Diseases for those who have run out of other options. It includes the National Institute of health, the fda, the center for medicare and medicaid. Cms is the Largest Health insurer with an annual budget of 800 billion dollars. I believe you have the qualifications to do the job, but there is much that you will need to do in order to assure members of the committee that hhs is heading in the right direction. It is a turbulent time that lies ahead. One of the greatest challenges shoring up the exchanges and making sure that they are operating efficiently. Recent reports of the numerous issues faced by the state exchanges at something to implement the law have been cause for great concern. States are required to have a Healthcare Exchange where citizens can go and shop for Health Insurance. They have the option of starting their own exchange, using the exchange provided by the federal government, or in hybrid will stop they are determining what type of exchange to implement. Were given innts two stages for those days who were building all report all or part of their own exchanges. They quickly decided to build their own exchanges. In total, they spent 4. 7 billion on their exchanges. What is troubling is that seven days from the District Of Columbia failed to build a successful website. Received more than 1. 25 billion to build these exchanges. That is the huge amount of taxpayer dollars. It was apparently spent with little or no accountability. Many are looking to rebuild their systems. Introducing the state accountability act. It would be a statebased exchange and they decided to grants it and repay the that they receive from hhs. In addition to overseeing this massive expansion of benefits, you also be charged with the longevity and the sovereignty of the existing medicare trust. It is projected to go bankrupt in 2024. Between now and 2030, 70 6 million baby boomers will become eligible for medicare. The factoring in dallas, program will grow from 47 million beneficiaries to 80 million beneficiaries. That will be 2030. Maintaining the solvency of the program and continue to provide basefor an everincreasing will require Creative Solutions and a good secretary at the helm. Im counting on you to be there. One of the most important responsibilities you have on this committee is to be responsive. Several commitments were made by nominees about providing timely responses. More often than not, i have been deeply disappointed. That youray commitment will stand the test of time beyond your confirmation. Words and promises matter a great deal. I hope you will be up to that challenge. Overseeing the conflict infrastructure of a Department Like hhs is not a job for the faint of heart. Naturally, i wish you the best of luck as you learn to address these challenges and as you both through the confirmation process. You will need all the luck you can get. I am grateful to people like you are willing to take on these top responsibilities. We are grateful that you are willing to serve. Thank you. Thank you, senator hatch, and as we have ever since senator baucus went to china you and i will be working in a bipartisan way on this. It is a tradition to have the nominee introduced any family members who are here today, so why dont you do that . Thank you, mr. Chairman i would like to introduce my husband, my sister, and at 2 very good old friends. Thank you. We are glad you are here, and as senator hatch noted, Public Service is not, for family, for the faint hearted. We are glad you are here. Iousevergrac rockefeller is here to introduce some West Virginians, and dr. Coburn is on a tight schedule, so why dont we hear from you and then we will hear from home state senator rockefeller. Let me say what an honor it is to introduce ms. Burwell to the committee. I have worked with her for the , and prior too her confirmation as omb director , and i actually look for people who have strong trade strong traits, and the fact that she is willing to make this family sacrifice, and it is a family sacrifice, is reassuring for us as a country that we would have somebody i thought i would talk about 5 areas of Sylvia Burwell that not everybody else knows will stop the first is that she is competent. Says something, because so often we have people placed in positions in washington that arent competent for the task at hand. The second is that she has outstanding character, and i have experienced that over the past year working closely with her and the people at a one b on the problems we have seen both at home and security Homeland Security and cyber and other areas. When you have somebody that is competent and also a strong , you find a way to get past your differences to solve problems. Finally, as senator hatch mentioned, responsiveness is a key for congress. I have to tell you, i found her remarkably responsive. My partner and Homeland Security, tom carper, has as well. That comes along with her commitment. She is going to be committed to do the right things and keep hungers involved Keep Congress involved. Double make her an outstanding secretary, and that is she is a great listener. Even when she has her mind made up, which sometimes happens, she will listen to another point of view to gain information that she might not have. That is a characteristic too often that we dont see as members of congress and membe in members of the administration, whether they are republican or democrat. Finally, because she is West Virginian, she comes to washington with a lot of common sense. Is avorite quote is there symbol half full thimble and a half full of common sense in washington and she is the half. I will support her nomination on the floor and do everything to help her be successful at if she is sot hhs, given that responsibility. I thank the committee. Senator coburn, thank you very much for those powerful words and focus on competence and common sense and accountability. That is really quite of the realm in terms of the nominee. I know you are on a tight time schedule. Chairman rockefeller is here for another West Virginian. Too, want to thank senator coburn. Burwell, it is not usual to get introduced by him in such terms. Judge hestrict is a very strict judge of character, strong moral aspect to everything he does. I am very happy that he has introduced you. Me toan easy thing for do, but first i have to point out something of interest. On the Commerce Committee we were going to have a really interesting hearing in this room ncaa and the student athlete, it or is that really athlete student, and what are we doing, what is the ncaa doing, what are universities doing to make sure athletes are getting the academic training they need to. I think it is going to be an interesting hearing. The reason we were going to come it wasroom is that going to be packed because it is a subject of great controversy, but no, pushed aside by a higher order. But the order is that this room is an even halffull. Isnt even halffull. What makes me happy about that is that there is a general understanding in this somebody and certainly on this committee that you are that really Competent Person who relishes challenges and can balance challenges with family response abilities. You are just that way, and that is one of the things about growing up in a small community. I introduced you for the first time 16 years ago. We were becoming Deputy Director of omb at that point. More recently, i introduced you again to become director. That was easily done. Could not be more proud to speak for you and to present you to this committee. I have done this a lot with people but i dont think ive ever been as proud as the person as is sure of my feelings have with my feelings about you. Respect for your intelligence, your integrity, what i would call a ferocious integrity, a work ethic beyond contemplation, but all the while, you are relaxed, andappear as senator coburn said, you do listen. You are a very good listener. It is terribly important. And the business of writing letters you will do not because you have to do it but because it is in your interest to do and you will find a way to do it. I think you are going to be a superb secretary. The department is absolutely gargantuan in its size. Its millions and millions of americans, food and drug supply, protection of our country from outbreaks of attacks, theerror medical research we rely on for cuttingedge treatments, but andh we are underfunding, federal investments in global health, which i dont think most people know that much about and dont necessarily associate with your position. I think it is impossible to overstate how important the secretary of hhs have that degree of organizational intuitive skill. Not that they have to work at it hard, but it is just born with them and it is part of how they do things and people come to understand that and they draw people to them because, in the words senator coburn used, competency. Competency is a cherished commodity, and when people are in a high position and have that, you go want to work for them, people want to work harder for them. And the country feels prouder of them and maybe even the press is nice to them. So anyway, here you are, a proven manager, public and private, and so much the right person for this job that it is just a cliche to even say it. Are ahe fact that you proud native of West Virginia is very important. It is very important in character formation. And ones worldview. In that case, not a large worldview. I have known sylvia her entire parents, her wonderful cleo and bill, family, friends. I have attended church with your family. I was at your wedding reception. You interviewed me i think you told me when you were 6 years old, county courthouse steps. I have no idea what the question was, but i probably didnt answer it very well. I was probably terrified. I just have a deep and abiding , and because you of you, your family. I think family and you come together in a perfect way in american life. You are brilliant. You wont say that so i will have to do it for you. And as has been indicated, a harvard, rhodes scholar, and yet somehow you remain humble, always hardworking. Again, this word ferocious integrity, which means everything to me, and the central devotion and your purpose in Public Services to help People Better their position in life. You dont focus on just one group, but everybody has to have a better shot in life. You are possessed by that public passion. Partly fromo come your grandparents, because they got here and somehow helped instill that in you. You could have made a fortune when you graduated from harvard, and onto any place in the world, any law firm. You didnt. You headed directly into Public Service. You spent the majority of your life in Public Service, which is filled with controversy and not enormously high wages, and a lot of frustration, a lot of sleepless nights. That, hadnt been doing you were working for organizations doing that the , out inndation bentonville, that foundation. In both cases you are working on a worldwide basis. Office, we in my talked about one of the things i want to work on after i leave the senate, baby teeth, the health of teeth, which most people overlook, but which is absolutely essential in the moral selfconfidence, development of any young person, and appalachia it is a real problem. You spent a great deal of time at the Walmart Foundation doing exactly that. When it comes down to it, you want people to have Health Insurance, you want them to have that peace of mind. I dont need to do this, but i am going to do it because i so enjoy doing it. Your service in federal government is absolutely unmatched. The Clinton Administration staff director for the National Economic council. Wow, that is context stuff not that anybody can tell you what goes on there, but the future of the country depends enormously on what does go on their. Chief of staff to secretary robert rubin. Deputy chief of staff to the president of the United States. Deputy director of the office of management and budget, and then the director of that. You are central to crafting the clinton budget in the 1990s which led to budget surpluses for 3 years in a row, something ill most impossible to imagine something almost impossible to imagine, and Enormous Growth economically in our country. Hereearned i have found through your work with the Clinton Administration you just work because of the way you are work across the aisle with other people. It is your instinct to try to find common ground. You are very, very tough. Im thinking about the example we just talked about dust in underground mines. I wanted it to be one it is now two. I apologize to the audience for not going into this. Ms. Burwell did the right thing and came down at 1. 5, the first time in 41 years that the United States government had addressed the problem of breathable dust, dust, leading to black lung. It was a remarkable decision. You make that decision. Because of it, it is now in effect. Your philanthropic works speak for themselves. You are going to be speaking for yourself. Think of anybody more perfect to do hhs. There were so many bumps in the road i think that is innate, and we have discussed that. Enormous programs of the vast consequences. I dont think it ends. It is 15, 20 years before things settle out, and the various decks and crannies are taken care of, and people various nuts and crannies are taking care of, and people feel comfortable. And you just get down to the care. Ss of doing health so we need you, Sylvia Mathews burwell, very, very much. I think you gathered from a statement that i am probably going to vote for you. [laughter] but youre not just about budgets. You are about people, and you are about fighting for people that other people will not fight for, and you are fighting for people who could use a little help, and you are fair to people who dont need any help. You are just a fair person. A tough manager. Probably the smartest person in the city. Mr. Chairman, i am proud to present you Sylvia Mathews burwell. Thank you, chairman rockefeller. That was a wonderful introduction, and i will tell you, director burwell, im curious what you interview to rockefeller on when you were 6. [laughter] perhaps we will learn those secrets one day. At this point we would like you to deliver your testimony, and then we have 4 standard questions for nominees and we will be able to you with quickly able to deal with quickly and then we will have questions from the senators. We will make the prepared remarks part of the record in their entirety. Please proceed. Thank you, chairman wyden and Ranking Member hatch. Inviting thank you for me here today. I am honored that president obama has nominated me for secretary of health and Human Services, and it is a privilege to appear before this committee. I want to thank senator rockefeller and dr. Coburn for their kind words. I am honored to be introduced by numeral to such extraordinary Public Servants who have both spent their lives helping others and delivering for the American People. I am especially grateful for my husband and our children, for their tremendous support, and while my parents couldnt be here with us today, i want to recognize them for their instilling within me and my sister the enduring value of Public Service. As a secondgeneration greek immigrant, i was raised to be thankful for the tremendous opportunities this great nation offers and to appreciate the responsibilities that come with those opportunities. Westghout my childhood in virginia, my father an optometrist and Small Business owner, and my mother a teacher set a great example for me and my teacher through their engagement in service through our community and our church. It is that example that is an important part of why i am here today. Whether in the public or the private sector, working across a range of issues, i focus my work on it 3 things the link strong teams on a strengthening relationships, and building strong teams, strengthening relationships, and delivering results. In my role as omb director i worked with numbers of this committee and others to support efforts to return the budget process to regular order and drive towards progress on issues we all care deeply about. Toinfirmed, i look forward working alongside the remarkable men and women of the department of health and Human Services to build on their work to ensure that children, families, and seniors have the building blocks. F healthy and Productive Lives these issues are fundamental to all of us, whether it is the chronic condition of a child with love or the safety of the food we eat every day. I respect and appreciate the importance of the challenges before us. As we meet here today, scientists and researchers at the National Institutes of health are working to find cures for some of the worlds most serious diseases, and experts at the centers for Disease Control and prevention are working to prevent them from spreading. The fda is protecting the food the medications are doctors prescribe us. Parents and grand parents rely on the centers for medicare and medicaid services. Millions of children benefit from and start. Millions of americans are living with dignity in their own communities. The Department Work to ensure accessible Affordable Quality