tv Key Capitol Hill Hearings CSPAN November 14, 2014 9:00pm-11:01pm EST
bills to alleviate burdens on small businesses, h.r. 1422, the --.a. science advisory board mr. hoyer: the house is not in order. the speaker pro tempore: the gentleman is correct. the house will be in order. the gentleman is recognized. mr. mccarthy: the first h.r. 1422, the e.p.a. science advisory board reforming at, sponsored by representative chris stewart, would establish board member qualifications. the second, h.r. 4012, the by et science reform act, representative david schweikert, would prevent them finalizing a regulation unless the data is made public. and another by steve scalise will bring much-needed transparency to the permitting
process. i thank the gentleman and yield back. mr. hoyer: i thank the majority leader for that information and we will expect to be considering those piece of legislation. the majority leader, excuse me, has not mentioned, of course, four bill which is i know the majority leader is focused on that are very important and that must be passed prior to -- let me back up. are we still, mr. majority are we still expecting to end this session of the congress on the 11th of december? mr. mccarthy: if the gentleman yields. yes, it is our intention, and i do understand that government is only funded until the 11th. it's our intention to work -- continue to work with you and all members and have that finished by december 11 and be out. mr. hoyer: i thank the gentleman for that observation. let me say, mr. majority leader, i know there's been discussion on your side and my
side of the aisle, i know mrs. lowey is working with mr. rogers to affect an omnibus appropriation bill, as we all know not a single appropriation bill has been adopted. we're operating under a continuing resolution. that's not giving the stability that we need to give to the agencies to know what resources they have to accomplish the objectives we expect. can the gentleman tell me whether or not his expectation is we will proceed with an omnibus out of the ppropriations committee before december 11? and it's not on the schedule for next week, my presumption would be therefore it would be on the schedule for the first week in december when we get back, so that we can send it to the senate to be adopted. i yield to my friend. mr. mccarthy: i thank the gentleman for yielding. the gentleman is right. we did pass seven of the 12 --
11 out of the 12 out of committee. unfortunately the senate had passed none. and the best way for this house and this country to work is through regular order. and we hope to be able to get back that with the new senate. the gentleman is right, it is not scheduled for next week. no decisions are made but there's a possibility that we could end an omnibus in december. mr. hoyer: and is it the expectation of the majority leader that we would be considering an omnibus so that we would do the 12 appropriation bills in a single bill? i yield to my friend. mr. mccarthy: no decisions are made on the direction that we'll go. the gentleman knows that we were down at the white house just last week meeting with the president. i do believe the best way forward is that we would all work together and move this country in the right direction. so no decisions are made on the direction that we go. mr. hoyer: all right.
, we ld say on our side agree with mr. rogers and senator mcconnell who did indicate early on that an omnibus would be the preferable alternative. the problem is the gentleman well knows with the c.r., it gives a very limited ability of agencies, particularly department of defense, at a critical time to plan as they would like. general dempsey and others have mentioned that. so i'm hopeful that we'll be able to work together to accomplish that objective. the other -- there were three others. there's no mention of a tax extenders bill. as the gentleman knows, the senate is addressing that. does the gentleman have any idea, again given the fact that we have essentially three weeks left to go and a few days and cooperation's going to be essential if we get our work done, on where we're going on tax extenders?
i'll yield to my friend. mr. mccarthy: i thank the gentleman for yielding. i had just met with our chairman of ways and means and he's been working in the other house and nothing has been finalized yet. as you know, we had passed many of those bills permanently out of this house. negotiations are still going on with the senate. but it's our intention to have that done before the end of the year as well. mr. hoyer: given that intention , can the majority leader tell us whether or not there is an inclination -- the senate, as you know had, a different approach. they did a limited extension, not a permanent extension. and they dealt with all of the extenders. and they had a two-year extension, as you know. whether or not we are looking at doing something temporarily while we prepare for what i think both sides think are necessary, and that is a major
tax reform bill at some point in time in the spring or the summer, can the gentleman tell me whether there is that component of the consideration of the tax extenders legislation? i yield to my friend. mr. mccarthy: i thank the gentleman again. as the gentleman stated, yes, coming out of the house we made it permanent because that gives much greater stability to the country. and that's still part of the negotiation. the senate has a different idea than inside the house. none of that has been finalized yet. when the negotiation gets finalized, that will give us the answer. mr. hoyer: i thank the gentleman and urge him that we get to agreement pretty soon because if we're going to give some certainty to the business community, as well as individuals, we need to act on that and we have some -- approximately maybe -- maybe 10
days, if we count three days for each one of the weeks at that that's remaining, 10 days in order to accomplish that through the house and the senate. so it's necessary, i suggest respectfully to the majority leader, we come to agreement on that fairly soon. if we're going to have the ability to pass and send to the president that legislation. hirdly, the third of the items , the terrorism risk insurance act, which mr. hensarling just wrote an op ed about. i know the committee has acted or is contemplating action on that. can the gentleman tell me whether or not -- i know there has been some discussion on including it in the omnibus, i don't know whether that's rumor or fact that it's being considered, but account the gentleman tell me where we are on the terrorism risk insurance? as the gentleman knows, it passed 93-4 in the united states senate.
so it was not a partisan bill in the senate, overwhelming support for it. and i would hope that we could move it through the house in a similar bipartisan overwhelming fashion. i yield to my friend. mr. mccarthy: i thank the gentleman for yielding. i had just met with our chairman and he's scheduled to meet with the senate on the other side of the aisle early next week. the speaker and i have both put a statement out that we know the timeline of this, if they can't come to agreement, we are open to doing a one-year extension, making sure that it doesn't have any problems. but we would like to see a resolution of this with a negotiation between both sides. mr. hoyer: the senate bill of course is seven years as the gentleman knows. that gives a certain degree of certainty to the lenders and borrowers and those who do business with both lenders and borrowers and in the construction industry. i'm hopeful we could come to an agreement that is longer term
so we could give more confidence. i think that would be in the best interest, and very frankly i think would enjoy bipartisan significant support in this house, mr. majority leader. stly, the national defense act, authorization bill, which has passed this house, as you know, is pending in the senate. does the gentleman have any knowledge as to where that stands now and what possibilities there are to assure its adoption prior to the 11th of december? i yield to my friend. mr. mccarthy: i thank the gentleman for yielding and the gentleman is correct, we have passed it in the house. we have been working with the senate. think very strongly that we will get this done before september 11. i don't have a set date but -- december 11. i don't have a set date but i believe this is a top priority on both sides of the aisle. we need movement on the senate and we'll be done with it.
mr. hoyer: i thank the gentleman. given that expectation of moving on it, does the gentleman expect or know whether or not we will deal with the train and equip authorization within the framework of the national defense authorization act, or perhaps the omnibus or some other piece of legislation? i yield to my friend. mr. mccarthy: i thank the gentleman for yielding and you were with us at the white house when the president laid out the supplemental. appropriations committee is going through all the funding there. no decisions have been made yet. where that would move forward. but it's our intention to be able to have that question answered and be able to have the resources needed to do the job. i yield back. mr. hoyer: i >> the house and senate back in session before they take a thanksgiving break. to talk about that we give what we can expect, the chief congressional correspondent for the washington examiner.
let star in the senate and the senate and they plan to take up a bill on tuesday on the keystone xl pipeline. six hours of debate scheduled. the democrats from louisiana, why are they taking this up now? how does this tie and her reelection? between is a battle now sitting lawmakers. one in the house, one in the senate. one is a republican in the house. marye senate we have landrieu. they had an election on november 4. there was not a prevailing candidate with 50%. there has to be a runoff election. that is scheduled for december 6. each lawmaker is trying to show voters what kind of impact or influence they have on capitol hill. the best way to do that is to push a vote on the keystone xl project. it is essentially a pipeline
from the oil sands. that will eventually extend all the way to the gulf coast where there are oil refineries in louisiana. they promised job growth, a boost to the economy, and oil refinery. both lawmakers want to look like they are the ones who are one to bring this project to life. today in the house there was a vote on the keystone project. .hey have had several votes they voted again overwhelmingly. to green light the xl project. in the senate next week we are going to see the same thing happened. this time with a bill sponsored by mary landrieu.
the outcome is slightly less certain. the senate is still governed by democrats. they hold the gavel until the end of the year. it is unclear whether they will .et 60 votes needed to pass present obama has said that he is not ready to greenlight the project for variety of reasons. wrong ise will end up up in the air. what this is about as a political battle over this seat in louisiana which is very important to both parties. democrats want to hang onto it if they can. republicans are hoping to take a another seat to add to their majority. that will start in january. it is an interesting vote that
brings together politics and policy. the more exciting of the two will be next week in the senate. >> her arrival in that runoff has been spearheading this in the house. he was successful. >> he was. has promoted his ability or desire to have an impact on capitol hill throughout his campaign. he tried to show senator landrieu as someone who was ineffective even though she was the chairwoman of the energy committee in the senate. it is a tough position to be in because democrats push for green energy jobs. louisiana is an oil state. mary landrieu has been walking that. she's a bit of an endangered species.
she is double digits in the latest poll. it is a tough uphill battle for her to hold onto her seat. and for cassidy, the vote is just another feather in his cap. ,> let's turn to another votes the nsa surveillance program. senator leahy on the judiciary committee tweeted about the being poised to take up this act this month. what would this do and how likely is it to pass? >> it is interesting legislation. bit of an uncertain future in congress. many people support it. you have republicans and democrats behind it. ofwould end the collection data by the government which has been so controversial. it would turn into more of a targeted surveillance program
with extra safeguards in place to protect the public from unwarranted surveillance by the federal government. there are people who oppose it because they fear it may make it too difficult for intelligence to prevent and know about most of terrorism. in the senate there are a lot of people who support this legislation. whether it would end up going through the house before the end of the congress is unknown. i think there are people who say the house would take it up. there are summative proponents in the house on both sides of the aisle. the house version of the similar legislation is a watered-down version, fewer provisions and it that proponents of stopping the boat data collection feel are necessary. they are not the same bill in the house and senate. there would have to be a
unification. there is not a lot of time for congress to work on this. they only have a few weeks left until the end of this congress when they would to build these two up from scratch. momentumdefinitely behind this bill in the senate. it came up by surprise. it rather unexpectedly. i think there is definitely advocates on both sides. it is something everybody will be closely watching and something -- >> obama saying he is going to be pushing for immigration changes. he could take executive action as early as next week. you tweeted about speaker boehner's response to that saying that all of the options are on the table for fighting his plan on deportations. no government shutdown.
if president took action what are the options congress might take? >> republicans are divided. some want to include a provision in the government spending bill that would strip out funding for executive actions. a move like that might get democrats upset in the senate. they may not want to pass a bill like that. republican leaders want to avoid the gridlock we saw in october 2013 over the health care bill and government funding. that led to the government shutdown. in both the house and senate republican leaders are saying no to that option. in some ways that limits what they can do. they are talking my taking the president to court over this. that is a protracted exercise. that may not satisfy the conservative base. they are facing a dilemma. how they want to handle this. there is this outstanding
question on when exactly the president will act. the government funding bill of the congress needs to take up expires. does the president wait until after they pass something? that may buy them time to deal with the issue. the president is weighing whether to act next week or two wait until later which would still fulfill his promise of taking action before the end of the year. >> follow susan via twitter. on the examiner's website, washington examiner.com. >> next, a discussion about the health care law and the impact on consumers. after that, the supreme court oral argument in a whistleblower case. >> on newsmakers, a look at the
affordable care act. she now heads the nonprofit organization and role america with the goal of maximizing the americans who enroll for health coverage under the health care law. sunday at 10:00 a.m. c-span. >> the 2015 student cam video competition is underway. open to all middle and high school students to create a documentary on the theme the three branches and you showing how policy, law, or action in the government has affected you or your community. 200 cash prizes for students and teachers told ling $100,000. for the roles and how to get started go to student cam.org. >> the open enrollment. began this week.
discussion on the impact the laws having. >> "washington journal" continues. host: jane o'donnell is with "u.s.a. today," a health care reporter for that newspaper. open enrollment begins tomorrow. is it going to be ready? are the cites going to be ready? >> i think it's going to be as ready as it possibly can be. all the work's been done, we're all waiting to see and i'm sure folks in the government are nervous, but probably not as nervous as they were last year because there's been so much more testing, it's incredible. it's weeks and weeks compared to 10 days. >> march 23, 2010 that the president signed the a.c.a. what's the consensus on its success? >> it's still pretty divided. certainly listening to your callers and talking to people regularly, people are pretty divided. it's very politically polarized
as you well know. you tend to hear from people who are unhappy more than you hear from people who are happy. i've heard from a certain number of people that even if they're unheam with certain aspects of finding the doctor they want in a plan they can afford, that's a big concern. but some people are getting here that they never could have gotten. so i do hear with a fair number of people with advanced stage cancers who would be bankrupt if it wasn't for the law. i do tend to hear more about people who are paying out of pocket. >> new republican majority, both house and senate, how's that going to affect the a.c.a.? >> guest: you didn't hear as much on the campaign trail, it wasn't the big hot button issue that some expected maybe a year ago that it was expected it would be. what i'm hearing is that there isn't going to be the mood, or even the -- it's not likely to be repeeled.
they're probably going to be changes made. probably changes that everyone would agree should be made, certain loopholes closed. but you'll be hearing a sell about it but i don't think it's the priority that it once was. >> supreme court, what's going to happen up there? >> goodness, i certainly don't know that. but i would tell con seemers, even though the supreme court will look at whether the subsidaries are in fact legal if you're a state that didn't set up your own exchange, everything's going to go as it is now. no matter what the supreme court does, consumers shouldn't do anything different. they should still, what is it about 80% of people are eligible for subsidaries that buy on the government exchanges. so people should still pursue those subsidaries. host: is that the only case on health care that the supreme court is going to hear in the next session? guest: i'm not a supreme court reporter that's the only one i'm aware of. that's the big one. host: before we go back to
calls, want to point this out, the "u.s.a. today" has devoted a page and a half to your story this morning. and it's on rural hospitals. rural hospitals in critical condition, this is the front page of "u.s.a. today" this morning. is this because of the a.c.a.? guest: well, some of them say it's a little bit of the last straw. it certainly isn't because of the a.c.a. rural hospitals have been in decline for a number of years, but it's been a accumulation of things, the death spiral they've been in. one of the hospitals, i went to richland, georgia, right up the street from plains, georgia. their little hospital there, the electronic health records were kind of the last straw, which are required under the affordable care act. but largely, the populations that they're serving, they're serving very poor populations that are on medicare or medicaid, and of course georgia's one of the states that didn't expand medicaid, expansion of medicaid would make a big difference, but wouldn't
save a lot of these hospitals. host: and you have a chart in here over some of the hospitals that are closing. let's show this. is it centered down in the south? guest: it certainly does seem to be. there is a lot in the south. the south is where there's been the least medicaid expansion. there are a lot of these hospitals, it's really, i've covered health care over a year, i've been a reporter for a long time. but there are so many issues that go into this. you feel it can be rather depressing and i've covered a lot of depressing things in my career. there's so much that needs to be done in this air. they're not getting the care they need so they certainly need to be getting some preventive care and healthy lifestyle changes, frankly. host: jane o'donnell is our guest, u.s.a. today. fred is calling from suh city, owa.
caller: obama is from an old third world car who operates on socialism. i like capitalism. he's breaking our country. host: fred, how do you get your insurance? caller: i'm on medicare and i buy a supplemental health care. and i'm retired. host: can i play devils advocate. you talked about the fact -- caller: you sure cut me off fast, i thought it was my phone call but it seems like you want to control the call, if you can't do that, i guess i have to play by the rules. host: i just want to ask you a question. you talk about the president being a socialist and you're on medicare which is government funded. do you see any connection or any conflict in that statement? caller: yes, that's true.
but you can take that. i'm not advocating anything about it at all. rather to continue on this path, go ahead and take my medicare because our country's doing down the tube. it's just a matter of time before the whole financial system collapses, and you want us to pay for this affordable care act by sacrificing our military and cutting it back to dards in the ii stan most dangerous time that anybody could live at. host: ok, thank you fred. any reaction to his call? guest: i will say as an observer of this issue, i find that it is interesting because you brought up the point that comes up for me a lot is a lot of the people that are the biggest opponents of the federal government involved in health care often do get so many entight ltments and so much of their livelihood is dependent on the government. an interesting case, i'm in northern virginia but you go out to rural virginia, it's largely
republican signs but a lot of federal entitlements. host: have the cost of the a.c.a. been in line with what's predicted? have they been higher, lower? guest: i think they've pretty much been in line. it will take a lot to see what the health care savings are. you're not going to see the savings of these people that weren't getting care, are not getting care. i think it's on track so far. host: 36 billion according to a congressional budget office, net cost in 2014, the expected cost $1.38 5 to 2024, trillion. sweetie is in covington, georgia. hi sweetie. caller: hi, good morning, i'm glad you took my call. i'm going to try to be as nice as i can to our government. the affordable care act, i don't need to use it, i've been in business many years, but as a
grandmother i have children that do not have jobs and they're not able to get insurance and they're refusing to even use the social service system because they're saying there are people that are worse off than them. with the affordable care act in my opinion, it's already successful, because the calls that i heard, i do have a heart for people that never had insurance and now you have insurance, that's an excellent thing. but the whole thing with the affordable care act in america, if we continue to break down the person at the top, who's staff to be using his to get america balanced, you're always making references to who the forefathers were. tell the congress they are the forefathers. the forefathers before did what they had to do. since they had such an excellent vision, that's why we're still
tapping into those sources today. host: all right, jane o'donnell. anything you want to add to what sweetie had to say? guest: i'm a little confused, i wasn't exactly sure who she was mad at, but it was interesting to me that she was from georgia because i did spend so much time in georgia. i do wonder if her grandchildren aren't able to get jobs, how she would feel about medicaid expansions that a lot of people feel it would make such a difference in that state, especially if they're not willing to use social services. talk about rural hospitals closing, but the cost to any hospitals that have to continue under law to take these people who aren't getting health care, otherwise when they finally do have that hernia or the heart attack or diagnose of cancer they go to the emergency rooms and these hospitals are getting less money from the government to care for them. host: what is the resistance to medicaid expansion by some of the governors in the country? host: they just say it's going
to cost them. sure now the federal government will help them out but in two or three years, they're going to have to pay, what is it like 10%, and that could be backbreaking and their states are already struggling so much to stay afloat. that is the case. there is so much unemployment and so many businesses closes in a lot of these states that you can understand that point. but it does seem to spend much of next year working on a series of medicaid expansion. it will be interesting to see, even where we are right in the middle of maryland and virginia, one that did and one that didn't. it will be interesting to see what the affects are because these people are not getting, the states that didn't get expand aren't getting any better and they're going to need health care at some point. host: when is that series coming out? guest: in a fellowship so i'll be working on that, investigating it and learning more about it. host: laila tweets in, how many doctors, clinics hospitals
aren't accepting obama care? guest: i don't have numbers, there are no good numbers on that, but i did talk to a few people that had a devil of a time finding a doctor who would take their plan. the provider lists are often inaccurate. there's one man suing anthem blue cross because he must have called 40 doctors and it was either an error or the numbers didn't work or they simply wouldn't take it. so there are some complaints they're not getting the reimbursements under the affordable care act plan as they do under private insurance. host: speaking of numbers, this is from h.h.s., they say that 10.3 million people gained health insurance under the affordable care act. 32 million still lack coverage. political reports via h.h.s. that 9.9 million expected to enroll by the end of 2015. you said it's really hard to get
good numbers, i've got a headline over here from september that says 7.3 million have enrolled. why is it so hard to get good numbers? guest: i did see a report that the 9.9 million is supposedly the net and your 7.3 is the net, so either eight or 8.1 signed up, but then a lot of these people wound up not paying the premiums, which is another problem the doctors have. they don't know whether the person's paying their premiums so they actually treat their parkes and then there becomes a fight with the insurance company, they have to least cover part, i think it's a month of a cost and on insurance companies. for three months you have this 90 day grace period where you an get free insurance. host: when h.h.s. reports 10.3 million signed up, does that include the 19 to 26-year-olds who stay on their parents plan,
medicaid expansion? guest: it has to because it is only 7.3. i think it's the people that got in there under their parents. but the 9.9 is including, that's the net. so that is one of the reasons it seems like such a conservative estimate is because they were saying ok, a certain percentage, maybe another million or two, probably won't pay their premiums. o they're estimating that now. host: is it tough to get numbers out of h.h.s.? guest: it's tough to get everything out of h.h.s. again i've only covered them for a year, but i've covered federal agencies and this is a tough administration. host: hi alex. caller: good morning. first i've been around the a.c.a. for a year and i get a great subsidary in new york and i'm happy with it. just had a couple of comments. peter, you read from the "wall street journal" about how many people lack a basic understanding of how they can reenroll.
then you roll that clip of mitch mcconnell saying people hate it. how can people hate it if for example they don't even know they can change their policy, like that. that level of ignorance, half of them really say they hate it. my second point it seems like a psychology. i was a school teacher and i resented to have to get insurance, i always had to be a school teacher and do something i didn't really like. now i can do what i want to do and not be tied to my employer for my health insurance. host: how much do you pay a much? caller: yeah, i pay around $100 a month for my premium and receive a subsidary of little over $200 a month. and i have a bronze plan. host: are you employed? do you have a full time job? caller: i'm self employed. host: ok. caller: and yeah. host: anything else you would like to add? caller: well, i wanted to ask your guest, the psychology of it, it seems i'm more
liberateded. the gentleman from iowa who calls and hates obama, yet he's on medicare. what a great thing to be in our old age and not have to be consumed with this fear of going into hundreds of thousands of debt to get your hip replaced or your heart fixed. it's a wonderful thing. i don't know why people are so afraid of it. i wonder if your lovely guest could tell us. guest: it does seem to be politically motivated, generally. psychology, some people, whether i was in georgia or no matter where i was, there is a certain, you know, knee jerk reaction or kind of gut feeling. i shouldn't have to, i, meaning as a taxpayer, shouldn't have to pay for these people who can't pay for themselves. but, you know, i think when a lot of people see the subsidaries they can get and if they are indeed successful getting doctors, i think they would probably agree with the caller, where i found more complaints are the people who
are more middle class aren't getting subsidaries because as individual insurance, it isn't cheap to buy insurance on the exchange, or through just generally speaking it was never cheap. so they tend to get kind of upset and people, people, my company and other companies who are seeing they have higher and higher deductable plans get pretty upset and companies will often blame the affordable care act. sometimes that prickles down. host: in the "wall street journal," this democrat is giving up on obama care, nonprofit, professional and former hospital insurance coordinator currently works as a counselor at a social service agency in denver. he writes i voted for president obama again in 2012, then received a cancellation notice from my health insurance. this was due to obama care, the so called affordable care act. however i couldn't afford anything else. obama care is a failure for
anyone who thinks this is a misprint because no democratic activist would make such a comment, let me add that it is too big, too complicated and too expensive without a public option within its network of exchanges, obama care is a giant blank check to the insurance companies that pushed it through congress. is that accurate in your view? guest: well, i'm not going to give my opinion, but my thoughts on that are that it has done a fair amount of good. it is fairly complicated. i think it's going to take a while and require a lot of adjustment on a lot of people. i hear this a lot, people are still angry about is so-called promise that you can keep your plan. i heard from someone yesterday who said president obama said i could keep my plan and i couldn't. and their rates went up considerably. so you can understand why people are upset if they have very limited income and they're paying $300 more out of pocket.
host: how widespread was people losing their plan? caller: well, it was quite a few people. millions of people probably. i don't remember the number exactly. but it was quite considerable. now they may, they did get to keep them for a while but you're going to start to see more people get upset. there will probably be a second wave. host: doug in north carolina, gets employer insurance. hi doug. caller: good morning, how are you doing today? just wanted to flake a comment, i was listening to several of the callers, and there was a gentleman on just now talking about the gentleman being dissatisfied with the medicare, medicaid. i worked all my life, since i was 14 years old working in tobacco, in north carolina. i'm quite tired of having to take the burden on of everybody else. my deductable went up to $2,000. i went to purchase some meds and usually would have a $10 co pay
and now my meds are going to be $120. host: and this is through your employer insurance, doug? caller: yes, sir. host: why do you think the cost has gone up? caller: because this failed plan -- host: that your opinion or have you been told that by the people who run your insurance? caller: no, it's my opinion. to me, it's -- and she was making a comment that a lot of these comments may be politically driven. but, to me, it's taken away from our individual liberties. by forcing us to do this. you've got people that will get out and work every day, and are having to take on the burden of everybody else's insurance because they won't get out and work. i'm in a business where i see it a lot. people come in and they're driving vehicles that are worth more than my car, but yet they're getting services from the government. individuals need to take on
responsibility. we've been put into, i think a lot of people are being put into a nanny state and being dependent and made to be dependent on the government. where i came from, you get out, you work hard, and you pay your way through life. host: that's doug in north carolina. jane o'donnell. guest: he did sum up some of what i've been saying. he makes a very good point. i was talking to a colleague who has the same kind of thing where they're paying out of pocket, he's paying out of pocket for prescription medications until he hits his deductable, which was $3,000. you have that, you're not going to hit it. it can be very jarring. if you are someone who, when i bring up the political side, it is just kind of your theory on whether we should be helping the less fortunate of not, which is the idea of the affordable care act, provides care to people that can't have it or haven't been able to have it and can't afford it. so, we're looking a lot at high deduct i believe plans, as the
next big project we're working on. because it is going to be, i think the big story of the next year. host: so affordable care act, has it caused employer plans to higher? that was a very inarticulate question. host: but i know what you mean. there's a lot of blaming and scapegoating of the federal government in the law going on. it's difficult to prove but certainly this past year there were not so many costs that companies really could legitimately, regularly say sorry folks, your plan is going to cost you more because of the affordable care act. that was very convenient in a lot of cases. however they are going to have these cadillac plans, the really good plans that provide so much and so little out of the pocket cost to employee s, employees are going to be penalized in a few years.
so they are gradually going to these higher plans so we're all going to have to get used to that paying much more out of pocket and having sent deductables for family members. so it's the future. host: jim is in bay city, michigan, employer pranrovided. hi jim. caller: good morning, steve. i'm 91-year-old senior that's been a very good insurance with the company, but i got a daughter and her husband that's paying horrible, horrible deductable. no way in heck they can afford t. this new plan coming up, i suppose will be higher than ever. thank you. host: let's go to amy who is enrolled in the affordable care
act. caller: i think it's great. they wouldn't even pay for the testing for a life threatening condition i had. it took me two years to pay off the tests that they turned down. today, today i'm getting medication that will save my life under the affordable care act. host: what was your experience signing up? caller: it was easy as cake. i'm in seattle, i get to see the best doctors in town. there was someone at a local medical clinic that helped me sign up, it took me under an hour. it was easy. host: are you on medicaid xpansion or in a private plan? caller: i guess it's medicaid expansion, it's washington state. host: washington state. is there any cost to you? caller: there is not. they're literally saving my life. i have a life threatening condition that would have killed me in five years and today i'm
getting medication for it. host: thank you jam. jane o'donnell. caller: those are the stories that are heartening to hear and the administration wants to hear more of. that seems to be the lines the issues drawn those are the issues that are drawn down. theirople who are having lives saved or a getting medication for pre-existing conditions. that can really bankrupt people. it has done a lot of good. washington state is running its own state exchange. have some ofeem to the issues as, say, maryland. the state exchanges did tend to have more success. so much is being done for the federal exchange. i'm not expecting to wake up and have it implode.
there will be some problems. there are some fixes that will probably come in 4-6 weeks. i'm doing a story in a company that does have -- handle some of the exchanges. upgrades should allow handling all of the people. we will write a running story. it is kind of like gearing up for black friday. 's calling inon from west virginia. caller: good morning. wife now has the affordable care act. she had no insurance for eight years.
medicare. she has great coverage. you can't just look at the surface. you've got to look at the whole thing and see what money you can get extra. you can't do it by just going online and seeing the policies. you've got to fill the information out and then they will tell you how much you are going to pay. guest: people could be windowshopping today on healthcare.gov. you might have sticker shock like you do in a car dealership, but you need to realize that if
your income is below a certain level, you could get substantial subsidies. pointimportant to make a to be a don't want payment buyer when you are buying a car. you don't want to buy by the premium. if you need prescription drugs condition, the insurance will consider whether paying $300 or $400 per month, so that you do not have to pay out-of-pocket. it can be budget busting. the whole idea is for people to not have to go into debt. host: this is a tweet. it is probably because i have not brought it up. jonathan gruber, rich weinstein. they are talking about hearings on capitol hill.
mr. gruber is speaking on those hearings. it is -- is it a sideshow? guest: i think it is going to be a sideshow. i try to ignore that part of it. i do think it has become this kind of dramatic, theatrical sideshow when it really is important to focus on what you can afford. up, but can get caught you need to focus on, you need to have insurance by february 15 or you will be paying more at tax time. host: this is another tweet. very much so. we will see employers contributing to those more. -- is so much that many of us have not had to pay attention to, myself
included, because we have not had to pay out-of-pocket. it really is something that people need to consider when they have these plans. it is kind of like free money. host: hosea is calling from new mexico. -- jose is calling from new mexico. caller: i believe i speak for probably the majority of the american people, millions, hundreds of millions of when i saynd myself that we are disgusted with dr. gruber calling us stupid. he just proved that a phd can be stupid. i think the results of the election we had proved that the american people are not stupid. want gruber and these other idiots thinking that we are.
i hope the aca is dismantled. republicans to planld some sort of a self that works for all americans, whether you are poor, middle class, wealthy, whatever. we do need a safety net. that is what medicare and medicaid is for. in a country like america, we should have that. the middle class is being severely hurt. they are paying a lot of money. old saying, you can keep your plan, you can keep your doctor. that is not happening for the middle class. i just hope that the new congress, the republicans can fix the aca in a way that is fair for everybody.
host: all right. guest: i do think it is important to remember that we thataying for these people people don't think we should be paying for when they go to the hospital anyway. the emergency room has to treat people or stabilize them. such a large portion of the american public are not insured, are not getting health care, it is still costing taxpayers a lot of money. there are uncompensated care costs that hospitals have. i respect the caller's opinion. everyoneunlikely from i talk to that the law is going to get dismantled. health care costs have just been skyrocketing. suit -- those guys agree that something has to be done. it is very unlikely that that is going to happen.
"the new york times" has been putting together a series of articles on the aca with the question, is it working? they look at several different areas. as health care spending slowed down? medicare expansion, the effect on the health care industry. they talk about the percentage of uninsured people. they say that the number of uninsured americans has fallen by about 25% or about 8 million to 11 million people. you have reported on the health care industry. about thea little bit rural hospitals. what about the health care industry overall? it needs more people to be insured and it is going to help the industry more.
a huge primary care doctor shortage. we need more doctors to be treating all of these people. it does help the hospitals, the more people that are insured. we have a graph on the front page today about where the money comes from generally. so much of it is either from government sources or they call it self pay. hospitals often kind of smirk because so few people can pay. that goes into the bad debt that the hospitals have. they need as many people as possible to have insurance. this chart,ing to rural hospitals are getting 45% of the funding from medicare and another 14% from medicaid and other government 1.5%. well over half of their income. it is higher for rural hospitals because of the poverty
in a lot of these areas. urban hospitals are very similar. in washington dc, i bet it is almost the same. the people that are private pay until thee, deductibles become insurmountable, are generally paying their bills. the bad debt is not quite as bad. host: are more private companies getting into the exchanges? you have seen a little bit of a trend that some people find alarming where companies are letting people go, we are not going to have insurance. we'reies are saying, going to go to the exchanges. speaking, companies want to get out of the business of insurance. they will have private exchanges that they can outsource that type of work.
the government is very happy that employed people are having to go to the exchanges. that is not something they were banking on. host: are more health-care companies getting into the affordable care act business? participating? guest: for their employers? .ost: for the competition on the business side, or more companies saying, i want a piece of that action? guest: definitely. you see a lot of new entrants. medicaid companies are getting into insurance. there is quite a bit going on. there is a company that i am working on a profile of. saw this andle thought they were going to get into the business of setting up exchanges. software companies. there was a lot of growth in this area.
get into software or health care, those are the growth industries. host: dave is in maine. caller: i would like to ask a question about this. it seems to me the affordable care act blurs the lines between consumers and conscription's. this was nots into good enough, now we have gone to coercing and exporting the public trust government passed out of legislation. i would like to comment on this because you are a consumer reporter. it seems that consumerism is an act would take on freely and not being forced to participate. guest: it becomes kind of a political issue. we had to pass laws to make people wear their seat belts. i'm a reporter, not a political analyst or opinion writer. peopleis a matter of
probably would not do it unless they were required. the government increases they have to believe the penalty to get people to do this. if the government is paying for these people to get health care anyway and is is -- it is often when it is too late. the cost of treating things early as opposed to two late -- huge difference. it is going to save the government a lot of money and they have to force people to the extent of making it too expensive at some point to not do it. host: jamie and michigan. caller: we are very satisfied with the aca. our son and daughter-in-law finally have insurance. they don't have to worry if they have to go to the hospital or see a doctor. i'm on medicare. my husband is on medicare.
we still have the same doctors. we can go to any specialist without referral. our grandson is totally disabled. now he is on insurance. these people calling in, they don't know what they are talking about. c-span when they were putting through the aca. most of the amendments that the republicans are talking about now, they are the ones that put them in. i watched a meeting with president obama, i watched day and night when it was being made. republicans why the want to take the insurance away from these people now. thank you and have a good day. guest: i don't know that the republicans want to take the insurance away.
but they want to try something different. we will see what they come up with. said, these- caller kinds of cases, her disabled grandson, that is why the law is in place, to help people like that. seem to a lot of people to be the american way to let people like that go without health care. others may disagree. that is what the authors of the law want to to do. we have heard that the majority of americans want obamacare to be repealed. here are three gallup polls that have come out. more willing to defy obamacare rule about 35% of uninsured people in the u.s. would rather pay a fine than buy coverage. according to another poll, newly
insured through the exchanges give the coverage good marks according to this gallup poll. overall, not just the affordable care act, but the overall health care system, here is another poll. americans satisfied with how the health care system works for them, two out of three or satisfied. it comes down to what your personal situation is. i guess i was more of a risk taker when i was younger. there is a certain percentage of people and they are willing to say i am willing to take a chance because they are young and healthy. i have never gone without health care and i cannot imagine doing so. the options are going to be a lot smaller for where you were going to go to get health care. the federal clinics are going to be cut back. if you want to pay out of pocket
at an urgent care center, that is fine. it is interesting to see how contradictory and divided it is. practitioners going to become more -- nurse practitioners going to become more? guest: oh yes. physician assistants is one of the top jobs. because of the shortage of primary care doctors, there is going to be such a need for these kind of people, particularly in rural areas, but just anywhere. for basic things. host: have you noodle the round on healthcare.gov to see about buying? guest: i browsed around and it is a lot more user-friendly this year. i tried last year and i could not get on at the beginning. it is not orbitz or any of these other sites where we buy airline tickets or anything like that. it is starting to get better.
this is such an important decision and you need to be able and see if the doctors .nd hospitals so many of these people have never had insurance. they don't understand that there is often cost-sharing involved. host: jayne o'donnell, front-page piece this morning >> we talked to journalist david drucker about the current lame-duck session of congress and leadership elections for the next session. this is 45 minutes. >> our conversation about the affordable care act continues this morning, the second
enrollment begins tomorrow, november 15 and goes through february 15. we are going to talk about some of the economic aspects of the affordable care act. here are the numbers on the screen. we want to have you as a part of this conversation. (202) 585-3880, democrats. (202) 585-3881, republicans. .ndependents, (202) 585-3882 at the university of chicago's casey mulligan, a professor in economics. joining us on our set in washington is henry aaron of the brookings institution, and economics studies senior fellow and has covered health care for a long time. professor mulligan, i want to start with you in chicago. the white house said that here are some of the goals of the affordable care act. , put more money in
family's pockets. number two, help slow the growth of health care costs. reduce long-term deficit. improve health and make workers more productive. reduce job lock and encourage mobility and entrepreneurship. finally, improve financial security in the face of illness. casey mulligan, in your view, has the affordable care act achieved those goals? you asked me in the present tense. a lot of the provisions that the white house intended to achieve those goals have not come into play at. the cadillac tax. they intend that to help reduce the cost and that is not coming in until 2018. it is probably fairer to them, will it ever achieve those goals? there are a bunch of goals you mentioned. some of them, no, it will do the opposite.
the productivity example. there are so many taxes in this law. different workers, different sectors. it is going to cause people to do business differently than they do it now. tax andl do it for subsidy reasons, not for good business reasons to make the adjustments. that is going to be a loss in productivity. be $6,000 perwill year per worker who gets insured because of the loss -- law. i give an example here in chicago. our lowly cubs changed the way they do business with their grounds crew. not for good business reasons, but to save on taxes or penalties or whatever you want to call them. they were not able to handle 15 minutes of heavy rain and you lost half of the ballgame. that is a loss in productivity, a loss in value to the customer.
those kind of things are happening all over the economy and will happen even greater amounts when the lawfully kicks in. that is a big loss. they have it backwards to say that they are enhancing productivity. one can look at the price side of what the law is doing or the benefit side. law is toive of this enable people who previously did not have access to health insurance and hence suffered needless illnesses to have better access and that will improve their productivity. -- and thismployers is well-established among deciding hownd up much they want to pay workers overall. if they are paying more in the way of health insurance, there will be a little less wage, but there is no evidence that the
overall impact on the demand for labor by employers should be materially affected. but there is a more fundamental point really. this argument that the trade-off is between efficiency and compassion has been going on for 200 years, ever since the english poorhouse, when critics complained that if homeless mothers were given shelter and food and her children were similarly supported that somehow it would induce bad behavior on the part of the lower classes. we have is a compassionate society here and in all other developed countries struck a balance between providing support for those who need it and the kinds of incentives to which professor mulligan drew attention. there is a trade-off. i think the trade-off that the law strikes making sure that people have adequate insurance, giving them the option if they choose not to buy it, not to buy
it, and pay a tax instead, that is their call. it improves the options that are available for people to be able to achieve a fair balance between their needs and the incentives of society and that it requests for economic efficiency. guest: i'm glad we agree there is a trade-off. the white house to be killed study.- due a detailed there have a positive side effect to the trade-off -- they do not mention the trade off. at the end of the day, we made reach the right point in the trade-off, but i'm very worried that we do not discuss the cost part. ,here is a large employment tax the economic equivalent of an employment tax that is not
discussed anywhere. not in the white house, not a brookings, not at rand, no one is discussing it except in my book about the economic side effects of the lot. it is a huge tax. on mica andory laura smith from long beach california. 60's.re in their mike had a district manager job. the law said, look, we have big subsidies for you. npr was celebrating the big subsidies. what they didn't mention is that mr. smith had to get out of the job to get access to the subsidies. really a penalty. look, mr. smith, you want to make great contribution to economic activity? we are going to pull something back from you. as soon as you stop making your contribution, here are your goodies.
i may agree at the end of the day that balance has been achieved, but how do we know we achieve the balance unless we discuss it? jonathan gruber never discussed the employment tax. let's have the discussion and quantify it and compare it to the benefits and use arithmetic and numbers. guest: since we are going by anecdote, let me go back to the chicago baseball team example. i sat on the committee to study the economics of baseball several years ago. mulligan,ure mr. professor mulligan, that the owners of the chicago team could have afforded to pay their groundskeepers more. that was not an effect of the affordable care act. that was an excuse for the management to try to lower their and there was nothing in the economics of the situation that required the
sacrifice of the game that he described. aaron and casey mulligan. sy's calling in from plainview, new york. caller: good morning. i have been listening to your conversation. i have several comments to make. curve isall, the cost supposedly going down, but i think that is in effect a very high deductibles. to what iording looked up, is between $3000 and $6,000 per person. they are not really able to access health care unless it becomes catastrophic, in which case the plague would act as catastrophic insurance because you have to pay $3000 to $6,000 out-of-pocket, plus your monthly
premium. it becomes prohibitive. i don't know why they call it the affordable care act. it is only affordable to the lower, middle, and lower classes. the middle and the upper classes have subsidized them. if it was so great, why didn't the government try to get out of it themselves? and then when they could not get out of it and were forced to take obamacare, they somehow finagled subsidies for themselves, even though their incomes are well above the parameters for subsidies which end at $4000? host: we are going to leave it there. guest: let me start with the second part. the things i do when i am not here is sit on the executive board of the d.c. health exchange.
basically, what the federal government employees are doing is getting an employment-based insurance plan through the d.c. health exchange. as with other companies in which the employer pays a portion of the premium, that is also applying here in the case of federal employees. there is no really any special deal and there is no separate subsidy for employees. they are simply buying health insurance, buying coverage through the d.c. health exchange. curve, therest always has been a trade-off between paying high premiums and having low out-of-pocket expenses when you use health care or paying lower premiums and having to pay more up front, in the form of deductibles or some form of cost sharing at the time you use the services. that trade-off was not repealed
by the affordable care act. and this goes back to the bush administration and the medicare expansion act have been encouraged to move in the direction of high did a double plans. whether that is a good thing is something that is quite controversial. personally, i would go for a high deductible plan myself. but not everybody has the same tastes or risks that i have and might prefer more complete coverage of they want it. now, as in the past, they can get it by paying higher premiums. those are the gold or platinum plans under the health insurance exchange. i agree with the basic that one of the ways to bend the cost curve is to ask people to have more skin in the game and pay more when they make those visits.
that is a kind of trade-off. the other way i like to look at the cost curve is not in terms of inflation rates and health are, but how many hours does family have to work to pay for the health care that is received? the growth rate in that has not fallen at all. people are making less per hour. the growth rate of their wages has not been so great. previous trend in terms of how many hours you have to work to pay for health care has continued at the same rapid pace that it has been for a while. host: a tweet to the washington journal. guest: i'm not sure what aspect of sustaining. yes, we could sustain.
we can have a society with less free stuff rather than more. it is sustainable. maybe it is not desirable and it has winners and losers, but you could do it and our economy would be bigger now and more people would be working. work would be creating more value in the marketplace if we had stayed with the old system. but it has its costs. host: susan is calling in from the suburbs and virginia. -- in virginia. caller: good morning. this is an interesting conversation and i had to get up and call. i was on thement, internet for two or three days and it kept crashing. plan, iup buying a needed a really good plan because i am a prior heart patient. the cost now with having an
individual plan in northern virginia because i had to use the federal exchange is over $1000 per month. i cannot, for the life of me, understand why we could not get to buy into better drug costs , which i think big pharma has a hand in here. and then the insurance industry is giving me the option of one ppo and everything else was hmo. hmo, in the past, i had such a horrible experience because of my heart, they botched it, unfortunately. i don't know at this point what i am going to do. i see the cost going up and up. host: what would you like to see done? what the would like gentleman said here. financial transparency.
you have got to get into these and let the consumer and the reporters look at all the details. without the details, you cannot make a good decision. guest: let me first point out that under the prior system, it was sustainable. the caller would have faced medical underwriting from insurance companies and premiums that likely were even higher than those she now finds so distressing. and very possibly, she would have been denied coverage altogether or, if granted coverage, she could have been given some services and then the insurance company could have elected to cancel coverage altogether. federalw, through the exchanges and state exchanges, there is a menu of four grade levels of plans, ranging from pretty comprehensive coverage and that carries i premiums.
, you can have plans that have high detectable's and be a few thousand dollars per year and higher charges when you use services, until you have paid a certain amount out-of-pocket. at that point, everything is covered under all the plans. the premiums are much lower for that kind of plan. that is a trade-off. that is a fact of life because there is a simple iron law. the insurance companies who are writing your coverage have to collect enough money overall to stay in business. that means transferring funds tom those who are healthy those who are sick. mostu are paying everything in the way of health care, they are going to charge higher premiums. host: robert is calling in from illinois. caller: yes sir.
i have a few comments. hard and soft manipulation. tonsparent in regards getting elected by saying we will provide you health care to the masses. whenever you engage in that kind of behavior, people love free stuff and free health care. everything is not too free. is ifuth of the matter insurance companies were not so greedy and regard to pre-existing conditions, they would never have been able to engage in getting elected on the platform. everybody should be transparent in regard to corporations and ties to big form a cynical companies in order to get elected. the only beneficiary to the aca
is the pharmaceutical companies. in chicago, illinois, we have a bunch of them. the fact that everybody is required to pay for health care is ok, but when it gets to the point when the working poor and the middle class are paying for andybody and the rich again the pharmaceutical companies are making billions and billions of dollars. host: casey mulligan, university of chicago. callersoth the mentioned that they want to see some transparency and see the costs and benefits laid out. i agree with that. i am pessimistic. the new york times does not mention the tax that a pointed out. it is the single biggest tax. the don't mention it.
why not question it -- why not? maybe they think that the law is a good law and it is not a good idea to shine a light on its costs because others who are not as smart will exaggerate those costs. i'm pessimistic that we will see it. get very little coverage. i really appreciate being invited today. i think that is a permanent state of affairs. casey mulligan is the author of the book "side effects." he did a study for the mercator's center on the affordable care act and the economics of part-time work. henry aaron has been with the brookings institution since 1968. how many of those years have you studied health care? 1980, afterrted in
a stint in government were i was given a job because what i knew about welfare and social security. in the course of my two years in government service, i realized that health care policy was the emerging issue and the most important domestic, social policy issue that the nation would be facing and i think events have proven that inside correct. .ost: paul is an arkansas is that arkansas or alaska? caller: you always get it mixed up. ak is alaska. host: we are even. [laughter] caller: i asked her economics , couldor -- mr. mulligan you define fascism? my follow-up with liberty.
here is the issue. medicare.m on -- 68 years old, i'm on medicare. everyone i think a unique health care and we are going to force you to take health care. do you want it or not? president obama has said, i've got the pen. fascism is a situation where everybody, whoever is in power, whatever they say goes as law. that is based on roman law. our government, we based our government on common-law, which is a bicameral system and where the people have a say in the situation. host: we appreciate that. you have given us a little bit of that philosophy and titus into the affordable care act. areer: why so many people
rejecting the affordable care act is that we are being forced without any say, we are being forced to buy this policy. host: let's begin with casey mulligan. i'm not an expert on politics. i know that plays in. i wish i had more expertise. i would like to see the political process be more competitive. we have too many districts that are either all republican are all democrat and they virtually have nothing to choose from. is alack of competition problem. i'm not sure how it feeds into health care, but i sure it does. ly agree complete with professor mulligan about the lack of competitive districts. we have an elected congress that can be voted out of office.
as many democratic incumbents recently discovered. if you don't like the law, elect people to change it. that is called democracy, not fascism. host: leonard in ohio. caller: good morning. reagan saidident that insurance and everything would go down. now, we have the affordable care say is ah some people give me from the government. i would like to ask your guests, what is the difference between a person receiving welfare and the whole state receiving welfare? virginia,inas, florida, georgia, alabama, mississippi, arkansas, texas or welfare states. could you explain to me what is a welfare state? host: henry aaron? can answernot sure i
that question directly. there is something about all of the states that's a gentleman mentioned. they have elected to make a very bad deal for the citizens of their own states. support fromused the rest of the united states for expanding health care for poor residents of their own state. that strikes me as a poor decision. in the case of virginia, where i looked up the numbers, we are looking at a state that is turning done $2 billion per year in steady money. the enrollments have leveled off. funds would come from other states to support local residents. how thet clear to me legislature in the state of electoraten face the and say, we are turning done money and other states to help us support your neighbors.
the law does have built into it at the state level some perverse incentives. they are inviting individual states to take out of the federal treasury. america pays for that. surprisingly, a number of states have declined to take a bite out of the federal treasury. the rest of america ought to thank them, not criticize them. in charleston, south carolina. caller: very interesting show. i have a short statement and one question. real easyeasy -- is for people on obamacare to make the statement that they love it, they like it, they like everything about it. that is because most of them are not paying for it. now you get to the people who are paying the bill. i am 67.
i have worked on my life, paid my taxes. my question is if obama's amnesty plan goes through and we add 4-6,000,000 more people to our country, i would think that the majority of those people would not have money to pay for the affordable care act and they too will get a subsidy and the people that is paying the bills, the subsidies, how can you expect the 50% of people in this country paying the bills and the other 50% are sitting on their behind? something is getting to a boiling point. the country is already bankrupt, they just don't put it in words. this is causing a horrific rift between two sections of people. everybody is that their throats and we have mr. obama to thank
for it. i understand the frustration, but with all do respect, i think you have things backwards. people who are here without documentation are receiving free care. ,hen they go into a hospital the hospital is legally required to provide care for them. the kind of measures that are reported to be under consideration by the administration would enable those people to take regular employment and earn more than they are now able to do because they are not allowed effectively into many kinds of jobs. i think the measures that are now under consideration would actually help deal with the problem which troubles you, the last caller. i do understand the frustration.
you don't like to have freeloaders in the country. but i think the measures that the administration is considering would help ameliorate and reduce the magnitude of the problem that troubles you. host: william is in virginia. caller: i would like to ask the guys as they have any opinion on insurance companies. and they doinesses it by actuarial analysis. is there any way, any better way than what we have going on now where you could bend a business with a systemnce like they have in canada or something where everything is supposedly free? some thoughts on that. thank you. the caller is right. part of the insurance business is actuarial analysis.
another big part of the insurance business is regulation. the regulations are not new. they are increasing over time. that hurts the value that customers get out of their insurance. of those employees have to be devoted to understanding regulation, leveraging regulation to their advantage, lobbying. i would like to see a lot less regulated insurance industry, at least the part of the insurance industry that would be unregulated and people could deal with. that would save a lot of resources. something like 35% of insurance is overhead. costs thate types of every insurance plan owner has to pay for. they are really not necessary as a matter of technology. know: the collar wanted to if there are alternative ways to
pay for health benefits and pointed to the example in canada. there certainly are. the united states has one particular kind of arrangement under which private insurance companies provide most of the coverage. casey mulligan and i disagree about whether the insurance industry is desirable or essential for the industry to function reasonably well. there is no question that we could, if we wished, have a different kind of system. the canadians as do, a system organized by the state, but officially under a national law that requires a degree of uniformity. it pays through most of health care through taxation and provides services at lower price , at least hospital services, at the time the people made them. a lot of other countries do that .oo these systems have advantages and disadvantages.
there is one thing in common across the world. unless something really horrendous changes, we evolve, we change gradually. that is why for all its flaws and complexities, the affordable care act actually builds on the system that we had. it is an incremental change. it did not sweep out the whole health care system and replace it with a national health service as in great britain. it did not sweep away employment-based coverage and , as everybody a voucher senator mccain suggested during his presidential campaign. it builds on our system, which happens to be the most complicated in the world. surprise, the reform is complicated. it annoys a lot of people, it annoys me. i think there are things that can be done better. but if we were not going to have a revolution in the health-care system, we had to build on what was there before. it is a very complicated system.
the various disturbances that people are expressing frustrations are a product of that decision. sense that theny nation is disposed for revolutionary change, either toward vouchers or toward a national tax finance system. was barely tolerated politically, the reform that we had. we are going to try to make it work. i think it will work eventually. it will take time, money, patients, and i think we will be better off for it, but it is not going to be a smooth, bump list trip. mpless trip. host: casey mulligan, what would you recommend? guest: i would recommend a tax credit for people who don't get health insurance through their job. that would build on the old system, which had texted actions for people who did get it through the job.
i would roll back some of the regulations in the insurance industry, such as competing across state lines. it is hard to know exactly what that would achieve, but i think the market surprises you. i would do that. something needs to be done about pre-existing conditions. you don't need to have a huge redistribution to deal with produced or brooding -- pre-existing conditions. i think that is one of the big things that came up in this law. jim is in hamilton, montana. caller: yes, good morning. i was calling in to say the same thing. we get billions and billions and billions of dollars away. why can't it be free? pharmaceutical bills 32 -- $.32 to
$.87 of powder per pill. they are making $10 or $20 of pill. that is beyond greed. care, weup the health are going to have more fairness for the corporations and what they are charging their customers. but it should be free for everybody. host: casey mulligan. free? free stuff is a path to a real small economy. people create value so they can earn profit or a wager what have you. that goes for the workers. they work so they can get health care and schooling and vacations. the pharmaceutical companies as well.
they need to make money on their successful drugs because they have a great number of drugs that are not successful and they still have to pay the scientist 's and pay for the fda trials and so on. they need to earn a profit. you take away the profit and you are not going to have new drugs. there will be people who died because a new drug was not there for them because we were demonizing the inventors. for a long time and i think with some justification, people have been upset at the way in which insurance company executives have behaved. some insurance companies have engaged in what i would regard as really deplorable behavior and stonewalling certain practices. fundamentally, professor mulligan is correct. selling a product, insurance in this case. they have to receive enough money to cover costs. they have every incentive to try
to hone down those costs. that is where regulation comes in. in some cases, companies have engaged in practices in order to hold down costs that the american public to floors. you make a big claim, your insurance gets canceled. you happen to have had an illness in the past the past, we you really exorbitant premiums. this kinds of practices marks the reputation of the insurance industry. some bad actors have engaged in at. some of the behaviors have been driven by competition and the need for making a profit. an industryates intelligently, and i would be the first to say not all regulation is done intelligently , if one does it intelligently, the nation ends up gaining a lot . it gets a better product and at a reasonable price. host:
announced this week by the u.s. and china. and timlin much of the cato institute will discuss forfeiture loss and the renewed focus on police abuse of those laws. you can join the conversation at facebook and twitter. "washington journal" live at 7:00 a.m. eastern on c-span. >> this weekend we partnered with charter communications for a visit to madison, wisconsin. >> bob lafolette is probably the most important political figure in wisconsin history and one of the most important in the history of the 20th century
in the united states. he was a reforming governor. he defined what progressivism is. he was one of the first to use the term progressive to self-identify. he was a united states senator who was recognized by his peers in the 1950's as one of the five greatest senators in american history. he was an opponent of world war i. stood his ground advocating for freedom of speech. above all, bob lafolette was about the people. he spent the latter part of the 1990's giving speeches all over wisconsin. if you wanted a speaker for your club or our group, bob lafolette would give a speech. he had been to county fairs. every kind of event that you could imagine and built a reputation for himself. by 1900, he was ready to run for governor advocating on behalf of the people.
>> we're sitting in the first studio of frank lloyd wright. wright was actually born in richland center, wisconsin, which is not too far from here and he was -- his family took him first to weymouth, massachusetts, for a time. then they turned to madison. and he grew up in madison, spent his teenaged years there and attended very briefly a few years at the university of wisconsin before he decided to take off and find his fortune in chicago. decided he should come out to this part of the country, which is where her family was, the lloyd joneses, welch pioneers and spent his summers here. he spent his teen ainge summers in this valley, in these hills and that's where he got two things -- his love of nature and his understanding of nature. and he also got his understanding of the topography of these hills. >> watch awful our events from
madison saturday at noon eastern on c-span2's "book tv" and sunday afternoon at 2:00 on c-span3. >> next, the supreme court oral argument in a whistleblower case, homeland security office versus mclean. then president obama and the u.s. foreign policy. robert mclean was a u.s. air marshall and was fired. mr. mclean's supervisor told him that the cancellations were to save money. believing that the t.s.a.
action risked passenger safety he leaked the information to a reporter, prompting congressional criticism leading to the t.s. oomplet's reversal of its decision, this is an hour. s >> congress prohibited disclosures that would be debtmental to the security of transportation. the information ranges from a flight crew's plans for dealing with a hijacking attempt to vulnerabilities in airport security systems to the kind of federal air mar shall deployment information. under the whistleblower statutes, anyone of t.s.a.'s 60,000 employees may override
t.s.a.'s expert judgment and publicly disclose sensitive security information in that employee's possession based on that employee's reasonable belief about what public safety requires. -- as i point was understood it, he was fired and it wasn't until the case was before the mspd that a determination was made that this information qualified as what you call s.s.i. >> your honor, i think that's not quite correct. let me see if i can work it through. the information about federal air marshal deployment has been prohibited for more than a decade. it was prohibited expressly prior to 9/11. it was in regulation that is were promulgation by t.s.a. after 9/11. >> when was he first told? >> he was told that air marshal
deployment information was s.s.i. in the training and it's in the regs. he argued before the administrative judge that he was unaware that this information was s.s.i. and the judge rejected that. that's in petitioner's appendix from 100-a. the testimony was that he did not know it was s.s.i., was inconsistent, nuanced and evasive and the judge rejected that contention. what happens in the final order, which i know your honor is referring to, is that t.s.a. creates a final order determining something is s.s.i. precisely so it can be appealed to the court of appeals under 49 u.s.c. 46-110, which gives a person aggrieved by a t.s.a. order 60 days to appeal something to the court of appeals. mr. maclean did so and the rejected his argument. so i think as the case comes to this court there really is no
dispute that he understood that this was s.s.i. >> but it certainly will, in many cases, be a close question. i was very surprised to see in your reply brief the recognition that the employee can tell the media that federal air marshals will be absent from important flights, but declining to specify which flights. i think it would be very difficult to figure out which is s.s.i. and which is not given that fine line. air marshals have been cut 50% from transcontinental thrites. so, your honor, there may be close cases. again, the administrative judge heard this contention from mr. maclean and rejected it. >> what contention? >> that he did not know this was s.s.i.. >> what about my question? can somebody say the number of air marshals on transcontinental flights has been cut 50%? >> your honor, i think without specifying -- i don't know the answer to that.
i'm not someone at t.s.a. who has -- >> how is mr. maclean supposed to know? >> mr. maclean was trained to know, was trained in s.s.i., received training on that, and as i say, your honor, there is no dispute that he did know that this was s.s.i. details of federal -- >> i'm a little confused. i'd like, justice ginsburg, i thought from the briefing that that was done generally beforehand, that something would be distributed to people with a confidential notice on it -- >> that this was s.s.i. >> -- that this was s.s.i. but this particular information wasn't so designated before the release. >> that's correct, your honor. but there's -- the best practice is, is to mark information s.s.i. >> before it's going out. >> correct. but information can be s.s.i.
whether or not it is marked that way. and again, the regulations are clear on this that details of federal air marshal deployment are covered as s.s.i. and this issue was litigated before the administrative judge. >> if there were no regulations, just the statutes on the books, at that point are there any prohibitions on disclosure? there can be no s.s.i. without at least some regulation? >> that's correct, your honor. and so if i could turn toe that, what the federal circuit held, it held that whistleblower protection extended to this information. -b-8-5 perly read, 2302 foreclosures that. information that is specifically -- disclosure of which is specifically prohibited by law. the federal circuit found no prohibition and no law. under the s.s.i. regime
disclosure was prohibited both by the statute that mandated nondisclosure regulations and by the -- >> it wasn't prohibited by the statute until there were regulations, right? >> that's correct, your honor. >> it is prohibited by regulations. let's not play games. >> your honor, i think we would prevail even under that interpretation because it's prohibited by regulation that is the statute mandated to be disclosed. but i think under this court's decisions in robertson and in sims, which addressed the question of specifically exempted from disclosure by statute, and this court said that in robertson a regulation that gave to the administrator authority to exempt from disclosure after a public interest weighing and in sims, where the court had a statute that just gave to the c.i.a. director an instruction to protect sources and methods, and the court said in both cases those are specifically exempted by statute. >> but the reasoning apparently came as a surprise to the
government lawyer in the court of appeals. he said, i'll be as clear as i can, specifically prohibited by law here means statute. >> so, your honor -- >> maclean is supposed to know something that the lawyer -- government lawyer and the court of appeals doesn't. >> your honor, i think the lawyer did say about. but the lawyer went on to explain that regulations promulgated pursuant to a statutory mandate would control, an that's what the federal court understood. >> but we seem to be arguing that it's not simply mandated by statute. you use -- the two examples that you gave was authorize or permitted. so what is your position today? before the federal circuit it seems to have been this is statute, not regulation. now it's some regulations, but we don't know whether regulations that are mandated or regulations that are merely authorized. what is it? >> let me be as clear as i can. we believe that it is specifically prohibited first by a statute, which was the
argument that was made clearly below and in the briefs here, and that this qualifies. second, we think that it is prohibited by regulations that are prohibited pursuant to a statutory mandate, promulgated pursuant to statutory mandate. if i can point the court's attention to page -- >> i asked you whether or not the employee could be terminated if only the statute were on the books and no regulations yet. and i thought you said no. >> because there would be no s.s.i. designated. >> all right. so then the statute alone does not carry the day. >> so, your honor, i don't think that that's the way the court looked at it in robertson and the way the court looked at it in sims. in both of those cases there had been no determination not to disclose, until the administrator made the determination. and yet the court found that those were specifically -- that they were specifically --
nondisclosure was specifically authorized by statute. if i could just finish the answer to justice ginsburg and to the chief justice. at page 15-a of the appendix, what the federal circuit said was regulations promulgated pursuant to congress's express instructions would qualify as specific legal prohibitions. both arguments were -- >> i'm sorry, what was that quoted from? >> from the federal circuit's decision at 15-a. it's 15-a attached to the petition. so the federal circuit understood, just as they said, that regulations promulgated pursuant to congress's express instructions would qualify. >> counsel, could you qualify assuming -- because congress disagreed with robertson and -- didn't it? and amended foya. >> congress amended foya, yes. >> assume that we read statute more or less the way that foya does. do you meet the amended foya
criteria? >> we do, urn. >> and which prong of it, and why? >> first of all, i'd just like to say that the senate legislative history expressly considered this very question and said that if that -- i'm sorry. can i step back one second, your honor? we don't think that it meets the amended foyia. but taking that as a given, your honor, what the senate -- >> seems to be eminently reasonable, despite robertson. that's basically what you're arguing is one the two foy ya exceptions. so tell me which one. >> it's the foy ya exception, urn, that establishes particular criteria for withholding or refers to particular types of matters withheld. we think in the legislative history what the senate report said was that the sims statute, the section 102-d-3 of the national security act of 1947 would qualify and that's a statute that said the director
of c.i.a. shall be responsible for protecting intelligent sources and methods from unauthorized disclosure, period. that was all it said. that's no different from our statute and we think that even -- >> i think this is a little more specific than that. >> perhaps more specific. we think that it follows a theory that if the court relies on statute that we meet that statute. and, of course, that makes perfect sense. >> oh, my goodness, i'm not sure. >> excuse me. >> when you have a c.i.a. statute they say you cannot disclose agents or sources and, what does it say? >> your honor, it satisfies -- >> sources and methods, intelligence sources and methods. and there's another one that refers to critical infrastructure information, all right? if i accept those as being sufficiently specific or having sufficient criteria , i look at yours. and yours says there shall be regulations prohibiting the
disclosure of information obtained or developed in carrying out security. now hero's the cry tearian. if the undersecretary decides disclosing information would be detrimental to the security of transportation. that could include everything from a sparkplug that is deficient in the airplane to a terrorist. and i don't -- i mean, i don't know how i would judge that. i mean, to the ear, telling the c.i.a. you can't disclose sources seems a lot narrower than telling the department of transportation or -- what is it, d.o.t., that everybody in charge of airplanes, you have a regulation detrimental to the security of transportation. i don't know, how would you decide it? it sounds to me that that's quite a lot broader. >> so much can be detrimental to the security of an airplane. >> so, your honor, a couple of
points on that. first of all, the court interpreted the statute in robertson to be sufficiently specific, and in robertson what the statute said was an administrator shall order information withheld from public disslosh chure when in, the judgment of the administrator, it would adversely affect the interest of the person and is not required in the interest of the public. >> that's the one before. >> that's the one this court found. >> but subsequent to that congress amended the act, as was just pointed out, in a way that says you have to have specific cry tearian. >> if i may, your honor, it amended foyia. but strikingly, the congress did not amend and include that language when it passed the csra. >> no, i can deal with that on my own. i do have a question that only you can deal with, and the question i have that only you can deal with is this -- i mean, obviously, it's a matter of concern that someone could
go around and say there are no marshals on this airplane. that is obviously a matter of concern. a real fact that was worry about blowing up airplanes for that reason, per the president then, simply use -- cot president then use the second prong and say an executive order will require >> your honor, the president could do that. >> all right. now, in doing that, in doing that, does it automatically fall into the 400,000 regulations that govern defense department security information, or could he say, for the purpose of this statute, what we're talking about now, i determine that it should be kept secret. therefore, there is no prohibition against people communicating that
information with swedish people, british people, all kinds of airline officials, et cetera? now, you're saying yes, he could do that under this second prong, yes or no? >> yes, because there's an executive order -- >> yes. ok. fine. if that if he can do that, then there is no worry. >> your honor -- >> because if this am i right, there is no worry? >> no, your honor. >> because if, in fact, this is going to lead to blowing up airplanes, all he has to do is use that second prong. now, you say i'm not right. why not? >> you're not right, your honor, because that is fundamentally inconsistent with the judgment that congress made that the ssi system should coexist with the classified information and with executive orders. what your honor is saying is that it doesn't matter that the ssi system that congress set up doesn't -- wouldn't work and can't function because the president by executive order could fill in the gaps. but what congress -- >> i'm not saying anything like that. i am worried about a practical matter. i am worried about the decision of the court againou