It can undermine our budget and slow the Economic Growth in our states. As it stands, state economies are slowly recovering and we are returning to the revenues we collected back in 2008. We believed in flexible federalism. As we continue to work with congress and the administration, governors are committed to a collaboration to maintain and promote a balanced system. We have as congress and the initiation to keep four points in mind. This should produce savings for the federal and state. It cannot be accomplished by shifting costs from the federal government to the states or by imposing unfunded mandates. State should be given increased flexibility. Congress should not impose efforts as this. Many of the decisions that affect our health care are made in the states, especially those about Health Care Delivery systems. As the demand for primary care is straining, we face a rapidly aging population. More than 16 million individuals are projected to gain Health Insurance coverage by 2016. Many are looking for innovative ways to revamp how they deliver health care. The department of health and Human Services issued a number of states where they could work exactly on that. We will be spending time speaking about this and some other flexibilities. Our discussions will be about my nga chair initiative. Mine is called building a better bottom line, employing individuals with disabilities. We want to increase the jobs for everybody in our state. We cannot forget the people in our states with disabilities. We need to be the jobs governors for them as well. It is up to us to enable people to engage in productive employment and to participate fully in their communities. That is why i have chosen to focus this initiative on ways that states and businesses can increase Employment Opportunities for individuals with disabilities. It is designed to raise awareness of how talents can contribute to a companys bottom line. It is also defining way State Government and businesses can partner to bring opportunities to individuals in the labor market. This is the economic issue. We have invited one of the foremost leaders in our community to weigh in on this very important topic. We will be hearing from the president and ceo of walgreens. It is an incredible example of how employing those with disabilities makes good sense. He has a very compelling message. In our special session tomorrow, Judy Woodruff will moderate a discussion among the governors about how states can support businesses to include these individuals with disabilities. Will also be joined by a panel of experts. We have a lot to accomplish. We are optimistic about our state. We are aware of the leadership roles that are entrusted to us by the citizens of our state. We honor that by moving all of us for words. All of us forward. I would like to ask the vice chair of the National Governors association, the governor of oklahoma, to come up and say a few words. We will be happy to take for questions. [applause] thank you. It is a pleasure to be here today. We appreciate you joining us as we open up our session for the Governors Association to get numbers for our nation. I want to thank you for your leadership of the nga and the Time Commitment you have put in for this Bipartisan Organization as we Work Together to address the problems facing our nation to try to find solutions so we can move this forward together. We are going to have some very productive days as we get through our schedule. We have Great Programs that will be held this weekend. It is a very busy weekend. We have a lot of important things to discuss. I want to talk about programs and issues we will be discussing during this meeting. Economic development and our Commerce Committee have been in discussion about federal tax reform. That is an issue on the hearts and minds of each of our governors, getting our Economic Situation back in order. The current tax structure is up for much debate. Our slow Economic Growth and our concern over the sustainability of our federal debt is a few of the components trading the hardships upon our state and the need for comprehensive tax reform in the congress and within our nation itself. The nga has created a task force to develop consistent principles we believe democrats and republicans can support that will address federal tax reform from our governors to be able to present to congress and to the administration into the president. The task force will address longterm standing tax policies and how we can help grow our nations economy. We also face many challenges presented by the growth of cyberterrorism and its Cyber Attacks upon our nation. The nga has created a Resource Center for state Cyber Security to ensure we have adequate Cyber Security for state owned and a state based infrastructure. Governors will discuss the issue during the first one of our series which is on the health of Homeland Security committee itself. A second half will focus on another issue. This is one we have been very instrumental in addressing, and securing our nationwide Public Safety network. We will hear on the development and imputation and how we can Work Together to ensure success. Tomorrow the Work Force Committee will have a conversation about how states can best develop an innovative Human Capital strategy for our nation and work force and our jobs and to ensure that every child in our nation has effective teachers and we have great School Leaders and that we do everything we can do to meet the work force means across the nation. Governors are leading to ensure that all students regardless of race or zip code have the ability to move on. We will speak about some of the big issues, the extensive damage many states have received from National Disasters brought on by a super storm sandy and the floods that have hit the midwest. We are going to be talking about the resiliency of our flood protection that is viable to the health and safety of our citizens. We will be discussing extreme weather events and how we can improve communication once we do have a Natural Disaster and the coordination between our different agencies and the army corps of engineers and how important the role they play in helping us during recovery of these Natural Disasters. We will be heading to the white house. We will be considering nga policies and hear from let me talk about this. We will have one last session to discuss some other nga policies relating to the health of america and how we improve the outcomes of our nation. We have a great opportunity to hear from dr. Oz about taking personal responsibility and about the role of personal responsibility and government responsibility in taking care of our health. There is a lot of things that will be discussed in our various committees. That is a quick snapshot of some of the core issues. We will be working on some other issues dealing with our National Guard. It is of great concern to our governors. We are the commanders in chief of our National Guards. The Critical Role that the National Park place in responding to emergencies in disasters here at home as well as overseas where there is fighting. Last year we were able to deal with some important issues that were on the hearts and minds of our governors. The federal budget is helping to protect our National Guards so they do not take a disproportionate cut in the funding. The nga has been working to come up with some suggestions and has worked to convince congress to help moderate some of the cuts we have been seeing. We have also created another task force on how we deal with Substance Abuse, in particular subscription drug abuse. It is one of the Fastest Growing up abuses. Drug problems related to Prescription Drugs. I know we will be talking about that throughout our nation. Many states have already tackled this issue. A new initiative we have developed within the nga to implement a comprehensive and coordinated strategy to help reduce the use of Prescription Drugs and the abuse within our nation. We have seven states that have been leading this charge. They will share some lessons that have been learned of their analysis of that issue. Gov. Markell discuss that governors are advocating for various projects. We discussed that governors are advocating for various projects. We are talking about investment in our infrastructure and projects. Reauthorization of the secondary education act, restoring the 15 workforce investment act for our governors to be able to work on statewide programs on job training and doing what we think is in the best interests of our various industries as it relates to the work force. We have been doing a lot of work. There is still a lot more work to be done. We look forward to having a productive meeting and having some great speakers so it will be helping lead the discussion. These are the pressing issues facing our nation. We appreciate the governors to have joined us today. Thank you for coming. Will also been joined by the new government of puerto rico. We would be happy to take your questions. I was wondering if gov. Fallin can discuss the division among the states on medicaid expansion. Do think it might lead to people moving states that offering the expansion so they do not have to purchase Health Insurance . You are right. There has been a divergence of opinions about how states handle be Affordable Health care act. We respect to the other governors. We know each state has different budgets and populations and needs. They have different Unemployment Rate. Some have different political circumstances. That is why you see states have about a 50 50 split. Each of honor has to do what they believe is in the best interests of their state. We believe the expansion of medicaid would be unaffordable. We think medicaid needs to be reformed. We think it is unworkable. I think the test will still come in january to see if the government is ready to implement the federal exchange itself and be able to afford that. There are still some legal challenges with the state of oklahoma on the Affordable Health care act and the taxability on the states. There are these different scenarios that can play out. We respect the opinions and each state has to do what is in their best interest. For a lot of us, this is not a partisan issue at all. This is not a democrat or republican. It is a matter of the math. For us to have the opportunity to expand the population to have the government pick up 100 of the cost meant a lot of people who otherwise may not have access to good care will now have that access. In addition, we are getting a higher reimbursement for a portion of the population. Some of the important developments are taking place in the state and not necessarily in washington. We have a session later today where we will be learning from each other about some of the efforts under way to improve outcomes and reduce costs. There is much more that is going on. I mentioned a couple of states that are focusing exactly on that, payment reform with the intention of reducing costs. There is some very exciting work. We get to learn from each other. I will ask if my colleagues want to add anything to that. Hello. I cannot say i am delighted to be here. We were doing so well up until this moment, right . What i am delighted about is to be able to see mary again from the congress and to meet with all the governors. I think the emphasis that was just made by both governors emphasized that this is a National Governors conference. There has been some concentration lately on some of the difficulties and the congress at this time in terms of coming to a consensus. It is instructive for the nation. That is why we are pleased to hear that it is possible to set aside the democratic an ideological point of view to concentrate on the object, to serve our people. This is what this association does. As one of the recipients of the innovation grants, i believe that whatever difficulties there may be now with respect to programs and approaches in the congress, the various governors are engaged right now in a very intense effort to try to determine how we can get Better Outcomes and get cost controls into place. This is a great example of working together on a solution of a very crucial and central problem. I suspect these grants will go a long way toward helping resolve some of the questions of access and questions regarding how we can maximize the efficiency of that access as the numbers increase under medicaid. Do not hesitate if there is a question you want to answer. It is good to see you again. A question. At previous nga meetings, a number of governor spoke about getting waivers from the department of health in order to cap medicaid and then having a autonomy. The governor of vermont talked about what he did and what the results were when he got the waiver. Are you seeing a lot of sentiment for getting waivers from secretary sebelius at the department of hhs in experimenting with the individual solutions . Many states are in a continuous dialogue about how to make sure our systems can best serve the people of our states. Every time that we have ever met with the president , one of the things he brings up is he says i hear that you would like flexibility. Please identify the kind you see. That is a responsibility we are taking on to make sure that we are putting those ideas forward. They have been working with many of us. We have some pretty big waivers that some of us have gotten. There are lots of different ideas among set the stage. We appreciated the effort on both sides to grant the flexibility is we need to provide health care for the people. As has been one of our main messages to the president , states are great laboratories for democracy. Each state is different. My state has some loss we need to improve. I have been working on an oklahoma plan that best meet our budgetary needs but also will be able to raise the Health Outcome of our states. In my state, we will be looking at south Health Lifestyle choices, obesity, a tobacco use, Prescription Drug abuse, Mental Health issues. I put more money into my Health Care Authority to be able to address the woodworking effect for those who will be eligible for medicaid or have to pay a penalty or fine. I am putting more money into health for those that are uninsured. I am also putting money into mentalhealth illnesses in various programs that deal with emergency Crisis Centers and systems of care for our citizens to figure out what are the needs of not only our children but are families themselves and to get them into the right system. One of the thing that dr. Oz has told me in the past is the majority of the diseases that americans face are diseases related to health choices. Lifestyle choices. It is the things we do to ourselves. And how can we work with our state and improve the overall outcomes . We have asked the secretary and the president for the flexibility. We have a Great Program called insure oklahoma. Theyre able to get insurance. We would like to expand upon that. We have a waiver right now. They may discontinue that waiver. We are talking to the administration to allow us the flexibility to craft a Health Care Programs in our state was something we can afford to be able to do. They have told us our waiver will expire by the end of this year. What the president has told me personally is that if your waivers meet our goals they will be inclined to improve that. There are governors to have applied for waivers that have been turned it down. What is the goal . Mine is to improve access to health care. It is to improve the General Health of our systems and be able to do it in a way i can afford it. And have Health Professionals that can meet the needs of our population. One last point. On this issue, what we consistently hear from the white house is they are very comfortable with this idea of the states the laboratories of democracy. There are certain things they want to make sure we are achieving. What are we going to achieve . Medicaid and the road signs are exempt from sequestration. Are you concerned that any negotiation to sidestep sequestration will put those funds back on the table . Gene sperling said with respect to medicaid, many of us made the decision to expand and it was based on the deal on the table at the time. 100 for three years. It is pretty clear that this will not change. There is going to be a bipartisan message to the president. A couple of months ago a total delegation of three democrats and republicans came to washington. We met with the president and vice president. We met with john boehner and his leadership team. We met with harry reid and his leadership team. Our message was we think it is very important that governors have a seat at the table. We are partners. We