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Fourth year and the future years, they can actually utilize what is already being used in a local property tax or sales tax for these low income people. For these low income people. So, what i would ask, if the state chooses not to expand , what wouldto 138 you think the department would plan to handle be states rick states request to continue with business as usual . Senator, with regards to the specifics of the discussions thaten hhs and the state, is something in my current role i am not familiar with. What i can talk about is the philosophy of how to think about these issues in terms of me...

Delivered to people in ways that they can access it and use it in ways that prevent the kind of problems you described with the 12yearold that actually extend through adulthood for many. Absolutely. I look forward to working with you. Thank you. Thank you. Senator isakson is next. Congratulations on your nomination. Congratulations to your family or condolences to your family one way or another. Hearing before the Health Committee, i brought up an issue i already discussed with the chairman. In that meeting i told you i had no more responsibility as a member of the United States your noluding ...

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 fa...

We have seen for the past five years. My question is this. Do you think it is possible for you to change the by any means necessary culture at hhs that some of us in congress of you as bordering on lawless . , thank you. Harkening to my experience at the office of management and budget, there are challenging issues. Ais, iook around this d have had the opportunity to talk with you on a number of things that are positive and difficult. That is something i consider it my responsibility to do. I hope people feel in my role at omb that i have done that. Whether that is moving to more timely respon...

Response, you said that you were hopeful that ipad never needs to be used and the necessity to do so would never be triggered. Would you simply support its appeal . Also important to reflect that ipad, as currently written, would not affect beneficiaries. That is an important part of the law with regard to how it is implemented. As regard to the appeal on the things thate of the is hopefully a hopeful thing is to helpthings in place us all get to where we need to with regard to reducing Health Care Costs. May be barbed wire would be a better way to put it. I would echo my colleagues comments t...