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WATCH LIVE: Kathleen Sebelius testimony before congressional committee 8 a.m.

SebeliusThe nation’s top health official, former Kansas Governor Kathleen Sebelius, is expected to acknowledge the shortcomings of the Obamacare health insurance website to a congressional committee but also to insist that the law has “delivered on its product.”

Sebelius is expected to testify at 8 a.m. (CST) Wednesday to the U.S. House Energy and Commerce Committee

 

Testimony of Kathleen Sebelius
U.S. Department of Health and Human Services on Affordable Care Act Implementation House Committee on Energy & Commerce October 30, 2013

Good morning, Chairman Upton, Ranking Member Waxman, and members of the Committee. On October 1st, we launched one of the key provisions of the Affordable Care Act—the new Health Insurance Marketplace, where people without health insurance, including those who cannot afford health insurance, and those who are not part of a group plan, can go to get affordable coverage. Consumers can access the Marketplace in several ways—through a call center, by filling out a paper application, with the help of in-person assistance, or by going online and filling out an application on HealthCare.gov.

Over the past few weeks, millions of Americans have visited HealthCare.gov to look at their new health coverage options under the Affordable Care Act. In that time, nearly 700,000 applications have been submitted to the Federal and state marketplaces from across the Nation. This tremendous interest—with over 20 million unique visits to date to HealthCare.gov—confirms that the American people are looking for quality, affordable health coverage. Unfortunately, the experience on HealthCare.gov has been frustrating for many Americans. Some have had trouble creating accounts and logging in to the site, while others have received confusing error messages, or had to wait for slow page loads or forms that failed to respond in a timely fashion. The initial consumer experience of HealthCare.gov has not lived up to the expectations of the American people and is not acceptable. We are committed to fixing these problems as soon as possible.

Improvements Already Made to HealthCare.gov

To build the Marketplace, CMS used private sector contractors, just as it does to administer aspects of Medicare. CMS has a track record of successfully overseeing the many contractors our programs depend on to function. Unfortunately, a subset of those contracts for HealthCare.gov have not met expectations. Among other issues, the initial wave of interest stressed the account

service, resulting in many consumers experiencing difficulty signing up, while those who were able to sign up sometimes had problems logging in.

In response, we have made a number of improvements to the account service. We have updated the site several times with new code that includes bug fixes that have improved the HealthCare.gov experience. We continue to add more capacity in order to meet demand and execute software fixes to address the sign up and log in issues, stabilizing those parts of the service and allowing us to remove the virtual “waiting room.” Today, more individuals are successfully creating accounts, logging in, and moving on to apply for coverage and shop for plans. We are pleased with these quick improvements, but we know there is still significant, additional work to be done. We continue to conduct regular maintenance nearly every night to improve the consumer experience.

Reinforcements

To address the technical challenges with HealthCare.gov, we are putting in place tools and processes to aggressively monitor and identify parts of HealthCare.gov where individuals are encountering errors or having difficulty using the site, so we can prioritize and address them. We are also working to prevent new issues from cropping up as we improve the overall service and deploy fixes to the site during off-peak hours on a regular basis.

To ensure that we make swift progress, and that the consumer experience continues to improve, our team has called in additional help to solve some of the more complex technical issues we are encountering. We are bringing in people from both inside and outside government to scrub in with the team and help improve HealthCare.gov. Specifically, we are bringing on board management expert and former CEO and Chairman of two publicly traded companies, Jeff Zients, to work in close cooperation with our HHS team to provide management advice and counsel to the project. Mr. Zients has led some of the country’s top management firms, providing private sector companies around the world with best practices in management, strategy, and operations. He has a proven track record as Acting Director at the Office of Management and Budget and as the Nation’s first Chief Performance Officer. Working alongside our team and using his rich expertise and management acumen, Mr. Zients will provide advice, assessments, and recommendations.

Our team has also brought in additional experts and specialists drawn from within government, our contractors, and industry, including veterans of top Silicon Valley companies. These reinforcements include several Presidential Innovation Fellows. This new infusion of talent will bring a powerful array of subject matter expertise and skills, including extensive experience scaling major IT systems. They are part of a cross-functional team that is working aggressively to diagnose the parts of HealthCare.gov that are experiencing problems, learn from successful states, prioritize issues, and fix them.

As part of our team’s efforts to ramp up capacity and expertise with the country’s leading innovators and problem solvers, our contractors—including CGI, the lead firm responsible for the Federally-Facilitated Marketplace technology—have secured additional staff and made additional staffing commitments. They are providing and directing the additional resources needed for this project.

Expanding Access to Affordable Coverage Through the Health Insurance Marketplace

We are committed to improving the consumer experience with HealthCare.gov, which serves as an important entry point to the new Marketplace. The new Marketplace is a place that enables people without health insurance, including those who cannot afford health insurance, and those who are not part of a group plan, to finally start getting affordable coverage.

Just a few weeks into a six-month open enrollment period, while some consumers have had to wait too long to access the Marketplace via HealthCare.gov, the Marketplace is working for others and consumers are also utilizing the call center, paper applications and in-person assistance to apply for coverage.

The idea of the Marketplace is simple. By enrolling in private health insurance through the Marketplace, consumers effectively become part of a form of statewide group coverage that

spreads risk between sick people and healthy people, between young and old, and then bargains on their behalf for the best deal on health insurance. Because we have created competition where there was not competition before, insurers are now eager for new business, and have created new health care plans with more choices.

The bids submitted by insurers provide clear evidence that the Marketplace is encouraging plans to compete for consumers, resulting in more affordable rates. The weighted average premium for the second-lowest-cost silver plan, looking across 47 states and DC, is 16 percent below the premium level implied by earlier Congressional Budget Office estimates.1 Outside analysts have reached similar conclusions. A recent Kaiser Family Foundation report found that, “while premiums will vary significantly across the country, they are generally lower than expected,” and that fifteen of the eighteen states examined would have premiums below the CBO-projected national average of $320 per month for a 40-year-old in a silver plan.2

This is good news for consumers. In fact, some insurers lowered their proposed rates when they were finalized. In Washington, D.C., some issuers have reduced their rates by as much as
10 percent.3 In Oregon, two plans requested to lower their rates by 15 percent or more.4 New York State has said, on average, the approved 2014 rates for even the highest coverage levels of plans individual consumers can purchase through its Marketplace (gold and platinum) represent a 53 percent reduction compared to last year’s direct-pay individual market rates.5 Furthermore, states are using their rate review powers to review and adjust rates accordingly. In Oregon, the state has reduced rates for some plans by as much as 35 percent,6 and in Maryland, the state has reduced some rates for coverage offered through the Marketplace by almost 30 percent,7 offering consumers an even better deal on their coverage for the 2014 plan year.

In addition to the more affordable rates resulting from competition among insurers, insurance affordability programs, including premium tax credits and cost-sharing reductions, will help many eligible individuals and families, significantly reducing the monthly premiums and cost- sharing paid by consumers. Premium tax credits may be paid in advance and applied to the purchase of a qualified health plan through the Marketplace, enabling consumers to reduce the upfront cost of purchasing insurance. In addition, cost-sharing reductions will lower out-of- pocket payments for deductibles, coinsurance, and copayments for eligible individuals and families. A recent RAND report8 indicated that, for the average Marketplace participant nationwide, the premium tax credits will reduce out‐of‐pocket premium costs by 35 percent from their unsubsidized levels.9

CBO has projected that about 8 in 10 Americans who obtain coverage through the Marketplace will qualify for assistance to make their insurance more affordable, an estimated 20 million Americans by 2017.10 A family’s eligibility for these affordability programs depends on its family size, household income, and access to other types of health coverage.

The fact is that the Affordable Care Act delivered on its product: quality, affordable health insurance. The tremendous interest shown in HealthCare.gov shows that people want to buy this product. We know the initial consumer experience at HealthCare.gov has not been adequate. We will address these initial and any ongoing problems, and build a website that fully delivers on this promise of the Affordable Care Act.

Other Benefits of the Affordable Care Act

While we are working around the clock to address problems with HealthCare.gov, it is important to remember that the Affordable Care Act is much more than purchasing insurance through HealthCare.gov. Most Americans—85 percent—already have health coverage through an employer-based plan, or health benefit, such as Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP). For these Americans, the Affordable Care Act provides new benefits

and protections, many of which have been in place for some time. For example, because of the Affordable Care Act, millions of young adults have been able to stay on their parents’ plans until they are 26. Because of the Affordable Care Act, seniors on Medicare receive greater coverage of their prescription medicine, saving them billions. Because of the Affordable Care Act, for millions of Americans, recommended preventive care like mammograms is free through employer-sponsored health coverage. And in states where governors and legislatures have allowed it, the Affordable Care Act provides the opportunity for many Americans to get covered under Medicaid for the first time. In Oregon, for example, a Medicaid eligibility expansion will help cut the number of uninsured people by 10 percent, as a result of enrollment efforts over the last few weeks, resulting in 56,000 more Americans who will now have access to affordable health care.

The Affordable Care Act is also holding insurers accountable for the rates they charge consumers. For example, insurance companies are now required to justify a rate increase of
10 percent or more, shedding light on unnecessary costs. Since this rule was implemented,11 the proportion of rate filings requesting insurance premium increases of 10 percent or more has plummeted from 75 percent in 201012 to an estimated 14 percent in the first quarter of 2013,13 saving Americans an estimated $1.2 billion on their health insurance premiums.14 These figures strongly suggest the effectiveness of review of rate increases.

The rate review program works in conjunction with the so-called 80/20 rule (or Medical Loss Ratio rule),15 which generally requires insurance companies in the individual and small group markets to spend at least 80 percent of premiums on health care and quality improvement activities and no more than 20 percent on administrative costs (such as executive salaries and marketing) and profits. In the large group market (generally coverage sold to employers with more than 50 employees), insurers must spend at least 85 percent of premiums on medical care and quality improvement activities. If insurers fail to meet their medical loss ratio requirement, they must provide rebates to their customers.

New rules will help make health insurance even more affordable for more Americans beginning next year.16 Marketplace health insurance plans will be prohibited from charging higher premiums to applicants because of their current or past health problems or gender, and will be limited in how much more they can charge Americans based on their age.

Conclusion

The Affordable Care Act has already provided new benefits and protections to Americans with health insurance, and we are committed to improving the experience for consumers using HealthCare.gov so that Americans can easily access the quality, affordable health coverage they need. By enlisting additional technical help, aggressively monitoring errors, testing to prevent new issues from cropping up, and regularly deploying fixes to the site, we are working to ensure consumers’ interaction with HealthCare.gov is a positive one, and that the Affordable Care Act fully delivers on its promise.

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  • Glock Fortycal

    Pallone, this ACA IS socialized healthcare. What part of “YOU MUST BUY OR BE FINED” doesn’t make this a Government Run and socialized healthcare? Since when is it the Governments job to ensure all of us are “healthy” and “covered”? Screw off

    • Chief59

      Have you ever actually read the Constitution? You don’t have to go far, it’s right there in the preamble….

      “We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”

      See that part about promoting the general welfare? The government is in place to protect the citizens. Argue all you want, but it is the job of the government to make available affordable health care. The fact that nearly EVERY SINGLE OTHER first world country (and even a bunch of lesser countries) provide affordable health coverage should show you how true that is. It’s people like you that think your right to your GLOCK FORTYCAL is more important than people being healthy and fed that are setting this country back.

      • Glock Fortycal

        Uh, you obviously think the Government knows best….sad. Shame on you, and yes, I’ll keep my G27 and 180gr JHP to protect myself with. Tyrant

        • Chief59

          Government does not know best. However, it has an obligation to protect its people.

          • Glock Fortycal

            You mean during times of war right? It seems to me this current regime is trying to protect me from freedom. I don’t need this Government to protect me, Big Brother gives two $hit’s about you. Wake up, this is all about power and control.

          • Chief59

            I must have missed that part where it reads “in time of war”.

            How about a list of the freedoms you don’t have now that you have before this President took office?

          • Still waiting…

            **crickets**

      • A_citizen_patriot

        Well if your going to be quoting the constitution.

        A well regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed.

        Now lets look at the definition of a militia, the United States Code states that the militia is all male citizens and resident aliens at least 17 up to 45 with or without military service experience.

        Next the legal definition of infringed, the encroachment, breach, or violation of a right, law, regulation, or contract.

        I’m sure you notice that to “infringe” means to regulate. So by your same argument the government has violated the second amendment by enacting gun regulations. I know this article was not about gun control. But just because the constitution says something, does or does not mean they follow it.

        • alexander

          If ‘infringe’ means ‘regulate’, then what does ‘well regulated’ mean?

          “a WELL REGULATED militia”

          • Chief59

            You beat me to it. It says right in the Second Amendment “well regulated militia”, not everybody gets a bunch of guns. However, the phrase “promote the general welfare” is more vague and all-encompassing.

          • A_citizen_patriot

            please read above

          • A_citizen_patriot

            A_citizen_patriot alexander

            •3 hours ago

            Yes it says that but in the DC v Heller case the supreme court said, “Finally, the adjective “well-regulated” implies nothing more than the imposition of proper discipline and training.”
            I posted this earlier

        • alexander

          Should private citizens be allowed to own large-yield nuclear weapons?

          • A_citizen_patriot

            Im not arguing what people should be allowed to own. What my point is, is that cheif is saying “see right here it says general welfare, therefore they are allowed to regulate healthcare.” He is assuming that the meaning of that clause includes all forms of care for people. My point is that if we are takeing things to the max, all encompassing meaning of the words, then any arms regulation would be illegal. It could be argued that there are people losing their insurance that were already having their general welfare provided for.

          • alexander

            “My point is that if we are takeing things to the max, all encompassing
            meaning of the words, then any arms regulation would be illegal.”

            And my point is that, no, it wouldn’t be.

            Due to the prerequisite that the militia not only be regulated, but be ‘well’ regulated.

          • A_citizen_patriot

            Yes it says that but in the DC v Heller ca the supreme court said, “Finally, the adjective “well-regulated” implies nothing more than the imposition of proper discipline and training.”

            Further more in United States v Miller says “A body of citizens enrolled for military discipline.” And further, that ordinarily, when called for service these men were expected to appear bearing arms supplied by themselves and of the kind in common use at the time. The case was about a short barrel shotgun. The court ruled that the firearm was not “ordinary military equipment” and therefore was not protected under the second ammendment.

          • Chief59

            Our Constitution is able to be changed. The Second Amendment is one of those changes. It is possible for it to be modified to fit today’s time where nearly anyone can buy a weapon that is capable of murdering several people in a very short time. Possible, not plausible. Too many people think more of their guns than life itself.

          • A_citizen_patriot

            Yet some people think more of drinking then driving. And we still allow alcohol. I agree that guns can cause deaths. But why should I be prohibited from owning a certain type of gun when i have never been charged with a crime? If your charged with a dui should you still be allowed to buy alcohol? Alcohol cause more deaths every year then guns do.

          • Chief59

            I won’t argue on that. Alcohol is treated as no big deal, but it is addictive and dangerous. Marijuana is neither, but it’s illegal. If alcohol was illegal and pot wasn’t, I’d be perfectly happy. That’s coming from a guy who drinks and has never touched pot even once.

            I feel if a person is qualified to own a gun, great, but add many as you want. However, I feel that the choices should be limited to rifles (preferably only bolt action), shotguns, and revolvers. Everyone capable of owning a gun then can buy however they want of those choices. Also, guns should only be allowed to be bought/sold through licensed dealers, with a background check for EVERY purchase.

            Now, what topic can we jump to now?

          • A_citizen_patriot

            I disagree with you, look at the texas belltower sniper, he had a bolt action. I feel that full autos should be easier to get. If you look they are not illegal for civilians, just much more regulated. Please read the national firearms act for more info. Never has a legally owned full auto been used in a crime. But when it boils down nothing will stop bad people from doing bad things. About pot, i dont want it legalized, but if they do its not a huge deal, at least its a natural plant and not some chemical concoction like other drugs.

          • alexander

            In District of Columbia v. Heller, 554 U.S. 570 (2008), the Supreme Court held:

            2. Like most rights, the Second Amendment right is not unlimited. It is
            not a right to keep and carry any weapon whatsoever in any manner
            whatsoever and for whatever purpose: For example, concealed weapons
            prohibitions have been upheld under the Amendment or state analogues.
            The Court’s opinion should not be taken to cast doubt on longstanding
            prohibitions on the possession of firearms by felons and the mentally
            ill, or laws forbidding the carrying of firearms in sensitive places
            such as schools and government buildings, or laws imposing conditions
            and qualifications on the commercial sale of arms.

          • A_citizen_patriot

            Your right, if you would read what I said above, a short barrel shotgun is a example of a firarm that was specifically listed as not being in common use. Same with nuclear weapons. They are not in common use, soldiers are issued m-16, they are not issued nukes.

    • alexander

      “this ACA IS socialized healthcare”

      The massive failings of privatized healthcare have more to do with where we find ourselves than any Commie Marxist plot to destroy America.

  • Glock Fortycal

    “oh, here we go” from some stupid Dem. Seriously?

  • Glock Fortycal

    it’s a amazing to me how this clown can speculate on how people were in dire straights BEFORE the passing of the ACA but for some reason has amnesia when it comes to how many people will lose their “preferred” insurance or how many people have actually signed up for the ACA.

    • Chief59

      Are you saying people who could not get and/or afford insurance were not in dire straights? That’s a lot worse than someone having to change to a different plan due to the fact the one they are on doesn’t meet minimum requirements.

  • Glock Fortycal

    is this some kind of joke to these clowns?

  • Darwin

    Screw Obama and his wealth distribution.

    • Chief59

      You guys crack me up. Wealth redistribution has been going for decades and decades. Unfortunately, it’s taking our money and giving it to the richest to make them richer.

      • A_citizen_patriot

        How are they taking your money and giving it to the rich?

        • Chief59

          Look at Kansas right now. Our governor cut taxes for the wealthy and businesses, while also raising statewide sales tax. Sales tax directly hurts the people who can least afford it. In turn, the wealthy and businesses save tax money. They turn that money into new jobs, or buy new things. They keep it. That is one example.

          • A_citizen_patriot

            Cutting taxes for businesses is bad?

          • Chief59

            When it results in raising taxes on citizens in order to offset the cuts, yes. The “plan” was to lower taxes so that businesses would come to Kansas. That has yet to come to fruition. I have provided a link to our current tax law being called the “worst in the nation”. By a right-leaning organization!!!! A condensed version of what is said in the link is that it was a tax cut for the sake of a tax cut. It did not save money, did not boost the economy, and hurt the lower classes. That is stupid.

            http://www.governing.com/columns/public-finance/col-whats-wrong-kansas-tax-reform-measure.html

          • A_citizen_patriot

            Well I disagree with you on some points, but I do see where you are coming from. Thank you for citing a source.

          • Chief59

            Tax cuts can be a good thing, but businesses paying zero, while still making millions or billions in profit is absolutely stupid. Especially when the state is trying to make up the difference with a sales tax increase. So corporations can’t afford taxes, but a family of four that makes $30,000 per year can afford for an extra 1% increase? Trickle down economics has got to be one of the dumbest ideas anyone in our government has come up with. What’s even worse is they still try it 30 years later.

            It’s nice to discus differing opinions with someone who isn’t just spouting hate (example-Glock fortycal). I like to back up arguments with links when possible. Just trying to be civilized and not shout out I’m right, you’re wrong.

          • A_citizen_patriot

            Small businesses can benifit from tax cuts and they dont make millions. You can never make a perfect system unfortunatly, but some are better then others. I have for the most part been happy with Brownback, but thats not to say that at the end of this experiment it will all work out.
            It is nice to talk about issues without people insulting people that disagree with them. I wont name names, but there are people on here that dont care what you think, but that your a moron. That is half the problem with politics today, is that any one with a differing opinion from you are just brainwashed shills you havnt thought for themselves for 20 years. People need to stop acting like kids, and start talking like adults, maby congress would get more done that way.

          • Chief59

            I’m fine with tax cuts for small businesses. I work for one, and we could always use the help. However, the huge guys are the ones benefiting, not us.

  • Guest

    Hays POST if you want to keep people coming back to your site. Why don’t you stop moderating posts that are not swearing or Cursing but arguing the points. Showing your True Form EAGLE. Showing your true Form

  • passin_threw

    if my job performance was as awful as kathleen’s i’m pretty sure i’d have to sign up for obamacare….thank god i haven’t failed like her

  • A_citizen_patriot

    http://money.msn.com/saving-money-tips/post–5-things-we-now-know-about-obamacare
    wow look another article on how the government lied to people about the law

  • Chief59

    Still waiting on Hays Post to moderate this comment. Way to show your loyalties. This is why nobody takes your site as a legitimate news source. First, you copy and paste nearly everything here, you have no news yourself. Second, you only post stories that align with YOUR own political views. Finally, when disgusting, derogatory comments are made by people supporting your views, they are left on here. Way to show your true colors.

    Eagle Communications will not receive a penny of my money. My television, phone, and internet business will continue to go to companies other than Eagle.