Pocket. This is for the walmarts, this is for the Koch Brothers that pay your salary and you should be ashamed of yourself. Lets finish. A couple of comment there is. The cost of productivity, hes disagreeing with your figures and the other caller mentioned this was another biggovernment program. Well, i would encourage the gentleman to take a look at the study we put out specifically for the fast Food Industry where labor is 25 to 30 of the costs. And why do people buy fast food . Because its inexpensive and fast. If it becomes more expensive theyll lose customers and raise costs higher. So analyze that and the fast Food Industry we found the price increase would be about 38 in the short term. In the long term what will happen is firms will install machines that automate these jobs. Youll see cashiers replaced with kiosks. Youll seema sheens like the alpha. Google it. Its been invited thats an automated hamburger that cooks 360 gourmet hamburgers an hour or custom grinds a meat patti. So lets say you want one half pork, one half turkey or whatever your patti will be, custom grinds it, keeps the flavor in, cooks at an internal oven, adds the bun and does this 360 burgers an hour without a single human worker doing everything after the setup. Those machines are expensive but if you raise the minimum wage to 15 and hour and the fast food restaurants want to avoid hiking up their price what is they deal is start buying machines like that and that will mean less jobs and less opportunities for the workers that kendall wants to help. Lets hear from kendall fells, reaction to the callers or what james sherk said. The ceo of papas just came out this month and essentially said theres just been a lot of hubbub and the industry as a whole is overreacting to the increases happening in the minimum wage and the increases in the wages of fast food workers and that the industry would adjust accordingly the same way they do for the price of chicken wings or biscuits, et cetera. What we have to keep in mind is this is a 200 billion industry. Its one of the fastestgrowing industries in the country. They have plenty of money. Its more than enough money to go around and in the end theres no evidence that shows that the increase in minimum wage or wages as a whole from major corporations who are making a billion dollars a year will result in job losses. As far as automation is concerned. Automation is a reality of life. A lot of these stores already have automation but they still have employees. Automation is in a lot of these stores but workers are still making 7. 25 and those workers are out there on strike also saying we deserve 15 an hour. Nobody knows what these workers need more than someone who has to live this life. Somebody like Guadalupe Salazar whos a mcdonalds worker from oakland whos received 4 raise between increases her employer has given her and increases in the minimum wage. Shes basically received a 50 increase in her wages in the last two years and we havent even won the campaign yet and that speaks for itself. Kendall fells is the director of the organizing organizing director of the fight for 15 joining us from kansas city. James sherk is labor and Economics Research fellow at the heritage foundation. Gentlemen, thanks for being with us on washington journal this morning. Thank you. Thanks so much for having us. Tonight on cspan, we remember several Public Officials and activists who died this year. Including former new york governor mario cuomo, former senators edward brook and Fred Thompson, gun control advocate sara brady and several rights activist julian bond. The main thing i think that we need to think about Going Forward. But what are the principle were going to operateqn a 15 or 20point plan is great. Ahha, i can beat him, i got a 30point plan. Great. But what are the underlying principles . When the plans go asunder but you cant get agreement on them, Something Like that i think the United States and we as its citizens ought to remember our first principles. What i call our first principles. I dont think the declaration of independence and the constitution of the United States are outmoded documents. The declaration tells us [ applause ] the declaration tells us the rights come from god and not from government. The constitution has a framework set up not as some kind of result of bureaucratic haggling but as something that is designed to protect and promote freedom. And the president is right. In many ways we are a shining city on a hill. But the hard truth is that not everyone is sharing in this citys splendor and glory. A shining city is perhaps all the president sees from the portico of the white house and the veranda of his ranch where everyone seems to be doing well. But theres another city. Theres another part to the shining city the part where some people cant pay their mortgages and most young people cant afford one. Where students cant afford the education they need and middleclass parents watch the dreams they hold for their children evaporate. In this part of the city there are more poor than ever. More families in trouble, more and more people who need help the but cant find it everyone worse, there are elderly people who trumbull in the basements of the houses there and there are people who sleep in the citys streets, in the gutter where the glitter doesnt show. You can see the entire speeches from mario cuomo and Fred Thompson as well as other Public Officials and activists who died this year tonight on cspan at 8 00 p. M. Eastern. This sunday night on q a a Michael Ramirez on his book of a tier yall cartoons. I have this figure thats a conglomeration of extremist Israeli Settlers and a palestinian figure who if you notice hes on a prayer rug but he has his shoes on so both these figures are sort of utilizing a false religion for political purpose so it proves once again i am an equal opportunity offender. Sunday night at 8 00 eastern and pacific on cspans q a. The acting administrator of medicare and medicaid testified earlier this month on the staterun helts insurance exchanges where millions of americans have purchased Health Insurance. This house subcommittee hearing is almost two hours. Good morning. This subcommittee will now convene. The oversight investigation of subcommittee and commerce. This hearing is to continue examination of state Health Insurance marketplace established under the Affordable Care act, the aca. On september 29, the Committee Heard from a panel of witnesses representing six state exchanges. While attempting to paint a rosy picture, its clears you there are shortterm and longterm problems with state exchanges. One of our main concerns we will address is how centers for medicare and medicaid services, or cms is conducting oversight in taxpayer dollars invested in establishing state exchanges. Today we expect the director from cms back. Today cms has handed out 5. 51 billion to the states to help them establish insurance exchanges. Despite this whopping investment of taxpayer dollars, four state exchanges have been turned entirely over to the federal exchange while countless others are struggling to become selfsustaining. As the federal dollars run dry and enrollment numbers appear below administration projections, all state exchanges face significant budget shortfalls. By law, state exchanges were supposed to be selfsustaining by january 1 of 2015. At which point federal establishment grant money could not be used to operate the exchanges. Not be used. Yet cms has been issuing nocost extensions to exchanges allowing them to use the remainder of the grants through 2015 and in some cases 2016 against intent and letter of the law. Federal funds still cannot be used for operational costs but because of lax oversight and weak guidance we dont know whether or not state exchanges have spend this federal money appropriately. We intend to get clear answers today. In the over five years since the aca was enacted cms has issued two documents to inform state exchanges on the ways to spend federal establishment funds. The first guidance issued in march, 2014, was less than a page. The second guidance came only after the hhs office of Inspector General issued an alert to acting administrator andy slav it have highlighting with urgency the state exchanges that state exchanges may be using grant funds for operational expenses, which is not allowed. In fact, the oig had discovered based on budget documents that Washington Health benefit exchange might have used 10 million in establishment grant funds to support operations such as printing, postage and bank fees, again, not allowed. Hhs, oig urged acting administrator slavit to develop and issue clear guidance on the appropriate use of funds. What followed was a vague document bereft of concrete examples, based on these guidan guidance one wonders if theyre encouraging them to spend federal dollars in any way possible to keep the exchanges limping along. Through the committees information, we have learned state exchanges may have used establishment grant dollars to cover operational cost or transition costs when a state exchange shuts down and moves to the federal flat form. It hasnt been easy to discern because these funds have been comingled and expenses and costs have been redefined. For example rent, which is an operational cost by any definition suddenly becomes Business Development cost. Convoluted by design. In spite of or perhaps because of cms handsoff approach, exchanges are struggling to become selfsustaining. They face it problems, lowerthanexpected enrollment numbers and growing maintenance costs and as the hhs oig pointed out, state exchanges are facing uncertainties in revenue. Four state exchanges hawaii, nevada, new mexico and oregon have shut down their state exchanges and these four states alone receive 733 million in federal establishment grants. The taxpayers return on investment appears minimal at best. Further, there is little indication that cms has attempted to recoup this money. Its our hope the acting administrator commits to and lays out a blueprint recouping these dollars so the American People are not footing the tab for another aca failure. To better understand the challenges these exchanges face, the committee has a number of questions, why are state exchanges troubling to become selfsustaining given the extraordinary taxpayer investment . Is it lack of cms accountability oversight . Is cms taking a hands off approach which has allowed money to be spent uncontrollably, unwisely and impermissibly . And where an exchange has decided to shut down has cms sought to recoup the grant dollars. Are the exchanges doomed to fail . In my estimation, sees me oversight has been sloppy and ignorant butcms oversight has been sloppy and ignorant but we hope they will answer questions in overseeing the aca state exchanges swell provide members of blueprint and how the administration recouped loss taxpayer dollars moving forward. Right now the situation is a mess and taxpayers are on the losing side and thats unacceptable. The hearing comes as a time when premiums are on the rise, major insurers are questioning their decision to join the exchange, coops are failing and state exchanges are expressing doubts about their ability to exist long term. Mounting evidence suggests the aca faces insurmountable problems in 2016 and today we have an opportunity to ask cms top officials if and when the administration will address these concerns in a meaningful way. I think that the acting administrator slavit and look forward to hearing answers to our questions. I recognize Ranking Member ms. Degette for five minutes. Thank you very much, mr. Chairman, today were having yet another hearing on the Affordable Care act. As usual, mr. Chairman, im disappointed that here we are on having another hearing focused on undermining the law rather than focusing our efforts on trying to make the law work better and i know with respect to the topic of this hearing today cms is trying to implement efforts to make the law work better and i think that we should be using our time today to see how we can partner to make that happen. Since the aca was passed over five years ago, this committee has held dozens of oversight hearings on the law. Not one of them has been focused on ways to make the law work better. Not one of them has pressed a balanced view of the laws benefits, but despite that weve gotten a lot of good news out of these hearings about the number of americans that the law is helping and about what the agencies are trying to do to improve coverage despite some of the bumps in the road. You know, even more disturbingly to me, though, its been really an uphill climb to implement this legislation because some of our colleagues, both here in congress and around the country have intentionally placed roadblocks to implementation that make it harder for their own constituents to access care. Some of the governors when the law was passed refused to implement the Medicaid Expansion which would give Health Care Coverage to millions of lower income americans. One republican president ial candidate who also happens to be a u. S. Senator bragged he killed obamacare by limiting risk quarter payments. Ive got two things to say in response to that. First, i think its really disappointing that members of congress would brag about taking Health Care Away from vulnerable americans. Secondly, i think people are wrong on the facts. The Affordable Care act does s not going anywhere. Despite countless attempts to repeal, undermine, defund and defame the law, the Affordable Care act is making comprehensive health care a reality for American Families. Its saving lives. Since passage of the law more than five years ago, an estimated 17. 6 million americans have gained coverage through the acas various provisions. According to the recent cdc data, the uninsured rate has dropped to a historic low of 9 , down from 16 in 2010. I just ran into my colorado folks yesterday at the airport coming out here and they told me despite the fill your of the colorado coop a month or two ago, theyre expecting because of the revisions in colorado, they may be up to 95 coverage in colorado pretty soon. Thats extraordinary for the health care of our constituents and thats what we should be working to achieve. Ive gotten a article from the New York Times entitled rise in Cervical Cancer detection is linked to Affordable Health care, mr. Chairman, according to researchers from the american cancer society, more women are receiving an early diagnosis of Cervical Cancer due to an increase in Health Insurance coverage under the aca. Id like to ask unanimous consent to put that in the record. Without objection. Early diagnosis of Cervical Cancer improves womens prospects for survival of the disease and bolsters their hope to preserve fertility during treatment and women with Health Insurance are more likely to get a screening that can identify Cervical Cancer early. You know, i know that its hard to make this specific about constituents. Its hard sometimes for my colleagues on the other side of the aisle to acknowledge that actual people are being helped by this law but millions of americans are benefitting from it and a lot of people like me think we could be making it better. The reason im talking about this this morning is because on the house floor we will be likely voting this week on a reconciliation bill to repeal key parts of the Affordable Care act. This will be by our calculation the 62nd attempt to eliminate or repeal key provisions of the aca. If inacted, virtually all of the historic gains in Health Care Coverage weve made in the last five years would be lost. This would be a tragedy for the American People and a gross failure of leadership. Weve done so much good this year in this stub committee. We did bipartisan work on pandemic flu. We did bipartisan work on the volkswagen information and many other things. I think this could be the committee where we had these hearings and then we sat down to think about how to improve rather than undermine the Affordable Care act. I hope thats what well do in the next year but frankly i dont hold out a lot of hope. I yield back. I want to welcome today we have several members here from the National Democrat institute in support of the house democracy partnership. This is a peertopeer exchange cochaired by representative peter rosco and representative david price and guests from kenya and peru. Welcome here. Just to let you know. We this is a love fest among us. We all like each other so take back to your country sometimes we argue but in the end we are in here for the same cause. If the chairman will yield. We might disagree but we disagree in a civil way. Watch this, see . [ laughter ] thats torture for me. I now recognize mr. Upton for five minutes. I thank the good chairman. Today we continue our oversight into the on state Health Insurance marketplaces. Hardworking taxpayers invested some 5. 5 billion to establish the state exchanges yet they still continue to struggle, as we know. Exchanges are struggling to sign up new customers, struggling to fix it systems and ultimately struggling to become selfsustaining, we welcome to cms acting administrator mr. Slavit and we appreciate his testimony on