally, especially after such an egregious breach of trust. by the way, mr. dougal has called on several occasions but no one will call him back. not a single person has taken the time, after having his information exposed, to even call mr. dougal back. i tell you this story because it illustrates what happen as a result of incompetence with this website and this program. the administration and hhs new that americans' personal information was at risk before the website went up. i think senator roberts just spoke about the and dr. general's report from august that warmth that obamacare's exchanges may end up here legally exposing americans' private records to hackers and
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criminals. the report noted cms is working with a very tight deadline to ensure that security measures for the hub are set, tested, and implement it. further, senator roberts alluded to an internal memo from september 27 of detained by "the washington post" and to quote the memo, it says inherent security risks exposes the level of uncertainty that can be deemed as a high risk to personal financial information being exposed. and you have taken responsibility, and we appreciate that -- was written specifically to you from your administrator of health plan operations and deputy cio. you signed up and ready for to operate for six months with a mitigation plan to be implemented. in other words, you authorized to go forward realizing that the potential of exposing personal information was, and i quote from the memo, at high risk. my questions -- do you believe that six months is an acceptable
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amount of time for this website to operate in a manner that puts americans' financial information at risk for high risk of security breach? hasn't happened before? can you guarantee social security numbers are secure? will you shut down the website -- as my friends from them left have already suggested -- until security issues are fixed? i would also like to finish by get mr. dougal and answer in deleting the information from the system and we get the answer today, if possible. i have a copy of the letter he is we question -- he is requesting. we can bring the information over to your staffer as well. i certainly realize at the beginning of the testimony, the answer was given that the theware fix has happened on information, but the software fix was simply to disable the goes, so when mr. hadley
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to the website, he still sees the link but he cannot click the link. so, the guarantee and the clarification that simply tells mr. dougal that he has complete confidence his information has been deleted from the system has yet not been achieved. >> first of all, senator scott, we have reached out to mr. dougal several times a week will follow. happy to give you numbers. he does not think so, actually, because no one has called him. >> we have a disagreement there. >> yes, ma'am. >> the second question -- the hub --i keep trying to separate the two because they are two different systems. the hub was separately tested all the way through and there was a signoff from the chief information office. we should put that aside. what we are talking about is the ffm, the exchange peace, and
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that is the part i described herein in a six-month period, let me tell you what is going on. there is a dedicated security team working under the chief information officer. we do weekly testing of all devices, including internet facing web service, daily and weekly, 24/seven, continuous scans. we will have a full -- a stable environment with all security and controls on the software upgrade is done, and that is standard operating procedure. that will be within 60-90 days of us going live october 1. >> my time is up. thank you very much for your answer. i was only suggesting whether the hub or other entity, that i think the consumer sees is not what is going wrong, is that own,r confidence is going d and we want to make sure we anyt y'all to the fact that aspect is of not work them the confidence is gone. but thank you, senator. -- >> senator god, i would like
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also if you could make -- senator scott, i would like also for you to make that information available to the -- >> welcome, mrs. tavenner. i would concede that when you reorder 16 of the american economy there will be some ofple who are unhappy -- 1/6 the american economy there will be some people are unhappy. and when you stand up a brand- new mechanism to give 30 million people access to health care that they did not have, that there would also be some people who are unhappy with their experience. and i think at some level, this should be an exercise in setting the right expectations. that when you undergo this kind of effort to reorder a health- care system that everyone on this committee agrees is broken, there are going to be some and some will lose, and frankly, under any
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reform plan that has been debated in the last 20 years, that is true. what we are suggesting is that there are going to be far more people over the course of the rollout of this legislation who have a better experience than what is happening currently in the system the band have a worse experience. tole it is always risky legislate by anecdote, we are telling stories here today, so let me just add one to the mix. betty berger from connecticut. betty and her family had insurance. jobs andnd switched during the several week period in between his first job and his second job, their son was diagnosed with cancer. guess what? his new employer would not pick up coverage for the son. betty's story is one that can be repeated 2 million times every single year across the country. they went bankrupt. they lost their house. they lost their car.
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they lost their savings simply because their son had the misfortune of being diagnosed during a two-week period in which they did not have insurance. was not that they got dropped from coverage, their problem is they could not find any coverage, and the story can be told millions of times over. and i guess my confidence that in the end --while this is a disruption to a large section of the economy, my confidence that in the end there are going to be far, far more winners than losers, is rooted in part in connecticut by shakespeare and. we have an exchange that is up and working. in the first month of the exchange, we have hit 10% of our evenll enrollment goal, given the fact that the massachusetts connector, who is run by the same guy who was running connecticut's exchange in the first month only so 0.3% of total enrollment sign-up.
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so, i have confident that the rocket will fly off the shelves once people can get into the website -- this product will fly off of the sale -- shelves once people can get into the website because what we have seen in connecticut and also i am optimistic that once his site is up it will be up in time for the largest number of people to inoll, because what you said response to senator bennet's questions, the reality is that the vast majority of people are going to be looking for coverage as the enrollment date draws near. so, i guess that is the frame of my question to you. from the experience of people who have been able to access these exchanges -- either at the national level or state level -- what do we know about the quality of the product and, two, what do we know about the timing of when people actually sign up for plans like this? we have the massachusetts experience, the experience of medicare part d. to the extent your timeline
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plays out and we have a fully functioning website within the next dirty-60 days, is that in time for what we expect to be the majority of people coming in and wanting to access the product? >> let me start with the product. i think that we are extremely pleased with the product. and i think it is important not to lose sight of that. as i said before, we had about 25% new entrants into the market, new issuers offering new plants. we had over 200 issuers and i think) 3000 products. but i will get you that specific information. -- the insurance market wants us to succeed. they see it as a the business. so, we have been pleased with the states in the competition. there have been some exceptions as we talked about before, and we want to stimulate that as time goes on. the second piece -- we have always believed that the first enrollment surge would come mid-
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december and the second surge would come late february/early march. there would be people who want to sign up by january 1, but there would always be another group who would wait until the last minute to sign up. presumably the younger, healthier folks who would wait until it became an issue for them. so, that is what we believe. the product is very strong. we would like to see more competition. that will occur year to year. this is our first year in the market. but we have been pleased, and in fact, the pricing came in about 18% below what the cbo estimates were. and we would like more introduction in some markets, for sure. but a good start. >> thank you. >> thank you, senator. senator berger? >> welcome. last week in your time in the house, you noted that as insurance companies decided to cancel and stop plans, the aca
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did not force insurers to make such decisions. you stated -- and i quote -- the issuer has decided to change the plan. not have to. grandfathered in 2010 if it -- if they did not make significant changes. they could keep the plants they had. do you believe that that was an accurate statement you made? do you believe that was an accurate statement? >> yes, i do believe that. force aca did not insurers to make such decisions. "the insurer decided to change the plan, they didn't have to." >> can i finish my sentence. >> this will not increase cost
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sharing. >> they were allowed to make modest changes to benefits modest increases in fixed dollar copayments and deductibles. if health care costs went up, they could move up. they can modify their provider network, they could change the plan structure to add features like health reimbursement accounts. >> for an insurance product that did not meet the minimum coverage benefits that was a .stablished under the aca >> they could be grandfathered in under this, yes. >> but, the decisions that are made if they don't meet the minimum benefit that was established under the aca, that is an individual that will have the plan canceled, is that not correct? >> they can continue these plans, these plans could be grandfathered in it they made these kinds of changes, if they
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started to reduce benefits, then they fell under the requirements of the aca. share you personally with the secretary that there were problems with the exchange? >> i personally shared with the secretary in september that there was modest changes. >> we have had a lot of conversations on security. let me ask you very specifically, was there ever any and two and testing on the exchange? >> there was and to and testing on the hub. there was individual modular testing and demonstration testing inside the exchange meaning that we had sample cases, sample situations that we tested all the way through. we could not test live until we went live, therefore the temporary authorization -- signed on september 27,
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the authority to operate the noted this.the memo from a security perspective, the aspects of the system that were not tested due to the ongoing development exposed the level of uncertainty that can be deemed as a high risk for federally facilitated marketplace systems. did you bring that security concern to the secretaries attention and the attention of the omb? >> i did not. >> secretary stability us said that the implementation took place on october 1 because that was the law. have read the asked several times. my interpretation is that secretary stability us had the authority not to execute that on october 1. clearly, my interpretation, if
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you had not signed the authority to authorize the website, it would not have stood up on october 1. >> i don't know if your statements are accurate. law says that january 1 is when individuals have to have coverage. we put a recommendation in place that said that october 1 would be what we would put in so people had time to sign up. theo you think that secretary had the authority to waive this? >> i do not know the answer to that question. >> is it true that individuals that were enrolled after march 23, 2000 10 are not eligible for grandfathered plans? that question again. >> is it true that individuals who enrolled in health care plans after march 23, 2010, they are not eligible for grandfathered plants?
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>> that is true. >> do you think that americans should have the ability to keep their plan? >> i think individuals that we talked about in the grandfathered plan should be allowed to have that happen and then large employer plans were grandfathered as well. i think we tried to look at the individuals and who to grandfather. >> thank you. -- tor franken >> thank you for convening this hearing. like my colleagues, i am frustrated and disappointed that a month into the open enrollment, there's still problems with the federal marketplace. i appreciate your being here today. i think it is important that we understand what we're doing to to fix the problems that have hindered comparison-shopping and
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enrollment over the past month. my number one priority is to see to it that people of minnesota have access to our state run marketplace, that that access is protected. things seem to be going better. this is with the minnesota health insurance marketplace, then with it has been going better and a lot of states. thousands of individuals and families are completing applications for comprehensive and affordable health coverage. it was developed and operated by minnesota, it does rely on the federal hub for its eligibility determinations and this was a problem that we had very early on.
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we were getting people to be verified. also, when the hub is taken off- also go off-st line. what are you doing to make sure that minnesotans can continue to enroll in the health plans through our state run marketplace while is undergoing maintenance? >> in the case of the hub, there has been very little downtime of the hub itself. we do have a window that we had agreed to prior to going live with the system. there are certain components such as social security which is during that time. the hub has worked flawlessly. andas not been the issue certainly the minnesota state-
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based exchanges doing well and they have access to the hub. when we are going to schedule down time, we let states know ahead of time. this is a that we can plan accordingly. .> the hub did not work this was the first week. >> this is not the problem. we had these been established at the federal level. i think that minnesota has more problems. all behind us. they were not hub issues. >> these are almost separate from health care. it has been working a lot better. one of the critical elements of success to the state run market changes will be clear communications.
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do you have open lines of communications with the states, they are operating about the challenges that they are facing and interacting with >> yes, we have daily commute haitians and we have teams assigned to work with states. or two, we doek either a videoconference or we call the states. we have very open lines of communications with states. >> there has been a number of andtions about security private information. i am chairman of the judiciary committee. i spent a lot of time working on protecting privacy. to me. very concerning can you tell me what you are doing now to make sure that
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issumers health information securely protected? >> we are meeting all of the standards, we do continuous security testing. i have kind of walk through those. we have a dedicated security team, we also do independent security analysis. this is continuous. we treat their marketplace, the same way we would treat any other system. these are inherently high risk. , i am doingr reports about the high risk of these natures. high riskt as a system and we monitor it continuously. we have a team dedicated to report on it and make us aware of it right away. >> my time has expired, thank you. >> thank you, senator. >> i have two questions.
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we see a tale of two beltway bandits. who is the ceo of cgi? >> michael roach is the ceo of cgi global. >> my guess is from what information you have, you have donated up to $140 million for him to do this work? >> current spending is 400 million including cgi. this includes qssi. in such a sneaky way? why refuse to provide the contract to congress? i am from chicago where we
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always kind of follow the money. if i cannot find out where it >> i am happy to go back and check. a lot of information has been provided to congress. >> so, you will be able to provide the contract to us? >> i will get you everything i can, yes. >> don't you have money missing that has not been paid? my understanding is that there's about 100 million to go. after a disaster of this nature, is there a way to have accountability with the remaining funds? >> i will get back to you with that information. >> maybe he can skip a holiday in the bahamas. >> it appears you're going to inflict this on the people of illinois where media reports
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tell us of upwards of 30,000 residents might lose their health insurance because of this program. i think a story was just run, about 3.5 million americans will lose their health care because of this program. i'm not sure that is accurate. i think you're referring to cancel policies. >> i'm referring to the story. >> i don't know which. there are not 3 million people losing coverage. >> are you accountable for the taxpayers funds? >> i think i am. >> hundreds of millions of dollars. for michael roach, i would think that you have provided a substantial wealth to him. that i just point out think we ought to know the full
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details of the contract that you have signed with him. i thinks i'm wrong, you have statements of worth, you have a lot of information already, but i will get you anything else. >> i would go to the other ceo of qs as i've. i which is to thinking about a phone call that might have happened when you were ready for this hearing. tangois carol, whiskey fang f on my website. >> what? yeah., hundreds of millions of dollars, you should have something.
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mr. roachnder what is driving right now. probably something really nice. >> mr. chairman, i yield back. senator hagan.e, >> thank you, mr. chairman. thank you for being here. let me just ask about the december contingency planning. at the end of this month, either one or two things will be true. either the website will be working smoothly for the vast majority of its users or it won't. in both cases, the administration will have to take quick action to ensure that individuals across the country are being treated fairly. i am sure that people are
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planning for this at the end of the month. if the site works, individuals enrollve two weeks to in up land that will take effect on january 1. is the administration planning and outreach strategy to match this surge that is currently underway? if the site is not working, then what steps is the administration going to take including delaying the penalty or not buying insurance. and then what will they do to the individuals to make sure that there will not be a gap in their insurance coverage? a publicere is campaign that will match, the end of november and going into december, january, february, march. there are no plans to delay the individual mandate.
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what if the site is not working? >> the site will be working. the site is working now. we are making it performance improvements. >> are enough people able to get on the side? >> do you have numbers? >> we had over 700,000 who have completed applications. we will have mid november through october. >> they are waiving penalties for two months to make up for the lost time that it is taking getting the site up and running. anhink that that will be issue. one of the things i was concerned about him leading the
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the contracts to award this site. was it really awarded to companies that had been on an i.t. contractor that was back in 2007? was it not open to other companies? >> it was a contract which back in 2007, there was a list of vendors to do this kind of work. >> a lot has changed from 2007 until now. >> these are current vendors. the ir.ess was >> if you are not on that contract, would you not be eligible? >> that's right, you would not be eligible.
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this process was completed in 2007. it is been used for projects. it is a series of contractors who have been prescreened, prequalified. aey still are going through competitive bid process. this still is for the individuals that qualify in 2007. >> are those companies, would they be on that qualifying contractors? look at theave to individual side of this, certainly. on september 30, the night before the site was set to launch, what were your expectations for the launch day? >> that is a great question. wefirst expectation is that would go live shortly after midnight because we were doing
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a soft launch at midnight. we had pretty much promoted that the site would go live at 8 a.m. the normal cost them morning of october 1. we went shortly after midnight. we had tremendous interest, even during the night. my expectation was that it would work, it would have the customary glitches. it is a complicated website. bugs.w that it would be we had to pull functionality out to spend more time focusing on the application process. what i expected was a site that worked with some issues. more volumewas than we anticipated and we anticipated pretty high volume and then we ran into the issue with the establishment the e- mail accounts.
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to problem solve for that. those were two things we did not expect. >> it seems to the information i have been reading was that there was warning before the site went open. was a lot of concern that testing had not been done. in hindsight now, a lot of people are saying, why didn't the administration give the sitewarning about not living up to the expectations that was being called for and many people understood that it would be up and running and being able to access it quite easily? >> i would say that the testing around the hub was complete and i think the testing that had not been finished was testing in a live environment. , in ourour analysis
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modular testing, we had done independent verification him if that had passed security checks. we were comfortable and we did not have any high risk recommendations. we cannot do the the live into and testing. we did case testing prior to that. >> thank you very much, senator. >> i wasn't watching my clock. i apologize. >> the navigators are trying to help to facilitate alaska as well as enroll in alaska that has been set up for this. these are folks that want this to work. what i heard from them was stopped. it is not working. enroll29th of october,
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alaska confirmed that there was that hadhree alaskans successfully enrolled. there is nobody else that has confirmed that they have in thefully enrolled exchange from alaska. this is the fifth. he might have have somebody came in yesterday but as best as i can tell, it is three. in a letter that i received from enroll alaska, they confirm this and they have specific have specifically asked about the administration pulled the website down. one thing that was very disconcerting was to learn that perhaps the three that have been enrolled has been given incorrect information.
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it has discovered that they were talking late in the subsidy for alaskans incorrectly. therefore, they have suspended all in romans until the issue is resolved. this was last week. this subsidy calculator has been resolved. are you aware of this? has it been resolved? are we working on it? the concern is that not only can people not get onto enroll but if they do, the subsidy calculations are incorrect. >> so, we are aware, meaning the staff is aware of this issue and they are working on a fix to the system to correct the alaska issue. should alaskans do? should they stay off? >> i will get that information for you. >> what she did yesterday, i
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the exchanges will be 5f-line between 1 a.m. and a.m. eastern standard time until further notification. is that correct? is the window that we used to do software upgrades. that is why. >> ok. fair enough. might believe,e the son does not rise and set in washington, d.c. or on eastern standard time. when a family finishes up dinner, was the kids to bed in alaska, 9 a.m. is 1:00 a.m.. you have the time that alaskans would be able to sit and move through any aspects of this exchange, you are shut down. can you give me some indicator as to when this might be available for all americans to take a look at.
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>> we're in a situation where we have concerned with with the subsidy calculations in the state, we have maybe three people enrolled correctly. we are not sure, yet. we cannot get onto the exchanges when most people would have an opportunity to do so. i am having alaskans coming to me and saying, ok, it happens on january the fifth? i have an incident where i need my insurance. my insurance has been canceled. just about 60% of the folks who receive their insurance through our largest health insurance by a long margin have received their cancellation notices.
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so, you have that going on, you cannot get onto the exchanges. we are all saying that the exchange will get worked out. what they are coming to me and saying is if something happens to me and my family, that first week in january. if i had been able to apply for coverage, but for some reason, there is a glitch in the confirmation, getting my premium checked, if there is a health is at thejanuary, it individual that is on the hook? it hhs? will i beto know, taking care of, i don't have an answer for them. >> this is four hours of the day. >> i understand. >> it is very significant.
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thendividuals can go to call center and get help. that is true in alaska as well. if they want to submit paper applications, they can be processed and returned to them. >> what happens on january 1? who was on the hook? beforeill be resolved january 1. >> thank you. >> thank you, mr. chairman. thank you for holding this hearing. .hank you, administrator kavner i want to talk about massachusetts. everyone is frustrated by the first few weeks of and everyone is looking for answers. last week, president obama came to boston where he said health reform in massachusetts, like the affordable care act is not
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website, it is a value statement. the president is right. leaders in massachusetts like generations of national leaders fought for reform and health care. not because it was easy but because we all knew that the old system was broken. for years, costs exploded. too many consumers, patients, including those with insurance. a were threatened with financial ruin if they got sick. there has been a lot of comparisons between the aca rollout and our experience in massachusetts. what i can tell you all through the experience is that getting everyone into a new health care wasem wasn't easy and it not quick. in the first month, if people could sign up for subsidized coverage during our health reform launch in 2007, we got 123 people enrolled. because we were committing to
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making the law work into making sure that people have affordable health care, we kept working on it. we fixed the problems, we hit period lastedweour enrollment almost a full year. and yet it was only in the last total pool20% of the cut themselves and rolled. people signing up for nce had azed insura shorter time, and over 1/4 of them waited until the last month to get enrolled. i understand that the beginning -- butrollment period what we've learned in massachusetts is when it comes to enrolling in health care, a