tv Key Capitol Hill Hearings CSPAN November 19, 2014 8:00am-10:01am EST
for them to look at provider directories, the coverage that was talked about and tax season coming up one of the things that will be coming into effect is the shared responsibility fee. thank you again. >> okay, thanks very much, meena. we'll turn to dan durham from ahip. >> well, good afternoon, thank you, ed and sara. i look forward to talking about where we are in terms of results and expectations and hope to have a lot of good questions and discussion among the panel members today. i will focus on health plans top
priority, delivering value to consumers. american families want value for the money that they spend on their premium dollars. they want affordable quality coverage and they want choice. the bronze, the pratt numb, tailored networks to prodder provider networks. health plans are delivering what consumers want in a very competitive market. they're delivering affordability, value, and choices that meet consumers needs. health plans are delivering value by negotiating the best price for health care services and by collaborating with providers to insure quality care. however there are some major challenges in health plans effort to deliver value to consumers. the most significant challenges
arise when the market for services is not competitive. for example, while the rhetoric behind hospital consolidation is about efficiency the reality is higher prices for consumers. the ftc has been very clear on this. as have many studies in peer review journals. the robert wood johnson foundation study found that consolidation trends increase costs by as much as 20% with no counterveiling increase in quality. another significant challenge, high-priced specialty medicines that have no competitors. no leverage for health plans to negotiate a lower price for consumers. the latest to hit the market is hermoni, at $11,235 a pill. 95,000 for a 12-week course of
treatment for hepatitis-c. reasonable incentives to develop more medicines is appropriate but $95,000? really? is that reasonable. with many more high-priced specialty medicines in the pipeline this is clearly not sustainable for consumers that depend on medicaid, medicare, and private health insurance. in a 2008 health affairs article, joe newhouse and richard frank called this type of pricing is patent protection on steroids. their owe solution? defining arbitration. what is pharma's solution? put price controls on other stakeholders, ignore the price of the drug and their responsibility. in fact the aca includes limit the on what consumers have to pay out-of-pocket.
today 6%, 6% of $95,000 is what a consumer enrolled in a silver plan pays out-of-pocket for a 12-week course of herboni. the plan pays 94%. individuals with incomes of $17,500 or less pay 1%. the plan pays 99%. why? because the average maximum limit on cost sharing for silver plans is $5730. and it is $1100 for those with incomes of 150% of the poverty level or less. clearly the reform market limits consumers out-of-pocket expenses but it does not protect them from monopolistic pricing that drives up their premiums. so what's the real problem here? the cost-sharing or the price?
well, despite these significant limitations for markets that are not competitive, health plans are doing all they can to deliver value to consumers. we all debris that we have to stop paying for so oomph and start paying for value. and that is exactly what health plans are doing. this consumer-driven, value-oriented market is here to stay. 40% of health plan payments are now tied to value and this percentage is continuing to grow. the breath of innovation is consistent with our health plans. we're building on this tool, this map, so that policymakers,
reporters and consumers can see what's happening in their markets. so what are the results? this slide provides a few examples of how health plans are delivering value to consumers and we have many, many more. medical homes, anthem's patient centered medical home program resulted in a 15% reduction in medical canned pharmaceutical costs and quality was maintained or improved. accountable care. aetna's collaborative accountable care relationship with nova health, which is a physician association in maine, has improved quality of care at lower costs. 45% fewer hospital admissions and 56% fewer readmissions. cigna's programs across two
dozen states are seeing lower cost and fewer emergency room visits. and with oncology united's bundled payment, their approach saved $33 million without any reduction in quality. and importantly we are helping patients engage with their care. we have cost calculators that help them compare the cost of procedures and the quality of those providers that provide those procedures. we have mobile applications that provide important user-friendly health care information to consumers. these efforts and many more dry value by providing consumers with the tools and resources they need to make informed decisions. and, we are delivering value and choice to consumers through health plans competes on the
exchange. the results? high consumer satisfaction. just look at today's gallup pole. clear choice in high value networks, designs that meet the needs of consumers. according to mckenzie, 90% of individuals have access to broad networks and 92% have access to more tailored networks that deliver quality care with significantly lower premiums. do we want to take that choice away from consumers? well they just did in south dakota where a physician-owned specialty hospital succeeded in passing a ballot initiative on any willing provider. this destroys the value proposition and the ftc has been very clear. awp laws harm consumers. health plans are focused on five
areas to bring even more value, affordability, and stability to consumers. first, insurance providers have access to the right information to make the right decisions for their patients. we need effectiveness and value data that all stakeholders can use. second, alignment and integration across the entire system, from partnerships with providers, to removing unnecessary barriers to care from high-quality providers. health plans are leading the way and we are bilged on what works. -- building on what works. third, transparency. the only way to look, the only way for all of this to work is if we give consumers and providers access to the best information to make informed decisions with their care. so in conclusion we have come a long way since the passage of the aca four years ago but we
have a lot of challenges ahead of us. health plans are doing their part to be leaders and innovators to meet these challenges. from provider partnerships to equiping consumers with critical tools, and to innovative delivery models. health plans are changing the game of health care delivery to bring value to consumers. that's the bottom line and that's what we'll continue to do. thank you and i look forward to our discussion. >> okay. thanks, dan. let's if i can trouble you for the clicker. we'll allow professor jost to move his slides along. we'll turn to tim. >> thank you and thank you for inviting me today. i think you'll be able to tell by looking at the slide which of us work for the federal government or major corporation, and associations and which of us work out of a little office off of our bedroom. tomorrow the marketplace will open its doors for 2015.
the door will stay open through february 15th. during this three-month period it is hoped that three to five million americans will sign up for coverage for the first time. it is also hoped that most of the seven million americans currently covered through the marketplace will reenroll for the second year, making a significant further dent in the number of americans who remain uninsured and i just say, that the numbers i have in the slides are from the cbo report as i'm sure you noticed they put out a report this week with somewhat lower numbers. the reenrollment will vary somewhat between federally facilitated exchanges and various state markets. those covered through the federally facilitated marketplace should by now have received a redetermination notice from cms. this notice will be worded somewhat differently depending on the situation of the enrollee. those who received tax credits for 2014 and authorized access
to their 2013 tax returns, will, if those tax returns do not disclose an income close to or above the eligibility level, be encouraged to return to the exchange and update their eligibility information. if people do not return and update, they will simply receive the tax credit in 2015 that they received in 2014, which will in turn be based on their 2012 tax returns. enrollees should also by now received a second notice from their insurer advising them to reenroll for 2015. in most instances it will tell them that they will be reenrolled in the same plan that they were in for 2014 or a similar plan if they do not go back to the marketplace and choose a different plan. 2014 enrollees should return to the marketplace for 2015. first, they need to make sure their eligibility information is up-to-date. over the course of the year there may have been changes in
their income or household composition and these need to be reported. moves, qualification of a household member for other health coverage and changes to immigration status or incarceration of household members should also be reported. if further changes are expected in 2015 these should also be disclosed. 90% of the information on the online reapplication form will be prepopulated, enrollees need to check every item on the form to make sure everything is up-to-date. enrollees who fail to return to the exchange may well be receive smaller advanced premium tax credits than they are entitled to in 2015 if premiums may have gone up more than income. on the other hand, enrolees who have seen large increases in their income, or who have had members of their household move out or age off of coverage, may receive more in tax credits that they're entitled to and may have to pay back sizable amounts when
they file their taxes in 2015. enrollees should also return to the exchange to shop for plans rather than simply being auto enrolled in the same plan. the total number of insurers offering plans in the marketplace as we have already heard is increasing by a quarter, with new entrants in 3/4 of the states. as we already heard premiums are going up significantly for some plans or remaining stable or even dropping for others. advanced premium tax credits are based on the cost of the second lowest cost silver plan but plans that may have been the second lowest cost or lowest cost plan for 2014 may cost significantly more in 2015 while other plans may cost less. of course premium tax credits are not the only consideration that reenrollees should take into account. cost share something also important as sarah has said. those with incomes below 250% of
poverty who qualify for cost sharing reduction payments must purchase a silver plan even though it costs more because bronze plans do not wall for cost sharing reductions. moreover, some insurers are offering plans with basic benefits outside the deductible that offer much more value to those who need little care and consumers should be looking for these. consumers shouldn't just assume they need to pay 2 or 3, or $4,000 before they get anything at all. it is also hoped that information on networks and formularies will be better this time around and consumers should consider carefully whether they do better with a plan with narrower network that is less expensive or with the more comprehensive seven network which is likely to cost more. of course an enrollee who wishes to stay with the same plan can do so. simply enter iting the plan number that will be included in the reenrollment number, notice from the insurer when they go
online to update their eligibility information. it is vitally important that enrollees return to the marketplace within the first month of open enrollment by december 15th to update their information to reenroll to insure they have continuous coverage beginning on january 1st, 2015. enrollees can change plans anytime up to february 15th when open enrollment closes or up to that if they qualify for special enrollment period. the enrollment process has been significantly streamlined for most enrollees and should go much more smoothly this time around. much of the low-hanging fruit has already been plucked and new enrollees will be harder to find a recent kaiser health poll 90% of the uninsured were unaware that the open enrollment was opening again this month and 2/3 of them knew little or nothing about the health insurance
marketplaces and over half didn't know that they could get financial assistance through the marketplace. many will face language barriers. and we may well face a more hostile political environment following the election where negative messages have dominated the airwaves. it is rare that you have to go out into a market to sell a product with a torrent of advertisements that opposing your product. one factor that should not, and this is important, should not deter new enrollees from reenrolling or old enrollees or reenrolling the supreme court grant of second quarter airy in the king case. if the court validates the irs rule to allow federal exchanges to grant premium tax credits, its decision will only have perspective application. individuals enrolling now will not have to pay back credits they received before the court reaches its decision. i quote from a recent supreme
court case, the internal revenue code gives the commissioner discretion to decline to apply decisions of this court retroactively. most individuals with offers of employer sponsored coverage will not have the option of choosing premium tax credit financed coverage instead. some low-wage employees for whom coverage is not affordable, however, or employees who are offered coverage that does not meet minimum value requirements, such as not covering hospital services, clarification on that last week, may be able to choose marketplace coverage instead. other employees are able to choose among plans through a private exchanges. still others are offered employer coverage but may be eligible for medicaid or their children may be eligible for chip. employees of small employers that sign up for the shop exchanges will be able to offer employee choice in 2015 for the first time in many states.
and employees must also carefully considered coverage that offers them maximum value. while progressive often focus on access as key value in health policy, conservatives and libertarians often focus on choice. the affordable care act not only offers healthcare access to many who previously lacked it, but also offers unprecedented choice. consumers must be informed and educated however to fully exercise their choice opportunities and exercise them wisely. thank you. >> thanks very much, tim. even those of us who have pretty good understanding of the way insurance works, sometimes get confused with all of the different factors involved in all of this. i really appreciate the panelists putting it in words most of us can understand anyway. i would ask that you now join
the conversation. those of you here closer to the front are going to find it easier to manuever your way to one of the microphones that are up front here. there are also, i remind you, the green cards in your packets that you can write a question on and it will go forward. and, before we go to that portion, i wonder if we could just go back to something that was mentioned to meena in the presentation at least briefly, and tim, you talked about it as well, that is the redetermination process. we're talking about figuring out for people who are already enrolled in getting federal tax credits that lowers the cost of their premium what the next year's cost is going to be and what impact that's going to have on their spending. what, how important is that? and what kind of advice can you
offer to those in that situation? you talked a little about second lowest silver plan that might not be the second lowest silver plan. who cares about that? >> i think, maybe i could respond briefly and then meena can supplement. the premium tax credit is the formula is basically the that you look at a person's modified adjusted gross income and then depending on where that lies on a scale between 100 and 400% of poverty they have to spend a certain percentage of that on their premiums before they get any help through the premium tax credit. the amount they get though, however, is usually not based on the actual premium they pay but on the premium of the second lowest cost silver plan, that would be available to them in their geographic area given their family size and agings of their family and whether anybody
smokes. actually smoking is not a factor. the, and so, if you were in the second lowest cost silver plan this year or lowest cost, you would be getting maximum assistance. if, however, you were in the second lowest cost silver plan this year but your premiums went way up, and it's no longer the second lowest cost silver plan or someone else has undercut the premiums of the plan you're in and it is now the second lowest cost silver plan, your share goes up. the share that is covered by the premium tax credits goes down. and so it's really important -- maybe people want to stay with their plan and maybe that the difference is not that great but it is a factor that people should be aware of so that people can maximize the amount of tax credit that they received. we all like to get big tax sub sydy, right? and also minimize the amount of premium they have to pay.
>> so even if you had a plan that you liked and it worked for you financially last year, you really should be going back to shop to see what's available this year? >> yes. i mean you may decide to stay with the plans. and it may, there are of course other considerations, cost-sharing networks and formularies, service, quality but at least it is a factor people need to take into account. >> okay. yes, go right ahead. >> i'm dr. caroline poplin i'm a primary care physician. i'm also a medicare beneficiary. for doctors seshamani, and mr. jost, you've been talking about choice and wide choice consumers have. now part-d, gave consumers a lot of choice and what studies have shown is that consumers don't know what to do with the choice. that they're bewildered by more
than three or four choices. if you look at federal employees health benefit program which i'm also on, there is also a choice there and in fact i think most people stick with what they have because it is just too complicated to deal with all of the choices and have you fact are tored this into the way you're going to roll out the plan or help consumers, or, is it designed of how the marketplaces set these choices up for people? in health care, choice of provider works very well. choice of plan has not worked very well, at least in those two instances. >> well there's a couple of different ways of addressing that. one is to, well, standardize plans. some states have done that so that it, and of course the affordable care act went a long way towards standardizing plans by at least coming up with a minimum benefit package and
standardizing cost sharing by level. you can imagine what it would be like if every insurer could come up with any kind of cost-sharing combination and combination of benefits. we would be looking at tens of thousands of plans. it is standardized in some states and some are going further in standardizing. the other way would be come up with tools that help consumers shop. consumer checkbook has a tool like that for the federal employees benefit program. they developed a tool that would work on exchanges. i heard of other companies that are looking at that kind of a tool. i think that would be tremendously beneficial to consumers. if you could simply put in, you know, these are the kinds of drugs i'm using. these are the providers i use. these are the kinds of costs i expect to incur over the next year, these are conditions i have, and then it could direct you to three or four plans that would be best for you.
so i think this is an area where we need to grow, either in further standardization or further shopping tools. but i agree, right now, 106 plans, well that is an evening's work trying to work through that. >> even 46 plans. >> but i think the point you made there are these medal levels that divide out plans based on how much cost sharing there is helps with that and being able to through the window shopping as dr. collins showed, being able to see in a standardized way and put plans up side by side to be able to compare i think is important. lastly one thing that wasn't mentioned, in-person assistance, call center, navigators and all of our outreach attempts to help people and all of the information available on the website through local partners, through pharmacies, through physicians offices. i think all of those together can help with the consumer education as well so that the
choices is a reality. >> of course also agents and brokers. is a lot of them are out there to help and are eager to help. >> thank you. >> and actually that trigger as follow-up if i can. there have been stories in the national press the last couple of days describing the outreach effort that the administration is involved in as, what, low-key i guess was the characterization and, and being done with fewer resources. i wonder whether you think those are fair characterizations and how are you trying to maximize the impact that you have? >> i would say that now that we are, we have one year of the outreach under our belt, we learn from it. we're smarter because of it. we can target. we have relationships that were established last year, that we can continue to utilize and leverage and build upon. and, in my presentation i
mentioned that one of the messages that works very well are testimonials. we have seven million testimonials. we have seven million people who obtained coverage through the commonwealth fund report who are satisfied with their coverage. these are additional resources that we have this year we didn't have last year we hope to leverage in conjunction with all of our partners. >> okay. >> thank you. >> carl schmidt with aids institute. i have a question about transparency in formularies. you talked about the benefits, hopefully this year the transparency in providers and in your letter to issuers for 2015, you said that there would be, every plan has to have a formulary with tiering. one url and also on healthcare.gov website. so i've been using your great function this week, the shopping
function. and some are really good. some were good last year, some of the plans. but we're still finding a lot of them just go to their main website to get the formularies and we still can't find them. they still have 2014. and there is a, a better summary on the health reform, healthcare.gov for each plan, for more plan information. none of them i've seen have the formularies yet, na, i guess that means not available. i guess the question is, has this practice, this letter to the issuers, are you still going to be mandating that? we hope so because patients really, to make a choice, to have to get this information. i was able to ask someone from hhs the same question yesterday. they said, well it is up to the insurance companies as well. i would also ask you. they said they are the one who is provide the information to put it online and you did talk about the need for transparency.
that is very important to consumers to shop that transparency. i will also add that i had the pleasure of working at 88 s on the part d program. i headed up several implementations and it was a challenge to get things to where they are today and we have seen in states where they tried to put too many bills and whistles on their platforms, things didn't work. so just like in the part d experience which worked very well today we will see continued improvement in terms of what new features they will bring in overtime just like happened on part d. it was a work in progress and will only get better. >> i would echo transparency is very important, that is something we will continue to
work on. >> your presentation mentioned ahip has been making a deck of dealing with plans in the area of provider directories. we have been doing some programming on their own networks in which the question has been raised about directories that are out of date, providers that were in the directory accurately but were stricken from the rolls in mid year without the opportunity for the consumer to get out of that. talk able if you would about steps you have been taking and how much progress there has been? >> there has been a lot of progress. our plans are committed to transparency and we are committed to making sure consumers know what they're buying and configure out of their physician is in the network for the plan they are purchasing. right there on healthcare.gov you can go to the directories
and keep those directories up to date but there are challenges here. it is a 2 way street. providers have to engage in this as well. we have situations where some providers stop -- they form the plan. unless we get accurate information from the providers. that is critical so there is a role for providers to engage to make sure they are up-to-date as well so health plans and labor them in terms of who is in the network and who is not. >> part of what people need to decide is whether to switch in and out of their silver plan if it is not the second plan anymore and the critical piece of that decision is whether the providers are in the network.
and so having that information correct is the really important part of the competition aspect so we don't know yet how that is all going to play out, how many people are going to switch that people who need that information to make informed decisions, knowing whether the same network is available. >> an important point, and just last month we put a consumer guide to networks out that you can find on our web site. we put a lot of time and effort, literacy experts and consumer groups, it is a helpful guide and education will pull that consumers can use when they navigate different planned network configurations and provide the kind of information they need to make sure they are making the right price and will continue to focus on transparency because consumers have to know what plant is best for them.
that is the whole part of value and making sure consumers get the care they need. >> i would at the national association of insurance commissioners is reworking its model lacked on network adequacy which includes addressing the question of provider directories and they have been holding two hours of conference calls every week which i think is unprecedented in my experience so i think the state regulators who are ultimately responsible for this are very aware there is an issue that needs to be addressed. >> commercial alert, the alliance will be holding webinars to look at the soon-to-be actually in draft form already has been released new model regulations that the n naic is developing in the area of neural networks. that is on the eighteenth.
the nineteenth. you will be getting a notification suit. go right ahead. >> i am an attorney, my question builds upon several questions and specific to consumer confusion and entertaining costs as it relates to the tax credits they have been given so as mr. joe mentioned the supreme court did grant this issue, you and i and many educated consumers understand what that means in terms of impact on the decision and when it will take affect many other individuals may think that means i don't get a tax credit in addition to the fact that the data they had with regard to their taxes may change so i was wondering what the efforts word that had been made to address the specific issue. >> i think there are representatives of the media in this room and i hope they get
this message out. the effect is going to be perspective rather than retroactive. people should go ahead and enroll. as to what the supreme court will do i am hoping obviously it they conclude the irs is properly interpreting the statute and that solved the problem. if they don't, there are a very serious problems that face not only millions of americans who receive premium tax credits now and it would lose those, but really the non group marketing in two thirds of the state, we could because of all of the carry on ramifications of this decision, it is not just low income people, but moderate income people losing access to health insurance. it is for originally anybody who purchases health insurance that they don't get through their employer or dental program and it is very important that people
understand this is very serious business. there is no easy fix. the administration has properly interpreted the statute that the supreme court disagrees is going to be a national crisis which congress will have to fix. >> follow-up on that, i will ask him to comment on a lot of talk about states if the decision were to go in favor of the plaintiffs, states could have similarly operating exchanges could set up their own market places. >> how much time do we have? in the first place, it would take legislation. it would take some states, could be done by executive action and a few states in which that has already been done but states would have to affirmatively embrace setting up their own exchanges for that to happen.
secondly, under current regulations, a state has to give the federal government six months notice before it sets up a state exchange and under current guidance it has to do it by the first of may and have it approved by june 15th. if the supreme court delivers its decision by the end of june, it would be 2017 before states get state exchanges on line. states have to come up with funding, they would have to appoint a board, they may or not may not be able to contract with the federal website but the exchange is a lot more than a website, it is a navigator programs edifying plans. it is a heavy left. and have the lift that may demand a serious political commitment which i think is not there in quite a number of states. so again, i think that if the supreme court decides this case in favor of the plaintiffs which i hope it won't, it is going to
mean massive disruption of the insurance markets that is not easily fixed. >> thank you, thank you. national center for policy analysis, you had 7.3 million, the november 10th report said 7.1 at the end of october. it was 8.1 so the first question is where those million people go who left the exchanges and the second question is related. the network adequacy. how confident should i be when i sign up for 2015, the network gives me now will be exactly the same through 2015 or will doctors get fired or dropout? thank you. >> some of them may die.
>> what are you going to do about that? i think the reduction is pretty obvious, that any insurance company will have patrician over a year and 90% retention rate is pretty good. and also, you have people who get a job, employer coverage, they get medicaid there is the huge turnover over the course of the year and i was surprised to have 7.1 million in and new people coming on too but that was a very good retention rate and in terms of providers that is a problem now with employer plans too, it is a problem with any network and you can't be sure that your doctor is going to be fair. >> i would just add the.1 million and the 7.1 is not the same group of people.
insurance is dynamic. people come in and buy, people get married, people get divorced, have children, get a job, any number of reasons could lead to a natural turn in the marketplace. not that you have a.1 million people left a new end up with 7.1 million because the composition could be different because of these factors. that is the one point il look at. >> i want to follow up on that question too, what we are projecting this year to understand, you mentioned the numbers that people are expected to enroll and what the total number would be an estimate of 9 to 10 billion this year and by wonder if you could talk a little bit about what that means. >> since we have had experience from this past year there was data that could be used to look at all the markets so you have
people who are currently enrolled, people who would come in as newly enrolled and for the newly enrolled we take the experience from this past year in terms of pickup rates, percentage of people with various characteristics that took coverage, to be able to get a sense of how many people may coming, newly enrolled and from the rear and rolled population there are several estimates out there including issuing the industry and able to use that to get a sense of how many people are in the marketplace would stay in the marketplace and those two figures together give kind of a bottom up approach to give a sense of what may we be expecting this year using data that was not available when an initial cbo estimates were done. the other way to look at it is you have a market that is
growing and there's a ramp up associated with the growth of any market and from experience with the medicaid expansion if you move from a ramp up of three years to five years, that leads to a different trajectory and to each of those approaches lead you to the same place in this 9 to 9.9 million range. >> as you all are aware of the open enrollment last year went among the state run exchanges went better in some states than in others. in connecticut when treadwell. in maryland not so much. i wonder if panelists could talk about particular stage they might be looking at.
>> it is better than oregon. etna i picked up connecticut somewhere. i clearly see improvement. we will have to see. >> the panelists might want to address, it was a real enrollment process and i wonder more broadly what the application of the principle is, and that is is that enrollment process going to look this aim in a state operated exchange. and used auto enrollment? tim was describing the sequence of how and when one would have
to enroll what is automatically read and rules. how many federal rules apply to them? >> stake exchanges can do their real enrollment differently, basically in our regulation, on this issue states can provide their information on how they would like to do it. >> okay. some states as you said earlier, everyone is going to be enrolled. >> gin or again. >> a question for the audience about what contributed to what we are seeing in premiums this year. why is it that premiums have increased moderately or gone down in states and what do we
think is driving that, those changes? even if you look at employer based plant and look more broadly we have seen not much greater moderation in premiums on the employer based plans. would you like to address that? >> there are a number of underlying influences when it comes to premiums and i talked a lot about it in my presentation, in areas where there is substantial provider market consolidation, and to negotiate better rates for their consumers you tend to see a correlation in those areas where there isn't market competition among hospitals you have higher premiums, and that situation has to change before going to deliver the value to consumers. that is part of the equations,
goes to the underlying cost of care. similarly with prescription drugs, we look at small the -- plans had to submit their filings and rates in the spring of 2013 and they were locked in, came out of the market very late in 2013 and so when plans set their premiums they had no idea it would be priced at $1,000 a pill and they didn't have in their pharmacy budget because there is no transparency unlike health plans, they have to submit their rates for review and there is back and forth before they get approval. there is no such thing for prescription drugs and you don't know the price, our rates are set well in advance, very transparent process so that also has a significant impact and with the pipeline even more.
so you have the underlying costs of care that contributes and you also have a competitive marketplace and health plans are competing, they're competing based on value and the value comes from low-priced high-quality and that is why we have a choice in this marketplace because competition helps consumers and you do see variation by state, variation within the 501 market areas across the country because of these different factors that go into premium rate setting. >> i follow-up and ask how important the risk adjustment and the risk -- the three ares, reinsurance risk corridors and risk assessment provisions have been at keeping premiums moderate this year. >> they have been very important
and quickly the reinsurance program provides reinsurance for any plan in the individual market. the risk adjustment program, resources from plans that end up with low risk population to those with high risk population and the reinsurance provides of why we owe so that if one plant gets the premium one way they may either compensate or become compensated by plans that got their premiums in the other direction, dan said this, health plans were thrown a dart at a wall. they didn't know what the population would be that would show up and would end up securing and some big commercial, we have a number of big commercial center in watts of markets, that is increasing competition, and some premiums
were too low last year or raising those, tremendous amount of movement in the market and is again very important for consumers,. >> again on the coverage numbers. >> roughly and rolled through medicaid, later slide suggest only 10 million newly covered individuals in the new england journal reference. what happened to the 6 million people were they previously insured and headed to the roles of the uninsured? can you fill in the blanks on the coverage? >> part of it is the 10 million number is not as recent as the other numbers that i provided. but various aspects of the
insurance market when you include employer sponsored coverage, probably just that there is a difference in the timing of the numbers. >> it would be accurate to say 16 million people were benefited in terms of acquiring coverage? >> more than 16 million people benefit because the consumer protection provisions, and it is kind of -- a number of people enrolled in the marketplace, the one and only measure for success for the affordable care act much broader than that and looking at the drop in uninsured is important and takes into consideration there are many other ways they are obtaining insurance as well. >> asking people with both marketplace plans, newly
enrolled medicaid, and at health-insurance before them. that gives you a sense, and health insurance. >> another good point, some people have insurance before. >> some people shifted from individual. some of the data shifting from employer based plans. in the open enrollment period, in the open enrollment period for their employers, may be looking at whether they are paying a lot in their employer based plans and check out the marketplace. if they could pass before a tax credit if they're paying too much of their income you might see some shifting from employer
based systems in this open enrollment period. >> ten minutes left and we will get to as many questions we have in front of us as we can. don't think we will succeed in getting to all of them. if there's something you have to have, might want to repair to one microphone. let me just turn to one of these questions. a lot of commentators, can mentioned it as well, have suggested what happened last year was fairly large enrollment of people who were motivated to get insurance for one reason or another, the famous low hanging fruit. you might want to describe what if anything it's a chess is doing to convince those middle hanging fruit people that they
need to enroll as your 2 begins. >> with our very active outreach program, i think there are many people out there who are eligible for premium tax credits, who may be in plans and may not realize what opportunities are available that we can reach and so it comes back to the points i made last -- previously, the we are working closely with our partners, with local media, radio, tv, digital media, and also reaching out across provider groups, churches, any number of community organizations, i think having had the experience of the first year and having a lot of people who are enrolled or happy with their plans help to get more
people who may have been reluctant or hesitant or doubtful to see there are people who were able to get quality coverage and that is a very strong message as well. >> i wonder if the message is going to include at any level whether it is with your parter is or the work you do directly, about the sticks as well as the carrots. we were talking to a member of congress yesterday who pointed out that the penalty -- that is not the proper term, whatever the fee is. was not going to go to $95 but a maximum of 2% of the person's income. and if that word is getting out to people as a way of convincing them they need to look seriously about getting insurance for the
first time. >> one thing i would say on that, congress intentionally wrote the statute so this would be an educational process. the first year you get a little tapped next to a much bigger tax and by the third year a pretty big tax. but people are going to get to january and start working on their taxes and suddenly going to realize in february or march or april that novel lead to a $095 or 1% of their income for this year but they will also $0,325, almost $1,000 per family. or 2% of their income above next year. however, and in february 15th, people would not have a way without a special enrollment period. i think h h s has the authority
to declare a special enrollment period for people who are going to know the penalty for next year or who owe it for this year and to leave that open a bit longer. i don't see how that would hurt anybody and i think it would be a way to bring a lot more people into coverage. >> something to consider? your deliberations that the department? >> yes. >> independent consultant. you answered half of my question. the irs is going to motivate a lot of low hanging fruit the way the law is designed. a lady in my church looks to me to be a sort of the navigator. i know a little bit about health policy and she works for h&r block and hasn't received any guidance about this penalty or this thing she is supposed to deal with and i wondered how is the irs going to deal with that on two grounds? one is you already talked about
it might be easy on people but there's a certain disclosure element. is there a box i am going to check to declare if my coverage is credible or whatever the word is? how is that enforced? certainly i will make a lot of mistakes. lot of people make mistakes one way or the other. what do you mean by this coverage? how are they going to enforce that and put the wrong information in and what business would i'd be penalized? >> the forms are already online and instructions are online. ..
they're going to be major players in helping people understand how this works. they and jackson hewitt and turbotax and other people. but it's not easy. and the first year it's, a lot is going to be taken in trust because we don't have employer reporting in place yet and they're some other issues. >> how about health plans? to the of and responsibility to notify their policyholders that, yes, the insurance that you get from us qualifies you, is a qualified health plan and meets the requirements of the statute? >> that comes from the exchange so that's the exchange responsibility. >> i.c. sara? >> i've a question on imagine how important deductibles or in my presentation, that people should pay attention to what the deductibles are like.
will consumers have access to the information that they need about the implications of co-sharing provisions of plans available on the exchange is? will you be able to tell which are potential out of pocket costs might be over the course other than say the simple deductible or co-pay? >> one of the provisions of the affordable care act made requirements on the summit of benefits in coverage that health plans must provide, and then that they have to provide certain coverage examples that details out what our kind of the costs you could expect and with caution in the plan that you're considering what which are out of pocket cost the. >> shout out to the d.c. exchange. our operations director was poignant to me this morning to have a couple very good examples in their materials of just what you were describing. you know, how much is going to cost if you have a baby in this
period? how much is going to cost if you are managing type two diabetes, that sort of thing. it is very helpful to the people in our office in trying to decide as they did. we've come to the end of our time, and i apologize to those of you who have britain some very good questions though we haven't had a chance to get to, but there are a lot of questions in this area and we will try to keep up with this debate as it goes on and try to schedule programming that might be able to answer more questions. in the meantime, as you are putting on your winter coats to go outside, also take out the blue evaluation form and fill it out if you will, to give us some feedback. thanks to commonwealth and sara for helping us put together in being part of a very useful program. and i would ask you to join me in thanking the panel for a very enlightened discussion.
[applause] [inaudible conversations] >> the senate yesterday voted against and administered backed bill to overhaul the national security agency's surveillance programs in the 58-42 vote. too short of the 60 new to advance the bill. is amended it would have admitted the patriot act to store america's phone records.
>> 2013, the country learned that the government specifically the nsa had been collecting and storing enormous amounts of information about american citizens. and that the data collection at issue was not limited to those are actually suspected of terrorist activity or even necessarily to those who were connected to those suspected of engaging in terrorist activity. many were understandably very concerned about how much and what kind of data was being collected and whether or not this information could be or have been abused by government officials. to date, proponents of the metadata program claim that it cannot be used to identify ordinary american citizens. but earlier this year researcheresearche rs at stanford university proved that the very type of metadata collected under section 215 of
the patriot act could be used to uncover a lot of information including information about a person's politics, about what kind of medication they might be taking, about where to go to church and so on and so forth. this u.s.a. freedom act is a bipartisan piece of legislation that would invoke a data collection of the metadata currently gathered by nsa. it would help address the problem of the american government spying on its own citizens without cause. it also would improve the transparency for the data that nsa does collect. it has the support of leaders in our intelligence community, the department of justice, civil liberties groups, the national rifle association, and a whole bunch of tech companies. opponents it will impair our national security. they say this bill will keep our intelligence community from protecting us.
but what opponents of this bill failed fully to appreciate is that most americans are deeply, deeply concerned about the collection of their own personal information. this bill is an opportunity to strike a reasonable, prominent balance between protecting americans privacy and at the same time protecting our national security. while i believe that the are honest, decent people working in our intelligence community, and this is the norm, the overwhelming own, i think it's important for us to heed a warning given to us centris ago by james madison. in federalist 51 james madison wrote if men were angels, no government would be necessary. if angels were a government, neither external nor internal controls on government would be necessary. in framing a government, which is to be administered by men, over men, the great difficulty lies in this. you must first enable the government to control the governed, and the next place,
and control itself. congress should address this issue now. the provision of the patriot act authorized this kind of data collection expires just after memorial day this coming year and it's important to adopt a compromise well after this deadline that all interested parties can set. thank you, madam president. >> i thank the distinguished senator from utah has worked so hard on this. it's been more than a year since americans first learned the government had been secretly sweeping up the telephone records of innocent americans, whether there's any connection to terrorism or criminal activity. i introduce the original u.s.a. freedom act last october with the republican congressman jim sensenbrenner. the judiciary committee held six hearings, public hearings to address these issues. we learned that the bulk phone records had not as previously
advertised afforded 54 terrorism plots or even dozens or even a few. in fact, we learned through our public hearings after all the talk about we needed this because it afforded 54 terrorist acts, it may have possibly help on one. now, that is an important fact for those who now argue the nsa bulk phone record program xml essential to fight isil. it did nothing to stop isil in first place. it enhances privacy protections. it ends indiscriminate data collection. but it keeps the tools our intelligence community needs to protect our nation. that's important to remember and that's what our intelligence community strongly supports this
bill. i worked in law enforcement or i'm a native of vermont with the right to privacy is cherished. i know we can of both liberty and security. the u.s.a. freedom act provides the commonsense reforms to government surveillance. it promotes greater accountability and transparency in the government surveillance programs, improves the fisa court. it's a carefully crafted bill. it builds on what the house of representatives did. it has the support of the director of national intelligence. the attorney general, the director of nsa, american technology companies, the privacy and civil liberties groups across the political spectrum ranging from the nra to the aclu and tech freedom. lawmakers from all parts of the political spectrum from the right to the left support this bill. they know it is a reasonable, responsible compromised. no reason why we shouldn't continue on it. there are some members who want
parts of it and that's fine. let's have the votes. let's not block this bill and say, well, we wanted something better. that means you still vote yes, you don't vote no, you but maybe. let's have him some relevant votes and let's vote on them. don't let this get bogged down in procedural flimflam that the american public hates, as germane amendments and vote them up or down. and don't wait till next year on this. both the aclu and the nra pointed out, every day the senate fails to vote on these reforms, a day in which law-abiding citizens have reason to fear that the constitutional protections so dear to the factors and so crucial to the functioning of our free society no longer apply. at going the words you heard
from the center of utah. another day we act as an of the american businesses are harmed. one conservative think tank says it is the mistrust engendered by the nsa's programs could cause the u.s. technology industry between 35 billion, and 180 billion over the next three years. that's a staggering amount. asked the director of national intelligence, he will tell you, far better for national security and for our fight against terrorism if we pass this. so i thank the senators for their support. thank the majority leader for bringing support. takes center dean heller and mike lee and dick durbin and al franken, richard blumenthal for their help. and i ask unanimous consent for the statement of administration policy the support of this
u.s.a. freedom act as well as other items of support be printed in the record. >> without objection. >> i yield the floor. >> i would yield three minutes to the senator from florida, senator rubio. >> thank you, mr. president god forbid -- is in the united states and federal agencies need to determine who this person is courting with to carry out a potential back within the homeland. one of the tools were used as a tool that allows them to see people have been calling and interacting with so we can disrupt that sell before they carry out horrifying attack that can kill millions of people. today were able to do that because of a program that collects those records and keeps them. not in the hands of anyone is looking at them on irregular basis that keeps them readily available to the government so the government can access those records and disrupted a plot. what this bill would do is take a partner it would innocent ask companies to keep those records in the hopes that they would but
under this plan if this were to pass if we're to go target these numbers of isil and find out who they are coordinating with, those records may not be there. that would be horrifying result. here's why this doesn't make sense. first of all we are rushing us to the floor of the senate and the lame-duck session on an issue that doesn't even expire until next year on a pillow wasn't even listen to heard to any committee, and they cannot cite a single example of this program ever being abused. not one simple example of the specific program being abused by anybody intentionally. not one. we're dealing with a theoretical threat. the second thing is even as we speak law enforcement agencies investigating a common crime don't even need to go to court to access these very same records. they can issue an administrative subpoena and get a hold of them. we are making it harder to go after a terrorist and it will be to go after a common criminal. this is happening at a time when
homegrown violent extremism is the single fastest growing threat to the united states. people there at over been radicalized even on the internet and people travel to the middle east and been radicalized in hopes of returning and carrying out a taxi. i would hope this body would take more time to study an issue of this magnitude. because this program was designed to address what the intelligence gaps that existed after the 9/11 attacks. because i promise you if god forbid in horrifying event like that were to happen, the first question we would ask is why did we know about it and why didn't we prevent it? if this program is guided we will not be able to potentially know about it and will not be able to prevent it. >> this program does not got it. in fact, it enhances it. secondly, if this was important to stop isil, isil never would have started. the fact is we have this program way beyond anything anybody is talking about today.
it didn't slow up or eliminate one iota of isil. that is, that's a strong and we shouldn't have to. it has no effect on the everybody has read the intelligence knows that. i yield three minutes to the senator from connecticut. >> the senator from connecticut. >> thank you, mr. president. i want to begin by thanking our very best in college, the chairman of the judiciary committee, senator leahy for his leadership on this issue. my colleague whom he has named who have helped in drafting and crafting this very important piece of legislation, and to my friends and colleagues across the aisle, like the senator from utah who have supported and helped to make clear that this bill advances the cause of
safeguarding our nation without anyway detracting from its central operational intelligence capabilities. in fact, national intelligence director clapper has said, and unquoted, the bill will retain the essential operational capabilities of the existing bulk telephone metadata program while eliminating bulk collection, and, of course. this bill -- end of quote. this bill has confidence and credibility of our intelligence system. it advances that trust and confidence in the capability of government surveillance to do its job but at the same time protect our vital privacy interest. it advances the cause of constitutional liberty and the appearance and perception of trust in that system. and it does so by making the
foreign intelligence surveillance court look-alike and function like the courts that we are accustomed to seeing issue search words in the criminal process and protect essential liberties. more than just the government's version of the facts of law are presented to the foreign intelligence surveillance court. it doesn't by providing for a pallet review just like we have a normal civilian court. and it does it by increasing the transparency and accountability of the fisa court system. our founders would have been astonished and appalled to learn that we permit warrants to be issued by a secret court operating in secret issuing secret opinions, making secret
law, much like the star chamber did, that's why this reform is so profoundly and historically important. because we make the fisa court one that we can more aptly and abundantly trust. one that will have credibility and confidence. i support this bill. i thank my colleagues for showing that we can work together in a bipartisan way to safeguard the essential rights of americans at the same time that we protect and preserve our national security. thank you, mr. president. >> mr. president? >> the senator from california. >> thank you very much mr. president. i would like to speak to this bill and i would like to say that this is one of the few times that my vice chairman, the distinguished senator from georgia, and i have a disagreement. i very much support this 215 program.
the intelligence committee i think in a year has had maybe 12 hearings on this subject. many people think, well, we are using this program all the time. in fact, in 2013 we used 288 queries, and those queries went, 12 of them, went for a probable cause war and. in fact, you cannot collect content in a query. it is just the metadata. then the next problem has been, well, the government shouldn't hold the metadata. and this essentially is the big change that this bill makes. we voted out of our committee by a vote of 12-3 of fisa reform act. however, that bill is not going to pass in my judgment. may i ask that my time be extended, please? >> without objection. >> thank you very much.
i talked with the house, and here's what i got. if we didn't pass the house bill, yet there were members who wanted to end the whole program. i do not want to end the program. i'm prepared to make the compromise, which is that the metadata will be kept on the telecoms. senator chambliss and i wrote a letter to the four big telecoms and we asked them if they would hold the data? the answer came back from to, yes, and educating back from to, no. since that time the situation has changed. not in writing but my personal testimony from two of the companies that they will hold the data for at least two years for business reasons. now, here's the problem. the mandate was inherent in the 215 at is gone. at the fact is that the telecoms
have agreed to hold the data. the president himself has assured me of this. if we do not pass this bill we will lose this program. senator rubio sits on our committee. i listened to with interest the i agree with him in what he has said about isil and others that will come after us if they can. and the only protection we have essentially to disrupt the plot before becomes our reality in this country. and the program is not widely used as the 288 queries in a given year would indicate. additionally, in this bill, and this should i think be a satisfaction to a number of people, the fisa court would have to approve a query before that query takes place, rather than after the query.
so i'm prepared to support the bill, and they do so for very practical reasons. because without it i believe we will not have a program. so this is hard for me because i have a great committee, and i've tried to be supportive of those things that come out of our committee. i've talked to senator leahy. i said the one big problem i have is the foreign intelligence surveillance court is upset with the language. he has said we will change the language. senator blumenthal as an amendment which i assume will pass which does change the language and the major objection of the court, i believe, is ended by this language. if that's the case and the telecoms agreed to hold the data and the data is not held by the government that is held by the telecoms, i believe that solves
what is a very practical problem. so in any event i have agreed to support it come and i thank the chair and i yield the floor. >> how much of time on the other side has been used in? >> the senator from vermont has 30 seconds remaining. remaining. >> how much time do i have remain? >> six and a half minutes. >> i've only had one speaker and i had 15 minutes. did he use seven and a half minutes, eight and a half? >> the chair was instructed that the senator from california spoke on the senator from georgia is time. [inaudible] >> well, i would ask unanimous consent that the time that the senator from california used be added to my time for his.
>> is there objection? >> mr. president, reserving the right to object i would not object. i was going to yield the remainder of my time to the senator from texas, senator cruz, and asked that he be allowed up to four minutes. >> i would object to the. he can have your 30 seconds. >> and i will object to the request. [inaudible] >> i will not object to the request but i will yield the remainder of my time to the senator from texas. and i'm sorry the senator from georgia would not offer me the courtesy spirit the senator from georgia, without objection. >> i would recognize the senator from maine for two minutes. >> mr. president? mr. president? >> the senator from maine. >> thank you, mr. president. we need reform of the nsa programs, but not in this manner. let's remember why this
intelligence tool was put into place. it was enacted in the wake of the first terrorist attack in our country that took the lives of nearly 3000 people. and we have testimony from the former director at the fbi, from the former deputy director of the cia telling us that had this tool been in place, it is likely, most likely, that the plot that killed nearly 3000 people would have been uncovered. why would we weaken the ability of our intelligence community at a time when the threats against this country have never been greater? and let me address to my colleagues the privacy issue that has been raised. an issue that all of us care
about. this data, these data are far more safe, far more subject to privacy protections if they are held by the federal government were only 22 decades and trained government employees have access to them. instead, of nearly 150 telecommunications companies that employ thousands of workers, and the government is going to have to go to those companies and asked for the data. that greatly exposes the privacy of individual americans far more than the current system. so for both of those reasons i urge my colleagues to oppose the distinguished senator from vermont's bill.
it is a mistake. it would make us less safe, and we have expert testimony telling us that. thank you, mr. president. >> mr. president, i yield to minutes to the senator from indiana, senator coats. >> the senator from indiana. >> mr. president, i regret i just have to minutes. it's unfortunate something that has this consequence for americans is being debated in a limited time session here. we have t two bills. one produced by the intelligence committee written and supported by the chairman, a democrat from california, and by vice chairman, the republican from georgia. and it passed on a bipartisan measure with more than a three to one ratio. and here we are trying to go forward allowing only one vote on one bill. why do we have to rush this through in a lame-duck session we did have such consequences? and when the director of the
agency that oversees this can when asked in a public session by make him one of the ultimate consequences of this, his answer was, a compromise of our ability to detect terrorist attacks and the consequence will be americans will die. and when that happens, and those of us who go every to into the intelligence committee to know what the threat is, and it's greater than it's ever been, understand that it eventually something will happen here and people turned to us and said, do you have it didn't get every possible to place to prevent some happening? why didn't you? lets him have another repeat of 9/11 were the commission incomes to us and says, get the tools that you need. it has been so mischaracterize in terms of what does and doesn't do. even as i talked to my colleagues didn't have a full understanding of what it doesn't do. it has more oversight -- >> debating the bill on government surveillance which failed to pass. we have to leave the debate that
you can buy an income online. take you in live now to the fore of this as lawmakers begin a period of general speeches and later expecting work on a series of judicial nominations. yesterday a bill to begin construction of the keystone xl pipeline fail to passed by one vote, 59-41. now live to the senator on c-span2. the chaplain: let us pray. eternal god, we acknowledge today that without your protection, we labor in vain. give rest to the weary and joy to those who work for liberty. lord, use our senators to join you in bringing deliverance to captives
and sight to the morally and ethically blind. grant that our lawmakers will focus more on donation than duration, as you remind them of their accountability to you. may looking to you for help become their first option. we pray in your marvelous name. amen. the president pro tempore: please join me in reciting the pledge of allegiance. i pledge allegiance to the flag of the united states of america and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. the president pro tempore: the majority leader. mr. reid: i ask unanimous consent that at 3:00 p.m. today the senate proceed to executive
session and vote on cloture on executive calendar numbers 9 # # -- 928, 930, 1032, 1034. if cloture is invoked on any of these nominations that on thursday, november 20 at 2:00 p.m. all postcloture time be expired and the senate proceed to vote on confirmation of the nominations in the order above. the presiding officer: without objection, so ordered. mr. reid: thank you, mr. president. i would also ask consent that we had some nominations where cloture was invoked last night. further, that there be two minutes for debate prior to each vote and all roll call votes after the first vote in sequence be ten minutes in length. further, with respect to the nominations agreement that if any nomination is confirmed the motion to reconsider be considered maind laid on the table and the president be immediately notified of the senate's action. the president pro tempore:
without objection, so ordered. mr. reid: mr. president, i ask unanimous consent that following the cloture vote on executive calendar number 1034 the senate consider calendar numbers 596, 66, 1044, 1045 and 1056, that there be two minutes for debate equally divided between the two leader or their designees prior to each vote and upon the use or yielding back of that time the senate proceed to vote with no intervening action or debate on the nominations in the order lists, that all roll call votes be ten minutes in length and that the motions to reconsider be considered made and laid on the table with no intervening action or debate, that no further motion be in order to the nomination, any statements related to the nomination be printed in the record and the president be immediately notified of the senate's action and the senate then resume legislative session. the president pro tempore: without objection, so ordered. mr. reid: mr. president, we expect these nominations that i just listed to be confirmed by voice vote. mr. president, following my remarks and those of the republican leader the senate
will be in a period of morning business. during that period of time senators will be allowed to speak for up to ten minutes each. the time from 1:00 to 2:00 will be under the control of the republicans and the majority will control from 2:00 to 3:00 p.m. there will be an all senators briefing on isis at 4:30 p.m. this afternoon in the regular location. mr. president, i'm glad for a few minutes the president pro tempore is here in this body and presiding over the senate. mr. president, for years i've heard from senate republicans they simply wanted to do some ledges -- legislating. they were tired of being shut out of the legislative process. they weren't able to debate and offer amendments. mr. president, they assured the american people they were wholly dedicated to robust debate on the senate floor. yesterday a bill that was
bipartisan in nature and came out under the auspices of the chairman of the judiciary committee after actually years of consternation, debate, and just work by so many different people, came to the floor. mr. president, that was blocked yesterday, blocked from even having a hearing here on the senate floor. that's really wrong. this is a very important piece of legislation. it protects americans' rights to privacy without sacrificing u.s. intelligence, community's ability to gather information. i also say through the chair to my friend, the president pro tempore of the senate, it doesn't matter if you agree with the statement i just made or not. maybe some people disagree with
this legislation, and certainly there are people who disagree with it. but shouldn't we at least be able to debate the issue here on the floor? doesn't legislation of this magnitude merit the senate's consideration? yet, yesterday we were shut down once again, as has been going on for years, before we even got started. they wouldn't even let the senate debate this very important piece of legislation. we were ready to legislate in good faith. we've been ready for the last four years. we've been prevented numerous times from doing that. the republican leader and his caucus will have to do more than just pay lip service to an open bipartisan legislative process. at some point they must practice what they preach. maybe that will be the case come january. mr. president, last night just after the vote on keystone i heard the republican leader say he'll bring this same legislation to the senate floor early next year. so we look forward coming to
this floored early next year, and i would hope we can have an open amendment process and have a debate on that legislation, that the republican leader for months on record has wholeheartedly endorsed. and i really feel very bad that the chairman of our judiciary committee has worked so hard during the -- when we were in recess we talked several times about the importance of this legislation and how we're going to try to move it forward, and we saw yesterday we aren't going to move it forward even without a debate or vote on anything. that's really too bad. would the chair announce the business of the day. the presiding officer: under the previous order, the leadership time is reserved. under the previous order, the senate will be in a period of morning business with senators permitted to speak therein for up to ten minutes each.
mr. leahy: mr. president? the presiding officer: the senator from vermont. mr. leahy: i appreciate the kind words of the majority leader. of course he and i have been friends for decades. he worked with me all the way through on the efforts of the n.s.a., spying bill, u.s.a. freedom act. we knew that we had cosponsors, republicans and democrats, went across the political spectrum. it was an effort to do what was best for america and do it at a time when we would not be under urgent deadline. most of the things that we remember amending expire on july 1 of next year. and we had a piece of legislation that began in the
house of representatives by a republican chairman. we added to it here. very clear signal to the house of representatives if we passed it in the senate, they would have taken it up and passed it and we would be exercising something that would improve not only the security of americans, but also the privacy of americans and our individual liberties as americans, and we'd do it not under a deadline. so it's unfortunate that last night there was the partisan effort to stop it and an effort to, actually some of the worst fearmongering i've heard on this floor in 40 years. but i said i would thank the distinguished majority leader for his steadfast support.
mr. reid: mr. president? the presiding officer: the majority leader. mr. reid: i reason i feel -- and i made my remarks regarding this senator from vermont, there has been no one in modern history who has done more to protect the civil liberties of people than the senior senator from vermont. this legislation was drafted toward that effect, to make sure that we were able to do the necessary work of this country as it relates to what is in this bill. but also to protect the liberties of americans. i have such admiration for my friend from vermont from his work on land mines who at the time he started this conversation on land mines he was it. but of course there's now people all over the world who are
following his lead on the many, many people who have been killed, thousands of people, thousands. and as we speak still being killed with land mines from wars past. so the fact that we weren't able to get to this legislation does not take away in any way from the legacy of this good man who has done so much to affect the individual liberties of people in vermont and everyone else in the country. the presiding officer: the clerk will call the roll. quorum call:
mr. mcconnell: mr. president, are we in a quorum call? the presiding officer: yes, we are. mr. mcconnell: i ask consent that further proceedings under the quorum call be dispensed with. the presiding officer: without objection, so ordered. the republican leader is recognized. mr. mcconnell: mr. president, i rise this morning to celebrate the life and mourn the loss of a soldier from kentucky who died while serving in uniform. private first class joshua a. gray of van lear, kentucky, lost his life on february 10, 2014 at bagram airfield, afghanistan, from a noncombat related incident. p.f.c. gray was 21 years old. for his service in uniform, p.f.c. gray received several medals awards and decorations
including the army commendation medal, the army good conduct medal, the nato medal, the overseas service ribbon, the global war on terrorism service medal, the afghanistan campaign medal, and the expert marksmanship badge. josh's life may have been tragically cut short but it was full of promise. he excelled as a student. he scored a 34 out of 36 on the a.c.t. standardized test in high school putting his score in the 99th percentile. friends and teachers from johnson central high school where josh graduated in 2011 remember how very bright he was. josh was a very high-end student. he was an amazing kid says john robinson, one of josh's teachers. he was very super smart. he was always looking something up. he always had this thirst for
knowledge: computers, math, science and technology. he was always more than willing to do work. he often came to me with questions or answers. josh's fascination with computers led him salvaging an old massive i.b.m. server that he brought to school to tinker with. john robinson remembers the unit was so heavy, it required two people to carry it. he was carrying it around like it was nothing, john says. he left it here. i still have it. josh was known around school for carrying something else around. mr. waddles, his stuffed penguin and constant companion. though josh carried the stuffed penguin at first for laughs, it soon became his trademark. he took mr. waddles everywhere with him says tim adams district operator for johnson county
schools. it startd off as a joke but then it just caught on. mr. waddles became part of the class. josh participated on the johnson central high school academic team and the skills u.s.a. team, popular with his classmates, he was also named prom king and voted most unfrettable by his senior -- unforgettable by his senior class. he could have done anything with his life. he was one of the most brilliant people i've ever met and service is what he chose to do and to give his life. this is why it is so unfortunate says lindsey patrick, a classmate of josh's. joshua is musically gifted as well. his former music teacher remembers josh's musical talent. he was in my violin fiddle class, she says. he never wanted to learn to read music. instead, he sinced on playing his music by ear. he never actually needed the sheet music. he could just listen to the song
and play it. josh joined the army in november of 2012 and was assigned to headquarters and headquarters battalion 10th mountain division out of new york as a satellite communications systems operator and maintainer. he deployed to afghanistan in support of operation enduring freedom in january of 2014. josh's funeral was held at johnson county middle school, burden rid with full military honors in staffordsville in johnson county. so, mr. president, we're thinking of josh's family as i recount his story for my senate colleagues, including his parents, setting william gray and rob ingray, his brother dustin, his sister dalaney, his grandparents, his paternal grandmother, irene gray, and
many other family members and friends. private first class joshua a. gray was a bright man who could have done many things. the fact that he chose to serve his country in the united states army is a testament to his characteristic and his patriotism. i hope the family of private first class gray know that we in this united states senate honor his choice to serve and we're grateful for his sacrifice. mr. president, i suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call: