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tv   Politics and Public Policy Today  CSPAN  October 1, 2015 5:00pm-7:01pm EDT

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>> 45 years ago in june of 1970 a telegram arrived in upstate new york at the home of 18-year-old marty dempsey. congratulations, it read, you are appointed to the west point class of 1974. marty was honored. but he had just finished high school, and he wasn't entirely sure he wanted to head off to the academy. his mother, i'm told, thought different. she urged him to give it a try
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for the summer, which sounds like beast barracks meets sleep-away camp. sound advice with a little irish charm runs in the dempsey family. over the decades that followed he patrolled the iron curtain, commanded divisions on desert battlefields, and led america's soldiers. and more than a few times he burst into song. and over these last four years marty's wisdom, his vision, and his character have helped lead the greatest fighting force the world has ever known. secretary carter, deputy secretary work, members of congress and the joint chiefs,
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service secretaries, men and women of the defense department, our armed forces and our military families, it is a deep honor to join you as we pay tribute to a singular leader for our military and our nation and one of the finest men that i know, general martin dempsey. a little over four years ago i tapped marty to serve as chief of staff of the army. we let him enjoy it for one day. then i asked him to be chairman. so, let me say, marty, and more importantly deanie, this time i promise no surprises tomorrow.
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i chose marty for these leadership roles because of his moral fiber and his deep commitment to american strength and american values. i chose him because of his vision for our military as a more versatile and responsive force. i chose him because he had the steady hand we needed in this moment of transition, as we tackle emerging threats and support so many of our troops as they transition to civilian life. and i've watched marty manage each of these challenges with integrity and foresight and care. but perhaps most of all i chose marty because he's a leader you can trust. marty, you've always given to me strength. i can't tell you how much i have
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appreciated your candor and your counsel. and i've seen you build that trust not just with me but across our military, with our troops and their families, with congress and our allies abroad, and with the american people. today, thanks in no small measure to marty's leadership, america has reassured allies from europe to the asia-pacific. we ended our combat mission in afghanistan and brought america's longest war to a responsible end. we forged new partnerships from south asia to the sahel to meet terrorist threats. we built a coalition that is combatting isil in iraq and syria, and we have bolstered our cyberdefenses. we helped halt the spread of ebola in west africa. none of this would have been
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possible without marty's guidance and leadership, and what makes it more remarkable is he's guided our forces through a time of reckless budget cuts. in less than a week before congress needs to pass a budget to keep the government open, let me just say, now is not the time for games that lock in sequester. it's not good for our military readiness. it's not good for our troops. it's not good for our families, and it's not good for our country. as commander in chief, i believe we should invest in america and in our national security and not shortchange it. and yet even in these tough fiscal times, marty has made sure we maintain our military superiority. and no one can match our services because no one can match our service members.
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our sons and daughters who he's cared for like his own. and then he sees the west point classmates of his youth. he sees those he commanded. he sees their families, and in them he sees his own. there's deanie of, of course, marty's high school sweetheart, lifelong better half whose grace and resilience and good cheer embodies the military's spouses she fights so fiercely for. chris, megan and caitlin who followed in their father's footsteps to wear our nation's cloth, marty's mother, sarah, whom we thank for getting him to give the military a try for the summer, and there are his nine
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grandchildren, who we can be confident will mark this nation in so many positive ways in the future. on behalf of the american people, i want to thank the entire dempsey family for their service to our nation. and marty would be the first to tell you that he couldn't have done his job without his outstanding vice chair. and i, too, have depended on the advice and experience of admiral
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sandy wenafeld, thank you, sandy, for your outstanding service. and general joe dunford, in general paul silva, two of the most respected officers in our military, we have tested leaders ready to carry on marty and sandy's work. i could not be prouder of them and the service they've already rendered this great nation, and i could not be more confident in the advice and counsel that they'll provide me. thank you to them. thank you, ellen. thank you so much for everything that you've done. now, we're going to have a lot of work to do, long after not just marty's gone but i'm gone
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from the stage. there are always new threats. there are always new challenges in this ever-changing world. we have to degroid aade and ultimately destroy isil, the remnants of al qaeda, terror networks around the world. we have to adopt our defenses for the 21st century. we have to give our troops the support they need to meet their missions. we have to make sure that our forces and our families receive the pay and the benefits and the quality of life that they have earned. that is how we maintain a military that is second to none. and i'm confident that we are up to the task. i'm told that on marty's desk there's a box. it's a cigar box with 132 cards. each one with the name, picture, and story of every one of the
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132 soldiers who gave their lives under his command in iraq. and on top of the box are three words -- make it matter. make it matter. and every morning marty places three of those cards in his pocket. so that every moment as chair n chairman, every meeting, every trip, every decision, every troop review, every moment of every day some of those fallen heroes are with him. those cards were with him a few years back when for the first time as chairman marty spoke to a group of military children who had lost a parent. and that day as he walked
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through the crowd, some 600 gold star kids, young and so full of hope, he began to think about their lives and how each of them would have to make their way without a father or a mother, and marty had planned to speak. he couldn't. so, he did one of those things that he does best. he began to sing. and in that moment the highest ranking military leader in our nation forged a bond with those children. boys and girls who had at such a tender age had given up so much in a way that perhaps nobody else could. and year after year they've invited him back, because they know marty dempsey will always give them everything he has. his voice but even more, his
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full heart and soul. this is the man we honor today, a friend to so many troops and families across our military, a patriot with a profound love for our country and those who sacrifice for it, a trusted leader who at a time of great change made it matter. all the time. i am extraordinarily grateful to have had him by my side. through the bulk of my presidency, and i am extraordinarily proud to call him my friend. marty, for your lifetime of extraordinary service, you have the deepest thanks of a grateful nation. god bless you. and god bless our men and women in uniform.
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>> ladies and gentlemen, general dunford.
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>> good afternoon, distinguished guests, family and friends, thank you once again for joining us here today. s mr. president, secretary carter, thank you for the kind words and thank you for your trust in selecting me as your principal military adviser. before i begin i'd like to draw your attention to the men and women in formation today. they not only look superb but as secretary carter said they represent more than 2 million members of our total joint force. many of our soldiers, sailors and airmen and marines forward deployed some are in harm's way and as we enjoy today's ceremonies i ask you to keep them and their families in your thoughts and prayers as well. in addition to the many senior guests and officials mentioned by name as the ceremony began i'd like to thank our family and friends for making the effort to join us. i'm particularly appreciative
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that my brothers and their families are here along with ellen's sister, her brothers and their families. i'd also like to single out my mom and dad who were here. i became a marine because of my dad, and any success i've had in uniform was a result of my mother's discipline and exacting standards. so, mom and dad, thank you. more importantly i want to recognize my wife ellen and our children joseph, patrick and kathleen. without their love and support over these many years i wouldn't be standing here today. and, ellen, thanks for your willingness to continue to serve our men and women in uniform and their families. mr. president, i know i have big shoes to fill and we're all indebted to general marty dempsey for his extraordinary leadership, commitment and service and on a personal note for many years he's been a great friend, mentor and role model. deanie has been with him every step of the way and she's been a
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tireless advocate for military families even as she raised three soldiers of her own. the dempseys deployed active duty today with well earned a mir ration, appreciation and atexas from all soldiers, sailors and marines to include the dunfords. marty and deanie, thank you for what you have meant to those of us in uniform and our families, you are what winning looks like. it's a deep privilege to have the chance to continue that legacy of leadership. it's an honor to follow in the footsteps of admiral mullen and general pace and admiral meyers and the other distinguished chairmen who had a strong moral compass. in the days ahead i'll draw strength from their example and i'll look forward to serving with my fellow joint chiefs and combat and commanders and other senior leaders in our government as we tackle the challenges on our watch. i see several chiefs of defense from around the world here today. i look forward to working with
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you and further developing our relationships. it's customary for the incoming officer at events like this to be brief so i'll close by simply saying how humbled i am for the opportunity to represent our men and women in uniform. they are a true national treasure. my focus in the coming days will be to provide them with the leadership and the support that they deserve. god bless you all. and semper fidelis.
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>> ladies and gentlemen, by special request lizzie yagi representing the tragedy victims programs for survivors will introduce general dempsey. >> ladies and gentlemen, the 18th chairman of the joint chiefs of staff and my friend general dempsey.
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>> thanks, lizzie, being your friend and the lead vocalist among the taps kids will be my most cherished memory for my time as chairman. i want everybody to know that that's the first time the president ever made me cry. so, lest you think we've had this kind of back-and-forth over the course of time that's the first. and whoever had the over and under how long it would take me to cry it's when my son read my retirement order. there you go. i think my classmates have probably had a few side bets going. let me begin by thanking everyone for the kind words and the recognition. to tell you the truth, it rubs a bit uncomfortably against my conviction that duty is its own reward and that those called to serve should seek no recognition for simply doing their duty. we all owe this great country our very best and our fellow citizens our very best. it was humbling to accept this job four years ago. and it's humbling to relinquish
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it today. mr. president, thanks for being here and for allowing me to advi advise. i've been honored to work with you and your national security team. i know this is a very busy and very important week for you, but then again, they're all very busy and important weeks for the president of the united states. i also want to thank you in particular for allowing me to release my inner leprechaun from time to time during national security council meetings and importantly for allowing two dempseys into the situation room at the same time. i should have included this in my chairman's risk assessment. by the way, i hope you were able to get that good word in with me with the pope. i also want to thank the 22nd, the 23rd, the 24th, and the 25th secretaries of defense with whom i've served over the last five years. seriously? i really do appreciate them for
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their service to the nation, for their support to men and women in uniform and their families, and for teaming with the joint chiefs to protect this nation. you are all great patriots and prodigious leaders. there is no way i can explain what the past 41 years have meant to me in the next few minutes, and the next four years will be ably led by the 19th chairman. so, i'll focus on the moment right here, right now, surrounded by so many family and friends. let me start by thanking the old guard, the joint honor guard and the great military bands assembled here. i have been and will continue to be your biggest fan and your strongest advocate. you remind us of our history, and you set the cadence of our march into the future. you are outstanding soldiers, sailors, airmen, marines and coast guardsmen serving right here in our nation's capital. you inspire us. thank you for providing the
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images and the sounds that will ensure we will always remember this day. and, ladies and gentlemen, please join me in thanking them. i note with great esteem the presence of our service chiefs and our combatant commanders and the senior enlisted as visors and the chiefs of defense from some of our closest allies and as well some of the spouses of our closest allies and military leaders. few know the burdens you bear, willingly and even enthusiastically for our countries. deanie joins me in thanking you for your service and sacrifice, and most of all for ensuring the readiness of the young men and women we send into harm's way in the name of freedom. i'm honored by the presence of civilian leaders from across our government, in particular i thank my teammates from the
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department of defense, the service secretaries and the national security council staff. i will tell you that the glamour of working issues at this level wears off quickly. but i will always remember with fondness the camaraderie forged in the difficult work of national security. i also think you'd agree with me that the protocol team today has done an extraordinary job as they do every day. they are quiet professionals whose lot in life means they only get an "a" or an "f," well, mark this ceremony down as another "a." i wish i could introduce you to my personal staff. at a job like this at such a frenetic pace and with so much travel, we've become a family. deanie and i have said good-bye to them privately, but i'll say one more thank you, you left me a better chairman and left an indelible mark in our hearts in the process. in the crowd the great west point class of 1974 pride of the
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corps. from the national war college and even from my cap stone class apparently i made the right decision when i decided not to study too hard so i could make a lot of friends. i have both mentors and proteges here. as i've become older, i realized that the distinction between them blurs. we've learned from each other. i'll tell you this, deanie and i came into the military for each other, but we stayed in the military because of you. i admire you all. there are friends mere from the storied fighting 69th new york army national guard and from usa basketball, stars from the worlds of entertainment and professional sports who have traveled with us around the world, and superstars from the many private organizations dedicated to support our military, their families, the wou wounded, and our veterans. you've all touched our hearts, filled our souls, inspired us
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and made it an extraordinary four years. we are privileged to call you friends. another yates quote. think where man's glory most begins and ends and say my glory was i had such friends. i know in my heart that martin joseph dempsey, thomas joseph sullivan and bridget barber are all proudly looking down on us today. and they are probably up there whispering far too loudly for god's sake i just hope he doesn't start singing. my mom is sitting right over there thinking to herself, i told you so. if there's a more soft-spoken, respectful, humble woman on the face of the earth, i'd like to meet her. thanks for inspiring us to be humble, to always give just a little more than an honest day's work, to have courage and to live a life of faith. we love you, mom.
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marjorie sullivan is sitting at home in florida a little too frail to be with us here today, but she has been an unwavering champion and safety net on more than one occasion for our family throughout our career. we love you, too, mims. i have a big family. you remember what i said about protocol earning their "a," kind loving aunts and uncles, brothers and sisters, nieces and nephews, in-laws and outlaws, far too many to single out. though i haven't seen too much of you over the years, it's pretty darn remarkable how little we've changed. thank you for your support. i said i wouldn't reminisce but i'll make this one exception, about this time in 1974 i reported as a 2nd lieutenant to the armor school at ft. knox, kentucky, in preparing my remarks today i was struck by how much my emotions today remind me of my emotions then.
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in september 1974, just like today, i was a little nervous, i was humbled to wear the uniform of an army officer, i was eager to get started on a new career, and i was in love -- pardon me. and i was in love with a girl named deanie. i fell in love with deanie when she was 15. it took her a few years to come around to the idea. but i was sure that whatever life brought my way i wanted to experience it with her. here's the thing about deanie. she's the only one more passionate than me about military and their families. she's a better leader than i am. she has far more energy than einstein predicted could be packpack packed into a 5'2" body and she
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has shown amazing patience with the trials that accompany a military life. in every way she's made me a better person. because this has been her career just as much as mine. it's fitting and proper to say that we are both retiring today. congratulations, deanie sullivan-dempsey. so, i'm almost out of water to choke back the emotion which means i must be near the end. what we're really doing today is transferring our passion for the standard u.s. army nine-man infantry squad to our own squad of nine adorable, talented and exceptional grandchildren. they are in order of seniority,
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kayla, mckenna, luke, alexander, huntley, finley, braydon, samuel, and david. now, if you want to know what our principal goal in retirement will be, it will be to be the best grandparents we can be. lest you think we've forgotten them in the flush of the love for our grandchildren, we love our own children and their spouses. they have served our country, too. we've made 20 moves most of them with the kids, and they have been courageous, adamantive, resilient and willing to share their parents with a larger military family. it's been a joy watching them grow up, although until recently we did have some difficulty convincing them that the mayflower wasn't a moving van. i'm very happy that the j-3 allowed my son chris to escape the national military command center to attend the ceremony and as i said megan and kelly have also served along with
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shane formed the best trio of in-laws we could ever imagine. i know a little something about leadership and you have it all as well as many other extraordinary qualities that make you great couples, great parents and great patriots. we very much enjoy your company. we look forward to seeing more of you. and we hope the feeling is mutual. who stands for freedom goes with joyful tread. joyce kilmer. it has been my honor to walk with joyful tread alongside soldiers, sailors, airmen, marine and coast guards the past four years. they are truly the best of the world at what they do. they are our nation's best treasure and today we entrust them to our new chairman. you may know that the irish are somewhat stingy with compliment and generally reserved with the use of adjectives when irishmen truly respect someone they say simply you're a good man. well, you're a good man, joe
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dunford. as i depart i do so with great confidence that you and ellen are in the right place at the right time and at the right time for our nation. thanks to you both for taking on yet another challenging task for our nation. speaking of challenging tasks, there is a sense today that america's future is fraught with uncertainty and that the fabric that binds us is being mightily tested. however, i believe in absolute confidence of who we are and what we stand for. our nation and its armed forces remain the world's foremost symbols of strength, of hope and of freedom. the generation that is now blessed to serve will do its duty and will ensure that our nation remains strong. i thank god for sustaining me for these 41 years, and i pray that he keeps us all strong. it has been my privilege to wear the cloth of our nation. to all who will continue to serve after me, i ask only this in parting.
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make it matter.
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ladies and gentlemen, please be seated. at this time we ask that you please remain seated while the president departs.
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♪ ♪ tried to be a mother raise a daughter and a son be a lover to their father everything to everyone ♪ ♪ bright and early i dressed them for success from my head down to my boots ♪ ♪ and i will always do my duty no matter what the price i've counted up the costs i know the sacrifice ♪ ♪ oh and i don't want to die for you but if dying's asked of me well i'll bear the cross with honor because freedom don't come free ♪
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♪ i'm an american soldier an american beside my brothers and my sisters i will proudly take a stand ♪ ♪ where liberty's in jeopardy i will always do what's right i am out here on the front lines sleep in peace tonight ♪ ♪ american soldier i'm an american ♪ ♪ ♪ i'm an american soldier
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>> general dempsey and deanie just celebrated their 39th wedding anniversary. in their honor we perform their wedding song "close to you." ♪ ♪ why do birds suddenly appear every time you are near ♪ ♪ just like me they long to be close to you ♪ ♪ why do stars fall down from the sky every time you walk by ♪ ♪ just like me they long to be close to you ♪
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♪ on the day that you were born the angels got together and decided to create a dream come true ♪ ♪ so they sprinkled moon dust in your hair and golden starlight in your eyes of blue ♪ ♪ that is why all the boys in town boys in town follow you follow you all around ♪ ♪ just like me just like me they long to be close to you ♪ >> it has been a journey of four decades for the general and deanie, of family first, then again if you've served with them, you are part of their family. this irish ballad titled "the
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voyage" puts it all in perspective. ♪ ♪ i am a sailor you're my first mate ♪ ♪ signed on together we coupled our fate ♪ ♪ we hold out the anchor determined not to faint ♪ ♪ for the heart's treasure together we set sail ♪ ♪ ♪ to guide us we steered our own course ♪ ♪ we rode out the storms when the winds were gale force ♪ ♪ we sat out the doldrums in patience and hope ♪ ♪ working together we learned
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how to cope ♪ ♪ ♪ life is an ocean and a love is a boat ♪ ♪ and in troubled waters we learned how to float ♪ ♪ when we started together it was just me and you ♪ ♪ now look around us we have our own crew ♪ ♪ a true destination not marked on any chance we're navigating for the shores of the heart ♪ ♪ ♪ life is an ocean and a love is a boat and in troubled waters we
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learned how to float ♪ ♪ when we started the voyage there was just me and you ♪ ♪ now gathered round us we have our own crew ♪ ♪ . >> it just wouldn't be a musical tribute to the 18th chairman without his favorite song, from the chairman of the board, old blue eyes himself, the great frank sinatra. we now perform "new york new yo york." ♪
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♪ start spreading the news i am leaving today ♪ ♪ i want to be a part of it new york new york ♪ ♪ these vagabond shoes they are longing to stray ♪ ♪ right through the very heart of it new york new york ♪ ♪ i want to wake up in that city that never sleeps to find i'm a-number one top of the list ♪ ♪ king of the hill a-number one ♪
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♪ my little town blues they are melting away ♪ ♪ i'm gonna make a brand new start of it in old new york ♪ ♪ if i can, if i can make it there i'm going to make it anywhere ♪ ♪ it's up to you new york new york ♪ ♪ new york as we bid farewell to the dempseys we ask the chairman to
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assist us in singing the "parting glass." >> we'll get you out of the rain here in a second. last song. give me the tune. ♪ of all the money that ere i had i spent it in good company ♪ ♪ and all the harm that ere i've done ♪ and all i've done for want of w
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way to memory now i can't recall ♪ . ♪ so fill to me the parting glass ♪ ♪ good-bye and joy be to you all ♪ ♪ so fill to me a parting glass and drink and memory falls and gently rise and softly call ♪ ♪ good-bye and join me to you all ♪ ♪ for all the comrades that e'
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re i've had they're sorry for my going away ♪ ♪ and all the memories that e'er i've had they wish me one more day to stay ♪ ♪ but since it fell unto my luck that i should rise and you should not ♪ ♪ i'll gently rise and softly call good-bye enjoy thee to you all ♪ ♪ the parting glass and drink whatever befalls ♪ ♪ good-bye and joy thee to you all ♪
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♪ ♪ ♪ ♪ ♪ that i should rise and you should not ♪
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♪ good-bye and joy thee be to all ♪ ♪ ♪ good-bye and joy thee to you all ♪
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♪ ♪ in my mind i'm going to carolina ♪ ♪ can't you see the sunshine can't you just feel the moon shine ♪ ♪ ain't is just like a friend of mine hitting me from behind ♪ ♪ because i'm going to carolina in my mind ♪ ♪ >> ladies and gentlemen, please remain in place for the departure of the official party. ♪ in mind i'm going to carolina
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can't you see the sunshine can't you just feel the moon shine ♪ ♪ ain't it just like a friend of mine greeting me from behind because i'm going to carolina in my mind ♪ ♪ yes, i'm going to carolina in my mind ♪ tonight, remarks by massachusetts senator elizabeth wraurn warren and rodgers. we'll show you their remarks tonight at 8:00 eastern on c-span.
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>> the house energy and commerce committee heard from state health insurance marketplace officials on tuesday about the ongoing management and implementation of the affordable care act. the officials described the challenges their states faced in implementation and the steps to improve the enrollment and participation process. this is two hours. good morning. the subcommittee of oversight and investigation convenes this hearing today to examine the
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state health insurance marketplaces established under the affordable care act. we seek to understand the sustainability challenges these state exchanges continue to face. the centers for medicaid and medicare services has awarded $5.51 billion to the states to help them establish their exchanges. let me repeat that. the states receive $5.51 billion in federal taxpayer dollars to set up their own exchanges yet the aca had no specific definition of what a state exchange was supposed to do or what it was not supposed to do. this is compensation without limitation. since the funding for these exchanges came from the entitlement side of the budget, there was no oversight throughout the appropriations process. there was no budget for the state exchanges rather grant money flowed freely and rewarded bureaucratic "innovation." of course, no one bothered to
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make sure that it didn't create more government bloat. in fact, the states represented in our panel today -- california, connecticut, hawaii, massachusetts, minnesota and oregon -- were awarded over $2 billion of federal program dollars. oregon has already pulled the plug on its state exchange and hawaii is in the process of doing so. the faucet of establishment grant money finally turned off at the end of 2014 when state exchanges were supposed to be self-sustaining. despite this enormous taxpayer investment, state exchanges are still struggling. they continue to face i.t. problems, lower-than-expected enrollment numbers and growing maintenance costs. here are just a few more recent headlines from news articles on the state exchanges. "obamacare exchanges are a model of failure." or "nearly half of obamacare exchanges face financial woes." in another one "obamacare's failed state exchanges." the alarm bells are not only
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being sought in the media -- sounded in the media. earlier this year the department of health and human services office of inspector general alerted cms acting administrator that the state exchanges may be using federal establishment grant funds for operational expenses which is prohibited by law. hhs' oig urged them to develop an issue of clear guidance to the state exchanges on the appropriate use of grant funds. the guidance that followed was still vague, permissive and lacked real word examples. in fact, cms has seemed more focused on doling out taxpayer dollars rather than overseeing how the dollars are spent. the u.s. government accountability office just issued a record demanding cms conduct more oversight over state's i.t. projects.
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gao found they did not document, define or communicate its oversight roles and responsibilities to the states. further, cms often did not involve relevant executives to improve federal funding for state's it marketplace projects and although cms established a process for testing state marketplace systems. these systems were not always fully tested. we have a panel of witnesses today representing state exchanges with its own set of challenges and circumstances. the state of hawaii was awarded $205 million, but in june the governor announced its hawaii health connector does not generate "sufficient revenues to sustain operations" and will shut down. the commonwealth of massachusetts accepted $234 million for its health connector but enrolled only 13% of its goal the first year, temporarily placed individuals in medicaid because it couldn't determine eligibility and cost massachusetts an estimated $1 billion in additional funds. the state of minnesota initially
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received $155 million to launch its state exchange. the exchange received an additional $34 million from cms in part to fund ongoing fixes to the i.t. system. despite this infusion of funds, minnesota has announced it would revert to an old system next year or minnesota care premiums because of the continued exchange problems. the state of california received over $1 billion in federal grant dollars to establish its exchange, covered california, the most of any state. despite call center and website woes, california had the highest enrollment of 2014 but only retained 65% of its 2014 enrollees. this year california's enrollment numbers reached 1.4 million, falling 300,000 short of expectations. cms awarded the state of connecticut approximately $176 million in federal establishment
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grants, and as of september 2015, approximately 96,000 individuals were enrolled. only 50% enrollees were previously uninsured. oregon received $305 million for covered oregon. despite this heavy investment, covered oregon was dissolved early this year and transferred its responsibilities to the department of consumer and business services. the state is currently operating as a federally supported state-based marketplace and relies on healthcare.gov. so we're here to understand the challenges these state exchanges face. why are they struggling to become self-sustaining given the extraordinary taxpayer investment? is it a lack of accountability or oversight? where has cms been and are they encouraging fiscal restraint or taking a hands-off approach which has allowed money to be spent uncontrollably? and where an exchange has decided to shut down, has cms tried to recoup any federal
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grant dollars? lastly, are the exchanges doomed to fail? hopefully we will get answers to these important questions so i thank the witnesses for testifying today, and i recognize the ranking member from colorado for five minutes. >> thank you, mr. chairman. i think we can all stipulate that some states have struggled with the technological hurdles of setting up their own marketplaces. we all knew the affordable care act would face challenges in some aspects of implementation. and i've been saying for a long time that it's this committee's role to conduct oversight and improve that process. so i'm glad we're having the hearing today. i hope we have that goal in mind. i hope we're not hoping the state exchanges fail. i hope we're hoping that we can improve it and we can make it better. i think despite the fact that we had a rough start in many places, the aca is working and
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has greatly approved access to affordable high quality health insurance coverage. in the last five years, we've made progress in helping millions of americans throughout the country gain access to quality health care. here are some notable statistics. since passage of the law five years ago, 17.6 million previously uninsured individuals have gained health coverage through the aca's various provisions. nearly 10 million consumers have enrolled in state and federally facilitated exchanges. about 2.7 million of those individuals use state exchanges to select private plans. according to newly released data, the uninsured rate fell from 13.3% to 10.4% from 2013 to 2014, representing the largest single year reduction in the uninsured rate since 1987.
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in 2014, hospital uncompensated care costs were $7.4 billion lower than 2013 levels as a result of exchange coverage and medicaid expansion. the aca also improved health care delivery systems, hospital readmissions are down and indicators of patient safety like hospital-acquired conditions have improved significantly. all of the states before us today have taken significant steps to improve health coverage for their residents. their uninsured rates have plummeted due to efforts to implement the affordable care act. despite the technical and financial challenges that confronted hawaii's exchange, for example, its uninsurance rate has fallen and it stands at 5.2%. in just a few years since 2013, minnesota has reduced the number of people without health insurance by more than 50%. their uninsurance rate is one of the nation's lowest at 4.6%.
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massachusetts which already had one of the nation's lowest uninsurance rates in the country is down to just 3% in 2015 which is a 38% decrease since 2013. connecticut which now has a robust state-based marketplace cut its uninsurance rate by more than 60%. in connecticut, the uninsurance rate is 5%. and california, which also had one of the high est uninsurance rates in the country, 21.6%, has managed to drop its rate by 25%. and finally, oregon which had one of the nation's highest uninsurance rates of 20% in 2013 also reduced its uninsurance rate by 55% to 8.8% today. how did this all happen? how did states manage to insure so many millions of people?
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the affordable care act has really provided these tools. so as we discuss call centers, web-based portals and all these other things, let's not forget that the affordable care act is really working to achieve its goals. and let's work together to try to make it better. i want to thank you for having this hearing. i want to thank our californians for joining us, mr. chairman, and i want to yield the balance of my time to ms. matsui from california. >> thank you very much for yielding. peter lee, thank you for coming to testify today. and let me reiterate, the affordable care act is working. california is an early adopter in so many areas, not the least of which is health care. we have moved from paying for volume to paying for value. and to reform our system to make sure that everyone has access to quality affordable health care. covered california is an integral part of that, and i'm happy to say over 41,000 in my district of sacramento and
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nearly 2 million californians obtained coverage from 2012 to 2014. that's an average of a 5% reduction in the rate of uninsured. in sacramento, in 2012, 18% were uninsured. in 2014, it was down to 12%. that rate is likely to be lower in 2015. we need to continue to work to bring those numbers of uninsured down. by supporting the advancement made by covered california and other exchanges not by moving backward. thank you, and i yield back. >> gentle woman yields back. i know on our side, any members want to speak? i know mr. walden who's not a member of this committee wanted to sit in this hearing and has the right to do so. you will be recognized for two minutes. then you can yield to mr. walden for two minutes? thank you. >> i was a practicing physician before, and i just want to talk
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about the focus on insurance rates. coverage does not guarantee access to health care. deductibles are up. premiums are up. the cost is being shifted to the people. the uninsurance rate may be down, but the access, i would argue, has not improved dramatically. if you're a schoolteacher or factory worker or other middle class employee, if you have a $5,000 deductible, do you have affordable health insurance? i would argue that you do not. in many states, physicians aren't taking new medicaid patients. i know this because i'm a physician, and i talk to physicians all the time. in fact, many physicians aren't taking new medicare patients let alone medicaid patients. i just want to clarify that focusing only on uninsurance rates is not the only parameter to look at when you're looking at the ability of our citizens to access quality affordable health care and i yield to mr. walden. >> i thank the gentleman and the committee for letting me
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participate in this hearing. when i was in state legislature the oregon health plan itself was passed. when i became a majority leader we realized there would be a lot of work to implement the oregon health plan. i put it together and chaired it. i concur with those who think we need to do more to reform the delivery of health care and access to it. i have a pretty good record on doing both. mr. chairman, i want to thank you for holding this hearing on this issue, though. mr. allen, thank you for coming out from oregon. as you know, oregon received $305 million in federal grants to build cover oregon. only california and new york, states with about nine and four times the population respectively, received more. so we've got a lot of money out there. the exchange was launched with much fanfare. as an oregonian, i heard the long live oregon jingle that encouraged oregonians to sign up.
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the problem was when the lights came on and the curtain went up, it failed to sign up a single person online in one city. not one person was able to sign up that way. oregonians were forced to sign up using paper applications. the state decided to abandon the i.t. platform and move on to healthcare.gov. eventually, they shut down the entire program, which it did on june 30th. hundreds of millions of taxpayer dollars apparently down the drain. last february, chairman upton, murphy and pitts and i requested an independent federal investigation into the failure of cover oregon. while the gao did some good work on state exchanges generally, many questions about oregon remain unanswered. how did this happen? who was in charge? what can be done to make sure this never happens again anywhere in the country? we're sell awaiting the answers, frankly. going forward, the move to federal exchange poses a whole
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new set of questions. mr. allen, i understand you weren't there running this thing. so we're not here to point fingers. we're here to get answers as to how this happened and what we do now and how we're going to fund the next phase of this. i still don't have a clear understanding of what happened to $305 million establishment grants, and did cms even try to recoup this? what was the role of cms in all of this? did they do their due diligence? in spite of your repeated assurances that oregon exchange is financially self-sustaining, i think there are questions over how the state will pay the federal government for using healthcare.gov when it's required to do so in 2017. there are also concerns with significant insurance rate increases. in your testimony you state that the increases are a matter of the market rebalancing itself. whether it's indicative of future rate hikes remains to be seen. the collapse of cover oregon, though, is clearly an epic disaster for oregonians and for taxpayers across the united states.
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frankly, the aftermath hasn't inspired additional confidence in our state government or cms. i'm deeply disturbed about the role of the former governor, who has had to resign, and the role of his campaign consultants in calling the shots. so i hope the hearing will help us learn more about what happened, why it happened and what steps can be taken so that this kind of debacle never happens again. thank you, mr. chairman. i yield back the balance of my time. >> i yield back. >> and we represent mr. pallone for five minutes. >> thank you, mr. chairman. over five years ago we passed the affordable care act and fundamentally changed the health care system in this country. we expanded access to health care pour millions of americans and ensured that no individual could be denied coverage for arbitrary or discriminatory reasons. we guaranteed that insurance companies were in the business of making our citizens healthier, not just making a profit.
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and we strengthened medicare and put the program on firm financial footing. today my republican colleagues will tell a different story. we'll hear a lot about technical glitches, inefficiency, broken i.t. systems. if we just listen to the republican side, we are led to believe we poured money down the drain and saw no benefit. no doubt there are lessons to be learned from the implementation. we should learn those lessons and use them to improve going forward. but that doesn't mean we should lose sight of the bigger picture. make so mistake, the affordable care act is working. we are seeing successes throughout the country and the data is there to prove it. recent census data shows that the uninsured rate has significantly declined in every state. 76 million americans now have insurance. states that chose to embrace the full measure of the law and expand the medicaid programs and establish state-based marketplaces have seen the greatest gains for their citizens. and this success is true for the six states that we have joining
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us here today. despite early technological challenges in some of these states everyone here today has expanded access to care and significantly lowered their numbers of uninsured. it's important to look at how state-based marketplaces could be run more efficiently and effectively and how we can enhance the health care delivery system in this country, but let's do this with an eye for improvement, not as an opportunity to score political points. let's have a discussion on how to reach the remaining uninsured, how to continue to improve it and how to best address the challenges that remain. with that, i'd like to yield my remaining time to split between congressman kennedy and representative capps. i'll initially yield to mr. kennedy. >> i want to thank the ranking member for yielding. it is always nice to see a familiar face amongst our witnesses at hearings, and i'm pleased to have a chance to
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welcome luis gutierrez. mr. gutierrez throughout his career has championed the use of technology to help government do its work better, whether it's as our commonwealth's executor or the executive director of massachusetts health connector. he's pursued innovative strategies for critical services to those who need it most, particularly when it comes to health care. in his latest role, he's worked diligently to ensure massachusetts maintains its proud status as a state with one of the lowest uninsured rates in the country. as the uninsured rate continues to fall, nearing single digits, thanks to the affordable care act, i'm looking forward to hearing more about your efforts to make our system more efficient and effective as well as any best practices that you've encountered that could be applied across this country. thanks so much for being here. yield back.
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>> remaining time to ms. capps. >> thank you. to the ranking member for yielding and letting me, also, letting me waive onto this subcommittee for what i know to be a very important discussion. i wanted to come and personally welcome mr. lee, the executive director of covered california which is my state's health insurance marketplace which has helped connect so many of my constituents with health insurance. you know, california made a conscious decision to be an active player with the affordable care act implementation. and when there are problems, they have been responsive, holding insurance companies accountable and making covered california a national leader. thanks to their efforts, we've cut our state's uninsurance rate by 28%. pretty remarkable in my opinion. california shows that when a state is invested and buys into the goals of the affordable care act, prices can be held under control, quality plans can
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be made available for purchasers. i look forward to hearing how covered california could serve as a role model for states looking to get the best value for their residents while promoting high-quality care. and i'll yield back to the ranking member. >> i yield back. >> thank you. i know we asked for unanimous consent that written statements of members of the subcommittee be introduced into the record. mr. upland will have something. we'll leave it open for other members. without objection, the documents will be entered into the record. to our witnesses, you are aware that the committee is holding an investigative hearing and has a practice of taking testimony under oath. do any of you have any objections to testifying under oath? and all the witnesses say no. the chair advises you that under the rules of house and committee you are entitled to be advised by counsel. do you have a desire to be represent by counsel?
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and all the witnesses declined. in that case, please rise and raise your right hand and i'll swear you in. do you swear the testimony you are about to give is the truth, the whole truth and nothing but the truth? >> yes. >> thank you. all the witnesses have answered in the affirmative. you are now under oath and set subject to the penalties set forth under the united states code. we'll have you each give a one minute -- excuse me, five-minute summary of your statement. we're not trying to rush you. we'll begin with mr. allen. make sure your microphone is on and pull it very close to you. >> make sure the microphone's on. is the light on? >> there we go. >> pull it real close. >> thank you, chairman murphy, ranking member degette. my name is patrick allen and i'm the director of the oregon department of consumer and business services. we're the state's consumer protection agency. our mission is to serve and
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protect consumers and businesses in oregon while supporting a positive business climate in the state. my agency's responsible for regulating banks, credit unions, mortgage lenders and other nondepository programs. ule aspects of insurance, life, health, property and casualty. our system of worker health and safety, including oregon osha and state workers' compensation insurance and statewise construction standards. as of 90 days ago, after a brief transitional period, the department assumed responsibility for oregon's state-based health care marketplace. i appreciate the opportunity to be here today and to talk about the market place services in oregon and my agency's plans going forward. you have my written statement, so i will briefly summarize with three points. first, oregon's marketplace is successful. nearly 70,000 oregonians enrolled in coverage during open enrollment for 2014, despite needing to navigate a hybrid paper and automated system. using healthcare.gov that number
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increased to over 100,000 for 2015 open enrollment. between those private health insurance and the oregon health plan, the rate of uninsured in oregon declined from 14% to under 9%. second, oregon's health insurance marketplace is healthy, competitive and sustainable. for 2016, 11 companies will offer oregonians 120 various plans at various coverage levels. ing oro individual insurance market was one of the lowest priced in the nation in 2015. we're in the process of rebalancing the market to ensure its long-term sustainability. and while the percentage increase has been significant. the resultant rates are very comparable to those available in neighboring markets in california and washington and remain very affordable. third, the marketplace as run by the state of oregon is efficient. financially sustainable and subject to ongoing oversight.
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because of economies of scale and other efficiencies, we as a state agency are able to operate the marketplace with about 60% fewer staff than the previous organization. we're completely financed by an assessment on participating insurers with no state funding or taxpayer funding involved. we have access to the federal platform at currently no cost, we have adequate financial capacity to pay a reasonable technology cost to the federal government, another state and partnership arrangement or to a private vendor should that be necessary. i'd be happy to answer questions that you might have. >> i thank you. ms. otoole. i'm sorry i didn't introduce you before. this is allison otoole, the interim executive officer from minnesota. you're recognized for five minutes. you now the drill with the microphone. >> good morning chairman murphy, ranking member degette. my name is allison o'toole and
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i'm the interim ceo of minnsure, which is minnesota's online health insurance marketplace. thank you for inviting me today. i am honored to share with you the success we've seen in minnesota. let me begin with an update on how minnsure has benefitted us. for the purposes of background, building it was no easy task but we've provided minnesotans with comprehensive coverage. for the purposes of background, i want to provide the committee with a full picture of where we are today. since october 1, 2013, more than 500,000 minnesotans have used minnsure to shop and procure affordable insurance. minnesota has the lowest rate of uninsured in state history. in our first year, the uninsured rate dropped by a whopping 40%.
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and now nearly 95% of minnesotans are covered. and they're saving money. more than $31 million in premium payments through tax credits in 2014 alone. and i'm pleased to report that minnsure is financially sustainable. we have a balanced, conservative, sustainable budget that's based on real numbers and real experience. and we've come a long way since our launch two years ago. the last 18 months have brought measurable progress, along with a deep commitment to transparency and accountability. and most importantly, we're making a difference in the lives and health of minnesotans. minnesotans like richard dean, a cattle farmer who with his newly purchased coverage went to the doctor for the first time in years, discovered he had cancer and was able to successfully treat it. today richard's cancer-free. and like jake sanders. he's a small business owner.
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he and his wife have three small children, one who has had a pre-existing condition since birth. minnsure allowed jake to find a lower cost policy for his family, and today he knows his son will be covered. covering more minnesotans has always been our foundational goal since day one. and minnsure's technology performance has improved dramatically since then. after lots of hard work, there is a night and day difference between the first and second open enrollment periods. call wait times fell and they were able to complete the enrollment process with ease. our dedication to improving minnsure continues today this is important to us, because we think no one should struggle to find a health insurance plan that fits their needs. it's also important in making sure minnesotans can live their lives and focus on the important things like going to work, taking care of their families
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and starting a business, instead of worrying about how they're going to pay for big medical bills. as we approach minnsure's third open enrollment period, there's plenty of work ahead. our i.t. teams are hard at work improving website performance and ensuring a positive consumer experience. there's also a strong focus on improving minnsure's functionality. for medical assistance and minnesota care. one final point that sets us apart. in minnesota, our state recently created a 29-person bipartisan health care task force of health care and community leaders who will help address questions like access to care and financing. minnesota's taking oversight and accountability seriously, and i'm thankful to these people for their thoughtful approach to addressing many tough questions that remain for our health care programs. thank you again for inviting me here today. as minnsure's interim ceo, my eyes are squarely focused on
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preparing for the third open enrollment period, improving the experience for minnesotans and making sure that as many people as possible take advantage of the products minnsure has to offer. we want to see people like richard and jake and their families get the care they need and deserve. i look forward to your questions and thank you again for having me. >> thank you, ms. o'toole. now we recognize luis gutierrez. you're recognized for five minutes. >> chairman murphy, ranking member degette, good morning. thank you for the opportunity to testify regarding the massachusetts health connector authority, our state-based marketplace. my name is luis gutierrez and i have served since february of this year following the election of massachusetts governor charlie baker. as the new state administration took office, massachusetts was
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partway through a second attempt to implement a health insurance eligibility and enrollment system to enable affordable care act access to our residents. while proficient eligibility determination front end was completed, a range of back office enrollment functions remained under development. much of this year has been devoted to stabilizing operations and completing the systems foundations to complete massachusetts' state-based market please. upon taking office, the baker administration moved into effect several changes to the connector authority. first, it altered the structure, placing the health and human services as chair. the secretary of health and human services also oversees the state's medicaid organization, and this change reflects the importance of successful
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coordination between the exchange and the state medicaid agency. second, it replaced management, hiring for experience and large-scale system implementations, along with a new chief operating officer, a woman distinguished in massachusetts payer operations. third, it appointed an outstanding program management lead to lead the combined health insurance exchange, medicaid integrated eligibility systems and implementation effort. fourth, because the health insurance exchange and eligibility initiative is shared between the health connector and the state's medicare organization, it reestablished a formal governance structure led by the state medicaid agency, the health connector and the state's central information technology division. fifth, it undertook a six-week intensive examination to assess
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the state of health operations and lay a path for resolving existing problems. and finally, it completed the process for transferring individuals from temporary coverage where they had been placed in 2014 to appropriate placement in either qualified health plans or medicaid. the health connector is now better situated to service the needs of residents of massachusetts. for 2016, we have 11 issuers presenting 83 qualified health plans on the connector, and 25 plans across issuers of qualified dental plans. our enrollment totals over 175,000 qualified health plan enrollees and 40,000 qualified dent an plan enrollees. massachusetts is one of five states with less than 5% uninsured. we have significantly expanded customer service components for this fall's open enrollment period with 200 additional
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customer service hours, including evenings and saturdays and sundays. users may update their applications and make changes without needing to call the call center. massachusetts believes that states need flexibility to continue to innovate health care reform and meet health care needs. we could not provide to the low income populations without the flexibility of the state marketplace. for example, our program which had subsidies for those earning less than 300% of the federal poverty level. we desire the ability to recognize local market conditions and the definition of small business size. going forward there are potentially more seamless ways to integrate medicare and subsidies. it is important that states be offered the chance to make this
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work better for everyone. massachusetts remains committed to make sure that those who need insurance can obtain it both now and in the future with the state-based marketplace as one component of that strategy. thank you. >> thank you, mr. gutierrez. now we turn to mr. jeff kissel. the director of the hawaii heal health. >> thank you. honorable members of the oversight and investigation subcommittee. it's a pleasure to come before you to report on the activities of the exchange, but before doing so, i'd like to explain the health care environment in hawaii to help you understand the context of my remarks. yes, hawaii has among the lowest insurance rates in the nation. this is, however, because of the passage of the hawaii prepaid health care act of 1974. at that point, the state undertook as a matter of policy the responsibility for providing access to health care and
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wellness resources for virtually every employed resident of our state. over the past half century, both democratic and republican administrations in hawaii have not only supported the provisions of the act, they've developed substantial resources and focussed on leading the insurance and health care industry to actually delivering these services to an ever increasing percentage of our population. the evidence of our success is clear. hawaii is not ranked among the states with the lowest rates of diabetes, obesity, infant mortality and other critical public health care metrics. our population, however, enjoys a longer lifespan and by any measure, healthier outcomes from diseases and other health issues faced by a diverse ethnic and cultural mix. i believe this is a direct result of our ability to
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develop excellent health care access and secure its viability through the prepaid health care act with its employer mandate to provide insurance. in this context, the passage of the affordable care act was widely viewed as an opportunity to extend access to health care and wellness resources to even more of hawaii's population. for the most part, that effort's been successful. taken together, the expanded medicare program and the affordable care act have reduced hawaii's uninsured rate, already low, by more than half. unfortunately, a lack of planning, unclear business process design and utterly inadequate program management as technology systems were implemented resulted in excessive spending and delays in delivering the important services to the people who most needed it in our state. since i became executive director of our team at the hawaii health connector, we've come a long way of achieving the forward-thinking health care act with the provisions of the
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affordable care act. our business processes now utilize technology to support a well-trained outreach team of workers as they assist our customers with the enrollment process. this change in approach converted our computer systems to a resource rather than a barrier to entry. in december 2014, we produced a comprehensive, ten-year strategic business plan, a copy of which is attached to this testimony. it detailed a report on our condition, the activities, sustainability required by both the affordable care act and state enabling legislation. it also presented both the advantages and the challenges as the exchange commenced its second full year of operations. in that plan, we explained to cms and our state administration how we would meet sustainability and other important requirements of the affordable care act. we recommended a financial approach that relied on debt financing and generating
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enrollment revenue from about 70,000 enrollees at the rate of $12 million a year. i'm pleased to say that our enrollment in 2014 and 2015 increased by more than 400%. it is nearly now 40,000. moreover, the hawaii health connector was able to add thousands of individuals to the expanded medicaid program further reducing the costs of our community. even though we were able to overcome first year technology challenges, it became clear to all of us that the cost of maintaining, upgrading and ultimately replacing the technology had the potential to exceed its initial cost. while the federal government funded the initial cost, the people of hawaii are responsible for the ongoing costs. after consulting with cms, our state administration elected to migrate to healthcare.gov as a supported, state-based exchange to ensure continued access to qualified health plans for our residents. i fully understand the basis for that decision as the risks of operating independently are
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greatly mitigated by the assistance of healthcare.gov technology and support from cms. we're continuing to work to harmonize the affordable care act with hawaii's framework to provide outstanding access to health care to virtually every resident and when necessary, any of the millions of visitors we welcome to our state each year. we thank you for your time, your dedication and interest in improving the quality of life in our country by addressing this important issue before the people of the united states. i look forward to any questions you have. >> thank you. and now recognize mr. peter lee, the executive director of covered california from the state of california. >> good morning chairman murphy, ranking member degette and distinguished members of the committee and the members from california, matsui and capps,
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who were able to join you. it's a honor to be here in front of you before the subcommittee to speak we've had in california implementing the affordable care act. this landmark legislation has dramatically changed health care in california and in the nation by putting in place new protections that benefit all americans. i'm pleased to address how covered california is working, what we consider to be the keys to our success and how we are actively working to improve what we are doing in california. first, let me note that california's a state that embraced the affordable care act from day one. we were the first to establish a state-based exchange. that legislation was passed with a republican governor and democratic legislature. since then, some of the tools we've put in place to build on are being an active purchaser. covered california chooses which plans to participate. we negotiate with them to make sure the rates, their quality, their networks provide the best value to consumers. second, we provide standard benefit designs. covered california sets the benefits so they benefit
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consumers. in california in the individual market, you will not see consumers surprised by not getting access to primary care because they didn't pay a deductible first. that's a standard that we have placed that primary care access is not subject to a debit before. the health care is competing on apples to apples bases. third, california has expanded its medicaid program. under governor jerry brown and our legislature deciding to expand medicaid has meant that millions of californians have had the benefit of coverage they would not otherwise have. so in california the affordable care act is working. covered california is working. 65% of voters say that and say they have seen the affordable care act working in our state. first and foremost because of strong enrollment. today we have over 1.3 million californians covered by covered california.
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there's an additional 500,000 that have had coverage in the last year and a half that aren't covered today. that's not because they're uninsured. they're now with employer-based coverage or medicaid or medicare coverage. but exchanges across the nation are providing a safety net and a weigh station of individuals moving into the employer-based coverage with other options they did not have before. this is part of why all of us will have about a one-third of our population turn over every year. we are now the glue holding together the employer-based system in public programs. in california, insurance rates are under control. for 2016, the average rate increase in california will be 4%. in 2015, the average rate increase was 4.2%. two years in a row we've proven the naysayers wrong. this comes on the heels of years of double-digit rate increases in the individual market. and let me make clear that in california, the beneficiaries of
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those low rates are not just those in covered california, but the entire individual market. we have 1 million individuals that buy insurance not through covered california. they benefit from our negotiating on behalf of consumers. how did we get there? we have a good risk mix. we have a young mix, a diverse mix that reflects the population of california, and we take that data and meet with our health plans to the tune of $300 million of premium savings by showing the plans, the data that there's a good risk mix. they've demonstrated that in the rates they've put before californians. coming forward in 2016, there's going to be more plan choices. we'll be expanding from the 10 plans to 12. we're adding oscar and united health care. this means for every californian, they'll have at least three plans to choose from and the vast majority will have four, five, six plans to choose. but we don't think more is
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always better. we pick plans. we make sure that they're delivering value and they're building on the platform that congresswoman matsui noted of making sure that we're changing the delivery system and lowering costs for everybody over the long term. that's the future that we need to be looking for, building a delivery system that puts patients first, makes sure care is delivered when they need it. covered california is delivering on that promise. we still have work to do, and i look forward to taking your questions as we talk about our path forward in the future. thank you very much. >> thank you, mr. lee. and now finally, we turn to mr. jim wadleigh of access health connecticut. you're recognized for five minutes. >> good morning, chairman murphy, and members of the subcommittee. thank you for this opportunity to offer testimony as you examine the condition of several state-based health insurance marketplaces. my name is jim wadleigh, one of the nation's best in healthiest state marketplace.
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access health connecticut was established in 2012 by governor malloy, lieutenant governor weiman and the connecticut state assembly. their leadership has been critical to our success. so, too, has the commitment of the access health connecticut team. since we launched our state-based marketplace two years ago we've worked together to meet the unique needs of our citizens. while staying focused on innovation, collaboration and expanded coverage. today, i'm pleased to report that 760,000 state residents and small business owners have used the exchange to enroll in qualified health plans and medicaid. we've exceeded federal enrollment goals by more than 200%. we've cut connecticut's uninsured rate in half from 8% to less than 4%. that's 128,000 people who are now more likely to go to a doctor. we've worked with connecticut's insurance commissioner to keep costs down. rates for our most affordable
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plans have remained flat for the last two years. we've become a self-sustaining exchange, well ahead of next year's deadline and no longer use state or federal funding for operating costs. how did we achieve this success? we heeded the old adage, an ounce of prevention is worth a pound of cure. we kept things simple and stayed true to our mission. our exchange is considered a national model because of its straight-forward design and ease of use. over 96% of access health connecticut customers say they are satisfied. the development of the stable, user-friendly website was overseen by an executive leadership team with a passion for health care and decades of experience in the industry. we set priorities, established clear business requirements and tightly managed scope of this project. to reduce the number of uninsured residents we conducted extensive research and partnered with numerous state and community-based organizations. this helped us better understand
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and reach those individuals and families most in need. we used creative, award-winning marketing tactics while sticking to a simple enrollment message. in addition to putting feet on the street, we opened store on main street. it's one of two brick and mortar stores we operate. taking a page from apple's customer service playbook, we provide free professional guidance in a personal touch to help consumers navigate the complexity of health insurance. the success of these stores has exceeded expectations. not even the blizzard of 2015 which dumped two and a half feet across the state could keep people away. our year-over-year foot traffic in january more than doubled. access health connecticut is the first state exchange to integrate closely with our back end systems.
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this nationally recognized award-winning apps allows customers to look at accounts, purchase plans all from the palm of their hands. our ability to collaborate across boundaries for health insurance and state human services has been recognized by our peers. solid technology and a commitment to exceptional consumer service has made us a model for other states. connecticut isn't just ahead of every other state, it's in its own league entirely. we will continue to collaborate with other state-based exchanges as we did with maryland to share our expertise, business we will continue to innovate and develop new strategies that expand access to health care, promote health and wellness and eliminate health disparities.
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we will continue to explore new opportunities to reduce costs. safeguard our long-term financial stability and keep premiums affordable to all consumers. and we will never lose sight of why we do this. it's for hard-working people like walter who operates a small small tailoring and dry-cleaning shop in connecticut. once he hit 50 and developed a chronic health issue, his insurance company began raising his rates on a regular basis. walter lives in fear of losing his coverage month after month, year after year. through access health connecticut, walter found a cheaper plan that allows him to keep his own doctors and afford prescriptions. today at age 60, walter says he's living the american dream and has the peace of mind knowing that he can't be drop because of age or pre-existing condition. thank you for the privilege of appearing before the sub committee. i welcome the opportunity to answer any questions you may have. >> thank you, mr. wadleigh. i recognize myself for five minutes of questions. i'm going to ask a number of questions, so please answer them quickly, if you could. first i want to ask each of you
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if your state has spent any federal establishment dollars for your state exchange. >> i do not believe so. >> ms. o'toole? >> no. >> mr. gutierrez? microphone please. >> we have not spent outside any written authority from cms. >> mr. kissel? >> we have one item that we are trying to reconcile with our auditors before spending it. it's in a segregated account. >> mr. lee? >> we are spending establishment funds to continue the final establishment of our exchange, federal dollars, but no operational funds. >> mr. wadleigh? >> no. >> can i ask each of you what your operational costs are this year for the exchange, mr. allen? >> for the current state fiscal year which began july 1st, our operational costs are about $12 million. >> ms. o'toole? >> thank you, mr. chair, sorry, i'm having trouble with the microphone. we are about the same, and i'm
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happy to provide the committee with a full balance sheet of our budget. >> thank you. mr. gutierrez? >> we are still in a very much a build year. our operation and billed expenses within the connector are on the order of about $65 million. >> mr. kissel? >> a little over $8.5 million. >> our total budget is about $330 million. i don't have it off the top of my head. >> and mr. wadleigh, would you know? >> our total budget for the year is $28 million. and roughly $18 million of that is dedicated to operational costs. >> so, with all that, and i would appreciate, this committee would appreciate if we got more detailed audited information as to what your costs are. i'm curious, have any of your states worked out what it's costed per enrollee? mr. allen? >> yes, our exchange is funned entirely through an assessment
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on -- >> no i mean in terms of how many enrollees does your state have? >> right now we have 107,000. >> and how much have you spent so far for operational and establishment expenses, state and federal money? >> are you referring to since the beginning of the program? >> yeah. >> i believe that's on the record of $305 million. in federal grants, and there's a bit more now. in the assessment value. >> if you added state to that as well. >> i would have to add state as well. >> you can get that information for us? >> ms. o'toole? >> you have to keep your microphone on. >> i'm very sorry. mr. chairman, i'm happy to provide you a balance sheet. we can e-mail -- send that to the committee right away. >> mr. gutierrez, do you know what you've spent for established and operational costs per enrollee? how many enrollees? >> not offhand.
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we'd be happy to provide that. >> mr. kissel, do you know? >> i do. it's a very large number. over $50,000. but i want to point out with respect, chairman murphy, it's like saying that the first year's use of a freeway is only for the people, the cost of the entire freeway is only for the people who use it for the first year. >> i got that, mr. lee? >> we have no the done a per enrollee cost, but i note that we've managed over $10 billion of premiums in the first year and a half, and we anticipate over $7 billion in premiums next year. and the $1 billion from the federal government have established -- >> i need to know in terms of your establishment operational costs per enrollee, do you now that number offhand? >> no i do not. >> mr. wadleigh? >> no, i do not. >> i know different costs up front. but of your states, who's keeping and who's turning it over to the federal? who's maintaining your state exchange? oregon you're getting rid of yours, right?
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>> we're operating the marketplace in oregon and using the federal platform. >> ms. o'toole? using the federal >> keeping minnesota. >> retaining massachusetts. >> moving to healthcare.gov. >> california's managing our system. >> connecticut is keeping our system. >> you're getting less and less federal subsidy, right? over time. right? so that will mean more and more to the states. so that's going to continue on. mr. kissel, in your testimony you were critical of project hawaii. can can you be a little more specific? >> yes. when i joined the health octoberer in october 2014, i examined the project which had had a miserable track record. and i admit that. and i looked at the project management tracking tools, and they were virtually nonexistent. the project was not tracked. it didn't have hours tracked. it didn't have a critical path.
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did really didn't define what the end game and goals were. and i was very disappointed, because i came out of the infrastructure business. and i worked for companies that built projects. we built roads, bridges, bases and bombs for the departments of transportation and the department of defense. and these departments had extensive resources for tracking, monitoring and verifying project progress. >> when i read the g.o. report, there were clearly a lot of problems. from the testimony, it sounds like it's all rainbows and unicorns. it's not rainbows and unicorns. it was a mess. there was some mess ups here. some big ones that cost taxpayers billions of dollars, and we'd much rather hear from people who say yeah, let me tell you the problems and how we addressed it. that helps us a great deal. >> thank you, mr. chairman. mr. allen, yes or no, are you denying that your exchange had problems? >> no.
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>> ms. o'toole? >> no, i'm not. >> mr. gutierrez? >> no, i'm not. >> certainly not you, mr. kissel. mr. lee, did your exchange have problems? >> absolutely not. ours had some problems on the way. >> mr. wadleigh, i don't now, it may rainbows and unicorns for you. have even you had problems? >> yes, we did. >> everybody's had problems. what we're thinking about here is how did we recognize those problems and then move forward to try to fix it. i start with you, since you're our model student, mr. wadleigh. if you want to talk about what access health connecticut, very briefly, what problems you saw and what you've done to move through those. i think that would be very instructive for us. >> thank you for the question. so i think, as we've looked at the challenges from the onset of
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this very large project, which really, it was. we saw some of the challenges being time wise. we saw some of the challenges being management of scope. could we deliver everything that we needed to deliver for me in a ten-month period? no, the answer was we couldn't. so we went back to the drawing board a number of times to review everything that we needed to implement for the october 1st, 2013 time frame and deferred functionality out to later months for us that we knew that would not impact our customers. and ultimately that came back around as some of our key decisions that we made, unbeknownst to us, that's really -- >> and are you continuing to try to refine and improve the efficiencies in your system? >> every day. we -- >> thank you. mr. lee, i only have 2:57, so could you answer the same question? >> yea

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