WEBVTT
Region: id=rollup2 lines=2 scroll=up
00:07:36.289 --> 00:07:40.660 region:rollup2
ACTUALLY WILL GO AHEAD AND GET
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STARTED SOMEWHERE OTHER MEMBERS
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WILL UP WILL BE TRICKLING AND SO
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BUT IN THE INTEREST OF. OF OUR
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SPEAKERS WHO'VE TRAVELED MANY OF
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THEM LONG DISTANCES TO BE HERE
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WE WANT TO GIVE.
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AMPLE OPPORTUNITY FOR THEM TO
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BE ABLE TO PARTICIPATE AND.
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AND MOVE FORWARD SO THIS POINT
00:07:55.108 --> 00:07:59.846 region:rollup2
A MINUTE JUST MAKE SOME OPENING
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REMARKS AND PASS IT OFF TO MY CO
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CHAIR A DOCTOR ARAMBULA SO.
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FIRST OF ALL GOOD AFTERNOON AND
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WELCOME TO THE FOURTH IN A
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SERIES OF HEARINGS OF THE SELECT
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COMMITTEE ON HEALTH CARE
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DELIVERY. AND UNIVERSAL COVERAGE
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AS WE DIG DEEPER INTO THIS
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POLICY RECOGNIZE THAT IN ORDER
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TO BE SUCCESSFUL IN DEFINING A
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PATHWAY TO UNIVERSAL COVERAGE WE
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MUST ADDRESS SOME OBVIOUS AND
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POTENTIAL CHALLENGES RELATED
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STATE. AND FEDERAL LAW.
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FOR EXAMPLE MEDICARE IS FUNDED
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THROUGH A PROTECTED MEDICARE
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TRUST FUND AND FEDERAL LAW
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ESTABLISHES THE RULES FOR HOW
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THAT MONEY CAN BE SPENT.
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ACCESS IN THOSE FUNDS WOULD
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REQUIRE CONGRESSIONAL ACTION.
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THEY'RE ALSO STATE
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CONSTITUTIONAL ISSUES PROP
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NINETY EIGHT REQUIRES FORTY
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PERCENT OF STATE GENERAL FUND
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REVENUES TO GO TO QUE TO
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FOURTEEN EDUCATION.
00:08:34.981 --> 00:08:38.518 region:rollup2
BEGAN LIMITS FROM PROPOSITIONS
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THIRTEEN FOUR IMPOSED SPENDING
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LIMITS ON THE STATE.
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TO ENSURE THAT REVENUE IN IT IN
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EXCESS OF THOSE LIMITS WOULD BE
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RETURNED TO TAXPAYERS.
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IF TAXES WERE INCREASED TO FIND
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A HEALTHCARE SYSTEM HOW WOULD
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THOSE REVENUES BE AFFECTED.
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THREE POINT THREE MILLION
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CALIFORNIANS GET THEIR COVERAGE
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THROUGH SELF INSURED OR SELF
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FUNDED PLANS THAT ARE SUBJECT TO
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A RECESS.
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ADMINISTERED BY THE US
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DEPARTMENT OF LABOR.
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THEY ARE EXEMPT FROM THE STATE
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SPECIFIC INSURANCE REGULATIONS.
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TODAY WE HAVE IMPRESSIVE PANEL
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OF EXPERTS WHO WILL WALK US
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THROUGH THESE ISSUES AND MORE.
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FOLLOWING EACH PRESENTATION THE
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MEMBERS WILL HAVE A THE
00:09:13.386 --> 00:09:16.756 region:rollup2
OPPORTUNITY ASK QUESTIONS THE
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LAST TWO PANELS WERE PRESENT
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TOGETHER.
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MEMBERS WILL HAVE AN OPTION AS
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QUESTIONS AFTER THEY PRESENT.
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WILL ALSO HAVE PUBLIC COMMENT
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I'D LIKE TO ENSURE THAT DURING
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THE PUBLIC COMMENT PERIOD WE
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ALLOWS MANY PEOPLE TO SPEAK AS
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POSSIBLE. I CRINGE EVERYONE TO
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BE RESPECTFUL ND MORE AND LIMIT
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THEIR PRE* INSTITUTE TWO
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MINUTES DURING THE. PUBLIC
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COMMENT MORE DETAILED WRITTEN
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COMMENTS ARE WELCOMED AND CAN
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MEET SUBMITTED DIRECTLY TO THE
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COMMITTEE.
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THANK YOU VERYMUCH I THAT I'D
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LIKE TO INVITE MARCO CHAIR.
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DOCTOR LOOKING ARAMBULA TO
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OFFER THE OPENING REMARKS.
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THANK YOU.
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I'D LIKE TO THANK EVERYONE FOR
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ATTENDING TODAY'S HEARING.
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THIS HEARING IS THE FIFTH IN A
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SERIES OF HEARINGS THAT WE'VE
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HAD TO EXPLORE THE WAYS TO
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IMPROVE OUR STATE'S HEALTH CARE
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SYSTEM. AND PROVIDE UNIVERSAL
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HEALTHCARE FOR ALL CALIFORNIANS.
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IN OUR PREVIOUS HEARINGS WE
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FOCUSED ON CALIFORNIA'S CURRENT
00:10:01.701 --> 00:10:05.305 region:rollup2
SYSTEM.
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INCLUDING PUBLIC PROGRAMS THE
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INDIVIDUAL MARKET EMPLOYER BASED
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COVERAGE. SAFETY NET PROGRAMS
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AND CURRENT GAPS IN COVERAGE.
00:10:11.644 --> 00:10:14.147 region:rollup2
WE'VE ALSO HEARD ABOUT MODELS OF
00:10:13.012 --> 00:10:15.849 region:rollup2
UNIVERSAL COVERAGE SYSTEMS IN
00:10:14.147 --> 00:10:17.617 region:rollup2
OTHER COUNTRIES.
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WE'VE HAD EXPERTS SHARE DETAILS
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ABOUT DIFFERENT MODELS AND
00:10:18.985 --> 00:10:22.622 region:rollup2
PROGRAMS FROM DIFFERENT STATES
00:10:20.620 --> 00:10:23.723 region:rollup2
AND OUR LAST HEARING WE HEARD
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ABOUT CHALLENGES IN ACCESSING
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CARE.
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AND THE BECAUSE OF HIGH PRICES.
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THANKS TO THESE HEARINGS THE
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MEMBER OF THIS COMMITTEE HAVE A
00:10:30.497 --> 00:10:33.266 region:rollup2
MUCH BETTER APPRECIATION OF THE
00:10:32.699 --> 00:10:34.834 region:rollup2
COMPLEXITY OF OUR HEALTHCARE
00:10:33.266 --> 00:10:36.803 region:rollup2
SYSTEM.
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THAT BEING SAID I BELIEVE
00:10:36.803 --> 00:10:40.340 region:rollup2
TODAY'S HEARING.
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MAYBE THE MOST IMPORTANT HEARING
00:10:40.340 --> 00:10:43.977 region:rollup2
WE'VE HAD TO DATE.
00:10:42.642 --> 00:10:45.645 region:rollup2
WE WILL FOCUS ON THE
00:10:43.977 --> 00:10:47.313 region:rollup2
IMPLEMENTATION CHALLENGES AND
00:10:45.645 --> 00:10:49.716 region:rollup2
CONSIDERATIONS WILL NEED TO
00:10:47.313 --> 00:10:50.850 region:rollup2
ADDRESS AS WE MOVE FORWARD WITH
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ANY CHANGES TO CALIFORNIA'S
00:10:50.850 --> 00:10:54.487 region:rollup2
HEALTH CARE SYSTEM.
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THIS COMMITTEE'S CHARGE IS TO
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FIND WORKABLE SOLUTIONS THAT
00:10:56.022 --> 00:10:59.626 region:rollup2
WILL EXPAND HEALTHCARE COVERAGE
00:10:58.057 --> 00:11:01.327 region:rollup2
AND INCREASED ACCESS TO CARE.
00:10:59.626 --> 00:11:02.562 region:rollup2
THAT IS WHY I BELIEVE THAT
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TODAY'S HEARING MAYBE THE MOST
00:11:02.562 --> 00:11:05.865 region:rollup2
IMPORTANT HEARING.
00:11:04.230 --> 00:11:07.333 region:rollup2
IF WE CAN IDENTIFY THE
00:11:05.865 --> 00:11:09.269 region:rollup2
IMPLEMENTATION CONSIDERATIONS
00:11:07.333 --> 00:11:10.703 region:rollup2
AND CHALLENGES WELL UNDERSTAND
00:11:09.269 --> 00:11:11.704 region:rollup2
THE CHALLENGES WE FACE IN
00:11:10.703 --> 00:11:13.706 region:rollup2
IMPROVING OUR CURRENT HEALTHCARE
00:11:11.704 --> 00:11:14.774 region:rollup2
SYSTEM.
00:11:13.706 --> 00:11:16.576 region:rollup2
I AM INTERESTED IN HEARING ABOUT
00:11:14.774 --> 00:11:20.313 region:rollup2
WHAT CURRENT FEDERAL LAW WILL
00:11:16.576 --> 00:11:21.881 region:rollup2
ALLOW US TO DO. AND NOT TO DO.
00:11:20.313 --> 00:11:23.149 region:rollup2
WE ALSO NEED TO UNDERSTAND THE
00:11:21.881 --> 00:11:24.918 region:rollup2
CONSTRAINTS ARE STATE'S
00:11:23.149 --> 00:11:26.653 region:rollup2
CONSTITUTION PUT ON EXPANSION
00:11:24.918 --> 00:11:28.388 region:rollup2
PROPOSALS.
00:11:26.653 --> 00:11:30.089 region:rollup2
FINALLY WE NEED TO FIGURE OUT
00:11:28.388 --> 00:11:31.925 region:rollup2
HOW WE PAY FOR ANY CHANGES WE
00:11:30.089 --> 00:11:32.992 region:rollup2
WANT TO MAKE.
00:11:31.925 --> 00:11:34.827 region:rollup2
AS THE CHAIR OF THE BUDGET
00:11:32.992 --> 00:11:36.829 region:rollup2
SUBCOMMITTEE ON HEALTH AND HUMAN
00:11:34.827 --> 00:11:38.498 region:rollup2
SERVICES I BELIEVE IT IS
00:11:36.829 --> 00:11:40.934 region:rollup2
IMPERATIVE THAT WE UNDERSTAND
00:11:38.498 --> 00:11:42.235 region:rollup2
THAT IT WILL COST TAXPAYERS AND
00:11:40.934 --> 00:11:44.037 region:rollup2
HOW WE PAY FOR EXPANSIONS TO OUR
00:11:42.235 --> 00:11:46.206 region:rollup2
SYSTEM.
00:11:44.037 --> 00:11:47.373 region:rollup2
AS WE WORK TOWARDS THE IDEAL
00:11:46.206 --> 00:11:49.008 region:rollup2
THAT HEALTHCARE IS A HUMAN RIGHT
00:11:47.373 --> 00:11:51.444 region:rollup2
IN CALIFORNIA.
00:11:49.008 --> 00:11:53.379 region:rollup2
TODAY'S HEARING WILL HELP INFORM
00:11:51.444 --> 00:11:55.915 region:rollup2
US HOW WE MOVE FORWARD.
00:11:53.379 --> 00:11:57.717 region:rollup2
AS I HAVE SAID MANY TIMES NOW WE
00:11:55.915 --> 00:11:59.452 region:rollup2
ARE CALIFORNIA WE DON'T FOLLOW
00:11:57.717 --> 00:12:01.087 region:rollup2
WE LEAD.
00:11:59.452 --> 00:12:02.655 region:rollup2
AND NOW BEFORE WE START THE REST
00:12:01.087 --> 00:12:03.690 region:rollup2
OF OUR HEARING I'D LIKE TO OFFER
00:12:02.655 --> 00:12:04.224 region:rollup2
OUR FELLOW MEMBERS AN
00:12:03.690 --> 00:12:09.128 region:rollup2
OPPORTUNITY FOR AN OPENING
00:12:04.224 --> 00:12:09.896 region:rollup2
STATEMENT.
00:12:09.128 --> 00:12:11.364 region:rollup2
OKAY.
00:12:09.896 --> 00:12:12.832 region:rollup2
WILL GO AHEAD AND GET STARTED
00:12:11.364 --> 00:12:14.634 region:rollup2
THEN WE HAVE AN OVERVIEW SUSAN
00:12:12.832 --> 00:12:15.335 region:rollup2
PHILLIPS SENIOR HEALTH CARE
00:12:14.634 --> 00:12:16.402 region:rollup2
MANAGEMENT CONSULTING WITH
00:12:15.335 --> 00:12:18.471 region:rollup2
MILLIMAN.
00:12:16.402 --> 00:12:19.906 region:rollup2
SHE'S FOCUSES ON DEVELOPING
00:12:18.471 --> 00:12:21.274 region:rollup2
PRACTICAL SOLUTIONS TO ALIGN
00:12:19.906 --> 00:12:22.308 region:rollup2
INCENTIVES IN OUR HEALTHCARE
00:12:21.274 --> 00:12:22.976 region:rollup2
SYSTEM TO ENCOURAGE VALUE
00:12:22.308 --> 00:12:29.582 region:rollup2
QUALITY AND ACCESS.
00:12:22.976 --> 00:12:30.650 region:rollup2
SUSAN.
00:12:29.582 --> 00:12:31.985 region:rollup2
MEMBERS OF THE COMMITTEE I
00:12:30.650 --> 00:12:33.720 region:rollup2
WANTED THANK YOU FOR THE
00:12:31.985 --> 00:12:35.221 region:rollup2
OPPORTUNITY TO SPEAK TODAY. AS
00:12:33.720 --> 00:12:37.156 region:rollup2
PART OF THESE VERY IMPORTANT
00:12:35.221 --> 00:12:39.058 region:rollup2
SERIES OF HEARINGS. AS A
00:12:37.156 --> 00:12:40.860 region:rollup2
LONGTIME RESIDENT OF CALIFORNIA
00:12:39.058 --> 00:12:42.595 region:rollup2
AS A PATIENT AND USER OF THE
00:12:40.860 --> 00:12:43.863 region:rollup2
HEALTHCARE SYSTEM MYSELF. I'M
00:12:42.595 --> 00:12:45.031 region:rollup2
EXCITED THAT YOU'RE UNDERTAKING
00:12:43.863 --> 00:12:46.933 region:rollup2
EFFORTS TO CONSIDER OUR
00:12:45.031 --> 00:12:48.268 region:rollup2
HEALTHCARE DELIVERY SYSTEM AND
00:12:46.933 --> 00:12:49.702 region:rollup2
HOW TO MAKE IT BETTER AND MORE
00:12:48.268 --> 00:12:51.170 region:rollup2
ACCESSIBLE FOR ALL MEMBERS OF
00:12:49.702 --> 00:12:52.639 region:rollup2
OUR COMMUNITY.
00:12:51.170 --> 00:12:53.740 region:rollup2
AS MENTIONED I AM HEALTHCARE
00:12:52.639 --> 00:12:54.741 region:rollup2
MANAGEMENT CONSULTANT WHAT
00:12:53.740 --> 00:12:56.509 region:rollup2
MILLIMAN MILLMAN IS AN
00:12:54.741 --> 00:12:58.611 region:rollup2
INDEPENDENT CONSULTING FIRM
00:12:56.509 --> 00:13:00.947 region:rollup2
OFFERING ACTUARIAL AND RELATED
00:12:58.611 --> 00:13:01.481 region:rollup2
SERVICES TO PUBLIC AND. PRIVATE
00:13:00.947 --> 00:13:04.250 region:rollup2
SECTOR CLIENTS AROUND THE
00:13:01.481 --> 00:13:05.885 region:rollup2
COUNTRY. WE ROUTINELY ROUTINELY
00:13:04.250 --> 00:13:07.220 region:rollup2
WORK WITH PUBLIC PARTNERS
00:13:05.885 --> 00:13:08.855 region:rollup2
I INCLUDING STATE MEDICAID
00:13:07.220 --> 00:13:11.124 region:rollup2
PROGRAMS STATE EMPLOYEE HEALTH
00:13:08.855 --> 00:13:13.993 region:rollup2
INSURANCE PROGRAMS AS WELL AS
00:13:11.124 --> 00:13:15.361 region:rollup2
PROVIDERS PAYERS AND EMPLOYERS.
00:13:13.993 --> 00:13:16.863 region:rollup2
YOU ALREADY HAD A NUMBER OF
00:13:15.361 --> 00:13:18.097 region:rollup2
SPEAKERS THROUGHOUT THESE
00:13:16.863 --> 00:13:20.299 region:rollup2
INFORMATIVE HEARINGS AND ARE
00:13:18.097 --> 00:13:21.100 region:rollup2
ALREADY WELL VERSED IN THE
00:13:20.299 --> 00:13:22.602 region:rollup2
COMPLEXITY OF OUR HEALTHCARE.
00:13:21.100 --> 00:13:23.936 region:rollup2
SYSTEM.
00:13:22.602 --> 00:13:25.438 region:rollup2
MY JOB TODAY'S TO GIVE YOU AN
00:13:23.936 --> 00:13:27.407 region:rollup2
OVERVIEW OF IMPLEMENTATION
00:13:25.438 --> 00:13:28.775 region:rollup2
ISSUES. THAT WOULD ARISE
00:13:27.407 --> 00:13:31.778 region:rollup2
DEPENDING ON THE POLICY
00:13:28.775 --> 00:13:33.413 region:rollup2
SOLUTIONS YOU ARE CONSIDERING.
00:13:31.778 --> 00:13:35.581 region:rollup2
MY GOAL IS TO PROVIDE YOU A
00:13:33.413 --> 00:13:37.116 region:rollup2
USEFUL FRAMEWORK TO EVALUATE
00:13:35.581 --> 00:13:38.685 region:rollup2
VARIOUS PROPOSALS THAT YOU MAY
00:13:37.116 --> 00:13:40.687 region:rollup2
BE CONSIDERING OVER THE NEXT FEW
00:13:38.685 --> 00:13:41.454 region:rollup2
WEEKS OR MONTHS.
00:13:40.687 --> 00:13:43.589 region:rollup2
I'M GONNA T. OF THE KEY
00:13:41.454 --> 00:13:44.657 region:rollup2
IMPLEMENTATION ISSUES AND THE
00:13:43.589 --> 00:13:47.093 region:rollup2
SPEAKERS THAT ARE FOLLOWING ME
00:13:44.657 --> 00:13:47.660 region:rollup2
WILL PRESENT A DEEPER DIVE INTO
00:13:47.093 --> 00:13:48.561 region:rollup2
EACH OF THE AREAS I WILL LAY
00:13:47.660 --> 00:13:49.529 region:rollup2
OUT.
00:13:48.561 --> 00:13:52.298 region:rollup2
I WILL NOTE THAT MOST OF MY
00:13:49.529 --> 00:13:54.300 region:rollup2
COMMENTS.
00:13:52.298 --> 00:13:55.601 region:rollup2
ARE ALSO SUMMARIZED IN A REPORT
00:13:54.300 --> 00:13:57.337 region:rollup2
THAT WAS FUNDED BY THE
00:13:55.601 --> 00:13:58.871 region:rollup2
CALIFORNIA HEALTHCARE FOUNDATION
00:13:57.337 --> 00:14:00.873 region:rollup2
AND CO AUTHORED BY MYSELF AND
00:13:58.871 --> 00:14:02.608 region:rollup2
MARY MULTI CALLED KEY QUESTIONS
00:14:00.873 --> 00:14:03.409 region:rollup2
WHEN CONSIDERING A STATE BASED
00:14:02.608 --> 00:14:05.311 region:rollup2
SINGLE PAYER SYSTEM. IN
00:14:03.409 --> 00:14:06.979 region:rollup2
CALIFORNIA.
00:14:05.311 --> 00:14:08.147 region:rollup2
I BELIEVE YOU MAY ALREADY HAVE.
00:14:06.979 --> 00:14:10.183 region:rollup2
THAT REPORT IS PART OF YOUR
00:14:08.147 --> 00:14:12.118 region:rollup2
BRIEFING MATERIALS.
00:14:10.183 --> 00:14:13.753 region:rollup2
I'M ONE OF THE KEY THEMES I CAME
00:14:12.118 --> 00:14:15.054 region:rollup2
THAT HAS COME OUT OUT OF THE
00:14:13.753 --> 00:14:16.989 region:rollup2
HEARING SO FAR IS THAT
00:14:15.054 --> 00:14:18.491 region:rollup2
CALIFORNIA HAS MADE A LOT QUITE
00:14:16.989 --> 00:14:19.859 region:rollup2
A LOT OF PROGRESS.
00:14:18.491 --> 00:14:21.394 region:rollup2
IN REDUCING THE NUMBER OF
00:14:19.859 --> 00:14:23.296 region:rollup2
UNINSURED IN CALIFORNIA IN THE
00:14:21.394 --> 00:14:25.365 region:rollup2
LAST FEW YEARS AND REALLY MOVING
00:14:23.296 --> 00:14:27.066 region:rollup2
TOWARDS UNIVERSAL COVERAGE.
00:14:25.365 --> 00:14:28.801 region:rollup2
HOWEVER THERE DOES REMAIN ABOUT
00:14:27.066 --> 00:14:30.636 region:rollup2
THREE MILLION PEOPLE WHO ARE ARE
00:14:28.801 --> 00:14:32.438 region:rollup2
UNINSURED.
00:14:30.636 --> 00:14:34.006 region:rollup2
AND ALSO EVEN WITH PROGRESS
00:14:32.438 --> 00:14:35.341 region:rollup2
TOWARDS UNIVERSAL COVERAGE MUCH
00:14:34.006 --> 00:14:37.243 region:rollup2
WORK REMAINS TO BE DONE TO
00:14:35.341 --> 00:14:37.744 region:rollup2
IMPROVE AFFORDABILITY IMPROVE
00:14:37.243 --> 00:14:39.479 region:rollup2
ACCESS TO COMPREHENSIVE
00:14:37.744 --> 00:14:41.247 region:rollup2
BENEFITS.
00:14:39.479 --> 00:14:42.115 region:rollup2
AND REDUCE FRAGMENTATION AND
00:14:41.247 --> 00:14:44.050 region:rollup2
EFFICIENCIES OF OUR HEALTHCARE
00:14:42.115 --> 00:14:45.818 region:rollup2
SYSTEM.
00:14:44.050 --> 00:14:47.553 region:rollup2
THERE ARE MANY POLICY APPROACHES
00:14:45.818 --> 00:14:49.288 region:rollup2
TO ACHIEVING UNIVERSAL COVERAGE
00:14:47.553 --> 00:14:50.923 region:rollup2
AND THESE MAY INCLUDE SINGLE
00:14:49.288 --> 00:14:52.592 region:rollup2
PAYER A PUBLIC OPTION.
00:14:50.923 --> 00:14:54.727 region:rollup2
A POLICY AND OR POLICY
00:14:52.592 --> 00:14:56.229 region:rollup2
APPROACHES A BUILD ON EXISTING
00:14:54.727 --> 00:14:57.930 region:rollup2
PROGRAMS SUCH AS MEDICAL OR
00:14:56.229 --> 00:14:59.132 region:rollup2
COVER CALIFORNIA.
00:14:57.930 --> 00:15:00.833 region:rollup2
I WON'T BE GETTING INTO EACH OF
00:14:59.132 --> 00:15:02.568 region:rollup2
THESE UP POLICY OPTIONS IN
00:15:00.833 --> 00:15:04.103 region:rollup2
DETAIL BUT INSTEAD I'LL BE
00:15:02.568 --> 00:15:07.607 region:rollup2
RAISING KEY IMPLEMENTATION
00:15:04.103 --> 00:15:08.574 region:rollup2
QUESTIONS FOR YOU TO CONSIDER.
00:15:07.607 --> 00:15:09.976 region:rollup2
ONE OF THE FIRST THINGS I WANT
00:15:08.574 --> 00:15:12.311 region:rollup2
TO DO IS JUST CLARIFY SOME
00:15:09.976 --> 00:15:14.347 region:rollup2
TERMINOLOGY.
00:15:12.311 --> 00:15:17.049 region:rollup2
FIRST WHAT ARE WE TALKING ABOUT
00:15:14.347 --> 00:15:18.317 region:rollup2
WHEN WE REFER TO SINGLE PAYER.
00:15:17.049 --> 00:15:20.219 region:rollup2
AND THE DEFINITION YOU SEE ON
00:15:18.317 --> 00:15:21.687 region:rollup2
THIS SLIDE IS ONE THAT WE LAID
00:15:20.219 --> 00:15:23.222 region:rollup2
OUT IN THE PAPER AND HAS GENERAL
00:15:21.687 --> 00:15:25.158 region:rollup2
CONSENSUS.
00:15:23.222 --> 00:15:27.593 region:rollup2
BUT FUNDAMENTALLY SINGLE PAYER
00:15:25.158 --> 00:15:29.228 region:rollup2
IS A SINGLE CENTRALIZED PUBLIC.
00:15:27.593 --> 00:15:30.797 region:rollup2
PUBLICLY ORGANIZED MEANS TO
00:15:29.228 --> 00:15:32.465 region:rollup2
COLLECT HEALTHCARE DOLLARS AND
00:15:30.797 --> 00:15:34.367 region:rollup2
PAY FOR HEALTHCARE SERVICES FOR
00:15:32.465 --> 00:15:36.636 region:rollup2
ALL MEMBERS OF OUR COMMUNITY.
00:15:34.367 --> 00:15:38.571 region:rollup2
I HIGHLY THE WORD SINGLE HERE
00:15:36.636 --> 00:15:40.206 region:rollup2
BECAUSE IT IT DOES APPLY JUST
00:15:38.571 --> 00:15:42.542 region:rollup2
SAT SINGLE AND NOT A MULTIPLE
00:15:40.206 --> 00:15:43.876 region:rollup2
PAYER SYSTEM.
00:15:42.542 --> 00:15:45.578 region:rollup2
AS ALL OF YOU KNOW WE CURRENTLY
00:15:43.876 --> 00:15:47.780 region:rollup2
OPERATE IN A MULTIPLE PAYER
00:15:45.578 --> 00:15:49.348 region:rollup2
SYSTEM INCLUDING MEDICARE
00:15:47.780 --> 00:15:50.983 region:rollup2
MEDICAID I'LL COVER CALIFORNIA
00:15:49.348 --> 00:15:52.552 region:rollup2
CALPERS.
00:15:50.983 --> 00:15:54.120 region:rollup2
AND FEDERAL PROGRAMS SUCH AS THE
00:15:52.552 --> 00:15:57.490 region:rollup2
VETERANS ADMINISTRATION AND A
00:15:54.120 --> 00:15:58.658 region:rollup2
NUMBER OF PRIVATE PAYERS.
00:15:57.490 --> 00:16:00.393 region:rollup2
THE NEXT TERM I ONCE YOU DEFINE
00:15:58.658 --> 00:16:02.328 region:rollup2
IS UNIVERSAL COVERAGE.
00:16:00.393 --> 00:16:04.797 region:rollup2
SOMETIMES A NOTION OF SINGLE
00:16:02.328 --> 00:16:06.365 region:rollup2
PAYER AND UNIVERSAL COVERAGE
00:16:04.797 --> 00:16:08.634 region:rollup2
GETS A BIT MUDDLED. BUT IMPORTS
00:16:06.365 --> 00:16:10.102 region:rollup2
NO THAT THE IDEA OF SINGLE PAYER
00:16:08.634 --> 00:16:12.338 region:rollup2
AND UNIVERSAL COVERAGE ARE ARE
00:16:10.102 --> 00:16:13.439 region:rollup2
DISTINCT.
00:16:12.338 --> 00:16:15.208 region:rollup2
UNIVERSAL COVERAGE IS REALLY
00:16:13.439 --> 00:16:16.442 region:rollup2
TALKING ABOUT.
00:16:15.208 --> 00:16:18.444 region:rollup2
MAKING SURE THAT EVERYONE HAS
00:16:16.442 --> 00:16:19.912 region:rollup2
HEALTH INSURANCE COVERAGE.
00:16:18.444 --> 00:16:21.247 region:rollup2
IT'S REALLY TALKING ABOUT ALL
00:16:19.912 --> 00:16:22.515 region:rollup2
COVERED LIVES AND MAKING SURE
00:16:21.247 --> 00:16:24.584 region:rollup2
THEY'VE ACCESS TO HEALTH
00:16:22.515 --> 00:16:26.452 region:rollup2
INSURANCE IN SOME WAY.
00:16:24.584 --> 00:16:28.321 region:rollup2
SINGLE PAYER IS REALLY TALKING
00:16:26.452 --> 00:16:30.556 region:rollup2
ABOUT THE PAYMENT SYSTEM WHICH
00:16:28.321 --> 00:16:32.091 region:rollup2
USES ONE PUBLICLY ORGANIZED
00:16:30.556 --> 00:16:33.993 region:rollup2
CENTRAL MEANS OF PAYING FOR
00:16:32.091 --> 00:16:35.294 region:rollup2
HEALTHCARE SERVICES.
00:16:33.993 --> 00:16:37.797 region:rollup2
SO I JUST THOUGHT IT WAS HELPFUL
00:16:35.294 --> 00:16:38.865 region:rollup2
TO TEE UP THOSE DEFINITIONS.
00:16:37.797 --> 00:16:40.266 region:rollup2
AS I MENTIONED UNIVERSAL
00:16:38.865 --> 00:16:41.934 region:rollup2
COVERAGE CAN BE ACHIEVED THROUGH
00:16:40.266 --> 00:16:43.970 region:rollup2
A VARIETY OF POLICY OPTIONS.
00:16:41.934 --> 00:16:44.804 region:rollup2
INCLUDING SINGLE PAYER PUBLIC
00:16:43.970 --> 00:16:46.772 region:rollup2
OPTION OR EXTENDING CURRENT
00:16:44.804 --> 00:16:48.508 region:rollup2
COVERAGE PROGRAMS.
00:16:46.772 --> 00:16:50.309 region:rollup2
AND SOME OF THESE POLICY OPTIONS
00:16:48.508 --> 00:16:51.677 region:rollup2
MIGHT BE BROAD AND EXPANSIVE
00:16:50.309 --> 00:16:53.613 region:rollup2
WHILE OTHERS MIGHT BE CONSIDERED
00:16:51.677 --> 00:16:55.348 region:rollup2
INCREMENTAL.
00:16:53.613 --> 00:16:57.383 region:rollup2
THE ANCHOR MENTAL APPROACHES
00:16:55.348 --> 00:16:59.752 region:rollup2
ARE LIKELY TO HAVE FEWER
00:16:57.383 --> 00:17:02.388 region:rollup2
IMPLEMENTATION ISSUES THEN SAY
00:16:59.752 --> 00:17:04.857 region:rollup2
BROAD EXPANSIVE APPROACHES LIKE
00:17:02.388 --> 00:17:06.659 region:rollup2
SINGLE LIKE SINGLE PAYER.
00:17:04.857 --> 00:17:08.527 region:rollup2
AND THAT'S ESPECIALLY TRUE IF A
00:17:06.659 --> 00:17:09.495 region:rollup2
NEW POLICY APPROACH REQUIRES
00:17:08.527 --> 00:17:10.963 region:rollup2
PEOPLE TO CHANGE HEALTHCARE
00:17:09.495 --> 00:17:13.199 region:rollup2
COVERAGE.
00:17:10.963 --> 00:17:14.901 region:rollup2
AND.
00:17:13.199 --> 00:17:15.401 region:rollup2
IT TO THE TO CHANGE THE HEALTH
00:17:14.901 --> 00:17:18.170 region:rollup2
CARE COVERAGE THAT THEY
00:17:15.401 --> 00:17:19.539 region:rollup2
CURRENTLY HAVE.
00:17:18.170 --> 00:17:21.207 region:rollup2
SO ULTIMATELY ITS SUPPORT FOR
00:17:19.539 --> 00:17:22.608 region:rollup2
POLICYMAKERS TO CONSIDER THE
00:17:21.207 --> 00:17:23.476 region:rollup2
TRADE OFFS OF THE POLICY
00:17:22.608 --> 00:17:25.244 region:rollup2
APPROACHES.
00:17:23.476 --> 00:17:26.979 region:rollup2
THE COSTS
00:17:25.244 --> 00:17:28.548 region:rollup2
THE DISRUPTION THAT MIGHT MIGHT
00:17:26.979 --> 00:17:31.918 region:rollup2
ENSUE.
00:17:28.548 --> 00:17:33.052 region:rollup2
AND OF COURSE THE BENEFITS.
00:17:31.918 --> 00:17:33.853 region:rollup2
AND IT'S ALSO IMPORTANT TO
00:17:33.052 --> 00:17:35.655 region:rollup2
CONSIDER WHAT'S REALLY
00:17:33.853 --> 00:17:37.690 region:rollup2
ACHIEVABLE IN THE SHORT TERM
00:17:35.655 --> 00:17:39.125 region:rollup2
VERSUS A LONGER TERM.
00:17:37.690 --> 00:17:40.526 region:rollup2
AND AS YOU ALL KNOW.
00:17:39.125 --> 00:17:42.094 region:rollup2
NOT EVERY GOALS ACHIEVABLE
00:17:40.526 --> 00:17:43.296 region:rollup2
OVERNIGHT.
00:17:42.094 --> 00:17:44.797 region:rollup2
SO I WOULD SAY IT'S IMPORTANT
00:17:43.296 --> 00:17:46.432 region:rollup2
TO LAY OUT A ROADMAP
00:17:44.797 --> 00:17:47.934 region:rollup2
ARTICULATING WHAT THE FINAL
00:17:46.432 --> 00:17:49.435 region:rollup2
DESTINATION IS.
00:17:47.934 --> 00:17:51.170 region:rollup2
WHETHER IT BE SINGLE PAYER OR
00:17:49.435 --> 00:17:53.773 region:rollup2
SOME OTHER MEANS OF OF ACHIEVING
00:17:51.170 --> 00:17:55.174 region:rollup2
UNIVERSAL AFFORDABLE COVERAGE.
00:17:53.773 --> 00:17:57.176 region:rollup2
IN ADDITION TO LAYING OUT A
00:17:55.174 --> 00:17:58.978 region:rollup2
ROADMAP I'M A BIG PROPONENT.
00:17:57.176 --> 00:18:00.379 region:rollup2
OF CAREFULLY ASSESSING POLICY
00:17:58.978 --> 00:18:02.548 region:rollup2
OPTIONS TO MINIMIZE ANY
00:18:00.379 --> 00:18:04.016 region:rollup2
UNINTENDED CONSEQUENCES.
00:18:02.548 --> 00:18:05.351 region:rollup2
AND TO UNDERSTAND COURSE
00:18:04.016 --> 00:18:07.420 region:rollup2
PROJECTED COSTS AND BENEFITS OF
00:18:05.351 --> 00:18:08.487 region:rollup2
VARIOUS OPTIONS.
00:18:07.420 --> 00:18:10.122 region:rollup2
SO THE I'LL GET INTO THIS A
00:18:08.487 --> 00:18:11.691 region:rollup2
LITTLE BIT LATER MY PRESENTATION
00:18:10.122 --> 00:18:17.096 region:rollup2
WHEN I LAY OUT A FRAMEWORK OF
00:18:11.691 --> 00:18:18.431 region:rollup2
COMPARING VARIOUS OPTIONS.
00:18:17.096 --> 00:18:20.333 region:rollup2
SO I'M GONNA WALK THROUGH A
00:18:18.431 --> 00:18:21.901 region:rollup2
COUPLE OF ON IMPORTANT
00:18:20.333 --> 00:18:24.904 region:rollup2
IMPLEMENTATION QUESTIONS AND I'M
00:18:21.901 --> 00:18:26.105 region:rollup2
CALLING FIRST ORDER QUESTIONS.
00:18:24.904 --> 00:18:28.874 region:rollup2
ONE FIRST ORDER QUESTION OF
00:18:26.105 --> 00:18:31.043 region:rollup2
COURSES WHO'S IN AND WHO'S OUT.
00:18:28.874 --> 00:18:33.946 region:rollup2
AS WE'VE ALREADY HEARD OF THERE
00:18:31.043 --> 00:18:35.715 region:rollup2
ARE CONSIDERATIONS RELATED TO.
00:18:33.946 --> 00:18:36.549 region:rollup2
WHICH POPULATION OF CALIFORNIA
00:18:35.715 --> 00:18:38.451 region:rollup2
WOULD BE CONSIDERED.
00:18:36.549 --> 00:18:41.187 region:rollup2
.
00:18:38.451 --> 00:18:43.356 region:rollup2
UNDER A NEW UP PAYMENT MODEL.
00:18:41.187 --> 00:18:45.324 region:rollup2
SO WITH EVERY HOUSEHOLD IN EVERY
00:18:43.356 --> 00:18:47.560 region:rollup2
CONSUMER IN CALIFORNIA BE
00:18:45.324 --> 00:18:49.095 region:rollup2
INCLUDED IN A POLICY PROPOSAL.
00:18:47.560 --> 00:18:51.097 region:rollup2
SO FOR EXAMPLE FOR TALKING
00:18:49.095 --> 00:18:52.832 region:rollup2
ABOUT A SINGLE PAYER SYSTEM
00:18:51.097 --> 00:18:53.766 region:rollup2
WOULD WE INCLUDE THE SIX MILLION
00:18:52.832 --> 00:18:55.701 region:rollup2
MEDICARE BENEFICIARIES IN
00:18:53.766 --> 00:18:57.203 region:rollup2
CALIFORNIA.
00:18:55.701 --> 00:18:58.938 region:rollup2
ABOUT FORTY PERCENT OF THOSE
00:18:57.203 --> 00:19:00.306 region:rollup2
MEDICARE BENEFICIARIES SO ABOUT
00:18:58.938 --> 00:19:01.841 region:rollup2
TWO MILLION ARE ENROLLED IN
00:19:00.306 --> 00:19:02.742 region:rollup2
MEDICARE ADVANTAGE
00:19:01.841 --> 00:19:04.276 region:rollup2
WHICH MEANS THEY GET COVERAGE
00:19:02.742 --> 00:19:05.845 region:rollup2
THROUGH A HEALTH PLAN.
00:19:04.276 --> 00:19:07.613 region:rollup2
WITH THOSE INDIVIDUALS HAVE THE
00:19:05.845 --> 00:19:09.615 region:rollup2
OPTION OF SWITCHING TO A STATE
00:19:07.613 --> 00:19:11.283 region:rollup2
BASED SINGLE PAYER OPTION WHILE
00:19:09.615 --> 00:19:13.285 region:rollup2
STILL GETTING MEDICARE BENEFITS
00:19:11.283 --> 00:19:14.654 region:rollup2
THAT THEY'RE ELIGIBLE FOR.
00:19:13.285 --> 00:19:16.789 region:rollup2
AND AS YOU ALL KNOW MEDICARE IS
00:19:14.654 --> 00:19:18.190 region:rollup2
A FEDERAL PROGRAM SO CALIFORNIA
00:19:16.789 --> 00:19:19.358 region:rollup2
WOULD HAVE TO BE HAVE TO
00:19:18.190 --> 00:19:19.859 region:rollup2
CONSIDER WHETHER THIS IS
00:19:19.358 --> 00:19:21.894 region:rollup2
FEASIBLE FROM A FEDERAL
00:19:19.859 --> 00:19:23.162 region:rollup2
PERSPECTIVE.
00:19:21.894 --> 00:19:24.697 region:rollup2
SIMILAR SET OF QUESTIONS ARISE
00:19:23.162 --> 00:19:26.932 region:rollup2
FOR THE THIRTEEN MILLION PEOPLE
00:19:24.697 --> 00:19:28.234 region:rollup2
IN THE MEDICARE PROGRAM.
00:19:26.932 --> 00:19:29.769 region:rollup2
WITH THOSE INDIVIDUALS BE
00:19:28.234 --> 00:19:31.303 region:rollup2
INCLUDED IN A STATE BASED SINGLE
00:19:29.769 --> 00:19:34.106 region:rollup2
PAYER OPTION OR ANOTHER
00:19:31.303 --> 00:19:35.107 region:rollup2
UNIVERSAL COVERAGE PROPOSAL.
00:19:34.106 --> 00:19:36.542 region:rollup2
AND HOW ABOUT INDIVIDUALS
00:19:35.107 --> 00:19:39.011 region:rollup2
RECEIVE HEALTH INSURANCE THROUGH
00:19:36.542 --> 00:19:40.446 region:rollup2
SELF INSURED EMPLOYERS.
00:19:39.011 --> 00:19:41.514 region:rollup2
WHAT IS A FEASIBILITY OF MOVING
00:19:40.446 --> 00:19:42.081 region:rollup2
THESE EMPLOYEES AND THEIR
00:19:41.514 --> 00:19:44.316 region:rollup2
DEPENDENTS TO A STATE BASED
00:19:42.081 --> 00:19:45.685 region:rollup2
PROGRAM?
00:19:44.316 --> 00:19:47.787 region:rollup2
DOES THE STATE HAVE THE CURRENT
00:19:45.685 --> 00:19:49.288 region:rollup2
AUTHORITIES AND LEVERS TO MAKE
00:19:47.787 --> 00:19:50.656 region:rollup2
THESE CHANGES. AS I MENTION
00:19:49.288 --> 00:19:53.092 region:rollup2
OTHERS SPEAKERS WILL GET INTO
00:19:50.656 --> 00:19:54.794 region:rollup2
MEDICARE MEDICARE MEDICAID ALL
00:19:53.092 --> 00:19:56.662 region:rollup2
THE EMPLOYEE RETIREMENT INCOME
00:19:54.794 --> 00:19:58.297 region:rollup2
SECURITY ACT OR ERISA. AND
00:19:56.662 --> 00:19:59.932 region:rollup2
FEDERAL WAIVERS AND AUTHORITIES
00:19:58.297 --> 00:20:01.067 region:rollup2
IN MUCH MORE DETAIL.
00:19:59.932 --> 00:20:02.668 region:rollup2
BUT I DID WANT TO POINT OUT
00:20:01.067 --> 00:20:04.103 region:rollup2
POINT THESE OUT AS KEY
00:20:02.668 --> 00:20:05.571 region:rollup2
FUNDAMENTAL FIRST ORDER
00:20:04.103 --> 00:20:07.106 region:rollup2
FEASIBILITY QUESTIONS THAT
00:20:05.571 --> 00:20:07.573 region:rollup2
REALLY HAVE TO BE CONSIDERED.
00:20:07.106 --> 00:20:09.708 region:rollup2
WHEN THINKING ABOUT A
00:20:07.573 --> 00:20:13.145 region:rollup2
COMPREHENSIVE WIDE REACHING
00:20:09.708 --> 00:20:14.947 region:rollup2
POLICIES SUCH A SINGLE PAYER.
00:20:13.145 --> 00:20:17.583 region:rollup2
ANOTHER QUESTION IS.
00:20:14.947 --> 00:20:19.051 region:rollup2
THAT HAS TO DO WITH BENEFITS.
00:20:17.583 --> 00:20:21.287 region:rollup2
WHAT BENEFITS WOULD BE COVERED
00:20:19.051 --> 00:20:22.488 region:rollup2
UNDER SAY SINGLE PAYER OPTON OR
00:20:21.287 --> 00:20:24.190 region:rollup2
SOME OTHER UNIVERSAL COVERAGE
00:20:22.488 --> 00:20:25.858 region:rollup2
OPTION?
00:20:24.190 --> 00:20:27.960 region:rollup2
FOR EXAMPLE WOULD BE ESSENTIALLY
00:20:25.858 --> 00:20:29.195 region:rollup2
ADOPT ESSENTIAL HEALTH BENEFITS
00:20:27.960 --> 00:20:29.929 region:rollup2
WHICH IS THE MINIMUM FLOOR
00:20:29.195 --> 00:20:31.630 region:rollup2
THAT'S LAID OUT BY THE
00:20:29.929 --> 00:20:34.233 region:rollup2
AFFORDABLE CARE ACT.
00:20:31.630 --> 00:20:35.067 region:rollup2
OR WOULD IT BE ON MEDI CAL WOULD
00:20:34.233 --> 00:20:37.470 region:rollup2
THE MEDI CAL BENEFITS BE THE
00:20:35.067 --> 00:20:38.838 region:rollup2
RIGHT SET OF BENEFITS.
00:20:37.470 --> 00:20:40.906 region:rollup2
WHAT'S IT COST FOR THE TOTAL
00:20:38.838 --> 00:20:41.640 region:rollup2
BENEFIT PACKAGE.
00:20:40.906 --> 00:20:44.043 region:rollup2
WHAT ABOUT?
00:20:41.640 --> 00:20:46.011 region:rollup2
SPECIFIC BUT BENEFITS SUCH AS
00:20:44.043 --> 00:20:47.446 region:rollup2
DENTAL CARE FOR ADULTS WITHOUT
00:20:46.011 --> 00:20:50.116 region:rollup2
BEING CLINTON. HOW ABOUT
00:20:47.446 --> 00:20:52.585 region:rollup2
NUTRITIONAL COUNSELING OR NON
00:20:50.116 --> 00:20:54.253 region:rollup2
EMERGENCY TRANSPORTATION?
00:20:52.585 --> 00:20:55.588 region:rollup2
AND THEN WHAT ABOUT COST SHARING
00:20:54.253 --> 00:20:56.922 region:rollup2
WITH THEIR BE PAYMENTS AT THE
00:20:55.588 --> 00:20:58.791 region:rollup2
POINT OF SERVICE. AND IF SO HOW
00:20:56.922 --> 00:20:59.792 region:rollup2
MUCH.
00:20:58.791 --> 00:21:01.293 region:rollup2
WOULD EVERYONE BE CHARGES SAME
00:20:59.792 --> 00:21:03.562 region:rollup2
AMOUNT.
00:21:01.293 --> 00:21:05.231 region:rollup2
OR WOULD BE BASED ON INCOME.
00:21:03.562 --> 00:21:06.465 region:rollup2
SO THESE ARE AGAIN BIG BIG
00:21:05.231 --> 00:21:07.566 region:rollup2
PICTURE QUESTIONS THAT WOULD
00:21:06.465 --> 00:21:10.136 region:rollup2
HAVE TO BE ADDRESSED FROM
00:21:07.566 --> 00:21:11.237 region:rollup2
IMPLEMENTATION PERSPECTIVE.
00:21:10.136 --> 00:21:12.371 region:rollup2
AND OF COURSE THE NEXT BIG
00:21:11.237 --> 00:21:14.573 region:rollup2
QUESTION IS HOW WILL IT BE PAID
00:21:12.371 --> 00:21:16.175 region:rollup2
FOR.
00:21:14.573 --> 00:21:18.210 region:rollup2
THERE IS UNCERTAINTY REGARDING
00:21:16.175 --> 00:21:19.345 region:rollup2
WHETHER AND HOW DOLLARS A AND
00:21:18.210 --> 00:21:21.347 region:rollup2
AND WHETHER.
00:21:19.345 --> 00:21:23.749 region:rollup2
DOLLARS A CALIFORNIA RECEIVES
00:21:21.347 --> 00:21:25.618 region:rollup2
THROUGH FEDERAL CHANNELS CAN
00:21:23.749 --> 00:21:27.453 region:rollup2
REALLY BE REDISTRIBUTED TO SOME
00:21:25.618 --> 00:21:29.488 region:rollup2
KIND OF CENTRALIZED
00:21:27.453 --> 00:21:30.556 region:rollup2
CALIFORNIA BASED FUND.
00:21:29.488 --> 00:21:31.891 region:rollup2
AND THESE ARE BIG POLICY
00:21:30.556 --> 00:21:32.625 region:rollup2
CONSIDERATIONS THAT WOULD HAVE
00:21:31.891 --> 00:21:34.960 region:rollup2
TO BE.
00:21:32.625 --> 00:21:35.794 region:rollup2
BROUGHT UP AND DISCUSSED WITH
00:21:34.960 --> 00:21:37.863 region:rollup2
THE FEDERAL DEPARTMENT OF HEALTH
00:21:35.794 --> 00:21:39.298 region:rollup2
AND HUMAN SERVICES.
00:21:37.863 --> 00:21:39.865 region:rollup2
A AGAIN TO THE EXTENT THAT SELF
00:21:39.298 --> 00:21:41.867 region:rollup2
INSURED EMPLOYERS ARE IN THE
00:21:39.865 --> 00:21:43.602 region:rollup2
MIX.
00:21:41.867 --> 00:21:45.604 region:rollup2
RISA WOULD VERY WELL BE A
00:21:43.602 --> 00:21:48.908 region:rollup2
CONCERN.
00:21:45.604 --> 00:21:51.043 region:rollup2
WAIVERS UNDER THE ACA MEDICARE
00:21:48.908 --> 00:21:52.545 region:rollup2
AND MEDICAID AGAIN MAYBE A PATH
00:21:51.043 --> 00:21:54.079 region:rollup2
FOR OBTAINING SOME OF
00:21:52.545 --> 00:21:55.447 region:rollup2
APPROPRIATE PERMISSIONS FROM THE
00:21:54.079 --> 00:21:57.183 region:rollup2
FEDERAL GOVERNMENT.
00:21:55.447 --> 00:21:58.651 region:rollup2
ON AND TO SEE WHETHER CALIFORNIA
00:21:57.183 --> 00:22:01.086 region:rollup2
COULD STILL RECEIVE.
00:21:58.651 --> 00:22:02.721 region:rollup2
SOME NECESSARY FUNDS FOR FROM
00:22:01.086 --> 00:22:04.657 region:rollup2
THE FEDERAL GOVERNMENT.
00:22:02.721 --> 00:22:05.157 region:rollup2
BUT REALLY THOSE PATS DEPEND ON
00:22:04.657 --> 00:22:07.760 region:rollup2
THE SCOPE OF THE POLICY
00:22:05.157 --> 00:22:09.328 region:rollup2
APPROACH.
00:22:07.760 --> 00:22:11.263 region:rollup2
SO ARE SPEAKERS TODAY WILL AGAIN
00:22:09.328 --> 00:22:12.598 region:rollup2
FOCUS MORE ONEROUS AND MEDICARE
00:22:11.263 --> 00:22:14.200 region:rollup2
MEDICAID AND THE FEDERAL
00:22:12.598 --> 00:22:15.834 region:rollup2
AUTHORITIES AND AND WAIVERS IN
00:22:14.200 --> 00:22:18.003 region:rollup2
MORE DETAIL BUT I DID FIND A. T.
00:22:15.834 --> 00:22:19.705 region:rollup2
THOSE UP AND THOSE ARE JUST A
00:22:18.003 --> 00:22:20.306 region:rollup2
FEDERAL CONSIDERATIONS.
00:22:19.705 --> 00:22:22.241 region:rollup2
THEY'RE ALSO STATE
00:22:20.306 --> 00:22:23.242 region:rollup2
CONSIDERATIONS THAT AFFECT HOW
00:22:22.241 --> 00:22:23.542 region:rollup2
THE WEATHER THE PROGRAM WOULD
00:22:23.242 --> 00:22:25.778 region:rollup2
HAVE SAID.
00:22:23.542 --> 00:22:27.379 region:rollup2
FUNDS.
00:22:25.778 --> 00:22:28.781 region:rollup2
SO AS YOU ALL VERY WELL KNOWN
00:22:27.379 --> 00:22:30.149 region:rollup2
UNLIKE THE FEDERAL GOVERNMENT
00:22:28.781 --> 00:22:31.750 region:rollup2
STATES CANNOT OPERATE WITH THE
00:22:30.149 --> 00:22:33.686 region:rollup2
BUDGET DEFICIT.
00:22:31.750 --> 00:22:35.788 region:rollup2
SO IF THE STATE WERE TO CONSIDER
00:22:33.686 --> 00:22:37.223 region:rollup2
A COMPREHENSIVE POLICY APPROACH
00:22:35.788 --> 00:22:38.958 region:rollup2
SUCH A SINGLE PAYER. IT'S
00:22:37.223 --> 00:22:40.526 region:rollup2
IMPORTED MAKE SURE THERE'S
00:22:38.958 --> 00:22:42.328 region:rollup2
ENOUGH MONEY TO SUPPORT IT.
00:22:40.526 --> 00:22:44.897 region:rollup2
ENSURING THAT THE REVENUE TRENDS
00:22:42.328 --> 00:22:46.365 region:rollup2
KEEP PACE WILL HEALTHCARE COST
00:22:44.897 --> 00:22:49.001 region:rollup2
TRENDS IS ILLEGITIMATE AND
00:22:46.365 --> 00:22:51.737 region:rollup2
FUNDAMENTAL CONCERN.
00:22:49.001 --> 00:22:53.105 region:rollup2
SO HOT SO HOW WE ARE MAKING SURE
00:22:51.737 --> 00:22:55.708 region:rollup2
TO COLLECT ENOUGH FROM YOU TO
00:22:53.105 --> 00:22:56.542 region:rollup2
SUPPORT A NEW PROGRAM ISRAELI.
00:22:55.708 --> 00:22:59.278 region:rollup2
ON IS REALLY A FIRST ORDER
00:22:56.542 --> 00:23:01.814 region:rollup2
QUESTION.
00:22:59.278 --> 00:23:02.514 region:rollup2
ANOTHER A QUESTION HAS TO DO
00:23:01.814 --> 00:23:04.416 region:rollup2
WITH STATE CONSTITUTIONAL
00:23:02.514 --> 00:23:05.784 region:rollup2
CONCERNS WHICH WAS
00:23:04.416 --> 00:23:07.686 region:rollup2
TOUCHED ON EARLIER BY IN THE
00:23:05.784 --> 00:23:08.888 region:rollup2
OPENING REMARKS.
00:23:07.686 --> 00:23:10.489 region:rollup2
YOU'LL HEAR MORE ABOUT THIS FROM
00:23:08.888 --> 00:23:12.124 region:rollup2
THE CALIFORNIA BUDGET POLICY
00:23:10.489 --> 00:23:13.692 region:rollup2
CENTER BUT THERE ARE BURGEONING
00:23:12.124 --> 00:23:15.928 region:rollup2
RULES REGARDING ALLOCATION OF
00:23:13.692 --> 00:23:17.296 region:rollup2
STATE TROUGH FUNDS TO K. THROUGH
00:23:15.928 --> 00:23:18.797 region:rollup2
TWELVE EDUCATION.
00:23:17.296 --> 00:23:20.966 region:rollup2
SO THIS MEANS INCREASES TO THE
00:23:18.797 --> 00:23:21.400 region:rollup2
GENERAL FUNDS THROUGH TAXATION
00:23:20.966 --> 00:23:23.302 region:rollup2
COULD TRIGGER THESE
00:23:21.400 --> 00:23:24.937 region:rollup2
REQUIREMENTS.
00:23:23.302 --> 00:23:26.538 region:rollup2
THIS ISN'T IMPORTANT FEASIBILITY
00:23:24.937 --> 00:23:28.173 region:rollup2
CONSIDERATION WHEN THINKING
00:23:26.538 --> 00:23:29.842 region:rollup2
ABOUT ANY PROPOSAL THAT'S
00:23:28.173 --> 00:23:32.011 region:rollup2
RELYING ON.
00:23:29.842 --> 00:23:32.678 region:rollup2
GENERATING ENOUGH TAX REVENUE
00:23:32.011 --> 00:23:37.950 region:rollup2
THAT WOULD THEN AFFECT THE
00:23:32.678 --> 00:23:38.117 region:rollup2
GENERAL FUNDS.
00:23:37.950 --> 00:23:40.019 region:rollup2
SO.
00:23:38.117 --> 00:23:41.787 region:rollup2
.
00:23:40.019 --> 00:23:43.923 region:rollup2
I WOULD LIKE TO GET INTO NEXT TO
00:23:41.787 --> 00:23:45.891 region:rollup2
A SET OF DESIGN QUESTIONS SO WE
00:23:43.923 --> 00:23:47.493 region:rollup2
FIRST HAD FIRST ORDER QUESTIONS
00:23:45.891 --> 00:23:48.861 region:rollup2
ARE REALLY ARE IMPORTANT
00:23:47.493 --> 00:23:50.963 region:rollup2
FEASIBILITY QUESTIONS AND NOW
00:23:48.861 --> 00:23:52.364 region:rollup2
WE'RE GETTING INTO A NEXT LEVEL
00:23:50.963 --> 00:23:54.533 region:rollup2
OF QUESTIONS I. DO HAVE TO DO
00:23:52.364 --> 00:23:56.268 region:rollup2
WITH IMPLEMENTATION BUT REALLY
00:23:54.533 --> 00:23:57.069 region:rollup2
ARE FROM A DESIGN PERSPECTIVE.
00:23:56.268 --> 00:23:59.104 region:rollup2
SO IF WE WERE STARTING FROM
00:23:57.069 --> 00:24:01.006 region:rollup2
SCRATCH.
00:23:59.104 --> 00:24:03.075 region:rollup2
CIRCUS IN DESIGNING A NEW
00:24:01.006 --> 00:24:04.310 region:rollup2
PROGRAM THESE ARE. THEY KEY
00:24:03.075 --> 00:24:05.711 region:rollup2
DESIGN QUESTIONS THAT WOULD HAVE
00:24:04.310 --> 00:24:07.846 region:rollup2
TO BE CONSIDERED AS PART OF THE
00:24:05.711 --> 00:24:08.380 region:rollup2
IMPLEMENTATION PHASE.
00:24:07.846 --> 00:24:09.948 region:rollup2
SO STARTING WITH THE FIRST
00:24:08.380 --> 00:24:11.784 region:rollup2
BULLET.
00:24:09.948 --> 00:24:12.284 region:rollup2
HOW WOULD A SINGLE PAYER PROGRAM
00:24:11.784 --> 00:24:13.819 region:rollup2
ARRANGE FOR HEALTH CARE
00:24:12.284 --> 00:24:14.920 region:rollup2
SERVICES?
00:24:13.819 --> 00:24:15.821 region:rollup2
WITH THE SYSTEM USE
00:24:14.920 --> 00:24:17.656 region:rollup2
INTERMEDIARIES SUCH AS HELP
00:24:15.821 --> 00:24:19.325 region:rollup2
PLANTS.
00:24:17.656 --> 00:24:21.527 region:rollup2
OR WOULD PROVIDERS OF BE PAID
00:24:19.325 --> 00:24:23.796 region:rollup2
DIRECTLY THROUGH SOME STATE
00:24:21.527 --> 00:24:25.431 region:rollup2
BASED ADMINISTERED ENTITY.
00:24:23.796 --> 00:24:27.232 region:rollup2
ON JUST USE A COVER CALIFORNIA'S
00:24:25.431 --> 00:24:28.667 region:rollup2
AN EXAMPLE SINCE I WAS A PROGRAM
00:24:27.232 --> 00:24:29.702 region:rollup2
THAT WAS ESTABLISHED IN MORE
00:24:28.667 --> 00:24:31.437 region:rollup2
RECENT YEARS.
00:24:29.702 --> 00:24:33.272 region:rollup2
THEY HAD TO THINK THROUGH THIS
00:24:31.437 --> 00:24:35.407 region:rollup2
AS A DESIGN QUESTION AND THEY
00:24:33.272 --> 00:24:36.875 region:rollup2
DECIDED TO GO AHEAD OF CONTRACT
00:24:35.407 --> 00:24:37.943 region:rollup2
WITH HEALTH PLANS IN THE STATE.
00:24:36.875 --> 00:24:39.845 region:rollup2
TO OFFER COVERAGE AND PAY FOR
00:24:37.943 --> 00:24:41.747 region:rollup2
HEALTHCARE SERVICES.
00:24:39.845 --> 00:24:43.248 region:rollup2
SO THAT'S ONE MODEL HOW YOU
00:24:41.747 --> 00:24:44.416 region:rollup2
ARRANGE TO PAY FOR HEALTHCARE
00:24:43.248 --> 00:24:45.718 region:rollup2
SERVICES WHETHER YOU'D USE
00:24:44.416 --> 00:24:47.052 region:rollup2
INTERMEDIARIES SUCH AS HEALTH
00:24:45.718 --> 00:24:49.254 region:rollup2
PLANS ARE PAID DIRECT PAY
00:24:47.052 --> 00:24:51.623 region:rollup2
PROVIDERS PHYSICIANS DOCTORS.
00:24:49.254 --> 00:24:55.060 region:rollup2
HOSPITALS DIRECTLY IS UP A KEY
00:24:51.623 --> 00:24:56.595 region:rollup2
FUNDAMENTAL DESIGN QUESTION.
00:24:55.060 --> 00:24:58.497 region:rollup2
THE SECOND QUESTION IS REGARDING
00:24:56.595 --> 00:25:00.432 region:rollup2
ADEQUACY OF PAYMENT.
00:24:58.497 --> 00:25:01.500 region:rollup2
HOW MUCH SHOULD DOCTORS
00:25:00.432 --> 00:25:02.835 region:rollup2
HOSPITALS AND OTHER HEALTHCARE
00:25:01.500 --> 00:25:04.903 region:rollup2
PROVIDERS GET PAID FOR THE
00:25:02.835 --> 00:25:06.071 region:rollup2
SERVICES THEY RENDER?
00:25:04.903 --> 00:25:09.641 region:rollup2
HOW WOULD YOU SAID THAT PAYMENT
00:25:06.071 --> 00:25:10.909 region:rollup2
AMOUNT TO MAKE SHIRTS ADEQUATE?
00:25:09.641 --> 00:25:12.511 region:rollup2
WOULD PAYMENTS BE TIED TO SAY
00:25:10.909 --> 00:25:13.879 region:rollup2
FOR EXAMPLE IN EXISTING FEE
00:25:12.511 --> 00:25:15.447 region:rollup2
SCHEDULE SUCH AS THE MEDICARE
00:25:13.879 --> 00:25:17.649 region:rollup2
FEE SCHEDULES OR SOME OTHER
00:25:15.447 --> 00:25:18.984 region:rollup2
MECHANISM.
00:25:17.649 --> 00:25:20.119 region:rollup2
SENDING THE APPROPRIATE PAYMENT
00:25:18.984 --> 00:25:22.354 region:rollup2
AMOUNT TO MAKE SURE THAT YOUR
00:25:20.119 --> 00:25:24.957 region:rollup2
PROVIDERS PARTICIPATING IN THE
00:25:22.354 --> 00:25:26.625 region:rollup2
PROGRAM IS IMPORTANT.
00:25:24.957 --> 00:25:28.694 region:rollup2
AND ONE CONSIDERING PAN POLICIES
00:25:26.625 --> 00:25:30.863 region:rollup2
IT'S ALSO PRIME TO ENSURE THAT
00:25:28.694 --> 00:25:33.065 region:rollup2
PAYMENT POLICIES AND. ENCOURAGE
00:25:30.863 --> 00:25:34.233 region:rollup2
APPROPRIATE HEALTH CARE USE.
00:25:33.065 --> 00:25:35.868 region:rollup2
I THINK WE ALL KNOW FROM A
00:25:34.233 --> 00:25:39.004 region:rollup2
TRADITIONAL FEE FOR SERVICE
00:25:35.868 --> 00:25:40.506 region:rollup2
PAYMENTS THAT ON IT JUDICIAL P.
00:25:39.004 --> 00:25:41.040 region:rollup2
FOR SERVICE PAYMENTS REALLY PAY
00:25:40.506 --> 00:25:43.509 region:rollup2
PROVIDERS ON A PER SERVICE
00:25:41.040 --> 00:25:45.110 region:rollup2
BASIS.
00:25:43.509 --> 00:25:48.180 region:rollup2
AND THAT PAYMENT SYSTEM TENDS
00:25:45.110 --> 00:25:50.315 region:rollup2
TOWARD MORE USE AND MORE VOLUME.
00:25:48.180 --> 00:25:51.216 region:rollup2
AND MORE IS NOT NECESSARILY
00:25:50.315 --> 00:25:53.052 region:rollup2
BETTER AND CAN DRIVE UP
00:25:51.216 --> 00:25:54.053 region:rollup2
HEALTHCARE COSTS.
00:25:53.052 --> 00:25:56.054 region:rollup2
SO THE LAST SEVERAL YEARS
00:25:54.053 --> 00:25:57.589 region:rollup2
THERE'S BEEN A MOVEMENT BY
00:25:56.054 --> 00:25:59.625 region:rollup2
PUBLIC PAYERS AS WELL PRIVATE
00:25:57.589 --> 00:26:02.661 region:rollup2
PAYERS SHIRLEY TYPE PAYMENT TO
00:25:59.625 --> 00:26:04.930 region:rollup2
VALUE. OR QUALITY AND TO ENSURE
00:26:02.661 --> 00:26:06.131 region:rollup2
BETTER HEALTH A TO ENCOURAGE
00:26:04.930 --> 00:26:06.565 region:rollup2
RATHER BETTER HEALTH HEALTH
00:26:06.131 --> 00:26:09.101 region:rollup2
OUTCOMES AND BETTER
00:26:06.565 --> 00:26:10.402 region:rollup2
EFFICIENCIES.
00:26:09.101 --> 00:26:12.204 region:rollup2
AND JUST TO CONTINUE USING
00:26:10.402 --> 00:26:13.972 region:rollup2
COVERED CALIFORNIA AS AN EXAMPLE
00:26:12.204 --> 00:26:15.307 region:rollup2
IN THEIR PROCUREMENT PROCESS
00:26:13.972 --> 00:26:17.009 region:rollup2
THEY ENCOURAGE ON PAYMENT
00:26:15.307 --> 00:26:18.577 region:rollup2
METHODS THAT ARE ALTERNATE
00:26:17.009 --> 00:26:20.412 region:rollup2
ALTERNATIVE FROM FEE FOR SERVICE
00:26:18.577 --> 00:26:24.082 region:rollup2
MODELS. SO FOR EXAMPLE THEY
00:26:20.412 --> 00:26:25.551 region:rollup2
ENCOURAGE OF PAYERS TO CONSIDER.
00:26:24.082 --> 00:26:27.286 region:rollup2
ON VALUE BASED
00:26:25.551 --> 00:26:29.121 region:rollup2
PAYMENTS ON AS PART OF THEIR
00:26:27.286 --> 00:26:31.490 region:rollup2
PROCUREMENT PROCESS.
00:26:29.121 --> 00:26:32.958 region:rollup2
SO THE WAY PAYMENT SYSTEMS ARE
00:26:31.490 --> 00:26:35.527 region:rollup2
DESIGNED IS AN IMPORTANT DESIGN
00:26:32.958 --> 00:26:36.962 region:rollup2
CONSIDERATION.
00:26:35.527 --> 00:26:38.263 region:rollup2
THE OTHER IS A PROVIDER
00:26:36.962 --> 00:26:40.365 region:rollup2
PARTICIPATION I ALREADY
00:26:38.263 --> 00:26:41.633 region:rollup2
MENTIONED THAT PAYMENT ADEQUACY
00:26:40.365 --> 00:26:43.202 region:rollup2
IS REALLY IMPORTANT TO MAKE SURE
00:26:41.633 --> 00:26:44.269 region:rollup2
THAT STE. POSITIONS REALLY
00:26:43.202 --> 00:26:46.805 region:rollup2
PARTICIPATE IN THE IN THE
00:26:44.269 --> 00:26:49.141 region:rollup2
PROGRAM.
00:26:46.805 --> 00:26:51.110 region:rollup2
BUT HOW WOULD A. THIS HOW WOULD
00:26:49.141 --> 00:26:53.779 region:rollup2
POSITION PARTICIPATION WORK SAY
00:26:51.110 --> 00:26:55.314 region:rollup2
IN A TRUE SINGLE PAYER SYSTEM.
00:26:53.779 --> 00:26:56.882 region:rollup2
IF YOU REALLY JUST HAVE A SINGLE
00:26:55.314 --> 00:26:59.718 region:rollup2
PAYER SYSTEM WITH NO WHETHER
00:26:56.882 --> 00:27:01.553 region:rollup2
PAIRS WELL YOU'D HAVE TO INCLUDE
00:26:59.718 --> 00:27:03.422 region:rollup2
ALL PHYSICIANS PRACTICING IN THE
00:27:01.553 --> 00:27:05.524 region:rollup2
STATE. OTHERWISE HE WOULDN'T BE
00:27:03.422 --> 00:27:06.792 region:rollup2
ABLE TO SEE PATIENTS BECAUSE
00:27:05.524 --> 00:27:08.460 region:rollup2
THERE WOULD BE NO OTHER PAYERS
00:27:06.792 --> 00:27:10.262 region:rollup2
THEORETICALLY.
00:27:08.460 --> 00:27:12.431 region:rollup2
SO A SINGLE PAYER SYSTEM WOULD
00:27:10.262 --> 00:27:14.066 region:rollup2
HAVE TO REALLY ALLOW ANY WILLING
00:27:12.431 --> 00:27:15.734 region:rollup2
PROVIDER TO PARTICIPATE IN THE
00:27:14.066 --> 00:27:17.769 region:rollup2
SYSTEM.
00:27:15.734 --> 00:27:20.172 region:rollup2
SO THIS RAISES A A KEY QUESTION
00:27:17.769 --> 00:27:22.107 region:rollup2
ABOUT QUALITY AND HOW A SINGLES
00:27:20.172 --> 00:27:23.375 region:rollup2
PAYER SYSTEM CURRENTLY MAKE SURE
00:27:22.107 --> 00:27:23.876 region:rollup2
THE PATIENTS ARE REALLY GETTING
00:27:23.375 --> 00:27:26.512 region:rollup2
QUALITY CARE. FOR THEIR
00:27:23.876 --> 00:27:28.780 region:rollup2
PATIENTS.
00:27:26.512 --> 00:27:29.281 region:rollup2
SO AGAIN JUST TO CONTINUE USING
00:27:28.780 --> 00:27:30.082 region:rollup2
COVERED CALIFORNIA AS AN
00:27:29.281 --> 00:27:31.884 region:rollup2
EXAMPLE.
00:27:30.082 --> 00:27:33.552 region:rollup2
.
00:27:31.884 --> 00:27:35.354 region:rollup2
COVERED CALIFORNIA DECIDERS OKAY
00:27:33.552 --> 00:27:37.122 region:rollup2
TO BE SELECTIVE ABOUT WHICH
00:27:35.354 --> 00:27:39.091 region:rollup2
PROVIDERS.
00:27:37.122 --> 00:27:40.726 region:rollup2
PAGE IN THEIR NETWORKS AS LONG
00:27:39.091 --> 00:27:42.327 region:rollup2
AS THEY'RE SUFFICIENT ACCESS.
00:27:40.726 --> 00:27:43.462 region:rollup2
SO THIS WAS THE DESIGN CHOICE
00:27:42.327 --> 00:27:45.898 region:rollup2
THAT WAS MADE AND IT WAS MADE
00:27:43.462 --> 00:27:48.300 region:rollup2
TWO ENCOURAGE THE USE OF HIGH
00:27:45.898 --> 00:27:50.135 region:rollup2
VALUE. NETWORKS OR HIGH QUALITY
00:27:48.300 --> 00:27:52.337 region:rollup2
LOW COST.
00:27:50.135 --> 00:27:54.173 region:rollup2
THIS IS AN HEALTH SYSTEMS.
00:27:52.337 --> 00:27:55.574 region:rollup2
SO PROVIDER PARTICIPATION AS
00:27:54.173 --> 00:27:57.543 region:rollup2
WELL AS A QUALITY OF CARE
00:27:55.574 --> 00:27:58.310 region:rollup2
ASSOCIATED WITH THE PROVIDERS IS
00:27:57.543 --> 00:28:01.079 region:rollup2
REALLY AN IMPORTANT DESIGN
00:27:58.310 --> 00:28:02.147 region:rollup2
QUESTION.
00:28:01.079 --> 00:28:04.449 region:rollup2
THE NEXT IS A CONSUMER
00:28:02.147 --> 00:28:06.351 region:rollup2
PARTICIPATION AND I HAVE.
00:28:04.449 --> 00:28:07.853 region:rollup2
TOUCH ON THIS ALREADY THOSE A
00:28:06.351 --> 00:28:09.354 region:rollup2
BIG IMPLEMENTATION QUESTION
00:28:07.853 --> 00:28:11.456 region:rollup2
ABOUT FIGURING OUT YOU KNOW
00:28:09.354 --> 00:28:12.891 region:rollup2
WHO'S IN AND WHO'S OUT.
00:28:11.456 --> 00:28:14.459 region:rollup2
AND IF YOU'RE CONSIDERING THIS
00:28:12.891 --> 00:28:15.694 region:rollup2
FROM A SINGLE PAYER APPROACH
00:28:14.459 --> 00:28:17.329 region:rollup2
WHICH INCLUDES ALL CALIFORNIA
00:28:15.694 --> 00:28:18.430 region:rollup2
RESIDENTS.
00:28:17.329 --> 00:28:19.364 region:rollup2
AND THERE'S STILL SOME
00:28:18.430 --> 00:28:20.699 region:rollup2
ELIGIBILITY QUESTIONS TO SORT
00:28:19.364 --> 00:28:22.534 region:rollup2
pOUT.
00:28:20.699 --> 00:28:24.203 region:rollup2
SO FOR EXAMPLE WHAT IS BEING A
00:28:22.534 --> 00:28:26.872 region:rollup2
RESIDENT MEAN.
00:28:24.203 --> 00:28:28.607 region:rollup2
WITH THIS INCLUDE SOMEONE WHO
00:28:26.872 --> 00:28:30.876 region:rollup2
SAY FOR UP WITH.
00:28:28.607 --> 00:28:32.878 region:rollup2
WAS SO IF YOU'RE ON DECIDING
00:28:30.876 --> 00:28:33.845 region:rollup2
THAT EVERYONE THAT IS A RESIDENT
00:28:32.878 --> 00:28:37.516 region:rollup2
IS INCLUDED.
00:28:33.845 --> 00:28:40.185 region:rollup2
YOU HAVE JUST DEFINED RESIDENCY.
00:28:37.516 --> 00:28:41.920 region:rollup2
WOOD ON A PERSON WHO'S. LIVED IN
00:28:40.185 --> 00:28:43.555 region:rollup2
THE STATE FOR A FEW MONTHS BE
00:28:41.920 --> 00:28:45.791 region:rollup2
ELIGIBLE FOR THE PROGRAM.
00:28:43.555 --> 00:28:47.492 region:rollup2
WHAT ABOUT SOMEONE WHO WORKS IN
00:28:45.791 --> 00:28:49.728 region:rollup2
THE STATE OUR LIVES ELSEWHERE?
00:28:47.492 --> 00:28:50.362 region:rollup2
SO USES EXAMPLES OF ELIGIBILITY
00:28:49.728 --> 00:28:52.130 region:rollup2
QUESTIONS THAT HAVE TO BE SORTED
00:28:50.362 --> 00:28:53.665 region:rollup2
OUT.
00:28:52.130 --> 00:28:55.634 region:rollup2
ON ALREADY TOUCHED ON COVERED
00:28:53.665 --> 00:28:58.670 region:rollup2
BENEFITS AND SERVICES SO I WILL
00:28:55.634 --> 00:28:59.638 region:rollup2
ON. WON'T REPEAT THAT. I DO WANT
00:28:58.670 --> 00:29:01.640 region:rollup2
TO TOUCH ON GOVERNANCE AND
00:28:59.638 --> 00:29:03.542 region:rollup2
ADMINISTRATION.
00:29:01.640 --> 00:29:05.844 region:rollup2
SETTING UP A SOUND GOVERNANCE
00:29:03.542 --> 00:29:06.979 region:rollup2
MODEL IS REALLY IMPORTANT.
00:29:05.844 --> 00:29:08.380 region:rollup2
US SOUND GOVERNANCE MODEL
00:29:06.979 --> 00:29:10.082 region:rollup2
PROMOTES ACCOUNTABILITY
00:29:08.380 --> 00:29:12.084 region:rollup2
EFFECTIVE OVERSIGHT. AND
00:29:10.082 --> 00:29:13.385 region:rollup2
EVIDENCE BASED DATA DRIVEN
00:29:12.084 --> 00:29:15.220 region:rollup2
APPROACH TO IMPLEMENTATION AND
00:29:13.385 --> 00:29:17.556 region:rollup2
MANAGEMENT.
00:29:15.220 --> 00:29:19.224 region:rollup2
IT ALSO ENCOURAGES CONSUMER AND
00:29:17.556 --> 00:29:21.526 region:rollup2
STAKEHOLDER PARTICIPATION AS
00:29:19.224 --> 00:29:22.361 region:rollup2
WELL AS TRANSPARENCY.
00:29:21.526 --> 00:29:24.263 region:rollup2
SO IF WE WERE STARTING FROM
00:29:22.361 --> 00:29:26.031 region:rollup2
SCRATCH CONCERNING NEW PROGRAMS
00:29:24.263 --> 00:29:27.165 region:rollup2
SUCH AS SINGLE PAYER. THEN WE
00:29:26.031 --> 00:29:28.700 region:rollup2
NEED TO THINK THROUGH HOW THE
00:29:27.165 --> 00:29:29.968 region:rollup2
PROGRAM WOULD BE GOVERNED AND BY
00:29:28.700 --> 00:29:31.536 region:rollup2
WHOM.
00:29:29.968 --> 00:29:32.638 region:rollup2
WOULD THERE BE A NEW BOARD.
00:29:31.536 --> 00:29:35.474 region:rollup2
WOULD BE ADMINISTERED BY AN
00:29:32.638 --> 00:29:37.309 region:rollup2
EXISTINGAGENCY OR NEW AGENCY.
00:29:35.474 --> 00:29:39.011 region:rollup2
AND AGAIN JUST USE COVERED
00:29:37.309 --> 00:29:40.212 region:rollup2
CALIFORNIA JUST EXAMPLE. OF THE
00:29:39.011 --> 00:29:41.813 region:rollup2
STATE AT THAT POINT WHEN
00:29:40.212 --> 00:29:43.649 region:rollup2
IMPLEMENTING THAT PROGRAM
00:29:41.813 --> 00:29:45.817 region:rollup2
DECIDE TO ESTABLISH A NEW BOARD
00:29:43.649 --> 00:29:47.352 region:rollup2
TO OVERSEE THE EXCHANGE AND SET
00:29:45.817 --> 00:29:48.286 region:rollup2
THE DIRECTION FOR THE PROGRAM.
00:29:47.352 --> 00:29:51.623 region:rollup2
AGAIN THAT WAS ONE DESIGN CHOICE
00:29:48.286 --> 00:29:53.258 region:rollup2
THAT WAS MADE.
00:29:51.623 --> 00:29:54.126 region:rollup2
ADMINISTRATIVE FUNCTIONS ALSO
00:29:53.258 --> 00:29:55.694 region:rollup2
NEED TO BE HANDLED BY SOME
00:29:54.126 --> 00:29:57.329 region:rollup2
ENTITY.
00:29:55.694 --> 00:29:58.730 region:rollup2
IF WE WERE TO CONSIDER A SINGLE
00:29:57.329 --> 00:30:00.532 region:rollup2
PAYER PROGRAM THAT CENTRALLY
00:29:58.730 --> 00:30:02.734 region:rollup2
ADMINISTERED WHAT ARE THE
00:30:00.532 --> 00:30:04.469 region:rollup2
FUNCTIONS THAT WOULD. NEED TO BE
00:30:02.734 --> 00:30:06.405 region:rollup2
ARRANGED FOR A NEED TO. CONTINUE
00:30:04.469 --> 00:30:07.506 region:rollup2
TO OCCUR.
00:30:06.405 --> 00:30:09.574 region:rollup2
FOR EXAMPLE.
00:30:07.506 --> 00:30:11.076 region:rollup2
ASSED A STATE ADMINISTERED
00:30:09.574 --> 00:30:13.278 region:rollup2
AGENCY OR CENTRALLY ADMINISTERED
00:30:11.076 --> 00:30:14.846 region:rollup2
INTERCEDING WOULD HAVE TO.
00:30:13.278 --> 00:30:16.114 region:rollup2
PAY DOCTORS
00:30:14.846 --> 00:30:17.649 region:rollup2
HOSPITALS AND PROVIDERS FOR
00:30:16.114 --> 00:30:18.583 region:rollup2
HEALTHCARE SERVICES
00:30:17.649 --> 00:30:19.985 region:rollup2
WE NEED TO PAY FOR PRESCRIPTION
00:30:18.583 --> 00:30:21.019 region:rollup2
DRUGS.
00:30:19.985 --> 00:30:22.287 region:rollup2
IT WOULD NEED TO ENSURE THE
00:30:21.019 --> 00:30:23.255 region:rollup2
PAYMENTS ARE ACCURATE AND THE
00:30:22.287 --> 00:30:26.224 region:rollup2
NEED TO WATCH OUT FOR FRAUD AND
00:30:23.255 --> 00:30:28.093 region:rollup2
ABUSE.
00:30:26.224 --> 00:30:29.928 region:rollup2
FINANCIAL AN ACTUARIAL ANNOUNCES
00:30:28.093 --> 00:30:32.464 region:rollup2
TO ESTIMATE BUDGET IMPACTS WOULD
00:30:29.928 --> 00:30:33.832 region:rollup2
ALSO BE NECESSARY.
00:30:32.464 --> 00:30:35.767 region:rollup2
WE'D ALSO NEED THE FUNCTIONS OF
00:30:33.832 --> 00:30:36.334 region:rollup2
ANALYTICS TO TO TO DETERMINE
00:30:35.767 --> 00:30:38.837 region:rollup2
WHETHER THEY'RE SUFFICIENT
00:30:36.334 --> 00:30:40.939 region:rollup2
SUPPLY OF PRIMARY AND SPECIALTY
00:30:38.837 --> 00:30:42.274 region:rollup2
CARE SERVICES AND TO ASSESS
00:30:40.939 --> 00:30:43.508 region:rollup2
WHETHER PATRONS ARE REALLY
00:30:42.274 --> 00:30:45.377 region:rollup2
GETTING APPROPRIATE CARE WHEN
00:30:43.508 --> 00:30:46.978 region:rollup2
THEY NEED IT.
00:30:45.377 --> 00:30:49.181 region:rollup2
MANY OF THESE FUNCTIONS ARE
00:30:46.978 --> 00:30:50.148 region:rollup2
ADMINISTERED CURRENTLY IN PUBLIC
00:30:49.181 --> 00:30:52.050 region:rollup2
BY MULTIPLE PUBLIC AND PRIVATE
00:30:50.148 --> 00:30:53.819 region:rollup2
PAYERS.
00:30:52.050 --> 00:30:54.886 region:rollup2
SO IN A SINGLE PAYER SYSTEM
00:30:53.819 --> 00:30:56.588 region:rollup2
THESE FUNCTIONS DON'T
00:30:54.886 --> 00:30:58.690 region:rollup2
NECESSARILY GO AWAY BUT THERE'S
00:30:56.588 --> 00:31:00.258 region:rollup2
POTENTIAL FOR REDUCTION OF THAT
00:30:58.690 --> 00:31:02.427 region:rollup2
DUPLICATION ACROSS PAYERS AND
00:31:00.258 --> 00:31:03.862 region:rollup2
SYSTEMS.
00:31:02.427 --> 00:31:05.464 region:rollup2
IN THE TRANSITION HOWEVER THESE
00:31:03.862 --> 00:31:06.865 region:rollup2
FUNCTIONS WOULD HAVE TO BE STOOD
00:31:05.464 --> 00:31:09.634 region:rollup2
UP AND SOME CONSCIOUS DELIBERATE
00:31:06.865 --> 00:31:10.969 region:rollup2
FASHION.
00:31:09.634 --> 00:31:12.871 region:rollup2
SO A LAID OUT ON A LOT OF
00:31:10.969 --> 00:31:14.473 region:rollup2
IMPLEMENTATION ISSUES AND IT'S
00:31:12.871 --> 00:31:15.540 region:rollup2
QUITE A LOT OF INFORMATION SO I
00:31:14.473 --> 00:31:17.242 region:rollup2
THOUGHT IT WAS IMPORTANT TO
00:31:15.540 --> 00:31:19.077 region:rollup2
LEAVE YOU WITH SOME KIND OF
00:31:17.242 --> 00:31:21.413 region:rollup2
FRAMEWORK TO EVALUATE. DIFFERENT
00:31:19.077 --> 00:31:26.385 region:rollup2
FOR PROPOSALS THAT YOU MAY BE
00:31:21.413 --> 00:31:28.820 region:rollup2
CONSIDERING IN THE NEAR FUTURE.
00:31:26.385 --> 00:31:30.989 region:rollup2
SO ON THIS SLIDE HERE IS A A
00:31:28.820 --> 00:31:33.725 region:rollup2
SUGGESTED FRAMEWORK.
00:31:30.989 --> 00:31:35.894 region:rollup2
ON AND AND WHAT IT DOES IS I YOU
00:31:33.725 --> 00:31:37.896 region:rollup2
SEE ON THE LEFT HAND SIDE. OWN
00:31:35.894 --> 00:31:40.332 region:rollup2
I'VE LAID OUT. SUGGEST YOUR
00:31:37.896 --> 00:31:42.300 region:rollup2
CRITERIA TO CONSIDER WHEN YOU
00:31:40.332 --> 00:31:44.002 region:rollup2
ARE LOOKING AND EVALUATING BEARS
00:31:42.300 --> 00:31:45.704 region:rollup2
POLICY PROPOSALS.
00:31:44.002 --> 00:31:47.939 region:rollup2
SO IN YOU'D BE EVALUATING POLICY
00:31:45.704 --> 00:31:49.508 region:rollup2
PROPOSALS AGAINST THE STATUS QUO
00:31:47.939 --> 00:31:51.777 region:rollup2
WHAT WE HAVE NOW. AND AGAINST
00:31:49.508 --> 00:31:53.445 region:rollup2
EACH OTHER.
00:31:51.777 --> 00:31:54.846 region:rollup2
AND OF THESE CRITERIA CHRIS
00:31:53.445 --> 00:31:56.748 region:rollup2
COULD BE TWEAKED BASED ON YOUR
00:31:54.846 --> 00:31:58.850 region:rollup2
OVERALL POLICY GOALS.
00:31:56.748 --> 00:32:00.218 region:rollup2
SO IT'LL BE HELPFUL JUST TO TAKE
00:31:58.850 --> 00:32:01.987 region:rollup2
A COUPLE MINUTES TO WALK THROUGH
00:32:00.218 --> 00:32:03.755 region:rollup2
EACH ONE.
00:32:01.987 --> 00:32:05.056 region:rollup2
A FIRST OF ALL IS COVERAGE HOW
00:32:03.755 --> 00:32:07.025 region:rollup2
MANY ADDITIONAL AND INFO
00:32:05.056 --> 00:32:08.794 region:rollup2
INDIVIDUALS WERE ARE CURRENTLY
00:32:07.025 --> 00:32:11.496 region:rollup2
UNINSURED WOULD GAIN ACCESS TO
00:32:08.794 --> 00:32:12.864 region:rollup2
HEALTH INSURANCE.
00:32:11.496 --> 00:32:14.132 region:rollup2
AND THE SECOND IS SOMETHING WE
00:32:12.864 --> 00:32:15.400 region:rollup2
CALL UP IN CALLING A DISRUPTION
00:32:14.132 --> 00:32:17.369 region:rollup2
INDEX
00:32:15.400 --> 00:32:18.970 region:rollup2
HOW MANY INDIVIDUALS WHO
00:32:17.369 --> 00:32:20.138 region:rollup2
CURRENTLY HAVE SOME KIND OF
00:32:18.970 --> 00:32:23.108 region:rollup2
COVERAGE. WOULD HAVE TO CHANGE
00:32:20.138 --> 00:32:25.577 region:rollup2
THEIR PLANS.
00:32:23.108 --> 00:32:27.779 region:rollup2
THE THIRD IS SYSTEM WIDE COSTS.
00:32:25.577 --> 00:32:29.681 region:rollup2
WHAT IS A PROJECTED IMPACT ON
00:32:27.779 --> 00:32:30.715 region:rollup2
TOTAL HEALTH CARE EXPENDITURES
00:32:29.681 --> 00:32:31.383 region:rollup2
AND WE'RE LOOKING AT TOLL HELP
00:32:30.715 --> 00:32:33.018 region:rollup2
HEALTHCARE EXPENDITURES OF
00:32:31.383 --> 00:32:34.119 region:rollup2
COURSES?
00:32:33.018 --> 00:32:34.986 region:rollup2
IMPORTANT TO LOOK AT THE
00:32:34.119 --> 00:32:36.955 region:rollup2
ADMINISTRATIVE COSTS THAT IS
00:32:34.986 --> 00:32:37.389 region:rollup2
PART OF.
00:32:36.955 --> 00:32:39.424 region:rollup2
THE TOTAL HEALTHCARE
00:32:37.389 --> 00:32:40.659 region:rollup2
EXPENDITURES.
00:32:39.424 --> 00:32:42.360 region:rollup2
THE FOR THIS PAYMENT FOR
00:32:40.659 --> 00:32:44.529 region:rollup2
HEALTHCARE SERVICES.
00:32:42.360 --> 00:32:46.465 region:rollup2
SPECIFICALLY OBJECT IMPACTS ON
00:32:44.529 --> 00:32:47.732 region:rollup2
THE REIMBURSEMENT LEVELS FOR
00:32:46.465 --> 00:32:50.635 region:rollup2
DOCTORS HOSPITALS AND OTHER
00:32:47.732 --> 00:32:51.503 region:rollup2
PROVIDERS IN THE STATE.
00:32:50.635 --> 00:32:53.338 region:rollup2
WHAT ABOUT AVAILABILITY OF
00:32:51.503 --> 00:32:55.540 region:rollup2
SERVICES?
00:32:53.338 --> 00:32:57.542 region:rollup2
DOES A POLICY IMPACT ACCESS TO
00:32:55.540 --> 00:32:59.678 region:rollup2
CARE IN ANYWAY WOULD IMPROVE IT
00:32:57.542 --> 00:33:00.912 region:rollup2
HER WOULD EXACERBATE ANY HEALTH
00:32:59.678 --> 00:33:03.148 region:rollup2
CARE ACCESS ISSUES.
00:33:00.912 --> 00:33:05.116 region:rollup2
.
00:33:03.148 --> 00:33:06.685 region:rollup2
THE NEXUS QUALITY.
00:33:05.116 --> 00:33:08.353 region:rollup2
WITH THE PROPOSAL HAVE
00:33:06.685 --> 00:33:10.322 region:rollup2
ANY PROVISIONS RELATED TO SAFETY
00:33:08.353 --> 00:33:12.224 region:rollup2
AND QUALITY.
00:33:10.322 --> 00:33:13.492 region:rollup2
WOULD IT ENCOURAGE USE OF
00:33:12.224 --> 00:33:15.060 region:rollup2
PRIMARY CARE OR PREVENTIVE
00:33:13.492 --> 00:33:17.629 region:rollup2
SERVICES.
00:33:15.060 --> 00:33:19.364 region:rollup2
FOR EXAMPLE ENCOURAGING USE OF
00:33:17.629 --> 00:33:21.600 region:rollup2
CANCER SCREENINGS AND PREVENTIVE
00:33:19.364 --> 00:33:25.370 region:rollup2
SERVICES THAT MIGHT PREVENT.
00:33:21.600 --> 00:33:27.405 region:rollup2
FUTURE HEALTHCARE COSTS.
00:33:25.370 --> 00:33:29.774 region:rollup2
HELD UP FINANCIAL BARRIERS.
00:33:27.405 --> 00:33:30.275 region:rollup2
SEARCHES CO PAYMENTS OR MONTHLY
00:33:29.774 --> 00:33:32.611 region:rollup2
PAYMENTS IN THE FORM OF
00:33:30.275 --> 00:33:34.412 region:rollup2
PREMIUMS.
00:33:32.611 --> 00:33:36.548 region:rollup2
THOSE COULD POSE REAL BARRIERS
00:33:34.412 --> 00:33:39.217 region:rollup2
TO LOW INCOME CALIFORNIANS SO
00:33:36.548 --> 00:33:42.487 region:rollup2
THAT IS CERTAINLY A CRITERIA.
00:33:39.217 --> 00:33:44.022 region:rollup2
THAT THAT SHOULD BE CONSIDERED.
00:33:42.487 --> 00:33:46.758 region:rollup2
THE NEXT OR POTENTIAL DOWNSTREAM
00:33:44.022 --> 00:33:47.192 region:rollup2
EFFECTS SUCH AS THOSE.
00:33:46.758 --> 00:33:49.728 region:rollup2
THAT MIGHT.
00:33:47.192 --> 00:33:51.496 region:rollup2
AFFECT THE HEALTHCARE WORKFORCE
00:33:49.728 --> 00:33:54.866 region:rollup2
AND INDIVIDUALS THAT ARE AND
00:33:51.496 --> 00:33:56.234 region:rollup2
HELP HER WORKFORCE PIPELINE.
00:33:54.866 --> 00:33:58.303 region:rollup2
THE NEXT ONE IS A THAT I'VE
00:33:56.234 --> 00:34:00.672 region:rollup2
LISTED IS INVESTMENTS IN SOCIAL
00:33:58.303 --> 00:34:02.207 region:rollup2
DETERMINANTS OF HEALTH CARE.
00:34:00.672 --> 00:34:04.543 region:rollup2
SO THE QUESTION THERE AS DOES A
00:34:02.207 --> 00:34:05.977 region:rollup2
PROPOSAL ENCOURAGE OUR SYSTEM TO
00:34:04.543 --> 00:34:08.113 region:rollup2
REALLY LOOK AT A PERSON AS A
00:34:05.977 --> 00:34:09.814 region:rollup2
WHOLE. INCLUDING ALTHOUGH SOCIO
00:34:08.113 --> 00:34:11.416 region:rollup2
ECONOMIC FACTORS THAT AFFECT
00:34:09.814 --> 00:34:12.550 region:rollup2
HEALTH AND WELL BEING.
00:34:11.416 --> 00:34:14.719 region:rollup2
SUCH AS HOUSING AND FOOD
00:34:12.550 --> 00:34:16.121 region:rollup2
SECURITY.
00:34:14.719 --> 00:34:18.023 region:rollup2
AND OF COURSE LAST ONE IS
00:34:16.121 --> 00:34:19.524 region:rollup2
FEASIBILITY.
00:34:18.023 --> 00:34:21.059 region:rollup2
WHAT IS TRULY FEASIBLE AGAIN
00:34:19.524 --> 00:34:24.329 region:rollup2
FROM A FEDERAL PERSPECTIVE AND
00:34:21.059 --> 00:34:25.964 region:rollup2
FROM A STATE PERSPECTIVE?
00:34:24.329 --> 00:34:27.666 region:rollup2
AND IN TERMS OF VISIBILITY CAN
00:34:25.964 --> 00:34:29.234 region:rollup2
WE OBTAIN THE SUFFICIENT DOLLARS
00:34:27.666 --> 00:34:30.602 region:rollup2
AND GENERATE SUFFICIENT REVENUES
00:34:29.234 --> 00:34:32.270 region:rollup2
TO ESTABLISH AND SUSTAIN THE
00:34:30.602 --> 00:34:34.072 region:rollup2
PROGRAM.
00:34:32.270 --> 00:34:34.973 region:rollup2
AND WHAT IS FEASIBLE FROM A
00:34:34.072 --> 00:34:41.179 region:rollup2
STATE CONSTITUTION AND THE
00:34:34.973 --> 00:34:43.682 region:rollup2
BUDGETING RULES PURSE.
00:34:41.179 --> 00:34:45.951 region:rollup2
SO THIS THIS LAST SLIDE HERE IS
00:34:43.682 --> 00:34:47.552 region:rollup2
REALLY INTENDED TO SHOW HOW SUCH
00:34:45.951 --> 00:34:49.521 region:rollup2
A FRAMEWORK CONSISTS COMPLETELY
00:34:47.552 --> 00:34:51.423 region:rollup2
HYPOTHETICAL HERE. BUT HOW SUCH
00:34:49.521 --> 00:34:53.191 region:rollup2
A FRAMEWORK COULD BE APPLIED.
00:34:51.423 --> 00:34:54.659 region:rollup2
SO I A HYPOTHETICAL OPTION
00:34:53.191 --> 00:34:56.027 region:rollup2
NUMBER ONE HYPOTHETICAL OPTION
00:34:54.659 --> 00:34:57.595 region:rollup2
NUMBER TWO.
00:34:56.027 --> 00:35:00.665 region:rollup2
AND AGAIN THIS IS JUST TO SHOW
00:34:57.595 --> 00:35:01.533 region:rollup2
HOW IT GOT THE CRITERIA AND ONCE
00:35:00.665 --> 00:35:03.301 region:rollup2
YOU'VE ANALYZE EACH OF THE
00:35:01.533 --> 00:35:04.536 region:rollup2
OPTIONS HOW THEY FARED AGAINST
00:35:03.301 --> 00:35:06.371 region:rollup2
EACH OTHER AND AGAINST THE
00:35:04.536 --> 00:35:08.573 region:rollup2
STATUS QUO.
00:35:06.371 --> 00:35:10.408 region:rollup2
SO WHEN LOOKING AT YOU PROPOSALS
00:35:08.573 --> 00:35:11.977 region:rollup2
ANALYSTS COULD TAKE A LOOK AT
00:35:10.408 --> 00:35:12.277 region:rollup2
EACH CRITERIA.
00:35:11.977 --> 00:35:14.779 region:rollup2
AND THEN.
00:35:12.277 --> 00:35:16.514 region:rollup2
SEE HOW THEY DID FOR EACH OF
00:35:14.779 --> 00:35:18.450 region:rollup2
THE SPECIFIC CRITERIA. IN THIS
00:35:16.514 --> 00:35:19.718 region:rollup2
ONE IT LOOKS LIKE HYPOTHETICAL
00:35:18.450 --> 00:35:21.119 region:rollup2
OPTION NUMBER ONE IT MAY
00:35:19.718 --> 00:35:23.121 region:rollup2
INCREASE COVERAGE.
00:35:21.119 --> 00:35:24.489 region:rollup2
BY BY A LOT.
00:35:23.121 --> 00:35:26.758 region:rollup2
BUT IN MAY BE DIFFICULT TO
00:35:24.489 --> 00:35:28.360 region:rollup2
IMPLEMENT.
00:35:26.758 --> 00:35:31.129 region:rollup2
DO A FEASIBILITY DUE TO BEARS A
00:35:28.360 --> 00:35:32.998 region:rollup2
FEASIBILITY.
00:35:31.129 --> 00:35:33.765 region:rollup2
HYPOTHETICAL OPTION TWO MIGHT
00:35:32.998 --> 00:35:35.834 region:rollup2
BE MORE INCREMENTAL IN ITS
00:35:33.765 --> 00:35:38.136 region:rollup2
APPROACH.
00:35:35.834 --> 00:35:39.804 region:rollup2
AND MIGHT BE MORE FEASIBLE BUT
00:35:38.136 --> 00:35:41.339 region:rollup2
MAY ONLY RESULT IN A SMALL
00:35:39.804 --> 00:35:43.108 region:rollup2
INCREASE OF COVERAGE.
00:35:41.339 --> 00:35:45.110 region:rollup2
SO THE JUST ONE WAY FOR YOU TO
00:35:43.108 --> 00:35:46.811 region:rollup2
WELL.
00:35:45.110 --> 00:35:47.812 region:rollup2
COMPARE VARIOUS PROPOSALS THAT
00:35:46.811 --> 00:35:50.515 region:rollup2
YOU MIGHT BE CONSIDERING IN THE
00:35:47.812 --> 00:35:54.252 region:rollup2
NEXT FEW WEEKS AND MONTHS.
00:35:50.515 --> 00:35:56.054 region:rollup2
SO.
00:35:54.252 --> 00:35:56.655 region:rollup2
SERB THEIR OWN LIKE THAT THAT
00:35:56.054 --> 00:35:57.155 region:rollup2
ACTUALLY CONCLUDES MY REMARKS
00:35:56.655 --> 00:35:59.157 region:rollup2
SO.
00:35:57.155 --> 00:36:01.960 region:rollup2
.
00:35:59.157 --> 00:36:03.728 region:rollup2
YOU TAKE QUESTIONS NOW OR.
00:36:01.960 --> 00:36:05.163 region:rollup2
YEAH ACTUALLY AND WE WILL TAKE
00:36:03.728 --> 00:36:06.331 region:rollup2
QUESTIONS FOR YOU AND THEN WE'LL
00:36:05.163 --> 00:36:10.402 region:rollup2
MOVE ON TO OUR THE REST FOR
00:36:06.331 --> 00:36:12.137 region:rollup2
PANEL SO QUESTION. FOR SUSAN.
00:36:10.402 --> 00:36:13.772 region:rollup2
IN MANY OF YOURS YOU'RE
00:36:12.137 --> 00:36:14.973 region:rollup2
COMPARING THE STATUS QUO TO
00:36:13.772 --> 00:36:16.508 region:rollup2
POTENTIAL OPTIONS I WAS
00:36:14.973 --> 00:36:18.376 region:rollup2
WONDERING IF YOU COULD COMMENT
00:36:16.508 --> 00:36:19.811 region:rollup2
ON THE STATUS QUO.
00:36:18.376 --> 00:36:21.913 region:rollup2
AND TO DESCRIBE SOME OF THE
00:36:19.811 --> 00:36:23.815 region:rollup2
STRENGTHS AND WEAKNESSES THAT WE
00:36:21.913 --> 00:36:25.316 region:rollup2
CURRENTLY FACE TO.
00:36:23.815 --> 00:36:27.519 region:rollup2
HOPEFULLY INSPIRE US TO WANT TO
00:36:25.316 --> 00:36:29.387 region:rollup2
CHANGE.
00:36:27.519 --> 00:36:30.188 region:rollup2
RIGHT SO.
00:36:29.387 --> 00:36:33.391 region:rollup2
CERTAINLY.
00:36:30.188 --> 00:36:35.493 region:rollup2
I'D I THINK THE FIRST REMARK
00:36:33.391 --> 00:36:36.594 region:rollup2
THAT I MADE ABOUT HOW. ON THE
00:36:35.493 --> 00:36:38.596 region:rollup2
YOU KNOW AND ON A NOTE OF
00:36:36.594 --> 00:36:40.231 region:rollup2
OPTIMISM IS THAT WE HAVE MADE
00:36:38.596 --> 00:36:43.368 region:rollup2
QUITE A LOT OF PROGRESS IN THE
00:36:40.231 --> 00:36:44.702 region:rollup2
LAST FEW YEARS. TO BOMB EXPAND
00:36:43.368 --> 00:36:45.904 region:rollup2
COVERAGE AND REDUCE THE NUMBER
00:36:44.702 --> 00:36:47.739 region:rollup2
OF UNINSURED.
00:36:45.904 --> 00:36:49.107 region:rollup2
SO ON BUT THERE'S STILL DOES
00:36:47.739 --> 00:36:50.175 region:rollup2
REMAIN QUITE A LOT OF WORK TO DO
00:36:49.107 --> 00:36:52.010 region:rollup2
TO ENSURE THAT THE LIVE
00:36:50.175 --> 00:36:53.745 region:rollup2
REMAINING THREE MILLION ARE IN
00:36:52.010 --> 00:36:55.013 region:rollup2
FACT HAVE SOME SORT OF COVERAGE.
00:36:53.745 --> 00:36:56.347 region:rollup2
AND OF COURSE OUR SYSTEM DOES
00:36:55.013 --> 00:36:59.117 region:rollup2
HAVE ISSUES IN TERMS OF OF
00:36:56.347 --> 00:37:00.552 region:rollup2
FRAGMENTATION. ON THE VARIATION
00:36:59.117 --> 00:37:02.287 region:rollup2
IN QUALITY OF HEALTH CARE.
00:37:00.552 --> 00:37:04.889 region:rollup2
AFFORDABILITY AND THESE ARE
00:37:02.287 --> 00:37:06.858 region:rollup2
STILL ONGOING CONCERNS.
00:37:04.889 --> 00:37:09.527 region:rollup2
SO ON YES SO THE STATUS QUO
00:37:06.858 --> 00:37:10.528 region:rollup2
STILL HAS ITS ISSUES AND THERE'S
00:37:09.527 --> 00:37:17.001 region:rollup2
DEFINITELY QUITE A LOT OF WORK
00:37:10.528 --> 00:37:19.037 region:rollup2
TO BE DONE.
00:37:17.001 --> 00:37:20.071 region:rollup2
YOU.
00:37:19.037 --> 00:37:21.840 region:rollup2
MY QUESTION IS.
00:37:20.071 --> 00:37:22.907 region:rollup2
WREAK REGARDING YOUR YOUR
00:37:21.840 --> 00:37:24.275 region:rollup2
FRAMEWORK TO DO AND GO BACK IN
00:37:22.907 --> 00:37:24.909 region:rollup2
THE.
00:37:24.275 --> 00:37:26.911 region:rollup2
THE PREVIOUS SLIDE IF YOU DON'T
00:37:24.909 --> 00:37:28.213 region:rollup2
MIND.
00:37:26.911 --> 00:37:29.981 region:rollup2
SO OF THOSE MEAN YOU'VE GOT A
00:37:28.213 --> 00:37:31.416 region:rollup2
LOT OF THINGS AARON WHAT WOULD
00:37:29.981 --> 00:37:32.884 region:rollup2
YOU CONSIDER TO BE.
00:37:31.416 --> 00:37:33.952 region:rollup2
THE MOST CRITICAL OF THOSE OR OR
00:37:32.884 --> 00:37:37.255 region:rollup2
HAVE YOU GIVEN THAT.
00:37:33.952 --> 00:37:39.090 region:rollup2
MUCH CONSIDERATION.
00:37:37.255 --> 00:37:41.226 region:rollup2
WELL I AM I I THINK IT IT IS
00:37:39.090 --> 00:37:43.228 region:rollup2
IMPORTANT FOR.
00:37:41.226 --> 00:37:45.230 region:rollup2
IN TERMS OF SETTING POLICY GOALS
00:37:43.228 --> 00:37:46.531 region:rollup2
FOR APOLLO FOR POLICYMAKERS WHEN
00:37:45.230 --> 00:37:48.500 region:rollup2
WE THINK ABOUT THE ROADMAP AND
00:37:46.531 --> 00:37:50.535 region:rollup2
WHERE YOU WANT TO BE. AND.
00:37:48.500 --> 00:37:52.871 region:rollup2
WHATEVER YOU SET YOUR CRITERIA
00:37:50.535 --> 00:37:54.672 region:rollup2
TO BE SHOULD MATCH THE GOALS I
00:37:52.871 --> 00:37:57.709 region:rollup2
DO THINK THAT COVERAGE IS
00:37:54.672 --> 00:38:00.778 region:rollup2
PROBABLY. ONE THAT IT IS ONE OF
00:37:57.709 --> 00:38:02.680 region:rollup2
THOSE THAT. MIGHT BE ONE TO PUT
00:38:00.778 --> 00:38:03.948 region:rollup2
UP THERE AND OF COURSE
00:38:02.680 --> 00:38:06.184 region:rollup2
FEASIBILITY.
00:38:03.948 --> 00:38:07.719 region:rollup2
IF IF IT'S NOT FEASIBLE THEN
00:38:06.184 --> 00:38:09.954 region:rollup2
THAT'S OBVIOUSLY.
00:38:07.719 --> 00:38:10.488 region:rollup2
UP AND ISSUE SO. ON THOSE ARE A
00:38:09.954 --> 00:38:12.557 region:rollup2
COUPLE THAT I WOULD PUT UP
00:38:10.488 --> 00:38:14.926 region:rollup2
THERE.
00:38:12.557 --> 00:38:16.227 region:rollup2
DIVERT THANK YOU VERY MUCH.
00:38:14.926 --> 00:38:17.896 region:rollup2
WE'RE GOING TO SHIFT AROUND THE
00:38:16.227 --> 00:38:18.496 region:rollup2
ORDER A LITTLE BIT FOR THE THREE
00:38:17.896 --> 00:38:19.330 region:rollup2
FUTURE I THINK GUARDINO THAT.
00:38:18.496 --> 00:38:20.565 region:rollup2
SO.
00:38:19.330 --> 00:38:23.334 region:rollup2
.
00:38:20.565 --> 00:38:25.003 region:rollup2
I TWO ONE.
00:38:23.334 --> 00:38:27.505 region:rollup2
GONNA GO AHEAD AND INTRODUCE A.
00:38:25.003 --> 00:38:29.007 region:rollup2
AND AND MARIE.
00:38:27.505 --> 00:38:30.341 region:rollup2
MARCIA RALLY HOPE WE GOT THAT WE
00:38:29.007 --> 00:38:31.843 region:rollup2
GOT THAT RIGHT PROFESSOR OF LAW
00:38:30.341 --> 00:38:33.611 region:rollup2
UNIVERSITY OF MATT MISSOURI.
00:38:31.843 --> 00:38:35.814 region:rollup2
KANSAS CITY.
00:38:33.611 --> 00:38:37.282 region:rollup2
UM'S SHE SPECIALIZES IN HEALTH
00:38:35.814 --> 00:38:42.120 region:rollup2
CARE LAW AND SHE'S GOING TO BE.
00:38:37.282 --> 00:38:52.096 region:rollup2
TALKING TO US ABOUT A RECESS.
00:38:42.120 --> 00:38:53.231 region:rollup2
IN A MOMENT.
00:38:52.096 --> 00:38:55.500 region:rollup2
AND AFTER YOUR PRESENTATION
00:38:53.231 --> 00:38:57.635 region:rollup2
HENRY WE WILL ASK QUESTIONS SO
00:38:55.500 --> 00:38:58.269 region:rollup2
THAT WE MAKE. AND THEN WILL WAIT
00:38:57.635 --> 00:38:59.103 region:rollup2
ON THE OTHER TO AYE AYE AND YOU
00:38:58.269 --> 00:39:00.605 region:rollup2
OTHER TWO PANELISTS ASK
00:38:59.103 --> 00:39:01.806 region:rollup2
QUESTIONS IF YOU BOTH PRESENTED
00:39:00.605 --> 00:39:03.975 region:rollup2
SO I JUST WANNA MAKE SURE SHE.
00:39:01.806 --> 00:39:06.945 region:rollup2
WELL ISN'T STUCK IN CALIFORNIA
00:39:03.975 --> 00:39:09.280 region:rollup2
FOR ANOTHER DAY OR MINE WHEN HE
00:39:06.945 --> 00:39:10.949 region:rollup2
SAID IT WOULD BE STUCK IN ANYWAY
00:39:09.280 --> 00:39:12.350 region:rollup2
UP A LONGTIME RESIDENT BEFORE I
00:39:10.949 --> 00:39:15.119 region:rollup2
MOVED TO.
00:39:12.350 --> 00:39:18.056 region:rollup2
KANSAS CITY TO BECOME A FULL
00:39:15.119 --> 00:39:20.124 region:rollup2
TIME TENURED FULL PROFESSOR. AT
00:39:18.056 --> 00:39:22.093 region:rollup2
THE LAW SCHOOL THERE AND SO
00:39:20.124 --> 00:39:24.229 region:rollup2
REMAIN DEEPLY INTERESTED. AND
00:39:22.093 --> 00:39:28.132 region:rollup2
INVESTED I THINK AND.
00:39:24.229 --> 00:39:29.033 region:rollup2
CALIFORNIA'S ACTIVITY IN THIS
00:39:28.132 --> 00:39:29.734 region:rollup2
AREA.
00:39:29.033 --> 00:39:30.768 region:rollup2
SO MY TOPIC TODAY IS THE
00:39:29.734 --> 00:39:31.302 region:rollup2
IMPLEMENTATION CONSIDERATION OF
00:39:30.768 --> 00:39:33.071 region:rollup2
ARRESTS OF THE EMPLOYEE
00:39:31.302 --> 00:39:34.372 region:rollup2
RETIREMENT INCOME SECURITY ACT
00:39:33.071 --> 00:39:34.973 region:rollup2
OF NINETEEN SEVENTY FOUR I
00:39:34.372 --> 00:39:35.607 region:rollup2
ALWAYS TELL MY STUDENTS WILL
00:39:34.973 --> 00:39:36.708 region:rollup2
NEVER HEAR ME SAY IT THAT WAY
00:39:35.607 --> 00:39:37.508 region:rollup2
AGAIN. WHAT A MOUTHFUL?
00:39:36.708 --> 00:39:39.544 region:rollup2
?
00:39:37.508 --> 00:39:39.811 region:rollup2
SO WHAT IS A WRESTLER.
00:39:39.544 --> 00:39:41.312 region:rollup2
ALRIGHT.
00:39:39.811 --> 00:39:42.647 region:rollup2
IT'S A FEDERAL LAW OKAY AND WE
00:39:41.312 --> 00:39:45.083 region:rollup2
ARE IN THE LAND OF MY FOR YOUR
00:39:42.647 --> 00:39:46.618 region:rollup2
SPONSORED HEALTH INSURANCE WE
00:39:45.083 --> 00:39:49.721 region:rollup2
ARE NOT IN THE LAND OF MEDICARE
00:39:46.618 --> 00:39:50.321 region:rollup2
AND MEDICAID. FOR MY REMARKS.
00:39:49.721 --> 00:39:52.423 region:rollup2
RIGHT.
00:39:50.321 --> 00:39:53.858 region:rollup2
INNOCENTLY REGULATES PRIVATE
00:39:52.423 --> 00:39:56.094 region:rollup2
SECTOR WHAT WE'VE BEEN CALL
00:39:53.858 --> 00:39:57.829 region:rollup2
COMMERCIAL SECTOR PENSIONS AND
00:39:56.094 --> 00:39:59.364 region:rollup2
OTHER EMPLOYEE BENEFIT PROGRAMS
00:39:57.829 --> 00:40:01.099 region:rollup2
INCLUDING JOB BASED HEALTH
00:39:59.364 --> 00:40:02.667 region:rollup2
COVERAGE WHY AM I TELLING YOU
00:40:01.099 --> 00:40:04.435 region:rollup2
HISTORY. IT'S GOING TO BE REALLY
00:40:02.667 --> 00:40:05.837 region:rollup2
SIGNIFICANT ONE EXPLAINED TO YOU
00:40:04.435 --> 00:40:07.905 region:rollup2
THAT MUCH OF THE INTERPRETATION
00:40:05.837 --> 00:40:09.107 region:rollup2
OF A RISA HAS RESTED WITH THE
00:40:07.905 --> 00:40:10.375 region:rollup2
COURTS.
00:40:09.107 --> 00:40:11.910 region:rollup2
PART OF THE REASON IS THE
00:40:10.375 --> 00:40:13.478 region:rollup2
HISTORY OF HOW THE SAUSAGE BUT
00:40:11.910 --> 00:40:14.879 region:rollup2
MADE US LEGISLATORS I HOPE YOU
00:40:13.478 --> 00:40:17.048 region:rollup2
WILL BE ALTERNATELY HORRIFIED
00:40:14.879 --> 00:40:17.615 region:rollup2
AND AMUSED.
00:40:17.048 --> 00:40:18.783 region:rollup2
THAT MAY TELL YOU A TALE OF
00:40:17.615 --> 00:40:21.152 region:rollup2
ORISSA.
00:40:18.783 --> 00:40:23.221 region:rollup2
OKAY RISA WAS PASSED BY THE
00:40:21.152 --> 00:40:24.889 region:rollup2
CONGRESS IN THE WANING DAYS OF
00:40:23.221 --> 00:40:27.025 region:rollup2
THE NIXON ADMINISTRATION YES
00:40:24.889 --> 00:40:28.660 region:rollup2
THERE ARE ACTUAL TRANSCRIPTS OF
00:40:27.025 --> 00:40:30.194 region:rollup2
TAPES OF. ON.
00:40:28.660 --> 00:40:31.863 region:rollup2
FORMER PRESIDENT NIXON JUST
00:40:30.194 --> 00:40:33.131 region:rollup2
BEFORE HIS RESIGNATION TALKING
00:40:31.863 --> 00:40:35.199 region:rollup2
ABOUT WE SHOULD MOVE THIS ALONG
00:40:33.131 --> 00:40:36.434 region:rollup2
WILL DISTRACT PEOPLE.
00:40:35.199 --> 00:40:37.568 region:rollup2
WE KNOW THE REST OF THE STORY IT
00:40:36.434 --> 00:40:40.305 region:rollup2
WAS SIGNED INTO LAW BY BEEN
00:40:37.568 --> 00:40:43.875 region:rollup2
PRESIDENT FORD.
00:40:40.305 --> 00:40:46.711 region:rollup2
RIGHT NOW RISA HAD BEEN A MORNIN
00:40:43.875 --> 00:40:49.347 region:rollup2
SINCE ACTUALLY THE NINETEEN.
00:40:46.711 --> 00:40:51.115 region:rollup2
WHEN IT WAS PRIMARILY A PENSION
00:40:49.347 --> 00:40:52.417 region:rollup2
BILL THOSE OF YOU OLD ENOUGH TO
00:40:51.115 --> 00:40:54.252 region:rollup2
REMEMBER THE STUDEBAKER
00:40:52.417 --> 00:40:55.987 region:rollup2
AUTOMOTIVE COMPANIES. KNOW THAT
00:40:54.252 --> 00:40:57.755 region:rollup2
IT'S TALE OF WOE ITS DISSOLUTION
00:40:55.987 --> 00:40:59.557 region:rollup2
ITS ULTIMATE BANKRUPTCY AND YET
00:40:57.755 --> 00:41:01.459 region:rollup2
MORE TRAGICALLY THE BANKRUPTCY
00:40:59.557 --> 00:41:02.093 region:rollup2
IT TURNS OUT OF ITS ENTIRE
00:41:01.459 --> 00:41:05.797 region:rollup2
EMPLOYEE.
00:41:02.093 --> 00:41:07.598 region:rollup2
RETIREMENT FUND.
00:41:05.797 --> 00:41:10.501 region:rollup2
LEFT WHAT WE USED TO CALL WHEN I
00:41:07.598 --> 00:41:11.869 region:rollup2
WORKED IN A THE PENSION AREA THE
00:41:10.501 --> 00:41:13.104 region:rollup2
STUDEBAKER PEOPLE WHO WAS ALSO
00:41:11.869 --> 00:41:14.439 region:rollup2
TALKING ABOUT LIKE A VAMPIRE รณ
00:41:13.104 --> 00:41:15.873 region:rollup2
IS TO THE BIG A PERSON IS IN THE
00:41:14.439 --> 00:41:17.408 region:rollup2
WAITING ROOM. AND YOU KNOW THAT
00:41:15.873 --> 00:41:20.044 region:rollup2
WAS A PERSON WHO HAD ABSOLUTELY
00:41:17.408 --> 00:41:21.312 region:rollup2
NO RETIREMENT INCOME AFTER
00:41:20.044 --> 00:41:23.081 region:rollup2
ENTIRE.
00:41:21.312 --> 00:41:25.083 region:rollup2
SUPPOSEDLY VESTED CAREER WHICH
00:41:23.081 --> 00:41:26.684 region:rollup2
STUDEBAKER AUTOMOTIVE.
00:41:25.083 --> 00:41:28.186 region:rollup2
OKAY THE TRAGEDY OF THIS PEOPLE
00:41:26.684 --> 00:41:30.421 region:rollup2
WHICH WAS WRITTEN LARGE ACROSS
00:41:28.186 --> 00:41:32.056 region:rollup2
ALL OF AMERICANS NEWSPAPER.
00:41:30.421 --> 00:41:33.825 region:rollup2
OKAY AND TELEVISION PROGRAM IS
00:41:32.056 --> 00:41:35.360 region:rollup2
ACTUALLY WHAT GENERATED THE PUSH
00:41:33.825 --> 00:41:36.894 region:rollup2
FIRST WITH PRESIDENT KENNEDY AND
00:41:35.360 --> 00:41:38.296 region:rollup2
THEN FORD ON A PENSION REFORM
00:41:36.894 --> 00:41:39.831 region:rollup2
BILL. WYMAN TALKING ABOUT A
00:41:38.296 --> 00:41:41.366 region:rollup2
PENSION REFORM BILL
00:41:39.831 --> 00:41:43.267 region:rollup2
BECAUSE HEALTH BENEFITS WERE
00:41:41.366 --> 00:41:45.003 region:rollup2
ADDED THIS FLOOR AMENDMENT.
00:41:43.267 --> 00:41:47.005 region:rollup2
TO A PENSION REFORM BILL.
00:41:45.003 --> 00:41:48.773 region:rollup2
OKAY.
00:41:47.005 --> 00:41:49.374 region:rollup2
AND THIS EXPLAINS WHY THE
00:41:48.773 --> 00:41:52.043 region:rollup2
LEGISLATIVE HISTORY IS QUITE
00:41:49.374 --> 00:41:53.678 region:rollup2
BEEN.
00:41:52.043 --> 00:41:54.912 region:rollup2
IT ALSO EXPLAINS WHY.
00:41:53.678 --> 00:41:57.448 region:rollup2
SPRING COURT HAS BEEN CALLED
00:41:54.912 --> 00:41:59.584 region:rollup2
UPON SO MANY TIMES TO EXPLAIN
00:41:57.448 --> 00:42:00.952 region:rollup2
WHAT THE BILL MEANS WHAT THE
00:41:59.584 --> 00:42:02.987 region:rollup2
LANGUAGE OF THE STATUTE MEANS
00:42:00.952 --> 00:42:04.589 region:rollup2
SINCE THERE'S. RELATIVELY FAMILY
00:42:02.987 --> 00:42:05.723 region:rollup2
LOOKING AGAIN THIS MORNING FOR
00:42:04.589 --> 00:42:07.358 region:rollup2
PRINTED VOLUMES OF THE
00:42:05.723 --> 00:42:09.260 region:rollup2
LEGISLATIVE HISTORY OF ARRESTS
00:42:07.358 --> 00:42:11.462 region:rollup2
AND THE CONGRESS.
00:42:09.260 --> 00:42:13.197 region:rollup2
SCARCELY A MENTION OF HEALTH.
00:42:11.462 --> 00:42:15.233 region:rollup2
BUT THEY USED TO CALL.
00:42:13.197 --> 00:42:17.568 region:rollup2
AND QUICKTIME'S NINETEEN SEVENTY
00:42:15.233 --> 00:42:19.303 region:rollup2
THREE HOSPITALIZATION COVERAGE
00:42:17.568 --> 00:42:20.338 region:rollup2
OKAY BUT WHAT THEY MEANT WAS
00:42:19.303 --> 00:42:21.806 region:rollup2
HEALTH INSURANCE OFFERED BY
00:42:20.338 --> 00:42:23.574 region:rollup2
EMPLOYERS.
00:42:21.806 --> 00:42:24.642 region:rollup2
ALRIGHT SO IT'S RELEVANT BECAUSE
00:42:23.574 --> 00:42:26.277 region:rollup2
EVEN THOUGH IT WAS A LATE
00:42:24.642 --> 00:42:27.879 region:rollup2
ADDITION I THINK WE COULD AGREE
00:42:26.277 --> 00:42:29.447 region:rollup2
NOW AYE AYE I THINK IF I WERE TO
00:42:27.879 --> 00:42:31.149 region:rollup2
CUENTA PHRASE WOULD BE SOMETHING
00:42:29.447 --> 00:42:32.784 region:rollup2
LIKE AMENDED HASTE REPENT AT
00:42:31.149 --> 00:42:35.086 region:rollup2
LEISURE.
00:42:32.784 --> 00:42:36.754 region:rollup2
OKAY WE PUT IT IN THERE WE
00:42:35.086 --> 00:42:37.789 region:rollup2
DIDN'T REALLY KNOW WHAT IT MEANT
00:42:36.754 --> 00:42:40.258 region:rollup2
WE'VE RELIED ON THE SUPREME
00:42:37.789 --> 00:42:40.792 region:rollup2
COURT OKAY TO EXPLAIN TO US AND
00:42:40.258 --> 00:42:41.592 region:rollup2
IT'S LIKE THAT'S WHAT THAT
00:42:40.792 --> 00:42:43.528 region:rollup2
MEANT.
00:42:41.592 --> 00:42:44.829 region:rollup2
AND IN SOME WAYS AN UNHAPPY
00:42:43.528 --> 00:42:46.431 region:rollup2
THAT'S WHAT THAT MEANS IT'S NO
00:42:44.829 --> 00:42:47.598 region:rollup2
SURPRISE THAT THE FORTIETH
00:42:46.431 --> 00:42:48.833 region:rollup2
ANNIVERSARY OF THE REST OF THE
00:42:47.598 --> 00:42:50.234 region:rollup2
CONFERENCE.
00:42:48.833 --> 00:42:51.669 region:rollup2
TO LOOK BACK AT IT AMONG ALL THE
00:42:50.234 --> 00:42:53.004 region:rollup2
SORT OF BIGGER RISK GEEKS WAS
00:42:51.669 --> 00:42:54.539 region:rollup2
CALLED THE EMPLOYEE RETIREMENT
00:42:53.004 --> 00:42:55.606 region:rollup2
INCOME SECURITY ACT OF NINETEEN
00:42:54.539 --> 00:42:57.742 region:rollup2
SEVENTY FOUR WHAT WERE THEY
00:42:55.606 --> 00:42:58.976 region:rollup2
THINKING.
00:42:57.742 --> 00:42:59.610 region:rollup2
AND I PERSONALLY THOUGHT I WISH
00:42:58.976 --> 00:43:01.446 region:rollup2
I HAD NAMED IT.
00:42:59.610 --> 00:43:02.780 region:rollup2
IT'S BRILLIANT.
00:43:01.446 --> 00:43:04.415 region:rollup2
WHAT WERE THEY THINKING I DON'T
00:43:02.780 --> 00:43:05.550 region:rollup2
THINK WE'LL EVER KNOW?
00:43:04.415 --> 00:43:08.719 region:rollup2
OKAY WHAT WE KNOW NOW IS WHAT
00:43:05.550 --> 00:43:09.921 region:rollup2
THE SUPREME COURT.
00:43:08.719 --> 00:43:11.088 region:rollup2
ALRIGHT AND THEN FINALLY
00:43:09.921 --> 00:43:12.957 region:rollup2
RESEARCH IS RELEVANT TO HEALTH
00:43:11.088 --> 00:43:14.559 region:rollup2
POLICY BECAUSE IT PREMIUMS THE
00:43:12.957 --> 00:43:15.493 region:rollup2
WORD OF THE DAY ALRIGHT STATE
00:43:14.559 --> 00:43:16.894 region:rollup2
LAWS THAT RELATE TO EMPLOYEE
00:43:15.493 --> 00:43:18.696 region:rollup2
PLANS.
00:43:16.894 --> 00:43:20.998 region:rollup2
PUSHES ALL THE AIR OUT OF THE
00:43:18.696 --> 00:43:22.633 region:rollup2
ROOM IS THE WAY I DESCRIBE IT.
00:43:20.998 --> 00:43:24.302 region:rollup2
IF YOU WANT AIR IN THE ROOM TO
00:43:22.633 --> 00:43:26.204 region:rollup2
DO SOMETHING ELSE YOU'RE GOING
00:43:24.302 --> 00:43:29.207 region:rollup2
TO HAVE TO ARGUE YOU LEFT OF
00:43:26.204 --> 00:43:31.108 region:rollup2
SOME HERE. OKAY HOW BY NOT
00:43:29.207 --> 00:43:32.276 region:rollup2
SUCKING IT ALL OUT TO CONGRESS.
00:43:31.108 --> 00:43:34.145 region:rollup2
FEDERAL PREEMPTION IS THE
00:43:32.276 --> 00:43:35.613 region:rollup2
DOCTRINE MUCH BIGGER THAN EVER
00:43:34.145 --> 00:43:36.314 region:rollup2
SET A MUCH BIGGER THAN HEALTH
00:43:35.613 --> 00:43:37.782 region:rollup2
CARE THOSE OF YOU WHO ARE
00:43:36.314 --> 00:43:38.649 region:rollup2
ATTORNEYS THAT ASSERTS THAT WHEN
00:43:37.782 --> 00:43:39.917 region:rollup2
A STATE LAW AND FEDERAL LAW
00:43:38.649 --> 00:43:42.687 region:rollup2
CONFLICT.
00:43:39.917 --> 00:43:45.189 region:rollup2
FEDERAL LAW DISPLACES OR PREEMPT
00:43:42.687 --> 00:43:46.657 region:rollup2
STATE LAW ARM ESSENTIALLY A
00:43:45.189 --> 00:43:48.893 region:rollup2
UNDER THE SUPERCENTER SUPREMACY
00:43:46.657 --> 00:43:49.794 region:rollup2
CLAUSE OF THE.
00:43:48.893 --> 00:43:53.131 region:rollup2
XIN WHICH IS OF COURSE.
00:43:49.794 --> 00:43:54.899 region:rollup2
ARTICLE SIX SECTION TWO. IT
00:43:53.131 --> 00:43:55.733 region:rollup2
MOVE EVEREST IS ADMINISTERED.
00:43:54.899 --> 00:43:57.135 region:rollup2
IT'S DIVISION IT'S
00:43:55.733 --> 00:43:59.003 region:rollup2
ADMINISTRATIONS DIVIDED AMONG
00:43:57.135 --> 00:44:00.371 region:rollup2
THREE ENTITIES AND THE FEDERAL
00:43:59.003 --> 00:44:01.806 region:rollup2
GOVERNMENT THE UNITED STATES
00:44:00.371 --> 00:44:03.474 region:rollup2
DEPARTMENT OF LABOR. THE
00:44:01.806 --> 00:44:04.575 region:rollup2
INTERNAL REVENUE SERVICE AND
00:44:03.474 --> 00:44:05.943 region:rollup2
ACTUALLY THE PENSION BENEFIT
00:44:04.575 --> 00:44:07.578 region:rollup2
GUARANTY.
00:44:05.943 --> 00:44:08.946 region:rollup2
OPERATION IF YOU THINK OF IT AS
00:44:07.578 --> 00:44:10.715 region:rollup2
PRIMARILY AS A GOAL WHICH WAS TO
00:44:08.946 --> 00:44:12.917 region:rollup2
CREATE WHAT.
00:44:10.715 --> 00:44:13.818 region:rollup2
FIDUCIARY DUTIES IN PENSION PLAN
00:44:12.917 --> 00:44:15.286 region:rollup2
ADMINISTRATORS JUST THINK
00:44:13.818 --> 00:44:17.021 region:rollup2
STUDEBAKER PEOPLE AND YOU'LL
00:44:15.286 --> 00:44:19.056 region:rollup2
THINK ABOUT WHY WHAT WAS THE
00:44:17.021 --> 00:44:20.424 region:rollup2
PURPOSE RIGHT TO CREATE. RULES
00:44:19.056 --> 00:44:21.626 region:rollup2
ABOUT THE ADMINISTRATION OF
00:44:20.424 --> 00:44:23.528 region:rollup2
PENSION PLANS THAT WOULD
00:44:21.626 --> 00:44:25.630 region:rollup2
SAFEGUARD THOSE WHO BELIEVE
00:44:23.528 --> 00:44:27.198 region:rollup2
THEMSELVES AND. ACCORDING TO
00:44:25.630 --> 00:44:28.766 region:rollup2
PLAN DOCUMENTS WERE VESTED TO
00:44:27.198 --> 00:44:30.401 region:rollup2
PROTECT THEIR RETIREMENT INCOME.
00:44:28.766 --> 00:44:32.103 region:rollup2
OKAY IT MAKES SENSE THEN THAT IT
00:44:30.401 --> 00:44:34.105 region:rollup2
WOULD FIT THIS WAY. BUT THAT
00:44:32.103 --> 00:44:35.473 region:rollup2
ALSO WERE HEALTH.
00:44:34.105 --> 00:44:37.441 region:rollup2
BENEFITS DIDN'T AS WELL THEY'RE
00:44:35.473 --> 00:44:38.676 region:rollup2
CONSIDERED AN EMPLOYEE WELFARE.
00:44:37.441 --> 00:44:41.979 region:rollup2
BENEFIT.
00:44:38.676 --> 00:44:44.682 region:rollup2
ALRIGHT.
00:44:41.979 --> 00:44:47.184 region:rollup2
SO I GOT A LOT OF CALLS ON THE
00:44:44.682 --> 00:44:48.252 region:rollup2
DAY AFTER A OF THE AFFORDABLE
00:44:47.184 --> 00:44:49.520 region:rollup2
CARE ACT WAS SIGNED INTO LAW SO
00:44:48.252 --> 00:44:51.455 region:rollup2
SUNLAND MARCH TWENTY THIRD
00:44:49.520 --> 00:44:52.823 region:rollup2
TWENTY TEN FROM PEOPLE WHO KNOW
00:44:51.455 --> 00:44:53.758 region:rollup2
THAT I'M. A SOMETHING OF
00:44:52.823 --> 00:44:55.226 region:rollup2
INTEREST SO.
00:44:53.758 --> 00:44:57.295 region:rollup2
GEEK IN THE CITY
00:44:55.226 --> 00:44:59.397 region:rollup2
DID WE JUST PEEL APPEAL REPEAL
00:44:57.295 --> 00:45:02.133 region:rollup2
LARISSA AND WHAT NOT.
00:44:59.397 --> 00:45:03.234 region:rollup2
OKAY WE AMENDED IT IN SOME WAYS
00:45:02.133 --> 00:45:05.503 region:rollup2
WE ACTUALLY CREATED SOME
00:45:03.234 --> 00:45:07.204 region:rollup2
EXEMPTIONS TO IT IN OTHER WAYS.
00:45:05.503 --> 00:45:09.073 region:rollup2
BUT THERE ARE ACTUALLY SPECIFIC
00:45:07.204 --> 00:45:10.841 region:rollup2
PROVISIONS IN THE AFFORDABLE
00:45:09.073 --> 00:45:12.843 region:rollup2
CARE ACT WHICH FILE.
00:45:10.841 --> 00:45:14.812 region:rollup2
TOURISTS AND I THOUGHT THAT'S
00:45:12.843 --> 00:45:15.746 region:rollup2
WORTH POINTING OUT TO YOU OKAY
00:45:14.812 --> 00:45:18.049 region:rollup2
SOMETIMES IT'S DESCRIBED AS IN
00:45:15.746 --> 00:45:19.784 region:rollup2
ON EASY RELATIONSHIP WE COULD
00:45:18.049 --> 00:45:21.252 region:rollup2
SAY THAT THE TWO STATUTES MIGHT.
00:45:19.784 --> 00:45:21.852 region:rollup2
BE SEEN AS NOT PERFECTLY DOVE
00:45:21.252 --> 00:45:23.521 region:rollup2
TAILING MIGHT BE A WAY TO PUT
00:45:21.852 --> 00:45:24.255 region:rollup2
IT.
00:45:23.521 --> 00:45:25.923 region:rollup2
OKAY SO.
00:45:24.255 --> 00:45:26.991 region:rollup2
.
00:45:25.923 --> 00:45:27.558 region:rollup2
WHAT DOES THAT MEAN AS A
00:45:26.991 --> 00:45:28.492 region:rollup2
PRACTICAL MATTER THAT MEANS
00:45:27.558 --> 00:45:31.963 region:rollup2
THAT?
00:45:28.492 --> 00:45:33.331 region:rollup2
?
00:45:31.963 --> 00:45:34.265 region:rollup2
IT DID AMENDED SO THAT THERE ARE
00:45:33.331 --> 00:45:35.366 region:rollup2
RULES RELATING TO THE
00:45:34.265 --> 00:45:36.701 region:rollup2
PROHIBITION OF PRE EXISTING
00:45:35.366 --> 00:45:38.669 region:rollup2
CONDITIONS THAT PROHIBIT
00:45:36.701 --> 00:45:40.037 region:rollup2
LIFETIME AND ANNUAL DOLLAR
00:45:38.669 --> 00:45:42.139 region:rollup2
LIMITS FOR ESSENTIAL BENEFITS.
00:45:40.037 --> 00:45:43.774 region:rollup2
SOME RESTRAINTS ON RECISIONS OF
00:45:42.139 --> 00:45:45.743 region:rollup2
INSURANCE POLICIES ON RECORD
00:45:43.774 --> 00:45:46.844 region:rollup2
COVERED STANDARDS BUT THERE ARE
00:45:45.743 --> 00:45:48.446 region:rollup2
OTHER THINGS THAT WERE NOT
00:45:46.844 --> 00:45:50.781 region:rollup2
CHANGED THOSE OF YOU WHO HAVE
00:45:48.446 --> 00:45:51.682 region:rollup2
EVER WONDERED WHY. IT MATTERS
00:45:50.781 --> 00:45:53.317 region:rollup2
WHETHER OR NOT SOMETHING IS
00:45:51.682 --> 00:45:54.452 region:rollup2
INTEREST QUALIFY PLAN WHETHER OR
00:45:53.317 --> 00:45:56.187 region:rollup2
NOT THE MINIMUM ESSENTIAL
00:45:54.452 --> 00:45:57.655 region:rollup2
BENEFIT STANDARD APPLIES THAT'S
00:45:56.187 --> 00:46:00.458 region:rollup2
A RISK.
00:45:57.655 --> 00:46:02.093 region:rollup2
pORISSA.
00:46:00.458 --> 00:46:03.327 region:rollup2
DIVIDING ALL EMPLOYER SPONSORED
00:46:02.093 --> 00:46:06.030 region:rollup2
HEALTH INSURANCE.
00:46:03.327 --> 00:46:08.332 region:rollup2
WHO SETS?
00:46:06.030 --> 00:46:09.333 region:rollup2
OKAY THOSE THAT WILL RECEIVE THE
00:46:08.332 --> 00:46:10.768 region:rollup2
MINIMUM ESSENTIAL BENEFITS
00:46:09.333 --> 00:46:11.369 region:rollup2
REQUIREMENT AND THOSE THAT ARE
00:46:10.768 --> 00:46:13.204 region:rollup2
OUTSIDE OF IT AND EXEMPT FROM
00:46:11.369 --> 00:46:14.071 region:rollup2
IT.
00:46:13.204 --> 00:46:15.439 region:rollup2
SO THE MOST RELEVANT QUESTION
00:46:14.071 --> 00:46:16.741 region:rollup2
YOU CAN ASK WHEN YOU LOOK AT THE
00:46:15.439 --> 00:46:18.009 region:rollup2
AFFORDABLE CARE ACT THE MINIMUM
00:46:16.741 --> 00:46:19.377 region:rollup2
ESSENTIAL BENEFIT STANDARD IS.
00:46:18.009 --> 00:46:21.412 region:rollup2
US INTERESTS.
00:46:19.377 --> 00:46:22.980 region:rollup2
QUALIFY PLAN.
00:46:21.412 --> 00:46:24.682 region:rollup2
THE MINIMUM ESSENTIAL BENEFIT
00:46:22.980 --> 00:46:26.884 region:rollup2
REQUIREMENTS DO NOT APPLY.
00:46:24.682 --> 00:46:27.818 region:rollup2
TO A SELF FUNDED PLAN SO I
00:46:26.884 --> 00:46:28.919 region:rollup2
THOUGHT MAYBE I SHOULD SAY A
00:46:27.818 --> 00:46:29.687 region:rollup2
LITTLE BIT MORE ABOUT. WHAT THAT
00:46:28.919 --> 00:46:32.123 region:rollup2
IS?
00:46:29.687 --> 00:46:32.857 region:rollup2
OKAY.
00:46:32.123 --> 00:46:34.225 region:rollup2
N THE PRIVATE SECTOR THE
00:46:32.857 --> 00:46:36.560 region:rollup2
DIFFERENCE BETWEEN A FULLY
00:46:34.225 --> 00:46:38.462 region:rollup2
INSURED AND A SELF INSURED
00:46:36.560 --> 00:46:39.330 region:rollup2
HEALTH PLAN SO OFTEN HEARD SURE
00:46:38.462 --> 00:46:40.531 region:rollup2
TO HEALTH PLAN IS WHERE AN
00:46:39.330 --> 00:46:42.466 region:rollup2
UNSURE WHERE AN EMPLOYER
00:46:40.531 --> 00:46:44.535 region:rollup2
TYPICALLY. VERY LARGE EMPLOYER
00:46:42.466 --> 00:46:45.369 region:rollup2
BUT INCREASINGLY CREEPING DOWN
00:46:44.535 --> 00:46:47.738 region:rollup2
WHEN I SAY VERY LARGE I MEAN
00:46:45.369 --> 00:46:49.740 region:rollup2
FIVE HUNDRED PLUS. EMPLOYEES.
00:46:47.738 --> 00:46:50.341 region:rollup2
BUT CREEPING DOWN.
00:46:49.740 --> 00:46:51.008 region:rollup2
FOR REASONS WILL DISCUSS IN A
00:46:50.341 --> 00:46:53.711 region:rollup2
SECOND.
00:46:51.008 --> 00:46:55.646 region:rollup2
ASSUME RISK.
00:46:53.711 --> 00:46:58.115 region:rollup2
THEY FUNCTION AS THEIR OWN
00:46:55.646 --> 00:46:59.984 region:rollup2
HEALTH INSURANCE COMPANY.
00:46:58.115 --> 00:47:00.985 region:rollup2
WHEN I SAY ASSUME RISK THAT
00:46:59.984 --> 00:47:02.553 region:rollup2
MEANS THEY HAVEN'T SHIFTED THE
00:47:00.985 --> 00:47:04.555 region:rollup2
RISK. OKAY OF EXTRAORDINARY
00:47:02.553 --> 00:47:05.990 region:rollup2
HEALTHCARE COSTS.
00:47:04.555 --> 00:47:07.992 region:rollup2
PERHAPS SHOWING UP IN THEIR
00:47:05.990 --> 00:47:10.261 region:rollup2
POPULATION RIGHT IN THEIR RISK
00:47:07.992 --> 00:47:11.662 region:rollup2
POOL ON TO ANYONE ELSE.
00:47:10.261 --> 00:47:12.863 region:rollup2
THE ONLY WAY THEY KIND OF
00:47:11.662 --> 00:47:13.698 region:rollup2
STRATEGIZE AROUND AS A BY
00:47:12.863 --> 00:47:14.899 region:rollup2
PRODUCT CALLED STOP LOSS
00:47:13.698 --> 00:47:15.466 region:rollup2
INSURANCE
00:47:14.899 --> 00:47:16.834 region:rollup2
WHICH IS JUST WHAT AT TIMES
00:47:15.466 --> 00:47:17.902 region:rollup2
LIKE.
00:47:16.834 --> 00:47:18.669 region:rollup2
RIGHT AND SOME OF YOU MAY KNOW
00:47:17.902 --> 00:47:20.137 region:rollup2
SOMETHING ABOUT OF BECAUSE THE
00:47:18.669 --> 00:47:21.639 region:rollup2
CALIFORNIA LEGISLATURE HAS GIVEN
00:47:20.137 --> 00:47:23.040 region:rollup2
SOME THOUGHT. TO CHANGING
00:47:21.639 --> 00:47:24.208 region:rollup2
CALIFORNIA LAW AND STOP LOSS
00:47:23.040 --> 00:47:26.343 region:rollup2
INSURANCE NEW YORK HAS JUST
00:47:24.208 --> 00:47:28.879 region:rollup2
CHANGED ITS LAW I BELIEVE
00:47:26.343 --> 00:47:30.247 region:rollup2
WISCONSIN AS WELL. ALRIGHT SO
00:47:28.879 --> 00:47:32.350 region:rollup2
STOP LOSS INSURANCE IS LIKE A
00:47:30.247 --> 00:47:33.884 region:rollup2
STOP GAP RIGHT IN CASE THE MAN
00:47:32.350 --> 00:47:35.453 region:rollup2
WITH THE ACTUAL SKULL AS WE SAY
00:47:33.884 --> 00:47:36.387 region:rollup2
LAW SCHOOL SHOWS UP IN YOUR. IN
00:47:35.453 --> 00:47:37.521 region:rollup2
YOUR RISK POOL OTHER THAN THAT
00:47:36.387 --> 00:47:40.858 region:rollup2
YOU'RE FUNCTIONING AS YOUR OWN
00:47:37.521 --> 00:47:42.226 region:rollup2
RISK PARA. EMPLOYEES DO NOT KNOW
00:47:40.858 --> 00:47:43.427 region:rollup2
THAT THIS IS HOW IT IS WORKING
00:47:42.226 --> 00:47:45.196 region:rollup2
BECAUSE YOU HIRE AN INSURANCE
00:47:43.427 --> 00:47:47.398 region:rollup2
COMPANY JUST TO ADMINISTER THE
00:47:45.196 --> 00:47:48.299 region:rollup2
BENEFITS AND THEY PUT OUT A CARD
00:47:47.398 --> 00:47:49.967 region:rollup2
THAT LOOKS JUST LIKE AN
00:47:48.299 --> 00:47:51.669 region:rollup2
INSURANCE CARD. THAT THEY WOULD
00:47:49.967 --> 00:47:52.269 region:rollup2
PUT OUT IF THEY WERE RUNNING THE
00:47:51.669 --> 00:47:53.437 region:rollup2
INSURANCE PROGRAM IT WILL SAY
00:47:52.269 --> 00:47:55.473 region:rollup2
LIKE.
00:47:53.437 --> 00:47:57.675 region:rollup2
AETNA ON IT SO TYPICALLY
00:47:55.473 --> 00:47:59.710 region:rollup2
EMPLOYEES HAVE NO IDEA.
00:47:57.675 --> 00:48:01.312 region:rollup2
BUT THIS IS WHAT THEY HAVE AND
00:47:59.710 --> 00:48:02.346 region:rollup2
THEN EXPLAIN TO ME HOW THEY FIND
00:48:01.312 --> 00:48:05.216 region:rollup2
OUT IN A MINUTE.
00:48:02.346 --> 00:48:06.484 region:rollup2
THE OTHER SIDE OF IT IS THAT SO
00:48:05.216 --> 00:48:07.017 region:rollup2
EMPLOYER COULD CHOOSE TO
00:48:06.484 --> 00:48:08.753 region:rollup2
ESSENTIALLY CONTRACT WITH
00:48:07.017 --> 00:48:10.221 region:rollup2
INSURANCE.
00:48:08.753 --> 00:48:11.122 region:rollup2
RIGHT BIG RISK GOES TO THE
00:48:10.221 --> 00:48:12.456 region:rollup2
INSURANCE COMPANY EVERYONE
00:48:11.122 --> 00:48:13.991 region:rollup2
UNDERSTANDS THAT RIGHT IF I HAVE
00:48:12.456 --> 00:48:15.659 region:rollup2
THE MAN WITH THE ACTUAL SCRAWL.
00:48:13.991 --> 00:48:17.428 region:rollup2
AND HIS WIFE AN OLDER LITTLE
00:48:15.659 --> 00:48:18.929 region:rollup2
EGGSHELL CHILDREN RIGHT AND THE
00:48:17.428 --> 00:48:20.598 region:rollup2
ONLY ONE HUMPTY DUMPTY
00:48:18.929 --> 00:48:22.199 region:rollup2
REPLACEMENTS OKAY.
00:48:20.598 --> 00:48:23.834 region:rollup2
IN THE NEXT YOU KNOW FISCAL
00:48:22.199 --> 00:48:24.969 region:rollup2
QUARTER WHATEVER THE RISK IS ON
00:48:23.834 --> 00:48:27.071 region:rollup2
YOU.
00:48:24.969 --> 00:48:28.105 region:rollup2
INSURANCE COMPANY RAY I'M NOT
00:48:27.071 --> 00:48:29.473 region:rollup2
TAKING THAT RISK YOU TOOK THAT
00:48:28.105 --> 00:48:30.908 region:rollup2
RISK
00:48:29.473 --> 00:48:32.710 region:rollup2
OKAY WHEN YOU WROTE THE POLICY
00:48:30.908 --> 00:48:35.679 region:rollup2
OR THE CONTRACT WITH ME.
00:48:32.710 --> 00:48:36.981 region:rollup2
NOW THE DIFFERENCES IS THAT RISA
00:48:35.679 --> 00:48:40.217 region:rollup2
PUTS OUTSIDE OF REGULATION THE
00:48:36.981 --> 00:48:40.885 region:rollup2
ONE THAT'S CALLED SELF INSURED.
00:48:40.217 --> 00:48:42.019 region:rollup2
OUTSIDE OF WHAT KIND OF
00:48:40.885 --> 00:48:44.054 region:rollup2
REGULATION ESSENTIALLY OUTSIDE
00:48:42.019 --> 00:48:45.489 region:rollup2
OF STATE REGULATION.
00:48:44.054 --> 00:48:47.258 region:rollup2
ALL THOSE REGULATIONS A CANNON
00:48:45.489 --> 00:48:48.292 region:rollup2
REQUIRED BENEFITS SPECIFIC
00:48:47.258 --> 00:48:50.494 region:rollup2
BENEFITS BE ADDED.
00:48:48.292 --> 00:48:52.296 region:rollup2
RIGHT ALL OF THAT.
00:48:50.494 --> 00:48:53.531 region:rollup2
SOMETIMES O. EMPLOYERS AND I
00:48:52.296 --> 00:48:55.432 region:rollup2
KNOW YOU'LL APPRECIATE THAT DEFY
00:48:53.531 --> 00:48:57.134 region:rollup2
TALK INSURANCE TALK IT'S BECAUSE
00:48:55.432 --> 00:48:59.170 region:rollup2
OF OR EVEN KNOW WHAT IT SOUNDS
00:48:57.134 --> 00:49:00.171 region:rollup2
LIKE. A WILL REFER THIS TO AS
00:48:59.170 --> 00:49:02.039 region:rollup2
REGULATORY BURDEN.
00:49:00.171 --> 00:49:03.541 region:rollup2
ALRIGHT.
00:49:02.039 --> 00:49:04.742 region:rollup2
AND YOU CAN IMAGINE THE BIGGEST
00:49:03.541 --> 00:49:06.243 region:rollup2
REGULATORY BURDEN OF ALL WOULD
00:49:04.742 --> 00:49:07.878 region:rollup2
HAVE BEEN WHAT THE MINIMUM
00:49:06.243 --> 00:49:10.581 region:rollup2
ESSENTIAL. BENEFITS REQUIREMENTS
00:49:07.878 --> 00:49:11.048 region:rollup2
OF THE ACA THAT IS THE LIST
00:49:10.581 --> 00:49:12.082 region:rollup2
CONGRESS DELEGATED THE
00:49:11.048 --> 00:49:13.417 region:rollup2
AUTHORITY.
00:49:12.082 --> 00:49:14.919 region:rollup2
TO WHAT'S NOW CALLED WHAT THE
00:49:13.417 --> 00:49:17.922 region:rollup2
INSTITUTE OF MEDICINE TO PRODUCE
00:49:14.919 --> 00:49:19.790 region:rollup2
A LIST CONTRACEPTIVES FOR WOMEN
00:49:17.922 --> 00:49:21.225 region:rollup2
YOU NOKIA TRICK RIGHT. POST A
00:49:19.790 --> 00:49:22.426 region:rollup2
LIST FOR MEN WOMEN CHILDREN OF
00:49:21.225 --> 00:49:23.928 region:rollup2
ALL THE MINIMUM ESSENTIAL
00:49:22.426 --> 00:49:25.429 region:rollup2
BENEFITS YOU COULDN'T CALLED
00:49:23.928 --> 00:49:27.231 region:rollup2
INSURANCE UNLESS IT.
00:49:25.429 --> 00:49:28.599 region:rollup2
HAD AT THEIR THEIR RIGHT FOR
00:49:27.231 --> 00:49:28.999 region:rollup2
THAT YOU COULD BUY WHAT HEALTH
00:49:28.599 --> 00:49:30.267 region:rollup2
INSURANCE WITHOUT
00:49:28.999 --> 00:49:32.236 region:rollup2
HOSPITALIZATION. HEALTH
00:49:30.267 --> 00:49:33.537 region:rollup2
INSURANCE WITHOUT A DRUG.
00:49:32.236 --> 00:49:35.639 region:rollup2
OUR HELL TO TRANSFER THEM
00:49:33.537 --> 00:49:37.174 region:rollup2
ATTORNEY COVERAGE.
00:49:35.639 --> 00:49:38.909 region:rollup2
RIGHT HEALTH INSURANCE WITH.
00:49:37.174 --> 00:49:40.711 region:rollup2
LIFETIME CAP OF FIVE THOUSAND
00:49:38.909 --> 00:49:42.780 region:rollup2
DOLLARS A EVERY POSSIBLE
00:49:40.711 --> 00:49:44.215 region:rollup2
PERMUTATION WAS OUT THERE OKAY
00:49:42.780 --> 00:49:46.317 region:rollup2
SO THE SOURCE OF THIS IS WHAT
00:49:44.215 --> 00:49:48.686 region:rollup2
HEALTH INSURER SHOULD LOOK LIKE
00:49:46.317 --> 00:49:49.220 region:rollup2
IMPORTED IT. YOU KNOW BE WITHIN
00:49:48.686 --> 00:49:50.321 region:rollup2
THE PROPER TERM FOR HEALTH
00:49:49.220 --> 00:49:52.289 region:rollup2
INSURANCE.
00:49:50.321 --> 00:49:54.525 region:rollup2
NO SUCH RULES.
00:49:52.289 --> 00:49:56.126 region:rollup2
ON THE A RISA.
00:49:54.525 --> 00:49:57.695 region:rollup2
RIGHT FULLY INSURED PLANTS NOW
00:49:56.126 --> 00:49:59.363 region:rollup2
THE VERY LARGEST EMPLOYERS CAN
00:49:57.695 --> 00:50:01.165 region:rollup2
WE THINK BOEING FOR A MINUTE
00:49:59.363 --> 00:50:03.167 region:rollup2
OKAY. YOU UNDERSTAND THEY MIGHT
00:50:01.165 --> 00:50:04.401 region:rollup2
OFFER VARIOUS PRODUCTS AND SOME
00:50:03.167 --> 00:50:06.136 region:rollup2
MIGHT BE SELF INSURED AND SOME
00:50:04.401 --> 00:50:07.238 region:rollup2
MIGHT BE FULLY INSURED TO SO
00:50:06.136 --> 00:50:08.405 region:rollup2
YOU'LL BE READY FOR MY ADVANCE
00:50:07.238 --> 00:50:10.074 region:rollup2
TO RECEIVE SOME OF OUR SOMEDAY.
00:50:08.405 --> 00:50:11.775 region:rollup2
YOU'LL IS ALSO NOT ALL EMPLOYERS
00:50:10.074 --> 00:50:12.877 region:rollup2
ARE INTO GROUPS SOME YOU KNOW
00:50:11.775 --> 00:50:14.245 region:rollup2
OUR FRIEND ONE FROM A ONE FROM
00:50:12.877 --> 00:50:15.913 region:rollup2
DEEP APPLYING LARGE ITS KEEP IT
00:50:14.245 --> 00:50:17.815 region:rollup2
SIMPLE TODAY. THE SORT OF OFF
00:50:15.913 --> 00:50:18.816 region:rollup2
INTO GROUPS IMMACULATE WHITE
00:50:17.815 --> 00:50:19.416 region:rollup2
SHOE TERMINUS.
00:50:18.816 --> 00:50:21.118 region:rollup2
BECAUSE IT TURNS OUT THAT AT
00:50:19.416 --> 00:50:23.120 region:rollup2
LEAST FIFTY PERCENT.
00:50:21.118 --> 00:50:23.954 region:rollup2
OF OF CALIFORNIANS.
00:50:23.120 --> 00:50:26.290 region:rollup2
PROBABLY CLOSER TO SIXTY
00:50:23.954 --> 00:50:28.959 region:rollup2
SEVENTY.
00:50:26.290 --> 00:50:33.464 region:rollup2
OKAY ARE IN A GARISSA SELF
00:50:28.959 --> 00:50:34.598 region:rollup2
INSURED COVERAGE.
00:50:33.464 --> 00:50:36.300 region:rollup2
NUMBER I SAID IT DOESN'T MATTER
00:50:34.598 --> 00:50:38.969 region:rollup2
IF YOU DON'T KNOW IT.
00:50:36.300 --> 00:50:39.904 region:rollup2
YOU STILL ARE.
00:50:38.969 --> 00:50:40.871 region:rollup2
ALRIGHT HOW DO YOU FIND OUT YOU
00:50:39.904 --> 00:50:42.673 region:rollup2
FIND IT BECAUSE THE RULES ARE
00:50:40.871 --> 00:50:44.542 region:rollup2
DIFFERENT ABOUT APPEALS ON
00:50:42.673 --> 00:50:45.843 region:rollup2
COVERAGE LIMITATIONS OF IT A LOT
00:50:44.542 --> 00:50:48.078 region:rollup2
LOTS AND LOTS OF WAYS YOU FIND
00:50:45.843 --> 00:50:49.480 region:rollup2
OUT. OF SHAPE WHEN YOU NEED TO
00:50:48.078 --> 00:50:50.514 region:rollup2
KNOW BELIEVE ME YOU FIND OUT.
00:50:49.480 --> 00:50:52.616 region:rollup2
ALRIGHT SO WHERE DOES THAT MEAN
00:50:50.514 --> 00:50:54.084 region:rollup2
PRACTICALLY IT MEANS THAT THERE
00:50:52.616 --> 00:50:55.719 region:rollup2
ARE VAST NUMBERS OF PEOPLE WHO
00:50:54.084 --> 00:50:56.186 region:rollup2
ALREADY ESSENTIALLY INSULATED
00:50:55.719 --> 00:50:58.355 region:rollup2
FROM CALIFORNIA STATE
00:50:56.186 --> 00:50:59.723 region:rollup2
REGULATION.
00:50:58.355 --> 00:51:01.191 region:rollup2
OF THE EMPLOYER SPONSORED HEALTH
00:50:59.723 --> 00:51:03.093 region:rollup2
INSURANCE OF THEIR IN.
00:51:01.191 --> 00:51:04.728 region:rollup2
ALRIGHT.
00:51:03.093 --> 00:51:06.363 region:rollup2
AYE AND THE REASON WHY THAT
00:51:04.728 --> 00:51:07.765 region:rollup2
MATTERS IS THAT SO TO TRY AND
00:51:06.363 --> 00:51:08.232 region:rollup2
BRING THEM BACK INSIDE THE TENT
00:51:07.765 --> 00:51:10.000 region:rollup2
YOU SEE WOULD REQUIRE
00:51:08.232 --> 00:51:10.868 region:rollup2
ESSENTIALLY.
00:51:10.000 --> 00:51:13.337 region:rollup2
FLYING FULL IN THE FACE.
00:51:10.868 --> 00:51:14.471 region:rollup2
OVERSEE.
00:51:13.337 --> 00:51:16.607 region:rollup2
NOW THE AFFORDABLE CARE ACT DID
00:51:14.471 --> 00:51:18.609 region:rollup2
NOTHING TO BREAK UP THIS IDEA OF
00:51:16.607 --> 00:51:20.311 region:rollup2
WE SORT. EMPLOYER SPONSORED
00:51:18.609 --> 00:51:21.845 region:rollup2
HEALTH COVERAGE BY THESE TWO
00:51:20.311 --> 00:51:22.880 region:rollup2
WAYS THAT'S WHY I GAVE YOU THE
00:51:21.845 --> 00:51:25.282 region:rollup2
EXAMPLE OF THE MINIMUM ESSENTIAL
00:51:22.880 --> 00:51:26.216 region:rollup2
BENEFITS IT BALLOTS TO.
00:51:25.282 --> 00:51:27.851 region:rollup2
OKAY SO IT'S NOT LIKE WILL THE
00:51:26.216 --> 00:51:29.119 region:rollup2
ACA BROKE THAT SO MAYBE WE COULD
00:51:27.851 --> 00:51:30.754 region:rollup2
BREAK THAT TO KNOW IT DOESN'T
00:51:29.119 --> 00:51:33.123 region:rollup2
BREAK IT AT ALL.
00:51:30.754 --> 00:51:34.825 region:rollup2
IN MANY WAYS THE ACA IS
00:51:33.123 --> 00:51:36.927 region:rollup2
INCREMENTAL STE COVERAGE.
00:51:34.825 --> 00:51:38.595 region:rollup2
AND THIS IS A GOOD EXAMPLE.
00:51:36.927 --> 00:51:40.798 region:rollup2
OKAY BECAUSE THERE'S NOT A LOT
00:51:38.595 --> 00:51:42.266 region:rollup2
OF RATIONALITY TO THIS DIVISION
00:51:40.798 --> 00:51:43.701 region:rollup2
ALRIGHT BUT THERE'S A LONG
00:51:42.266 --> 00:51:45.002 region:rollup2
HISTORY.
00:51:43.701 --> 00:51:47.871 region:rollup2
OF HONORING THIS DIVISION FOR
00:51:45.002 --> 00:51:49.306 region:rollup2
OTHER PURPOSES.
00:51:47.871 --> 00:51:51.342 region:rollup2
SO I AYE THOUGHT MIGHT BE
00:51:49.306 --> 00:51:53.344 region:rollup2
INTERESTING TO LOOKS.
00:51:51.342 --> 00:51:55.179 region:rollup2
TALK ABOUT.
00:51:53.344 --> 00:51:56.213 region:rollup2
WHAT'S LEFT TO THE STATE.
00:51:55.179 --> 00:51:57.848 region:rollup2
OKAY DIFFERENCE A COMES INTO THE
00:51:56.213 --> 00:52:00.551 region:rollup2
ROOM.
00:51:57.848 --> 00:52:02.119 region:rollup2
WHAT'S LEFT. ANY. WELL YOU THE
00:52:00.551 --> 00:52:03.454 region:rollup2
STATE'S MAKE TAX AND REGULATE
00:52:02.119 --> 00:52:05.022 region:rollup2
TRADITIONAL INSURERS PERFORMING
00:52:03.454 --> 00:52:06.056 region:rollup2
TRADITIONAL INSURANCE FUNCTIONS
00:52:05.022 --> 00:52:08.092 region:rollup2
YES I WROTE A SENTENCE WITH
00:52:06.056 --> 00:52:09.126 region:rollup2
TRADITIONAL AND IT TWICE.
00:52:08.092 --> 00:52:11.095 region:rollup2
BECAUSE THE CASE LAW HAS BEEN
00:52:09.126 --> 00:52:12.830 region:rollup2
VERY CLEAR.
00:52:11.095 --> 00:52:14.198 region:rollup2
I'M TALKING ABOUT THE CLASSIC
00:52:12.830 --> 00:52:15.733 region:rollup2
FUNCTIONS OF THE STATE AND RATED
00:52:14.198 --> 00:52:17.368 region:rollup2
INSURANCE DO YOU HAVE TO HAVE A
00:52:15.733 --> 00:52:18.836 region:rollup2
LICENSE TO SELL.
00:52:17.368 --> 00:52:20.437 region:rollup2
INSURANCE IN THIS JURISDICTION
00:52:18.836 --> 00:52:21.905 region:rollup2
TO OUR BROKERS AND AGENTS HAVE
00:52:20.437 --> 00:52:23.440 region:rollup2
TO BE LICENSE
00:52:21.905 --> 00:52:24.942 region:rollup2
OTHER CAPITALIZATION
00:52:23.440 --> 00:52:26.710 region:rollup2
REQUIREMENTS WHAT ARE THAT YOU
00:52:24.942 --> 00:52:29.513 region:rollup2
SEE THAT MOST COR.
00:52:26.710 --> 00:52:30.681 region:rollup2
RIGHT IT I CALL IT THE BUSINESS
00:52:29.513 --> 00:52:31.782 region:rollup2
SHARON'S AND THAT IT'S A TERM
00:52:30.681 --> 00:52:32.916 region:rollup2
THAT GETS REPEATED OVER AND OVER
00:52:31.782 --> 00:52:36.020 region:rollup2
AGAIN IN THE CASE OF.
00:52:32.916 --> 00:52:37.788 region:rollup2
REGULATING IT AS A BUSINESS.
00:52:36.020 --> 00:52:38.889 region:rollup2
ALRIGHT AS A BUSINESS ENTITY.
00:52:37.788 --> 00:52:40.824 region:rollup2
YOU CAN REGULATE MULTIPLE
00:52:38.889 --> 00:52:44.361 region:rollup2
EMPLOYER WELFARE ARRANGEMENTS
00:52:40.824 --> 00:52:47.331 region:rollup2
WELL WHAT ARE THOSE SAY. AMAZON.
00:52:44.361 --> 00:52:49.800 region:rollup2
AND JP MORGAN. AND BERKSHIRE
00:52:47.331 --> 00:52:51.468 region:rollup2
HATHAWAY WANTED TO COMBINE ALL
00:52:49.800 --> 00:52:53.404 region:rollup2
OF THEIR COVERED LIVES ONE
00:52:51.468 --> 00:52:55.439 region:rollup2
MILLION OR SO AND FORMA MULTI
00:52:53.404 --> 00:52:57.808 region:rollup2
EMPLOYER HEALTH INSURANCE PLAN.
00:52:55.439 --> 00:52:58.876 region:rollup2
IT'S MY SECOND BOOK.
00:52:57.808 --> 00:52:59.443 region:rollup2
ALRIGHT BETTING ON HOW TO SET IT
00:52:58.876 --> 00:53:00.844 region:rollup2
UP BUT THAT THAT'S WHERE IT
00:52:59.443 --> 00:53:03.147 region:rollup2
WOULD REST.
00:53:00.844 --> 00:53:04.615 region:rollup2
OKAY.
00:53:03.147 --> 00:53:06.116 region:rollup2
REGULAR HOSPITAL RATES CHARGED
00:53:04.615 --> 00:53:07.584 region:rollup2
TO INSURERS ANOTHER TO PAY
00:53:06.116 --> 00:53:09.253 region:rollup2
HEALTH CARE BILLS THE CONTAX
00:53:07.584 --> 00:53:10.320 region:rollup2
HEALTH CARE PROVIDERS YOU CAN
00:53:09.253 --> 00:53:12.256 region:rollup2
PROVIDE REMEDIES FOR INJURIES
00:53:10.320 --> 00:53:13.257 region:rollup2
WHEN THE HEALTH PLAN CONTROLS
00:53:12.256 --> 00:53:14.992 region:rollup2
MEDICAL CARE DELIVERY IN OTHER
00:53:13.257 --> 00:53:16.360 region:rollup2
WORDS. IT DOESN'T TAKE AWAY
00:53:14.992 --> 00:53:17.361 region:rollup2
TRADITIONAL MED MAL CASE YOU
00:53:16.360 --> 00:53:19.163 region:rollup2
NEED TO UNDERSTAND ONE ARREST
00:53:17.361 --> 00:53:19.863 region:rollup2
WAS FIRST PASSED SOME PEOPLE
00:53:19.163 --> 00:53:21.632 region:rollup2
THOUGHT IT FEDERAL EYES MET
00:53:19.863 --> 00:53:23.801 region:rollup2
BALBOA. NEVER ACTUALLY HAD TO BE
00:53:21.632 --> 00:53:25.202 region:rollup2
LITIGATION OVER TO TO JUST TAKE
00:53:23.801 --> 00:53:28.038 region:rollup2
THE AUTHORITY TO HAVE DIFFERENT
00:53:25.202 --> 00:53:29.339 region:rollup2
STANDARDS FOR MEN. YOU KNOW UP
00:53:28.038 --> 00:53:31.275 region:rollup2
UP TO CONGRESS ALRIGHT.
00:53:29.339 --> 00:53:32.376 region:rollup2
SO WHAT CAN'T THE STATE'S DO.
00:53:31.275 --> 00:53:34.545 region:rollup2
BECAUSE WE'RE ALSO INTERESTED IN
00:53:32.376 --> 00:53:35.546 region:rollup2
THE WHAT NOT TO WEAR RIGHT.
00:53:34.545 --> 00:53:37.181 region:rollup2
CAN'T THEY DO THEY CAN'T
00:53:35.546 --> 00:53:38.682 region:rollup2
DIRECTLY REGULATE PRIVATE
00:53:37.181 --> 00:53:42.186 region:rollup2
EMPLOYER SPONSORED HEALTH PLANS
00:53:38.682 --> 00:53:43.754 region:rollup2
I CANNOT SAY. YOU. MUST DO THIS
00:53:42.186 --> 00:53:45.155 region:rollup2
WITHIN YOUR PLAN ALRIGHT THE
00:53:43.754 --> 00:53:47.024 region:rollup2
PURPOSE OF A RISK IS WHAT TO
00:53:45.155 --> 00:53:48.692 region:rollup2
STANDARDIZE.
00:53:47.024 --> 00:53:49.727 region:rollup2
AND THEN ALSO I CALL IT IT'S NOT
00:53:48.692 --> 00:53:51.895 region:rollup2
REALLY AWARE BUT SORT OF
00:53:49.727 --> 00:53:53.997 region:rollup2
FIDUCIARY AYE. RIGHT IT'S ABOUT
00:53:51.895 --> 00:53:55.532 region:rollup2
HAVING QUALITY ADMINISTRATION
00:53:53.997 --> 00:53:57.000 region:rollup2
RIGHT MANDATE THAT YOU CANNOT
00:53:55.532 --> 00:53:58.669 region:rollup2
MANDATE THE PRIVATE EMPLOYERS
00:53:57.000 --> 00:54:00.404 region:rollup2
OFFER A PAY FOR INSURANCE.
00:53:58.669 --> 00:54:01.805 region:rollup2
RIGHT PROBABLY CAN'T TAX PRIVATE
00:54:00.404 --> 00:54:04.074 region:rollup2
EMPLOYER PRO CLEAR SPONSORED
00:54:01.805 --> 00:54:05.509 region:rollup2
HEALTH PLANS THEMSELVES.
00:54:04.074 --> 00:54:06.009 region:rollup2
AND YOU CAN'T REGULATE SELF
00:54:05.509 --> 00:54:07.377 region:rollup2
INSURED PRIVATE EMPLOYEE
00:54:06.009 --> 00:54:11.315 region:rollup2
BENEFITS
00:54:07.377 --> 00:54:13.984 region:rollup2
OR FINANCIAL SOLVENCY.
00:54:11.315 --> 00:54:15.786 region:rollup2
SO EVERYTHING AFTER THIS IS SO
00:54:13.984 --> 00:54:17.421 region:rollup2
WE ARE ON THE LINE BETWEEN WHAT
00:54:15.786 --> 00:54:19.256 region:rollup2
THE STATE MAY AND MAY NOT TO IS
00:54:17.421 --> 00:54:21.358 region:rollup2
ANYTHING ANYONE WISHES TO.
00:54:19.256 --> 00:54:22.993 region:rollup2
RIGHT IT'S ALL ABOUT ANALOGIZE
00:54:21.358 --> 00:54:24.661 region:rollup2
DOING RIGHT IS ANALOGY MONGERING
00:54:22.993 --> 00:54:25.963 region:rollup2
RIGHT IS IT MORE LIKE THIS ISN'T
00:54:24.661 --> 00:54:27.564 region:rollup2
MORE LIKE THAT AND THAT'S WHERE
00:54:25.963 --> 00:54:29.266 region:rollup2
THE CASE LOGOS AND THAT'S
00:54:27.564 --> 00:54:29.833 region:rollup2
ACTUALLY WHAT THE SUPREME COURT
00:54:29.266 --> 00:54:30.634 region:rollup2
SPECIALIZES IN DOING IN THIS
00:54:29.833 --> 00:54:32.903 region:rollup2
AREA.
00:54:30.634 --> 00:54:34.171 region:rollup2
OKAY SO WHAT HAPPENS IS THAT A
00:54:32.903 --> 00:54:36.140 region:rollup2
RECIPROCAL MERGE DIRECT
00:54:34.171 --> 00:54:37.141 region:rollup2
REGULATION OF EMPLOYER SUPPLANTS
00:54:36.140 --> 00:54:38.742 region:rollup2
BUT IT ALLOWS THE STATE
00:54:37.141 --> 00:54:39.610 region:rollup2
REGULATION OF THE INSURANCE
00:54:38.742 --> 00:54:41.678 region:rollup2
CARRIERS THAT PROVIDE THE
00:54:39.610 --> 00:54:43.881 region:rollup2
COVERAGE.
00:54:41.678 --> 00:54:45.315 region:rollup2
ALRIGHT IT ALLOWS REGULATION OF
00:54:43.881 --> 00:54:46.917 region:rollup2
INSURANCE COVERS BUT CANNOT
00:54:45.315 --> 00:54:49.186 region:rollup2
REACH INTO THE PLANT ITSELF. AS
00:54:46.917 --> 00:54:51.088 region:rollup2
IF TO SAY YOU ARE AN INSURANCE
00:54:49.186 --> 00:54:53.357 region:rollup2
PLAN WE'RE GONNA TREAT YOU LIKE
00:54:51.088 --> 00:54:54.625 region:rollup2
AN INSURANCE PLAN NOW. THAT'S AN
00:54:53.357 --> 00:54:55.659 region:rollup2
EMPLOYER SPONSORED.
00:54:54.625 --> 00:54:57.661 region:rollup2
RAY BENEFITS
00:54:55.659 --> 00:54:59.763 region:rollup2
WELFARE BENEFITS.
00:54:57.661 --> 00:55:01.231 region:rollup2
YOU DON'T GET TO DEMINT
00:54:59.763 --> 00:55:02.733 region:rollup2
AS THE WRESTLING WHICH GOES YOU
00:55:01.231 --> 00:55:05.169 region:rollup2
DON'T GET TO DEMAND AN INSURANCE
00:55:02.733 --> 00:55:07.437 region:rollup2
COMPANY. WHICH IS ACTUALLY WHAT
00:55:05.169 --> 00:55:09.940 region:rollup2
I THINK UNDER MANY PROPOSALS.
00:55:07.437 --> 00:55:11.575 region:rollup2
MIGHT ACTUALLY BE WHAT SOME
00:55:09.940 --> 00:55:13.844 region:rollup2
STATES HAVE TRIED TO DO WHERE'S
00:55:11.575 --> 00:55:15.245 region:rollup2
THE AMBIGUITY REGULATION OF STOP
00:55:13.844 --> 00:55:16.747 region:rollup2
LOSS INSURANCE CALIFORNIA HAS
00:55:15.245 --> 00:55:18.415 region:rollup2
DOUBLED IN THIS IS OF SAID NEW
00:55:16.747 --> 00:55:20.017 region:rollup2
YORK WISCONSIN RECENTLY.
00:55:18.415 --> 00:55:21.652 region:rollup2
INDEPENDENT EXTERNAL REVIEW OF
00:55:20.017 --> 00:55:22.920 region:rollup2
APPEALS PROGRAMS AMBIGUOUS WHERE
00:55:21.652 --> 00:55:24.555 region:rollup2
THE LINE IS.
00:55:22.920 --> 00:55:26.623 region:rollup2
EMPLOYER PAIR PLAY HEALTH CARE
00:55:24.555 --> 00:55:27.791 region:rollup2
PROGRAMS UP REGULATION OF THIRD
00:55:26.623 --> 00:55:29.059 region:rollup2
PARTY ADMINISTRATORS THAT
00:55:27.791 --> 00:55:30.494 region:rollup2
ADMINISTER SELF INSURED PLANS
00:55:29.059 --> 00:55:32.162 region:rollup2
REMEMBER I SAID ONE AETNA IN ITS
00:55:30.494 --> 00:55:33.497 region:rollup2
GUYS OF NOT BEING IMMATURE BUT
00:55:32.162 --> 00:55:34.765 region:rollup2
JUST BEING AN ADMINISTRATOR.
00:55:33.497 --> 00:55:36.900 region:rollup2
RUNS A PLANNING GIVES AT MY
00:55:34.765 --> 00:55:39.269 region:rollup2
CARDS CAN WE REGULATE THEM AS A
00:55:36.900 --> 00:55:40.337 region:rollup2
PROVIDER OF WHAT WE GONNA CALL
00:55:39.269 --> 00:55:42.005 region:rollup2
THAT ADMINISTRATION.
00:55:40.337 --> 00:55:43.540 region:rollup2
SERVICES RIGHT THAT'S TRICKY
00:55:42.005 --> 00:55:46.176 region:rollup2
BECAUSE THEY'RE NOT ASSURE
00:55:43.540 --> 00:55:48.111 region:rollup2
MEMBER ASSEMBLY EMPLOYER CARRIES
00:55:46.176 --> 00:55:48.712 region:rollup2
THE REST THURMOND MINISTRY.
00:55:48.111 --> 00:55:49.913 region:rollup2
THERE HEALTH MINISTER THEY'VE
00:55:48.712 --> 00:55:52.316 region:rollup2
PUSH PAPER
00:55:49.913 --> 00:55:53.650 region:rollup2
OR VIRTUAL FORMS ARE ALRIGHT AND
00:55:52.316 --> 00:55:55.852 region:rollup2
SO YOU CAN SEE WHERE WHERE THE
00:55:53.650 --> 00:55:57.287 region:rollup2
FIGHT GOES FROM THERE.
00:55:55.852 --> 00:55:58.789 region:rollup2
ALRIGHT SO WHAT ABOUT STATE
00:55:57.287 --> 00:56:01.525 region:rollup2
SPECIFIC HEALTH CARE REFORM
00:55:58.789 --> 00:56:02.993 region:rollup2
RIGHT ARM RESTORE MAY.
00:56:01.525 --> 00:56:05.095 region:rollup2
PROHIBIT AN EMPLOYER MANDATE
00:56:02.993 --> 00:56:06.997 region:rollup2
BECAUSE IT RELATES TO EMPLOYER
00:56:05.095 --> 00:56:10.300 region:rollup2
SPONSORED PLANS RECESS LANGUAGE
00:56:06.997 --> 00:56:13.237 region:rollup2
SAYS ANYTHING THAT RELATES TO.
00:56:10.300 --> 00:56:15.005 region:rollup2
OR IS IN RELATION TO EMPLOYER
00:56:13.237 --> 00:56:16.673 region:rollup2
SPONSORED PLANS IT WOULD ALL
00:56:15.005 --> 00:56:18.408 region:rollup2
DEPEND ON ITS CHARACTERISTICS ON
00:56:16.673 --> 00:56:19.776 region:rollup2
HOW FAR YOU COULD PUSH IT TO ONE
00:56:18.408 --> 00:56:21.011 region:rollup2
SIDE OF THE LINE OF THE OTHER.
00:56:19.776 --> 00:56:22.779 region:rollup2
AN INDIVIDUAL MANDATE MEANING
00:56:21.011 --> 00:56:24.448 region:rollup2
PUTTING IT ON WHAT THE
00:56:22.779 --> 00:56:25.782 region:rollup2
INDIVIDUAL INSURED IS MOST
00:56:24.448 --> 00:56:27.050 region:rollup2
LIKELY TO AVOID CHALLENGE THIS
00:56:25.782 --> 00:56:27.885 region:rollup2
IS MY OPINION IF IT MAKES NO
00:56:27.050 --> 00:56:30.687 region:rollup2
REFERENCE TO EMPLOYER SPONSORED
00:56:27.885 --> 00:56:32.723 region:rollup2
HEALTH.
00:56:30.687 --> 00:56:34.124 region:rollup2
RIGHT STAYING FAR AWAY FROM
00:56:32.723 --> 00:56:35.993 region:rollup2
RIGHT THINK OF RESOURCES THE
00:56:34.124 --> 00:56:37.194 region:rollup2
THIRD RAIL IN.
00:56:35.993 --> 00:56:38.762 region:rollup2
DON'T WANT TO TOUCH THE ELECTRIC
00:56:37.194 --> 00:56:40.297 region:rollup2
FENCE OKAY I JUST WELL IF I WANT
00:56:38.762 --> 00:56:41.965 region:rollup2
TO CREATE INDIVIDUAL MANDATE AYE
00:56:40.297 --> 00:56:43.333 region:rollup2
I WANT TO STAY AWAY. FROM
00:56:41.965 --> 00:56:44.468 region:rollup2
TALKING ABOUT NUCLEAR SPONSORED
00:56:43.333 --> 00:56:46.136 region:rollup2
HEALTH PLANS IN PARTICULAR IS MY
00:56:44.468 --> 00:56:47.237 region:rollup2
FOCUS.
00:56:46.136 --> 00:56:48.305 region:rollup2
EVEN TAXES YOU SHOULD KNOW
00:56:47.237 --> 00:56:50.274 region:rollup2
BECAUSE PEOPLE OFTEN THINK OF
00:56:48.305 --> 00:56:52.042 region:rollup2
TAXES IS BEING RELATIVELY WHAT
00:56:50.274 --> 00:56:53.977 region:rollup2
LAWS OF GENERAL APPLICATION.
00:56:52.042 --> 00:56:55.545 region:rollup2
RIGHT IT'S OF WHAT AND THEN
00:56:53.977 --> 00:56:56.780 region:rollup2
THERE IS A RULE THAT SAYS A LOT
00:56:55.545 --> 00:56:58.682 region:rollup2
GENERAL OBLIGATION INCIDENTALLY
00:56:56.780 --> 00:57:00.217 region:rollup2
AFFECTS ON RISA PLAN. SURELY
00:56:58.682 --> 00:57:01.919 region:rollup2
CAN'T BE SEEN AS ATTEMPTING TO
00:57:00.217 --> 00:57:02.486 region:rollup2
REGULATE IN A RESERVE PLAN IN
00:57:01.919 --> 00:57:04.621 region:rollup2
THERE FOR YOU KNOW GETTING
00:57:02.486 --> 00:57:06.256 region:rollup2
ELECTROCUTED BUT EVENTAXES CAN
00:57:04.621 --> 00:57:08.525 region:rollup2
REYES SARISSA PRETENSION. IN
00:57:06.256 --> 00:57:09.559 region:rollup2
CERTAIN CIRCUMSTANCES DEPENDING
00:57:08.525 --> 00:57:10.327 region:rollup2
ON HOW THE ORGANIZED.
00:57:09.559 --> 00:57:11.862 region:rollup2
STATE LAW CONDITIONS TAX
00:57:10.327 --> 00:57:13.397 region:rollup2
ADVANTAGES OR DISADVANTAGES ON
00:57:11.862 --> 00:57:14.731 region:rollup2
PLAN DESIGN FEATURES AND THOSE
00:57:13.397 --> 00:57:16.400 region:rollup2
OF YOU WHO KNOW. WHAT'S
00:57:14.731 --> 00:57:19.036 region:rollup2
SOMETIMES CALLED THE WALMART
00:57:16.400 --> 00:57:19.569 region:rollup2
CASE REALLY THE REAL PATROL CASE
00:57:19.036 --> 00:57:21.538 region:rollup2
OF THE STATE OF MARYLAND A
00:57:19.569 --> 00:57:23.073 region:rollup2
SPIEGLER. OKAY WHERE THE
00:57:21.538 --> 00:57:24.308 region:rollup2
MARYLAND LEGISLATURE. THEY
00:57:23.073 --> 00:57:25.509 region:rollup2
DIDN'T HESITATE TO HAPPEN
00:57:24.308 --> 00:57:26.977 region:rollup2
ELABORATE LEGISLATIVE HISTORY
00:57:25.509 --> 00:57:28.211 region:rollup2
WHERE THEY ESSENTIALLY SAID I
00:57:26.977 --> 00:57:29.947 region:rollup2
HATE WALMART.
00:57:28.211 --> 00:57:30.847 region:rollup2
ON AND WRITTEN REPLETE
00:57:29.947 --> 00:57:32.482 region:rollup2
THROUGHOUT THE LEGISLATIVE
00:57:30.847 --> 00:57:33.417 region:rollup2
HISTORY PASSED A LAW THAT SAID
00:57:32.482 --> 00:57:35.986 region:rollup2
THEY'RE GOING TO HAVE A CERTAIN
00:57:33.417 --> 00:57:37.521 region:rollup2
KIND OF PAPER PLATES TAX OPTION.
00:57:35.986 --> 00:57:38.889 region:rollup2
THE BITE WOULD ONLY BE ON
00:57:37.521 --> 00:57:40.357 region:rollup2
EMPLOYERS ABOVE A CERTAIN SIZE
00:57:38.889 --> 00:57:41.925 region:rollup2
SURPRISE THE ONLY EMPLOYER ABOVE
00:57:40.357 --> 00:57:42.826 region:rollup2
A CERTAIN SIZE IN THE STATE OF
00:57:41.925 --> 00:57:43.927 region:rollup2
MARYLAND WHAT THERE WAS JOHNS
00:57:42.826 --> 00:57:45.996 region:rollup2
HOPKINS BUT THERE WAS A JOHNS
00:57:43.927 --> 00:57:47.531 region:rollup2
HOPKINS EXCEPTION.
00:57:45.996 --> 00:57:49.566 region:rollup2
OTHER THAN THAT WAS WALMART.
00:57:47.531 --> 00:57:50.767 region:rollup2
OKAY A MOMENT WAS LIKE EXCUSE ME
00:57:49.566 --> 00:57:52.069 region:rollup2
YOU KNOW ALL THE SIX LITTLE LIKE
00:57:50.767 --> 00:57:53.437 region:rollup2
THOSE OF YOU WHO ARE ATTORNEYS A
00:57:52.069 --> 00:57:54.972 region:rollup2
BILL OF ATTAINDER. YOU KNOW
00:57:53.437 --> 00:57:57.007 region:rollup2
YOU'VE PASSED THE LAW TO TARGET
00:57:54.972 --> 00:57:59.609 region:rollup2
ONE CORPORATION AND IT COMES
00:57:57.007 --> 00:58:02.312 region:rollup2
FROM AN ANTI WALMART ANIMUS.
00:57:59.609 --> 00:58:04.648 region:rollup2
THIS SURELY CANNOT BE YOU KNOW
00:58:02.312 --> 00:58:05.649 region:rollup2
THE STATE REGULATION RIGHT SO
00:58:04.648 --> 00:58:07.517 region:rollup2
AND OF COURSE OF THAT STATUTE
00:58:05.649 --> 00:58:09.519 region:rollup2
WAS BROUGHT DEBT WAS STRUCK DOWN
00:58:07.517 --> 00:58:11.254 region:rollup2
THE LIGHT THEIR LOT TO TAKE WAYS
00:58:09.519 --> 00:58:12.089 region:rollup2
ONE MIGHT BE. A.
00:58:11.254 --> 00:58:13.156 region:rollup2
PROBABLY BEST NOT TO FILL YOUR
00:58:12.089 --> 00:58:14.858 region:rollup2
LEGISLATIVE HISTORY WITH.
00:58:13.156 --> 00:58:16.994 region:rollup2
.
00:58:14.858 --> 00:58:17.594 region:rollup2
PROTESTATIONS OF HATRED. OKAY OF
00:58:16.994 --> 00:58:18.495 region:rollup2
A PARTICULAR CORPORATE CITIZEN
00:58:17.594 --> 00:58:20.130 region:rollup2
JUST.
00:58:18.495 --> 00:58:22.399 region:rollup2
JUST GUESSING
00:58:20.130 --> 00:58:23.900 region:rollup2
BUT BECAUSE THE COURT WAS THE
00:58:22.399 --> 00:58:25.569 region:rollup2
JUDGE WAS QUITE STRUCK BY THAT
00:58:23.900 --> 00:58:27.170 region:rollup2
AS ANYONE WOULD BE GREAT BUT
00:58:25.569 --> 00:58:28.872 region:rollup2
ANOTHER MIGHT BE THAT HOME SO
00:58:27.170 --> 00:58:30.340 region:rollup2
YOU CAN'T JUST SORT OF KIND OF
00:58:28.872 --> 00:58:31.108 region:rollup2
MONKEY WITH IT TO KINDA.
00:58:30.340 --> 00:58:32.709 region:rollup2
YOU KNOW WE'RE NOT TRYING TO
00:58:31.108 --> 00:58:33.810 region:rollup2
KILL SMALL ENTREPRENEURIAL
00:58:32.709 --> 00:58:35.345 region:rollup2
BUSINESSES WERE TRYING TO YOU
00:58:33.810 --> 00:58:36.813 region:rollup2
KNOW TARGET WHAT WE SEE IS THE
00:58:35.345 --> 00:58:38.548 region:rollup2
BIGGEST OFFENDERS ARE THINGS
00:58:36.813 --> 00:58:39.950 region:rollup2
LIKE THIS. SO EVEN THEN THAT WAS
00:58:38.548 --> 00:58:41.318 region:rollup2
REALLY A TAX
00:58:39.950 --> 00:58:43.820 region:rollup2
BUT ATTACKS FOUND NOT TO BE
00:58:41.318 --> 00:58:44.721 region:rollup2
NEUTRAL RIGHT.
00:58:43.820 --> 00:58:46.390 region:rollup2
SO ONCE I GOT A COUPLE OF OTHER
00:58:44.721 --> 00:58:47.824 region:rollup2
CASES BEYOND FIEDLER IF YOU WANT
00:58:46.390 --> 00:58:49.693 region:rollup2
TO TALK ABOUT THEM THE GOLDEN
00:58:47.824 --> 00:58:51.762 region:rollup2
GATE RESTAURANT ASSOCIATION LOTS
00:58:49.693 --> 00:58:54.197 region:rollup2
OF PEOPLE ASK ME SOON. WILL OR
00:58:51.762 --> 00:58:55.098 region:rollup2
HOW DID THAT WORK. WITH THE REST
00:58:54.197 --> 00:58:56.533 region:rollup2
ANOTHER AND I YOU KNOW IN A
00:58:55.098 --> 00:58:57.634 region:rollup2
LITTLE UP ENOUGH TO BE DANGEROUS
00:58:56.533 --> 00:58:59.002 region:rollup2
HOW DID THAT WORK RIGHT WITH A
00:58:57.634 --> 00:59:00.637 region:rollup2
HEALTHY CALIFORNIA. AND YOU
00:58:59.002 --> 00:59:03.340 region:rollup2
SHOULD KNOW LITERACY ISSUES WERE
00:59:00.637 --> 00:59:04.841 region:rollup2
RAISED VERY EARLY. AS CHALLENGES
00:59:03.340 --> 00:59:07.577 region:rollup2
TO HELP THE CALABASAS AND
00:59:04.841 --> 00:59:08.979 region:rollup2
FRANCISCO EVEN THE WAY IT WAS
00:59:07.577 --> 00:59:10.847 region:rollup2
DESIGNED A FEW RUPAUL.
00:59:08.979 --> 00:59:11.982 region:rollup2
AN EXTRAORDINARY FACT SITUATION
00:59:10.847 --> 00:59:12.616 region:rollup2
WHERE THE CITY OF SAN FRANCISCO
00:59:11.982 --> 00:59:14.418 region:rollup2
ESSENTIALLY CREATES AN INSURANCE
00:59:12.616 --> 00:59:15.585 region:rollup2
COMPANY.
00:59:14.418 --> 00:59:17.020 region:rollup2
I DON'T THINK IT'S EVERY
00:59:15.585 --> 00:59:19.322 region:rollup2
MUNICIPALITY IN THE UNITED
00:59:17.020 --> 00:59:20.757 region:rollup2
STATES OR EVEN IN CALIFORNIA
00:59:19.322 --> 00:59:21.992 region:rollup2
THAT WOULD SAY. I'VE GOT IT I'VE
00:59:20.757 --> 00:59:23.360 region:rollup2
GOT A WAY AROUND IT IS A LET'S
00:59:21.992 --> 00:59:24.895 region:rollup2
CREATE AN INSURANCE COMPANY
00:59:23.360 --> 00:59:26.129 region:rollup2
ESSENTIALLY DOUBLE DELIVERS
00:59:24.895 --> 00:59:27.531 region:rollup2
NEVER MIND JUST FINANCES BECAUSE
00:59:26.129 --> 00:59:29.733 region:rollup2
RIGHT IT'S VISIBLE HEALTHCARE
00:59:27.531 --> 00:59:30.934 region:rollup2
DELIVERY. BUT THAT IS ACTUALLY
00:59:29.733 --> 00:59:33.770 region:rollup2
THE SERVE DOUBLE DIMENSION TO
00:59:30.934 --> 00:59:35.939 region:rollup2
THAT IS ACTUALLY WHAT SAVED IT.
00:59:33.770 --> 00:59:37.374 region:rollup2
FORMER US AT THE NINTH CIRCUIT.
00:59:35.939 --> 00:59:39.376 region:rollup2
OKAY WITH THE NINTH CIRCUIT SAID
00:59:37.374 --> 00:59:41.144 region:rollup2
LISTEN THEY GAVE EMPLOYERS IN
00:59:39.376 --> 00:59:42.846 region:rollup2
CALIFORNIA A CHOICE AND ONE OF
00:59:41.144 --> 00:59:44.548 region:rollup2
THEM WAS NOT TRAINED MONKEY WITH
00:59:42.846 --> 00:59:46.116 region:rollup2
YOUR WRISTS A PLAN YOU COULD
00:59:44.548 --> 00:59:47.517 region:rollup2
JUST GO AHEAD AND BE AND.
00:59:46.116 --> 00:59:49.920 region:rollup2
HEALTHY SAN FRANCISCO ORAL TO
00:59:47.517 --> 00:59:51.354 region:rollup2
COULD PAY YOU KNOW SOME AMOUNT
00:59:49.920 --> 00:59:52.556 region:rollup2
BUT WE WEREN'T TRYING OF IT IS
00:59:51.354 --> 00:59:54.157 region:rollup2
THE IDEA THAT IT WASN'T AN ALL
00:59:52.556 --> 00:59:55.492 region:rollup2
OR NOTHING SEEMED PRETTY
00:59:54.157 --> 00:59:57.360 region:rollup2
POWERFUL AND THAT IT WASN'T ALL
00:59:55.492 --> 00:59:59.229 region:rollup2
TRYING TO REACH YOUR HANDS IN
00:59:57.360 --> 00:59:59.729 region:rollup2
UNTIL PEOPLE. ALL TELL YOU HOW
00:59:59.229 --> 01:00:01.298 region:rollup2
TO ORGANIZE YOUR PLAN.
00:59:59.729 --> 01:00:02.299 region:rollup2
NOW JUST
01:00:01.298 --> 01:00:04.067 region:rollup2
IF IT'S HELPFUL TO PEOPLE
01:00:02.299 --> 01:00:05.268 region:rollup2
REMEMBER WHERE WE WERE SO THIS
01:00:04.067 --> 01:00:06.503 region:rollup2
CASE WHICH BEHIND CIRCUIT
01:00:05.268 --> 01:00:07.871 region:rollup2
OPINION CAME DOWN IN TWO
01:00:06.503 --> 01:00:09.239 region:rollup2
THOUSAND EIGHT IF IT'S USEFUL
01:00:07.871 --> 01:00:11.208 region:rollup2
FOR PEOPLE TO REMEMBER.
01:00:09.239 --> 01:00:12.242 region:rollup2
BUT THEN IT WAS A PETITION FOR
01:00:11.208 --> 01:00:15.011 region:rollup2
REHEARING ON FONG.
01:00:12.242 --> 01:00:15.745 region:rollup2
.
01:00:15.011 --> 01:00:17.647 region:rollup2
SPUR ABOUT THAT.
01:00:15.745 --> 01:00:19.049 region:rollup2
WHICH WAS DENIED SO IT TOOK
01:00:17.647 --> 01:00:20.016 region:rollup2
AWHILE BUT EVENTUALLY A PETITION
01:00:19.049 --> 01:00:21.418 region:rollup2
FOR CERT AT THE SUPREME COURT
01:00:20.016 --> 01:00:22.252 region:rollup2
WAS FILED AND THAT WOULD HAVE
01:00:21.418 --> 01:00:23.720 region:rollup2
BEEN LIKE JUNE OF TWO THOUSAND
01:00:22.252 --> 01:00:25.055 region:rollup2
NINE. THOSE OF YOU KNOW WHO
01:00:23.720 --> 01:00:26.256 region:rollup2
FOLLOW THE SUPREME COURT NO THAT
01:00:25.055 --> 01:00:28.058 region:rollup2
THEY WOULDN'T CONSIDER TAKING
01:00:26.256 --> 01:00:28.592 region:rollup2
THAT UP UNTIL THE FALL OF TWO
01:00:28.058 --> 01:00:30.494 region:rollup2
THOUSAND TEN AND THEN THEY
01:00:28.592 --> 01:00:31.061 region:rollup2
WOULDN'T ACTUALLY HEAR IT UNTIL
01:00:30.494 --> 01:00:32.929 region:rollup2
THE SPRING. BREAK AND GUESS
01:00:31.061 --> 01:00:35.665 region:rollup2
WHAT.
01:00:32.929 --> 01:00:38.535 region:rollup2
BEFORE KERRICK PATH.
01:00:35.665 --> 01:00:40.003 region:rollup2
SO IT UNFIT IN ESSENCE BECAME.
01:00:38.535 --> 01:00:41.872 region:rollup2
MOOD NOW THE SUPREME COURT
01:00:40.003 --> 01:00:44.274 region:rollup2
DOESN'T SAY THAT THAT DOESN'T
01:00:41.872 --> 01:00:46.243 region:rollup2
SAY HOW WE WOULD RULED THIS WAY
01:00:44.274 --> 01:00:47.611 region:rollup2
THEY JUST CLIMB. OKAY SO YOU
01:00:46.243 --> 01:00:49.312 region:rollup2
CANNOT READ A GREAT DEAL INTO A
01:00:47.611 --> 01:00:49.913 region:rollup2
BOOK BUT WE DO KNOW IS THAT SO
01:00:49.312 --> 01:00:51.214 region:rollup2
IT NEVER WENT BEYOND THE NINTH
01:00:49.913 --> 01:00:52.415 region:rollup2
CIRCUIT.
01:00:51.214 --> 01:00:54.417 region:rollup2
OKAY THIS IS A THEORY FROM THE
01:00:52.415 --> 01:00:55.752 region:rollup2
NINTH CIRCUIT RIGHT THAT THIS
01:00:54.417 --> 01:00:56.520 region:rollup2
MIGHT BE PERMISSIBLE THAT IT'S
01:00:55.752 --> 01:00:57.888 region:rollup2
SOMEWHERE I'VE PUT.
01:00:56.520 --> 01:00:58.955 region:rollup2
WELL THIS MIGHT BE WHERE THE
01:00:57.888 --> 01:01:00.390 region:rollup2
STORY CONTINUES.
01:00:58.955 --> 01:01:01.758 region:rollup2
RIGHT THIS IS A QUESTION WORTH
01:01:00.390 --> 01:01:03.860 region:rollup2
ASKING.
01:01:01.758 --> 01:01:05.295 region:rollup2
AND WORTH HAVING ANSWERED.
01:01:03.860 --> 01:01:07.364 region:rollup2
BUT I DO THINK IT WOULD TAKE A
01:01:05.295 --> 01:01:08.265 region:rollup2
TRIP TO THE SUPREME COURT. A
01:01:07.364 --> 01:01:10.467 region:rollup2
ROUNDTRIP TICKET IS OFTEN
01:01:08.265 --> 01:01:11.134 region:rollup2
DESCRIBED TO MY STUDENTS.
01:01:10.467 --> 01:01:12.536 region:rollup2
WHICH MEANS IT UP TO GO UP THERE
01:01:11.134 --> 01:01:14.171 region:rollup2
AND ASK FOR CERTIORARI IT'S
01:01:12.536 --> 01:01:14.804 region:rollup2
DISCRETIONARY JURISDICTION AND
01:01:14.171 --> 01:01:15.105 region:rollup2
THEN YOU'D HAVE TO GET THERE ON
01:01:14.804 --> 01:01:17.407 region:rollup2
THE MERITS.
01:01:15.105 --> 01:01:18.742 region:rollup2
OKAY.
01:01:17.407 --> 01:01:20.710 region:rollup2
AND I'M NOT AN INEXPENSIVE
01:01:18.742 --> 01:01:22.212 region:rollup2
TICKET.
01:01:20.710 --> 01:01:23.780 region:rollup2
ARE INTELLECTUALLY FASCINATING
01:01:22.212 --> 01:01:25.515 region:rollup2
STROKING
01:01:23.780 --> 01:01:28.451 region:rollup2
BUT MY HUSBAND'S MONEY. I WOULD
01:01:25.515 --> 01:01:32.989 region:rollup2
LIKE TO PRESENT THIS ISSUE.
01:01:28.451 --> 01:01:34.090 region:rollup2
IT NEEDS TO BE ANSWERED.
01:01:32.989 --> 01:01:35.492 region:rollup2
MY FATHER WANTED TO SAY A LITTLE
01:01:34.090 --> 01:01:37.027 region:rollup2
BIT ABOUT GO BABY OF LIBERTY
01:01:35.492 --> 01:01:38.261 region:rollup2
MUTUAL ANOTHER COUPLE CASES ARE
01:01:37.027 --> 01:01:39.529 region:rollup2
EXTREMELY RECENT OF THE SUPREME
01:01:38.261 --> 01:01:40.697 region:rollup2
COURT WHAT THE CONTROLS ABOUT A
01:01:39.529 --> 01:01:41.898 region:rollup2
RECESSION GO BAY I HAD SOME
01:01:40.697 --> 01:01:42.732 region:rollup2
QUESTIONS.
01:01:41.898 --> 01:01:44.334 region:rollup2
FROM PEOPLE.
01:01:42.732 --> 01:01:45.302 region:rollup2
ASKING ME WHAT COULD WE DO
01:01:44.334 --> 01:01:47.537 region:rollup2
SOMETHING ELSE COULD WE DO IT
01:01:45.302 --> 01:01:49.306 region:rollup2
ALL PAYERS CLAIMS DATABASE KIND
01:01:47.537 --> 01:01:51.541 region:rollup2
OF ATTEMPT AT REFORM COOLEY MAKE
01:01:49.306 --> 01:01:52.742 region:rollup2
A MOVE TOWARDS TRANSPARENCY.
01:01:51.541 --> 01:01:55.045 region:rollup2
AND SO THOSE OF YOU WHO KNOW
01:01:52.742 --> 01:01:57.047 region:rollup2
THIS CASE NO THE VERMONT STATUTE
01:01:55.045 --> 01:01:59.216 region:rollup2
FOR ALL PAYERS CLAIMS DATABASE.
01:01:57.047 --> 01:02:00.784 region:rollup2
STRUCK DOWN ON THE GROUNDS OF A
01:01:59.216 --> 01:02:02.752 region:rollup2
RECIPIENT XIN.
01:02:00.784 --> 01:02:04.554 region:rollup2
SIGNIFICANTLY ON JUSTICE KENNEDY
01:02:02.752 --> 01:02:06.323 region:rollup2
WHO WROTE THE OPINION WAS NOT
01:02:04.554 --> 01:02:07.991 region:rollup2
CONCERNED THAT THIS WAS THE
01:02:06.323 --> 01:02:13.196 region:rollup2
STATE OF VERMONT TRYING TO DO
01:02:07.991 --> 01:02:16.166 region:rollup2
SOMETHING IT WASN'T DUPLICATION.
01:02:13.196 --> 01:02:17.968 region:rollup2
DIDN'T REQUIRE DUPLICATION.
01:02:16.166 --> 01:02:18.568 region:rollup2
ALRIGHT ANY ALSO WASN'T
01:02:17.968 --> 01:02:19.336 region:rollup2
CONCERNED THAT THE STATE OF
01:02:18.568 --> 01:02:21.771 region:rollup2
VERMONT WAS TRYING TO DO
01:02:19.336 --> 01:02:23.006 region:rollup2
SOMETHING THAT SEVENTEEN OTHER
01:02:21.771 --> 01:02:24.007 region:rollup2
STATES WE TRY TO DO A DIFFERENT
01:02:23.006 --> 01:02:24.908 region:rollup2
WAY SO. IT WASN'T.
01:02:24.007 --> 01:02:26.376 region:rollup2
BECAUSE THAT WASN'T TRUE SO
01:02:24.908 --> 01:02:28.912 region:rollup2
WASN'T ADMINISTRATIVE BURDEN.
01:02:26.376 --> 01:02:30.113 region:rollup2
IT WAS JUST.
01:02:28.912 --> 01:02:34.851 region:rollup2
THE DEPARTMENT LABOR COULD DO
01:02:30.113 --> 01:02:35.785 region:rollup2
THIS IF THEY WANTED TO.
01:02:34.851 --> 01:02:38.321 region:rollup2
SO YOU SEE HOW STRONG THE
01:02:35.785 --> 01:02:40.657 region:rollup2
PREEMPTION IS.
01:02:38.321 --> 01:02:41.858 region:rollup2
EVEN JUST THE OPTION OF DOING IT
01:02:40.657 --> 01:02:44.027 region:rollup2
SUCKED THE AIR OUT OF THE ROOM
01:02:41.858 --> 01:02:45.395 region:rollup2
FOR VERMONT TO BE ABLE TO DO IT
01:02:44.027 --> 01:02:47.497 region:rollup2
NOW I THINK SEVENTEEN STATES
01:02:45.395 --> 01:02:51.067 region:rollup2
HAVE PASSED.
01:02:47.497 --> 01:02:52.435 region:rollup2
IN ONE FORM ANOTHER A KIND OF AU
01:02:51.067 --> 01:02:52.969 region:rollup2
PAIRS CLAIM DATABASE OF
01:02:52.435 --> 01:02:54.738 region:rollup2
PHARMACEUTICALS DIFFERENT
01:02:52.969 --> 01:02:55.238 region:rollup2
THINGS.
01:02:54.738 --> 01:02:56.406 region:rollup2
ALRIGHT AND THEY'RE ALL
01:02:55.238 --> 01:02:59.242 region:rollup2
STRUGGLING.
01:02:56.406 --> 01:03:01.444 region:rollup2
OKAY ON ON THIS SAME GROUNDS
01:02:59.242 --> 01:03:02.012 region:rollup2
ONES TO SAY JUST BOUGHT A COUPLE
01:03:01.444 --> 01:03:02.979 region:rollup2
WORDS OF HAVING COMPLETELY
01:03:02.012 --> 01:03:04.481 region:rollup2
OVERWHELMED ABOUT TWO VERY
01:03:02.979 --> 01:03:06.483 region:rollup2
RECENT CASES AT THE SUPREME
01:03:04.481 --> 01:03:08.585 region:rollup2
COURT NO WE WON'T OF TO THE
01:03:06.483 --> 01:03:10.687 region:rollup2
SEVEN ON THE FIRST AMENDMENT BUT
01:03:08.585 --> 01:03:11.354 region:rollup2
I WANT TO KNOW THE TO RISA.
01:03:10.687 --> 01:03:12.922 region:rollup2
HAS BEEN AT THIS REAP BRING CORD
01:03:11.354 --> 01:03:14.624 region:rollup2
AGAIN VERY RECENTLY. OKAY IN
01:03:12.922 --> 01:03:15.925 region:rollup2
CASES INVOLVING RELIGIOUSLY
01:03:14.624 --> 01:03:17.027 region:rollup2
SPONSORED HEALTH PLANS FLICK
01:03:15.925 --> 01:03:17.994 region:rollup2
WIFE SHE TELLING ME THIS WELL
01:03:17.027 --> 01:03:18.995 region:rollup2
YOU SHOULD KNOW THAT RELIGIOUS
01:03:17.994 --> 01:03:20.030 region:rollup2
BY RELIGIOUS ORDERS HEALTH PLAN
01:03:18.995 --> 01:03:21.498 region:rollup2
SPONSORED BY RELIGIOUS ORDERS
01:03:20.030 --> 01:03:24.401 region:rollup2
THINK A CATHOLIC ORDER. THAT
01:03:21.498 --> 01:03:25.368 region:rollup2
SPONSORS A PLAN YOU KNOW FOR TO
01:03:24.401 --> 01:03:27.470 region:rollup2
PUT DATA AT A PARTICULAR
01:03:25.368 --> 01:03:29.139 region:rollup2
FACILITY OKAY ARE EXEMPT FROM
01:03:27.470 --> 01:03:30.273 region:rollup2
ARREST.
01:03:29.139 --> 01:03:33.009 region:rollup2
NO IN THE COURSE OF OF MEN ARE
01:03:30.273 --> 01:03:33.643 region:rollup2
TWO CASES.
01:03:33.009 --> 01:03:35.445 region:rollup2
THE PREMISE AND THEY HAVE NOT
01:03:33.643 --> 01:03:36.012 region:rollup2
BEEN DOING FOR ARGUMENT TWO
01:03:35.445 --> 01:03:36.813 region:rollup2
SEPARATE CASES WHY DOES THIS
01:03:36.012 --> 01:03:37.580 region:rollup2
MATTER.
01:03:36.813 --> 01:03:38.481 region:rollup2
OUR SUPREME COURT WILL HAVE TO
01:03:37.580 --> 01:03:39.883 region:rollup2
GRAPPLE WITH HOW STRONG THE
01:03:38.481 --> 01:03:41.284 region:rollup2
RECIPIENT XIN IS IN THOSE CASES
01:03:39.883 --> 01:03:42.752 region:rollup2
YOU DO UNDERSTAND THAT RELIGIOUS
01:03:41.284 --> 01:03:44.287 region:rollup2
ORDERS. OR THE PEOPLE WHO ARE
01:03:42.752 --> 01:03:46.356 region:rollup2
RELIGIOUSLY AFFILIATED ARE ON
01:03:44.287 --> 01:03:48.191 region:rollup2
THE OTHER SIDE OF THE PREEMPTION
01:03:46.356 --> 01:03:49.893 region:rollup2
ARGUMENT THEY ARE ARGUING NO NO
01:03:48.191 --> 01:03:51.528 region:rollup2
IT'S GOT TO BE WEAKER WE CAN'T
01:03:49.893 --> 01:03:53.330 region:rollup2
BE FORCED.
01:03:51.528 --> 01:03:54.998 region:rollup2
VIRUSES TO DO THIS FOR THE FIRST
01:03:53.330 --> 01:03:56.800 region:rollup2
TIME I THINK WE HAVE QUITE
01:03:54.998 --> 01:03:57.267 region:rollup2
POSSIBLY FOR THE CURRENT COURT
01:03:56.800 --> 01:04:00.136 region:rollup2
EXTREMELY SYMPATHETIC
01:03:57.267 --> 01:04:02.872 region:rollup2
PLAINTIFFS.
01:04:00.136 --> 01:04:04.174 region:rollup2
FOR FIRST AMENDMENT REASONS.
01:04:02.872 --> 01:04:05.842 region:rollup2
AND THEY WILL BE RELUCTANT TO
01:04:04.174 --> 01:04:09.179 region:rollup2
TAKE THE SLEDGEHAMMER OVER
01:04:05.842 --> 01:04:11.715 region:rollup2
SUPREME XIN I BELIEVE IN GOAL.
01:04:09.179 --> 01:04:12.882 region:rollup2
OKAY SO I ACTUALLY THINK WE'RE
01:04:11.715 --> 01:04:14.084 region:rollup2
GOING TO SEE YOUR SUPREME XIN.
01:04:12.882 --> 01:04:15.318 region:rollup2
PERHAPS.
01:04:14.084 --> 01:04:17.187 region:rollup2
LUCENT.
01:04:15.318 --> 01:04:18.788 region:rollup2
SO OFTEN.
01:04:17.187 --> 01:04:20.690 region:rollup2
NOW YOU I SAID.
01:04:18.788 --> 01:04:22.625 region:rollup2
WELL THAT'S INTERESTING WILL
01:04:20.690 --> 01:04:24.260 region:rollup2
WOULD BE LOOSING A SOFTENING OF
01:04:22.625 --> 01:04:26.162 region:rollup2
RECIPIENTS AND I MIGHT ACTUALLY
01:04:24.260 --> 01:04:28.198 region:rollup2
CREATE THE SPACE.
01:04:26.162 --> 01:04:29.499 region:rollup2
RIGHT FOR IDEAS ABOUT STATE
01:04:28.198 --> 01:04:30.934 region:rollup2
SPECIFIC HEALTH REFORM
01:04:29.499 --> 01:04:32.402 region:rollup2
HEALTHCARE REFORM SOCIAL YOU
01:04:30.934 --> 01:04:33.803 region:rollup2
ULTIMATELY THAT I'M A PRAGMATIST
01:04:32.402 --> 01:04:34.804 region:rollup2
I PRACTICED LAW FOR OVER TWENTY
01:04:33.803 --> 01:04:36.406 region:rollup2
YEARS BEFORE I BECAME A LAW
01:04:34.804 --> 01:04:38.174 region:rollup2
PROFESSOR I'LL TELL YOU. THAT IN
01:04:36.406 --> 01:04:40.310 region:rollup2
MASSACHUSETTS THEY SIMPLY
01:04:38.174 --> 01:04:41.211 region:rollup2
NEGOTIATED THIS PROBLEM AWAY.
01:04:40.310 --> 01:04:42.011 region:rollup2
OKAY YOU DO REMEMBER
01:04:41.211 --> 01:04:42.879 region:rollup2
MASSACHUSETTS MADE OF ON THE
01:04:42.011 --> 01:04:45.749 region:rollup2
STATE'S PACIFIC HEALTH CARE
01:04:42.879 --> 01:04:47.317 region:rollup2
REFORM AT SIX YEARS BEFORE THE
01:04:45.749 --> 01:04:49.686 region:rollup2
PORTAL CARE ACT WHICH COURSES
01:04:47.317 --> 01:04:50.320 region:rollup2
FROM THE CARE BUT ON STEROIDS.
01:04:49.686 --> 01:04:50.954 region:rollup2
RIGHT WOULD THAT THEY NEGOTIATED
01:04:50.320 --> 01:04:54.224 region:rollup2
WITH.
01:04:50.954 --> 01:04:56.459 region:rollup2
RIGHT SO THAT'S ONE OPTION.
01:04:54.224 --> 01:04:57.026 region:rollup2
OKAY NO ONE EVERYONE BUT WAS ON
01:04:56.459 --> 01:04:58.061 region:rollup2
THEN GOES WHAT WAS ON THE
01:04:57.026 --> 01:04:58.661 region:rollup2
BARGAINING TABLE YOU WILL NOT
01:04:58.061 --> 01:05:02.665 region:rollup2
REYES NERISSA.
01:04:58.661 --> 01:05:03.266 region:rollup2
ATTACK.
01:05:02.665 --> 01:05:05.268 region:rollup2
AND THEN EVERYONE SAID WHAT IT
01:05:03.266 --> 01:05:05.835 region:rollup2
WOULD TAKE.
01:05:05.268 --> 01:05:08.004 region:rollup2
TO GET THEM TO BUY INTO THE
01:05:05.835 --> 01:05:09.105 region:rollup2
PROPOSITION.
01:05:08.004 --> 01:05:10.740 region:rollup2
OKAY ALTERNATELY YOU COULD
01:05:09.105 --> 01:05:12.308 region:rollup2
LITIGATED WHICH APPEARS TO BE
01:05:10.740 --> 01:05:13.943 region:rollup2
WHERE SORT OF LAW HEALTHY SAN
01:05:12.308 --> 01:05:15.111 region:rollup2
FRANCISCO WAS GOING RIGHT. YOU
01:05:13.943 --> 01:05:17.180 region:rollup2
COULD TRY LEGISLATIVE YOU COULD
01:05:15.111 --> 01:05:18.248 region:rollup2
TRY AND SEE IF YOU COULD GET A
01:05:17.180 --> 01:05:19.516 region:rollup2
RESEARCH AMENDED IT WAS HAS BEEN
01:05:18.248 --> 01:05:20.283 region:rollup2
AMENDED MANY TIMES
01:05:19.516 --> 01:05:22.152 region:rollup2
YOU COULD TRY TO GET AN
01:05:20.283 --> 01:05:24.120 region:rollup2
EXEMPTION. AS YOU MAY OR MAY NOT
01:05:22.152 --> 01:05:25.989 region:rollup2
KNOW HAWAII HAS HAD AN EXEMPTION
01:05:24.120 --> 01:05:27.390 region:rollup2
SINCE NINETEEN EIGHTY FOUR. FOR
01:05:25.989 --> 01:05:28.992 region:rollup2
ITS OWN STATE SPECIFIC HEALTH
01:05:27.390 --> 01:05:31.428 region:rollup2
CARE REFORM YOU COULD BE LIKE.
01:05:28.992 --> 01:05:32.996 region:rollup2
HAWAII TO.
01:05:31.428 --> 01:05:34.664 region:rollup2
OKAY WE WANNA. WANNA BE LIKE
01:05:32.996 --> 01:05:35.498 region:rollup2
THAT.
01:05:34.664 --> 01:05:36.966 region:rollup2
OKAY WE JUST WANNA BE
01:05:35.498 --> 01:05:38.935 region:rollup2
SPECIFICALLY ALLOWED TO GO OFTEN
01:05:36.966 --> 01:05:41.771 region:rollup2
BY ME.
01:05:38.935 --> 01:05:43.773 region:rollup2
AND ALLOWED TO DO OUR OWN THING.
01:05:41.771 --> 01:05:44.908 region:rollup2
OKAY WIDE IF WAY BROKER THIS WAY
01:05:43.773 --> 01:05:46.443 region:rollup2
HAD ITS OWN STATE SPECIFIC
01:05:44.908 --> 01:05:48.845 region:rollup2
HEALTH CARE REFORM IN THE WORKS
01:05:46.443 --> 01:05:49.879 region:rollup2
BEFORE A MISSILE WAS PASSED.
01:05:48.845 --> 01:05:51.247 region:rollup2
AND SO THE PROBABLY HAD THE
01:05:49.879 --> 01:05:53.349 region:rollup2
STRONGEST ARGUMENT AND THE
01:05:51.247 --> 01:05:55.151 region:rollup2
QUICKEST MOBILIZATION AROUND HIM
01:05:53.349 --> 01:05:57.153 region:rollup2
WOMEN WOMEN IN.
01:05:55.151 --> 01:05:58.021 region:rollup2
WE GOOD DOING THIS LONG BEFORE
01:05:57.153 --> 01:05:59.956 region:rollup2
YOU ARRANGE THE TEXTURES WERE
01:05:58.021 --> 01:06:02.525 region:rollup2
NOT. YOU KNOW. THAT WE WE DON'T
01:05:59.956 --> 01:06:05.261 region:rollup2
WANT TO ABANDON THIS OKAY WE
01:06:02.525 --> 01:06:06.062 region:rollup2
ACTUALLY WANT TO DEVELOP THIS.
01:06:05.261 --> 01:06:07.697 region:rollup2
AND SO AND SO THAT'S HOW IT
01:06:06.062 --> 01:06:08.965 region:rollup2
WORKED.
01:06:07.697 --> 01:06:11.301 region:rollup2
I'M I COULD BILLS AT LEAST I'M
01:06:08.965 --> 01:06:13.002 region:rollup2
SURE YOU CAN THINK OF MANY MORE.
01:06:11.301 --> 01:06:13.570 region:rollup2
ALRIGHT I'M GONNA STOP THERE.
01:06:13.002 --> 01:06:15.939 region:rollup2
THANK YOU AND THANK YOU FOR
01:06:13.570 --> 01:06:17.507 region:rollup2
LETTING ME COME A TEST.
01:06:15.939 --> 01:06:19.209 region:rollup2
THANK YOU VERY MUCH I'D LIKE TO
01:06:17.507 --> 01:06:23.880 region:rollup2
ASK IF THERE ARE ANY MEMBERS
01:06:19.209 --> 01:06:25.648 region:rollup2
THAT DIES HAVE QUESTIONS.
01:06:23.880 --> 01:06:27.951 region:rollup2
SURE I'M GETTING A STAB AT THIS.
01:06:25.648 --> 01:06:29.185 region:rollup2
.
01:06:27.951 --> 01:06:31.454 region:rollup2
AND I SHOULD PROBABLY START BY
01:06:29.185 --> 01:06:32.922 region:rollup2
SAYING I'M NOT A LAWYER.
01:06:31.454 --> 01:06:35.992 region:rollup2
PRACTICE THE OTHER SIDE I'M AS A
01:06:32.922 --> 01:06:37.260 region:rollup2
DOCTOR I. AM COMING TO GRIPS
01:06:35.992 --> 01:06:38.528 region:rollup2
WITH THIS BUT MY PROFESSION
01:06:37.260 --> 01:06:39.863 region:rollup2
TAUGHT ME TO BE A PROBLEM SOLVER
01:06:38.528 --> 01:06:41.631 region:rollup2
SO I'M REALLY LOOKING FOR
01:06:39.863 --> 01:06:43.266 region:rollup2
SOLUTIONS FORWARD.
01:06:41.631 --> 01:06:44.868 region:rollup2
AND WAS HOPING YOU COULD TALK
01:06:43.266 --> 01:06:48.037 region:rollup2
ABOUT THE ROLE THAT A PAYROLL
01:06:44.868 --> 01:06:50.907 region:rollup2
TAX MAY PLAY. IN HELPING US TO
01:06:48.037 --> 01:06:52.575 region:rollup2
FINANCE UNIVERSAL HEALTHCARE.
01:06:50.907 --> 01:06:54.244 region:rollup2
AND IF NOTHING PREVENTED
01:06:52.575 --> 01:06:56.813 region:rollup2
EMPLOYERS FROM MAINTAINING
01:06:54.244 --> 01:06:59.015 region:rollup2
MULTISTATE ERISA PLANS AMMAN.
01:06:56.813 --> 01:07:00.550 region:rollup2
WITH THAT TAX.
01:06:59.015 --> 01:07:03.052 region:rollup2
IF THEY WANTED TO DO SO WOULD A
01:07:00.550 --> 01:07:05.355 region:rollup2
STATE IMPOSED PAYROLL TAX PASSED
01:07:03.052 --> 01:07:06.523 region:rollup2
THE WRITTEN MOSTLY.
01:07:05.355 --> 01:07:08.091 region:rollup2
WELL AS I'VE SAID TAX HASN'T
01:07:06.523 --> 01:07:09.459 region:rollup2
BEEN A MIXED BAG RIGHT IF THE
01:07:08.091 --> 01:07:11.361 region:rollup2
TAX LOOKS LIKE.
01:07:09.459 --> 01:07:13.596 region:rollup2
APPEAR PLAY OPTION IN THE GUISE
01:07:11.361 --> 01:07:15.698 region:rollup2
OF ATTACKS.
01:07:13.596 --> 01:07:17.767 region:rollup2
RIGHT MEMBER IN THE MARYLAND
01:07:15.698 --> 01:07:19.335 region:rollup2
CASE.
01:07:17.767 --> 01:07:20.803 region:rollup2
HE YOU JUST GOTTA PAY A HIGHER
01:07:19.335 --> 01:07:22.805 region:rollup2
PERCENTAGE BUT WAIT A MINUTE
01:07:20.803 --> 01:07:24.340 region:rollup2
NEWLY ONE IS GONNA PUT IT CLINIC
01:07:22.805 --> 01:07:24.741 region:rollup2
IN.
01:07:24.340 --> 01:07:26.142 region:rollup2
RIGHT.
01:07:24.741 --> 01:07:27.443 region:rollup2
THEN NO COULD YOU TRY AND ARGUE
01:07:26.142 --> 01:07:29.245 region:rollup2
THAT THIS IS A LAW OF NEUTRAL
01:07:27.443 --> 01:07:31.648 region:rollup2
GENERAL NEUTRAL APPLICATION
01:07:29.245 --> 01:07:33.349 region:rollup2
INCIDENTLY AFFECTING. UNDER IS A
01:07:31.648 --> 01:07:35.285 region:rollup2
FAMINE BUT PLAN BUT NOT IN ITS
01:07:33.349 --> 01:07:37.086 region:rollup2
TARGET TO DO THAT WOULD BE THE
01:07:35.285 --> 01:07:38.021 region:rollup2
ARGUMENT DO I THINK THIS WOULD
01:07:37.086 --> 01:07:39.255 region:rollup2
HAVE TO BE LITIGATED IF THEY
01:07:38.021 --> 01:07:40.657 region:rollup2
WERE NOT IN AGREEMENT NOT TO
01:07:39.255 --> 01:07:42.458 region:rollup2
RAISE IT I THINK IT MIGHT WELL
01:07:40.657 --> 01:07:43.726 region:rollup2
HAVE TO BE TEST.
01:07:42.458 --> 01:07:44.727 region:rollup2
BUT I DO THINK THAT YES THERE'S
01:07:43.726 --> 01:07:46.763 region:rollup2
AN ARGUMENT.
01:07:44.727 --> 01:07:47.664 region:rollup2
THERE.
01:07:46.763 --> 01:07:49.098 region:rollup2
OKAY THERE'S A CASE CALL
01:07:47.664 --> 01:07:51.134 region:rollup2
TRAVELERS FROM NINETEEN NINETY
01:07:49.098 --> 01:07:53.303 region:rollup2
FIVE WHICH MAKES IT CLEAR. THAT
01:07:51.134 --> 01:07:54.671 region:rollup2
IF SOMETHING IS INCIDENTAL TO
01:07:53.303 --> 01:07:56.339 region:rollup2
LOVE GENERAL APPLICATION.
01:07:54.671 --> 01:07:58.308 region:rollup2
SO YOU TRYING GET INTO THE
01:07:56.339 --> 01:07:59.475 region:rollup2
TRAVELERS CRAWL INSIDE OF IT.
01:07:58.308 --> 01:08:03.212 region:rollup2
ANTS AND STAY IN THAT SPEAKS
01:07:59.475 --> 01:08:04.714 region:rollup2
THE GREAT QUESTION.
01:08:03.212 --> 01:08:06.683 region:rollup2
KIND OF ALONG THE LINES
01:08:04.714 --> 01:08:08.151 region:rollup2
A LITTLE BIT.
01:08:06.683 --> 01:08:08.918 region:rollup2
I WAS THERE BEEN MANY LEGAL TO.
01:08:08.151 --> 01:08:12.255 region:rollup2
LIKELY BE
01:08:08.918 --> 01:08:12.889 region:rollup2
THE MORE LEGAL.
01:08:12.255 --> 01:08:15.358 region:rollup2
YOU KNOW WHAT IT WHAT WOULD YOU
01:08:12.889 --> 01:08:17.126 region:rollup2
THINK.
01:08:15.358 --> 01:08:17.961 region:rollup2
CHALLENGE MIGHT LOOK LIKE AND
01:08:17.126 --> 01:08:21.230 region:rollup2
HOW LONG WOULD SOMETHING LIKE
01:08:17.961 --> 01:08:23.499 region:rollup2
THAT PLAY OUT.
01:08:21.230 --> 01:08:24.400 region:rollup2
WELL. IN SAN FRANCISCO THE
01:08:23.499 --> 01:08:26.002 region:rollup2
GOLDEN GATE RESTAURANT
01:08:24.400 --> 01:08:27.704 region:rollup2
ASSOCIATION WHICH SOME OF YOU
01:08:26.002 --> 01:08:29.272 region:rollup2
MAY KNOW WAS A VERY LARGE. VERY
01:08:27.704 --> 01:08:32.041 region:rollup2
LONG AND WELL ESTABLISHED RIGHT
01:08:29.272 --> 01:08:35.545 region:rollup2
RESTAURANT ASSOCIATION UMP.
01:08:32.041 --> 01:08:36.145 region:rollup2
WELL FUNDED OF. TOOK UP IT SO
01:08:35.545 --> 01:08:37.814 region:rollup2
YOU CAN ACTUALLY SEE PRIVATE
01:08:36.145 --> 01:08:39.482 region:rollup2
INDUSTRY COMING AND I THINK YOU
01:08:37.814 --> 01:08:40.450 region:rollup2
MIGHT SEE EMPLOYERS BECAUSE YOU
01:08:39.482 --> 01:08:42.151 region:rollup2
HAVE TO UNDERSTAND IF YOU TELL
01:08:40.450 --> 01:08:43.152 region:rollup2
PEOPLE YOU'RE NO LONGER TO HAVE
01:08:42.151 --> 01:08:45.254 region:rollup2
THAT RISA.
01:08:43.152 --> 01:08:47.190 region:rollup2
SHIELD.
01:08:45.254 --> 01:08:48.458 region:rollup2
RIGHT FROM STATE HEALTHCARE
01:08:47.190 --> 01:08:50.059 region:rollup2
REGULATION OF HOPE RIGHT THAT'S
01:08:48.458 --> 01:08:51.694 region:rollup2
MONEY.
01:08:50.059 --> 01:08:52.929 region:rollup2
THAT'S SIGNIFICANT MONEY THE
01:08:51.694 --> 01:08:55.064 region:rollup2
REGULATORY BURDEN TRANSLATES
01:08:52.929 --> 01:08:56.899 region:rollup2
INTO THE SIGNIFICANT COST.
01:08:55.064 --> 01:08:57.467 region:rollup2
RIGHT AND SO. SOMEONE WHO'S
01:08:56.899 --> 01:08:58.201 region:rollup2
CONCERNED ENOUGH ABOUT THAT
01:08:57.467 --> 01:09:00.303 region:rollup2
COST.
01:08:58.201 --> 01:09:01.738 region:rollup2
I THINK.
01:09:00.303 --> 01:09:02.805 region:rollup2
WAS LIKELY TO GATHER AROUND A
01:09:01.738 --> 01:09:05.408 region:rollup2
GROUP OF OTHER CONCERNED IF
01:09:02.805 --> 01:09:06.042 region:rollup2
THERE'S NO AGREEMENT AND AND I
01:09:05.408 --> 01:09:07.710 region:rollup2
THINK YOU'RE LIKELY TO SEE THE
01:09:06.042 --> 01:09:09.012 region:rollup2
CHALLENGE REGISTRY HOW LONG WILL
01:09:07.710 --> 01:09:10.413 region:rollup2
IT DO THINK A CASE LIKE THIS
01:09:09.012 --> 01:09:12.281 region:rollup2
WOULD LIKELY GO TO THE SUPREME
01:09:10.413 --> 01:09:13.783 region:rollup2
COURT I DON'T WANNA. BEAT YOU
01:09:12.281 --> 01:09:14.650 region:rollup2
KNOW DISHONEST HERE
01:09:13.783 --> 01:09:15.551 region:rollup2
BECAUSE A BE A CASE OF FIRST
01:09:14.650 --> 01:09:17.487 region:rollup2
IMPRESSION I TOLD YOU THIS WAS
01:09:15.551 --> 01:09:19.155 region:rollup2
NOT DECIDED.
01:09:17.487 --> 01:09:20.923 region:rollup2
RIGHT STUMBLED RIGHT UP TO IT
01:09:19.155 --> 01:09:22.091 region:rollup2
STOPPED. UCAS STUMBLED AROUND A
01:09:20.923 --> 01:09:25.094 region:rollup2
FEW TIMES.
01:09:22.091 --> 01:09:26.396 region:rollup2
AND THAT CAN TAKE A FEW YEARS
01:09:25.094 --> 01:09:27.230 region:rollup2
DEPENDING ON ALONG THE WAY TO
01:09:26.396 --> 01:09:28.631 region:rollup2
THE GOLDEN GATE RESTAURANT
01:09:27.230 --> 01:09:29.666 region:rollup2
ASSOCIATION A GOOD EXAMPLE OF A
01:09:28.631 --> 01:09:30.433 region:rollup2
TIME OF ONE AGAINST THEM THE
01:09:29.666 --> 01:09:31.701 region:rollup2
GOLDEN GATE RESTAURANT
01:09:30.433 --> 01:09:32.902 region:rollup2
ASSOCIATION WILL PETITION FOR
01:09:31.701 --> 01:09:34.937 region:rollup2
REHEARING. DO UNDERSTAND
01:09:32.902 --> 01:09:36.372 region:rollup2
PROLONGED EACH PHASE OF IT A
01:09:34.937 --> 01:09:38.608 region:rollup2
LITTLE BIT MORE NANBAN PRE
01:09:36.372 --> 01:09:39.776 region:rollup2
HEARING US DE YOU KNOW. THERE
01:09:38.608 --> 01:09:44.013 region:rollup2
ARE MANY PROCEDURAL MOVES TO
01:09:39.776 --> 01:09:44.647 region:rollup2
MADE ALONG THE WAY TO THE
01:09:44.013 --> 01:09:45.815 region:rollup2
SUPREME COURTS UNNECESSARILY OR
01:09:44.647 --> 01:09:46.883 region:rollup2
AKA.
01:09:45.815 --> 01:09:48.317 region:rollup2
SO A LOT DEPENDS ON CONDUCT IT
01:09:46.883 --> 01:09:49.252 region:rollup2
WOULDN'T KNOW ABOUT EARNERS
01:09:48.317 --> 01:09:49.919 region:rollup2
STRATEGY THAT I WOULDN'T KNOW
01:09:49.252 --> 01:09:53.389 region:rollup2
WHAT THOUGH.
01:09:49.919 --> 01:09:54.857 region:rollup2
BUT YES IT'S NOT INSTANTANEOUS.
01:09:53.389 --> 01:09:56.092 region:rollup2
THAT THEY CAN KIND OF FOCUS YOU
01:09:54.857 --> 01:09:57.660 region:rollup2
YOU GOT MY INTEREST EARLY ON WE
01:09:56.092 --> 01:09:58.461 region:rollup2
GOT THIS.
01:09:57.660 --> 01:09:59.729 region:rollup2
FIRST OFF THANK YOU AT THIS
01:09:58.461 --> 01:10:01.564 region:rollup2
POUNDS HOPING TO BE FASCINATING
01:09:59.729 --> 01:10:04.233 region:rollup2
I'M GLAD I AM IF I COULD PICK UP
01:10:01.564 --> 01:10:06.335 region:rollup2
ANOTHER RESEARCH JUNKIE OF BEEN
01:10:04.233 --> 01:10:08.604 region:rollup2
AWARE THE DEATH.
01:10:06.335 --> 01:10:11.774 region:rollup2
I'M NOT QUITE THERE YET BUT I'M
01:10:08.604 --> 01:10:14.177 region:rollup2
CLOSER THAN I WAS EARLIER.
01:10:11.774 --> 01:10:15.244 region:rollup2
WHY?
01:10:14.177 --> 01:10:16.379 region:rollup2
FROM MY MOTHER'S WOMB SANTA OF A
01:10:15.244 --> 01:10:18.247 region:rollup2
RISK.
01:10:16.379 --> 01:10:19.615 region:rollup2
SO I'M AND DO A LITTLE MATH HERE
01:10:18.247 --> 01:10:20.583 region:rollup2
AND I'M GOOD AT SMALL MATH SO.
01:10:19.615 --> 01:10:22.718 region:rollup2
WE HAVE BASICALLY THREE MILLION
01:10:20.583 --> 01:10:25.121 region:rollup2
UNINSURED. WE HAVE THIRTEEN
01:10:22.718 --> 01:10:26.689 region:rollup2
MILLION PEOPLE TO MEDICAID OR
01:10:25.121 --> 01:10:27.757 region:rollup2
MEDICARE OUT THERE EXPANSION.
01:10:26.689 --> 01:10:29.625 region:rollup2
SO THAT LEAVES TWENTY TWO
01:10:27.757 --> 01:10:32.628 region:rollup2
MILLION PEOPLE OUT THERE COVERED
01:10:29.625 --> 01:10:33.629 region:rollup2
BY SOME SORT OF PLANS YOU SAID.
01:10:32.628 --> 01:10:35.631 region:rollup2
FIFTY TO SIXTY PERCENT OF THOSE
01:10:33.629 --> 01:10:37.233 region:rollup2
ARE POSSIBLY COVERED BY RISA
01:10:35.631 --> 01:10:41.070 region:rollup2
PLANTS IS THAT.
01:10:37.233 --> 01:10:43.406 region:rollup2
WELL COVERED BY EMPLOYER FUNDED
01:10:41.070 --> 01:10:44.874 region:rollup2
OKAY A HEALTH INSURANCE NOW YOU
01:10:43.406 --> 01:10:46.476 region:rollup2
CAN DISCERN THAN YOU BACK THE
01:10:44.874 --> 01:10:47.543 region:rollup2
NUMBER OUT FROM THE FORM IRIS
01:10:46.476 --> 01:10:49.278 region:rollup2
FORM FIFTY FIVE HUNDRED AND THE
01:10:47.543 --> 01:10:50.780 region:rollup2
LAWYER HAS DONE SOME GOOD NUMBER
01:10:49.278 --> 01:10:51.981 region:rollup2
CRUNCHING ON THIS BUT THAT
01:10:50.780 --> 01:10:53.716 region:rollup2
NUMBER IT'S ALWAYS A LITTLE OLD.
01:10:51.981 --> 01:10:54.717 region:rollup2
NUMBERS BEEN GOING UP SINCE THE
01:10:53.716 --> 01:10:56.619 region:rollup2
PASSAGE OF THE AFFORDABLE CARE
01:10:54.717 --> 01:10:58.354 region:rollup2
ACT BECAUSE THE REGULATORY
01:10:56.619 --> 01:10:59.989 region:rollup2
BURDEN HAS BEEN RAISED.
01:10:58.354 --> 01:11:01.724 region:rollup2
RIGHT ELIZABETH REACHING DEEPER
01:10:59.989 --> 01:11:02.892 region:rollup2
INTO THE EMPLOYER POPULATION SO
01:11:01.724 --> 01:11:03.860 region:rollup2
USED TO BE YOU JUST WOULDN'T SEE
01:11:02.892 --> 01:11:04.994 region:rollup2
THIS KIND OF THING UNLESS THEY
01:11:03.860 --> 01:11:06.295 region:rollup2
HAD AT LEAST FIVE HUNDRED NOW
01:11:04.994 --> 01:11:07.463 region:rollup2
IT'S DIPPING LOWER.
01:11:06.295 --> 01:11:08.931 region:rollup2
SO I'M GONNA ASSUME THAT THAT
01:11:07.463 --> 01:11:10.166 region:rollup2
NUMBERS AT LEAST THAT'S WHY I'M
01:11:08.931 --> 01:11:11.300 region:rollup2
HESITANT TO SAY I KNOW THE
01:11:10.166 --> 01:11:12.935 region:rollup2
NUMBER WILL BE DON'T HAVE TO HIT
01:11:11.300 --> 01:11:14.504 region:rollup2
A BUTTON. BUT SOME BE BACK SO
01:11:12.935 --> 01:11:16.072 region:rollup2
THE DATA FROM AYE ARRESTS.
01:11:14.504 --> 01:11:17.440 region:rollup2
FIFTY FIVE HUNDRED AND THEN I
01:11:16.072 --> 01:11:19.041 region:rollup2
THE CONCERT EFFECTIVE PROJECT IS
01:11:17.440 --> 01:11:20.643 region:rollup2
GOING UP I WOULD SAY. IT'S
01:11:19.041 --> 01:11:21.477 region:rollup2
PROBABLY THE NEW NORMAL. IN
01:11:20.643 --> 01:11:23.579 region:rollup2
CALIFORNIA WOULD SAY THE
01:11:21.477 --> 01:11:26.082 region:rollup2
MAJORITY OF CALIFORNIANS I'M
01:11:23.579 --> 01:11:26.682 region:rollup2
GONNA GUESS FOREIGN EMPLOYER
01:11:26.082 --> 01:11:27.717 region:rollup2
SPONSORED HEALTH INSURANCE ARE
01:11:26.682 --> 01:11:30.486 region:rollup2
IN.
01:11:27.717 --> 01:11:31.287 region:rollup2
AN EMPLOYER SELF FUNDED PLAN
01:11:30.486 --> 01:11:32.522 region:rollup2
WHICH MEANS IT'S EXEMPT FROM
01:11:31.287 --> 01:11:34.557 region:rollup2
STATE REGULATION.
01:11:32.522 --> 01:11:36.926 region:rollup2
UNDER RISA.
01:11:34.557 --> 01:11:38.060 region:rollup2
ALREADY STATUS QUO ANTE
01:11:36.926 --> 01:11:39.295 region:rollup2
AND YOU UNDERSTAND WHAT IT KNOW
01:11:38.060 --> 01:11:41.664 region:rollup2
THAT CULTURE SHOCK THIS.
01:11:39.295 --> 01:11:43.132 region:rollup2
WOULD BE.
01:11:41.664 --> 01:11:44.667 region:rollup2
OKAY WE ALWAYS ASSUME ALL THAT
01:11:43.132 --> 01:11:45.168 region:rollup2
IS HIGHLY REGULATED INDUSTRY
01:11:44.667 --> 01:11:46.602 region:rollup2
HEALTH CARE YOU KNOW BUT
01:11:45.168 --> 01:11:48.171 region:rollup2
ACTUALLY WE.
01:11:46.602 --> 01:11:50.573 region:rollup2
THE ACA DID NOTHING TO THE STAR
01:11:48.171 --> 01:11:52.208 region:rollup2
OF THIS SORTING.
01:11:50.573 --> 01:11:53.176 region:rollup2
MECHANISM AND THIS TREATING TO
01:11:52.208 --> 01:11:54.544 region:rollup2
DIFFERENT GROUPS VERY
01:11:53.176 --> 01:11:55.778 region:rollup2
DIFFERENTLY ONE ESSENTIALLY IS
01:11:54.544 --> 01:11:57.747 region:rollup2
PROTECTED FROM REGULATION.
01:11:55.778 --> 01:11:59.815 region:rollup2
RIGHT.
01:11:57.747 --> 01:12:01.717 region:rollup2
PROTECT ITS THERE'S A BARRIER.
01:11:59.815 --> 01:12:04.187 region:rollup2
ILLEGAL THERE.
01:12:01.717 --> 01:12:05.121 region:rollup2
SUPERBLY BY THOSE NUMBERS
01:12:04.187 --> 01:12:06.489 region:rollup2
ABOUT A QUARTER OF THE
01:12:05.121 --> 01:12:08.591 region:rollup2
POPULATION IN CALIFORNIA.
01:12:06.489 --> 01:12:09.892 region:rollup2
BIG SAID.
01:12:08.591 --> 01:12:11.027 region:rollup2
AND I DON'T WANT TO PRETEND TO
01:12:09.892 --> 01:12:12.528 region:rollup2
AND EXPERTISE ON THIS I MEAN I I
01:12:11.027 --> 01:12:13.596 region:rollup2
READ TO LLOYDS REPORTS YOU KNOW
01:12:12.528 --> 01:12:15.164 region:rollup2
I READ A CONSULTING FIRMS
01:12:13.596 --> 01:12:16.065 region:rollup2
REPORTS ARE PUBLICLY AVAILABLE
01:12:15.164 --> 01:12:18.034 region:rollup2
BUT YES.
01:12:16.065 --> 01:12:19.669 region:rollup2
FOR A LONG TIME NOBODY KNEW WHAT
01:12:18.034 --> 01:12:20.903 region:rollup2
THESE NUMBERS OR BECAUSE EVEN
01:12:19.669 --> 01:12:21.737 region:rollup2
THE FIFTY FIVE HUNDRED AND THIS
01:12:20.903 --> 01:12:23.539 region:rollup2
IS OUR HOPE THAT NOW WE HAVE
01:12:21.737 --> 01:12:25.441 region:rollup2
THIS. AND AND SO WE CAN KIND OF
01:12:23.539 --> 01:12:26.809 region:rollup2
BACK IT OUT CALIFORNIA IS ONE OF
01:12:25.441 --> 01:12:28.110 region:rollup2
THE TOP SIX
01:12:26.809 --> 01:12:30.546 region:rollup2
STATES IN THE COUNTRY COUNTRY
01:12:28.110 --> 01:12:32.915 region:rollup2
FOR THE HIGHEST PERCENTAGE OF.
01:12:30.546 --> 01:12:33.549 region:rollup2
WHAT YOU BUT IT'S NOT EVEN WHAT
01:12:32.915 --> 01:12:35.351 region:rollup2
YOU GONNA BE KNOCKING OF HIS
01:12:33.549 --> 01:12:36.719 region:rollup2
RISE ON LIKE NEW YORK'S IN THERE
01:12:35.351 --> 01:12:37.220 region:rollup2
AND VOTE I?
01:12:36.719 --> 01:12:38.955 region:rollup2
BUT ACTUALLY EVEN LIKE I
01:12:37.220 --> 01:12:42.058 region:rollup2
BELIEVE.
01:12:38.955 --> 01:12:43.159 region:rollup2
INDIANA NEBRASKA IT ITS TENDS TO
01:12:42.058 --> 01:12:44.927 region:rollup2
BE STATEMENT THINK OF MEAT
01:12:43.159 --> 01:12:47.163 region:rollup2
PACKING MEAT PROCESSING POULTRY
01:12:44.927 --> 01:12:49.398 region:rollup2
PROCESS SIT WITH REALLY LARGE
01:12:47.163 --> 01:12:51.200 region:rollup2
EMPLOYERS AND THEN IT DRIBBLES.
01:12:49.398 --> 01:12:51.767 region:rollup2
DOWN FROM IT WHY WOULD SMALLER
01:12:51.200 --> 01:12:52.034 region:rollup2
EMPLOYERS BE WILLING TO TAKE
01:12:51.767 --> 01:12:54.470 region:rollup2
THIS RISK
01:12:52.034 --> 01:12:56.272 region:rollup2
BECAUSE THEY TRYING TO.
01:12:54.470 --> 01:12:57.540 region:rollup2
AVOID THE REGULATORY BURDEN I
01:12:56.272 --> 01:12:58.674 region:rollup2
AND THEY ALWAYS FEEL LIKE THEY
01:12:57.540 --> 01:12:59.842 region:rollup2
CAN PROTECT THEMSELVES OF STOP
01:12:58.674 --> 01:13:00.943 region:rollup2
LOSS INSURANCE WHICH IS WHY I
01:12:59.842 --> 01:13:01.777 region:rollup2
THINK THE LEGISLATURE GOT
01:13:00.943 --> 01:13:03.145 region:rollup2
INTERESTED AND STOP LOSS
01:13:01.777 --> 01:13:05.448 region:rollup2
INSURANCE BECAUSE OF CHANGE THE
01:13:03.145 --> 01:13:06.616 region:rollup2
RULES ON. HOW SMALL YOU CAN BE A
01:13:05.448 --> 01:13:08.084 region:rollup2
HOW EARLY YOU CAN ATTACH STOP
01:13:06.616 --> 01:13:09.986 region:rollup2
LOSS INSURANCE TO PROTECT YOU
01:13:08.084 --> 01:13:12.154 region:rollup2
FROM HAVING? THE ACTUAL SKULL
01:13:09.986 --> 01:13:12.989 region:rollup2
FAMILY THEN WE IN SOME WAYS TO
01:13:12.154 --> 01:13:15.925 region:rollup2
CREATE INCENTIVES AND
01:13:12.989 --> 01:13:17.994 region:rollup2
DISINCENTIVES FOR SELF INSURING.
01:13:15.925 --> 01:13:19.829 region:rollup2
RIGHT AND I THINK I DON'T WAS
01:13:17.994 --> 01:13:21.030 region:rollup2
ANYBODY'S MOUTH I SUSPECT THAT
01:13:19.829 --> 01:13:22.031 region:rollup2
THE CALIFORNIA LEGISLATURE WE
01:13:21.030 --> 01:13:23.099 region:rollup2
SECOND SAY IN NEW YORK AND
01:13:22.031 --> 01:13:24.734 region:rollup2
WISCONSIN THERE ON THE RECORD
01:13:23.099 --> 01:13:26.435 region:rollup2
THEY WERE CONCERNED SMALLER AND
01:13:24.734 --> 01:13:28.170 region:rollup2
SMALLER EMPLOYERS. WERE SELF
01:13:26.435 --> 01:13:29.438 region:rollup2
INSURING TAKING THEMSELVES OUT
01:13:28.170 --> 01:13:31.474 region:rollup2
OF THE STATE REGULATORY
01:13:29.438 --> 01:13:34.944 region:rollup2
INFRASTRUCTURE.
01:13:31.474 --> 01:13:36.979 region:rollup2
UNBEKNOWNST TO THEIR EMPLOYEES.
01:13:34.944 --> 01:13:38.180 region:rollup2
AND AND YOU KNOW THAT. CREATING
01:13:36.979 --> 01:13:39.849 region:rollup2
ESSENTIALLY HEALTH INSURANCE
01:13:38.180 --> 01:13:42.985 region:rollup2
PLANS THAT WERE NOT.
01:13:39.849 --> 01:13:44.453 region:rollup2
MINIMUM ESSENTIAL COVERAGE.
01:13:42.985 --> 01:13:48.190 region:rollup2
IS IT IS A SOBERING.
01:13:44.453 --> 01:13:49.592 region:rollup2
PROFILE.
01:13:48.190 --> 01:13:53.663 region:rollup2
THANK THANK YOU VERY VERY MUCH.
01:13:49.592 --> 01:13:54.664 region:rollup2
ANYONE ELSE AT THE.
01:13:53.663 --> 01:13:56.465 region:rollup2
KNOWING THAT YOU GET YOUR
01:13:54.664 --> 01:13:57.700 region:rollup2
WORKING STAYS ON JEWISH BUT WE
01:13:56.465 --> 01:13:58.200 region:rollup2
UNDERSTAND THAT YOU NEED TO
01:13:57.700 --> 01:13:59.235 region:rollup2
THINK CLASS WENT TO THE
01:13:58.200 --> 01:14:01.037 region:rollup2
PENTAGON.
01:13:59.235 --> 01:14:02.638 region:rollup2
THANK YOU SOME
01:14:01.037 --> 01:14:04.407 region:rollup2
CAPTION IT COULD I ASK SORRY MY
01:14:02.638 --> 01:14:05.608 region:rollup2
APOLOGIES I I CAME LATE BUT I.
01:14:04.407 --> 01:14:06.809 region:rollup2
BUT YEARS AGO ACTUALLY READ OF
01:14:05.608 --> 01:14:07.777 region:rollup2
MANY OF THE ARRESTS OF CASES I
01:14:06.809 --> 01:14:08.978 region:rollup2
AM A LAWYER AND A LITTLE BIT OF
01:14:07.777 --> 01:14:09.612 region:rollup2
INTEREST A GEEK.
01:14:08.978 --> 01:14:13.182 region:rollup2
AND.
01:14:09.612 --> 01:14:15.017 region:rollup2
AND I HAVE LIKE MANY OF US VIEW
01:14:13.182 --> 01:14:15.952 region:rollup2
THIS AS A A REAL BARRIER TO US
01:14:15.017 --> 01:14:17.553 region:rollup2
TRYING TO DO IMPORTANT THINGS
01:14:15.952 --> 01:14:18.888 region:rollup2
HERE IN CALIFORNIA. OF AND I
01:14:17.553 --> 01:14:20.289 region:rollup2
APOLOGIZE I WAS OUT OF THE ROOM
01:14:18.888 --> 01:14:22.158 region:rollup2
WHEN YOU WENT THROUGH YOUR
01:14:20.289 --> 01:14:23.626 region:rollup2
PRESENTATION BUT. I AM THERE WAS
01:14:22.158 --> 01:14:24.760 region:rollup2
NO RISK CHALLENGE OF THE ACA
01:14:23.626 --> 01:14:27.997 region:rollup2
RIGHT.
01:14:24.760 --> 01:14:29.131 region:rollup2
NO BECAUSE ACTUALLY THE ACA
01:14:27.997 --> 01:14:30.132 region:rollup2
AMENDED SARISSA WHO IN SOME
01:14:29.131 --> 01:14:31.967 region:rollup2
SIGNIFICANT WAYS THAT IT NEEDS
01:14:30.132 --> 01:14:33.402 region:rollup2
TO IN ORDER TO PERFORM SOME OF
01:14:31.967 --> 01:14:35.037 region:rollup2
ITS FUNCTIONS ABOUT IT IF YOU
01:14:33.402 --> 01:14:35.971 region:rollup2
THINK ABOUT THE ACA FROM TEMPLES
01:14:35.037 --> 01:14:37.306 region:rollup2
ME UP. IT ALSO TRYING TO
01:14:35.971 --> 01:14:38.708 region:rollup2
STANDARDIZE HEALTH INSURANCE
01:14:37.306 --> 01:14:40.142 region:rollup2
ONLY COMING FROM THE GOVERNMENT
01:14:38.708 --> 01:14:41.911 region:rollup2
I OFTEN PUT IT THIS WAY. IN
01:14:40.142 --> 01:14:43.913 region:rollup2
UNDER RISA THE IMPULSE WAS TO
01:14:41.911 --> 01:14:44.413 region:rollup2
LET THE EMPLOYER STANDARDIZE IT
01:14:43.913 --> 01:14:46.148 region:rollup2
YOU KNOW THE MULTI STATE
01:14:44.413 --> 01:14:48.050 region:rollup2
EMPLOYERS SO THEY COULD HAVE
01:14:46.148 --> 01:14:49.652 region:rollup2
CONSISTENCY ACROSS STATES. AND
01:14:48.050 --> 01:14:50.920 region:rollup2
UNDER THE ACA TO STANDARDIZE BUT
01:14:49.652 --> 01:14:51.654 region:rollup2
WITH THE GOVERNMENT ALL DEPENDS
01:14:50.920 --> 01:14:53.356 region:rollup2
ON WHO YOU WANT TO HAVE DO THE
01:14:51.654 --> 01:14:54.824 region:rollup2
STANDARDIZING BEFORE COME FROM A
01:14:53.356 --> 01:14:56.792 region:rollup2
HEALTH CARE FEDERALISM OF THE
01:14:54.824 --> 01:14:59.028 region:rollup2
NEED FOR BETTER STANDARDIZATION.
01:14:56.792 --> 01:15:00.229 region:rollup2
SO HAS SOME EXEMPTIONS THAT HAS
01:14:59.028 --> 01:15:02.264 region:rollup2
SOME ALTERATIONS BECAUSE THAT'S
01:15:00.229 --> 01:15:04.567 region:rollup2
FEDERAL LAW SO YOU CAN DO THAT
01:15:02.264 --> 01:15:04.900 region:rollup2
STATE LAW CANNOT AMEND A RESERVE
01:15:04.567 --> 01:15:06.669 region:rollup2
RIGHT THAT'S.
01:15:04.900 --> 01:15:09.238 region:rollup2
BECAUSE OF. YOU KNOW.
01:15:06.669 --> 01:15:11.040 region:rollup2
IT SUPERIORITY FEDERAL STATUTE.
01:15:09.238 --> 01:15:12.041 region:rollup2
PUMP IT AND I THE THE BALL POINT
01:15:11.040 --> 01:15:13.275 region:rollup2
A RELIGION TO ME IS THAT YOU
01:15:12.041 --> 01:15:14.577 region:rollup2
FEEL COMFORTABLE THAT ACCOUNT
01:15:13.275 --> 01:15:16.145 region:rollup2
FOR AN INDIVIDUAL MANDATE WOULD
01:15:14.577 --> 01:15:17.980 region:rollup2
AVOID INTEREST CHARGE AGAIN AS
01:15:16.145 --> 01:15:19.348 region:rollup2
LONG AS WE DON'T. REFERENCE
01:15:17.980 --> 01:15:20.583 region:rollup2
EMPLOYER SPONSORED OIL WOULDN'T
01:15:19.348 --> 01:15:21.350 region:rollup2
FEEL COMFORTABLE ABOUT ANYTHING
01:15:20.583 --> 01:15:23.586 region:rollup2
WITH.
01:15:21.350 --> 01:15:24.553 region:rollup2
ERISA IT GOES TO THE SUIT WELL
01:15:23.586 --> 01:15:25.554 region:rollup2
FOR SO MANY GHOST A FEDERAL
01:15:24.553 --> 01:15:26.222 region:rollup2
DISTRICT COURT TODAY TELL YOU
01:15:25.554 --> 01:15:28.457 region:rollup2
THIS SOMETIMES FILL DISK RECORD
01:15:26.222 --> 01:15:31.260 region:rollup2
JUDGES DECIDE THE CASES
01:15:28.457 --> 01:15:32.361 region:rollup2
DIFFERENTLY ON THE SAME FACTS.
01:15:31.260 --> 01:15:33.596 region:rollup2
PART THE REASON THIS IS SUCH A
01:15:32.361 --> 01:15:34.563 region:rollup2
GNARLY AREA OF LAW IS THAT WE
01:15:33.596 --> 01:15:36.165 region:rollup2
DON'T NECESSARILY EVEN HAVE
01:15:34.563 --> 01:15:38.234 region:rollup2
CONSENSUS ON HOW TO INTERPRET
01:15:36.165 --> 01:15:39.368 region:rollup2
AND APPLY IT.
01:15:38.234 --> 01:15:41.170 region:rollup2
AND IT GOES TO THE SUPREME COURT
01:15:39.368 --> 01:15:42.872 region:rollup2
SO FREQUENTLY.
01:15:41.170 --> 01:15:44.407 region:rollup2
BECAUSE IT IS SO GNARLY THAT WE
01:15:42.872 --> 01:15:45.975 region:rollup2
OFTEN END UP WITH CONFLICTS ON
01:15:44.407 --> 01:15:47.243 region:rollup2
THE CIRCUIT LEVEL SO I HAVE NO.
01:15:45.975 --> 01:15:48.544 region:rollup2
CONFIDENCE I'M SORRY I HOPE I
01:15:47.243 --> 01:15:49.512 region:rollup2
DIDN'T PROTRUDE I CITY OF
01:15:48.544 --> 01:15:51.047 region:rollup2
COMPANIES YOU COULD MAKE SUCH AN
01:15:49.512 --> 01:15:52.081 region:rollup2
ARGUMENT BUT IF I JUST SHOW YOU
01:15:51.047 --> 01:15:53.516 region:rollup2
IT UP KIND OF HOLLOW OPEN
01:15:52.081 --> 01:15:54.784 region:rollup2
CRAWLING TO TO MAKE THAT
01:15:53.516 --> 01:15:56.385 region:rollup2
ARGUMENT AND JUST REASONABLE AN
01:15:54.784 --> 01:15:58.287 region:rollup2
INDIVIDUAL MANDATE IS MOST
01:15:56.385 --> 01:15:59.555 region:rollup2
LIKELY TO AVOID CHALLENGE. IF IT
01:15:58.287 --> 01:16:00.489 region:rollup2
MAKES NO REFERENCE TO EMPLOYER
01:15:59.555 --> 01:16:02.057 region:rollup2
SPONSORED HEALTH PLANS ARE
01:16:00.489 --> 01:16:03.025 region:rollup2
SAYING THAT'S HOW YOU AVOID IT
01:16:02.057 --> 01:16:05.561 region:rollup2
DOES MEAN THAT WILL BE
01:16:03.025 --> 01:16:06.896 region:rollup2
CHALLENGED EXACTLY GO TO SHOW.
01:16:05.561 --> 01:16:09.098 region:rollup2
THERE ARE WAYS TO DO THINGS I
01:16:06.896 --> 01:16:11.033 region:rollup2
THINK MAKE YOU LESS AND MORE
01:16:09.098 --> 01:16:15.271 region:rollup2
VULNERABLE. SAWS AND SOME
01:16:11.033 --> 01:16:16.238 region:rollup2
PRACTICAL ON THINKING THAT WAY
01:16:15.271 --> 01:16:19.108 region:rollup2
RIGHT. THEN THEN.
01:16:16.238 --> 01:16:21.110 region:rollup2
AS A REPRESENTATIVE OF SAN
01:16:19.108 --> 01:16:23.312 region:rollup2
FRANCISCO IS VERY FAMILIAR WITH
01:16:21.110 --> 01:16:26.682 region:rollup2
THE LAWSUIT BROUGHT BY THE GOING
01:16:23.312 --> 01:16:27.683 region:rollup2
GET RESTAURANT ASSOCIATION I
01:16:26.682 --> 01:16:29.051 region:rollup2
HAVEN'T SEEN A LEGAL MOUSE.
01:16:27.683 --> 01:16:31.520 region:rollup2
HOW MUCH ROOM WITH THEIR BE?
01:16:29.051 --> 01:16:32.521 region:rollup2
A AROUND WHAT SAN FRANCISCO DID
01:16:31.520 --> 01:16:33.389 region:rollup2
ANOTHER WORDS I'M FAMILIAR WITH
01:16:32.521 --> 01:16:34.123 region:rollup2
WHAT SAN FRANCISCO DID WITH THAT
01:16:33.389 --> 01:16:35.124 region:rollup2
PETER PLAY ORDINANCE.
01:16:34.123 --> 01:16:36.959 region:rollup2
BUT HAVE THERE BEEN.
01:16:35.124 --> 01:16:37.726 region:rollup2
LAW REVIEW ARTICLES ARE OTHERS
01:16:36.959 --> 01:16:39.295 region:rollup2
TALK ABOUT HOW MUCH ROOM IS
01:16:37.726 --> 01:16:39.895 region:rollup2
THERE BEYOND WHAT SAN FRANCISCO
01:16:39.295 --> 01:16:41.530 region:rollup2
DID THAT WOULD AVOID THE PIN
01:16:39.895 --> 01:16:42.364 region:rollup2
NUMBER.
01:16:41.530 --> 01:16:43.299 region:rollup2
I THINK EVERYONE AGREES THAT IF
01:16:42.364 --> 01:16:44.567 region:rollup2
YOU THE COURAGE AND THE
01:16:43.299 --> 01:16:46.101 region:rollup2
FORTITUDE IN THE FINANCING TO
01:16:44.567 --> 01:16:47.736 region:rollup2
SET UP YOUR OWN HEALTH INSURANCE
01:16:46.101 --> 01:16:49.171 region:rollup2
COMPANY COULD PROBABLY IT DIDN'T
01:16:47.736 --> 01:16:50.506 region:rollup2
MAKE AS MUCH OR A RUN THAT AT
01:16:49.171 --> 01:16:52.108 region:rollup2
THIS GOAL AS THE GOLDEN GATE
01:16:50.506 --> 01:16:53.742 region:rollup2
RESTAURANT ASSOCIATION IS.
01:16:52.108 --> 01:16:54.376 region:rollup2
HELP THE SAN FRANCISCO DID
01:16:53.742 --> 01:16:55.744 region:rollup2
MEMBER THAT DID NOT GO TO THE
01:16:54.376 --> 01:16:57.146 region:rollup2
SUPREME COURT BUT THAT MIGHT BE
01:16:55.744 --> 01:16:57.913 region:rollup2
YOUR STRONGEST I GIVE YOU THE
01:16:57.146 --> 01:16:59.248 region:rollup2
OTHER POINT OF LIGHT AT THE
01:16:57.913 --> 01:17:01.016 region:rollup2
OTHER END OF THE FIEDLER CASE
01:16:59.248 --> 01:17:01.851 region:rollup2
AMERICA ON THE WALMART CASE.
01:17:01.016 --> 01:17:03.252 region:rollup2
SOMEWHERE BETWEEN WOULD BE THE
01:17:01.851 --> 01:17:04.520 region:rollup2
TRAVELER CASE FROM NINETEEN
01:17:03.252 --> 01:17:06.789 region:rollup2
NINETY FIVE OR CIVIL YOU MIGHT
01:17:04.520 --> 01:17:08.524 region:rollup2
HAVE A STATUTE. THAT WAS WHAT OF
01:17:06.789 --> 01:17:10.326 region:rollup2
GENERAL APPLICATION THAT ONLY
01:17:08.524 --> 01:17:13.229 region:rollup2
INCIDENTALLY BURDEN GENEROUS
01:17:10.326 --> 01:17:14.196 region:rollup2
SUPPLANTING OR YOUR SO NO I KNOW
01:17:13.229 --> 01:17:16.132 region:rollup2
OF NO LAW REVIEW ARTICLE THAT
01:17:14.196 --> 01:17:18.267 region:rollup2
SORT OF. MEDICINE THAT THERE ARE
01:17:16.132 --> 01:17:19.802 region:rollup2
A COUPLE OF PEOPLE IN THE
01:17:18.267 --> 01:17:21.070 region:rollup2
COUNTRY WHO RIGHT ON THIS. IS
01:17:19.802 --> 01:17:22.371 region:rollup2
PETER JACOBSEN.
01:17:21.070 --> 01:17:24.707 region:rollup2
ATTIC LUCK.
01:17:22.371 --> 01:17:26.275 region:rollup2
IF YOU WANT BUT I DON'T HIDE IT
01:17:24.707 --> 01:17:28.077 region:rollup2
PUT MY EMAIL ON THAT FIRST THE
01:17:26.275 --> 01:17:29.879 region:rollup2
VERY FIRST SLIDE AS A BE HAPPY
01:17:28.077 --> 01:17:31.180 region:rollup2
TO SEND YOU LIKE. LINKS TO THAT
01:17:29.879 --> 01:17:32.281 region:rollup2
WHAT THEY WRITE ABOUT YOU GUYS
01:17:31.180 --> 01:17:33.549 region:rollup2
THEIR PEOPLE ALWAYS LIKE ME
01:17:32.281 --> 01:17:37.753 region:rollup2
TRYING TO PUT THESE PIECES
01:17:33.549 --> 01:17:38.721 region:rollup2
TOGETHER LIKE. LIKE A MOSAIC.
01:17:37.753 --> 01:17:40.022 region:rollup2
YOU KNOW BECAUSE THIS HAS NOT
01:17:38.721 --> 01:17:40.856 region:rollup2
BEEN RULED ON. LIVES ALL AGREE
01:17:40.022 --> 01:17:44.159 region:rollup2
OKAY THIS WOULD BE A CASE OF
01:17:40.856 --> 01:17:45.127 region:rollup2
FIRST IMPRESSION.
01:17:44.159 --> 01:17:46.228 region:rollup2
AND IN A SENSE WITH THE GORSUCH
01:17:45.127 --> 01:17:47.963 region:rollup2
WELL THEN THE THE NEWLY
01:17:46.228 --> 01:17:50.232 region:rollup2
CONSTITUTED COURT WHETHER THEY
01:17:47.963 --> 01:17:52.234 region:rollup2
BE MORE OR LESS LIKELY. YOUR WAS
01:17:50.232 --> 01:17:53.536 region:rollup2
LOOKING FOR WHO.
01:17:52.234 --> 01:17:54.870 region:rollup2
UP IN A COURT WHOEVER HAS A BACK
01:17:53.536 --> 01:17:56.739 region:rollup2
ON AND HIGHLY TECHNICAL
01:17:54.870 --> 01:17:57.973 region:rollup2
EXTREMELY DIFFICULT AND
01:17:56.739 --> 01:17:59.241 region:rollup2
COMPLICATED AREA LIKE A RESERVE
01:17:57.973 --> 01:17:59.742 region:rollup2
THERE'S A LOT OF DIFFERENCE IF
01:17:59.241 --> 01:18:02.578 region:rollup2
ANYBODY HAS IN A RESERVE
01:17:59.742 --> 01:18:03.512 region:rollup2
BACKGROUND.
01:18:02.578 --> 01:18:04.713 region:rollup2
NOT GONNA BE SUPPRESSED KNOW
01:18:03.512 --> 01:18:06.582 region:rollup2
THAT RIGHT I ALSO PRACTICE IN
01:18:04.713 --> 01:18:07.616 region:rollup2
ANY TRUST. I CAN TELL YOU ON THE
01:18:06.582 --> 01:18:08.651 region:rollup2
SUPREME COURT HAS A BACKGROUND
01:18:07.616 --> 01:18:10.686 region:rollup2
IN ANY TOUGHEST
01:18:08.651 --> 01:18:12.054 region:rollup2
AND PEOPLE TEND TO FOR.
01:18:10.686 --> 01:18:14.023 region:rollup2
OKAY EVEN SOMETIMES ACROSS THE
01:18:12.054 --> 01:18:15.891 region:rollup2
POLITICAL SPECTRUM BECAUSE IT'S
01:18:14.023 --> 01:18:18.294 region:rollup2
JUST SO COMPLICATED.
01:18:15.891 --> 01:18:19.161 region:rollup2
SO I'D LIKE REALLY CAN'T SAY WE
01:18:18.294 --> 01:18:20.663 region:rollup2
HAVE A COUPLE OF BUSINESS
01:18:19.161 --> 01:18:22.698 region:rollup2
LITIGATORS.
01:18:20.663 --> 01:18:23.766 region:rollup2
ON THERE AND SO YES I THINK
01:18:22.698 --> 01:18:24.333 region:rollup2
THEY'RE GOING TO BE PEOPLE WHO
01:18:23.766 --> 01:18:26.101 region:rollup2
ARE GOING TO KNOW SOMETHING
01:18:24.333 --> 01:18:28.070 region:rollup2
ABOUT THIS.
01:18:26.101 --> 01:18:29.638 region:rollup2
THAT I CAN'T SAY MORE THAN THAT
01:18:28.070 --> 01:18:31.140 region:rollup2
IT'S NOT WE'RE GONNA KNOW WHO
01:18:29.638 --> 01:18:32.608 region:rollup2
CARES THE MOST ABOUT RISK BY WHO
01:18:31.140 --> 01:18:33.876 region:rollup2
GETS TO WRITE THE OPINIONS IN
01:18:32.608 --> 01:18:36.445 region:rollup2
THE TWO CASES INVOLVING.
01:18:33.876 --> 01:18:38.013 region:rollup2
RELIGIOUS PLANTS.
01:18:36.445 --> 01:18:39.915 region:rollup2
RIGHT THAT I TALKED ABOUT
01:18:38.013 --> 01:18:40.749 region:rollup2
BECAUSE THEY WERE GONNA WHO
01:18:39.915 --> 01:18:44.353 region:rollup2
STEPS FORWARD TO SAY I WANNA
01:18:40.749 --> 01:18:45.187 region:rollup2
WRITE A GNARLY A RECIPIENT.
01:18:44.353 --> 01:18:46.789 region:rollup2
IT IMPLICATES THE FIRST SUMMIT
01:18:45.187 --> 01:18:48.991 region:rollup2
WE'RE GOING TO FIGURE OUT WHO.
01:18:46.789 --> 01:18:52.428 region:rollup2
SO JUSTICE KENNEDY WROTE THE
01:18:48.991 --> 01:18:54.063 region:rollup2
OPINION RIGHT AND SO BAKER.
01:18:52.428 --> 01:18:55.664 region:rollup2
THAT TELLS US SOMETHING ARGUES
01:18:54.063 --> 01:18:56.665 region:rollup2
INTERESTED IN HE WAS A BUSINESS
01:18:55.664 --> 01:18:58.734 region:rollup2
LITIGATOR RIGHT IN SACRAMENTO.
01:18:56.665 --> 01:19:00.603 region:rollup2
M..
01:18:58.734 --> 01:19:01.570 region:rollup2
BUT THIS IS VERY MUCH YOU KNOW
01:19:00.603 --> 01:19:02.972 region:rollup2
KILLING IT TO CAN IN MEANING THE
01:19:01.570 --> 01:19:05.207 region:rollup2
ENTRANCES SO I I DON'T WANT TO
01:19:02.972 --> 01:19:06.575 region:rollup2
PRETEND YOU DON'T KNOW WHO WOULD
01:19:05.207 --> 01:19:07.710 region:rollup2
BE IF THIS ONE TO THE RECORD WHO
01:19:06.575 --> 01:19:09.511 region:rollup2
WOULD STEP FORWARD TO WRITE YOU
01:19:07.710 --> 01:19:11.480 region:rollup2
DO KNOW THAT THE. CHIEF JUSTICE
01:19:09.511 --> 01:19:14.817 region:rollup2
ASSIGNS THE WRITING.
01:19:11.480 --> 01:19:16.452 region:rollup2
SO AND IF HE IF HE IN THIS CASE
01:19:14.817 --> 01:19:17.987 region:rollup2
IS IN THE MAJORITY HIS IT CAN'T
01:19:16.452 --> 01:19:20.356 region:rollup2
EVEN ASSIGN IT TO HIMSELF.
01:19:17.987 --> 01:19:21.890 region:rollup2
SO IT'S POSSIBLE.
01:19:20.356 --> 01:19:24.126 region:rollup2
YOU KNOW ANYTHING FROM CHIEF
01:19:21.890 --> 01:19:26.528 region:rollup2
JUSTICE JOHN ROBERTS TO.
01:19:24.126 --> 01:19:28.264 region:rollup2
THANK YOU.
01:19:26.528 --> 01:19:30.065 region:rollup2
FOR WHAT IT'S WORTH THE DISSENT
01:19:28.264 --> 01:19:31.166 region:rollup2
IN THE US SO TAKE CASE WAS.
01:19:30.065 --> 01:19:32.735 region:rollup2
.
01:19:31.166 --> 01:19:34.903 region:rollup2
KAGAN.
01:19:32.735 --> 01:19:36.205 region:rollup2
AND GINSBURG.
01:19:34.903 --> 01:19:39.008 region:rollup2
KENNEDY AND BRIAR WORLD
01:19:36.205 --> 01:19:40.275 region:rollup2
OPPOSITION AND THEN.
01:19:39.008 --> 01:19:43.545 region:rollup2
IF YOU CARE ABOUT THESE KIND
01:19:40.275 --> 01:19:44.380 region:rollup2
COUNTING NOSES.
01:19:43.545 --> 01:19:47.016 region:rollup2
THANK YOU.
01:19:44.380 --> 01:19:48.284 region:rollup2
THANK.
01:19:47.016 --> 01:19:50.119 region:rollup2
NEXT WE HAVE DOCTOR Q. PENSKE
01:19:48.284 --> 01:19:52.121 region:rollup2
WHO IS AN ASSOCIATE DIRECTOR OF
01:19:50.119 --> 01:19:52.588 region:rollup2
THE PROGRAM ON MEDICARE POLICY
01:19:52.121 --> 01:19:54.556 region:rollup2
AT THE. KAISER FAMILY
01:19:52.588 --> 01:19:56.558 region:rollup2
FOUNDATION.
01:19:54.556 --> 01:19:58.027 region:rollup2
AS AN EXPERT ON MEDICARE POLICY
01:19:56.558 --> 01:19:59.662 region:rollup2
DOCTOR COULD DANCE HE FOCUSES ON
01:19:58.027 --> 01:20:01.230 region:rollup2
PRODUCING TIMELY AND
01:19:59.662 --> 01:20:02.564 region:rollup2
AUTHORITATIVE ANALYSIS.
01:20:01.230 --> 01:20:04.066 region:rollup2
I'M WAITING MEDICARE REFORM
01:20:02.564 --> 01:20:04.667 region:rollup2
PROPOSALS AND ON INFORMING THE
01:20:04.066 --> 01:20:06.268 region:rollup2
DEBATE ABOUT THE FUTURE OF THE
01:20:04.667 --> 01:20:07.236 region:rollup2
MEDICARE PROGRAM.
01:20:06.268 --> 01:20:09.305 region:rollup2
THANK YOU FOR COMING. GOOD
01:20:07.236 --> 01:20:11.106 region:rollup2
AFTERNOON AND THANK YOU FOR THE
01:20:09.305 --> 01:20:12.808 region:rollup2
OPPORTUNITY TO BE WITH YOU.
01:20:11.106 --> 01:20:14.443 region:rollup2
AT TODAY'S COMMITTEE HEARING ON
01:20:12.808 --> 01:20:16.278 region:rollup2
IMPLEMENTATION CONSIDERATIONS
01:20:14.443 --> 01:20:18.113 region:rollup2
FOR UNIVERSAL COVERAGE.
01:20:16.278 --> 01:20:19.114 region:rollup2
MY NAME IS JULIA QB ON SKI AND I
01:20:18.113 --> 01:20:21.383 region:rollup2
ASSOCIATE DIRECTOR OF THE
01:20:19.114 --> 01:20:23.552 region:rollup2
PROGRAM ON MEDICARE POLICY AT
01:20:21.383 --> 01:20:24.019 region:rollup2
THE KAISER FAMILY FOUNDATION.
01:20:23.552 --> 01:20:25.954 region:rollup2
KAISER IS A NONPROFIT
01:20:24.019 --> 01:20:27.356 region:rollup2
ORGANIZATION FOCUSING ON
01:20:25.954 --> 01:20:29.224 region:rollup2
NATIONAL HEALTH ISSUES AND WE
01:20:27.356 --> 01:20:29.692 region:rollup2
SERVICE THE NONPARTISAN SOURCE
01:20:29.224 --> 01:20:31.860 region:rollup2
OF FACTS ANALYSIS AND
01:20:29.692 --> 01:20:34.163 region:rollup2
JOURNALISM.
01:20:31.860 --> 01:20:35.264 region:rollup2
FOR POLICY MAKERS THE MEDIA THE
01:20:34.163 --> 01:20:36.532 region:rollup2
HEALTH POLICY COMMUNITY AND THE
01:20:35.264 --> 01:20:37.833 region:rollup2
PUBLIC.
01:20:36.532 --> 01:20:38.434 region:rollup2
AND FOR THE RECORD WE ARE NOT
01:20:37.833 --> 01:20:40.536 region:rollup2
AFFILIATED WITH KAISER
01:20:38.434 --> 01:20:42.938 region:rollup2
PERMANENTE A.
01:20:40.536 --> 01:20:44.273 region:rollup2
MY ROLE TODAY IS TO PROVIDE YOU
01:20:42.938 --> 01:20:46.342 region:rollup2
WITH INFORMATION ABOUT THE
01:20:44.273 --> 01:20:48.077 region:rollup2
FEDERAL LAW CONSIDERATIONS
01:20:46.342 --> 01:20:49.044 region:rollup2
RELATED TO MEDICARE. THAT ARE
01:20:48.077 --> 01:20:50.846 region:rollup2
RELEVANT TO THE STATE'S
01:20:49.044 --> 01:20:53.949 region:rollup2
DISCUSSION ABOUT IMPLEMENTATION
01:20:50.846 --> 01:20:55.718 region:rollup2
OF A SINGLE PAYER SYSTEM.
01:20:53.949 --> 01:20:57.019 region:rollup2
LET ME BEGIN BY PROVIDING YOU
01:20:55.718 --> 01:20:59.888 region:rollup2
WITH A QUICK OVERVIEW OF
01:20:57.019 --> 01:21:01.390 region:rollup2
MEDICARE TO SET SOME CONTEXT.
01:20:59.888 --> 01:21:03.359 region:rollup2
MEDICARE COVER SIXTY MILLION
01:21:01.390 --> 01:21:05.360 region:rollup2
PEOPLE IN THE U. S. AND SIX
01:21:03.359 --> 01:21:07.863 region:rollup2
MILLION PEOPLE IN CALIFORNIA OR
01:21:05.360 --> 01:21:09.598 region:rollup2
ONE IN SIX STATE RESIDENTS.
01:21:07.863 --> 01:21:11.600 region:rollup2
MOST PEOPLE WITH MEDICARE ARE
01:21:09.598 --> 01:21:13.302 region:rollup2
AGES SIXTY FIVE AND OLDER BUT A
01:21:11.600 --> 01:21:15.170 region:rollup2
SMALL SHARE QUALIFY BECAUSE
01:21:13.302 --> 01:21:17.039 region:rollup2
THEY'RE UNDER AGE SIXTY FIVE AND
01:21:15.170 --> 01:21:18.340 region:rollup2
HAVE A PERMANENT DISABILITY.
01:21:17.039 --> 01:21:19.708 region:rollup2
AND WHILE MOST PEOPLE WITH
01:21:18.340 --> 01:21:22.044 region:rollup2
MEDICARE ARE IN TRADITIONAL
01:21:19.708 --> 01:21:24.713 region:rollup2
MEDICARE ALSO KNOWN AS FEE FOR
01:21:22.044 --> 01:21:25.814 region:rollup2
SERVICE MEDICARE. MORE THAN FOUR
01:21:24.713 --> 01:21:27.449 region:rollup2
IN TEN BENEFICIARIES IN
01:21:25.814 --> 01:21:29.151 region:rollup2
CALIFORNIA ARE ENROLLED IN
01:21:27.449 --> 01:21:30.419 region:rollup2
MEDICARE ADVANTAGE.
01:21:29.151 --> 01:21:31.687 region:rollup2
WHERE THERE MEDICARE COVERED
01:21:30.419 --> 01:21:34.189 region:rollup2
BENEFITS ARE DELIVERED THROUGH
01:21:31.687 --> 01:21:34.690 region:rollup2
PRIVATE PLANS LIKE HMOS AND PPO
01:21:34.189 --> 01:21:38.827 region:rollup2
DOES THAT CONTRACT WITH
01:21:34.690 --> 01:21:40.763 region:rollup2
MEDICARE?
01:21:38.827 --> 01:21:44.133 region:rollup2
MEDICARE BENEFITS ARE DIVIDED UP
01:21:40.763 --> 01:21:46.101 region:rollup2
INTO FOUR PARTS A. B. C. AND D..
01:21:44.133 --> 01:21:48.303 region:rollup2
GENERALLY SPEAKING A COVERS
01:21:46.101 --> 01:21:50.973 region:rollup2
HOSPITAL SERVICES BE COVERS
01:21:48.303 --> 01:21:52.641 region:rollup2
PHYSICIAN SERVICES D. COVERS
01:21:50.973 --> 01:21:55.544 region:rollup2
PRESCRIPTION DRUGS AND SEE
01:21:52.641 --> 01:21:57.379 region:rollup2
REFERS TO MEDICARE ADVANTAGE.
01:21:55.544 --> 01:21:58.814 region:rollup2
IN TWENTY SIXTEEN SPENDING ON
01:21:57.379 --> 01:22:01.016 region:rollup2
THESE BENEFITS WAS SIX HUNDRED
01:21:58.814 --> 01:22:02.551 region:rollup2
AND SEVENTY FIVE BILLION DOLLARS
01:22:01.016 --> 01:22:03.652 region:rollup2
AND HERE AND FIGURE TO YOU CAN
01:22:02.551 --> 01:22:05.020 region:rollup2
SEE HOW THE SPENDING WAS
01:22:03.652 --> 01:22:07.055 region:rollup2
DISTRIBUTED.
01:22:05.020 --> 01:22:08.724 region:rollup2
THIS TOTAL INCLUDES MEDICARE'S
01:22:07.055 --> 01:22:10.726 region:rollup2
ADMINISTRATIVE COSTS BOTH THE
01:22:08.724 --> 01:22:12.261 region:rollup2
COST TO THE GOVERNMENT TO
01:22:10.726 --> 01:22:13.996 region:rollup2
OPERATE THE MEDICARE PROGRAM.
01:22:12.261 --> 01:22:14.863 region:rollup2
AND THE COSTS TO PRIVATE
01:22:13.996 --> 01:22:16.431 region:rollup2
MEDICARE ADVANTAGE AND PARTY
01:22:14.863 --> 01:22:17.933 region:rollup2
PLANS.
01:22:16.431 --> 01:22:19.268 region:rollup2
TOGETHER THESE ADMINISTRATIVE
01:22:17.933 --> 01:22:20.569 region:rollup2
EXPENSES WERE ABOUT SEVEN
01:22:19.268 --> 01:22:22.871 region:rollup2
PERCENT OF TOTAL SPENDING IN
01:22:20.569 --> 01:22:24.606 region:rollup2
TENTY SIXTEEN.
01:22:22.871 --> 01:22:26.108 region:rollup2
FOR PEOPLE TURNING SIXTY FIVE IN
01:22:24.606 --> 01:22:28.210 region:rollup2
ROLLING IN PART A AND B. IS
01:22:26.108 --> 01:22:29.578 region:rollup2
AUTOMATIC IF THEY'RE ALREADY
01:22:28.210 --> 01:22:31.046 region:rollup2
GETTING SOCIAL SECURITY BENEFITS
01:22:29.578 --> 01:22:33.949 region:rollup2
AT THAT POINT. THOUGH
01:22:31.046 --> 01:22:34.917 region:rollup2
TECHNICALLY PART BE IS VOLUNTARY
01:22:33.949 --> 01:22:36.685 region:rollup2
BUT IF PEOPLE DON'T WANT PART
01:22:34.917 --> 01:22:38.620 region:rollup2
BEEP BEEP PARTY COVERAGE THEY
01:22:36.685 --> 01:22:39.755 region:rollup2
HAVE TO OPT OUT OF THE PARTY
01:22:38.620 --> 01:22:41.757 region:rollup2
PROGRAM.
01:22:39.755 --> 01:22:43.725 region:rollup2
IF PEOPLE WANT PART DEED DRUG
01:22:41.757 --> 01:22:45.694 region:rollup2
COVERAGE THEY MUST SIGN UP FOR A
01:22:43.725 --> 01:22:47.062 region:rollup2
PLAN THAT OFFERS THIS COVERAGE
01:22:45.694 --> 01:22:50.332 region:rollup2
IS NOT AUTOMATIC LIKE A AND B.
01:22:47.062 --> 01:22:52.067 region:rollup2
ENROLLMENT.
01:22:50.332 --> 01:22:54.036 region:rollup2
THE DIFFERENT PARTS OF MEDICARE
01:22:52.067 --> 01:22:57.139 region:rollup2
ARE FINANCED DIFFERENTLY.
01:22:54.036 --> 01:22:57.973 region:rollup2
PART A LOT IS FUNDED MAINLY BY
01:22:57.139 --> 01:22:59.508 region:rollup2
A TWO POINT NINE PERCENT PAYROLL
01:22:57.973 --> 01:23:00.476 region:rollup2
TAX
01:22:59.508 --> 01:23:02.811 region:rollup2
ON EARNINGS THAT.
01:23:00.476 --> 01:23:04.646 region:rollup2
IS EQUALLY SPLIT BETWEEN
01:23:02.811 --> 01:23:06.582 region:rollup2
EMPLOYERS AND EMPLOYEES.
01:23:04.646 --> 01:23:07.449 region:rollup2
AND THIS MONEY IS DEPOSITED INTO
01:23:06.582 --> 01:23:09.418 region:rollup2
THE HOSPITAL INSURANCE TRUST
01:23:07.449 --> 01:23:10.986 region:rollup2
FUND.
01:23:09.418 --> 01:23:12.087 region:rollup2
HIGHER INCOME TAX PAYERS
01:23:10.986 --> 01:23:13.489 region:rollup2
PAY AN ADDITIONAL ZERO POINT
01:23:12.087 --> 01:23:15.424 region:rollup2
NINE PERCENT MAYOR MEDICARE
01:23:13.489 --> 01:23:17.559 region:rollup2
PAYROLL TAX.
01:23:15.424 --> 01:23:18.894 region:rollup2
PART B. IS FUNDED BY A GENERAL
01:23:17.559 --> 01:23:20.295 region:rollup2
REVENUES FROM THE FEDERAL
01:23:18.894 --> 01:23:21.330 region:rollup2
GOVERNMENT WHICH IS MOSTLY
01:23:20.295 --> 01:23:23.065 region:rollup2
INCOME TAX.
01:23:21.330 --> 01:23:25.067 region:rollup2
WHICH ARE SAID TO COVER SEVENTY
01:23:23.065 --> 01:23:26.802 region:rollup2
FIVE PERCENT OF PROGRAM COSTS
01:23:25.067 --> 01:23:28.704 region:rollup2
EACH YEAR. AND BENEFICIARIES
01:23:26.802 --> 01:23:29.671 region:rollup2
ALSO PAY MONTHLY PREMIUMS WHICH
01:23:28.704 --> 01:23:31.507 region:rollup2
COVER THE OTHER TWENTY FIVE
01:23:29.671 --> 01:23:33.342 region:rollup2
PERCENT.
01:23:31.507 --> 01:23:34.543 region:rollup2
HIGHER INCOME BENEFICIARIES PAY
01:23:33.342 --> 01:23:35.844 region:rollup2
A HIGHER SHARE OF PROGRAM
01:23:34.543 --> 01:23:37.713 region:rollup2
COSTING RECEIVE A LOWER FEDERAL
01:23:35.844 --> 01:23:40.215 region:rollup2
SUBSIDY.
01:23:37.713 --> 01:23:41.984 region:rollup2
PARTY IS FUNDED SIMILAR LEAD TO
01:23:40.215 --> 01:23:43.285 region:rollup2
PART BE WITH GENERAL REVENUES
01:23:41.984 --> 01:23:45.521 region:rollup2
COVERING ABOUT SEVENTY FIVE
01:23:43.285 --> 01:23:47.689 region:rollup2
PERCENT OF PROGRAM COSTS EACH
01:23:45.521 --> 01:23:49.591 region:rollup2
YEAR AND BENEFICIARY PREMIUMS
01:23:47.689 --> 01:23:51.593 region:rollup2
AND STATE TRANSFERS COVERING THE
01:23:49.591 --> 01:23:53.595 region:rollup2
REST. AND LIKE PART BE HIGHER
01:23:51.593 --> 01:23:55.163 region:rollup2
INCOME BENEFICIARIES PAY A
01:23:53.595 --> 01:23:57.266 region:rollup2
HIGHER SHARE OF PROGRAM COSTS
01:23:55.163 --> 01:23:58.567 region:rollup2
FOR PART D. COVERAGE.
01:23:57.266 --> 01:23:59.902 region:rollup2
SO LET ME TRANSLATE THESE
01:23:58.567 --> 01:24:01.203 region:rollup2
DIFFERENT FUNDING STREAMS AND
01:23:59.902 --> 01:24:03.238 region:rollup2
ACTUAL DOLLAR AMOUNTS.
01:24:01.203 --> 01:24:04.740 region:rollup2
FOR TWENTY SIXTEEN FOR PARTS A
01:24:03.238 --> 01:24:06.208 region:rollup2
BMD.
01:24:04.740 --> 01:24:07.376 region:rollup2
PART SEE IS NOT SHOWN
01:24:06.208 --> 01:24:08.510 region:rollup2
SEPARATELY HERE BECAUSE IT
01:24:07.376 --> 01:24:10.412 region:rollup2
DOESN'T HAVE ITS OWN FINANCING
01:24:08.510 --> 01:24:11.847 region:rollup2
STREAM.
01:24:10.412 --> 01:24:13.882 region:rollup2
SO TOTAL REVENUE TO MEDICARE AND
01:24:11.847 --> 01:24:16.151 region:rollup2
TWENTY SIXTEEN WAS SEVEN HUNDRED
01:24:13.882 --> 01:24:18.086 region:rollup2
AND TEN BILLION DOLLARS.
01:24:16.151 --> 01:24:19.888 region:rollup2
PART A REVENUE IN TWENTY
01:24:18.086 --> 01:24:21.757 region:rollup2
SIXTEEN TOTAL TWO HUNDRED AND
01:24:19.888 --> 01:24:23.358 region:rollup2
NINETY ONE BILLION DOLLARS OF
01:24:21.757 --> 01:24:24.760 region:rollup2
WHICH THE VAST MAJORITY TWO
01:24:23.358 --> 01:24:29.598 region:rollup2
HUNDRED AND FIFTY FOUR BILLION
01:24:24.760 --> 01:24:31.600 region:rollup2
DOLLARS WAS FOUND PAYROLL TAXES.
01:24:29.598 --> 01:24:33.235 region:rollup2
PART BE REVENUE IN TWENTY
01:24:31.600 --> 01:24:34.836 region:rollup2
SIXTEEN WAS THREE HUNDRED AND
01:24:33.235 --> 01:24:36.238 region:rollup2
THIRTEEN BILLION DOLLARS. OF
01:24:34.836 --> 01:24:37.606 region:rollup2
WHICH THREE QUARTERS OR TWO
01:24:36.238 --> 01:24:38.106 region:rollup2
HUNDRED AND THIRTY SIX BILLION
01:24:37.606 --> 01:24:40.542 region:rollup2
DOLLARS WAS FROM GENERAL
01:24:38.106 --> 01:24:42.077 region:rollup2
REVENUE.
01:24:40.542 --> 01:24:43.812 region:rollup2
BENEFICIARIESPAID SEVENTY TWO
01:24:42.077 --> 01:24:46.915 region:rollup2
BILLION DOLLARS IN PART B.
01:24:43.812 --> 01:24:48.850 region:rollup2
PREMIUMS IN TWENTY SIXTEEN.
01:24:46.915 --> 01:24:50.252 region:rollup2
PARDEE REVENUE WAS A HUNDRED AND
01:24:48.850 --> 01:24:51.920 region:rollup2
SIX BILLION DOLLARS IN TWENTY
01:24:50.252 --> 01:24:53.088 region:rollup2
SIXTEEN OF WHICH EIGHTY TWO
01:24:51.920 --> 01:24:55.057 region:rollup2
BILLION WAS FROM GENERAL
01:24:53.088 --> 01:24:56.191 region:rollup2
REVENUES AND BENEFICIARIES PAID
01:24:55.057 --> 01:24:58.360 region:rollup2
FOURTEEN BILLION DOLLARS IN
01:24:56.191 --> 01:24:59.528 region:rollup2
PARTY PREMIUMS.
01:24:58.360 --> 01:25:01.496 region:rollup2
SO I KNOW I JUST MENTIONED A LOT
01:24:59.528 --> 01:25:03.265 region:rollup2
OF NUMBERS AND YOU MAY REMEMBER
01:25:01.496 --> 01:25:05.200 region:rollup2
NOT OF THEM BUT THE POINT I'D
01:25:03.265 --> 01:25:07.169 region:rollup2
LIKE TO EMPHASIZE IS THAT.
01:25:05.200 --> 01:25:08.937 region:rollup2
MEDICARE RECEIVES A SIGNIFICANT
01:25:07.169 --> 01:25:10.739 region:rollup2
INVESTMENT OF FEDERAL DOLLARS
01:25:08.937 --> 01:25:12.874 region:rollup2
FROM PAYROLL TAXES AND GENERAL
01:25:10.739 --> 01:25:14.610 region:rollup2
REVENUES BUT ALSO A NOT
01:25:12.874 --> 01:25:15.077 region:rollup2
INSIGNIFICANT PORTION OF FUNDING
01:25:14.610 --> 01:25:16.878 region:rollup2
IS FROM BENEFICIARIES
01:25:15.077 --> 01:25:17.980 region:rollup2
THEMSELVES.
01:25:16.878 --> 01:25:20.816 region:rollup2
IN THE FORM OF MONTHLY PREMIUM
01:25:17.980 --> 01:25:22.651 region:rollup2
PAYMENTS.
01:25:20.816 --> 01:25:24.319 region:rollup2
SO NOW WE FOCUS IN ON THE
01:25:22.651 --> 01:25:25.620 region:rollup2
SPECIFICS OF MEDICARE WAIVER
01:25:24.319 --> 01:25:27.189 region:rollup2
AUTHORITY WHICH I KNOW YOU'RE
01:25:25.620 --> 01:25:29.157 region:rollup2
VERY INTERESTED IN.
01:25:27.189 --> 01:25:30.959 region:rollup2
SO TITLE EIGHTEEN OF THE SOCIAL
01:25:29.157 --> 01:25:33.061 region:rollup2
SECURITY ACT IS HEALTH INSURANCE
01:25:30.959 --> 01:25:35.330 region:rollup2
FOR THE AGED AND DISABLED WHICH
01:25:33.061 --> 01:25:37.265 region:rollup2
WE KNOW AS MEDICARE.
01:25:35.330 --> 01:25:39.067 region:rollup2
WHO QUALIFIES FOR THE PROGRAM
01:25:37.265 --> 01:25:41.036 region:rollup2
THAT BENEFITS TO WHICH THEY ARE
01:25:39.067 --> 01:25:42.738 region:rollup2
ENTITLED THE MONTHLY PREMIUMS
01:25:41.036 --> 01:25:44.072 region:rollup2
THAT PEOPLE PAY THE COST SHARING
01:25:42.738 --> 01:25:46.975 region:rollup2
PAYMENTS THAT THEY PAY FOR
01:25:44.072 --> 01:25:48.844 region:rollup2
SERVICES? HOW PROVIDERS ARE PAID
01:25:46.975 --> 01:25:51.013 region:rollup2
AND HOW THE PROGRAM IS FINANCED
01:25:48.844 --> 01:25:53.815 region:rollup2
ARE ALL GOVERNED BY STATUTE?
01:25:51.013 --> 01:25:55.450 region:rollup2
BUT FEDERAL LAW ALSO PERMITS THE
01:25:53.815 --> 01:25:58.186 region:rollup2
SECRETARY OF HEALTH AND HUMAN
01:25:55.450 --> 01:26:00.222 region:rollup2
SERVICES OR HHS TO WAIVE CERTAIN
01:25:58.186 --> 01:26:01.089 region:rollup2
PROVISIONS OF MEDICARE LAW IN
01:26:00.222 --> 01:26:02.658 region:rollup2
ORDER TO CONDUCT DEMONSTRATION
01:26:01.089 --> 01:26:04.159 region:rollup2
PROJECTS.
01:26:02.658 --> 01:26:05.660 region:rollup2
AND TEST MODELS OF PAYMENT AND
01:26:04.159 --> 01:26:07.429 region:rollup2
DELIVERY SYSTEM REFORMS RELATED
01:26:05.660 --> 01:26:08.730 region:rollup2
TO MEDICARE.
01:26:07.429 --> 01:26:11.133 region:rollup2
I WANT TO TALK ABOUT TO SPECIFIC
01:26:08.730 --> 01:26:13.602 region:rollup2
PROVISIONS THAT ALLOW FOR THIS
01:26:11.133 --> 01:26:15.170 region:rollup2
TYPE OF WAIVER ACTIVITY.
01:26:13.602 --> 01:26:16.672 region:rollup2
ONE IS SECTION FOUR OH TWO OF
01:26:15.170 --> 01:26:19.141 region:rollup2
THE SOCIAL SECURITY AMENDMENTS
01:26:16.672 --> 01:26:22.377 region:rollup2
OF NINETEEN SIXTY SEVEN WHICH.
01:26:19.141 --> 01:26:24.946 region:rollup2
AIMS TO IMPROVE THE EFFICIENCY
01:26:22.377 --> 01:26:26.181 region:rollup2
AND ECONOMY OF MEDICARE ALLOWING
01:26:24.946 --> 01:26:27.449 region:rollup2
FOR EXPERIMENTS AND
01:26:26.181 --> 01:26:29.351 region:rollup2
DEMONSTRATIONS TO TEST
01:26:27.449 --> 01:26:31.019 region:rollup2
ALTERNATIVE METHODS OF PAYING
01:26:29.351 --> 01:26:32.988 region:rollup2
FOR MEDICARE SERVICES.
01:26:31.019 --> 01:26:35.157 region:rollup2
OR COVERING OTHER BENEFITS THAT
01:26:32.988 --> 01:26:37.192 region:rollup2
ARE NOT ALREADY PAID FOR.
01:26:35.157 --> 01:26:38.994 region:rollup2
BY MEDICARE.
01:26:37.192 --> 01:26:41.730 region:rollup2
THE WAIVER AUTHORIZES THE
01:26:38.994 --> 01:26:42.230 region:rollup2
SECRETARY TO WAIVE MEDICARE
01:26:41.730 --> 01:26:44.800 region:rollup2
PAYMENTS.
01:26:42.230 --> 01:26:46.702 region:rollup2
THAT ARE REQUIRED TO CARRY OUT
01:26:44.800 --> 01:26:50.338 region:rollup2
THE DEMONSTRATION UNDER THE
01:26:46.702 --> 01:26:51.707 region:rollup2
SECTION FOUR OH TO AUTHORITY.
01:26:50.338 --> 01:26:55.110 region:rollup2
THAT.
01:26:51.707 --> 01:26:56.745 region:rollup2
SECTION ELEVEN FIFTEEN A
01:26:55.110 --> 01:26:58.914 region:rollup2
ESTABLISH A CENTER FOR MEDICARE
01:26:56.745 --> 01:27:00.682 region:rollup2
AND MEDICAID INNOVATION THIS WAS
01:26:58.914 --> 01:27:02.651 region:rollup2
AUTHORIZED OR CREATED BY THE
01:27:00.682 --> 01:27:04.019 region:rollup2
AFFORDABLE CARE ACT.
01:27:02.651 --> 01:27:05.921 region:rollup2
DOES SENATOR MEDICARE AND
01:27:04.019 --> 01:27:07.622 region:rollup2
MEDICARE AND MEDICAID INNOVATION
01:27:05.921 --> 01:27:09.891 region:rollup2
ALSO KNOWN AS THE INNOVATION
01:27:07.622 --> 01:27:11.860 region:rollup2
CENTER OR CMMI. HAS BROAD
01:27:09.891 --> 01:27:14.162 region:rollup2
AUTHORITY TO TEST INNOVATIVE
01:27:11.860 --> 01:27:16.298 region:rollup2
MODELS FOR SERVICE DELIVERY AND
01:27:14.162 --> 01:27:19.267 region:rollup2
PAYMENT METHODS THAT DECREASE
01:27:16.298 --> 01:27:21.703 region:rollup2
COSTS AND OR IMPROVE.
01:27:19.267 --> 01:27:23.872 region:rollup2
OR MAINTAIN QUALITY IN MEDICARE
01:27:21.703 --> 01:27:25.307 region:rollup2
MEDICAID AND CHIP.
01:27:23.872 --> 01:27:27.075 region:rollup2
SINCE TWENTY ELEVEN THIS HAS
01:27:25.307 --> 01:27:28.844 region:rollup2
BEEN THE PRIMARY VEHICLE FOR
01:27:27.075 --> 01:27:31.079 region:rollup2
TESTING INNOVATIONS AND MEDICARE
01:27:28.844 --> 01:27:33.215 region:rollup2
PAYMENT AND SERVICE DELIVERY.
01:27:31.079 --> 01:27:34.349 region:rollup2
IN ADDITION CONGRESS CAN ALSO
01:27:33.215 --> 01:27:35.417 region:rollup2
MANDATE.
01:27:34.349 --> 01:27:36.418 region:rollup2
SPECIFIC MEDICARE
01:27:35.417 --> 01:27:39.187 region:rollup2
DEMONSTRATIONS THROUGH
01:27:36.418 --> 01:27:40.956 region:rollup2
LEGISLATION.
01:27:39.187 --> 01:27:43.125 region:rollup2
I WANT NOTE THAT THESE MEDICARE
01:27:40.956 --> 01:27:45.627 region:rollup2
WAIVERS AND DEMONSTRATIONS ARE
01:27:43.125 --> 01:27:47.162 region:rollup2
DIFFERENT FROM MEDICAID AND ACA
01:27:45.627 --> 01:27:49.331 region:rollup2
WAIVERS WHICH CHIQUITA WILL BE
01:27:47.162 --> 01:27:51.533 region:rollup2
TELLING YOU MORE ABOUT SHORTLY.
01:27:49.331 --> 01:27:53.034 region:rollup2
THOSE WAIVERS MAY BE MORE OF A
01:27:51.533 --> 01:27:55.203 region:rollup2
VEHICLE FOR EXPANDING STATE'S
01:27:53.034 --> 01:27:57.205 region:rollup2
DISCRETION OVER PROGRAM RULES
01:27:55.203 --> 01:27:59.274 region:rollup2
GOVERNING ELIGIBILITY BENEFITS
01:27:57.205 --> 01:28:00.442 region:rollup2
AT CETERA. BUT THIS IS GENERALLY
01:27:59.274 --> 01:28:02.611 region:rollup2
NOT THE CASE
01:28:00.442 --> 01:28:05.080 region:rollup2
FOR MEDICARE WAIVERS.
01:28:02.611 --> 01:28:06.681 region:rollup2
AT UNLIKE MEDICAID AN ACA THERE
01:28:05.080 --> 01:28:09.050 region:rollup2
IS REALLY LITTLE PRECEDENT FOR
01:28:06.681 --> 01:28:11.253 region:rollup2
STATES TO SEEK BROAD WAIVERS OF
01:28:09.050 --> 01:28:12.587 region:rollup2
FEDERAL LAW RELATED TO MEDICARE
01:28:11.253 --> 01:28:14.589 region:rollup2
IN LARGE PART I THINK BECAUSE
01:28:12.587 --> 01:28:15.924 region:rollup2
MEDICARE IS A NATIONAL PROGRAM.
01:28:14.589 --> 01:28:16.525 region:rollup2
AND STATES ARE NOT REALLY
01:28:15.924 --> 01:28:20.595 region:rollup2
RESPONSIBLE FOR ADMINISTERING
01:28:16.525 --> 01:28:22.697 region:rollup2
IT.
01:28:20.595 --> 01:28:24.132 region:rollup2
SO AND BECAUSE THE SECTION FOR
01:28:22.697 --> 01:28:25.567 region:rollup2
O. TO AUTHORITY HAS REALLY NOT
01:28:24.132 --> 01:28:27.903 region:rollup2
BEEN USED
01:28:25.567 --> 01:28:29.704 region:rollup2
IN THE CONTEXT OF A STATE BASED
01:28:27.903 --> 01:28:31.673 region:rollup2
HEALTH CARE PROGRAM. AND THE
01:28:29.704 --> 01:28:34.209 region:rollup2
SECRETARY WAIVER AUTHORITY UNDER
01:28:31.673 --> 01:28:36.144 region:rollup2
SECTION ODE TO IS LIMITED TO
01:28:34.209 --> 01:28:37.679 region:rollup2
MEDICARE'S PAYMENT RULES I WANT
01:28:36.144 --> 01:28:40.682 region:rollup2
TO FOCUS MORE ON THE INNOVATION
01:28:37.679 --> 01:28:41.883 region:rollup2
CENTER AND WHAT IT DOES.
01:28:40.682 --> 01:28:43.652 region:rollup2
SO AS I SAID THE CENTER HAS
01:28:41.883 --> 01:28:46.054 region:rollup2
BROAD AUTHORITY TO TEST AND
01:28:43.652 --> 01:28:47.856 region:rollup2
DEVELOP NEW PAYMENT AND SERVICE
01:28:46.054 --> 01:28:48.657 region:rollup2
DELIVERY MODELS AND MEDICARE AND
01:28:47.856 --> 01:28:50.959 region:rollup2
THIS INCLUDES STATEWIDE
01:28:48.657 --> 01:28:52.861 region:rollup2
INITIATIVES.
01:28:50.959 --> 01:28:54.696 region:rollup2
THE INNOVATION CENTER PLAYS AN
01:28:52.861 --> 01:28:57.065 region:rollup2
INTEGRAL ROLE IN THE PROCESS OF
01:28:54.696 --> 01:28:59.034 region:rollup2
GOING FROM THE IDEA OF A MODEL
01:28:57.065 --> 01:29:00.468 region:rollup2
TO ACTUALLY TESTING IT.
01:28:59.034 --> 01:29:02.571 region:rollup2
THE GENERAL OUTLINE OF THIS
01:29:00.468 --> 01:29:04.005 region:rollup2
PROCESS IS THAT THE INNOVATION
01:29:02.571 --> 01:29:05.907 region:rollup2
CENTER SOLICITS IDEAS FOR NEW
01:29:04.005 --> 01:29:08.243 region:rollup2
MODELS.
01:29:05.907 --> 01:29:10.078 region:rollup2
IT REVIEWS SELECTS AND DEVELOPS
01:29:08.243 --> 01:29:11.580 region:rollup2
THE MOST PROMISING MODELS.
01:29:10.078 --> 01:29:12.914 region:rollup2
IT DETERMINES THE APPROPRIATE
01:29:11.580 --> 01:29:14.683 region:rollup2
BENCHMARKS.
01:29:12.914 --> 01:29:16.218 region:rollup2
TO MEASURE THE PERFORMANCE OF
01:29:14.683 --> 01:29:18.620 region:rollup2
THE MODEL.
01:29:16.218 --> 01:29:19.688 region:rollup2
AND SELECT PARTNERS TO TEST THE
01:29:18.620 --> 01:29:22.357 region:rollup2
MODELS TYPICALLY THROUGH A
01:29:19.688 --> 01:29:26.094 region:rollup2
COMPETITIVE PROCESS.
01:29:22.357 --> 01:29:27.395 region:rollup2
THESE MODELS REQUIRE RIGOROUS
01:29:26.094 --> 01:29:27.929 region:rollup2
MONITORING TESTING AND
01:29:27.395 --> 01:29:29.931 region:rollup2
INDEPENDENT EVALUATIONS OF
01:29:27.929 --> 01:29:32.267 region:rollup2
THEIR.
01:29:29.931 --> 01:29:33.401 region:rollup2
PROGRESS.
01:29:32.267 --> 01:29:35.804 region:rollup2
TYPICALLY THESE MODELS HAVE AN
01:29:33.401 --> 01:29:37.505 region:rollup2
END DATE ALTHOUGH THE DURATION
01:29:35.804 --> 01:29:38.873 region:rollup2
AND THE SCOPE OF THE MODELS CAN
01:29:37.505 --> 01:29:41.710 region:rollup2
BE EXPANDED THROUGH A FORMAL
01:29:38.873 --> 01:29:43.111 region:rollup2
RULE MAKING PROCESS. IF THE HHS
01:29:41.710 --> 01:29:45.447 region:rollup2
SECRETARY DETERMINES THAT
01:29:43.111 --> 01:29:47.849 region:rollup2
EXPANSION OF THE MODEL WILL
01:29:45.447 --> 01:29:49.351 region:rollup2
REDUCE PROGRAM SPENDING AND BY
01:29:47.849 --> 01:29:51.419 region:rollup2
THAT I MEAN MEDICARE PROGRAM
01:29:49.351 --> 01:29:54.689 region:rollup2
SPENDING SPECIFICALLY. WITHOUT
01:29:51.419 --> 01:29:58.460 region:rollup2
REDUCING QUALITY OR WILL IMPROVE
01:29:54.689 --> 01:30:00.829 region:rollup2
QUALITY. INCREASING SPENDING.
01:29:58.460 --> 01:30:03.064 region:rollup2
THESE MODELS ARE NOT INITIALLY
01:30:00.829 --> 01:30:05.267 region:rollup2
REQUIRED TO BE BUDGET NEUTRAL.
01:30:03.064 --> 01:30:07.269 region:rollup2
BUT THE MODELS CAN BE TERMINATED
01:30:05.267 --> 01:30:09.704 region:rollup2
OR MODIFIED UNLESS THE HHS
01:30:07.269 --> 01:30:12.073 region:rollup2
SECRETARY DETERMINES THAT A
01:30:09.704 --> 01:30:13.708 region:rollup2
MODEL AS MODIFIED. IS EXPECTED
01:30:12.073 --> 01:30:15.777 region:rollup2
TO IMPROVE QUALITY WITHOUT
01:30:13.708 --> 01:30:17.145 region:rollup2
INCREASING SPENDING REDUCE
01:30:15.777 --> 01:30:19.681 region:rollup2
SPENDING WITHOUT REDUCING
01:30:17.145 --> 01:30:21.549 region:rollup2
QUALITY OR IMPROVE QUALITY AND
01:30:19.681 --> 01:30:23.952 region:rollup2
REDUCE SPENDING.
01:30:21.549 --> 01:30:25.954 region:rollup2
SO JUST TO BE CLEAR THE CORE
01:30:23.952 --> 01:30:27.989 region:rollup2
PURPOSE OF THE INNOVATION CENTER
01:30:25.954 --> 01:30:29.658 region:rollup2
IS TO TEST INNOVATIVE PAYMENT
01:30:27.989 --> 01:30:31.860 region:rollup2
AND SERVICE DELIVERY MODELS TO
01:30:29.658 --> 01:30:33.495 region:rollup2
REDUCE PROGRAM EXPENDITURES
01:30:31.860 --> 01:30:36.064 region:rollup2
WHILE PRESERVING OR ENHANCING
01:30:33.495 --> 01:30:37.232 region:rollup2
THE QUALITY OF CARE.
01:30:36.064 --> 01:30:39.534 region:rollup2
THERE ARE SEVERAL DIFFERENT
01:30:37.232 --> 01:30:40.936 region:rollup2
CATEGORIES OF INNOVATION MODELS
01:30:39.534 --> 01:30:42.270 region:rollup2
THAT THE CENTER CARRIES OUT AND
01:30:40.936 --> 01:30:43.438 region:rollup2
I DON'T HAVE TIME TO FOCUS ON
01:30:42.270 --> 01:30:45.173 region:rollup2
THE SPECIFICS OF EACH OF THESE
01:30:43.438 --> 01:30:46.541 region:rollup2
CATEGORIES. BUT I DID WANT YOU
01:30:45.173 --> 01:30:47.876 region:rollup2
TO SEE THE RANGE OF MODELS THAT
01:30:46.541 --> 01:30:49.511 region:rollup2
THE INNOVATION CENTER HAS
01:30:47.876 --> 01:30:50.745 region:rollup2
AUTHORITY TO TEST.
01:30:49.511 --> 01:30:52.347 region:rollup2
AND CALIFORNIA ACTUALLY DOES
01:30:50.745 --> 01:30:54.149 region:rollup2
HAVE INITIATIVES UNDERWAY IN
01:30:52.347 --> 01:30:55.250 region:rollup2
SEVERAL OF THESE CATEGORIES.
01:30:54.149 --> 01:30:57.819 region:rollup2
BUT I WANT TO HIGHLIGHT THIS
01:30:55.250 --> 01:30:59.688 region:rollup2
LAST CATEGORY INNOVATION I IN
01:30:57.819 --> 01:31:01.389 region:rollup2
INITIATIVES TO ACCELERATE. THE
01:30:59.688 --> 01:31:02.457 region:rollup2
DEVELOPMENT AND TESTING OF NEW
01:31:01.389 --> 01:31:04.526 region:rollup2
PAYMENT AND SERVICE DELIVERY
01:31:02.457 --> 01:31:05.593 region:rollup2
MODELS.
01:31:04.526 --> 01:31:07.529 region:rollup2
THIS IS WHERE SEVERAL STATE
01:31:05.593 --> 01:31:08.396 region:rollup2
BASED INITIATIVES.
01:31:07.529 --> 01:31:10.065 region:rollup2
THAT INVOLVE MEDICARE
01:31:08.396 --> 01:31:12.367 region:rollup2
PARTICIPATION ARE BEING
01:31:10.065 --> 01:31:14.269 region:rollup2
IMPLEMENTED INCLUDING MARYLAND'S
01:31:12.367 --> 01:31:15.303 region:rollup2
ALL PAYER MODEL I KNOW YOU'VE
01:31:14.269 --> 01:31:17.405 region:rollup2
ALREADY HEARD.
01:31:15.303 --> 01:31:19.007 region:rollup2
AT A PREVIOUS HEARING DETAILS
01:31:17.405 --> 01:31:20.475 region:rollup2
ABOUT MARYLAND'S MODEL SO I
01:31:19.007 --> 01:31:22.911 region:rollup2
WON'T GO INTO DETAIL ABOUT IT
01:31:20.475 --> 01:31:24.245 region:rollup2
HERE. BUT ORIGINALLY OUT I WON
01:31:22.911 --> 01:31:26.047 region:rollup2
AND I MENTION A COUPLE POINTS
01:31:24.245 --> 01:31:27.349 region:rollup2
ABOUT IT MARYLAND'S MODEL
01:31:26.047 --> 01:31:28.817 region:rollup2
ORIGINALLY TOOK THE FORM OF A
01:31:27.349 --> 01:31:29.985 region:rollup2
WAIVER ESTABLISHED IN FEDERAL
01:31:28.817 --> 01:31:31.486 region:rollup2
LAW.
01:31:29.985 --> 01:31:33.154 region:rollup2
UNDER THE ORIGINAL WAIVER
01:31:31.486 --> 01:31:34.723 region:rollup2
MEDICARE PAYS HOSPITAL RATES
01:31:33.154 --> 01:31:36.825 region:rollup2
THAT MEDICARE'S BUT THAT MARILYN
01:31:34.723 --> 01:31:38.793 region:rollup2
STATS NOT THE RATES THAT
01:31:36.825 --> 01:31:40.495 region:rollup2
MEDICARE'S SETS.
01:31:38.793 --> 01:31:41.496 region:rollup2
AND I ALSO THINK IT'S IMPORTANT
01:31:40.495 --> 01:31:43.631 region:rollup2
TO EMPHASIZE THAT MARILYN'S
01:31:41.496 --> 01:31:45.133 region:rollup2
WEAVER IS UNIQUE.
01:31:43.631 --> 01:31:46.835 region:rollup2
AND SOMEWHAT LIMITED IN SCOPE
01:31:45.133 --> 01:31:49.270 region:rollup2
AND THAT IT DOESN'T CHANGE
01:31:46.835 --> 01:31:51.806 region:rollup2
MEDICARE BENEFITS OR ELIGIBILITY
01:31:49.270 --> 01:31:53.541 region:rollup2
OR COST SHARING OR FINANCING OR
01:31:51.806 --> 01:31:55.310 region:rollup2
THE FUNDING STREAMS ASSOCIATED
01:31:53.541 --> 01:31:56.478 region:rollup2
WITH THE MEDICARE TRUST FUNDS.
01:31:55.310 --> 01:31:58.313 region:rollup2
NOR THE UNDERLYING COVERAGE
01:31:56.478 --> 01:31:59.347 region:rollup2
ARRANGEMENTS OF PEOPLE WITH WITH
01:31:58.313 --> 01:32:01.016 region:rollup2
MEDICARE IN THE STATE OF
01:31:59.347 --> 01:32:02.484 region:rollup2
MARYLAND.
01:32:01.016 --> 01:32:04.052 region:rollup2
IT'S ALSO IMPORTANT TO KNOW
01:32:02.484 --> 01:32:06.021 region:rollup2
THAT MARILYN'S ORIGINAL WAIVER
01:32:04.052 --> 01:32:07.522 region:rollup2
IS SHIFTING AWAY FROM THE
01:32:06.021 --> 01:32:08.957 region:rollup2
STATUTORY WAIVER THAT THE STATE
01:32:07.522 --> 01:32:11.092 region:rollup2
RECEIVED.
01:32:08.957 --> 01:32:11.960 region:rollup2
TO THIS NEW ALL PAYER MODEL
01:32:11.092 --> 01:32:13.495 region:rollup2
WHICH WAS DEVELOPED IN
01:32:11.960 --> 01:32:16.197 region:rollup2
PARTNERSHIP WITH THE INNOVATION
01:32:13.495 --> 01:32:16.765 region:rollup2
CENTER. AND HAS VERY SPECIFIC
01:32:16.197 --> 01:32:18.967 region:rollup2
MEDICARE SAVINGS TARGETS TO
01:32:16.765 --> 01:32:22.103 region:rollup2
MEET.
01:32:18.967 --> 01:32:23.004 region:rollup2
IN ORDER TO CONTINUE.
01:32:22.103 --> 01:32:24.305 region:rollup2
I ALSO WANT TO CALL YOUR
01:32:23.004 --> 01:32:25.840 region:rollup2
ATTENTION TO THE STATE
01:32:24.305 --> 01:32:27.208 region:rollup2
INNOVATION MODELS.
01:32:25.840 --> 01:32:29.210 region:rollup2
WHICH FALLS WITHIN THIS
01:32:27.208 --> 01:32:32.113 region:rollup2
CATEGORY WHICH IS WHERE STATES
01:32:29.210 --> 01:32:32.881 region:rollup2
CAN DESIGN AND TEST NEW A MULTI
01:32:32.113 --> 01:32:35.283 region:rollup2
PAYER.
01:32:32.881 --> 01:32:37.018 region:rollup2
AT PAYMENT AND DELIVERY MODELS
01:32:35.283 --> 01:32:40.321 region:rollup2
WHICH WITH POTENTIAL TO IMPROVE
01:32:37.018 --> 01:32:40.789 region:rollup2
CARE AND LOWER COSTS NOT AND TO
01:32:40.321 --> 01:32:42.357 region:rollup2
IMPROVE HEALTH SYSTEM
01:32:40.789 --> 01:32:43.892 region:rollup2
PERFORMANCE.
01:32:42.357 --> 01:32:45.627 region:rollup2
THIS MODEL HAS BEEN ROLLING OUT
01:32:43.892 --> 01:32:47.028 region:rollup2
IN SEVERAL STAGES AND IN FACT
01:32:45.627 --> 01:32:49.397 region:rollup2
CALIFORNIA DID RECEIVE TWO
01:32:47.028 --> 01:32:50.732 region:rollup2
ROUNDS OF FUNDING IN THE DESIGN
01:32:49.397 --> 01:32:52.667 region:rollup2
STAGES.
01:32:50.732 --> 01:32:53.968 region:rollup2
OF THIS INITIATIVE.
01:32:52.667 --> 01:32:56.438 region:rollup2
CURRENTLY THERE ARE ELEVEN
01:32:53.968 --> 01:32:58.006 region:rollup2
STATES IN THE TESTING STAGE
01:32:56.438 --> 01:33:00.141 region:rollup2
WITH THE WIDE RANGE OF PROPOSALS
01:32:58.006 --> 01:33:02.777 region:rollup2
BEING TESTED AND THESE STATE
01:33:00.141 --> 01:33:04.846 region:rollup2
INNOVATION MODELS ARE BURIED.
01:33:02.777 --> 01:33:06.414 region:rollup2
AND ALSO AMBITIOUS.
01:33:04.846 --> 01:33:07.882 region:rollup2
IT'S DIFFICULT TO SUMMARIZE
01:33:06.414 --> 01:33:09.851 region:rollup2
THEM IN A SENTENCE OR TWO.
01:33:07.882 --> 01:33:11.086 region:rollup2
BUT BUT I WOULD SAY IN GENERAL
01:33:09.851 --> 01:33:12.654 region:rollup2
SEVERAL STATES HAVE BUILT THEIR
01:33:11.086 --> 01:33:14.456 region:rollup2
PLANS AROUND PATIENT CENTERED
01:33:12.654 --> 01:33:16.424 region:rollup2
MEDICAL HOMES.
01:33:14.456 --> 01:33:18.626 region:rollup2
INTEGRATING PRIMARY CARE AND
01:33:16.424 --> 01:33:19.727 region:rollup2
BEHAVIORAL HEALTH CARE.
01:33:18.626 --> 01:33:21.129 region:rollup2
EXPANDING HEALTH INFORMATION
01:33:19.727 --> 01:33:23.164 region:rollup2
TECHNOLOGY EFFORTS LIKE
01:33:21.129 --> 01:33:25.333 region:rollup2
TELEHEALTH. AND MOVING TO VALUE
01:33:23.164 --> 01:33:26.301 region:rollup2
BASED PAYMENTS SHARED SAVINGS
01:33:25.333 --> 01:33:29.104 region:rollup2
AND ACCOUNTABLE CARE PAYMENT
01:33:26.301 --> 01:33:30.972 region:rollup2
MODELS.
01:33:29.104 --> 01:33:32.474 region:rollup2
CMS HAS SOMEWHAT HOPEFULLY I
01:33:30.972 --> 01:33:34.008 region:rollup2
THINK RELEASED GUIDANCE
01:33:32.474 --> 01:33:36.478 region:rollup2
IN SUPPORT OF MEDICARE
01:33:34.008 --> 01:33:38.413 region:rollup2
PARTICIPATION IN THESE MODELS
01:33:36.478 --> 01:33:40.215 region:rollup2
THOUGH I'D ALSO NOTE THAT THE
01:33:38.413 --> 01:33:42.217 region:rollup2
INTEGRATION OF MEDICARE IN STATE
01:33:40.215 --> 01:33:44.686 region:rollup2
INNOVATION MODELS IS SUBJECT TO
01:33:42.217 --> 01:33:46.654 region:rollup2
ADDITIONAL SCRUTINY. BY CMS.
01:33:44.686 --> 01:33:47.455 region:rollup2
FOR STATES THAT WANT TO
01:33:46.654 --> 01:33:49.224 region:rollup2
INCORPORATE MEDICARE
01:33:47.455 --> 01:33:51.392 region:rollup2
PARTICIPATION IN A STATE
01:33:49.224 --> 01:33:52.760 region:rollup2
INNOVATION MODEL THE PLAN MUST
01:33:51.392 --> 01:33:54.929 region:rollup2
ADHERE TO SEVERAL SPECIFIC
01:33:52.760 --> 01:33:56.397 region:rollup2
PRINCIPLES AND IT MUST HAVE A
01:33:54.929 --> 01:33:57.899 region:rollup2
CLEARLY DEFINED TARGET
01:33:56.397 --> 01:34:00.201 region:rollup2
POPULATION EITHER.
01:33:57.899 --> 01:34:02.637 region:rollup2
AFFECTED PATIENTS OR AFFECTED
01:34:00.201 --> 01:34:04.606 region:rollup2
PROVIDERS OR BOTH.
01:34:02.637 --> 01:34:06.774 region:rollup2
IT MUST HAVE A CLEAR POTENTIAL
01:34:04.606 --> 01:34:08.009 region:rollup2
TO IMPROVE QUALITY AND REDUCE
01:34:06.774 --> 01:34:10.378 region:rollup2
THE SPENDING FOR THE COVERED
01:34:08.009 --> 01:34:11.913 region:rollup2
POPULATION. AND THE STATE MUST
01:34:10.378 --> 01:34:14.782 region:rollup2
HAVE DEMONSTRATED PREPAREDNESS
01:34:11.913 --> 01:34:15.984 region:rollup2
TO UNDERTAKE THE PROPOSAL.
01:34:14.782 --> 01:34:17.619 region:rollup2
AND I WOULD SAY THAT AT THE END
01:34:15.984 --> 01:34:19.287 region:rollup2
OF THE DAY THE DECISION RESTS
01:34:17.619 --> 01:34:21.122 region:rollup2
WITH THE INNOVATION CENTER AND
01:34:19.287 --> 01:34:23.391 region:rollup2
ITS FEDERAL PARTNERS. AS TO
01:34:21.122 --> 01:34:24.826 region:rollup2
WHETHER TO MOVE FORWARD WITH THE
01:34:23.391 --> 01:34:26.794 region:rollup2
STATE'S PLAN UNDER THE STATE
01:34:24.826 --> 01:34:27.962 region:rollup2
INNOVATIONS MODEL OR ANY OF THE
01:34:26.794 --> 01:34:30.398 region:rollup2
OTHER MODELS.
01:34:27.962 --> 01:34:35.003 region:rollup2
THAT THE INNOVATION CENTER HAS
01:34:30.398 --> 01:34:37.438 region:rollup2
STATUTORY AUTHORITY TO PURSUE.
01:34:35.003 --> 01:34:39.340 region:rollup2
SO OBVIOUSLY A KEY QUESTION IT.
01:34:37.438 --> 01:34:42.477 region:rollup2
FOR CALIFORNIA IS WHETHER THE
01:34:39.340 --> 01:34:44.712 region:rollup2
STATE CAN USE EXISTING CMMI
01:34:42.477 --> 01:34:47.048 region:rollup2
AUTHORITY OR SECTION FOUR OH TO
01:34:44.712 --> 01:34:48.716 region:rollup2
MEDICARE WAIVER AUTHORITY. IN
01:34:47.048 --> 01:34:50.585 region:rollup2
THE IMPLEMENTATION OF A SINGLE
01:34:48.716 --> 01:34:52.153 region:rollup2
PAYER SYSTEM.
01:34:50.585 --> 01:34:53.254 region:rollup2
I THINK IT'S CLEAR THAT THE
01:34:52.153 --> 01:34:55.256 region:rollup2
FEDERAL GOVERNMENT DOES
01:34:53.254 --> 01:34:56.658 region:rollup2
RECOGNIZE THAT STATES PLAY A KEY
01:34:55.256 --> 01:34:58.626 region:rollup2
ROLE IN HEALTH CARE DELIVERY AND
01:34:56.658 --> 01:35:00.662 region:rollup2
REFORM EFFORTS.
01:34:58.626 --> 01:35:02.230 region:rollup2
AND HAS IN FACT OPENS THE DOOR
01:35:00.662 --> 01:35:05.433 region:rollup2
TO STATE INITIATIVES THAT
01:35:02.230 --> 01:35:07.068 region:rollup2
INCLUDE MEDICARE PARTICIPATION.
01:35:05.433 --> 01:35:08.803 region:rollup2
EXISTING AUTHORITY DOES IN FACT
01:35:07.068 --> 01:35:10.071 region:rollup2
ALLOW FOR MODELS TESTING CHANGES
01:35:08.803 --> 01:35:12.507 region:rollup2
TO MEDICARE PAYMENT AND SERVICE
01:35:10.071 --> 01:35:13.908 region:rollup2
DELIVERY TO IMPROVE QUALITY AND
01:35:12.507 --> 01:35:15.710 region:rollup2
A CHIEF PROGRAM SAVINGS I'VE
01:35:13.908 --> 01:35:16.744 region:rollup2
SAID THAT OVER AND OVER AGAIN.
01:35:15.710 --> 01:35:18.513 region:rollup2
AND THERE'S CLEARLY THE
01:35:16.744 --> 01:35:21.416 region:rollup2
POTENTIAL TO TAKE STEPS TOWARD
01:35:18.513 --> 01:35:22.984 region:rollup2
TRANSFORMATIVE SYSTEM CHANGE IN
01:35:21.416 --> 01:35:24.485 region:rollup2
THE STATE INNOVATION MODELS
01:35:22.984 --> 01:35:26.721 region:rollup2
UNDER THE INNOVATION CENTERS
01:35:24.485 --> 01:35:28.089 region:rollup2
EXISTING AUTHORITY.
01:35:26.721 --> 01:35:29.991 region:rollup2
BUT FOR IMPLEMENTATION OF A
01:35:28.089 --> 01:35:31.526 region:rollup2
SINGLE PAYER SYSTEM THE STATE
01:35:29.991 --> 01:35:33.461 region:rollup2
WOULD NEED MORE THAN JUST A
01:35:31.526 --> 01:35:35.396 region:rollup2
WAIVER OF STATUTORY PROVISIONS
01:35:33.461 --> 01:35:37.465 region:rollup2
RELATED TO MEDICARE PAYMENT AND
01:35:35.396 --> 01:35:38.933 region:rollup2
SERVICE DELIVERY. AND WOULD NEED
01:35:37.465 --> 01:35:41.235 region:rollup2
TO SEEK PERMISSION TO MAKE
01:35:38.933 --> 01:35:42.937 region:rollup2
BROADER CHANGES WHICH MAY NOT BE
01:35:41.235 --> 01:35:44.939 region:rollup2
ENVISIONED IN THEIR ENTIRETY IN
01:35:42.937 --> 01:35:46.874 region:rollup2
THE CURRENT ROSTER OF INNOVATION
01:35:44.939 --> 01:35:48.509 region:rollup2
CENTER ACTIVITIES. AND WHICH DO
01:35:46.874 --> 01:35:49.677 region:rollup2
NOT SEEM TO FALL WITHIN THE
01:35:48.509 --> 01:35:51.579 region:rollup2
SCOPE OF SECTION FOUR OH TO
01:35:49.677 --> 01:35:53.114 region:rollup2
AUTHORITY.
01:35:51.579 --> 01:35:55.049 region:rollup2
SEEKING PERMISSION FOR THE
01:35:53.114 --> 01:35:57.018 region:rollup2
MEDICARE CHANGES THAT ARE LIKELY
01:35:55.049 --> 01:35:58.519 region:rollup2
TO BE NEEDED FOR IMPLEMENTATION
01:35:57.018 --> 01:36:00.822 region:rollup2
OF A STATE BASED SINGLE PAYER
01:35:58.519 --> 01:36:02.757 region:rollup2
SYSTEM WOULD BE A A DEPARTURE
01:36:00.822 --> 01:36:04.058 region:rollup2
FROM EXISTING APPLICATIONS OF
01:36:02.757 --> 01:36:05.793 region:rollup2
THE DEMONSTRATION AND MODEL
01:36:04.058 --> 01:36:07.128 region:rollup2
TESTING PROCESS. WHEREBY THE
01:36:05.793 --> 01:36:08.563 region:rollup2
STATE WOULD BE SEEKING TO MAKE
01:36:07.128 --> 01:36:09.764 region:rollup2
PERMANENT CHANGES TO THE STATE'S
01:36:08.563 --> 01:36:11.132 region:rollup2
ENTIRE HEALTH CARE DELIVERY
01:36:09.764 --> 01:36:13.234 region:rollup2
SYSTEM FOR ALL OF THE STATE'S
01:36:11.132 --> 01:36:15.403 region:rollup2
RESIDENTS. AND NOT JUST ON A
01:36:13.234 --> 01:36:17.005 region:rollup2
TIME LIMITED BASIS.
01:36:15.403 --> 01:36:19.340 region:rollup2
WITH THAT WITH THEM FOCUSED
01:36:17.005 --> 01:36:21.075 region:rollup2
MUCH BROADER THAN JUST MEDICARE
01:36:19.340 --> 01:36:22.510 region:rollup2
PAYMENT AND SERVICE DELIVERY.
01:36:21.075 --> 01:36:23.478 region:rollup2
AND AS SUCH I THINK THERE IS A
01:36:22.510 --> 01:36:25.713 region:rollup2
REALLY A GREAT DEAL OF
01:36:23.478 --> 01:36:28.182 region:rollup2
UNCERTAINTY AS TO WHAT AT
01:36:25.713 --> 01:36:28.182 region:rollup2
ADMINISTRATION AND PERHAPS
01:36:28.249 --> 01:36:32.620 region:rollup2
ADMINISTRATION. WILL ENTERTAIN
01:36:30.685 --> 01:36:35.556 region:rollup2
THROUGH WAIVERS OR INNOVATION
01:36:32.620 --> 01:36:37.358 region:rollup2
CENTER MODELS.
01:36:35.556 --> 01:36:39.293 region:rollup2
SO I WOULD CONCLUDE BY SAYING
01:36:37.358 --> 01:36:40.528 region:rollup2
THAT I I THINK USING CMMI
01:36:39.293 --> 01:36:43.197 region:rollup2
AUTHORITY OR OTHER MEDICARE
01:36:40.528 --> 01:36:44.098 region:rollup2
WAIVER AUTHORITY. TO IMPLEMENT A
01:36:43.197 --> 01:36:46.834 region:rollup2
SINGLE PAYER SYSTEM IN
01:36:44.098 --> 01:36:48.136 region:rollup2
CALIFORNIA WOULD BE NECESSARY.
01:36:46.834 --> 01:36:50.104 region:rollup2
BUT IT DOES NOT APPEAR TO BE
01:36:48.136 --> 01:36:51.806 region:rollup2
SUFFICIENT.
01:36:50.104 --> 01:36:54.275 region:rollup2
BEYONCE SEEKING PERMISSION FROM
01:36:51.806 --> 01:36:55.843 region:rollup2
HHS FOR CHANGES THAT CAN BE MADE
01:36:54.275 --> 01:36:57.779 region:rollup2
UNDER EXISTING AUTHORITY
01:36:55.843 --> 01:36:59.514 region:rollup2
FLEXIBLE AS IT MIGHT BE WITH
01:36:57.779 --> 01:37:02.050 region:rollup2
REGARD TO STATE INNOVATIVE
01:36:59.514 --> 01:37:03.484 region:rollup2
ACTIVITY. IT IS STILL THE CASE
01:37:02.050 --> 01:37:05.453 region:rollup2
THAT FEDERAL STATUTORY CHANGES
01:37:03.484 --> 01:37:06.788 region:rollup2
WOULD BE NEEDED MEANING CONGRESS
01:37:05.453 --> 01:37:07.889 region:rollup2
WOULD NEED TO PASS AND THE
01:37:06.788 --> 01:37:09.190 region:rollup2
PRESIDENT WOULD NEED TO SIGN
01:37:07.889 --> 01:37:10.758 region:rollup2
LEGISLATION TO MAKE NUMEROUS
01:37:09.190 --> 01:37:12.093 region:rollup2
CHANGES.
01:37:10.758 --> 01:37:14.929 region:rollup2
I I THINK PERHAPS MOST
01:37:12.093 --> 01:37:17.131 region:rollup2
IMPORTANTLY THE EXISTING
01:37:14.929 --> 01:37:18.633 region:rollup2
STATUTORY WAIVER PROCESS AND THE
01:37:17.131 --> 01:37:21.302 region:rollup2
AUTHORITY GRANTED THE INNOVATION
01:37:18.633 --> 01:37:23.571 region:rollup2
CENTER DO NOT APPEAR TO PERMIT
01:37:21.302 --> 01:37:25.973 region:rollup2
THE HHS SECRETARY TO SIMPLY
01:37:23.571 --> 01:37:26.607 region:rollup2
REDIRECTS. MEDICARE'S FUNDING
01:37:25.973 --> 01:37:29.711 region:rollup2
STREAMS.
01:37:26.607 --> 01:37:31.412 region:rollup2
INCLUDING THE PAYROLL TAXES THE
01:37:29.711 --> 01:37:34.282 region:rollup2
GENERAL REVENUES AND BENEFICIARY
01:37:31.412 --> 01:37:36.484 region:rollup2
PREMIUMS OR TRUST FUND DOLLARS
01:37:34.282 --> 01:37:39.153 region:rollup2
TO STATES TO OVERSEE AND MANAGE
01:37:36.484 --> 01:37:40.254 region:rollup2
THESE FUNDS IN THEIR ENTIRETY ON
01:37:39.153 --> 01:37:41.723 region:rollup2
BEHALF OF THE STATE'S ENTIRE
01:37:40.254 --> 01:37:44.792 region:rollup2
MEDICARE POPULATION THROUGH A
01:37:41.723 --> 01:37:46.227 region:rollup2
STATE BASED HEALTH CARE PROGRAM.
01:37:44.792 --> 01:37:47.895 region:rollup2
THE SECRETARY ALSO HAS NO
01:37:46.227 --> 01:37:50.364 region:rollup2
AUTHORITY TO CHANGE MEDICARE
01:37:47.895 --> 01:37:52.100 region:rollup2
ELIGIBILITY OR ENROLLMENT RULES.
01:37:50.364 --> 01:37:54.502 region:rollup2
OR TO CHANGE THE RULES RELATED
01:37:52.100 --> 01:37:56.537 region:rollup2
TO HOW MUCH BENEFICIARIES PAY IN
01:37:54.502 --> 01:37:58.239 region:rollup2
PREMIUMS AND COST SHARING.
01:37:56.537 --> 01:37:59.073 region:rollup2
THESE ARE ALL THINGS THAT WOULD
01:37:58.239 --> 01:38:00.875 region:rollup2
NEED TO BE CHANGED THROUGH
01:37:59.073 --> 01:38:02.110 region:rollup2
FEDERAL LEGISLATION TO FULLY
01:38:00.875 --> 01:38:03.711 region:rollup2
INCORPORATE MEDICARE
01:38:02.110 --> 01:38:05.546 region:rollup2
BENEFICIARIES IN THE STATE
01:38:03.711 --> 01:38:07.148 region:rollup2
SINGLE PAYER SYSTEM.
01:38:05.546 --> 01:38:08.616 region:rollup2
AND BEYOND THE LEGISLATIVE
01:38:07.148 --> 01:38:10.118 region:rollup2
CHANGES THAT WOULD BE NEEDED
01:38:08.616 --> 01:38:11.652 region:rollup2
INCORPORATING MEDICARE IN A
01:38:10.118 --> 01:38:12.987 region:rollup2
SINGLE PAYER SYSTEM AT THE STATE
01:38:11.652 --> 01:38:15.423 region:rollup2
LEVEL WOULD REQUIRE A HIGH
01:38:12.987 --> 01:38:17.091 region:rollup2
DEGREE OF COLLABORATION. BETWEEN
01:38:15.423 --> 01:38:18.926 region:rollup2
THE FEDERAL GOVERNMENT AND THE
01:38:17.091 --> 01:38:21.396 region:rollup2
STATE TO MAKE IT WORK AND I
01:38:18.926 --> 01:38:22.430 region:rollup2
THINK IT'S AN OPEN QUESTION AS
01:38:21.396 --> 01:38:24.732 region:rollup2
TO THE WILLINGNESS OF THIS
01:38:22.430 --> 01:38:26.134 region:rollup2
ADMINISTRATION TO COLLABORATE.
01:38:24.732 --> 01:38:28.669 region:rollup2
ON CHANGES OF THIS MAGNITUDE AT
01:38:26.134 --> 01:38:29.771 region:rollup2
THIS TIME.
01:38:28.669 --> 01:38:31.706 region:rollup2
BUT EVEN THEN A CONDUCIVE
01:38:29.771 --> 01:38:33.674 region:rollup2
POLITICAL ENVIRONMENT WHERE THAT
01:38:31.706 --> 01:38:34.675 region:rollup2
COLLABORATION EXISTED THE STATE
01:38:33.674 --> 01:38:35.877 region:rollup2
WOULD REALLY NEED TO WORK
01:38:34.675 --> 01:38:37.578 region:rollup2
CLOSELY WITH THE FEDERAL
01:38:35.877 --> 01:38:40.681 region:rollup2
GOVERNMENT TO ADDRESS MANY
01:38:37.578 --> 01:38:42.950 region:rollup2
STATUTORY. FIVE REGULATORY AND
01:38:40.681 --> 01:38:45.086 region:rollup2
ADMINISTRATIVE ISSUES RELATED TO
01:38:42.950 --> 01:38:46.721 region:rollup2
INTEGRATING MEDICARE INTO THE
01:38:45.086 --> 01:38:48.489 region:rollup2
STATE'S SINGLE PAYER SYSTEM.
01:38:46.721 --> 01:38:57.465 region:rollup2
BUT I DON'T AND.
01:38:48.489 --> 01:38:58.533 region:rollup2
CHIQUITA.
01:38:57.465 --> 01:39:03.404 region:rollup2
SO OUR NEXT SPEAKER HANG ON
01:38:58.533 --> 01:39:05.206 region:rollup2
SECOND.
01:39:03.404 --> 01:39:06.808 region:rollup2
CHIQUITA BROOKS.
01:39:05.206 --> 01:39:07.375 region:rollup2
WITH YOUR. OKAY ARE A GOOD
01:39:06.808 --> 01:39:09.110 region:rollup2
THOUGHT.
01:39:07.375 --> 01:39:10.878 region:rollup2
MANAGING DIRECTOR FROM AN THAT
01:39:09.110 --> 01:39:12.480 region:rollup2
HELP. OF FORMER POLICY IF ISSUE
01:39:10.878 --> 01:39:13.915 region:rollup2
PLAYED A KEY ROLE IN GUIDING THE
01:39:12.480 --> 01:39:17.185 region:rollup2
AFFORDABLE CARE ACT THROUGH
01:39:13.915 --> 01:39:18.786 region:rollup2
PASSAGE AND IMPLEMENTATION.
01:39:17.185 --> 01:39:19.887 region:rollup2
PLEASE CLICK THANK YOU IT'S A
01:39:18.786 --> 01:39:21.255 region:rollup2
PLEASURE TO BE HERE WITH YOU
01:39:19.887 --> 01:39:22.990 region:rollup2
THANK YOU FOR INVITING ME.
01:39:21.255 --> 01:39:24.425 region:rollup2
IT'S ALWAYS WONDERFUL TO TALK
01:39:22.990 --> 01:39:26.127 region:rollup2
ABOUT COVERAGE AND SO I'M REALLY
01:39:24.425 --> 01:39:28.095 region:rollup2
EXCITED TO BE HERE. I'M GONNA
01:39:26.127 --> 01:39:29.530 region:rollup2
FOCUS NEXT ON MEDICAID AND
01:39:28.095 --> 01:39:30.898 region:rollup2
MARKETPLACE WHICH I KNOW YOU'RE
01:39:29.530 --> 01:39:31.999 region:rollup2
PRETTY FAMILIAR WITH GIVEN
01:39:30.898 --> 01:39:34.068 region:rollup2
CALIFORNIA'S.
01:39:31.999 --> 01:39:35.236 region:rollup2
VERY IMPORTANT ROLE IN
01:39:34.068 --> 01:39:37.905 region:rollup2
IMPLEMENTATION.
01:39:35.236 --> 01:39:38.840 region:rollup2
OF BOTH OF THOSE PROGRAMS AS
01:39:37.905 --> 01:39:42.109 region:rollup2
YOU KNOW.
01:39:38.840 --> 01:39:44.278 region:rollup2
MEDICAID IS A JOINTLY FUNDED
01:39:42.109 --> 01:39:46.147 region:rollup2
PROGRAM I'VE JOINTLY FEDERAL AND
01:39:44.278 --> 01:39:48.049 region:rollup2
STATE PROGRAM AND THE MEDICAID
01:39:46.147 --> 01:39:50.685 region:rollup2
STATUTE ESTABLISHES CERTAIN
01:39:48.049 --> 01:39:52.386 region:rollup2
RULES. THAT STATES MUST ME AND
01:39:50.685 --> 01:39:53.354 region:rollup2
IN ORDER TO RECEIVE FEDERAL
01:39:52.386 --> 01:39:55.323 region:rollup2
FUNDING.
01:39:53.354 --> 01:39:57.091 region:rollup2
UNDER SECTION ELEVEN FIFTEEN OF
01:39:55.323 --> 01:39:58.359 region:rollup2
THE SOCIAL SECURITY ACT THE
01:39:57.091 --> 01:40:00.561 region:rollup2
SECRETARY OF HEALTH AND HUMAN
01:39:58.359 --> 01:40:02.997 region:rollup2
SERVICES HAS BROAD BUT NOT
01:40:00.561 --> 01:40:05.066 region:rollup2
UNLIMITED. AUTHORITY TO WAIVE
01:40:02.997 --> 01:40:06.934 region:rollup2
CERTAIN FEDERAL REQUIREMENTS.
01:40:05.066 --> 01:40:08.436 region:rollup2
FOR THE MEDICAID PROGRAM. AND
01:40:06.934 --> 01:40:10.104 region:rollup2
THE SLIDE YOU CAN SEE A COUPLE
01:40:08.436 --> 01:40:11.572 region:rollup2
OF THE KEY PROVISIONS.
01:40:10.104 --> 01:40:13.407 region:rollup2
THE FEDERAL.
01:40:11.572 --> 01:40:15.343 region:rollup2
MEDICAID LAW REQUIRES THAT
01:40:13.407 --> 01:40:17.678 region:rollup2
WEAVERS FURTHER THE OBJECTIVES
01:40:15.343 --> 01:40:19.747 region:rollup2
OF THE PROGRAM SO I THE INTENT
01:40:17.678 --> 01:40:22.083 region:rollup2
OF A DEMONSTRATION IS TO IN IN
01:40:19.747 --> 01:40:24.085 region:rollup2
SOME WAY MOVE FORWARD WHAT THE
01:40:22.083 --> 01:40:25.219 region:rollup2
MEDICAID PROGRAM I. WAS INTENDED
01:40:24.085 --> 01:40:26.287 region:rollup2
TO DO.
01:40:25.219 --> 01:40:28.422 region:rollup2
IT'S AUTHORIZED FOR
01:40:26.287 --> 01:40:30.258 region:rollup2
DEMONSTRATION PURPOSES SUBJECT
01:40:28.422 --> 01:40:32.126 region:rollup2
TO EVALUATION SIMILAR TO WHAT
01:40:30.258 --> 01:40:34.328 region:rollup2
JULIET WAS SAYING ABOUT
01:40:32.126 --> 01:40:35.563 region:rollup2
INNOVATION CENTER AUTHORITY. AND
01:40:34.328 --> 01:40:37.365 region:rollup2
YOU KNOW IT'S IMPORTANT TO NOTE
01:40:35.563 --> 01:40:38.399 region:rollup2
THAT WAIVERS ARE SUPPOSED TO BE
01:40:37.365 --> 01:40:40.568 region:rollup2
TESTING SOMETHING SO THEY'RE
01:40:38.399 --> 01:40:41.702 region:rollup2
SUPPOSED TO BE. DOING SOMETHING
01:40:40.568 --> 01:40:43.604 region:rollup2
DIFFERENT THAN WHAT THE FEDERAL
01:40:41.702 --> 01:40:45.406 region:rollup2
LAW REQUIRES IN ORDER TO
01:40:43.604 --> 01:40:47.542 region:rollup2
EVALUATE AND.
01:40:45.406 --> 01:40:49.543 region:rollup2
I IT IS THOSE EFFORTS
01:40:47.542 --> 01:40:51.512 region:rollup2
AND A WAIVER NEEDS TO AFFECT A
01:40:49.543 --> 01:40:53.214 region:rollup2
SECTION OF THE MEDICAID LOT THAT
01:40:51.512 --> 01:40:55.182 region:rollup2
IS SUBJECT TO WAVER AND WE'LL
01:40:53.214 --> 01:40:57.251 region:rollup2
TALK ABOUT THAT MORE DEATH.
01:40:55.182 --> 01:40:59.420 region:rollup2
BY LONG STANDING OF PRACTICE
01:40:57.251 --> 01:41:00.288 region:rollup2
WAIVERS MONTHS MUST BE BUDGET
01:40:59.420 --> 01:41:01.989 region:rollup2
NEUTRAL TO THE FEDERAL
01:41:00.288 --> 01:41:03.758 region:rollup2
GOVERNMENT THAT MEANS THAT OVER
01:41:01.989 --> 01:41:05.893 region:rollup2
A FIVE YEAR PERIOD THE STATE'S
01:41:03.758 --> 01:41:07.695 region:rollup2
DEMONSTRATION SHOULD NOT COST
01:41:05.893 --> 01:41:09.730 region:rollup2
MORE. ADDED TO THE FEDERAL
01:41:07.695 --> 01:41:11.098 region:rollup2
GOVERNMENT ON THE MEDICAID SIDE
01:41:09.730 --> 01:41:12.500 region:rollup2
THEN IT WOULD IN ABSENCE OF THE
01:41:11.098 --> 01:41:14.435 region:rollup2
WEAVER. THIS IS TYPICALLY
01:41:12.500 --> 01:41:15.603 region:rollup2
EVALUATED ON A PER MEMBER PER
01:41:14.435 --> 01:41:17.572 region:rollup2
MONTH BASIS
01:41:15.603 --> 01:41:19.941 region:rollup2
BUDGET NEUTRALITY IS A BIG PART
01:41:17.572 --> 01:41:20.474 region:rollup2
OF NEGOTIATIONS BETWEEN THE
01:41:19.941 --> 01:41:22.310 region:rollup2
FEDERAL GOVERNMENT IN THE
01:41:20.474 --> 01:41:23.678 region:rollup2
STATE'S.
01:41:22.310 --> 01:41:24.211 region:rollup2
PUBLIC COMMENT PERIODS ARE ALSO
01:41:23.678 --> 01:41:26.247 region:rollup2
REQUIRED BOTH AT THE STATE
01:41:24.211 --> 01:41:28.115 region:rollup2
LEVEL.
01:41:26.247 --> 01:41:29.917 region:rollup2
AND THE AND THE FEDERAL LEVEL
01:41:28.115 --> 01:41:31.552 region:rollup2
GIVEN JUST THE IMPORTANCE OF AYE
01:41:29.917 --> 01:41:34.121 region:rollup2
THE AUTHORITY OF THE ELEVEN
01:41:31.552 --> 01:41:35.656 region:rollup2
FIFTEEN AND THE CHANGES THAT
01:41:34.121 --> 01:41:37.725 region:rollup2
THAT CAN BE CONTEMPLATED.
01:41:35.656 --> 01:41:40.061 region:rollup2
I THE ON THE OTHER SIDE OF THE
01:41:37.725 --> 01:41:41.996 region:rollup2
SLIDE SHE GIVES YOU A.
01:41:40.061 --> 01:41:43.197 region:rollup2
BASICALLY AN OVERVIEW OF A LOT
01:41:41.996 --> 01:41:45.366 region:rollup2
OF THE COMMON.
01:41:43.197 --> 01:41:47.735 region:rollup2
WAIVERS THAT WE'VE SEEN ACROSS
01:41:45.366 --> 01:41:50.171 region:rollup2
THE STATES. FOR ELEVEN FIFTEEN
01:41:47.735 --> 01:41:51.539 region:rollup2
AUTHORITY IN FACT CALIFORNIA HAS
01:41:50.171 --> 01:41:53.274 region:rollup2
SOME OF THESE WAIVERS ARE NO
01:41:51.539 --> 01:41:54.775 region:rollup2
THEIR FAMILIAR TO YOU. I'VE
01:41:53.274 --> 01:41:56.077 region:rollup2
MANAGED CARE MANY STATES
01:41:54.775 --> 01:41:57.411 region:rollup2
IMPLEMENTED MANAGED CARE IN
01:41:56.077 --> 01:41:59.647 region:rollup2
THEIR STATES THROUGH ELEVEN
01:41:57.411 --> 01:42:01.749 region:rollup2
FIFTEEN AUTHORITY PARTICULARLY.
01:41:59.647 --> 01:42:03.050 region:rollup2
IN THE EARLY YEARS BEFORE IT
01:42:01.749 --> 01:42:04.318 region:rollup2
BECAME EASIER TO DO THAT.
01:42:03.050 --> 01:42:07.121 region:rollup2
UNDER.
01:42:04.318 --> 01:42:09.056 region:rollup2
UNDER REGULAR MEDICAID LAW.
01:42:07.121 --> 01:42:11.559 region:rollup2
DELIVERY SYSTEM REFORM WAIVERS
01:42:09.056 --> 01:42:13.461 region:rollup2
รณ OF WHICH CALIFORNIA HAS ONE.
01:42:11.559 --> 01:42:15.663 region:rollup2
AYE UNCOMPENSATED CARE POOL
01:42:13.461 --> 01:42:17.531 region:rollup2
SWEAR TYPICALLY HOSPITALS ARE
01:42:15.663 --> 01:42:19.133 region:rollup2
GIVEN AT PAYMENTS FOR
01:42:17.531 --> 01:42:21.869 region:rollup2
UNCOMPENSATED CARE.
01:42:19.133 --> 01:42:23.804 region:rollup2
AND EXPANSION RELATED OF WAIVERS
01:42:21.869 --> 01:42:26.340 region:rollup2
AGAIN A NUMBER OF STATES BEFORE
01:42:23.804 --> 01:42:28.342 region:rollup2
THE ACA EXPANDED COVERAGE TO
01:42:26.340 --> 01:42:29.710 region:rollup2
ADDITIONAL POPULATION.
01:42:28.342 --> 01:42:30.211 region:rollup2
SOME AFTER BUT MADE SOME
01:42:29.710 --> 01:42:35.082 region:rollup2
ADJUSTMENTS TO MEDICAID
01:42:30.211 --> 01:42:36.584 region:rollup2
COVERAGE.
01:42:35.082 --> 01:42:38.252 region:rollup2
SO THIS NEXT SLIDE REALLY
01:42:36.584 --> 01:42:40.021 region:rollup2
OUTLINES WHAT ARE SOME OF THE
01:42:38.252 --> 01:42:42.256 region:rollup2
IMPORTANT PROVISIONS THAT THE
01:42:40.021 --> 01:42:43.324 region:rollup2
STATUTE MAKES CLEAR THAT ELEVEN
01:42:42.256 --> 01:42:44.892 region:rollup2
FIFTEEN WAIVER CAN.
01:42:43.324 --> 01:42:46.594 region:rollup2
.
01:42:44.892 --> 01:42:47.995 region:rollup2
CAN CHANGE
01:42:46.594 --> 01:42:49.764 region:rollup2
THE FIRST IS STATEWIDE MRS
01:42:47.995 --> 01:42:51.198 region:rollup2
REQUIREMENT IN THE FEDERAL LAW
01:42:49.764 --> 01:42:51.732 region:rollup2
THAT THE MEDICAID PROGRAM REALLY
01:42:51.198 --> 01:42:53.934 region:rollup2
LOOK CONSISTENT ACROSS THE
01:42:51.732 --> 01:42:56.804 region:rollup2
STATE.
01:42:53.934 --> 01:42:57.571 region:rollup2
I IN TERMS OF. HOW IT OPERATES
01:42:56.804 --> 01:42:58.839 region:rollup2
AND THAT'S ACTUALLY SOMETHING
01:42:57.571 --> 01:43:00.074 region:rollup2
THAT CAN BE WAIVED?
01:42:58.839 --> 01:43:02.510 region:rollup2
THERE'S ALSO REQUIREMENT FOR
01:43:00.074 --> 01:43:04.245 region:rollup2
SINGLE STATE AGENCY TO IMPLEMENT
01:43:02.510 --> 01:43:05.813 region:rollup2
AND SET THE RULES ANOTHER
01:43:04.245 --> 01:43:07.214 region:rollup2
PROVISION THAT CAN BE WAIVED IN
01:43:05.813 --> 01:43:08.449 region:rollup2
MOST THESE KEY PROVISIONS ARE
01:43:07.214 --> 01:43:10.918 region:rollup2
ACTUALLY IN.
01:43:08.449 --> 01:43:12.219 region:rollup2
THE TEMPLATE THAT CMS PUTS OUT
01:43:10.918 --> 01:43:14.088 region:rollup2
FOR STATES IS THEY'RE THINKING
01:43:12.219 --> 01:43:15.756 region:rollup2
ABOUT THEIR WAIVERS.
01:43:14.088 --> 01:43:17.625 region:rollup2
THE NEXT IS ELIGIBILITY AND
01:43:15.756 --> 01:43:19.860 region:rollup2
REALLY CAN GO IN TWO DIRECTIONS
01:43:17.625 --> 01:43:22.296 region:rollup2
STATES HAVE USED THAT AND THEIR
01:43:19.860 --> 01:43:24.532 region:rollup2
ABILITY TO EXPAND. IT TO WAVE
01:43:22.296 --> 01:43:25.699 region:rollup2
ELIGIBILITY TO EXPAND COVERAGE
01:43:24.532 --> 01:43:27.201 region:rollup2
THEY CAN ALSO GO IN A MORE
01:43:25.699 --> 01:43:28.936 region:rollup2
RESTRICTIVE WAY WHERE SOME
01:43:27.201 --> 01:43:30.671 region:rollup2
STATES HAVE IMPOSED TIME LIMITS
01:43:28.936 --> 01:43:32.873 region:rollup2
ENROLLMENT CAPS.
01:43:30.671 --> 01:43:35.976 region:rollup2
UNCERTAIN POPULATIONS
01:43:32.873 --> 01:43:37.745 region:rollup2
AND I STATES MAY ALSO I WAVED
01:43:35.976 --> 01:43:39.480 region:rollup2
THE REQUIREMENTS FOR PRESUMPTIVE
01:43:37.745 --> 01:43:41.248 region:rollup2
ELIGIBILITY AND RETROACTIVE
01:43:39.480 --> 01:43:43.017 region:rollup2
COVERAGE.
01:43:41.248 --> 01:43:45.453 region:rollup2
FOR BENEFITS AND SERVICES.
01:43:43.017 --> 01:43:46.721 region:rollup2
AGAIN STATES HAVE USED THAT
01:43:45.453 --> 01:43:49.390 region:rollup2
KIND OF AUTHORITY TO VARY
01:43:46.721 --> 01:43:50.791 region:rollup2
BENEFITS PARTICULARLY FOR AYE IS
01:43:49.390 --> 01:43:52.426 region:rollup2
THEY EXPANDED COVERAGE TO NEW
01:43:50.791 --> 01:43:53.828 region:rollup2
POPULATIONS THEY MIGHT HAVE
01:43:52.426 --> 01:43:55.796 region:rollup2
IMPOSED NEW THINGS LIKE.
01:43:53.828 --> 01:43:57.331 region:rollup2
PREMIUMS WITHIN CERTAIN LIMITS
01:43:55.796 --> 01:43:59.767 region:rollup2
OR BURIED THE BENEFITS.
01:43:57.331 --> 01:44:01.869 region:rollup2
FOR DIFFERENT POPULATIONS.
01:43:59.767 --> 01:44:03.237 region:rollup2
COST SHARING CAN BE WAIVED BUT
01:44:01.869 --> 01:44:05.239 region:rollup2
WITH SOME SIGNIFICANT
01:44:03.237 --> 01:44:07.408 region:rollup2
RESTRICTIONS IN THE LA.
01:44:05.239 --> 01:44:08.342 region:rollup2
THERE ARE REQUIREMENTS THAT
01:44:07.408 --> 01:44:10.344 region:rollup2
COST SHARING.
01:44:08.342 --> 01:44:11.412 region:rollup2
IN THE FORM OF DEDUCTIBLES AND
01:44:10.344 --> 01:44:14.014 region:rollup2
COPAYS.
01:44:11.412 --> 01:44:15.549 region:rollup2
MOSTLY BE ON A VOLUNTARY BASIS
01:44:14.014 --> 01:44:17.585 region:rollup2
STATES ARE SUPPOSED TO ONLY
01:44:15.549 --> 01:44:19.320 region:rollup2
IMPLEMENT THOSE FOR TWO YEARS
01:44:17.585 --> 01:44:21.088 region:rollup2
THERE ARE YOU AGAIN THERE IS
01:44:19.320 --> 01:44:24.058 region:rollup2
SOME FLEXIBILITY TO IMPOSE COST
01:44:21.088 --> 01:44:25.926 region:rollup2
SHARING ABOVE. CURRENT STATUTORY
01:44:24.058 --> 01:44:28.162 region:rollup2
REQUIREMENTS BY.
01:44:25.926 --> 01:44:29.764 region:rollup2
THOSE PROVISIONS THAT IT CANNOT
01:44:28.162 --> 01:44:30.998 region:rollup2
BE WAIVED ENTIRELY.
01:44:29.764 --> 01:44:33.400 region:rollup2
THE DELIVERY SYSTEM.
01:44:30.998 --> 01:44:34.902 region:rollup2
AT ONE THAT STATES HAVE WAVES
01:44:33.400 --> 01:44:36.470 region:rollup2
AND IN TERMS OF FREEDOM AND
01:44:34.902 --> 01:44:38.072 region:rollup2
CHOICE PARTICULARLY. WHEN
01:44:36.470 --> 01:44:39.406 region:rollup2
THINKING ABOUT MANAGED CARE AND
01:44:38.072 --> 01:44:40.040 region:rollup2
OTHER TYPES OF.
01:44:39.406 --> 01:44:42.109 region:rollup2
OF.
01:44:40.040 --> 01:44:43.644 region:rollup2
CHANGES THEIR.
01:44:42.109 --> 01:44:45.479 region:rollup2
AND THEN IF FINANCING
01:44:43.644 --> 01:44:47.515 region:rollup2
REIMBURSEMENT WHICH IS OFTEN A
01:44:45.479 --> 01:44:49.416 region:rollup2
CORE PART OF ELEVEN FIFTEEN
01:44:47.515 --> 01:44:51.452 region:rollup2
WAIVER AUTHORITY WHERE THE STATE
01:44:49.416 --> 01:44:52.920 region:rollup2
IS ASKING THE FEDERAL GOVERNMENT
01:44:51.452 --> 01:44:55.055 region:rollup2
TO PAY FOR SOMETHING THAT THEY
01:44:52.920 --> 01:44:56.857 region:rollup2
WOULDN'T NORMALLY PAY COSTS THAT
01:44:55.055 --> 01:44:59.760 region:rollup2
ARE NOT OTHERWISE MAGICAL.
01:44:56.857 --> 01:45:01.395 region:rollup2
AND SO I. AGAIN WITH CONSTRAINTS
01:44:59.760 --> 01:45:04.265 region:rollup2
ON BUDGET NEUTRALITY IS A BIG
01:45:01.395 --> 01:45:05.766 region:rollup2
PART OF WAIVERS BUT I. DID BUT
01:45:04.265 --> 01:45:06.967 region:rollup2
UNDER ELEVEN FIFTEEN AUTHORITY
01:45:05.766 --> 01:45:09.136 region:rollup2
MANY STATES HAVE GOTTEN
01:45:06.967 --> 01:45:10.271 region:rollup2
AUTHORITY TO GET. COVERAGE FOR
01:45:09.136 --> 01:45:13.240 region:rollup2
THINGS THAT OTHERWISE WOULD NOT
01:45:10.271 --> 01:45:14.708 region:rollup2
A THING.
01:45:13.240 --> 01:45:16.944 region:rollup2
SO WHILE THAT'S ALREADY IN.
01:45:14.708 --> 01:45:19.079 region:rollup2
MEDICAID ISRAEL IS QUITE BROAD
01:45:16.944 --> 01:45:22.283 region:rollup2
THERE ARE SOME RESTRICTIONS.
01:45:19.079 --> 01:45:24.018 region:rollup2
I'M WHAT CANNOT BE WAIVED.
01:45:22.283 --> 01:45:25.152 region:rollup2
UNDER THE STATUTE
01:45:24.018 --> 01:45:27.621 region:rollup2
AND ONE OF THE FIRST.
01:45:25.152 --> 01:45:29.590 region:rollup2
AT KEY ONES IS THE FEDERAL
01:45:27.621 --> 01:45:31.725 region:rollup2
MEDICAL ASSISTANCE PERCENTAGE OR
01:45:29.590 --> 01:45:33.727 region:rollup2
F. MAP THAT FORMULA THAT IS
01:45:31.725 --> 01:45:35.462 region:rollup2
REALLY THE SPLIT BETWEEN WHAT
01:45:33.727 --> 01:45:37.865 region:rollup2
THE FEDERAL GOVERNMENT AND THE
01:45:35.462 --> 01:45:39.466 region:rollup2
STATE OUR PAIN. I'M IT VARIES
01:45:37.865 --> 01:45:40.067 region:rollup2
ACROSS THE STATES AND IT DOES
01:45:39.466 --> 01:45:41.468 region:rollup2
VERY.
01:45:40.067 --> 01:45:43.337 region:rollup2
IN PARTICULAR FOR CERTAIN
01:45:41.468 --> 01:45:45.973 region:rollup2
SERVICES IN CALIFORNIA.
01:45:43.337 --> 01:45:47.541 region:rollup2
FOR MOST SERVICES LESS COVERAGE
01:45:45.973 --> 01:45:49.910 region:rollup2
IT'S FIFTY PERCENT.
01:45:47.541 --> 01:45:52.613 region:rollup2
ANOTHER IMPORTANT PROVISION.
01:45:49.910 --> 01:45:54.014 region:rollup2
OF NOTE THAT CANNOT BE WAIVED
01:45:52.613 --> 01:45:55.516 region:rollup2
IF THE F. MAP CLAIMING
01:45:54.014 --> 01:45:57.918 region:rollup2
PROPHECIES.
01:45:55.516 --> 01:45:59.820 region:rollup2
AND WHAT I MEAN THERE IS THAT
01:45:57.918 --> 01:46:02.089 region:rollup2
WHILE THE FEDERAL GOVERNMENT CAN
01:45:59.820 --> 01:46:02.723 region:rollup2
WAVE WHAT CAN BE MATCHED.
01:46:02.089 --> 01:46:04.892 region:rollup2
IT'S STILL.
01:46:02.723 --> 01:46:06.293 region:rollup2
IT IT IT'S STILL NEEDS TO BE A
01:46:04.892 --> 01:46:07.995 region:rollup2
MATCHING DOLLAR SO IN OTHER
01:46:06.293 --> 01:46:09.296 region:rollup2
WORDS THE STATE PUTS UP FUNDS
01:46:07.995 --> 01:46:10.998 region:rollup2
AND THE FEDERAL GOVERNMENT
01:46:09.296 --> 01:46:13.200 region:rollup2
MATCHES THOSE FUNDS. SO THAT'S
01:46:10.998 --> 01:46:16.036 region:rollup2
SOMETHING THAT WE DO NOT THINK I
01:46:13.200 --> 01:46:18.072 region:rollup2
CAN BE WAIVED UNDER THE STATUTE.
01:46:16.036 --> 01:46:19.940 region:rollup2
EVER END UNDER THE ELEVEN
01:46:18.072 --> 01:46:21.342 region:rollup2
FIFTEEN AUTHORITY THEIR OTHER
01:46:19.940 --> 01:46:22.710 region:rollup2
PROVISIONS I MENTION THE COST
01:46:21.342 --> 01:46:24.745 region:rollup2
SHARING REQUIREMENTS THAT THERE
01:46:22.710 --> 01:46:26.080 region:rollup2
ARE RESTRICTIONS ON HOW MUCH
01:46:24.745 --> 01:46:28.082 region:rollup2
COST SHARING CAN BE WAIVED.
01:46:26.080 --> 01:46:30.284 region:rollup2
INCOME COUNTING ROLES SO FOR THE
01:46:28.082 --> 01:46:31.151 region:rollup2
COR POPULATION COVERED UNDER THE
01:46:30.284 --> 01:46:34.655 region:rollup2
ACA.
01:46:31.151 --> 01:46:36.690 region:rollup2
SO NOT THAT DISABLED AND I'M.
01:46:34.655 --> 01:46:39.093 region:rollup2
AND NOT AT THE ELDERLY THERE
01:46:36.690 --> 01:46:41.195 region:rollup2
ARE. RESTRICTIONS ON CHANGING
01:46:39.093 --> 01:46:44.064 region:rollup2
HOW INCOME IS COUNTED AND AND
01:46:41.195 --> 01:46:46.166 region:rollup2
ASSETS TEST CANNOT BE IMPOSED.
01:46:44.064 --> 01:46:47.301 region:rollup2
SO THOSE ARE KIND OF AN OVERVIEW
01:46:46.166 --> 01:46:49.169 region:rollup2
OF SOME OF THAT THAT KEY
01:46:47.301 --> 01:46:51.772 region:rollup2
PROVISIONS.
01:46:49.169 --> 01:46:53.340 region:rollup2
AND YEAH I I THINK YOU ALL HAVE
01:46:51.772 --> 01:46:54.441 region:rollup2
WITH YOU THAT WE JUST FINISHED A
01:46:53.340 --> 01:46:56.176 region:rollup2
PAPER FOR THE CALIFORNIA
01:46:54.441 --> 01:46:57.211 region:rollup2
HEALTHCARE FOUNDATION. THAT
01:46:56.176 --> 01:46:58.979 region:rollup2
LOOKS AT THE LEGAL
01:46:57.211 --> 01:47:00.614 region:rollup2
CONSIDERATIONS AND AND WE TALK
01:46:58.979 --> 01:47:01.782 region:rollup2
ABOUT SINGLE PAYER BUT WE ALSO
01:47:00.614 --> 01:47:03.384 region:rollup2
TALK ABOUT SOME OF THE OTHER
01:47:01.782 --> 01:47:05.252 region:rollup2
PROPOSALS THAT YOU MIGHT.
01:47:03.384 --> 01:47:07.454 region:rollup2
CONSIDER PUBLIC OPTION ANOTHER
01:47:05.252 --> 01:47:09.657 region:rollup2
AFFORDABILITY PROPOSALS AND.
01:47:07.454 --> 01:47:11.926 region:rollup2
I WOULD LEAVE YOU WITH AND THE
01:47:09.657 --> 01:47:13.627 region:rollup2
MEDICAID SIDE ONE IMPORTANT NOTE
01:47:11.926 --> 01:47:15.362 region:rollup2
AND JULIET MADE THIS POINT.
01:47:13.627 --> 01:47:17.331 region:rollup2
THAT WAIVERS ARE DISCRETIONARY
01:47:15.362 --> 01:47:18.666 region:rollup2
AND YOU KNOW I'VE GIVEN YOU AN
01:47:17.331 --> 01:47:20.334 region:rollup2
OUTLINE OF SOME OF THE
01:47:18.666 --> 01:47:22.569 region:rollup2
PROVISIONS THAT ARE SEEN.
01:47:20.334 --> 01:47:23.971 region:rollup2
EXPECTED. TO NOT BE WAIVED IN
01:47:22.569 --> 01:47:25.506 region:rollup2
THOSE THAT CAN BE WAIVED.
01:47:23.971 --> 01:47:26.874 region:rollup2
AND IT'S TYPICALLY THE CASE
01:47:25.506 --> 01:47:27.474 region:rollup2
THAT ONCE SOMETHING HAS BEEN
01:47:26.874 --> 01:47:29.677 region:rollup2
WAIVED THAT THAT IS PERMITTED
01:47:27.474 --> 01:47:31.578 region:rollup2
BY.
01:47:29.677 --> 01:47:33.113 region:rollup2
FUTURE ADMINISTRATIONS I'M BUT
01:47:31.578 --> 01:47:34.715 region:rollup2
WE DO NOTE THAT.
01:47:33.113 --> 01:47:37.451 region:rollup2
DIFFERENT ADMINISTRATIONS.
01:47:34.715 --> 01:47:39.286 region:rollup2
CERTAINLY HAVE DISCRETION ABOUT
01:47:37.451 --> 01:47:40.621 region:rollup2
WHETHER OR NOT THEY'RE GOING TO
01:47:39.286 --> 01:47:42.656 region:rollup2
APPROVE WAIVERS.
01:47:40.621 --> 01:47:44.692 region:rollup2
SO IMPORTANT TO NOTE THAT
01:47:42.656 --> 01:47:46.560 region:rollup2
WAIVERS ARE DISCRETIONARY.
01:47:44.692 --> 01:47:48.929 region:rollup2
SOFT UP WITH MEDICAID AND NOW
01:47:46.560 --> 01:47:50.331 region:rollup2
SWITCH GEARS AND TALK ABOUT THE
01:47:48.929 --> 01:47:52.599 region:rollup2
MARKETPLACE.
01:47:50.331 --> 01:47:53.167 region:rollup2
AS YOU KNOW THE AFFORDABLE CARE
01:47:52.599 --> 01:47:55.836 region:rollup2
ACT.
01:47:53.167 --> 01:47:58.305 region:rollup2
FIVE IT WAS PASSED IN TWO
01:47:55.836 --> 01:48:00.507 region:rollup2
THOUSAND AND TEN AND EXPANDED
01:47:58.305 --> 01:48:02.209 region:rollup2
COVERAGE AYE GIVING STATES MORE
01:48:00.507 --> 01:48:04.011 region:rollup2
FLEXIBILITY TO.
01:48:02.209 --> 01:48:06.980 region:rollup2
ESTABLISH EXCHANGES AND OF
01:48:04.011 --> 01:48:08.515 region:rollup2
COURSE CALIFORNIA EX OF THAT
01:48:06.980 --> 01:48:11.085 region:rollup2
STAB WISH COVERED CALIFORNIA.
01:48:08.515 --> 01:48:13.587 region:rollup2
GAVE A. SIGNIFICANT.
01:48:11.085 --> 01:48:16.156 region:rollup2
STEWART WAIVER AUTHORITY UNDER
01:48:13.587 --> 01:48:18.092 region:rollup2
SECTION THIRTEEN THIRTY TWO
01:48:16.156 --> 01:48:20.127 region:rollup2
STATE AND. WAIVERS AND WE'RE
01:48:18.092 --> 01:48:20.894 region:rollup2
JUST STARTING GET EXPERIENCE
01:48:20.127 --> 01:48:23.831 region:rollup2
WITH THESE WAIVERS.
01:48:20.894 --> 01:48:25.499 region:rollup2
THE BULK OF THE ACA STARTED IN.
01:48:23.831 --> 01:48:27.434 region:rollup2
TWENTY FOURTEEN.
01:48:25.499 --> 01:48:29.403 region:rollup2
AND I REALLY THIS WAIVER
01:48:27.434 --> 01:48:31.438 region:rollup2
AUTHORITY JUST KICKED IN IN TWO
01:48:29.403 --> 01:48:33.073 region:rollup2
THOUSAND AND SEVENTEEN SO WE'RE
01:48:31.438 --> 01:48:35.442 region:rollup2
STARTING GOT OUR FIRST TASTE OF
01:48:33.073 --> 01:48:36.577 region:rollup2
WHAT ADMINISTRATIONS WILL
01:48:35.442 --> 01:48:38.245 region:rollup2
APPROVE UNDER THIS AUTHORITY.
01:48:36.577 --> 01:48:38.946 region:rollup2
AS I MENTIONED IT'S IT'S FAIRLY
01:48:38.245 --> 01:48:41.048 region:rollup2
BROAD.
01:48:38.946 --> 01:48:43.951 region:rollup2
THE STATE'S CAN.
01:48:41.048 --> 01:48:44.518 region:rollup2
A PROPOSED A WAVE FOUR KEY
01:48:43.951 --> 01:48:46.420 region:rollup2
PARTS OF THE AFFORDABLE CARE
01:48:44.518 --> 01:48:47.988 region:rollup2
ACT.
01:48:46.420 --> 01:48:50.557 region:rollup2
THE INDIVIDUAL MANDATE WHICH WE
01:48:47.988 --> 01:48:53.026 region:rollup2
ALL KNOW WAS RECENTLY ALTERED BY
01:48:50.557 --> 01:48:54.728 region:rollup2
AND. BE A BY THE CONGRESS AND
01:48:53.026 --> 01:48:56.530 region:rollup2
SIGNED INTO LAW THAT THE PENALTY
01:48:54.728 --> 01:48:58.265 region:rollup2
IS NOW REDUCED TO ZERO BUT THAT
01:48:56.530 --> 01:48:59.933 region:rollup2
IS STILL IN THE STATUTE A PART
01:48:58.265 --> 01:49:02.703 region:rollup2
OF THE.
01:48:59.933 --> 01:49:03.971 region:rollup2
A. STATUTE THAT STATES CAN WAVE
01:49:02.703 --> 01:49:06.807 region:rollup2
AS WELL AS THE EMPLOYER MANDATE
01:49:03.971 --> 01:49:08.242 region:rollup2
IS ALSO A PROVISION THAT STATES
01:49:06.807 --> 01:49:10.244 region:rollup2
CAN WAIVE THE FEE CHOOSE TO.
01:49:08.242 --> 01:49:11.745 region:rollup2
BENEFITS AND SUBSIDIES SO THE
01:49:10.244 --> 01:49:12.746 region:rollup2
AFFORDABLE CARE ACT CREATED THE
01:49:11.745 --> 01:49:14.548 region:rollup2
ESSENTIAL HEALTH BENEFIT
01:49:12.746 --> 01:49:16.550 region:rollup2
REQUIREMENT THAT IS SOMETHING
01:49:14.548 --> 01:49:18.218 region:rollup2
THAT CAN BE WAIVED UNDER
01:49:16.550 --> 01:49:20.053 region:rollup2
THIRTEEN THIRTY TWO AUTHORITY.
01:49:18.218 --> 01:49:21.822 region:rollup2
AS CAN THE SUBSIDIES THEIR
01:49:20.053 --> 01:49:23.457 region:rollup2
PREMIUM TAX CREDITS THAT ARE
01:49:21.822 --> 01:49:25.526 region:rollup2
AVAILABLE TO PEOPLE BETWEEN
01:49:23.457 --> 01:49:26.493 region:rollup2
THREE HUNT EXCUSE ME ONE HUNDRED
01:49:25.526 --> 01:49:28.228 region:rollup2
AND THIRTY THREE PERCENT OF THE
01:49:26.493 --> 01:49:29.463 region:rollup2
FEDERAL POVERTY LEVEL TO FOUR
01:49:28.228 --> 01:49:31.932 region:rollup2
HUNDRED PERCENT OF THE FOUGHT
01:49:29.463 --> 01:49:34.535 region:rollup2
FEDERAL POWERLESS. DE LEVEL. ARE
01:49:31.932 --> 01:49:36.203 region:rollup2
ALSO AND FOR THE PROVISIONS THAT
01:49:34.535 --> 01:49:37.638 region:rollup2
THE STATE'S CAN WAVE AND I'LL
01:49:36.203 --> 01:49:39.339 region:rollup2
TALK ABOUT THAT IN A LITTLE MORE
01:49:37.638 --> 01:49:40.908 region:rollup2
DEPTH BUT I KNOW THAT STATES CAN
01:49:39.339 --> 01:49:41.842 region:rollup2
USE THOSE DOLLARS AND REPURPOSE
01:49:40.908 --> 01:49:44.344 region:rollup2
THOSE.
01:49:41.842 --> 01:49:46.713 region:rollup2
FOR ALTERNATIVE APPROACHES.
01:49:44.344 --> 01:49:48.982 region:rollup2
AND ALSO EXCHANGE RULES SEE
01:49:46.713 --> 01:49:50.651 region:rollup2
STATES CAN MODIFY OR ELIMINATE.
01:49:48.982 --> 01:49:51.952 region:rollup2
EXCHANGE RULES IF THEY CHOOSE
01:49:50.651 --> 01:49:53.187 region:rollup2
TO.
01:49:51.952 --> 01:49:54.588 region:rollup2
A PARTICULARLY IF THEY'RE MAKING
01:49:53.187 --> 01:49:56.790 region:rollup2
MAJOR CHANGES TO THE BENEFITS.
01:49:54.588 --> 01:49:58.992 region:rollup2
CITIES.
01:49:56.790 --> 01:49:59.993 region:rollup2
THERE ARE RESTRICTIONS ON.
01:49:58.992 --> 01:50:02.196 region:rollup2
THE.
01:49:59.993 --> 01:50:03.230 region:rollup2
THIRTEEN THIRTY TWO A WAIVER
01:50:02.196 --> 01:50:04.932 region:rollup2
AUTHORITY.
01:50:03.230 --> 01:50:07.034 region:rollup2
MOST SAID THE CONSUMER
01:50:04.932 --> 01:50:09.436 region:rollup2
PROTECTIONS BETTER IN THE A. C.
01:50:07.034 --> 01:50:11.105 region:rollup2
A. ARE ACTUALLY NOT WAY ABLE SO
01:50:09.436 --> 01:50:13.173 region:rollup2
THINGS LIKE EACH RATING.
01:50:11.105 --> 01:50:16.176 region:rollup2
PROHIBITION ON.
01:50:13.173 --> 01:50:17.678 region:rollup2
HEALTH STATUS IS GENDER EXCITER.
01:50:16.176 --> 01:50:19.613 region:rollup2
THOSE ARE NOT WEAVERVILLE
01:50:17.678 --> 01:50:21.915 region:rollup2
PROVISIONS UNDER THIRTEEN THIRTY
01:50:19.613 --> 01:50:23.717 region:rollup2
TWO.
01:50:21.915 --> 01:50:25.219 region:rollup2
AND THEN THERE ARE SIGNIFICANT
01:50:23.717 --> 01:50:26.954 region:rollup2
STATUTORY GUARDRAILS WHICH ARE
01:50:25.219 --> 01:50:28.822 region:rollup2
ALSO IMPORTANT TO KEEP IN MIND
01:50:26.954 --> 01:50:30.491 region:rollup2
AND WHEN THINKING ABOUT.
01:50:28.822 --> 01:50:32.759 region:rollup2
THIRTEEN THIRTY TWO A WAIVER
01:50:30.491 --> 01:50:35.028 region:rollup2
AUTHORITY. THE FIRST THE SCOPE
01:50:32.759 --> 01:50:36.296 region:rollup2
OF COVERAGE WAIVERS MUST PROVIDE
01:50:35.028 --> 01:50:38.632 region:rollup2
COVERAGE TO AT LEAST AS MANY
01:50:36.296 --> 01:50:41.702 region:rollup2
PEOPLE AS THE ACA WOULD.
01:50:38.632 --> 01:50:44.171 region:rollup2
IN ABSENCE OF THE WAIVER.
01:50:41.702 --> 01:50:45.839 region:rollup2
I'D THE WAIVER MUST ALSO A
01:50:44.171 --> 01:50:48.208 region:rollup2
PROVIDE COVERAGE THAT IS LEAST
01:50:45.839 --> 01:50:50.511 region:rollup2
AS LEAST AS COMPREHENSIVE AS THE
01:50:48.208 --> 01:50:52.446 region:rollup2
COVERAGE OFFERED A ON IT.
01:50:50.511 --> 01:50:54.414 region:rollup2
THROUGH THE EXCHANGE
01:50:52.446 --> 01:50:55.983 region:rollup2
THE WAIVER MUST PROVIDE COVERAGE
01:50:54.414 --> 01:50:57.584 region:rollup2
AND COST SHARING PROTECTIONS
01:50:55.983 --> 01:50:59.686 region:rollup2
AGAINST EXCESSIVE OUT OF POCKET
01:50:57.584 --> 01:51:01.955 region:rollup2
SPENDING THAT IS AT LEAST AS
01:50:59.686 --> 01:51:03.991 region:rollup2
AFFORDABLE. OF THE EXCHANGE
01:51:01.955 --> 01:51:05.692 region:rollup2
COVERAGE AND THE WAIVER MUST NOT
01:51:03.991 --> 01:51:07.394 region:rollup2
INCREASE THE FEDERAL DEFICIT
01:51:05.692 --> 01:51:10.497 region:rollup2
INCLUDING CHANGES TO INCOME
01:51:07.394 --> 01:51:12.132 region:rollup2
PAYROLL FOR EXCISE TAX REVENUE.
01:51:10.497 --> 01:51:14.234 region:rollup2
AND SO I THINK YOU KNOW YOU CAN
01:51:12.132 --> 01:51:16.203 region:rollup2
REALLY TELL FROM THE FIRST THREE
01:51:14.234 --> 01:51:17.804 region:rollup2
THAT THOSE. RESTRICTIONS ARE
01:51:16.203 --> 01:51:19.139 region:rollup2
REALLY ABOUT MAKING SURE THAT IF
01:51:17.804 --> 01:51:20.807 region:rollup2
THE STATE IS GOING TO COME IN
01:51:19.139 --> 01:51:22.242 region:rollup2
AND AND MAKE CHANGES UNDER
01:51:20.807 --> 01:51:24.645 region:rollup2
THIRTEEN THIRTY TWO THAT THERE
01:51:22.242 --> 01:51:26.346 region:rollup2
REALLY PROPOSING TO PROVIDE.
01:51:24.645 --> 01:51:28.148 region:rollup2
ADDITIONAL BENEFITS AND.
01:51:26.346 --> 01:51:30.317 region:rollup2
AT A REALLY COMPREHENSIVE
01:51:28.148 --> 01:51:31.385 region:rollup2
PACKAGE I KNOW THE DEFICIT
01:51:30.317 --> 01:51:33.720 region:rollup2
NEUTRALITY DOES.
01:51:31.385 --> 01:51:36.523 region:rollup2
EXTEND TO.
01:51:33.720 --> 01:51:38.358 region:rollup2
IT YOUR YOUR EMPLOYMENT TO YOUR.
01:51:36.523 --> 01:51:40.327 region:rollup2
TALKING ABOUT BOTH TREASURY AND
01:51:38.358 --> 01:51:41.795 region:rollup2
HHS WHEN THINKING ABOUT DEFICIT
01:51:40.327 --> 01:51:43.797 region:rollup2
NEUTRALITY AND IT'S.
01:51:41.795 --> 01:51:45.532 region:rollup2
IT IS A DIFFERENT STANDARD THAN
01:51:43.797 --> 01:51:46.600 region:rollup2
WHAT WE'VE SEEN ON IN THE BUDGET
01:51:45.532 --> 01:51:48.802 region:rollup2
NEUTRALITY.
01:51:46.600 --> 01:51:50.404 region:rollup2
IN THE MEDICAID PROGRAM BECAUSE
01:51:48.802 --> 01:51:52.072 region:rollup2
THAT'S.
01:51:50.404 --> 01:51:53.373 region:rollup2
A LITTLE BIT BROADER.
01:51:52.072 --> 01:51:55.542 region:rollup2
SO THIS NEXT SLIDE JUST GIVES
01:51:53.373 --> 01:51:55.909 region:rollup2
YOU AN OVERVIEW OF SOME OF THE
01:51:55.542 --> 01:51:57.811 region:rollup2
KEY.
01:51:55.909 --> 01:51:59.112 region:rollup2
WAIVERS THAT HAVE BEEN PROPOSED
01:51:57.811 --> 01:52:01.982 region:rollup2
BY STATES.
01:51:59.112 --> 01:52:03.083 region:rollup2
UNDER THIRTEEN THIRTY TWO AND
01:52:01.982 --> 01:52:05.719 region:rollup2
DEFINITE COUPLE OF.
01:52:03.083 --> 01:52:07.754 region:rollup2
PROPOSALS THAT WOULD HAVE SOME
01:52:05.719 --> 01:52:08.589 region:rollup2
SIGNIFICANT CHANGES TO THE EAST
01:52:07.754 --> 01:52:11.291 region:rollup2
CA.
01:52:08.589 --> 01:52:13.627 region:rollup2
HOWEVER WE REALLY HAVEN'T SEEN
01:52:11.291 --> 01:52:16.063 region:rollup2
AN APPROVAL YET. OF THE MAJOR
01:52:13.627 --> 01:52:18.265 region:rollup2
MAJOR CHAINS MOST OF THE WAIVERS
01:52:16.063 --> 01:52:19.333 region:rollup2
THAT HAVE BEEN APPROVED FALL
01:52:18.265 --> 01:52:20.534 region:rollup2
INTO THIS CATEGORY OF
01:52:19.333 --> 01:52:21.635 region:rollup2
REINSURANCE AND THOSE OF THE
01:52:20.534 --> 01:52:24.037 region:rollup2
WAIVERS.
01:52:21.635 --> 01:52:25.138 region:rollup2
AT THE BOTTOM ALASKA OREGON
01:52:24.037 --> 01:52:26.607 region:rollup2
MINNESOTA.
01:52:25.138 --> 01:52:28.242 region:rollup2
ARE THE ONES WITH.
01:52:26.607 --> 01:52:28.942 region:rollup2
.
01:52:28.242 --> 01:52:31.578 region:rollup2
AT WITH.
01:52:28.942 --> 01:52:33.413 region:rollup2
APPROVED REINSURANCE WE VARIOUS
01:52:31.578 --> 01:52:34.948 region:rollup2
AND WHAT WE SEE IN THESE WAIVERS
01:52:33.413 --> 01:52:36.917 region:rollup2
IS THAT THE STATE HAS PROVIDED
01:52:34.948 --> 01:52:39.920 region:rollup2
SOME FUNDING TO HELP COVER A
01:52:36.917 --> 01:52:41.822 region:rollup2
PORTION OF HIGH COST CLAIMS FOR
01:52:39.920 --> 01:52:43.790 region:rollup2
HIGH COST INDIVIDUALS. IN THE
01:52:41.822 --> 01:52:45.525 region:rollup2
INDIVIDUAL MARKET AND THIS
01:52:43.790 --> 01:52:46.960 region:rollup2
REALLY LOWERS PREMIUMS FOR
01:52:45.525 --> 01:52:48.795 region:rollup2
PEOPLE INSIDE AND OUTSIDE THE
01:52:46.960 --> 01:52:50.731 region:rollup2
EXCHANGE.
01:52:48.795 --> 01:52:52.065 region:rollup2
AND IT'S REALLY I THINK I WORTH
01:52:50.731 --> 01:52:54.101 region:rollup2
NOTING WHEN TALKING ABOUT
01:52:52.065 --> 01:52:56.303 region:rollup2
AFFORDABILITY UP PROPOSALS TO
01:52:54.101 --> 01:52:56.770 region:rollup2
LOOK A LITTLE BIT AT REINSURANCE
01:52:56.303 --> 01:52:58.271 region:rollup2
A NUMBER OF STATES ARE
01:52:56.770 --> 01:53:00.307 region:rollup2
CONSIDERING IT. REINSURANCE
01:52:58.271 --> 01:53:01.808 region:rollup2
PARTICULARLY BENEFITS THOSE WHO
01:53:00.307 --> 01:53:03.877 region:rollup2
GET COVERAGE IN THE INDIVIDUAL
01:53:01.808 --> 01:53:05.178 region:rollup2
MARKET AND WHO DO NOT QUALIFY
01:53:03.877 --> 01:53:05.812 region:rollup2
FOR TAX CREDITS.
01:53:05.178 --> 01:53:07.180 region:rollup2
SO.
01:53:05.812 --> 01:53:09.283 region:rollup2
FOR SOME OF THE STATES THAT ARE
01:53:07.180 --> 01:53:11.051 region:rollup2
CONSIDERING PROPOSALS BECAUSE
01:53:09.283 --> 01:53:12.819 region:rollup2
THEY'RE CONCERNED ABOUT PREMIUMS
01:53:11.051 --> 01:53:13.820 region:rollup2
THE TAX CREDITS REALLY DO ASSIST
01:53:12.819 --> 01:53:15.489 region:rollup2
INDIVIDUALS.
01:53:13.820 --> 01:53:16.623 region:rollup2
WHEN PREMIUMS INCREASE BUT
01:53:15.489 --> 01:53:17.891 region:rollup2
REINSURANCE IS ONE OF THE
01:53:16.623 --> 01:53:19.359 region:rollup2
STRATEGIES.
01:53:17.891 --> 01:53:20.827 region:rollup2
THAT STATES ARE CONSIDERING.
01:53:19.359 --> 01:53:23.597 region:rollup2
.
01:53:20.827 --> 01:53:25.632 region:rollup2
TO TRY TO LOWER PREMIUMS OVERALL
01:53:23.597 --> 01:53:27.301 region:rollup2
AND WHEN A STATE DOES THAT THEY
01:53:25.632 --> 01:53:29.503 region:rollup2
BENEFIT THE FEDERAL GOVERNMENT
01:53:27.301 --> 01:53:30.671 region:rollup2
BECAUSE THEY AYE TAX CREDITS ARE
01:53:29.503 --> 01:53:32.739 region:rollup2
LOWER THAN THEY WOULD BE
01:53:30.671 --> 01:53:34.274 region:rollup2
OTHERWISE AND SO THROUGH THESE
01:53:32.739 --> 01:53:35.842 region:rollup2
ELEVEN FIFTEEN WAIVERS STATES
01:53:34.274 --> 01:53:38.378 region:rollup2
BEEN ABLE TO GET. FEDERAL
01:53:35.842 --> 01:53:40.280 region:rollup2
FUNDING TO HELP OFFSET THE COSTS
01:53:38.378 --> 01:53:42.215 region:rollup2
AND THE AMOUNTS HAVE A HAVE
01:53:40.280 --> 01:53:44.484 region:rollup2
VARIED A BIT BASED ON CONDITIONS
01:53:42.215 --> 01:53:46.653 region:rollup2
WITHIN THE STATE'S. BUT ON THE
01:53:44.484 --> 01:53:49.022 region:rollup2
STATE'S OBSCENE AND SOME OF
01:53:46.653 --> 01:53:49.923 region:rollup2
THEIR COSTS OFFSET. UNDER THESE
01:53:49.022 --> 01:53:50.824 region:rollup2
REINSURANCE WAIVERS.
01:53:49.923 --> 01:53:52.859 region:rollup2
SO.
01:53:50.824 --> 01:53:54.728 region:rollup2
.
01:53:52.859 --> 01:53:55.896 region:rollup2
THINKING AGAIN A LITTLE BIT MORE
01:53:54.728 --> 01:53:57.698 region:rollup2
BROADLY.
01:53:55.896 --> 01:53:59.433 region:rollup2
L. AGAIN ELEVEN AT THIRTEEN
01:53:57.698 --> 01:54:01.101 region:rollup2
THIRTY TWO AUTHORITY IS PRETTY
01:53:59.433 --> 01:54:02.569 region:rollup2
BROAD WHERE STATES COULD TOTALLY
01:54:01.101 --> 01:54:04.905 region:rollup2
RE PURPOSE.
01:54:02.569 --> 01:54:06.440 region:rollup2
THOSE FUNDS AND USE THEM IN A
01:54:04.905 --> 01:54:07.641 region:rollup2
DIFFERENT WAY THAT'S A LITTLE
01:54:06.440 --> 01:54:09.342 region:rollup2
DIFFERENT THAN WHAT WE'RE SEEING
01:54:07.641 --> 01:54:10.477 region:rollup2
WITH THE REINSURANCE WAIVERS
01:54:09.342 --> 01:54:12.612 region:rollup2
THEY'RE GETTING PASSED THROUGH
01:54:10.477 --> 01:54:15.582 region:rollup2
FUNDING WHICH IS THEY'RE MAKING
01:54:12.612 --> 01:54:18.018 region:rollup2
SOME KIND OF CHANGE TO. I'D THE
01:54:15.582 --> 01:54:19.920 region:rollup2
ACA AS IT IS AND THE FEDERAL
01:54:18.018 --> 01:54:22.189 region:rollup2
GOVERNMENT IS GIVING THEM AS
01:54:19.920 --> 01:54:24.024 region:rollup2
SOME SAVINGS AS A RESULT OF THAT
01:54:22.189 --> 01:54:25.692 region:rollup2
SO. JUST TO KIND OF DISPUTE DRAW
01:54:24.024 --> 01:54:28.061 region:rollup2
DISTINCTION BETWEEN TOTALLY RE
01:54:25.692 --> 01:54:30.030 region:rollup2
PURPOSING THE DOLLARS VERSES ON
01:54:28.061 --> 01:54:31.531 region:rollup2
A PROPOSAL THAT ACTUALLY ACHIEVE
01:54:30.030 --> 01:54:33.734 region:rollup2
SAVINGS TO THE FEDERAL
01:54:31.531 --> 01:54:35.535 region:rollup2
GOVERNMENT. THERE REALLY ARE TWO
01:54:33.734 --> 01:54:37.204 region:rollup2
DIFFERENT APPROACHES THAT STATES
01:54:35.535 --> 01:54:39.106 region:rollup2
COULD THINK ABOUT WHEN THINKING
01:54:37.204 --> 01:54:40.140 region:rollup2
ABOUT THIRTEEN THIRTY TWO WAIVER
01:54:39.106 --> 01:54:42.542 region:rollup2
AUTHORITY.
01:54:40.140 --> 01:54:44.378 region:rollup2
ANOTHER IMPORTANT POINT AGAIN
01:54:42.542 --> 01:54:45.612 region:rollup2
IS JUST THE DEFICIT NEUTRALITY
01:54:44.378 --> 01:54:46.713 region:rollup2
IS A LITTLE BIT BROADER THAN
01:54:45.612 --> 01:54:48.115 region:rollup2
JUST WHAT'S HAPPENING WITH THE
01:54:46.713 --> 01:54:50.684 region:rollup2
TAX CREDITS.
01:54:48.115 --> 01:54:52.252 region:rollup2
THE TREASURY IS LOOKING AT.
01:54:50.684 --> 01:54:54.154 region:rollup2
OTHER PARTS OF THE HEALTHCARE
01:54:52.252 --> 01:54:54.621 region:rollup2
SYSTEM AND IT'S ABOUT THE
01:54:54.154 --> 01:54:57.157 region:rollup2
OVERALL COSTS NOT HER
01:54:54.621 --> 01:54:59.493 region:rollup2
INDIVIDUAL.
01:54:57.157 --> 01:55:01.528 region:rollup2
AND AGAIN WE HAVE LIMITED
01:54:59.493 --> 01:55:02.863 region:rollup2
EXPERIENCE THERE BEEN A COUPLE
01:55:01.528 --> 01:55:03.930 region:rollup2
OF WAIVERS SOME OF THEM WITH
01:55:02.863 --> 01:55:06.099 region:rollup2
WITHDRAWN.
01:55:03.930 --> 01:55:07.968 region:rollup2
SO WE DON'T HAVE A FULL SENSE
01:55:06.099 --> 01:55:09.503 region:rollup2
OF WHAT MIGHT BE A APPROVED.
01:55:07.968 --> 01:55:11.471 region:rollup2
.
01:55:09.503 --> 01:55:13.473 region:rollup2
BY THAT THIS ADMINISTRATION OUR
01:55:11.471 --> 01:55:14.908 region:rollup2
FUTURE ADMINISTRATIONS.
01:55:13.473 --> 01:55:17.577 region:rollup2
IN THE GUIDANCE ITSELF IT DOES
01:55:14.908 --> 01:55:19.913 region:rollup2
NOTE THAT THAT HHS AND TREASURY
01:55:17.577 --> 01:55:22.549 region:rollup2
CAN REJECT A WAIVER EVEN IF IT
01:55:19.913 --> 01:55:23.950 region:rollup2
MEETS THE FOR GUARD RAILS SO.
01:55:22.549 --> 01:55:25.919 region:rollup2
JUST IMPORTANT TO KNOW.
01:55:23.950 --> 01:55:27.988 region:rollup2
AS THE IN TERMS OF THINKING
01:55:25.919 --> 01:55:30.090 region:rollup2
THROUGH THE WAIVER AUTHORITY.
01:55:27.988 --> 01:55:31.625 region:rollup2
SO AS I SAID IN OUR PAPER WE
01:55:30.090 --> 01:55:34.060 region:rollup2
TALK IN MORE DEPTH ABOUT.
01:55:31.625 --> 01:55:34.795 region:rollup2
MANY OF THE COVERAGE PROPOSALS
01:55:34.060 --> 01:55:36.596 region:rollup2
CERTAINLY.
01:55:34.795 --> 01:55:38.398 region:rollup2
SINGLE PAPER YOU SINGLE PAYER
01:55:36.596 --> 01:55:40.133 region:rollup2
AND I'M HAPPY TO ANSWER REALLY
01:55:38.398 --> 01:55:40.901 region:rollup2
SPECIFIC QUESTIONS I JUST LEAVE
01:55:40.133 --> 01:55:42.536 region:rollup2
YOU WITH.
01:55:40.901 --> 01:55:44.838 region:rollup2
THESE THOUGHTS THERE'S
01:55:42.536 --> 01:55:47.174 region:rollup2
CONSIDERABLE FLEXIBILITY FOR.
01:55:44.838 --> 01:55:48.809 region:rollup2
WAIVERS IN BOTH MEDICAID AND
01:55:47.174 --> 01:55:50.844 region:rollup2
MARKETPLACE COVERAGE.
01:55:48.809 --> 01:55:52.712 region:rollup2
BUT YOU KNOW SOME OF YOUR
01:55:50.844 --> 01:55:53.447 region:rollup2
PROPOSALS MAY TEST NEW IDEAS AND
01:55:52.712 --> 01:55:55.415 region:rollup2
SO.
01:55:53.447 --> 01:55:57.450 region:rollup2
YOU KNOW WE DON'T HAVE AS MUCH
01:55:55.415 --> 01:55:59.252 region:rollup2
EXPERIENCE WITH WHETHER HOW
01:55:57.450 --> 01:56:00.387 region:rollup2
ADMINISTRATION WILL. WILL
01:55:59.252 --> 01:56:01.888 region:rollup2
PERCEIVE THOSE
01:56:00.387 --> 01:56:03.223 region:rollup2
THANK YOU. GREAT THANK YOU VERY
01:56:01.888 --> 01:56:06.660 region:rollup2
MUCH SHOULD QUESTIONS FOR OUR
01:56:03.223 --> 01:56:08.328 region:rollup2
PANEL.
01:56:06.660 --> 01:56:13.467 region:rollup2
I HAVE.
01:56:08.328 --> 01:56:15.268 region:rollup2
START WITH.
01:56:13.467 --> 01:56:16.736 region:rollup2
I'M. THERE'S A LOT OF QUESTIONS
01:56:15.268 --> 01:56:19.272 region:rollup2
SO I WANNA ASK ALL OF THEM AND
01:56:16.736 --> 01:56:20.407 region:rollup2
I'M NOT EXACTLY SURE WHO TO
01:56:19.272 --> 01:56:24.444 region:rollup2
ADDRESS TWO. BUT.
01:56:20.407 --> 01:56:25.412 region:rollup2
.
01:56:24.444 --> 01:56:26.546 region:rollup2
YOU KNOW WE KNOW THE CURRENT
01:56:25.412 --> 01:56:28.014 region:rollup2
SYSTEM IS NOT WORKING AND THAT'S
01:56:26.546 --> 01:56:29.082 region:rollup2
WHY WE'RE TRYING TO LOOK AT
01:56:28.014 --> 01:56:31.284 region:rollup2
ALTERNATIVES.
01:56:29.082 --> 01:56:33.453 region:rollup2
EVERYTHING FROM YOU KNOW THE
01:56:31.284 --> 01:56:35.155 region:rollup2
COVERAGE AVAILABLE BEING
01:56:33.453 --> 01:56:37.190 region:rollup2
RESTRICTED IN SO MANY DIFFERENT
01:56:35.155 --> 01:56:38.625 region:rollup2
WAYS YOU KNOW AS FAR AS THE
01:56:37.190 --> 01:56:41.194 region:rollup2
PATIENT.
01:56:38.625 --> 01:56:42.662 region:rollup2
EX AGAIN CARE THEY MAY NEED.
01:56:41.194 --> 01:56:43.763 region:rollup2
WITHOUT HAVING TO GO THROUGH
01:56:42.662 --> 01:56:45.165 region:rollup2
HOOPS AND ALL KINDS OF
01:56:43.763 --> 01:56:45.799 region:rollup2
BUREAUCRACY.
01:56:45.165 --> 01:56:52.606 region:rollup2
AND ACTUALLY ACCESS COVERAGE IS
01:56:45.799 --> 01:56:54.841 region:rollup2
WORTHLESS WITHOUT
01:56:52.606 --> 01:56:56.977 region:rollup2
ACCESS SO YOU KNOW I'M HOPING
01:56:54.841 --> 01:56:59.646 region:rollup2
THAT AS WE REALLY. MOVES FORWARD
01:56:56.977 --> 01:57:01.414 region:rollup2
TO TRY TO CREATE A PLAN FOR
01:56:59.646 --> 01:57:03.116 region:rollup2
CALIFORNIA THAT WE ACTUALLY
01:57:01.414 --> 01:57:04.951 region:rollup2
SOLVE SOME OF THE PROBLEMS. THAT
01:57:03.116 --> 01:57:06.052 region:rollup2
WE'RE EXPERIENCING.
01:57:04.951 --> 01:57:07.654 region:rollup2
CURRENTLY I'M ONE OF THE
01:57:06.052 --> 01:57:09.289 region:rollup2
QUESTIONS I HAD IS.
01:57:07.654 --> 01:57:10.857 region:rollup2
WE KNOW THAT GENERALLY THE
01:57:09.289 --> 01:57:13.093 region:rollup2
GOVERNMENT PLANS HAVE NOT
01:57:10.857 --> 01:57:15.662 region:rollup2
INCLUDED LONG TERM CARE.
01:57:13.093 --> 01:57:17.831 region:rollup2
VISION OR DENTAL.
01:57:15.662 --> 01:57:20.066 region:rollup2
WOULD THAT BE.
01:57:17.831 --> 01:57:23.637 region:rollup2
IT ARE IS ANYONE DOING THAT IN
01:57:20.066 --> 01:57:24.704 region:rollup2
THEIR STATE YOU KNOW OPTIONS OR.
01:57:23.637 --> 01:57:27.140 region:rollup2
HILL COULD THAT BE.
01:57:24.704 --> 01:57:28.775 region:rollup2
PART OF A.
01:57:27.140 --> 01:57:33.547 region:rollup2
YOU KNOW AND UNIVERSAL.
01:57:28.775 --> 01:57:36.650 region:rollup2
A PLAN THAT WE PUT FORWARD.
01:57:33.547 --> 01:57:38.752 region:rollup2
AND I.
01:57:36.650 --> 01:57:40.120 region:rollup2
THERE IT AT THAT. AREA RIGHT A
01:57:38.752 --> 01:57:41.321 region:rollup2
SO I THINK VISION AND DENTAL IN
01:57:40.120 --> 01:57:43.390 region:rollup2
PARTICULAR ARE.
01:57:41.321 --> 01:57:46.560 region:rollup2
AREAS THAT I THINK A NUMBER OF
01:57:43.390 --> 01:57:48.228 region:rollup2
STATES FIRE. SEE IS PRIORITIES.
01:57:46.560 --> 01:57:49.696 region:rollup2
AND.
01:57:48.228 --> 01:57:51.498 region:rollup2
AND.
01:57:49.696 --> 01:57:53.333 region:rollup2
DO AND THINK ABOUT HOW THEY CAN
01:57:51.498 --> 01:57:56.970 region:rollup2
PROVIDE COVERAGE FOR THOSE TWO I
01:57:53.333 --> 01:57:59.172 region:rollup2
TO. FIND THE MARKETPLACE SIDE.
01:57:56.970 --> 01:58:02.409 region:rollup2
THAT ESTATE.
01:57:59.172 --> 01:58:04.277 region:rollup2
IT IT DOWN IT SP CAN EXPAND THE
01:58:02.409 --> 01:58:05.579 region:rollup2
ESSENTIAL HEALTH BENEFIT PACKAGE
01:58:04.277 --> 01:58:07.714 region:rollup2
IN THE SENSE OF IF THE STATE
01:58:05.579 --> 01:58:09.416 region:rollup2
WANTS TO REQUIRE BENEFITS ABOVE
01:58:07.714 --> 01:58:11.718 region:rollup2
THE AFFORDABLE CARE ACT THEY CAN
01:58:09.416 --> 01:58:13.186 region:rollup2
DO SO THE ISSUE IS SHOW US. THAT
01:58:11.718 --> 01:58:16.356 region:rollup2
THEY NEED TO DO IT USING STATE
01:58:13.186 --> 01:58:17.290 region:rollup2
FUNDS SO ON THE FEDERAL
01:58:16.356 --> 01:58:23.330 region:rollup2
GOVERNMENT DOESN'T.
01:58:17.290 --> 01:58:24.998 region:rollup2
AT IT IS IS THAT FUNDING AS.
01:58:23.330 --> 01:58:27.033 region:rollup2
ON THE MEDICARE SIDE.
01:58:24.998 --> 01:58:30.270 region:rollup2
AS I MENTIONED.
01:58:27.033 --> 01:58:33.540 region:rollup2
UNDER SECTION FOUR OH TO THERE
01:58:30.270 --> 01:58:36.209 region:rollup2
IS AN OPTION TO TASK TO THE
01:58:33.540 --> 01:58:38.611 region:rollup2
ADDITION OF BENEFITS
01:58:36.209 --> 01:58:40.213 region:rollup2
UNDER MEDICARE THAT AREN'T THAT
01:58:38.611 --> 01:58:41.514 region:rollup2
AREN'T CURRENTLY PAID FOR BY
01:58:40.213 --> 01:58:43.483 region:rollup2
MEDICARE.
01:58:41.514 --> 01:58:46.152 region:rollup2
THAT COULD INCLUDE THINGS LIKE
01:58:43.483 --> 01:58:49.022 region:rollup2
VISION AND DENTAL SERVICES.
01:58:46.152 --> 01:58:51.891 region:rollup2
BUT BECAUSE THE SECTION FOR AU
01:58:49.022 --> 01:58:54.127 region:rollup2
TO AUTHORITY RELATES TO.
01:58:51.891 --> 01:58:55.161 region:rollup2
PAYMENT FORSERVICES THAT ARE
01:58:54.127 --> 01:58:57.097 region:rollup2
DESIGNED TO IMPROVE THE
01:58:55.161 --> 01:58:58.598 region:rollup2
EFFICIENCY AND THE ECONOMY OF
01:58:57.097 --> 01:59:00.667 region:rollup2
THE PROGRAM THOSE AT THEIR WORDS
01:58:58.598 --> 01:59:02.435 region:rollup2
IN THE STATUTE. I THINK IT WOULD
01:59:00.667 --> 01:59:03.737 region:rollup2
BE A STRETCH TO FIT LONG TERM
01:59:02.435 --> 01:59:06.773 region:rollup2
CARE.
01:59:03.737 --> 01:59:09.442 region:rollup2
UNDER THAT AUTHORITY. PRIMARILY
01:59:06.773 --> 01:59:11.011 region:rollup2
BECAUSE IT'S SUCH AN EXPENSIVE.
01:59:09.442 --> 01:59:13.380 region:rollup2
SERVICE.
01:59:11.011 --> 01:59:15.715 region:rollup2
IT'S HARD TO IMAGINE A SCENARIO
01:59:13.380 --> 01:59:17.050 region:rollup2
WHERE ADDING THE LONG TERM CARE
01:59:15.715 --> 01:59:19.419 region:rollup2
BENEFIT.
01:59:17.050 --> 01:59:21.388 region:rollup2
ACTUALLY LOWERS
01:59:19.419 --> 01:59:23.523 region:rollup2
COSTS AND NOT REALLY IS A HIGH
01:59:21.388 --> 01:59:25.859 region:rollup2
BAR FOR A BENEFIT LIKE LONG TERM
01:59:23.523 --> 01:59:26.693 region:rollup2
CARE VISION AND DENTAL I THINK
01:59:25.859 --> 01:59:28.395 region:rollup2
MAYBE.
01:59:26.693 --> 01:59:30.296 region:rollup2
LESS OF A STRETCH.
01:59:28.395 --> 01:59:32.165 region:rollup2
PARTICULARLY BECAUSE THEY CAN
01:59:30.296 --> 01:59:33.667 region:rollup2
BE VERY ESSENTIAL TO QUALITY OF
01:59:32.165 --> 01:59:35.402 region:rollup2
LIFE AND AND MIGHT ACTUALLY YOU
01:59:33.667 --> 01:59:37.237 region:rollup2
KNOW IMPROVE PEOPLE'S ABILITY TO
01:59:35.402 --> 01:59:39.372 region:rollup2
GET ABOUT ACCESS SERVICES KIND
01:59:37.237 --> 01:59:41.808 region:rollup2
OF. LIVE THEIR DAILY LIVES.
01:59:39.372 --> 01:59:43.309 region:rollup2
BUT BUT LONG TERM CARE AND
01:59:41.808 --> 01:59:45.078 region:rollup2
MEDICARE ARE OBVIOUSLY TWO VERY
01:59:43.309 --> 01:59:47.747 region:rollup2
DIFFERENT THINGS.
01:59:45.078 --> 01:59:49.549 region:rollup2
AND YOU KNOW BECAUSE LONG TERM
01:59:47.747 --> 01:59:51.017 region:rollup2
CARE IS A MEDICAID BENEFIT NOT A
01:59:49.549 --> 01:59:52.185 region:rollup2
MEDICARE BENEFIT IT TYPICALLY
01:59:51.017 --> 01:59:54.554 region:rollup2
HASN'T REALLY BEEN WITHIN THE
01:59:52.185 --> 01:59:56.890 region:rollup2
PURVIEW OF MEDICARE TO CONSIDER.
01:59:54.554 --> 01:59:59.325 region:rollup2
REFORMS THAT MIGHT AND LONG TERM
01:59:56.890 --> 02:00:01.795 region:rollup2
CARE TO THE MEDICARE BENEFIT
01:59:59.325 --> 02:00:02.896 region:rollup2
PACKAGE.
02:00:01.795 --> 02:00:05.498 region:rollup2
AND I WOULD JUST ADD IN
02:00:02.896 --> 02:00:07.700 region:rollup2
CALIFORNIA MEDI CAL DOES COVER A
02:00:05.498 --> 02:00:09.736 region:rollup2
LONG TERM CARE. OF COURSE THAT'S
02:00:07.700 --> 02:00:12.338 region:rollup2
THE MEDI CAL PROGRAM. AND.
02:00:09.736 --> 02:00:13.940 region:rollup2
AND IN TERMS OF THE ESSENTIAL
02:00:12.338 --> 02:00:16.209 region:rollup2
HEALTH BENEFITS BENCHMARK THE
02:00:13.940 --> 02:00:19.179 region:rollup2
CALIFORNIA HAS SET FOR. THE
02:00:16.209 --> 02:00:21.614 region:rollup2
MARKETPLACE PLANS ON CURRENTLY.
02:00:19.179 --> 02:00:23.149 region:rollup2
ADULT A DENTAL BENEFITS FOR
02:00:21.614 --> 02:00:24.751 region:rollup2
EXAMPLE ARE NOT INCLUDED SO.
02:00:23.149 --> 02:00:26.252 region:rollup2
THAT YOU KNOW SO ON THE
02:00:24.751 --> 02:00:28.054 region:rollup2
ESSENTIAL HEALTH BENEFITS
02:00:26.252 --> 02:00:29.956 region:rollup2
BENCHMARK PLAN THAT CHIQUITA WAS
02:00:28.054 --> 02:00:30.490 region:rollup2
REFERRING TO EARLIER THAT IS THE
02:00:29.956 --> 02:00:32.992 region:rollup2
AVENUE BY WHICH YOU COULD
02:00:30.490 --> 02:00:34.861 region:rollup2
EXPAND.
02:00:32.992 --> 02:00:36.429 region:rollup2
WHAT IS CONSIDERED ESSENTIAL
02:00:34.861 --> 02:00:38.331 region:rollup2
HEALTH BENEFITS ON THE FLOOR FOR
02:00:36.429 --> 02:00:40.600 region:rollup2
CALIFORNIA?
02:00:38.331 --> 02:00:42.302 region:rollup2
OKAY I'M JUST A QUICK FOLLOW UP
02:00:40.600 --> 02:00:44.704 region:rollup2
TO. THEM.
02:00:42.302 --> 02:00:47.107 region:rollup2
IN ONE OF OUR PREVIOUS HEARINGS.
02:00:44.704 --> 02:00:47.807 region:rollup2
WE DISCUSSED COST CONTAINMENT
02:00:47.107 --> 02:00:49.142 region:rollup2
AND WHEN WE.
02:00:47.807 --> 02:00:50.677 region:rollup2
HEARD ABOUT THE DIFFERENT PLANS
02:00:49.142 --> 02:00:53.279 region:rollup2
AND OTHER STATES.
02:00:50.677 --> 02:00:55.115 region:rollup2
IN THEY WERE GIVING ADVICE ON
02:00:53.279 --> 02:00:57.117 region:rollup2
YOU KNOW HOW.
02:00:55.115 --> 02:00:58.752 region:rollup2
SET UP YOU WANNA DO COST
02:00:57.117 --> 02:01:00.286 region:rollup2
CONTAINMENT UP FRONT BECAUSE.
02:00:58.752 --> 02:01:01.888 region:rollup2
SOME OF THE STATE'S THAT HAD
02:01:00.286 --> 02:01:03.456 region:rollup2
GONE DOWN THE ROAD.
02:01:01.888 --> 02:01:05.625 region:rollup2
FOUND THEY WEREN'T REALLY
02:01:03.456 --> 02:01:07.794 region:rollup2
EXPERIENCING SAVINGS AND MAYBE
02:01:05.625 --> 02:01:11.831 region:rollup2
EVEN HAVE. ADDITIONAL COSTS.
02:01:07.794 --> 02:01:13.133 region:rollup2
.
02:01:11.831 --> 02:01:16.236 region:rollup2
HOW WOULD YOU RECOMMEND WE GO
02:01:13.133 --> 02:01:17.904 region:rollup2
ABOUT STREAMLINING EFFICIENCIES?
02:01:16.236 --> 02:01:19.572 region:rollup2
AND THE BUREAUCRACY I MEAN YOU
02:01:17.904 --> 02:01:20.273 region:rollup2
KNOW WE HAVE ALREADY IN THE
02:01:19.572 --> 02:01:22.308 region:rollup2
SYSTEM THAT IS.
02:01:20.273 --> 02:01:23.643 region:rollup2
.
02:01:22.308 --> 02:01:25.845 region:rollup2
WHAT'S SPECIFIC GOALS SHOULD WE
02:01:23.643 --> 02:01:27.013 region:rollup2
BE LOOKING FOR. AS WE LOOK TO A
02:01:25.845 --> 02:01:28.414 region:rollup2
PLAN FOR CALIFORNIA THAT WOULD
02:01:27.013 --> 02:01:30.116 region:rollup2
HELP.
02:01:28.414 --> 02:01:32.685 region:rollup2
IN THE COST CONTAINMENT HOA BE
02:01:30.116 --> 02:01:35.054 region:rollup2
ACCOUNTABLE NOSES GOES DOWN THE
02:01:32.685 --> 02:01:36.222 region:rollup2
LINE WHO IS ACCOUNTABLE. IS THAT
02:01:35.054 --> 02:01:37.690 region:rollup2
THE LEGISLATURE IS IT YOU KNOW.
02:01:36.222 --> 02:01:40.627 region:rollup2
THE SIR I'M.
02:01:37.690 --> 02:01:43.329 region:rollup2
SOMEBODY THAT.
02:01:40.627 --> 02:01:48.301 region:rollup2
AND WILL BE LOOKING AT THAT.
02:01:43.329 --> 02:01:49.802 region:rollup2
AND WHO THE LA AU PAIR.
02:01:48.301 --> 02:01:50.870 region:rollup2
I DON'T EVEN KNOW HOW TO BEGIN
02:01:49.802 --> 02:01:53.873 region:rollup2
TO ANSWER THAT QUESTION IT'S
02:01:50.870 --> 02:01:55.909 region:rollup2
OBVIOUSLY A CENTRAL QUESTION IN.
02:01:53.873 --> 02:01:57.143 region:rollup2
DISCUSSIONS ABOUT YOU KNOW
02:01:55.909 --> 02:01:58.244 region:rollup2
TRANSFORMING OUR HEALTHCARE
02:01:57.143 --> 02:01:59.646 region:rollup2
SYSTEM.
02:01:58.244 --> 02:02:01.915 region:rollup2
YOU KNOW CLEARLY WITHIN
02:01:59.646 --> 02:02:03.983 region:rollup2
MEDICARE I THINK THIS IS ONE OF
02:02:01.915 --> 02:02:06.119 region:rollup2
THE PRIMARY GOALS OF THE
02:02:03.983 --> 02:02:07.654 region:rollup2
INNOVATION CENTER THAT IT WAS IT
02:02:06.119 --> 02:02:10.256 region:rollup2
WAS SET UP.
02:02:07.654 --> 02:02:11.758 region:rollup2
TO TRY TO TEST THESE NEW MODELS
02:02:10.256 --> 02:02:13.626 region:rollup2
OF PAYING FOR CARE RECOGNIZING
02:02:11.758 --> 02:02:15.328 region:rollup2
THAT.
02:02:13.626 --> 02:02:17.363 region:rollup2
YOU KNOW THE WAY WE DO IT NOW IS
02:02:15.328 --> 02:02:19.265 region:rollup2
NOT. WORKING SO WELL FOR
02:02:17.363 --> 02:02:20.800 region:rollup2
EVERYBODY IT'S IT'S IT'S NOT
02:02:19.265 --> 02:02:23.036 region:rollup2
EVEN WORKING SO WELL WITHIN
02:02:20.800 --> 02:02:25.939 region:rollup2
MEDICARE AND I THINK THAT'S WHY.
02:02:23.036 --> 02:02:28.274 region:rollup2
CMS HAS BEEN OR YOU KNOW AT
02:02:25.939 --> 02:02:30.076 region:rollup2
LEAST HAD BEEN PRETTY AGGRESSIVE
02:02:28.274 --> 02:02:31.878 region:rollup2
IN TRYING TO TEST A LOT OF
02:02:30.076 --> 02:02:33.279 region:rollup2
DIFFERENT NEW IDEAS IT'S KIND OF
02:02:31.878 --> 02:02:34.547 region:rollup2
LIKE THROW EVERYTHING AT THE
02:02:33.279 --> 02:02:37.417 region:rollup2
WALL AND SEE WHAT STICKS.
02:02:34.547 --> 02:02:38.017 region:rollup2
BUT IT'S IT'S ALSO A STRUGGLE I
02:02:37.417 --> 02:02:40.186 region:rollup2
THINK.
02:02:38.017 --> 02:02:42.222 region:rollup2
TOOK TO FIND SAVINGS TO SOME
02:02:40.186 --> 02:02:44.324 region:rollup2
EXTENT WHEN YOU'RE TESTING SO
02:02:42.222 --> 02:02:46.860 region:rollup2
MANY DIFFERENT THINGS.
02:02:44.324 --> 02:02:48.127 region:rollup2
YOU KNOW AS AS I SHOWED AND IN
02:02:46.860 --> 02:02:50.363 region:rollup2
THAT ONE SLIDE ALL THE DIFFERENT
02:02:48.127 --> 02:02:52.131 region:rollup2
CATEGORIES THAT ARE BEING TESTED
02:02:50.363 --> 02:02:53.633 region:rollup2
WITHIN THE INNOVATION CENTER
02:02:52.131 --> 02:02:55.602 region:rollup2
THERE IS A TREMENDOUS AMOUNT OF
02:02:53.633 --> 02:02:57.136 region:rollup2
INNOVATIVE ACTIVITY GOING ON AT
02:02:55.602 --> 02:02:58.671 region:rollup2
THE STATE LEVEL AT THE PROVIDER
02:02:57.136 --> 02:02:59.772 region:rollup2
LEVEL. AT LOTS OF DIFFERENT
02:02:58.671 --> 02:03:00.974 region:rollup2
LEVELS WITHIN OUR HEALTHCARE
02:02:59.772 --> 02:03:03.776 region:rollup2
SYSTEM.
02:03:00.974 --> 02:03:05.845 region:rollup2
AND SO WHILE THAT'S GREAT.
02:03:03.776 --> 02:03:07.614 region:rollup2
IT ALSO MAKES IT DIFFICULT TO
02:03:05.845 --> 02:03:09.882 region:rollup2
REALLY UNDERSTAND EXACTLY WHAT
02:03:07.614 --> 02:03:12.118 region:rollup2
IT IS THAT'S HAVING AN EFFECTIVE
02:03:09.882 --> 02:03:14.120 region:rollup2
FOR ACTUALLY SEEING SAVINGS
02:03:12.118 --> 02:03:15.855 region:rollup2
WHICH IS ALSO WHY THEY.
02:03:14.120 --> 02:03:18.124 region:rollup2
THE INNOVATION CENTER REALLY
02:03:15.855 --> 02:03:19.425 region:rollup2
TRIES VERY CAREFULLY TO SET UP
02:03:18.124 --> 02:03:21.361 region:rollup2
EVALUATIONS.
02:03:19.425 --> 02:03:23.363 region:rollup2
SEC TEST.
02:03:21.361 --> 02:03:25.732 region:rollup2
YOU KNOW THERE THE MODEL VERSES
02:03:23.363 --> 02:03:27.734 region:rollup2
VIENEN NOT MODEL TO FIGURE OUT
02:03:25.732 --> 02:03:29.936 region:rollup2
EXACTLY WHAT IS WORKING AND A
02:03:27.734 --> 02:03:31.704 region:rollup2
MODEL OR WHAT'S NOT WORKING.
02:03:29.936 --> 02:03:33.072 region:rollup2
SO THAT WE KNOW WE DON'T INVEST
02:03:31.704 --> 02:03:34.807 region:rollup2
FURTHER RESOURCES AND THINGS
02:03:33.072 --> 02:03:36.542 region:rollup2
THAT DON'T WORK.
02:03:34.807 --> 02:03:38.511 region:rollup2
SO THERE'S BEEN A LOT OF
02:03:36.542 --> 02:03:41.180 region:rollup2
SUPPORT FOR IDEAS LIKE PATIENT
02:03:38.511 --> 02:03:41.814 region:rollup2
CENTERED MEDICAL HOMES AND
02:03:41.180 --> 02:03:43.283 region:rollup2
ACCOUNTABLE CARE ORGANIZATIONS
02:03:41.814 --> 02:03:44.851 region:rollup2
AND.
02:03:43.283 --> 02:03:46.319 region:rollup2
I PROVIDERS TALKING TO EACH
02:03:44.851 --> 02:03:47.654 region:rollup2
OTHER AND NOT ORDERING
02:03:46.319 --> 02:03:49.289 region:rollup2
DUPLICATIVE TESTS AND THINGS
02:03:47.654 --> 02:03:51.090 region:rollup2
LIKE THAT THESE THINGS ARE ALL
02:03:49.289 --> 02:03:53.826 region:rollup2
GREAT IDEAS BUT THEY DO TAKE A
02:03:51.090 --> 02:03:56.362 region:rollup2
LOT OF TIME TO. BUILD UP TO GET
02:03:53.826 --> 02:03:58.031 region:rollup2
PROVIDERS TO TO WORK TOGETHER
02:03:56.362 --> 02:04:00.433 region:rollup2
AND AND SPEAK TO EACH OTHER.
02:03:58.031 --> 02:04:02.201 region:rollup2
AND TO GET PATIENTS INTO THE
02:04:00.433 --> 02:04:03.536 region:rollup2
SYSTEM AS WELL AND TO REALLY
02:04:02.201 --> 02:04:05.905 region:rollup2
MAKE THE MOST OUT OF THIS TYPE
02:04:03.536 --> 02:04:07.040 region:rollup2
OF COORDINATED CARE SYSTEM SO I
02:04:05.905 --> 02:04:08.474 region:rollup2
DON'T KNOW THAT'S ANSWERING YOUR
02:04:07.040 --> 02:04:10.476 region:rollup2
QUESTION DIRECTLY BUT THERE'S
02:04:08.474 --> 02:04:13.980 region:rollup2
CLEARLY A LOT OF INTEREST.
02:04:10.476 --> 02:04:16.215 region:rollup2
IN PURSUING. BETTER WAY TO YOU
02:04:13.980 --> 02:04:18.451 region:rollup2
KNOW BRING ABOUT PAYMENT REFORMS
02:04:16.215 --> 02:04:19.819 region:rollup2
AND DELIVERY SYSTEM REFORMS SO
02:04:18.451 --> 02:04:21.220 region:rollup2
TO THE EXTENT THAT YOU HAVE
02:04:19.819 --> 02:04:23.256 region:rollup2
GOALS THAT YOU'RE INTERESTED IN
02:04:21.220 --> 02:04:24.891 region:rollup2
ACHIEVING. THAT REQUIRE
02:04:23.256 --> 02:04:26.559 region:rollup2
PARTNERSHIP WITH THE FEDERAL
02:04:24.891 --> 02:04:28.661 region:rollup2
GOVERNMENT TO TEST THEM IN
02:04:26.559 --> 02:04:29.929 region:rollup2
MEDICARE AND MEDICAID AND THE
02:04:28.661 --> 02:04:31.864 region:rollup2
MARKET.
02:04:29.929 --> 02:04:34.667 region:rollup2
WILLING PARTNER.
02:04:31.864 --> 02:04:36.402 region:rollup2
IN CM MASS.
02:04:34.667 --> 02:04:38.571 region:rollup2
BUT YOU OBVIOUSLY HAVE TO THINK
02:04:36.402 --> 02:04:40.573 region:rollup2
THROUGH VERY CAREFULLY WHAT YOUR
02:04:38.571 --> 02:04:41.975 region:rollup2
GOALS ARE AND THE TARGET
02:04:40.573 --> 02:04:45.011 region:rollup2
POPULATIONS THAT YOU HAVE IN
02:04:41.975 --> 02:04:47.180 region:rollup2
MIND. TO DEVELOP VERY SPECIFIC.
02:04:45.011 --> 02:04:49.349 region:rollup2
THINGS THAT YOU WANT TO TEST.
02:04:47.180 --> 02:04:51.751 region:rollup2
IN TERMS OF ACHIEVING SAVINGS
02:04:49.349 --> 02:04:57.056 region:rollup2
AND IMPROVING QUALITY WITHIN.
02:04:51.751 --> 02:04:59.459 region:rollup2
THE CONTEXT OF THOSE PRO.
02:04:57.056 --> 02:05:01.260 region:rollup2
I. JUST I HAVE A LOT BUT I'LL
02:04:59.459 --> 02:05:02.795 region:rollup2
JUST DO ONE AND THEN SAVE IT FOR
02:05:01.260 --> 02:05:06.299 region:rollup2
THAT THE NEXT HEARING HOW.
02:05:02.795 --> 02:05:09.268 region:rollup2
AT ONE OF THE BIGGEST THINGS IS.
02:05:06.299 --> 02:05:10.703 region:rollup2
PATIENT TRYING TO NAVIGATE.
02:05:09.268 --> 02:05:12.205 region:rollup2
YOU KNOW THE WHOLE PROCESS AND
02:05:10.703 --> 02:05:15.174 region:rollup2
YOU KNOW I JUST LOOK AT. PEOPLE
02:05:12.205 --> 02:05:16.976 region:rollup2
I KNOW HAVE TO GO AND THEN YOU
02:05:15.174 --> 02:05:18.745 region:rollup2
KNOW THEY GO TO PRIMARY CARE BUT
02:05:16.976 --> 02:05:21.748 region:rollup2
THERE IMMEDIATELY REFER. AND
02:05:18.745 --> 02:05:24.250 region:rollup2
THEN THEY HAVE A NEED BUT THE
02:05:21.748 --> 02:05:25.785 region:rollup2
SPECIAL SAY SEND THEM TO NEVER.
02:05:24.250 --> 02:05:27.220 region:rollup2
GIVES THEM THE THING THAT THE
02:05:25.785 --> 02:05:28.488 region:rollup2
INITIAL REQUEST WAS FORMED IN
02:05:27.220 --> 02:05:30.056 region:rollup2
THE BACK WITH THE PRIMARY CARE
02:05:28.488 --> 02:05:31.657 region:rollup2
DOCTOR IN THEIR QUESTIONING WHY
02:05:30.056 --> 02:05:33.459 region:rollup2
THAT'S IN HAPPEN THEY CAN'T FIND
02:05:31.657 --> 02:05:34.827 region:rollup2
THE FILE WITH ALL THE TECHNOLOGY
02:05:33.459 --> 02:05:36.262 region:rollup2
WE HAVE RIGHT NOW THEY COULDN'T
02:05:34.827 --> 02:05:39.065 region:rollup2
FIND THE PATIENT'S FILE. AND
02:05:36.262 --> 02:05:41.267 region:rollup2
THEN YOU GET THE BILLS IN THE
02:05:39.065 --> 02:05:42.869 region:rollup2
MAIL ANNUAL WILL I HAVE
02:05:41.267 --> 02:05:44.971 region:rollup2
INSURANCE HOW COME I'M GETTING
02:05:42.869 --> 02:05:47.140 region:rollup2
THIS BILL AND. YOU KNOW JUST FOR
02:05:44.971 --> 02:05:49.709 region:rollup2
ME PERSONALLY HAVING GONE TO THE
02:05:47.140 --> 02:05:50.877 region:rollup2
EMERGENCY ROOM LAST YEAR WHEN
02:05:49.709 --> 02:05:51.644 region:rollup2
DURING SESSION.
02:05:50.877 --> 02:05:53.813 region:rollup2
FOR A.
02:05:51.644 --> 02:05:54.881 region:rollup2
ANALOGY. SOMETHING AND IN THE I
02:05:53.813 --> 02:05:56.048 region:rollup2
WAS ALLERGIC TO.
02:05:54.881 --> 02:05:57.517 region:rollup2
EXCEPT FOR THE TECHNICIAN AT THE
02:05:56.048 --> 02:05:59.118 region:rollup2
DOOR NO ONE EVEN LOOKED AT ME
02:05:57.517 --> 02:06:00.286 region:rollup2
THE DOCTOR SHOOK MY HAND ON THE
02:05:59.118 --> 02:06:01.687 region:rollup2
WAY OUT AND THEN I GOT A THREE
02:06:00.286 --> 02:06:03.456 region:rollup2
THOUSAND DOLLAR BILL. AND I
02:06:01.687 --> 02:06:05.057 region:rollup2
FOUND OUT THAT.
02:06:03.456 --> 02:06:06.159 region:rollup2
THE DOCTOR HAS TO PAY THE HIGH
02:06:05.057 --> 02:06:07.894 region:rollup2
IN ORDER FOR THE TECHNICIAN TO
02:06:06.159 --> 02:06:09.095 region:rollup2
GET PAID A LITTLE BIT.
02:06:07.894 --> 02:06:10.797 region:rollup2
AND THIS IS A WHOLE LOT OF
02:06:09.095 --> 02:06:14.534 region:rollup2
BUREAUCRACY IN.
02:06:10.797 --> 02:06:16.035 region:rollup2
NO AS WE GO DOWN THIS ROAD I.
02:06:14.534 --> 02:06:17.937 region:rollup2
REALLY WANT US TO MAKE SURE WE.
02:06:16.035 --> 02:06:18.638 region:rollup2
SPEND A LOT OF TIME ON THE COST
02:06:17.937 --> 02:06:24.677 region:rollup2
CONTAINMENT PART THIS ONE.
02:06:18.638 --> 02:06:26.979 region:rollup2
THANK YOU.
02:06:24.677 --> 02:06:28.114 region:rollup2
FIRST I'D LIKE TO JUST THANK THE
02:06:26.979 --> 02:06:29.682 region:rollup2
PANEL HEALTHCARE IS AWFULLY
02:06:28.114 --> 02:06:31.217 region:rollup2
COMPLICATED AND UNDERSTANDING
02:06:29.682 --> 02:06:33.186 region:rollup2
WHERE SOME OF THOSE ROADBLOCKS
02:06:31.217 --> 02:06:34.821 region:rollup2
ARE IS BENEFICIAL.
02:06:33.186 --> 02:06:37.423 region:rollup2
I WANTED TO SEE IF I COULD FIND
02:06:34.821 --> 02:06:39.092 region:rollup2
THE NEEDLE WITHIN THE HAYSTACK
02:06:37.423 --> 02:06:40.626 region:rollup2
THOUGH AND DOCTOR COMMANDS CAN.
02:06:39.092 --> 02:06:41.894 region:rollup2
A LITTLE BIT ON. UNDER YOUR
02:06:40.626 --> 02:06:43.429 region:rollup2
CATEGORIES FOR INNOVATION CENTER
02:06:41.894 --> 02:06:46.199 region:rollup2
MODELS.
02:06:43.429 --> 02:06:47.700 region:rollup2
YOU NOT GLOSSED OVER THE STRONG
02:06:46.199 --> 02:06:48.968 region:rollup2
STARTS FROM MOTHERS AND NEWBORN
02:06:47.700 --> 02:06:50.670 region:rollup2
INITIATIVES AND.
02:06:48.968 --> 02:06:52.071 region:rollup2
I HAVE
02:06:50.670 --> 02:06:53.506 region:rollup2
QUITE AN INTEREST IN THIS BOTH
02:06:52.071 --> 02:06:54.106 region:rollup2
BECAUSE I HAVE A TWO FIVE AND
02:06:53.506 --> 02:06:56.309 region:rollup2
SIX YEAR OLD AT HOME BUT ALSO
02:06:54.106 --> 02:06:58.277 region:rollup2
IN.
02:06:56.309 --> 02:06:59.378 region:rollup2
TRYING TO IMPLEMENT A HOME
02:06:58.277 --> 02:07:00.980 region:rollup2
VISITING PROGRAM HERE IN OUR
02:06:59.378 --> 02:07:01.447 region:rollup2
STATE AND WANT TO HEAR MORE
02:07:00.980 --> 02:07:04.417 region:rollup2
ABOUT THAT PROGRAM IN
02:07:01.447 --> 02:07:06.452 region:rollup2
PARTICULAR.
02:07:04.417 --> 02:07:08.054 region:rollup2
SO I DIDN'T REALLY TALK MUCH
02:07:06.452 --> 02:07:09.522 region:rollup2
ABOUT THOSE OTHER CATEGORIES TO
02:07:08.054 --> 02:07:11.657 region:rollup2
SOME EXTENT BECAUSE THEY'RE NOT
02:07:09.522 --> 02:07:13.926 region:rollup2
AS FOCUSED ON MEDICARE.
02:07:11.657 --> 02:07:17.597 region:rollup2
THAT SAID.
02:07:13.926 --> 02:07:18.898 region:rollup2
CLEARLY YOU KNOW BASED ON THE.
02:07:17.597 --> 02:07:20.900 region:rollup2
THE CATEGORIES THAT THE
02:07:18.898 --> 02:07:22.435 region:rollup2
INNOVATION CENTER IS PURSUING
02:07:20.900 --> 02:07:24.237 region:rollup2
AND EVEN IF YOU READ THE STATUTE
02:07:22.435 --> 02:07:25.738 region:rollup2
THERE ARE A LOT MORE.
02:07:24.237 --> 02:07:28.374 region:rollup2
OPPORTUNITIES.
02:07:25.738 --> 02:07:29.041 region:rollup2
THAT ARE LISTED IN THE STATUTE
02:07:28.374 --> 02:07:31.677 region:rollup2
AS FAR AS.
02:07:29.041 --> 02:07:34.080 region:rollup2
MODELS THAT CAN BE TESTED.
02:07:31.677 --> 02:07:35.781 region:rollup2
THERE IS A TREMENDOUS AMOUNT OF
02:07:34.080 --> 02:07:37.150 region:rollup2
ACTIVITY THAT THE STATE CAN
02:07:35.781 --> 02:07:38.317 region:rollup2
PURSUE WITH REGARD TO THESE
02:07:37.150 --> 02:07:39.485 region:rollup2
INNOVATION MODELS AND BY
02:07:38.317 --> 02:07:40.786 region:rollup2
GLOSSING OVER IT I DIDN'T MEAN
02:07:39.485 --> 02:07:43.623 region:rollup2
TO MAKE LIGHT OF IT.
02:07:40.786 --> 02:07:44.957 region:rollup2
AYE I JUST MOSTLY I MEANT TO
02:07:43.623 --> 02:07:46.159 region:rollup2
CONVEY THAT THAT'S TO SOME
02:07:44.957 --> 02:07:47.393 region:rollup2
EXTENT OUTSIDE MY AREA OF
02:07:46.159 --> 02:07:49.128 region:rollup2
EXPERTISE.
02:07:47.393 --> 02:07:51.731 region:rollup2
BUT.
02:07:49.128 --> 02:07:53.266 region:rollup2
BUT HE YOU KNOW THERE'S THERE'S
02:07:51.731 --> 02:07:55.234 region:rollup2
VERY MUCH AN INTEREST WITHIN THE
02:07:53.266 --> 02:07:57.003 region:rollup2
INNOVATION CENTER AT HEARING
02:07:55.234 --> 02:07:58.271 region:rollup2
FROM PEOPLE WHO HAVE IDEAS IT
02:07:57.003 --> 02:07:58.771 region:rollup2
DOESN'T EVEN HAVE TO BE A STATE
02:07:58.271 --> 02:08:00.339 region:rollup2
IT CAN BE AN INDIVIDUAL
02:07:58.771 --> 02:08:01.841 region:rollup2
PROVIDER.
02:08:00.339 --> 02:08:04.844 region:rollup2
OR A PROVIDER GROUP.
02:08:01.841 --> 02:08:06.379 region:rollup2
OR ANYBODY REALLY CAN CAN GO TO
02:08:04.844 --> 02:08:07.346 region:rollup2
THE INNOVATION CENTER WITH AN
02:08:06.379 --> 02:08:09.949 region:rollup2
IDEA.
02:08:07.346 --> 02:08:12.185 region:rollup2
ABOUT HOW TO YOU KNOW IMPROVE
02:08:09.949 --> 02:08:14.020 region:rollup2
QUALITY AND REDUCE SPENDING.
02:08:12.185 --> 02:08:14.820 region:rollup2
WITHIN MEDICARE MEDICAID AND
02:08:14.020 --> 02:08:17.723 region:rollup2
CHIP.
02:08:14.820 --> 02:08:20.393 region:rollup2
AND SO TO THE EXTENT THAT THE
02:08:17.723 --> 02:08:21.194 region:rollup2
STATE HAD COMES UP WITH SPECIFIC
02:08:20.393 --> 02:08:23.095 region:rollup2
THINGS THAT.
02:08:21.194 --> 02:08:25.164 region:rollup2
THAT IS THAT THEY'RE INTERESTED
02:08:23.095 --> 02:08:26.966 region:rollup2
IN IF YOU HAVE SPECIFIC IDEAS
02:08:25.164 --> 02:08:30.069 region:rollup2
THAT YOU WOULD LIKE.
02:08:26.966 --> 02:08:30.903 region:rollup2
TO TRY TO TEST WITH THEN UP YOU
02:08:30.069 --> 02:08:33.706 region:rollup2
KNOW THE STATE HEALTH CARE
02:08:30.903 --> 02:08:35.074 region:rollup2
DELIVERY SYSTEM I THINK THE CMMI
02:08:33.706 --> 02:08:36.542 region:rollup2
WOULD BE VERY INTERESTED IN
02:08:35.074 --> 02:08:39.712 region:rollup2
HEARING.
02:08:36.542 --> 02:08:43.516 region:rollup2
FROM FROM YOU ABOUT THOSE IDEAS
02:08:39.712 --> 02:08:44.884 region:rollup2
AND I'M AND WORKING WITH YEAR
02:08:43.516 --> 02:08:47.320 region:rollup2
TWO TO TRY TO MAKE IT WORK.
02:08:44.884 --> 02:08:48.554 region:rollup2
SO FOLLOW UP A FIVE MAN OF
02:08:47.320 --> 02:08:50.856 region:rollup2
HEART AND DIRECT SOMEONE
02:08:48.554 --> 02:08:52.625 region:rollup2
ABSOLUTELY WILL WANTS TO. MAKE
02:08:50.856 --> 02:08:53.726 region:rollup2
SURE WE'RE TALKING ABOUT IF IF I
02:08:52.625 --> 02:08:54.660 region:rollup2
CAN HOW MISS BROOKS WILSHIRE.
02:08:53.726 --> 02:08:55.728 region:rollup2
YOU POINT OUT THAT THE STATE
02:08:54.660 --> 02:08:57.163 region:rollup2
CANNOT GET A WAIVER FROM HER
02:08:55.728 --> 02:08:58.097 region:rollup2
THAT MEDICAID F. MAP CLAIMING
02:08:57.163 --> 02:08:59.398 region:rollup2
PROCESS ISN'T.
02:08:58.097 --> 02:09:02.034 region:rollup2
SO IF CALIFORNIA HAS A PUBLICLY
02:08:59.398 --> 02:09:03.636 region:rollup2
FINANCED HEALTHCARE SYSTEMS AS A
02:09:02.034 --> 02:09:05.171 region:rollup2
SINGLE PAYER SYSTEM.
02:09:03.636 --> 02:09:07.039 region:rollup2
WHAT CALIFORNIA BE ABLE TO GET A
02:09:05.171 --> 02:09:08.541 region:rollup2
WAIVER TO MORE EFFICIENTLY BILL
02:09:07.039 --> 02:09:09.842 region:rollup2
THE?
02:09:08.541 --> 02:09:12.678 region:rollup2
FEDERAL GOVERNMENT PRINT SHARE
02:09:09.842 --> 02:09:13.946 region:rollup2
OF THOSE QUALIFIED FOR MEDICARE.
02:09:12.678 --> 02:09:15.281 region:rollup2
IT SOUNDS AS THOUGH CALIFORNIA
02:09:13.946 --> 02:09:17.550 region:rollup2
WOULD NEED TO RETAIN THE
02:09:15.281 --> 02:09:19.452 region:rollup2
ADMINISTRATIVE SYSTEMS AND FOR
02:09:17.550 --> 02:09:20.953 region:rollup2
ELIGIBILITY DETERMINATION AND
02:09:19.452 --> 02:09:22.555 region:rollup2
OTHER RECORD KEEPING TO CAPTURE
02:09:20.953 --> 02:09:24.757 region:rollup2
THE FEDERAL FUNDS
02:09:22.555 --> 02:09:25.858 region:rollup2
IS THAT RIGHT. SO AND WE TALK
02:09:24.757 --> 02:09:27.393 region:rollup2
ABOUT THIS MORE IN THE PAPER I
02:09:25.858 --> 02:09:28.995 region:rollup2
THINK THEY'RE A COUPLE OF WAYS
02:09:27.393 --> 02:09:29.428 region:rollup2
THAT CALIFORNIA COULD GO UP THE
02:09:28.995 --> 02:09:32.531 region:rollup2
COULD GO.
02:09:29.428 --> 02:09:34.834 region:rollup2
TO DRAWDOWN MEDICAID FUNDS THE
02:09:32.531 --> 02:09:36.802 region:rollup2
ONE WAY WOULD BE CERTAINLY TO
02:09:34.834 --> 02:09:38.838 region:rollup2
FOLLOW ALL THE MEDICAID RULES
02:09:36.802 --> 02:09:41.073 region:rollup2
WHICH REALLY WOULD REQUIRE.
02:09:38.838 --> 02:09:42.608 region:rollup2
AND UP FRONT ELIGIBILITY
02:09:41.073 --> 02:09:44.944 region:rollup2
DETERMINATION.
02:09:42.608 --> 02:09:47.647 region:rollup2
AND IT MAY BE THAT TO THE
02:09:44.944 --> 02:09:48.581 region:rollup2
CONSUMER TO PEOPLE IT'S NOT AS
02:09:47.647 --> 02:09:50.016 region:rollup2
OBVIOUS.
02:09:48.581 --> 02:09:51.217 region:rollup2
BUT THERE'S A LITTLE BIT MORE
02:09:50.016 --> 02:09:53.819 region:rollup2
OF A BACK DOOR.
02:09:51.217 --> 02:09:55.354 region:rollup2
ENROLLMENT PROCESS IN PLACE.
02:09:53.819 --> 02:09:57.356 region:rollup2
THIS SECOND WAY THAT YOU COULD
02:09:55.354 --> 02:09:59.692 region:rollup2
GO IS LOOK FOR FEDERAL FUNDS.
02:09:57.356 --> 02:10:02.128 region:rollup2
IT IS LOOK FOR A FEDERAL WAIVER
02:09:59.692 --> 02:10:04.563 region:rollup2
AND TRY TO GET SOME FLEXIBILITY
02:10:02.128 --> 02:10:06.165 region:rollup2
ON THE ELIGIBILITY DETERMINATION
02:10:04.563 --> 02:10:07.433 region:rollup2
WE DO SAY THAT WE DO YOU THINK
02:10:06.165 --> 02:10:08.668 region:rollup2
THAT YOU WOULD HAVE TO DO SOME
02:10:07.433 --> 02:10:10.970 region:rollup2
KIND OF ELIGIBILITY
02:10:08.668 --> 02:10:11.504 region:rollup2
DETERMINATION. THAT SENSE OF BUT
02:10:10.970 --> 02:10:13.205 region:rollup2
IT MIGHT BE.
02:10:11.504 --> 02:10:14.440 region:rollup2
A LITTLE BIT DIFFERENT SO
02:10:13.205 --> 02:10:15.041 region:rollup2
INSTEAD OF DOING IT UP FRONT
02:10:14.440 --> 02:10:16.275 region:rollup2
MAYBE IT'S SOMETHING THAT YOU
02:10:15.041 --> 02:10:18.477 region:rollup2
DO.
02:10:16.275 --> 02:10:19.679 region:rollup2
AFTER PEOPLE ARE ALREADY
02:10:18.477 --> 02:10:22.181 region:rollup2
ENROLLED.
02:10:19.679 --> 02:10:23.983 region:rollup2
AND AND SO WE DO THINK THERE
02:10:22.181 --> 02:10:25.885 region:rollup2
ARE SOME POSSIBILITIES THAT.
02:10:23.983 --> 02:10:27.386 region:rollup2
THAT CALIFORNIA COULD TRY THAT
02:10:25.885 --> 02:10:29.255 region:rollup2
APPROACH WE DO THINK THAT WOULD
02:10:27.386 --> 02:10:30.890 region:rollup2
THAT THAT AT SOME POINT THERE'S
02:10:29.255 --> 02:10:32.258 region:rollup2
GOT TO BE SOME KIND OF
02:10:30.890 --> 02:10:32.425 region:rollup2
ELIGIBILITY DETERMINATION.
02:10:32.258 --> 02:10:35.194 region:rollup2
AND.
02:10:32.425 --> 02:10:37.029 region:rollup2
.
02:10:35.194 --> 02:10:38.497 region:rollup2
YOU KNOW I'M THE.
02:10:37.029 --> 02:10:42.101 region:rollup2
GO LEAVE IT THERE THANK YOU ALL
02:10:38.497 --> 02:10:43.135 region:rollup2
FOR YOUR EXPERTISE.
02:10:42.101 --> 02:10:47.907 region:rollup2
THANK YOU AND.
02:10:43.135 --> 02:10:49.675 region:rollup2
I AM.
02:10:47.907 --> 02:10:51.077 region:rollup2
STRUGGLING TO TRY TO UNDERSTAND
02:10:49.675 --> 02:10:52.712 region:rollup2
THIS ON SOME ASK YOU A COUPLE
02:10:51.077 --> 02:10:54.580 region:rollup2
QUESTIONS FIRST OF ALL DE DO YOU
02:10:52.712 --> 02:10:56.816 region:rollup2
HAVE KNOWLEDGE OF.
02:10:54.580 --> 02:10:59.351 region:rollup2
HOW VERMONT PROCEEDED AND AND
02:10:56.816 --> 02:11:01.887 region:rollup2
HOW FAR DID DATE YET?
02:10:59.351 --> 02:11:03.723 region:rollup2
THROUGH A PROCESS OF OVERWEIGHT
02:11:01.887 --> 02:11:05.991 region:rollup2
OF WAIVERS AND AND.
02:11:03.723 --> 02:11:08.327 region:rollup2
DO YOU HAVE KNOWLEDGE OF THAT.
02:11:05.991 --> 02:11:10.429 region:rollup2
MY UNDERSTANDING IS THAT VERMONT
02:11:08.327 --> 02:11:13.199 region:rollup2
GOT SO FAR AS.
02:11:10.429 --> 02:11:15.000 region:rollup2
TO TRIP UP ON THAT.
02:11:13.199 --> 02:11:17.136 region:rollup2
HOW TO PAY FOR IT
02:11:15.000 --> 02:11:19.004 region:rollup2
QUESTION AND DIDN'T ACTUALLY
02:11:17.136 --> 02:11:21.273 region:rollup2
RESOLVE THE QUESTION OF WHAT TO
02:11:19.004 --> 02:11:23.075 region:rollup2
DO WITH MEDICARE?
02:11:21.273 --> 02:11:25.144 region:rollup2
SO I I BELIEVE THEY'RE IT WAS
02:11:23.075 --> 02:11:26.879 region:rollup2
AN OPEN QUESTION AS TO HOW THE
02:11:25.144 --> 02:11:28.414 region:rollup2
EXTENT TO WHICH.
02:11:26.879 --> 02:11:30.416 region:rollup2
THEY WOULD INCORPORATE MEDICARE
02:11:28.414 --> 02:11:32.518 region:rollup2
PARTICIPATION IN THEIR SINGLE
02:11:30.416 --> 02:11:34.019 region:rollup2
PAYER SYSTEM AND IF THEY WENT
02:11:32.518 --> 02:11:35.688 region:rollup2
DOWN THAT PASSED HOW THEY WOULD
02:11:34.019 --> 02:11:37.723 region:rollup2
GO ABOUT IT IN TERMS OF SEEKING
02:11:35.688 --> 02:11:39.525 region:rollup2
WAIVER AUTHORITY. THROUGH
02:11:37.723 --> 02:11:41.527 region:rollup2
SECTION FOUR OH TO ARE THE
02:11:39.525 --> 02:11:43.262 region:rollup2
INNOVATION CENTER. BUT I DON'T
02:11:41.527 --> 02:11:44.630 region:rollup2
BELIEVE THOSE DETAILS GOT IRONED
02:11:43.262 --> 02:11:45.131 region:rollup2
OUT SO UNFORTUNATELY THAT
02:11:44.630 --> 02:11:47.166 region:rollup2
DOESN'T OFFER YOU. MUCH
02:11:45.131 --> 02:11:47.967 region:rollup2
GUIDANCE.
02:11:47.166 --> 02:11:51.103 region:rollup2
.
02:11:47.967 --> 02:11:52.238 region:rollup2
AT THIS POINT.
02:11:51.103 --> 02:11:54.273 region:rollup2
SO IT WOULD GET IT OBVIOUSLY
02:11:52.238 --> 02:11:54.874 region:rollup2
WAIVERS ARE SUPPOSED TO BE
02:11:54.273 --> 02:11:57.343 region:rollup2
TESTING TESTING SOMETHING I.
02:11:54.874 --> 02:11:59.311 region:rollup2
AND.
02:11:57.343 --> 02:12:01.213 region:rollup2
THEY HAVE TO BE RENEWED. AFTER
02:11:59.311 --> 02:12:02.548 region:rollup2
FIVE TYPICALLY.
02:12:01.213 --> 02:12:04.550 region:rollup2
DO DOES THE FEDERAL GOVERNMENT
02:12:02.548 --> 02:12:05.151 region:rollup2
TO DO THEY SAY YOU KNOW WHAT
02:12:04.550 --> 02:12:05.951 region:rollup2
WHOA WHOA WHOA WE'RE TWO YEARS
02:12:05.151 --> 02:12:07.920 region:rollup2
INTO THIS.
02:12:05.951 --> 02:12:09.355 region:rollup2
WE'RE GONNA.
02:12:07.920 --> 02:12:12.024 region:rollup2
STOP THE WAVER ME DECIDE EVER
02:12:09.355 --> 02:12:13.259 region:rollup2
HAPPENED OR.
02:12:12.024 --> 02:12:14.927 region:rollup2
I I I DON'T DO DOES THAT HAPPEN
02:12:13.259 --> 02:12:16.595 region:rollup2
I DON'T KNOW.
02:12:14.927 --> 02:12:18.130 region:rollup2
SO THE FEDERAL GOVERNMENT IS.
02:12:16.595 --> 02:12:20.766 region:rollup2
IS MONITORING THAT.
02:12:18.130 --> 02:12:21.367 region:rollup2
AND THEY DO LOOK AT WAIVERS AYE
02:12:20.766 --> 02:12:22.334 region:rollup2
THE AGAIN THEY'RE SUPPOSED TO
02:12:21.367 --> 02:12:24.770 region:rollup2
BE.
02:12:22.334 --> 02:12:26.472 region:rollup2
A FIVE YEAR PERIOD BUT THEY DO
02:12:24.770 --> 02:12:27.940 region:rollup2
CHECK IN TO SAY.
02:12:26.472 --> 02:12:29.542 region:rollup2
WITH THE STATE ON A YEARLY
02:12:27.940 --> 02:12:31.110 region:rollup2
BASIS TO DO AN EVALUATION AND.
02:12:29.542 --> 02:12:33.112 region:rollup2
.
02:12:31.110 --> 02:12:34.613 region:rollup2
AND LOOK TO SEE IF THINGS ARE
02:12:33.112 --> 02:12:36.182 region:rollup2
GOING AWRY SO.
02:12:34.613 --> 02:12:37.483 region:rollup2
I CAN'T THINK OF A SPECIFIC
02:12:36.182 --> 02:12:39.051 region:rollup2
EXAMPLE DOESN'T MEAN THAT THERE
02:12:37.483 --> 02:12:40.686 region:rollup2
IS ONE ISN'T ONE.
02:12:39.051 --> 02:12:42.121 region:rollup2
WHERE THAT FEDERAL GOVERNMENT
02:12:40.686 --> 02:12:43.789 region:rollup2
HAS ACTUALLY PULLED A WAIVER
02:12:42.121 --> 02:12:45.324 region:rollup2
BEFORE THE FIVE YEARS THAT
02:12:43.789 --> 02:12:47.459 region:rollup2
SOMETHING WE CAN LOOK INTO AND
02:12:45.324 --> 02:12:47.793 region:rollup2
GET BACK TO YOU ON BUT BUT THERE
02:12:47.459 --> 02:12:50.996 region:rollup2
IS?
02:12:47.793 --> 02:12:52.932 region:rollup2
IT. REALLY IS A YEARLY LOOK TO
02:12:50.996 --> 02:12:54.834 region:rollup2
SEE HOW THE STATE IS DOING BUT
02:12:52.932 --> 02:12:56.802 region:rollup2
THEY ARE STILL EVALUATED. THAT
02:12:54.834 --> 02:12:59.004 region:rollup2
THEIR VALUE WAITED OVER A FIVE
02:12:56.802 --> 02:13:01.273 region:rollup2
YEAR PERIOD ON THE MEDICAID.
02:12:59.004 --> 02:13:02.675 region:rollup2
I WOULD SAY ON THE MEDICARE SIDE
02:13:01.273 --> 02:13:05.744 region:rollup2
AND AGAIN I KNOW YOU HEARD MORE
02:13:02.675 --> 02:13:07.379 region:rollup2
IN FAR MORE DETAIL ON ON ALAN'S.
02:13:05.744 --> 02:13:09.915 region:rollup2
WAIVER AND THEY'RE ALL PAYER
02:13:07.379 --> 02:13:12.451 region:rollup2
MODEL BUT I BELIEVE THAT.
02:13:09.915 --> 02:13:14.687 region:rollup2
YOU KNOW THAT WAS IT ORIGINALLY
02:13:12.451 --> 02:13:17.823 region:rollup2
INCORPORATED IN STATUTE.
02:13:14.687 --> 02:13:20.392 region:rollup2
AS BASICALLY YOU KNOW MEDICARE
02:13:17.823 --> 02:13:22.061 region:rollup2
ALLOWING MARYLAND TO PAY
02:13:20.392 --> 02:13:22.895 region:rollup2
HOSPITAL'S DIFFERENTLY THAN THE
02:13:22.061 --> 02:13:24.563 region:rollup2
WAY MEDICARE NORMALLY PAYS
02:13:22.895 --> 02:13:26.532 region:rollup2
HOSPITALS.
02:13:24.563 --> 02:13:27.733 region:rollup2
BUT THAT WAS CONTINGENT UPON
02:13:26.532 --> 02:13:29.668 region:rollup2
ACHIEVING SPECIFIC SAVINGS
02:13:27.733 --> 02:13:30.035 region:rollup2
TARGETS.
02:13:29.668 --> 02:13:31.403 region:rollup2
AND.
02:13:30.035 --> 02:13:32.705 region:rollup2
YOU KNOW THAT THE PAYMENT
02:13:31.403 --> 02:13:35.174 region:rollup2
MECHANISM WAS BASICALLY A
02:13:32.705 --> 02:13:37.610 region:rollup2
PAYMENT PER HOSPITAL ADMISSION.
02:13:35.174 --> 02:13:40.012 region:rollup2
AND MARYLAND REALIZED THAT THEY
02:13:37.610 --> 02:13:41.580 region:rollup2
WERE AT SOME POINT NOT GOING TO
02:13:40.012 --> 02:13:43.849 region:rollup2
CONTINUE TO BE ACHIEVING THOSE
02:13:41.580 --> 02:13:45.551 region:rollup2
SAVINGS TARGETS AND THAT THAT
02:13:43.849 --> 02:13:47.219 region:rollup2
THERE WOULD NOT HAVE THAT
02:13:45.551 --> 02:13:49.121 region:rollup2
AUTHORITY RENEWED.
02:13:47.219 --> 02:13:52.625 region:rollup2
THE SO THEY NEEDED TO.
02:13:49.121 --> 02:13:54.894 region:rollup2
AND UNDERTAKE CHANGES TO THE
02:13:52.625 --> 02:13:56.929 region:rollup2
THEIR AND IT ORIGINAL WAIVER
02:13:54.894 --> 02:13:58.130 region:rollup2
WHICH IS WHICH RESULTED IN THE
02:13:56.929 --> 02:14:00.833 region:rollup2
ALL PAYER MODEL THAT THEY NOW
02:13:58.130 --> 02:14:02.167 region:rollup2
HAVE WHICH IS TRANSFORMING FROM
02:14:00.833 --> 02:14:03.269 region:rollup2
THERE YOU KNOW PAYMENT PER
02:14:02.167 --> 02:14:04.970 region:rollup2
ADMISSION TO MORE OF A GLOBAL
02:14:03.269 --> 02:14:06.539 region:rollup2
PAYMENT.
02:14:04.970 --> 02:14:08.107 region:rollup2
FOR A PATIENT FOR AN ENTIRE
02:14:06.539 --> 02:14:11.277 region:rollup2
YEAR.
02:14:08.107 --> 02:14:11.710 region:rollup2
SO IT IT'S TRANSFORMING RATHER
02:14:11.277 --> 02:14:14.480 region:rollup2
THAN.
02:14:11.710 --> 02:14:16.015 region:rollup2
YOU KNOW JUST PAYING A SPECIFIC
02:14:14.480 --> 02:14:17.349 region:rollup2
RATE FOR HOSPITAL ADMISSION
02:14:16.015 --> 02:14:19.118 region:rollup2
TRANSFORMING THE HOSPITAL'S
02:14:17.349 --> 02:14:20.853 region:rollup2
INCENTIVES TO REALLY TRY TO KEEP
02:14:19.118 --> 02:14:21.954 region:rollup2
PATIENTS OUT OF THE HOSPITAL. AS
02:14:20.853 --> 02:14:24.657 region:rollup2
OPPOSED TO BRING THEM INTO THE
02:14:21.954 --> 02:14:27.626 region:rollup2
HOSPITAL THE POINT IS THERE
02:14:24.657 --> 02:14:30.095 region:rollup2
ORIGINAL WAIVER IS MORPHING FROM
02:14:27.626 --> 02:14:32.064 region:rollup2
THE STATUTORY WAIVER TO THE CMMI
02:14:30.095 --> 02:14:33.666 region:rollup2
INNOVATION CENTER AUTHORITY. AND
02:14:32.064 --> 02:14:35.868 region:rollup2
THAT DOES HAVE TO BE RENEWED
02:14:33.666 --> 02:14:37.369 region:rollup2
EVERY FOUR YEARS IT IT SEEMS TO
02:14:35.868 --> 02:14:40.472 region:rollup2
ME THAT.
02:14:37.369 --> 02:14:42.308 region:rollup2
THEY MAY BE MOVING AWAY FROM.
02:14:40.472 --> 02:14:44.443 region:rollup2
YOU KNOW GRANTING SORT OF
02:14:42.308 --> 02:14:45.744 region:rollup2
PERMANENT WAIVERS OR STATUTORY
02:14:44.443 --> 02:14:46.645 region:rollup2
CHANGES
02:14:45.744 --> 02:14:49.014 region:rollup2
TO THEY.
02:14:46.645 --> 02:14:51.116 region:rollup2
YOU KNOW TRYING TO TEST THINGS
02:14:49.014 --> 02:14:52.918 region:rollup2
AND DEMONSTRATE THINGS THROUGH
02:14:51.116 --> 02:14:54.553 region:rollup2
THE THEY INNOVATION CENTER WITH
02:14:52.918 --> 02:14:56.188 region:rollup2
REGARD TO MEDICARE PAYMENTS.
02:14:54.553 --> 02:14:57.890 region:rollup2
WE THAT'S NOT THE CASE I THINK
02:14:56.188 --> 02:15:00.259 region:rollup2
FROM MEDICARE IN A CA.
02:14:57.890 --> 02:15:01.727 region:rollup2
BUT AGAIN YOU KNOW THEY'RE SO
02:15:00.259 --> 02:15:03.562 region:rollup2
THE DRIVING INTEREST IS IS
02:15:01.727 --> 02:15:05.764 region:rollup2
PROGRAM SAVINGS.
02:15:03.562 --> 02:15:07.933 region:rollup2
AND SO TO THE EXTENT THAT YOU
02:15:05.764 --> 02:15:09.468 region:rollup2
KNOW YOUR WAY FOR WHATEVER IT IS
02:15:07.933 --> 02:15:11.904 region:rollup2
HOWEVER IT'S DESIGNED CONTINUES
02:15:09.468 --> 02:15:13.305 region:rollup2
TO DEMONSTRATE PROGRAM SAVINGS.
02:15:11.904 --> 02:15:13.772 region:rollup2
IT'S IT'S KIND OF HARD TO AS
02:15:13.305 --> 02:15:16.308 region:rollup2
LONG AS QUALITY IS NOT
02:15:13.772 --> 02:15:19.011 region:rollup2
SUFFERING.
02:15:16.308 --> 02:15:20.112 region:rollup2
THEN I DON'T SEE WHY THE
02:15:19.011 --> 02:15:21.914 region:rollup2
GOVERNMENT WOULD NECESSARILY
02:15:20.112 --> 02:15:23.282 region:rollup2
STEP INTO POLITICAL ACT. IF
02:15:21.914 --> 02:15:24.850 region:rollup2
THEIR SAVINGS THAT THAT'S YOU
02:15:23.282 --> 02:15:26.285 region:rollup2
KNOW THAT'S ONE OF THE PRIMARY
02:15:24.850 --> 02:15:27.152 region:rollup2
GOALS SO.
02:15:26.285 --> 02:15:28.153 region:rollup2
I'M THINKING ABOUT.
02:15:27.152 --> 02:15:30.155 region:rollup2
.
02:15:28.153 --> 02:15:32.124 region:rollup2
THIS WOULD.
02:15:30.155 --> 02:15:33.425 region:rollup2
OBVIOUSLY AT A MINIMUM THE
02:15:32.124 --> 02:15:34.526 region:rollup2
REVIEW IF WE WERE TO MOVE
02:15:33.425 --> 02:15:36.762 region:rollup2
TOWARDS A SINGLE PAYER SYSTEM
02:15:34.526 --> 02:15:37.896 region:rollup2
WOULD REQUIRE A MEDICAID WAIVER.
02:15:36.762 --> 02:15:39.932 region:rollup2
AND MEDICARE WAIVER AT A MINIMUM
02:15:37.896 --> 02:15:41.934 region:rollup2
BUT.
02:15:39.932 --> 02:15:43.168 region:rollup2
I SENSE THAT IT'S MORE BECAUSE
02:15:41.934 --> 02:15:44.703 region:rollup2
OBVIOUSLY MORE COMPLICATED MEET
02:15:43.168 --> 02:15:46.305 region:rollup2
IT FEELS LIKE MORE MULTIPLE
02:15:44.703 --> 02:15:49.408 region:rollup2
WAIVERS WITHIN EACH OF THOSE
02:15:46.305 --> 02:15:52.211 region:rollup2
CATEGORIES ARE MY MISSING SO.
02:15:49.408 --> 02:15:54.179 region:rollup2
AT YOU WOULD I THINK YOU IF
02:15:52.211 --> 02:15:55.881 region:rollup2
IT'S YOUR PROBABLY AMANDA
02:15:54.179 --> 02:15:58.217 region:rollup2
MEDICAID WAIVER YOU'RE. GONNA
02:15:55.881 --> 02:15:59.752 region:rollup2
NEED A THIRTEEN THIRTY TO WAVER
02:15:58.217 --> 02:16:00.986 region:rollup2
ON THE MARKETPLACE SIDE.
02:15:59.752 --> 02:16:02.454 region:rollup2
ANDS
02:16:00.986 --> 02:16:03.389 region:rollup2
YEAH YEAH AND WHAT KIND OF
02:16:02.454 --> 02:16:05.524 region:rollup2
AUTHORITY YOU NEED ON THE
02:16:03.389 --> 02:16:07.593 region:rollup2
MEDICARE SIDE IS NOT ENTIRELY
02:16:05.524 --> 02:16:09.895 region:rollup2
CLEAR. BUT IN ADDITION TO
02:16:07.593 --> 02:16:11.730 region:rollup2
WHATEVER AUTHORITY YOU SEEK AS
02:16:09.895 --> 02:16:13.465 region:rollup2
FAR AS THE WAY FOR.
02:16:11.730 --> 02:16:15.734 region:rollup2
YOU'RE GOING TO NEED LEGISLATIVE
02:16:13.465 --> 02:16:18.003 region:rollup2
CHANGE AT THE FEDERAL LEVEL IF
02:16:15.734 --> 02:16:18.537 region:rollup2
THE SENATE ETHICS IT YEAH IT'S
02:16:18.003 --> 02:16:21.206 region:rollup2
INCOMPLETE TO JUST SEEK A
02:16:18.537 --> 02:16:22.508 region:rollup2
WAIVER.
02:16:21.206 --> 02:16:25.010 region:rollup2
BECAUSE EVEN THOUGH THE EXISTING
02:16:22.508 --> 02:16:27.312 region:rollup2
AUTHORITY IS PRETTY BROAD.
02:16:25.010 --> 02:16:28.947 region:rollup2
THERE'S NO READING OF THE
02:16:27.312 --> 02:16:30.482 region:rollup2
STATUTE IN AT AS FAR AS I READ
02:16:28.947 --> 02:16:32.217 region:rollup2
IT.
02:16:30.482 --> 02:16:35.521 region:rollup2
TO ALLOW THE STATE TO SORT OF
02:16:32.217 --> 02:16:37.890 region:rollup2
LAY CLAIM TO ALL OF THE MEDICARE
02:16:35.521 --> 02:16:38.857 region:rollup2
AND TRUST FUND DOLLARS AND USE
02:16:37.890 --> 02:16:40.526 region:rollup2
THEM.
02:16:38.857 --> 02:16:42.428 region:rollup2
IN THE STATE'S
02:16:40.526 --> 02:16:44.930 region:rollup2
HEALTH CARE PROGRAM.
02:16:42.428 --> 02:16:47.366 region:rollup2
THAT DOESN'T REALLY COMPORT
02:16:44.930 --> 02:16:50.169 region:rollup2
WITH THE EXISTING AUTHORITY THAT
02:16:47.366 --> 02:16:51.904 region:rollup2
THE SECRETARY OF HHS HAS.
02:16:50.169 --> 02:16:54.640 region:rollup2
SO FOR THAT YOU NEED
02:16:51.904 --> 02:16:56.775 region:rollup2
LEGISLATIVE CHANGE IF YOU WANTED
02:16:54.640 --> 02:16:58.610 region:rollup2
TO DO SOMETHING NOT QUITE AS
02:16:56.775 --> 02:17:00.779 region:rollup2
COMPLETE AS SINGLE PAYER.
02:16:58.610 --> 02:17:03.048 region:rollup2
LIKE MAYBE IN ALL PAYER SYSTEM
02:17:00.779 --> 02:17:03.615 region:rollup2
THAT THERE IS LANGUAGE IN THIS
02:17:03.048 --> 02:17:06.351 region:rollup2
STATUTE GOVERNING CMMI THAT
02:17:03.615 --> 02:17:08.987 region:rollup2
DOES.
02:17:06.351 --> 02:17:11.390 region:rollup2
ALLOW FOR OPPORTUNITIES FOR
02:17:08.987 --> 02:17:12.925 region:rollup2
STATES TO TEST ALL PAYER SYSTEMS
02:17:11.390 --> 02:17:14.626 region:rollup2
SO THAT I THINK IS AN AVENUE
02:17:12.925 --> 02:17:15.894 region:rollup2
THAT YOU COULD PURSUE IT'S
02:17:14.626 --> 02:17:17.596 region:rollup2
OBVIOUSLY NOT THE SAME AS
02:17:15.894 --> 02:17:19.998 region:rollup2
UNIVERSAL COVERAGE.
02:17:17.596 --> 02:17:22.134 region:rollup2
BUT IT COULD GET YOU SOMEWHERE
02:17:19.998 --> 02:17:22.901 region:rollup2
DOWN THE PATH TOWARDS PERHAPS
02:17:22.134 --> 02:17:25.070 region:rollup2
DEALING WITH SOME OF THESE
02:17:22.901 --> 02:17:26.004 region:rollup2
ADMINISTRATIVE COST ISSUES THAT
02:17:25.070 --> 02:17:28.874 region:rollup2
YOU MENTIONED.
02:17:26.004 --> 02:17:30.809 region:rollup2
ASSEMBLY MEMBER WALTER AND THAT.
02:17:28.874 --> 02:17:31.777 region:rollup2
ARE REALLY KIND OF.
02:17:30.809 --> 02:17:32.611 region:rollup2
PAIN IN THE* FOR A LOT OF
02:17:31.777 --> 02:17:34.947 region:rollup2
PEOPLE IN OUR CURRENT HEALTHCARE
02:17:32.611 --> 02:17:35.547 region:rollup2
SYSTEM.
02:17:34.947 --> 02:17:38.283 region:rollup2
REALISTICALLY.
02:17:35.547 --> 02:17:39.351 region:rollup2
THE WAIVER PROCESS IN GENERAL
02:17:38.283 --> 02:17:40.385 region:rollup2
FOR SOME OF THESE.
02:17:39.351 --> 02:17:41.687 region:rollup2
INITIATIVES THAT HAVE GONE
02:17:40.385 --> 02:17:43.322 region:rollup2
FORWARD.
02:17:41.687 --> 02:17:44.790 region:rollup2
HOW LONG DOES SOMETHING LIKE
02:17:43.322 --> 02:17:46.658 region:rollup2
THAT TAKE?
02:17:44.790 --> 02:17:47.559 region:rollup2
AS I START THINKING ABOUT OKAY
02:17:46.658 --> 02:17:48.494 region:rollup2
WE WANNA WANNA PUSH SOMETHING
02:17:47.559 --> 02:17:50.395 region:rollup2
FOR YOU.
02:17:48.494 --> 02:17:53.999 region:rollup2
HOW LONG?
02:17:50.395 --> 02:17:54.366 region:rollup2
THIS WOULD BE A. AN ENORMOUS.
02:17:53.999 --> 02:17:56.735 region:rollup2
LEFT I.
02:17:54.366 --> 02:17:58.437 region:rollup2
ON ON OUR AND IS A STATE YES
02:17:56.735 --> 02:17:59.705 region:rollup2
HOW LONG DEEP WITH THAT
02:17:58.437 --> 02:18:02.574 region:rollup2
POTENTIALLY PROSPER SAYS
02:17:59.705 --> 02:18:04.343 region:rollup2
POTENTIALLY TAPE.
02:18:02.574 --> 02:18:07.613 region:rollup2
I WOULD SAY YEARS.
02:18:04.343 --> 02:18:09.148 region:rollup2
AYE I THINK PROBABLY THAT YOU
02:18:07.613 --> 02:18:10.716 region:rollup2
COULDN'T DO IT IN LESS THAN
02:18:09.148 --> 02:18:12.184 region:rollup2
TWELVE MONTHS AND I WOULD SAY
02:18:10.716 --> 02:18:13.585 region:rollup2
PROBABLY MORE LIKE TWO TO THREE
02:18:12.184 --> 02:18:16.421 region:rollup2
YEARS.
02:18:13.585 --> 02:18:17.289 region:rollup2
.
02:18:16.421 --> 02:18:19.158 region:rollup2
THAT'S AND I DO WANNA MENTION
02:18:17.289 --> 02:18:21.293 region:rollup2
THAT IT YOU KNOW CALIFORNIA DOES
02:18:19.158 --> 02:18:23.395 region:rollup2
HAVE AN ELEVEN FIFTEEN MEDICAID
02:18:21.293 --> 02:18:24.229 region:rollup2
WAIVER AS IT IS SO. AND THERE
02:18:23.395 --> 02:18:26.431 region:rollup2
ARE QUITE A LOT OF.
02:18:24.229 --> 02:18:27.933 region:rollup2
.
02:18:26.431 --> 02:18:29.368 region:rollup2
EXPERIMENTS BEING DONE UNDER
02:18:27.933 --> 02:18:31.937 region:rollup2
ELEVEN FIFTEEN LIKE THE WHOLE
02:18:29.368 --> 02:18:33.505 region:rollup2
PERSON PROGRAM THAT LOOKS AT
02:18:31.937 --> 02:18:35.207 region:rollup2
DIFFERENT TYPES OF WAYS TO
02:18:33.505 --> 02:18:37.643 region:rollup2
IMPROVE THE DELIVERY SYSTEM AND
02:18:35.207 --> 02:18:39.645 region:rollup2
IMPROVE EFFICIENCIES WITHIN.
02:18:37.643 --> 02:18:41.747 region:rollup2
MEDICAID AND EVEN WITH THE DUAL
02:18:39.645 --> 02:18:43.182 region:rollup2
DUALLY ELIGIBLE PROGRAM SO FOLKS
02:18:41.747 --> 02:18:44.850 region:rollup2
WHO HAVE BOTH MEDICARE AND
02:18:43.182 --> 02:18:46.418 region:rollup2
MEDICAID SO.
02:18:44.850 --> 02:18:48.787 region:rollup2
I DO THINK IT'S IMPORTANT FOR
02:18:46.418 --> 02:18:50.389 region:rollup2
US TO MAKE SURE BUILDING ON ALL
02:18:48.787 --> 02:18:54.226 region:rollup2
THE EFFORTS THAT WE HAVE.
02:18:50.389 --> 02:18:54.827 region:rollup2
HAVE DONE SO FAR.
02:18:54.226 --> 02:18:58.297 region:rollup2
THANK YOU THANK YOU VERY MUCH
02:18:54.827 --> 02:18:59.464 region:rollup2
ANYONE.
02:18:58.297 --> 02:19:00.065 region:rollup2
OWNER WERE BUILT ON SOME
02:18:59.464 --> 02:19:00.232 region:rollup2
QUESTIONS A DOCTOR WOULD JUST
02:19:00.065 --> 02:19:01.700 region:rollup2
ASK
02:19:00.232 --> 02:19:03.335 region:rollup2
SO GIVEN THAT IT'LL TAKE TWO TO
02:19:01.700 --> 02:19:05.604 region:rollup2
THREE YEARS.
02:19:03.335 --> 02:19:06.638 region:rollup2
AND LET'S JUST.
02:19:05.604 --> 02:19:07.940 region:rollup2
TALK ABOUT REAL POLITIQUE.
02:19:06.638 --> 02:19:09.107 region:rollup2
AT THIS MOMENT WE'VE AN
02:19:07.940 --> 02:19:10.609 region:rollup2
ADMINISTRATION THAT WOULD NOT BE
02:19:09.107 --> 02:19:12.778 region:rollup2
OPEN TO WHAT WE'RE TALKING ABOUT
02:19:10.609 --> 02:19:14.880 region:rollup2
BUT MAYBE AFTER TWENTY TWENTY WE
02:19:12.778 --> 02:19:17.282 region:rollup2
WE MIGHT. WOULD IT MAKE SENSE
02:19:14.880 --> 02:19:18.650 region:rollup2
FOR US TO APPLY. TO THREE ARE
02:19:17.282 --> 02:19:20.652 region:rollup2
THE YEARS OUT BEFORE TWENTY
02:19:18.650 --> 02:19:22.487 region:rollup2
TWENTY OR. OR IF YOU HAVE AN
02:19:20.652 --> 02:19:23.822 region:rollup2
ADMINISTRATION THAT IS ADVERSE
02:19:22.487 --> 02:19:24.990 region:rollup2
TO THE TYPE AWAY FROM WERE
02:19:23.822 --> 02:19:26.458 region:rollup2
THINKING ABOUT.
02:19:24.990 --> 02:19:27.626 region:rollup2
A APPLYING IN TWO THOUSAND
02:19:26.458 --> 02:19:29.261 region:rollup2
EIGHTEEN OR TWO THOUSAND
02:19:27.626 --> 02:19:29.761 region:rollup2
NINETEEN WHAT WITH THAT. WITH
02:19:29.261 --> 02:19:32.231 region:rollup2
THAT.
02:19:29.761 --> 02:19:33.899 region:rollup2
LACK OF SUPPORT STYMIE RIGHT UP
02:19:32.231 --> 02:19:35.033 region:rollup2
THAT THE AT THE FRONT SUCH THAT
02:19:33.899 --> 02:19:36.602 region:rollup2
IT IT DOESN'T MAKE SENSE TO
02:19:35.033 --> 02:19:37.903 region:rollup2
APPLY FOR. THE WAIVER IF YOU
02:19:36.602 --> 02:19:38.403 region:rollup2
DON'T HAVE A SYMPATHETIC
02:19:37.903 --> 02:19:40.439 region:rollup2
ADMINISTRATION FROM THE
02:19:38.403 --> 02:19:42.040 region:rollup2
BEGINNING.
02:19:40.439 --> 02:19:43.909 region:rollup2
WELL I MIGHT START BY THE END BY
02:19:42.040 --> 02:19:45.110 region:rollup2
THINKING AND I THINK SUSAN YOU
02:19:43.909 --> 02:19:46.511 region:rollup2
WERE ALLUDING TO THIS THING
02:19:45.110 --> 02:19:48.647 region:rollup2
ABOUT SOME OF THE STEPS THAT
02:19:46.511 --> 02:19:50.415 region:rollup2
WOULD NEED WOULD BE NECESSARY
02:19:48.647 --> 02:19:52.150 region:rollup2
AND THOUGHT THROUGH BEFORE EVEN
02:19:50.415 --> 02:19:53.485 region:rollup2
GOING TO THE ADMINISTRATION SO
02:19:52.150 --> 02:19:55.954 region:rollup2
JUST TO LOOK AT. ON THE
02:19:53.485 --> 02:19:58.557 region:rollup2
MARKETPLACE SIDE TYPICALLY.
02:19:55.954 --> 02:20:00.525 region:rollup2
PLANS NEED TO KNOW SIX MONTHS
02:19:58.557 --> 02:20:02.995 region:rollup2
IN ADVANCE WHAT COVERAGE IS
02:20:00.525 --> 02:20:04.229 region:rollup2
GONNA LOOK LIKE SO YOU KNOW YOU
02:20:02.995 --> 02:20:06.064 region:rollup2
WOULD WANT TO HAVE AUTHORIZING
02:20:04.229 --> 02:20:07.366 region:rollup2
LEGISLATION MAKING A MAJOR
02:20:06.064 --> 02:20:08.433 region:rollup2
CHANGE. ALMOST.
02:20:07.366 --> 02:20:10.235 region:rollup2
.
02:20:08.433 --> 02:20:11.770 region:rollup2
DE.
02:20:10.235 --> 02:20:12.738 region:rollup2
I NOW HAVE TIME FOR THE PLANS TO
02:20:11.770 --> 02:20:14.840 region:rollup2
MAKE THAT KIND OF AND AN
02:20:12.738 --> 02:20:16.475 region:rollup2
ADJUSTMENT AND ENOUGH TIME FOR
02:20:14.840 --> 02:20:18.610 region:rollup2
THE FEDERAL GOVERNMENT TO PROVE
02:20:16.475 --> 02:20:19.745 region:rollup2
THAT SO WHEN YOU BACK INTO JUST
02:20:18.610 --> 02:20:21.380 region:rollup2
A CHANGE THAT WOULD BE ON THE
02:20:19.745 --> 02:20:23.815 region:rollup2
MARKETPLACE SIDE. YOU'RE REALLY
02:20:21.380 --> 02:20:25.017 region:rollup2
THINKING ABOUT PROBABLY A YEAR
02:20:23.815 --> 02:20:26.385 region:rollup2
BEFORE YOU WANT TO CHANGE JUST.
02:20:25.017 --> 02:20:28.587 region:rollup2
.
02:20:26.385 --> 02:20:30.055 region:rollup2
EH AGAIN THINKING ABOUT A
02:20:28.587 --> 02:20:31.623 region:rollup2
RELATIVELY STRAIGHTFORWARD
02:20:30.055 --> 02:20:33.625 region:rollup2
POLICY BUT WHERE THE PLANS WE
02:20:31.623 --> 02:20:35.260 region:rollup2
NEED TO DO SOMETHING. SO I MIGHT
02:20:33.625 --> 02:20:36.695 region:rollup2
THINK ABOUT OKAY THAN ON THE
02:20:35.260 --> 02:20:38.297 region:rollup2
MEDICAID SIDE IF WE'RE MAKING A
02:20:36.695 --> 02:20:39.731 region:rollup2
MAJOR CHANGE HOW DOES THAT FIT
02:20:38.297 --> 02:20:42.134 region:rollup2
IN WITH ALL OF THE OTHER.
02:20:39.731 --> 02:20:45.270 region:rollup2
CHANGES THAT WE ALREADY HAVE
02:20:42.134 --> 02:20:46.805 region:rollup2
BEEN MEDI CAL TIME AND AND AND.
02:20:45.270 --> 02:20:48.407 region:rollup2
REALLY START THERE.
02:20:46.805 --> 02:20:50.375 region:rollup2
BUT.
02:20:48.407 --> 02:20:51.610 region:rollup2
IT IS SO THAT I WOULD WOULD BE
02:20:50.375 --> 02:20:52.611 region:rollup2
MY SUGGESTION ABOUT PUBLIC THE
02:20:51.610 --> 02:20:54.012 region:rollup2
FIRST PLACE TO START TO REALLY
02:20:52.611 --> 02:20:56.181 region:rollup2
MAKE SURE OKAY WHAT'S
02:20:54.012 --> 02:20:59.318 region:rollup2
WHAT'S ARE COHESIVE PLAN.
02:20:56.181 --> 02:21:01.453 region:rollup2
MOVING FORWARD AND THEN THEN
02:20:59.318 --> 02:21:01.987 region:rollup2
GETTING MAKING SURE YOU MOVED IT
02:21:01.453 --> 02:21:04.656 region:rollup2
THROUGH. YOUR LEGISLATIVE
02:21:01.987 --> 02:21:07.259 region:rollup2
BODIES.
02:21:04.656 --> 02:21:09.194 region:rollup2
BEFORE STARTING THAT IS
02:21:07.259 --> 02:21:10.996 region:rollup2
STARTING THE WAIVER PROCESS IT'S
02:21:09.194 --> 02:21:12.631 region:rollup2
IT'S VERY POSSIBLE THAT THEY'LL
02:21:10.996 --> 02:21:13.632 region:rollup2
BE ANOTHER ADMINISTRATION WHO IS
02:21:12.631 --> 02:21:15.467 region:rollup2
MORE INTERESTED.
02:21:13.632 --> 02:21:16.668 region:rollup2
IN SOME OF THESE POLICIES BUT
02:21:15.467 --> 02:21:18.837 region:rollup2
IN SOME WAYS.
02:21:16.668 --> 02:21:20.806 region:rollup2
THINGS NEED TO BE TESTED AND.
02:21:18.837 --> 02:21:22.207 region:rollup2
SO I WOULDN'T I WOULDN'T
02:21:20.806 --> 02:21:23.408 region:rollup2
SPECULATE ON WHETHER YOU WANT TO
02:21:22.207 --> 02:21:23.575 region:rollup2
WAIT FOR THE NEXT ADMINISTRATION
02:21:23.408 --> 02:21:25.644 region:rollup2
OR.
02:21:23.575 --> 02:21:29.648 region:rollup2
.
02:21:25.644 --> 02:21:30.949 region:rollup2
OR ARE TESTED WITH THIS ONE.
02:21:29.648 --> 02:21:32.517 region:rollup2
BRENDA GUESS I WOULD ADD TO THE
02:21:30.949 --> 02:21:33.819 region:rollup2
EXTENT THAT. YOU KNOW AS I'VE
02:21:32.517 --> 02:21:36.755 region:rollup2
MENTIONED.
02:21:33.819 --> 02:21:38.223 region:rollup2
C. M. A MAIS AUTHORITY IS IS.
02:21:36.755 --> 02:21:40.659 region:rollup2
TO SOME EXTENT PRETTY BROAD.
02:21:38.223 --> 02:21:42.594 region:rollup2
SO IF YOU WERE INTERESTED AND
02:21:40.659 --> 02:21:45.030 region:rollup2
PERHAPS PURSUING SOME
02:21:42.594 --> 02:21:47.566 region:rollup2
INITIATIVES WITHIN THE EXISTING
02:21:45.030 --> 02:21:49.101 region:rollup2
AUTHORITY OF CMMI THAT MAY LAY
02:21:47.566 --> 02:21:51.636 region:rollup2
THE GROUNDWORK FOR EXAMPLE ALL
02:21:49.101 --> 02:21:53.638 region:rollup2
PAYER REFORM. THAT MIGHT GET YOU
02:21:51.636 --> 02:21:54.973 region:rollup2
SOMEWHERE DOWN THE PATH TOWARDS
02:21:53.638 --> 02:21:56.508 region:rollup2
A SINGLE PAYER SYSTEM THE NOT
02:21:54.973 --> 02:21:59.611 region:rollup2
COMPLETELY THERE.
02:21:56.508 --> 02:22:01.546 region:rollup2
THAT MIGHT GIVE YOU SOME.
02:21:59.611 --> 02:22:03.715 region:rollup2
YOU KNOW LEAD TIME TO DO SOME
02:22:01.546 --> 02:22:04.783 region:rollup2
OF THE OTHER PLANNING THAT MIGHT
02:22:03.715 --> 02:22:06.885 region:rollup2
NEED TO BE DONE FOR A MORE
02:22:04.783 --> 02:22:08.320 region:rollup2
COMPREHENSIVE STATE BASED SINGLE
02:22:06.885 --> 02:22:10.589 region:rollup2
PAYER SYSTEM.
02:22:08.320 --> 02:22:12.023 region:rollup2
THAT YOU KNOW PERHAPS YOU'RE
02:22:10.589 --> 02:22:13.358 region:rollup2
NOT GONNA FIND AS MUCH OF A
02:22:12.023 --> 02:22:14.526 region:rollup2
FRIENDLY AUDIENCE WITH THE
02:22:13.358 --> 02:22:15.560 region:rollup2
CURRENT ADMINISTRATION BUT YOU
02:22:14.526 --> 02:22:17.029 region:rollup2
WOULD. IN A FUTURE
02:22:15.560 --> 02:22:18.764 region:rollup2
ADMINISTRATION.
02:22:17.029 --> 02:22:21.299 region:rollup2
IF YOU KNOW THAT YOU KNOW THE
02:22:18.764 --> 02:22:22.667 region:rollup2
INNOVATION CENTER IS SEEKING YOU
02:22:21.299 --> 02:22:24.870 region:rollup2
KNOW PROPOSAL'S UNDERNEATH AND
02:22:22.667 --> 02:22:26.805 region:rollup2
ACCOUNTABLE CARE ORGANIZATION.
02:22:24.870 --> 02:22:27.973 region:rollup2
INITIATIVE FOR EXAMPLE THAT
02:22:26.805 --> 02:22:29.374 region:rollup2
COULD BE SOMETHING.
02:22:27.973 --> 02:22:31.643 region:rollup2
THAT YOU MIGHT WANT TO PURSUE
02:22:29.374 --> 02:22:33.044 region:rollup2
OR MORE TESTING WITHIN THE STATE
02:22:31.643 --> 02:22:35.213 region:rollup2
INNOVATION MODELS.
02:22:33.044 --> 02:22:37.015 region:rollup2
CATEGORY AND THERE ARE THOSE
02:22:35.213 --> 02:22:39.251 region:rollup2
AVENUES THAT YOU COULD PURSUE
02:22:37.015 --> 02:22:41.086 region:rollup2
INSTEAD OF JUST HOLDING OFF
02:22:39.251 --> 02:22:42.354 region:rollup2
APPLYING FOR ANYTHING. DOING
02:22:41.086 --> 02:22:44.189 region:rollup2
THINGS A LITTLE BIT MORE
02:22:42.354 --> 02:22:45.390 region:rollup2
INCREMENTALLY MY.
02:22:44.189 --> 02:22:47.726 region:rollup2
MIGHT HELP.
02:22:45.390 --> 02:22:48.527 region:rollup2
GET YOU SOMEWHERE DOWN DOWN THE
02:22:47.726 --> 02:22:50.695 region:rollup2
ROAD TOWARDS
02:22:48.527 --> 02:22:52.330 region:rollup2
TOWARDS THE END GOAL.
02:22:50.695 --> 02:22:54.132 region:rollup2
AND THEN IT JUST FALL BELOW BUT
02:22:52.330 --> 02:22:56.068 region:rollup2
I THINK THE CONVENTIONAL PUBLIC
02:22:54.132 --> 02:22:57.669 region:rollup2
WISDOM IS OR CONVENTIONAL
02:22:56.068 --> 02:22:59.171 region:rollup2
UNDERSTANDING OF THIS IS THAT WE
02:22:57.669 --> 02:23:01.440 region:rollup2
WOULD NEED TO GET WAIVERS FROM
02:22:59.171 --> 02:23:02.074 region:rollup2
AND A PRESIDENTIAL MINISTRATION
02:23:01.440 --> 02:23:04.209 region:rollup2
BUT I THINK WHAT YOU'RE LAYING
02:23:02.074 --> 02:23:04.776 region:rollup2
OUT HERE IS. AND MANY INSTANCES
02:23:04.209 --> 02:23:05.844 region:rollup2
OF WHAT WE'RE TALKING ABOUT
02:23:04.776 --> 02:23:07.779 region:rollup2
SINGLE PAYER
02:23:05.844 --> 02:23:09.648 region:rollup2
CONGRESSIONAL APPROVAL SO IT'S
02:23:07.779 --> 02:23:10.882 region:rollup2
IT'S NOT JUST SUPPORT FROM THE
02:23:09.648 --> 02:23:12.284 region:rollup2
EXECUTIVE BRANCH FEDERALLY ITS
02:23:10.882 --> 02:23:14.453 region:rollup2
SUPPORT FROM THE LEGISLATIVE
02:23:12.284 --> 02:23:16.121 region:rollup2
BRANCH AND AND CONGRESS. ON THAT
02:23:14.453 --> 02:23:17.889 region:rollup2
BUT IN YOUR IN YOUR PRESENTATION
02:23:16.121 --> 02:23:19.658 region:rollup2
YOU SAY THAT AS LONG AS THE
02:23:17.889 --> 02:23:20.926 region:rollup2
MEDICARE CHANGES ARE ORIENTED
02:23:19.658 --> 02:23:22.294 region:rollup2
AROUND IMPROVING QUALITY OR
02:23:20.926 --> 02:23:25.230 region:rollup2
SPENDING REDUCING SPENDING A
02:23:22.294 --> 02:23:26.698 region:rollup2
MEDICARE. IT'S A FAIRLY BROAD.
02:23:25.230 --> 02:23:27.365 region:rollup2
DEFINITION BUT THEN YOU ALSO SEE
02:23:26.698 --> 02:23:27.933 region:rollup2
BROADER CHANGES WOULD BE NEEDED
02:23:27.365 --> 02:23:29.901 region:rollup2
FOR THE IMPLEMENTATION OF A
02:23:27.933 --> 02:23:32.471 region:rollup2
SINGLE PAYER SYSTEM
02:23:29.901 --> 02:23:32.737 region:rollup2
COULD WE DEFINE A PILOT LIKE
02:23:32.471 --> 02:23:34.439 region:rollup2
FIVE YEAR.
02:23:32.737 --> 02:23:35.707 region:rollup2
.
02:23:34.439 --> 02:23:36.641 region:rollup2
DEMONSTRATION OF WHAT SINGLE
02:23:35.707 --> 02:23:38.176 region:rollup2
PAYER COULD LOOK LIKE IN
02:23:36.641 --> 02:23:40.078 region:rollup2
CALIFORNIA AND HAVE THAT.
02:23:38.176 --> 02:23:41.379 region:rollup2
BE CONSIDERED UNDER THIS BROAD
02:23:40.078 --> 02:23:42.948 region:rollup2
DEFINITION OF WHAT WOULD COME
02:23:41.379 --> 02:23:44.249 region:rollup2
UNDER MEDICARE WAIVER OR YOUR
02:23:42.948 --> 02:23:45.150 region:rollup2
YOU THINK THAT IT'S HOW YOU
02:23:44.249 --> 02:23:46.585 region:rollup2
SLICE IT AND DICE IT YOU REALLY
02:23:45.150 --> 02:23:48.653 region:rollup2
WOULD NEED CONGRESSIONAL.
02:23:46.585 --> 02:23:50.422 region:rollup2
I THINK IT'S POSSIBLE BUT I BUT
02:23:48.653 --> 02:23:51.990 region:rollup2
I WOULD JUST BE A LITTLE BIT
02:23:50.422 --> 02:23:54.593 region:rollup2
CAUTIOUS ABOUT.
02:23:51.990 --> 02:23:56.394 region:rollup2
YOU KNOW THE PILOT IN TERMS OF
02:23:54.593 --> 02:23:58.530 region:rollup2
HOW YOU'RE CHANGING.
02:23:56.394 --> 02:24:00.332 region:rollup2
ENROLLMENT IN MEDICARE OR
02:23:58.530 --> 02:24:02.267 region:rollup2
ELIGIBILITY FOR MEDICARE OR COST
02:24:00.332 --> 02:24:04.102 region:rollup2
SHARING FOR EXAMPLE THOSE THINGS
02:24:02.267 --> 02:24:05.604 region:rollup2
ARE ALL SPECIFIED IN STATUTE.
02:24:04.102 --> 02:24:07.005 region:rollup2
AND THERE'S NO WAIVER AUTHORITY
02:24:05.604 --> 02:24:08.907 region:rollup2
THAT ALLOWS STATES TO CHANGE
02:24:07.005 --> 02:24:11.576 region:rollup2
THOSE THINGS.
02:24:08.907 --> 02:24:13.311 region:rollup2
SO TO THE EXTENT THAT YOU
02:24:11.576 --> 02:24:15.547 region:rollup2
WANTED TO YOU KNOW.
02:24:13.311 --> 02:24:17.182 region:rollup2
MAKE PEOPLE ON MEDICARE.
02:24:15.547 --> 02:24:20.252 region:rollup2
HOLE IN TERMS OF NOT PAYING ANY
02:24:17.182 --> 02:24:22.854 region:rollup2
COST SHARING OR PREMIUMS.
02:24:20.252 --> 02:24:24.723 region:rollup2
THOSE THINGS ARE ALLOWED TO BE
02:24:22.854 --> 02:24:26.091 region:rollup2
CHANGED BY STATES EVEN IF IT
02:24:24.723 --> 02:24:27.826 region:rollup2
WOULD BE GREAT FOR A PATIENT
02:24:26.091 --> 02:24:28.326 region:rollup2
PERSPECTIVE. THOSE THINGS ARE
02:24:27.826 --> 02:24:30.428 region:rollup2
KIND OF SPECIFIED IN THE
02:24:28.326 --> 02:24:32.664 region:rollup2
STATUTE.
02:24:30.428 --> 02:24:34.666 region:rollup2
IT AND THIS HAS NEVER BEEN DONE
02:24:32.664 --> 02:24:35.867 region:rollup2
BEFORE SO IT'S NOT ENTIRELY
02:24:34.666 --> 02:24:38.236 region:rollup2
CLEAR TO ME THAT THE FEDERAL
02:24:35.867 --> 02:24:40.138 region:rollup2
GOVERNMENT WOULD SAY NO BUT YOU
02:24:38.236 --> 02:24:41.907 region:rollup2
REALLY HAVE TO BE VERY SPECIFIC
02:24:40.138 --> 02:24:43.642 region:rollup2
AND DEFINING YOUR GOALS. AND
02:24:41.907 --> 02:24:45.243 region:rollup2
DEMONSTRATING OVER THE COURSE OF
02:24:43.642 --> 02:24:46.611 region:rollup2
WHATEVER THE WAIVER PERIOD IS
02:24:45.243 --> 02:24:48.446 region:rollup2
THAT YOU ACHIEVE THOSE GOALS
02:24:46.611 --> 02:24:49.848 region:rollup2
SPECIFICALLY REFER GUARD TO
02:24:48.446 --> 02:24:52.017 region:rollup2
PROGRAM SAVINGS.
02:24:49.848 --> 02:24:53.585 region:rollup2
AND QUALITY IMPROVEMENTS
02:24:52.017 --> 02:24:55.320 region:rollup2
SO YOU KNOW I THINK YOU CAN
02:24:53.585 --> 02:24:56.655 region:rollup2
CERTAINLY TRY TO BE AS CREATIVE
02:24:55.320 --> 02:24:59.791 region:rollup2
AS POSSIBLE.
02:24:56.655 --> 02:25:02.494 region:rollup2
BUT AGAIN IT COMES BACK TO IT'S
02:24:59.791 --> 02:25:03.094 region:rollup2
A WAY FOR ITS TIME OMITTED IT'S
02:25:02.494 --> 02:25:05.297 region:rollup2
NOT.
02:25:03.094 --> 02:25:07.699 region:rollup2
IT'S NOT DESIGNED TO BE A
02:25:05.297 --> 02:25:09.467 region:rollup2
PERMANENT CHANGE TO THE MEDICARE
02:25:07.699 --> 02:25:10.735 region:rollup2
PROGRAM IT'S DESIGNED TO BE A
02:25:09.467 --> 02:25:12.604 region:rollup2
PERMANENT CHANGE TO THE STATE'S
02:25:10.735 --> 02:25:14.105 region:rollup2
HEALTH CARE DELIVERY SYSTEM THE
02:25:12.604 --> 02:25:15.907 region:rollup2
FEDERAL GOVERNMENT'S INTEREST IS
02:25:14.105 --> 02:25:17.142 region:rollup2
IN THE MEDICARE PROGRAM.
02:25:15.907 --> 02:25:17.642 region:rollup2
AND SO THAT THAT WILL BE THE
02:25:17.142 --> 02:25:19.144 region:rollup2
LENS THROUGH WHICH THEY
02:25:17.642 --> 02:25:20.679 region:rollup2
EVALUATE.
02:25:19.144 --> 02:25:23.582 region:rollup2
WHATEVER THE STATE.
02:25:20.679 --> 02:25:24.182 region:rollup2
PROPOSES TO DO AND WITH REGARD
02:25:23.582 --> 02:25:27.152 region:rollup2
TO A PILOT OR SOME OTHER TYPE
02:25:24.182 --> 02:25:28.787 region:rollup2
OF.
02:25:27.152 --> 02:25:29.654 region:rollup2
I'M CHINA. INTERNET LISTEN TO
02:25:28.787 --> 02:25:32.757 region:rollup2
WHAT YOU'RE SAYING AND WONDERING
02:25:29.654 --> 02:25:36.127 region:rollup2
AGAIN IF WE PROPOSED A PILOT. UP
02:25:32.757 --> 02:25:38.229 region:rollup2
THAT CHANGED HOW MEDICARE.
02:25:36.127 --> 02:25:40.699 region:rollup2
SPENDING WAS REDUCED OR QUALITY
02:25:38.229 --> 02:25:42.033 region:rollup2
IMPROVED AND AND AND SAID OUR
02:25:40.699 --> 02:25:42.901 region:rollup2
INTENT IS TO OBVIOUSLY DO
02:25:42.033 --> 02:25:44.302 region:rollup2
SOMETHING MORE PERMANENT BUT FOR
02:25:42.901 --> 02:25:46.237 region:rollup2
NOW WILL BRING INTO A FIGHTER
02:25:44.302 --> 02:25:48.807 region:rollup2
PILOT SURE. AND I AM YEAH AND I
02:25:46.237 --> 02:25:49.741 region:rollup2
THINK THAT CMS DOES ENVISION
02:25:48.807 --> 02:25:51.543 region:rollup2
THAT TYPE OF MEDICARE
02:25:49.741 --> 02:25:53.745 region:rollup2
PARTICIPATION IN THE STATE
02:25:51.543 --> 02:25:55.480 region:rollup2
INNOVATION MODELS.
02:25:53.745 --> 02:25:56.915 region:rollup2
INITIATIVE WITH WITHIN THE
02:25:55.480 --> 02:25:58.049 region:rollup2
INNOVATION CENTER SO I WOULD
02:25:56.915 --> 02:25:59.150 region:rollup2
ENCOURAGE YOU AND I'D BE HAPPY
02:25:58.049 --> 02:26:01.820 region:rollup2
TO CONNECT YOU WITH MORE
02:25:59.150 --> 02:26:04.055 region:rollup2
INFORMATION SO THAT YOU CAN SEE.
02:26:01.820 --> 02:26:06.257 region:rollup2
HOW ON THE ONE HAND?
02:26:04.055 --> 02:26:07.993 region:rollup2
THE INNOVATION CENTER IS
02:26:06.257 --> 02:26:10.161 region:rollup2
ENCOURAGING THAT THIS TYPE OF
02:26:07.993 --> 02:26:11.529 region:rollup2
IDEA AND ON THE OTHER HAND HOLD
02:26:10.161 --> 02:26:14.065 region:rollup2
STATES UP TO A VERY HIGH
02:26:11.529 --> 02:26:15.133 region:rollup2
STANDARD WITH REGARD TO MEDICARE
02:26:14.065 --> 02:26:17.369 region:rollup2
PARTICIPATION.
02:26:15.133 --> 02:26:19.437 region:rollup2
IN STATE INNOVATION MODELS.
02:26:17.369 --> 02:26:20.438 region:rollup2
AND I AND I MEAN I CAN TELL YOU
02:26:19.437 --> 02:26:22.440 region:rollup2
A LITTLE BIT MORE ABOUT THE
02:26:20.438 --> 02:26:23.808 region:rollup2
PRINCIPLES THAT THEY USE TO
02:26:22.440 --> 02:26:25.443 region:rollup2
EVALUATE THE DIFFERENCE STATE
02:26:23.808 --> 02:26:27.345 region:rollup2
INNOVATION MODELS WITH REGARD TO
02:26:25.443 --> 02:26:28.947 region:rollup2
MEDICARE PARTICIPATION. BUT I
02:26:27.345 --> 02:26:31.416 region:rollup2
THINK WHAT YOU BASICALLY NEED TO
02:26:28.947 --> 02:26:33.451 region:rollup2
KNOW IS THAT WHILE IT'S POSSIBLE
02:26:31.416 --> 02:26:33.618 region:rollup2
YOU CAN PROPOSE THIS TYPE OF.
02:26:33.451 --> 02:26:35.253 region:rollup2
OF.
02:26:33.618 --> 02:26:36.855 region:rollup2
PILOT TEST
02:26:35.253 --> 02:26:38.356 region:rollup2
THERE'S OBVIOUSLY NO GUARANTEE
02:26:36.855 --> 02:26:41.326 region:rollup2
THAT THE FEDERAL GOVERNMENT WILL
02:26:38.356 --> 02:26:41.960 region:rollup2
APPROVE IT SO IT LEAVES YOU TO
02:26:41.326 --> 02:26:44.296 region:rollup2
SOME EXTENT.
02:26:41.960 --> 02:26:45.830 region:rollup2
AT YOU KNOW AT THEIR MY HALF
02:26:44.296 --> 02:26:48.433 region:rollup2
THEIR MERCY IF YOU WELL.
02:26:45.830 --> 02:26:50.201 region:rollup2
IN TERMS OF MOVING FORWARD AND
02:26:48.433 --> 02:26:51.302 region:rollup2
JUST A BUT I GUESS STATISTICALLY
02:26:50.201 --> 02:26:51.936 region:rollup2
HOW OFTEN ARE MEDICARE MEDICAID
02:26:51.302 --> 02:26:54.406 region:rollup2
WAIVERS
02:26:51.936 --> 02:26:57.375 region:rollup2
A TONIGHT.
02:26:54.406 --> 02:26:58.910 region:rollup2
I DON'T KNOW THAT NUMBER OF NO I
02:26:57.375 --> 02:27:00.078 region:rollup2
WOULD SAY THAT PLAYED ON THE
02:26:58.910 --> 02:27:01.746 region:rollup2
MEDICARE SIDE OF LOOKED INTO
02:27:00.078 --> 02:27:03.048 region:rollup2
HISTORICALLY A LOT OF THE
02:27:01.746 --> 02:27:04.316 region:rollup2
MEDICARE WAIVERS WERE
02:27:03.048 --> 02:27:06.718 region:rollup2
CONGRESSIONALLY.
02:27:04.316 --> 02:27:08.420 region:rollup2
EITHER CONGRESSIONALLY MANDATED
02:27:06.718 --> 02:27:10.021 region:rollup2
SO THEY THEY HAD TO HAPPEN.
02:27:08.420 --> 02:27:11.856 region:rollup2
OR CMS.
02:27:10.021 --> 02:27:13.325 region:rollup2
UNDERTOOK THEM OF THEIR OWN
02:27:11.856 --> 02:27:15.093 region:rollup2
INITIATIVE
02:27:13.325 --> 02:27:16.027 region:rollup2
SO THEY ALSO KIND OF HAD TO
02:27:15.093 --> 02:27:17.696 region:rollup2
HAPPEN BECAUSE THE EN MASSE WAS
02:27:16.027 --> 02:27:20.365 region:rollup2
RUNNING THEM.
02:27:17.696 --> 02:27:22.267 region:rollup2
SO ON THE MEDICARE SIDE.
02:27:20.365 --> 02:27:24.369 region:rollup2
IT HASN'T HISTORICALLY BEEN THE
02:27:22.267 --> 02:27:26.404 region:rollup2
CASE THAT THEY'RE DENIED BECAUSE
02:27:24.369 --> 02:27:28.740 region:rollup2
THE VIEW OF THE ENTITIES THAT
02:27:26.404 --> 02:27:29.941 region:rollup2
ARE INITIATING THEIR WAY FURTHER
02:27:28.740 --> 02:27:31.543 region:rollup2
DEMONSTRATION IS THE FEDERAL
02:27:29.941 --> 02:27:32.410 region:rollup2
GOVERNMENT ITSELF. IT'S
02:27:31.543 --> 02:27:33.745 region:rollup2
DIFFERENT ON THE MEDICAID
02:27:32.410 --> 02:27:36.181 region:rollup2
DIFFERENT ON THE MEDICAID SIDE
02:27:33.745 --> 02:27:38.083 region:rollup2
AND I CAN'T I DON'T KNOW I DON'T
02:27:36.181 --> 02:27:39.551 region:rollup2
KNOW IF THAT STATISTIC IS KNOWN
02:27:38.083 --> 02:27:40.618 region:rollup2
BUT SOMETIMES IT'S HARD TO TELL
02:27:39.551 --> 02:27:42.187 region:rollup2
IN THE SENSE THAT.
02:27:40.618 --> 02:27:43.755 region:rollup2
THEN IF THE NEGOTIATIONS ARE
02:27:42.187 --> 02:27:45.256 region:rollup2
GOING THE WAY THE STATE ONCE
02:27:43.755 --> 02:27:46.991 region:rollup2
THEY MAY WITHDRAW THAT WAIVER IS
02:27:45.256 --> 02:27:47.359 region:rollup2
THAT BECAUSE OF WHAT THE FEDERAL
02:27:46.991 --> 02:27:48.793 region:rollup2
GOVERNMENT SAID.
02:27:47.359 --> 02:27:50.495 region:rollup2
.
02:27:48.793 --> 02:27:52.330 region:rollup2
YOU KNOW YOU CAN ALWAYS TELL
02:27:50.495 --> 02:27:53.998 region:rollup2
WORSE SEEING THIS A LITTLE BIT
02:27:52.330 --> 02:27:54.599 region:rollup2
WITH THAT THIRTEEN THIRTY TWOS
02:27:53.998 --> 02:27:55.600 region:rollup2
WHERE SOME OF THE STATES HAVE
02:27:54.599 --> 02:27:57.102 region:rollup2
PULLED BACK.
02:27:55.600 --> 02:27:58.503 region:rollup2
I'M SO WE HAVEN'T SEEN THE
02:27:57.102 --> 02:28:01.106 region:rollup2
ADMINISTRATION ACTUALLY DENY
02:27:58.503 --> 02:28:01.940 region:rollup2
THEM ONE WAS DEEMED INCOMPLETE.
02:28:01.106 --> 02:28:05.410 region:rollup2
THINK VERY MUCH.
02:28:01.940 --> 02:28:05.944 region:rollup2
YOU.
02:28:05.410 --> 02:28:10.882 region:rollup2
THANK YOU ALL VERY MUCH A
02:28:05.944 --> 02:28:11.850 region:rollup2
FIGURE.
02:28:10.882 --> 02:28:14.686 region:rollup2
NEXT I'D LIKE TO HAVE.
02:28:11.850 --> 02:28:16.154 region:rollup2
BE ENTIRE PANEL OF SCOTT GRAVES
02:28:14.686 --> 02:28:17.922 region:rollup2
BEN JOHNSON RYAN MILLER TO COME
02:28:16.154 --> 02:28:34.172 region:rollup2
FORWARD AND I'M GOING TO START
02:28:17.922 --> 02:28:34.172 region:rollup2
WITH CONCRETE
02:28:38.476 --> 02:28:40.011 region:rollup2
.
02:28:38.610 --> 02:28:41.579 region:rollup2
DOCTOR GRAVES JOINED THE BUDGET
02:28:40.011 --> 02:28:43.515 region:rollup2
CENTER IN TWO THOUSAND TWO AND I
02:28:41.579 --> 02:28:45.283 region:rollup2
SERVED AS DIRECTOR OF RESEARCH
02:28:43.515 --> 02:28:46.885 region:rollup2
SINCE TWO THOUSAND AND FOURTEEN.
02:28:45.283 --> 02:28:49.120 region:rollup2
IN THIS ROLE HE OVERSEES THE
02:28:46.885 --> 02:28:50.522 region:rollup2
BUDGET CENTERS ANALYTICAL WORK.
02:28:49.120 --> 02:28:52.090 region:rollup2
CONDUCTS RESEARCH AND ANALYSIS
02:28:50.522 --> 02:28:54.092 region:rollup2
RELATED TO HEALTH AND HUMAN
02:28:52.090 --> 02:28:55.393 region:rollup2
SERVICES AND CORRECTIONS.
02:28:54.092 --> 02:28:56.995 region:rollup2
AND AS THE ORGANIZATIONS LEAD
02:28:55.393 --> 02:28:58.029 region:rollup2
ANALYST ON THE STATE AND COUNTY
02:28:56.995 --> 02:28:59.864 region:rollup2
BUDGET PROCESS THANK YOU FOR
02:28:58.029 --> 02:29:01.166 region:rollup2
JOINING US.
02:28:59.864 --> 02:29:02.434 region:rollup2
THANK YOU THANK YOU FOR INVITING
02:29:01.166 --> 02:29:04.202 region:rollup2
THE BUDGET CENTER TO PARTICIPATE
02:29:02.434 --> 02:29:06.271 region:rollup2
IN THIS VERY IMPORTANT HEARING.
02:29:04.202 --> 02:29:07.705 region:rollup2
SO WHAT I'D LIKE TO DO TODAY.
02:29:06.271 --> 02:29:10.008 region:rollup2
OR THIS AFTERNOON.
02:29:07.705 --> 02:29:11.709 region:rollup2
IS TO TRY TO MAINTAIN YOUR
02:29:10.008 --> 02:29:13.878 region:rollup2
INTEREST FOR A FEW MINUTES IN
02:29:11.709 --> 02:29:15.146 region:rollup2
OUR STATE CONSTITUTION BECAUSE I
02:29:13.878 --> 02:29:16.047 region:rollup2
THINK IT'S IMPORTANT FOR
02:29:15.146 --> 02:29:17.315 region:rollup2
EVERYONE ON THIS COMMITTEE AND
02:29:16.047 --> 02:29:18.483 region:rollup2
EVERYONE IN THE LEGISLATURE TO
02:29:17.315 --> 02:29:20.218 region:rollup2
UNDERSTAND.
02:29:18.483 --> 02:29:22.687 region:rollup2
THAT EFFORTS TO MOVE CALIFORNIA
02:29:20.218 --> 02:29:24.556 region:rollup2
TOWARD UNIVERSAL COVERAGE.
02:29:22.687 --> 02:29:26.891 region:rollup2
WOULD ENTAIL CONSTRAINTS THAT
02:29:24.556 --> 02:29:29.227 region:rollup2
ARE BUILT IN OUGHT TO OUR STATE
02:29:26.891 --> 02:29:30.695 region:rollup2
CONSTITUTION SO IT'S IMPORTANT
02:29:29.227 --> 02:29:31.896 region:rollup2
TO UNDERSTAND OUT WHAT THOSE
02:29:30.695 --> 02:29:34.332 region:rollup2
CONSTRAINTS ARE.
02:29:31.896 --> 02:29:37.635 region:rollup2
AND HOW THE STATE MAY BE ABLE
02:29:34.332 --> 02:29:39.604 region:rollup2
TO ADDRESS THEM.
02:29:37.635 --> 02:29:41.139 region:rollup2
SO ONE STARTING POINT FOR
02:29:39.604 --> 02:29:42.474 region:rollup2
THINKING ABOUT MOVING TOWARD
02:29:41.139 --> 02:29:43.374 region:rollup2
UNIVERSAL COVERAGE IN CALIFORNIA
02:29:42.474 --> 02:29:45.610 region:rollup2
IS THAT.
02:29:43.374 --> 02:29:47.612 region:rollup2
SUCH COVERAGE WOULD VERY LIKELY
02:29:45.610 --> 02:29:48.279 region:rollup2
REQUIRE TAX INCREASES I GUESS
02:29:47.612 --> 02:29:49.581 region:rollup2
YOU COULD THINK THERE WOULD BE A
02:29:48.279 --> 02:29:52.350 region:rollup2
WAY THAT THE LEGISLATURE COULD
02:29:49.581 --> 02:29:54.319 region:rollup2
CUT HERE OR THERE AND USE THAT
02:29:52.350 --> 02:29:55.687 region:rollup2
SPENDING EXISTING EXPENDITURES
02:29:54.319 --> 02:29:57.488 region:rollup2
TO FIND UNIFORMS WENT UNIVERSAL
02:29:55.687 --> 02:29:58.890 region:rollup2
COVERAGE. WHAT'S MORE LIKELY IS
02:29:57.488 --> 02:30:00.525 region:rollup2
THAT A TAX INCREASE WOULD BE
02:29:58.890 --> 02:30:01.826 region:rollup2
REQUIRED AND IN FACT PRIOR
02:30:00.525 --> 02:30:02.894 region:rollup2
ESTIMATES HAVE SHOWN THAT FOR
02:30:01.826 --> 02:30:05.997 region:rollup2
EXAMPLE MOVING TOWARD A SINGLE
02:30:02.894 --> 02:30:07.465 region:rollup2
PAYER SYSTEM. COULD ENTAIL A TAX
02:30:05.997 --> 02:30:08.466 region:rollup2
INCREASE OF WELL OVER ONE
02:30:07.465 --> 02:30:10.001 region:rollup2
HUNDRED BILLION DOLLARS AND I
02:30:08.466 --> 02:30:11.035 region:rollup2
BELIEVE OF THE LEGISLATIVE
02:30:10.001 --> 02:30:13.071 region:rollup2
ANALYST'S OFFICE WILL BE
02:30:11.035 --> 02:30:13.972 region:rollup2
SUBSTANTIATING THAT I'M IN A FEW
02:30:13.071 --> 02:30:17.041 region:rollup2
MOMENTS.
02:30:13.972 --> 02:30:18.076 region:rollup2
SO TAX INCREASES ARE POSSIBLE
02:30:17.041 --> 02:30:20.345 region:rollup2
AS YOU KNOW AS LONG AS THE
02:30:18.076 --> 02:30:21.679 region:rollup2
LEGISLATURE CAN MUSTER A TWO
02:30:20.345 --> 02:30:23.715 region:rollup2
THIRDS VOTE OF EACH CHAMBER.
02:30:21.679 --> 02:30:24.515 region:rollup2
HARM BUT WE ALSO KNOW THAT THERE
02:30:23.715 --> 02:30:25.917 region:rollup2
ARE PROVISIONS WITHIN THE
02:30:24.515 --> 02:30:27.752 region:rollup2
CONSTITUTION.
02:30:25.917 --> 02:30:29.387 region:rollup2
THAT CONSTRAIN THE
02:30:27.752 --> 02:30:33.057 region:rollup2
LEGISLATURE'S ABILITY.
02:30:29.387 --> 02:30:35.293 region:rollup2
TO RAISE TAXES AND TO DEDICATE
02:30:33.057 --> 02:30:37.929 region:rollup2
THE REVENUES TO PARTICULAR
02:30:35.293 --> 02:30:39.230 region:rollup2
PURPOSES OKAY JUST RATHER THAN
02:30:37.929 --> 02:30:40.365 region:rollup2
I'M ALLOWING THEM TO FLOW INTO
02:30:39.230 --> 02:30:41.766 region:rollup2
THE GENERAL FUND SO WHAT I
02:30:40.365 --> 02:30:42.834 region:rollup2
WANTED TO DO TODAY IS TO TALK
02:30:41.766 --> 02:30:44.969 region:rollup2
ABOUT A COUPLE PROVISIONS IN
02:30:42.834 --> 02:30:46.871 region:rollup2
PARTICULAR. ONE YOU ARE VERY
02:30:44.969 --> 02:30:48.239 region:rollup2
FAMILIAR WITH PROPOSITION NINETY
02:30:46.871 --> 02:30:49.407 region:rollup2
EIGHT APPROVED BY THE VOTERS IN
02:30:48.239 --> 02:30:52.010 region:rollup2
NINETEEN EIGHTY EIGHT.
02:30:49.407 --> 02:30:53.044 region:rollup2
WHICH AMENDED ARTICLE SIXTEEN
02:30:52.010 --> 02:30:54.913 region:rollup2
SECTION EIGHT OF THE STATE
02:30:53.044 --> 02:30:56.748 region:rollup2
CONSTITUTION I'M AND WAS LATER
02:30:54.913 --> 02:30:58.750 region:rollup2
AMENDED BY PROPER LEVIN OF
02:30:56.748 --> 02:30:59.951 region:rollup2
NINETEEN NINETY. I'M A SECOND
02:30:58.750 --> 02:31:01.653 region:rollup2
PROVISION THAT YOU'RE PROBABLY
02:30:59.951 --> 02:31:03.721 region:rollup2
LESS FAMILIAR WITH AT LEAST UP
02:31:01.653 --> 02:31:04.322 region:rollup2
UNTIL THIS YEAR AMEND MAYBE LAST
02:31:03.721 --> 02:31:06.691 region:rollup2
YEAR.
02:31:04.322 --> 02:31:09.560 region:rollup2
IS PROP FOUR OF NINETEEN
02:31:06.691 --> 02:31:11.563 region:rollup2
SEVENTY NINE WHICH ADDED ARTICLE
02:31:09.560 --> 02:31:14.432 region:rollup2
THIRTEEN BE TO THE STATE
02:31:11.563 --> 02:31:16.134 region:rollup2
CONSTITUTION AND ITSELF WAS
02:31:14.432 --> 02:31:18.803 region:rollup2
LATER AMENDED BOTH BY PROP
02:31:16.134 --> 02:31:19.704 region:rollup2
NINETY EIGHT AS WELL AS BY PROP
02:31:18.803 --> 02:31:20.104 region:rollup2
ONE ELEVEN.
02:31:19.704 --> 02:31:21.406 region:rollup2
SO.
02:31:20.104 --> 02:31:21.839 region:rollup2
ARTICLE THIRTEEN BE ESSENTIALLY
02:31:21.406 --> 02:31:22.807 region:rollup2
IS THE GANG LIMIT.
02:31:21.839 --> 02:31:24.108 region:rollup2
AND I'LL BE GETTING INTO BOTH
02:31:22.807 --> 02:31:27.879 region:rollup2
OF THOSE ISSUES.
02:31:24.108 --> 02:31:28.579 region:rollup2
IN A MOMENT.
02:31:27.879 --> 02:31:30.315 region:rollup2
SO.
02:31:28.579 --> 02:31:31.449 region:rollup2
I CAN HAPPILY REPORT THAT I'M
02:31:30.315 --> 02:31:33.117 region:rollup2
NOT GOING TO BE GETTING INTO THE
02:31:31.449 --> 02:31:34.953 region:rollup2
COMPLEXITIES THE MECHANICS THE
02:31:33.117 --> 02:31:36.487 region:rollup2
FORMULAS ASSOCIATED WITH THE
02:31:34.953 --> 02:31:38.256 region:rollup2
PROPOSITION NINETY EIGHT OF
02:31:36.487 --> 02:31:39.891 region:rollup2
MINIMUM FUNDING GUARANTEE I WILL
02:31:38.256 --> 02:31:41.559 region:rollup2
JUST REMIND I'M ALL OF US IN THE
02:31:39.891 --> 02:31:43.227 region:rollup2
ROOM. THAT IT ESSENTIALLY
02:31:41.559 --> 02:31:45.663 region:rollup2
PROVIDES A MECHANISM ON FOR
02:31:43.227 --> 02:31:48.299 region:rollup2
PROVIDING EACH YEAR A GUARANTEED
02:31:45.663 --> 02:31:50.468 region:rollup2
LEVEL OF FUNDING TO K. TWELVE
02:31:48.299 --> 02:31:52.303 region:rollup2
SCHOOLS AND COMMUNITY COLLEGES
02:31:50.468 --> 02:31:53.571 region:rollup2
I'M ALSO KNOWN AS K. FOURTEEN
02:31:52.303 --> 02:31:55.540 region:rollup2
EDUCATION.
02:31:53.571 --> 02:31:56.307 region:rollup2
SO THE KEY ISSUE HERE RELATED TO
02:31:55.540 --> 02:31:57.709 region:rollup2
UNIVERSAL HEALTH COVERAGE IS
02:31:56.307 --> 02:32:00.211 region:rollup2
THIS
02:31:57.709 --> 02:32:02.780 region:rollup2
WOOD CAPE FOURTEEN EDUCATION BE
02:32:00.211 --> 02:32:05.049 region:rollup2
REQUIRED TO RECEIVE A PORTION OF
02:32:02.780 --> 02:32:06.918 region:rollup2
ANY TAX REVENUES.
02:32:05.049 --> 02:32:08.786 region:rollup2
RAISED TO FIND UNIVERSAL
02:32:06.918 --> 02:32:10.922 region:rollup2
COVERAGE.
02:32:08.786 --> 02:32:13.825 region:rollup2
EVEN IF THE LEGISLATURE DECIDED
02:32:10.922 --> 02:32:16.227 region:rollup2
TO DIRECT THOSE REVENUES INTO A
02:32:13.825 --> 02:32:17.562 region:rollup2
SPECIAL FUND RATHER THAN INTO
02:32:16.227 --> 02:32:19.797 region:rollup2
THE GENERAL FUND THAT IS
02:32:17.562 --> 02:32:21.499 region:rollup2
ESSENTIALLY THE KEY QUESTION.
02:32:19.797 --> 02:32:23.301 region:rollup2
ARM AROUND HOW PROPOSITION
02:32:21.499 --> 02:32:24.869 region:rollup2
NINETY EIGHT RELATES TO THE
02:32:23.301 --> 02:32:29.674 region:rollup2
STATE'S OF EFFORTS TO ACHIEVE
02:32:24.869 --> 02:32:31.409 region:rollup2
UNIVERSAL COVERAGE.
02:32:29.674 --> 02:32:33.244 region:rollup2
SO WHAT I WANT TO DO NOW IS
02:32:31.409 --> 02:32:34.078 region:rollup2
SPEAK FROM THIS VERY SIMPLE
02:32:33.244 --> 02:32:36.781 region:rollup2
GRAPHIC HERE.
02:32:34.078 --> 02:32:38.049 region:rollup2
TO LAY OUT SOME OF THE ISSUES.
02:32:36.781 --> 02:32:40.018 region:rollup2
THAT ARE PRESENT.
02:32:38.049 --> 02:32:41.819 region:rollup2
IN VARIOUS DEBATES AROUND
02:32:40.018 --> 02:32:43.287 region:rollup2
PROPOSITION NINETY EIGHT SO THE
02:32:41.819 --> 02:32:44.956 region:rollup2
FIRST THING TO UNDERSTAND IS
02:32:43.287 --> 02:32:46.391 region:rollup2
THAT IN ARTICLE SIXTEEN SECTION
02:32:44.956 --> 02:32:48.626 region:rollup2
IGHT.
02:32:46.391 --> 02:32:50.762 region:rollup2
ARE THE TERM A GENERAL FUND
02:32:48.626 --> 02:32:53.431 region:rollup2
REVENUES IS USE THE TERM GENERAL
02:32:50.762 --> 02:32:55.199 region:rollup2
FUND PROCEEDS OF TAXES IS USED
02:32:53.431 --> 02:32:57.268 region:rollup2
WHEN TALKING ABOUT HOW THE PROP
02:32:55.199 --> 02:32:58.870 region:rollup2
NINETY EIGHT GUARANTEE GETS
02:32:57.268 --> 02:33:01.105 region:rollup2
CALCULATED EACH YEAR. THE
02:32:58.870 --> 02:33:03.541 region:rollup2
CONSTITUTION DOES NOT TALK
02:33:01.105 --> 02:33:04.609 region:rollup2
SPECIFICALLY ABOUT SPECIAL FUND
02:33:03.541 --> 02:33:07.245 region:rollup2
REVENUES.
02:33:04.609 --> 02:33:09.013 region:rollup2
IN IN HAPPENED IN DISCUSSING
02:33:07.245 --> 02:33:10.548 region:rollup2
ARE DESCRIBING HOW THE PROP
02:33:09.013 --> 02:33:13.084 region:rollup2
NINETY EIGHT CALCULATIONS ARE
02:33:10.548 --> 02:33:15.219 region:rollup2
INTENDED TO BE DONE. SO. THERE
02:33:13.084 --> 02:33:17.522 region:rollup2
ARE VARYING INTERPRETATIONS.
02:33:15.219 --> 02:33:18.523 region:rollup2
OF WHAT THIS ACTUALLY MEANS ONE
02:33:17.522 --> 02:33:20.458 region:rollup2
INTERPRETATION.
02:33:18.523 --> 02:33:22.427 region:rollup2
YOU MIGHT CALL IT THE STRONG
02:33:20.458 --> 02:33:24.429 region:rollup2
INTERPRETATION ARGUES THAT
02:33:22.427 --> 02:33:26.197 region:rollup2
BECAUSE SPECIAL FUND REVENUES
02:33:24.429 --> 02:33:28.566 region:rollup2
ARE NOT MENTIONED.
02:33:26.197 --> 02:33:30.168 region:rollup2
IN THE STATE CONSTITUTION IN
02:33:28.566 --> 02:33:31.969 region:rollup2
THE CONTEXT OF NINETY EIGHT. AND
02:33:30.168 --> 02:33:33.671 region:rollup2
BECAUSE GENERAL FUND REVENUES
02:33:31.969 --> 02:33:36.040 region:rollup2
AND SPECIAL FUND REVENUES.
02:33:33.671 --> 02:33:38.209 region:rollup2
ARE DISTINCT FROM ONE ANOTHER
02:33:36.040 --> 02:33:40.778 region:rollup2
THEN SPECIAL FUND REVENUES WOULD
02:33:38.209 --> 02:33:42.113 region:rollup2
NEVER COUNT IN CALCULATING THE
02:33:40.778 --> 02:33:43.781 region:rollup2
PROPOSITION NINETY EIGHT
02:33:42.113 --> 02:33:45.149 region:rollup2
SPENDING GUARANTEE SO ONE
02:33:43.781 --> 02:33:47.151 region:rollup2
EXAMPLE OF HOW THIS COULD WORK.
02:33:45.149 --> 02:33:49.053 region:rollup2
THE LEGISLATURE TO PASS A TAX
02:33:47.151 --> 02:33:50.421 region:rollup2
INCREASE INTENDED TO ACHIEVE
02:33:49.053 --> 02:33:52.090 region:rollup2
UNIVERSAL COVERAGE.
02:33:50.421 --> 02:33:54.125 region:rollup2
IT COULD DIRECT THOSE REVENUES
02:33:52.090 --> 02:33:55.860 region:rollup2
INTO A SPECIAL FUND.
02:33:54.125 --> 02:33:57.662 region:rollup2
AND IT COULD PERMANENTLY EXCLUDE
02:33:55.860 --> 02:33:59.831 region:rollup2
THOSE REVENUES FROM THE
02:33:57.662 --> 02:34:02.300 region:rollup2
CALCULATION OF THE PROPOSITION
02:33:59.831 --> 02:34:04.035 region:rollup2
NINETY EIGHT GUARANTEE EACH YEAR
02:34:02.300 --> 02:34:05.737 region:rollup2
WHICHWOULD EFFECTIVELY MAIN
02:34:04.035 --> 02:34:08.473 region:rollup2
THAT K. FOURTEEN EDUCATION WOULD
02:34:05.737 --> 02:34:10.374 region:rollup2
DERIVE NO UP FINANCIAL BENEFIT
02:34:08.473 --> 02:34:12.577 region:rollup2
FROM THE REVENUES REYES TO
02:34:10.374 --> 02:34:14.045 region:rollup2
SUPPORT. UNIVERSAL COVERAGE
02:34:12.577 --> 02:34:15.346 region:rollup2
SO THAT'S ONE VEHICLE OUT AND
02:34:14.045 --> 02:34:17.081 region:rollup2
THAT VIEW WAS EXPRESSED IN A
02:34:15.346 --> 02:34:18.416 region:rollup2
LAWSUIT VERY CLEARLY BY THE
02:34:17.081 --> 02:34:19.951 region:rollup2
BROWN ADMINISTRATION IT WAS A
02:34:18.416 --> 02:34:20.985 region:rollup2
LAWSUIT THAT WAS BROUGHT IN TWO
02:34:19.951 --> 02:34:22.487 region:rollup2
THOUSAND TWELVE.
02:34:20.985 --> 02:34:24.188 region:rollup2
GOT BY K. TWELVE SCHOOL
02:34:22.487 --> 02:34:25.823 region:rollup2
OFFICIALS IN THE WAKE OF THE TWO
02:34:24.188 --> 02:34:27.558 region:rollup2
THOUSAND ELEVEN REALIGNMENT IN
02:34:25.823 --> 02:34:28.926 region:rollup2
WHICH THE STATE SHIFTED VARIOUS
02:34:27.558 --> 02:34:30.194 region:rollup2
PROGRAMS AND SERVICES TO THE
02:34:28.926 --> 02:34:31.729 region:rollup2
COUNTIES ALONG WITH BILLIONS OF
02:34:30.194 --> 02:34:32.864 region:rollup2
DOLLARS.
02:34:31.729 --> 02:34:34.665 region:rollup2
NEWS THAT PREVIOUSLY WERE
02:34:32.864 --> 02:34:37.802 region:rollup2
GENERAL FUND REVENUES.
02:34:34.665 --> 02:34:39.270 region:rollup2
BUT WERE SORT OF RE IMAGINED AS
02:34:37.802 --> 02:34:41.839 region:rollup2
SPECIAL FUND REVENUES.
02:34:39.270 --> 02:34:43.274 region:rollup2
THAT LAWSUIT WAS LATER MOVED
02:34:41.839 --> 02:34:44.509 region:rollup2
BECAUSE PROPOSITION THIRTY
02:34:43.274 --> 02:34:46.277 region:rollup2
PASSED IN TWO THOUSAND TWELVE
02:34:44.509 --> 02:34:48.045 region:rollup2
WHICH ESSENTIALLY GAVE K.
02:34:46.277 --> 02:34:49.580 region:rollup2
FOURTEEN EDUCATION BACK THE
02:34:48.045 --> 02:34:51.015 region:rollup2
REVENUES THAT WERE LOST AS A
02:34:49.580 --> 02:34:52.250 region:rollup2
RESULT OF THAT TRANSFERS OF THE
02:34:51.015 --> 02:34:54.185 region:rollup2
WAS NEVER ANY CONTROLLING
02:34:52.250 --> 02:34:55.319 region:rollup2
DECISION. THEY CAME OUT OF THAT
02:34:54.185 --> 02:34:57.522 region:rollup2
LAWSUIT SO THAT'S THE FIRST
02:34:55.319 --> 02:34:59.524 region:rollup2
INTERPRETATION THERE ON THE LEFT
02:34:57.522 --> 02:35:00.525 region:rollup2
UP LOOKING DOWN AT THE OTHER BOX
02:34:59.524 --> 02:35:02.126 region:rollup2
ON THE BOTTOM THE ONE ON THE
02:35:00.525 --> 02:35:04.095 region:rollup2
RIGHT. THERE'S ALSO ANOTHER
02:35:02.126 --> 02:35:05.596 region:rollup2
INTERPRETATION OF HOW TO THINK
02:35:04.095 --> 02:35:07.532 region:rollup2
ABOUT THE RELATIONSHIP BETWEEN
02:35:05.596 --> 02:35:09.167 region:rollup2
PROPOSITION NINETY EIGHT AND I
02:35:07.532 --> 02:35:11.402 region:rollup2
GENERAL FUND IN SPECIAL FUND
02:35:09.167 --> 02:35:14.205 region:rollup2
REVENUES IN THIS INTERPRETATION.
02:35:11.402 --> 02:35:16.407 region:rollup2
SORT OF ARGUES THAT THE GENERAL
02:35:14.205 --> 02:35:17.742 region:rollup2
FUND AS USED IN THE CONSTITUTION
02:35:16.407 --> 02:35:19.944 region:rollup2
SHOULD BE THOUGHT OF MORE
02:35:17.742 --> 02:35:22.413 region:rollup2
BROADLY TO ENCOMPASS REVENUES
02:35:19.944 --> 02:35:24.081 region:rollup2
THAT GO BEYOND THOSE THAT ARE
02:35:22.413 --> 02:35:26.784 region:rollup2
DEPOSITED INTO THE STATE'S
02:35:24.081 --> 02:35:29.253 region:rollup2
GENERAL FUND. EACH YEAR BY STATE
02:35:26.784 --> 02:35:31.856 region:rollup2
LAW ARE AS REQUIRED BY STATE LAW
02:35:29.253 --> 02:35:32.890 region:rollup2
SO THIS INTERPRETATION SHOWS UP
02:35:31.856 --> 02:35:34.992 region:rollup2
FROM TIME TO TIME WITHIN THE
02:35:32.890 --> 02:35:36.227 region:rollup2
LEGISLATURE IT WAS EXPRESSED IN
02:35:34.992 --> 02:35:37.795 region:rollup2
THE SENATE APPROPRIATIONS
02:35:36.227 --> 02:35:40.398 region:rollup2
COMMITTEE IS ANALYSIS OF SENATE
02:35:37.795 --> 02:35:41.632 region:rollup2
BILL FIVE SIXTY TWO. WHICH AIM
02:35:40.398 --> 02:35:43.734 region:rollup2
TO CREATE A SINGLE PAYER SYSTEM
02:35:41.632 --> 02:35:45.736 region:rollup2
IN CALIFORNIA SO IT WAS VERY
02:35:43.734 --> 02:35:47.738 region:rollup2
CLEARLY EXPRESS THEIR. IT IT HAS
02:35:45.736 --> 02:35:49.240 region:rollup2
ALSO BEEN IMPLIED IN A NUMBER OF
02:35:47.738 --> 02:35:50.908 region:rollup2
BALLOT MEASURES THAT HAVE RAISE
02:35:49.240 --> 02:35:52.677 region:rollup2
REVENUES FOR EXAMPLE EACH OF THE
02:35:50.908 --> 02:35:54.045 region:rollup2
THREE BALLOT MEASURES THAT HAVE
02:35:52.677 --> 02:35:56.013 region:rollup2
GONE TO THE VOTERS ASKING THEM
02:35:54.045 --> 02:35:57.348 region:rollup2
TO INCREASE TOBACCO TAX REVENUES
02:35:56.013 --> 02:35:58.950 region:rollup2
IN NINETEEN EIGHTY EIGHT.
02:35:57.348 --> 02:36:00.651 region:rollup2
NINETEEN NINETY EIGHT AND MOST
02:35:58.950 --> 02:36:03.087 region:rollup2
RECENTLY IN TWO THOUSAND SIXTEEN
02:36:00.651 --> 02:36:05.423 region:rollup2
HAVE RAISED A STATES EXCISE TAX
02:36:03.087 --> 02:36:07.124 region:rollup2
ON TOBACCO DEPOSITED THE
02:36:05.423 --> 02:36:08.292 region:rollup2
REVENUES INTO A SPECIAL FUND.
02:36:07.124 --> 02:36:10.094 region:rollup2
DIDN'T GO TO THE GENERAL FUND
02:36:08.292 --> 02:36:11.229 region:rollup2
BUT IN EACH CASE THEY FELT THAT
02:36:10.094 --> 02:36:12.897 region:rollup2
IT WOULD BE PRUDENT TO ADD
02:36:11.229 --> 02:36:14.732 region:rollup2
LANGUAGE TO THEIR MEASURE THAT
02:36:12.897 --> 02:36:18.903 region:rollup2
SAID BY THE WAY. A THESE ARE
02:36:14.732 --> 02:36:20.371 region:rollup2
REALLY SPECIAL FUND REVENUES
02:36:18.903 --> 02:36:21.872 region:rollup2
THEY'RE NOT ENTER DEPLETES DON
02:36:20.371 --> 02:36:23.808 region:rollup2
INTERPRET THEM AS GENERAL FUND
02:36:21.872 --> 02:36:25.176 region:rollup2
REVENUES SUBJECT TO THE
02:36:23.808 --> 02:36:26.844 region:rollup2
PROPOSITION NINETY EIGHT
02:36:25.176 --> 02:36:29.013 region:rollup2
GUARANTEE THEY FELT IT PRUDENT
02:36:26.844 --> 02:36:30.548 region:rollup2
TO ADD THAT LANGUAGE. EVEN
02:36:29.013 --> 02:36:32.850 region:rollup2
THOUGH THEY WERE RAISING AN
02:36:30.548 --> 02:36:35.253 region:rollup2
EXCISE TAX AND DEPOSITING THE
02:36:32.850 --> 02:36:36.554 region:rollup2
REVENUES INTO A BRAND NEW
02:36:35.253 --> 02:36:37.288 region:rollup2
SPECIAL FUNDS.
02:36:36.554 --> 02:36:38.189 region:rollup2
I'M GOING TO SKIP A FEW TECH
02:36:37.288 --> 02:36:39.957 region:rollup2
SLIDES HERE AND GO.
02:36:38.189 --> 02:36:40.358 region:rollup2
RIGHT TO THIS ONE I'M.
02:36:39.957 --> 02:36:41.892 region:rollup2
GIVEN THE VARYING
02:36:40.358 --> 02:36:44.362 region:rollup2
INTERPRETATIONS HERE I'M IT
02:36:41.892 --> 02:36:46.230 region:rollup2
SEEMS TO US THAT THE STATE COULD
02:36:44.362 --> 02:36:48.1000 region:rollup2
BE VULNERABLE TO LEGAL
02:36:46.230 --> 02:36:50.701 region:rollup2
CHALLENGES I'M IF IT DECIDED TO
02:36:48.1000 --> 02:36:52.136 region:rollup2
IF THE LEGISLATURE DECIDED TO
02:36:50.701 --> 02:36:54.405 region:rollup2
RAISE TAXES.
02:36:52.136 --> 02:36:56.540 region:rollup2
DEPOSIT THOSE DOLLARS INTO A
02:36:54.405 --> 02:36:58.476 region:rollup2
SPECIAL FUND AND EXCLUDE THEM
02:36:56.540 --> 02:37:00.878 region:rollup2
FROM THE PROPOSITION NINETY
02:36:58.476 --> 02:37:03.314 region:rollup2
EIGHT CALCULATIONS NOW LAWMAKERS
02:37:00.878 --> 02:37:04.916 region:rollup2
ARE COULD ATTEMPT TO DISSUADE
02:37:03.314 --> 02:37:07.518 region:rollup2
LIT AGAINST BY ADDING WHAT ARE
02:37:04.916 --> 02:37:08.819 region:rollup2
CALLED POISON PILLS TO A BILL.
02:37:07.518 --> 02:37:10.187 region:rollup2
I'M A POISON PILL WOULD
02:37:08.819 --> 02:37:11.656 region:rollup2
ESSENTIALLY BLOW UP THE
02:37:10.187 --> 02:37:13.457 region:rollup2
STRUCTURE WOULD SAY IF ANYONE
02:37:11.656 --> 02:37:15.226 region:rollup2
SUES ON THE BASIS OF PROPOSITION
02:37:13.457 --> 02:37:17.461 region:rollup2
NINETY EIGHT AND THE STATE LOSES
02:37:15.226 --> 02:37:19.230 region:rollup2
THAT LAWSUIT. THESE REVENUES
02:37:17.461 --> 02:37:20.765 region:rollup2
WOULD AUTOMATICALLY GO AWAY ON
02:37:19.230 --> 02:37:22.533 region:rollup2
THE LA AL POINTED OUT IN A
02:37:20.765 --> 02:37:24.001 region:rollup2
REPORT RELEASED LAST YEAR.
02:37:22.533 --> 02:37:25.503 region:rollup2
THAT THERE WERE FOR POISON
02:37:24.001 --> 02:37:26.704 region:rollup2
PILLS THAT THE LEGISLATURE
02:37:25.503 --> 02:37:28.205 region:rollup2
ADOPTED IN THE LATE EIGHTIES AND
02:37:26.704 --> 02:37:30.174 region:rollup2
EARLY NINETIES WHEN PROP NINETY
02:37:28.205 --> 02:37:31.709 region:rollup2
EIGHT WAS RELATIVELY NEW. AND NO
02:37:30.174 --> 02:37:32.777 region:rollup2
CONSEQUENCES EVER CAME FORTH
02:37:31.709 --> 02:37:34.378 region:rollup2
FROM THEM AND OTHER WORDS THAT
02:37:32.777 --> 02:37:36.280 region:rollup2
WERE NEVER LAWSUITS THAT SORT OF
02:37:34.378 --> 02:37:38.149 region:rollup2
TESTED ON WHETHER SOMEONE WOULD
02:37:36.280 --> 02:37:39.884 region:rollup2
TAKE IT ALL THE WAY SUE THE
02:37:38.149 --> 02:37:42.186 region:rollup2
STATE AND ARGUE THAT THE REVENUE
02:37:39.884 --> 02:37:43.587 region:rollup2
SHOULD INDEED BE COUNTED TOWARD
02:37:42.186 --> 02:37:45.656 region:rollup2
THE NINETY EIGHT GUARANTEE.
02:37:43.587 --> 02:37:47.591 region:rollup2
SO A POISON PILL IS ONE WAY TO
02:37:45.656 --> 02:37:49.593 region:rollup2
GO ANOTHER WAY TO GO IS TO
02:37:47.591 --> 02:37:52.163 region:rollup2
SIMPLY SOMEPLACE ON TO THE
02:37:49.593 --> 02:37:54.432 region:rollup2
BALLOT. A MEASURE THAT WOULD ASK
02:37:52.163 --> 02:37:55.766 region:rollup2
CALIFORNIA'S VOTERS TO RAISE THE
02:37:54.432 --> 02:37:57.268 region:rollup2
REVENUES NEEDED TO ACHIEVE
02:37:55.766 --> 02:37:59.437 region:rollup2
UNIVERSAL COVERAGE.
02:37:57.268 --> 02:38:01.872 region:rollup2
AND IT TO EXCLUDE THOSE REVENUES
02:37:59.437 --> 02:38:03.407 region:rollup2
EXPLICITLY FROM THE CALCULATION
02:38:01.872 --> 02:38:05.209 region:rollup2
OF THE PROPOSITION NINETY EIGHT
02:38:03.407 --> 02:38:07.578 region:rollup2
GUARANTEES SO THERE MAY BE A
02:38:05.209 --> 02:38:10.047 region:rollup2
LEGISLATIVE WAY TO ADDRESS THE
02:38:07.578 --> 02:38:11.615 region:rollup2
ISSUE THIS CONSTRAINT POSED BY
02:38:10.047 --> 02:38:12.984 region:rollup2
THESE VARYING INTERPRETATIONS.
02:38:11.615 --> 02:38:14.618 region:rollup2
BUT THERE'S ALSO MAYBE A MORE
02:38:12.984 --> 02:38:16.320 region:rollup2
OBVIOUS WAY THAT'S BEEN USED
02:38:14.618 --> 02:38:17.555 region:rollup2
MANY TIMES OVER THE DECADES
02:38:16.320 --> 02:38:18.489 region:rollup2
WHICH IS TO SIMPLY GO TO THE
02:38:17.555 --> 02:38:21.258 region:rollup2
VOTERS.
02:38:18.489 --> 02:38:22.293 region:rollup2
AND PASSED UP WE THE PEOPLE OF
02:38:21.258 --> 02:38:24.595 region:rollup2
CALIFORNIA TO AMEND OUR
02:38:22.293 --> 02:38:27.164 region:rollup2
CONSTITUTION IN ORDER TO ALLOW
02:38:24.595 --> 02:38:30.001 region:rollup2
REVENUES RAISED FOR UNIVERSAL
02:38:27.164 --> 02:38:32.269 region:rollup2
COVERAGE I'M TO UNAMBIGUOUSLY BE
02:38:30.001 --> 02:38:33.270 region:rollup2
USED FOR UNIVERSAL COVERAGE
02:38:32.269 --> 02:38:34.872 region:rollup2
RATHER THAN ONLY SORT OF HAVING
02:38:33.270 --> 02:38:36.874 region:rollup2
A CLOUD OVER YOUR HEAD.
02:38:34.872 --> 02:38:38.275 region:rollup2
WONDERING O. OF SOMEDAY THIS MAY
02:38:36.874 --> 02:38:39.276 region:rollup2
BE SUBJECT TO PROPOSITION NINETY
02:38:38.275 --> 02:38:40.644 region:rollup2
EIGHT AND WILL LOSE A
02:38:39.276 --> 02:38:41.512 region:rollup2
SIGNIFICANT PORTION OF THESE
02:38:40.644 --> 02:38:43.914 region:rollup2
REVENUES.
02:38:41.512 --> 02:38:45.916 region:rollup2
TO ANOTHER SERVICE AS OPPOSED
02:38:43.914 --> 02:38:47.651 region:rollup2
TO K. FOURTEEN ARE AS OPPOSED TO
02:38:45.916 --> 02:38:49.020 region:rollup2
UNIVERSAL COVERAGE.
02:38:47.651 --> 02:38:50.554 region:rollup2
I'M GONNA SKIP TO THE NEXT ISSUE
02:38:49.020 --> 02:38:52.490 region:rollup2
NOW WHICH IS PROPOSITION FOR AS
02:38:50.554 --> 02:38:54.425 region:rollup2
I MENTIONED A PASSED ORIGINALLY
02:38:52.490 --> 02:38:55.493 region:rollup2
IN NINETEEN SEVENTY NINE.
02:38:54.425 --> 02:38:57.261 region:rollup2
ESSENTIALLY THIS IS A
02:38:55.493 --> 02:38:59.096 region:rollup2
LIMITATION ON STATE AND LOCAL
02:38:57.261 --> 02:39:01.265 region:rollup2
SPENDING AND I WANTED TO LAY OUT
02:38:59.096 --> 02:39:02.566 region:rollup2
FIRST THE KEY ISSUE HERE I'M FOR
02:39:01.265 --> 02:39:04.368 region:rollup2
YOU RELATED TO UNIVERSAL
02:39:02.566 --> 02:39:07.338 region:rollup2
COVERAGE WHICH IS. IF THE
02:39:04.368 --> 02:39:08.973 region:rollup2
LEGISLATURE INCREASED TAXES TO
02:39:07.338 --> 02:39:10.674 region:rollup2
ACHIEVE UNIVERSAL COVERAGE.
02:39:08.973 --> 02:39:12.943 region:rollup2
WITH THESE TAXES ESSENTIALLY BE
02:39:10.674 --> 02:39:14.645 region:rollup2
SO HIGH THESE NEW REVENUES
02:39:12.943 --> 02:39:17.181 region:rollup2
BUT THEY WOULD CAUSE THE STATE
02:39:14.645 --> 02:39:18.215 region:rollup2
TO EXCEED ITS APPROPRIATIONS
02:39:17.181 --> 02:39:20.151 region:rollup2
LIMIT WHAT IS.
02:39:18.215 --> 02:39:21.652 region:rollup2
OFTEN KNOWN AS THE CAN LIMIT
02:39:20.151 --> 02:39:22.920 region:rollup2
AFTER ONE OF THE AUTHORS OF
02:39:21.652 --> 02:39:24.622 region:rollup2
PROPOSITION FOR IN NINETEEN
02:39:22.920 --> 02:39:26.123 region:rollup2
SEVENTY NINE.
02:39:24.622 --> 02:39:28.092 region:rollup2
SO I'VE GOT HERE.
02:39:26.123 --> 02:39:29.827 region:rollup2
HOPEFULLY A RELATIVELY SIMPLE
02:39:28.092 --> 02:39:31.429 region:rollup2
ILLUSTRATION I'M SORRY THERE
02:39:29.827 --> 02:39:32.930 region:rollup2
EVEN FOR BOXES ON THEIR MORE
02:39:31.429 --> 02:39:34.498 region:rollup2
TEXT THAN I WOULD HAVE LIKED.
02:39:32.930 --> 02:39:36.567 region:rollup2
THIS IS MY EFFORT TO SORT OF DO
02:39:34.498 --> 02:39:38.169 region:rollup2
STILL FOR YOU SO I DON'T HAVE TO
02:39:36.567 --> 02:39:39.503 region:rollup2
TALK ABOUT THIS WITH TECH SLIDES
02:39:38.169 --> 02:39:40.805 region:rollup2
THAT I'M GONNA SKIP THE NEXT
02:39:39.503 --> 02:39:42.139 region:rollup2
THREE AFTER THIS BUT I JUST
02:39:40.805 --> 02:39:44.041 region:rollup2
WANTED EVERYONE TO SORT OF BE ON
02:39:42.139 --> 02:39:45.876 region:rollup2
THE SAME PAGE OF JUST ABOUT HOW
02:39:44.041 --> 02:39:47.878 region:rollup2
BEGAN LIMIT WORKS. SO THAT THEN
02:39:45.876 --> 02:39:49.413 region:rollup2
YOU CAN USE THAT TO THINK ABOUT
02:39:47.878 --> 02:39:50.781 region:rollup2
WHETHER THIS WOULD AFFECT YOUR
02:39:49.413 --> 02:39:52.349 region:rollup2
EFFORTS TO MOVE TOWARD UNIVERSAL
02:39:50.781 --> 02:39:53.384 region:rollup2
COVERAGE IN CALIFORNIA SO THE
02:39:52.349 --> 02:39:55.619 region:rollup2
FIRST THING THAT HAPPENS AND IT
02:39:53.384 --> 02:39:57.855 region:rollup2
AGAIN LIMIT. IS THE STATE PASSED
02:39:55.619 --> 02:40:00.257 region:rollup2
TO CALCULATE ITS ANNUAL LIMIT
02:39:57.855 --> 02:40:02.426 region:rollup2
ESSENTIALLY THE LIMIT IS BASED
02:40:00.257 --> 02:40:03.794 region:rollup2
ON SPENDING BY THE STATE OF
02:40:02.426 --> 02:40:05.362 region:rollup2
CALIFORNIA CERTAIN TYPES OF
02:40:03.794 --> 02:40:06.764 region:rollup2
SPENDING BACK IN NINETEEN
02:40:05.362 --> 02:40:07.264 region:rollup2
SEVENTY EIGHT SEVENTY NINE SO
02:40:06.764 --> 02:40:08.399 region:rollup2
YOU HAVE WE'RE SENSUALLY
02:40:07.264 --> 02:40:10.401 region:rollup2
SETTING.
02:40:08.399 --> 02:40:12.369 region:rollup2
OUR LIMIT BASED ON THE DISCO ERA
02:40:10.401 --> 02:40:13.704 region:rollup2
EXPENDITURES OF CALIFORNIA
02:40:12.369 --> 02:40:15.739 region:rollup2
DURING JERRY BROWN'S.
02:40:13.704 --> 02:40:17.374 region:rollup2
PROBABLY HIS SECOND TERM AT
02:40:15.739 --> 02:40:19.276 region:rollup2
THAT POINT MAYBE HIS FIRST TERM
02:40:17.374 --> 02:40:21.412 region:rollup2
THE LIMIT IS ADJUSTED EACH YEAR
02:40:19.276 --> 02:40:23.113 region:rollup2
FOR VARIOUS FACTORS SUCH AS THE
02:40:21.412 --> 02:40:24.882 region:rollup2
POPPY THAT THE POPULATION
02:40:23.113 --> 02:40:26.150 region:rollup2
GROWING CALIFORNIA. DO WE HAVE
02:40:24.882 --> 02:40:27.518 region:rollup2
MORE KIDS THAT ARE K. TWELVE
02:40:26.150 --> 02:40:29.553 region:rollup2
SCHOOL SYSTEM.
02:40:27.518 --> 02:40:31.455 region:rollup2
DID OUR PER CAPITA PERSONAL
02:40:29.553 --> 02:40:33.224 region:rollup2
INCOME GO UP ALL OF THOSE THINGS
02:40:31.455 --> 02:40:34.525 region:rollup2
GET FACTORED INTO CALCULATING
02:40:33.224 --> 02:40:35.960 region:rollup2
AND NEW LIMITS SO ESSENTIALLY
02:40:34.525 --> 02:40:37.495 region:rollup2
EVERY YEAR YOU TAKE THE BASE
02:40:35.960 --> 02:40:39.063 region:rollup2
WHERE YOU ARE. YOU APPLY THE
02:40:37.495 --> 02:40:41.432 region:rollup2
ADJUSTMENT FACTORS AND YOU GET A
02:40:39.063 --> 02:40:43.334 region:rollup2
NEW BASE THAT IS YOUR NEW BEGAN
02:40:41.432 --> 02:40:44.702 region:rollup2
LIMIT EACH YEAR AND ALL LOCAL
02:40:43.334 --> 02:40:45.936 region:rollup2
GUY I BELIEVE ALMOST ALL LOCAL
02:40:44.702 --> 02:40:48.272 region:rollup2
GOVERNMENTS IN CALIFORNIA ARE
02:40:45.936 --> 02:40:49.340 region:rollup2
REQUIRED TO GO THROUGH THE SAME
02:40:48.272 --> 02:40:50.407 region:rollup2
EXERCISE EACH YEAR.
02:40:49.340 --> 02:40:52.943 region:rollup2
THE SECOND THING THE STATE HAS
02:40:50.407 --> 02:40:55.446 region:rollup2
TO DO IS TO DETERMINE THE
02:40:52.943 --> 02:40:56.447 region:rollup2
APPROPRIATIONS THAT ARE SUBJECT
02:40:55.446 --> 02:40:58.249 region:rollup2
TO THE LIMIT THAT WAS JUST
02:40:56.447 --> 02:40:59.617 region:rollup2
CALCULATED
02:40:58.249 --> 02:41:01.619 region:rollup2
SO A COUPLE IMPORTANT THINGS TO
02:40:59.617 --> 02:41:03.721 region:rollup2
KEEP IN MIND HERE. WE'RE TALKING
02:41:01.619 --> 02:41:06.390 region:rollup2
ABOUT APPROPRIATIONS FROM WHAT
02:41:03.721 --> 02:41:08.359 region:rollup2
ARE CALLED PROCEEDS OF TAXES TAX
02:41:06.390 --> 02:41:10.160 region:rollup2
PROCEEDS WHETHER TAX PROCEEDS
02:41:08.359 --> 02:41:12.129 region:rollup2
THERE THEY ARE THERE ARE VARIOUS
02:41:10.160 --> 02:41:13.464 region:rollup2
THINGS THAT FACTOR INTO PROCEEDS
02:41:12.129 --> 02:41:15.533 region:rollup2
OF TAXES I'M JUST GONNA TELL YOU
02:41:13.464 --> 02:41:16.767 region:rollup2
THE MAIN ONE. WHICH IS REVENUES
02:41:15.533 --> 02:41:18.602 region:rollup2
FROM.
02:41:16.767 --> 02:41:20.237 region:rollup2
STATES GENERAL TAXES THE
02:41:18.602 --> 02:41:21.639 region:rollup2
PERSONAL INCOME TAX
02:41:20.237 --> 02:41:24.041 region:rollup2
SALES AND USE TAX THE
02:41:21.639 --> 02:41:26.510 region:rollup2
CORPORATION TAX ALL THOSE BABIES
02:41:24.041 --> 02:41:29.580 region:rollup2
FOR THE MOST PART THAT IS WHAT.
02:41:26.510 --> 02:41:32.783 region:rollup2
ON THE PROCEEDS OF TAXES.
02:41:29.580 --> 02:41:32.783 region:rollup2
ARE MADE UP BY THERE ARE OTHER
02:41:32.850 --> 02:41:35.753 region:rollup2
REVENUES THEY GET FACTORED IN
02:41:34.351 --> 02:41:38.155 region:rollup2
OKAY SO YOU HAVE PROCEEDS OF
02:41:35.753 --> 02:41:39.890 region:rollup2
TAXES YOU NEXT STEP WITHIN THE
02:41:38.155 --> 02:41:43.127 region:rollup2
SECOND BOX ON THE BOTTOM IS TO
02:41:39.890 --> 02:41:45.195 region:rollup2
DECIDE. WHICH APPROPRIATIONS
02:41:43.127 --> 02:41:46.864 region:rollup2
FROM PROCEEDS OF TAXES ARE
02:41:45.195 --> 02:41:49.133 region:rollup2
SUBJECT TO THIS LIMIT BECAUSE
02:41:46.864 --> 02:41:51.068 region:rollup2
NOT ALL APPROPRIATIONS ARE.
02:41:49.133 --> 02:41:52.603 region:rollup2
BASED ON PROP FOR AN PROP ONE
02:41:51.068 --> 02:41:54.204 region:rollup2
ELEVEN THE STATE GETS TO TAKE A
02:41:52.603 --> 02:41:56.106 region:rollup2
LOT OF APPROPRIATIONS OFF THE
02:41:54.204 --> 02:41:57.474 region:rollup2
TOP YOU DON'T COUNT REVENUES
02:41:56.106 --> 02:41:58.609 region:rollup2
THAT YOU TRANSFER TO LOCAL
02:41:57.474 --> 02:42:00.377 region:rollup2
GOVERNMENTS IN THE FORM OF
02:41:58.609 --> 02:42:01.879 region:rollup2
FINANCIAL ASSISTANCE THAT COUNTS
02:42:00.377 --> 02:42:03.147 region:rollup2
TOWARD THEIR OWN GANG LIMITS.
02:42:01.879 --> 02:42:04.381 region:rollup2
YOU DON'T HAVE ANYTHING WE'RE
02:42:03.147 --> 02:42:05.783 region:rollup2
DOING IN CALIFORNIA BECAUSE THE
02:42:04.381 --> 02:42:07.618 region:rollup2
FEDERAL GOVERNMENT SAID WE HAD
02:42:05.783 --> 02:42:10.688 region:rollup2
TO OUR COURT SAID WE HAD TO.
02:42:07.618 --> 02:42:12.222 region:rollup2
YOU DON'T HAVE DEBT SERVICE.
02:42:10.688 --> 02:42:13.190 region:rollup2
SO THOSE ARE THE THREE MAJOR
02:42:12.222 --> 02:42:14.658 region:rollup2
ONES THERE ARE OTHER ONES THAT
02:42:13.190 --> 02:42:16.827 region:rollup2
I'M I I'M NOT GOING TO GET INTO
02:42:14.658 --> 02:42:18.395 region:rollup2
BUT THE IDEA IS BEGAN LIMIT
02:42:16.827 --> 02:42:20.831 region:rollup2
APPLIES TO CERTAIN
02:42:18.395 --> 02:42:22.833 region:rollup2
APPROPRIATIONS. FROM TAX
02:42:20.831 --> 02:42:24.802 region:rollup2
PROCEEDS EACH YEAR SO THEN WHAT
02:42:22.833 --> 02:42:26.570 region:rollup2
DO YOU DO YOU GO TO STEP THREE
02:42:24.802 --> 02:42:28.405 region:rollup2
BACK UP TO THE TOP NOW ON THE
02:42:26.570 --> 02:42:30.708 region:rollup2
RIGHT. AND ESSENTIALLY YOU
02:42:28.405 --> 02:42:31.976 region:rollup2
COMPARE YOUR LIMIT. TO THE EX TO
02:42:30.708 --> 02:42:33.711 region:rollup2
THE EXPENDITURES OR THE
02:42:31.976 --> 02:42:35.179 region:rollup2
APPROPRIATIONS THAT ARE SUBJECT
02:42:33.711 --> 02:42:37.081 region:rollup2
TO THE LIMIT AND WHAT IS THE
02:42:35.179 --> 02:42:40.818 region:rollup2
CONSTITUTION SAY HERE. IT SAYS
02:42:37.081 --> 02:42:40.818 region:rollup2
THAT IF.
02:42:40.884 --> 02:42:45.456 region:rollup2
YOUR EXPENDITURES ARE YOUR
02:42:42.553 --> 02:42:47.591 region:rollup2
APPROPRIATIONS REACH YOUR LIMIT.
02:42:45.456 --> 02:42:49.560 region:rollup2
ANY REVENUES REMAINING OVER THAT
02:42:47.591 --> 02:42:51.662 region:rollup2
TWO YEAR PERIOD ARE CONSIDERED
02:42:49.560 --> 02:42:53.430 region:rollup2
EXCESS REVENUES
02:42:51.662 --> 02:42:54.632 region:rollup2
THE CONSTITUTION SAYS WHAT DO
02:42:53.430 --> 02:42:56.700 region:rollup2
YOU DO WITH EXCESS REVENUES
02:42:54.632 --> 02:42:57.935 region:rollup2
COMING DOWN A STEP FOR.
02:42:56.700 --> 02:42:59.036 region:rollup2
HALF OF THEM GO TO PROP NINETY
02:42:57.935 --> 02:43:00.638 region:rollup2
EIGHT IN THE FORM OF ADDITIONAL
02:42:59.036 --> 02:43:02.373 region:rollup2
SPENDING AND HALF OF THEM GO
02:43:00.638 --> 02:43:05.009 region:rollup2
BACK TO THE VOTERS TO TAX PAYER
02:43:02.373 --> 02:43:06.477 region:rollup2
OR TO TO TAXPAYERS AS REBATES.
02:43:05.009 --> 02:43:07.711 region:rollup2
THE LEGISLATURE HAD THE OPTION
02:43:06.477 --> 02:43:09.480 region:rollup2
OF TAKING SOME OF THESE REVENUES
02:43:07.711 --> 02:43:10.748 region:rollup2
AND SAY WELL WAIT A MINUTE MAYBE
02:43:09.480 --> 02:43:11.982 region:rollup2
WE DON'T WANT TO DO THAT EXACTLY
02:43:10.748 --> 02:43:14.485 region:rollup2
WE'RE GONNA SPEND SOME OF THEM
02:43:11.982 --> 02:43:16.954 region:rollup2
FOR NON. A REP FOR.
02:43:14.485 --> 02:43:18.489 region:rollup2
APPROPRIATIONS THAT ARE EXEMPT
02:43:16.954 --> 02:43:19.823 region:rollup2
FROM BEGAN LIMIT RIGHT AS I
02:43:18.489 --> 02:43:21.759 region:rollup2
MENTIONED THAT NOT ALL
02:43:19.823 --> 02:43:23.027 region:rollup2
APPROPRIATIONS APPLY RIGHT TO
02:43:21.759 --> 02:43:24.595 region:rollup2
BEGIN LIMIT SO THERE ARE SOME
02:43:23.027 --> 02:43:25.763 region:rollup2
THINGS YOU MAY BE ABLE TO SPEND
02:43:24.595 --> 02:43:27.197 region:rollup2
SOME OF THOSE REVENUES ARE BUT
02:43:25.763 --> 02:43:28.198 region:rollup2
THE HOPE FOR THE MOST PART. THE
02:43:27.197 --> 02:43:30.367 region:rollup2
AUTOMATIC ANSWER THE
02:43:28.198 --> 02:43:32.169 region:rollup2
CONSTITUTION GIVES IS IF WE
02:43:30.367 --> 02:43:34.538 region:rollup2
SPEND UP TO OUR LIMIT. A COUPLE
02:43:32.169 --> 02:43:37.174 region:rollup2
YEARS IN A ROW.
02:43:34.538 --> 02:43:39.209 region:rollup2
ANY REVENUES BEYOND THAT LIMIT.
02:43:37.174 --> 02:43:41.078 region:rollup2
FROM PROCEEDS TO TAXES GO BACK
02:43:39.209 --> 02:43:41.912 region:rollup2
TO THE TAXPAYERS AND GO TO PROP
02:43:41.078 --> 02:43:43.280 region:rollup2
NINETY EIGHT IN THE FORM OF
02:43:41.912 --> 02:43:47.851 region:rollup2
ADDITIONAL SPENDING.
02:43:43.280 --> 02:43:51.188 region:rollup2
SO WHY DID I TELL YOU ALL THAT.
02:43:47.851 --> 02:43:53.691 region:rollup2
IF YOU THINK ABOUT IT.
02:43:51.188 --> 02:43:55.559 region:rollup2
RAISING REVENUES TO PAY FOR
02:43:53.691 --> 02:43:57.394 region:rollup2
UNIVERSAL COVERAGE OUR EXPANDED
02:43:55.559 --> 02:43:58.429 region:rollup2
COVERAGE IN CALIFORNIA.
02:43:57.394 --> 02:44:00.464 region:rollup2
WOULD BE CONSIDERED PROCEEDS OF
02:43:58.429 --> 02:44:02.032 region:rollup2
TAXES.
02:44:00.464 --> 02:44:03.801 region:rollup2
AND WOULD GO TO SERVICE SAYS
02:44:02.032 --> 02:44:05.536 region:rollup2
HEALTH CARE.
02:44:03.801 --> 02:44:08.372 region:rollup2
THAT ARE NOT SPECIFICALLY
02:44:05.536 --> 02:44:10.407 region:rollup2
EXCLUDED FROM AGAIN LIMIT.
02:44:08.372 --> 02:44:11.942 region:rollup2
THESE ARE ALL EXPENDITURES OR
02:44:10.407 --> 02:44:14.044 region:rollup2
APPROPRIATIONS THAT WOULD BE
02:44:11.942 --> 02:44:16.246 region:rollup2
COUNTED FOR THE GANG LIMIT NOW
02:44:14.044 --> 02:44:17.781 region:rollup2
RIGHT NOW WE HAVE ACCORDING TO
02:44:16.246 --> 02:44:19.583 region:rollup2
GOVERNOR BROWN'S DEPARTMENT
02:44:17.781 --> 02:44:21.185 region:rollup2
FINANCE WE HAVE ABOUT TWELVE
02:44:19.583 --> 02:44:23.354 region:rollup2
BILLION DOLLARS IN WHAT'S CALLED
02:44:21.185 --> 02:44:24.421 region:rollup2
ROOM. UNDERNEATH THE LIMITIN
02:44:23.354 --> 02:44:26.256 region:rollup2
OTHER WORDS WE'RE NOT AT THE
02:44:24.421 --> 02:44:28.392 region:rollup2
LIMIT WERE BELOW THE LIMIT FOR
02:44:26.256 --> 02:44:29.693 region:rollup2
THE APPROPRIATIONS THAT MATTER.
02:44:28.392 --> 02:44:31.428 region:rollup2
WE HAVE TWELVE BILLION DOLLARS
02:44:29.693 --> 02:44:33.197 region:rollup2
IN ROOM WHAT IF WE DECIDED TO DO
02:44:31.428 --> 02:44:35.365 region:rollup2
SINGLE PAYER IN CALIFORNIA AND
02:44:33.197 --> 02:44:36.533 region:rollup2
WE SOMEHOW GOT A TWO HUNDRED UP
02:44:35.365 --> 02:44:37.668 region:rollup2
ABOUT TWO HUNDRED BILLION DOLLAR
02:44:36.533 --> 02:44:39.837 region:rollup2
TAX INCREASE THROUGH THE
02:44:37.668 --> 02:44:41.004 region:rollup2
CALIFORNIA LEGISLATURE.
02:44:39.837 --> 02:44:42.239 region:rollup2
AND APPROPRIATE A TWO HUNDRED
02:44:41.004 --> 02:44:43.741 region:rollup2
BILLION DOLLARS TOWARD A SINGLE
02:44:42.239 --> 02:44:45.075 region:rollup2
PAYER SYSTEM
02:44:43.741 --> 02:44:47.578 region:rollup2
I'M WHAT YOU CAN SEE HAPPENING
02:44:45.075 --> 02:44:48.946 region:rollup2
IS YOU WOULD BY DEFINITION BE
02:44:47.578 --> 02:44:50.314 region:rollup2
EXCEEDING AGAIN LIMIT BECAUSE
02:44:48.946 --> 02:44:52.116 region:rollup2
YOU ONLY HAVE ABOUT TWELVE
02:44:50.314 --> 02:44:54.118 region:rollup2
BILLION DOLLARS IN ROOM. SO
02:44:52.116 --> 02:44:56.086 region:rollup2
ANYTHING THAT GOES BEYOND ANY
02:44:54.118 --> 02:44:57.821 region:rollup2
APPROPRIATIONS FROM PROCEEDS OF
02:44:56.086 --> 02:44:59.757 region:rollup2
TAXES THAT GO BEYOND TWELVE
02:44:57.821 --> 02:45:00.657 region:rollup2
BILLION AT THIS POINT AND THE
02:44:59.757 --> 02:45:02.926 region:rollup2
NUMBER MAY MOVE AROUND A LITTLE
02:45:00.657 --> 02:45:06.330 region:rollup2
BIT. WOULD BE CONSIDERED ACCESS
02:45:02.926 --> 02:45:08.365 region:rollup2
REVENUES AND WOULD HAVE TO BUY
02:45:06.330 --> 02:45:09.767 region:rollup2
ACCORDING TO THE CONSTITUTION.
02:45:08.365 --> 02:45:11.268 region:rollup2
GO BACK TO THE TAXPAYERS AND GO
02:45:09.767 --> 02:45:12.803 region:rollup2
TO ADDITIONAL PROPOSITION NINETY
02:45:11.268 --> 02:45:14.405 region:rollup2
EIGHT SPENDING AND COULD NOT BE
02:45:12.803 --> 02:45:16.306 region:rollup2
USED FOR THE PURPOSE FOR WHICH
02:45:14.405 --> 02:45:16.907 region:rollup2
THE REVENUES WERE RAISED. IN
02:45:16.306 --> 02:45:19.209 region:rollup2
OTHER WORDS UNIVERSAL COVERAGE
02:45:16.907 --> 02:45:21.145 region:rollup2
SO.
02:45:19.209 --> 02:45:22.513 region:rollup2
KEN THE LEGISLATURE IF IT WANTED
02:45:21.145 --> 02:45:24.515 region:rollup2
TO ADDRESS THIS ISSUE.
02:45:22.513 --> 02:45:25.549 region:rollup2
AND IT'S A SIMILAR ANSWER TO
02:45:24.515 --> 02:45:27.284 region:rollup2
WHAT I GAVE BEFORE I'M PROP
02:45:25.549 --> 02:45:30.087 region:rollup2
NINETY EIGHT CALIFORNIA VOTERS
02:45:27.284 --> 02:45:31.789 region:rollup2
ARE USED TO SEEING. A REQUEST TO
02:45:30.087 --> 02:45:33.157 region:rollup2
AMEND OUR STATE CONSTITUTION IT
02:45:31.789 --> 02:45:35.025 region:rollup2
HAPPENS EVERY TWO YEARS IT'S
02:45:33.157 --> 02:45:36.794 region:rollup2
GONNA HAPPEN AGAIN THIS YEAR THE
02:45:35.025 --> 02:45:38.595 region:rollup2
LEGISLATURE COULD ADVANCE A
02:45:36.794 --> 02:45:40.330 region:rollup2
CONSTITUTIONAL AMENDMENT. UP
02:45:38.595 --> 02:45:42.032 region:rollup2
THAT NOT ONLY PASSED VOTERS TO
02:45:40.330 --> 02:45:44.034 region:rollup2
RAISE THE TAXES NECESSARY TO
02:45:42.032 --> 02:45:45.369 region:rollup2
FUND THE SYSTEM THAT EXCLUDES
02:45:44.034 --> 02:45:47.004 region:rollup2
THE REVENUES SPECIFICALLY FROM
02:45:45.369 --> 02:45:48.772 region:rollup2
THE PROP NINETY EIGHT GUARANTEE
02:45:47.004 --> 02:45:51.442 region:rollup2
IF IT WANTED TO DO SO BUT COULD
02:45:48.772 --> 02:45:52.876 region:rollup2
ALSO ASK VOTERS TO REVISED AGAIN
02:45:51.442 --> 02:45:54.945 region:rollup2
LIMIT IN SUCH A WAY.
02:45:52.876 --> 02:45:56.246 region:rollup2
THAT THESE NEW EXPENDITURES
02:45:54.945 --> 02:45:58.415 region:rollup2
THESE NEW APPROPRIATIONS WOULD
02:45:56.246 --> 02:46:00.417 region:rollup2
NOT BELOW PASSED AGAIN LIMIT.
02:45:58.415 --> 02:46:02.486 region:rollup2
AND BE COUNTED SORT OF AS
02:46:00.417 --> 02:46:04.154 region:rollup2
EXCESS REVENUES NOT BEING ABLE
02:46:02.486 --> 02:46:06.323 region:rollup2
TO BE USED ESSENTIALLY FOR
02:46:04.154 --> 02:46:08.926 region:rollup2
UNIVERSAL COVERAGE.
02:46:06.323 --> 02:46:10.461 region:rollup2
SO HOPEFULLY THAT WAS I I TRIED
02:46:08.926 --> 02:46:11.995 region:rollup2
TO MAKE THAT AS CLEAR AS I COULD
02:46:10.461 --> 02:46:13.564 region:rollup2
HOPEFULLY IT WAS YOU KNOW IT WAS
02:46:11.995 --> 02:46:14.898 region:rollup2
CLEAR ENOUGH I'M I'M HAPPY TO
02:46:13.564 --> 02:46:15.999 region:rollup2
TAKE QUESTIONS FIRST I WANTED TO
02:46:14.898 --> 02:46:17.534 region:rollup2
GIVE YOU JUST A FEW CAN
02:46:15.999 --> 02:46:19.236 region:rollup2
CONCLUDING THOUGHTS.
02:46:17.534 --> 02:46:20.637 region:rollup2
IT'S THAT THAT THE FIRST KEY
02:46:19.236 --> 02:46:22.272 region:rollup2
POINT TO KEEP THAT THE KEEP IN
02:46:20.637 --> 02:46:24.942 region:rollup2
MIND HERE IS THAT.
02:46:22.272 --> 02:46:26.343 region:rollup2
EFFORTS TO ITS AT THE PRICE AS
02:46:24.942 --> 02:46:27.478 region:rollup2
A PROP NINETY EIGHT AND AGAIN
02:46:26.343 --> 02:46:28.979 region:rollup2
LIMIT BOTH CONSTRAIN THE
02:46:27.478 --> 02:46:31.815 region:rollup2
LEGISLATURE'S ABILITY.
02:46:28.979 --> 02:46:33.984 region:rollup2
TO SORT OF ENACT MAJOR NEW.
02:46:31.815 --> 02:46:35.586 region:rollup2
PROGRAM EXPENDITURES THIS ISN'T
02:46:33.984 --> 02:46:37.254 region:rollup2
SOMETHING THAT APPLIES JUST TO
02:46:35.586 --> 02:46:38.355 region:rollup2
UNIVERSAL COVERAGE WERE TALKING
02:46:37.254 --> 02:46:40.023 region:rollup2
ABOUT IT IN THE CONTEXT OF
02:46:38.355 --> 02:46:40.991 region:rollup2
UNIVERSAL COVERAGE HERE BUT IF
02:46:40.023 --> 02:46:42.993 region:rollup2
THE STATE WANTED TO MAKE
02:46:40.991 --> 02:46:44.561 region:rollup2
SUBSTANTIAL INVESTMENT IN HIGHER
02:46:42.993 --> 02:46:47.197 region:rollup2
EDUCATION THE YOU SEE IN THE CS
02:46:44.561 --> 02:46:48.932 region:rollup2
YOU. ARE IN AFFORDABLE CHILDCARE
02:46:47.197 --> 02:46:50.501 region:rollup2
ON IN A RANGE OF PROGRAMS AND
02:46:48.932 --> 02:46:52.169 region:rollup2
SERVICES IT WOULD STILL BE
02:46:50.501 --> 02:46:53.403 region:rollup2
DEALING. WITH THESE TYPES OF
02:46:52.169 --> 02:46:54.571 region:rollup2
ISSUES I'M BRINGING THEM UP
02:46:53.403 --> 02:46:56.340 region:rollup2
SPECIFICALLY BECAUSE WE'RE
02:46:54.571 --> 02:46:57.641 region:rollup2
TALKING ABOUT IT IN THE CONTEXT
02:46:56.340 --> 02:46:59.276 region:rollup2
OF UNIVERSAL COVERAGE.
02:46:57.641 --> 02:47:00.811 region:rollup2
I ALSO WANTED TO NOTE THAT SOME
02:46:59.276 --> 02:47:02.112 region:rollup2
ADVOCATES SPECIFICALLY SOME MAP
02:47:00.811 --> 02:47:04.114 region:rollup2
I'M PROPONENTS OF SENATE BILL
02:47:02.112 --> 02:47:05.249 region:rollup2
FIVE SIXTY TWO. HAVE ASSERTED
02:47:04.114 --> 02:47:07.217 region:rollup2
THAT THE LEGISLATURE COULD
02:47:05.249 --> 02:47:09.887 region:rollup2
ADDRESS THESE CONSTITUTIONAL
02:47:07.217 --> 02:47:11.421 region:rollup2
CONSTRAINTS LEGISLATIVELY I'M
02:47:09.887 --> 02:47:12.923 region:rollup2
WITHOUT GOING TO THE VOTERS
02:47:11.421 --> 02:47:15.058 region:rollup2
WITHOUT CONSULTING THE VOTERS
02:47:12.923 --> 02:47:16.860 region:rollup2
AND BASED ON OUR ANALYSIS OF YOU
02:47:15.058 --> 02:47:18.061 region:rollup2
KNOW GOOD WORK THE LA HOW HAS
02:47:16.860 --> 02:47:19.329 region:rollup2
DONE OF OUR READ OF THE STATE
02:47:18.061 --> 02:47:21.732 region:rollup2
CONSTITUTION.
02:47:19.329 --> 02:47:23.066 region:rollup2
OUR RESPONSE TO THAT IS
02:47:21.732 --> 02:47:24.601 region:rollup2
ESSENTIALLY IT SEEMS VERY
02:47:23.066 --> 02:47:26.870 region:rollup2
UNLIKELY THAT THE LEGISLATURE
02:47:24.601 --> 02:47:27.538 region:rollup2
COULD ADDRESS THE PROBLEM POSED
02:47:26.870 --> 02:47:29.940 region:rollup2
BY THE CAMERAMAN.
02:47:27.538 --> 02:47:31.041 region:rollup2
LEGISLATIVELY WITHOUT GOING TO
02:47:29.940 --> 02:47:33.010 region:rollup2
THE VOTERS.
02:47:31.041 --> 02:47:34.711 region:rollup2
AND THAT GOING AROUND PROP
02:47:33.010 --> 02:47:36.847 region:rollup2
NINETY EIGHT COULD TRIGGER A
02:47:34.711 --> 02:47:38.682 region:rollup2
LAWSUIT JUST BASED ON THESE
02:47:36.847 --> 02:47:40.450 region:rollup2
VARYING INTERPRETATIONS PALM
02:47:38.682 --> 02:47:42.052 region:rollup2
WHICH WOULD PUT. UNIVERSAL
02:47:40.450 --> 02:47:43.520 region:rollup2
COVERAGE ANY NEW PROGRAMS AND
02:47:42.052 --> 02:47:46.490 region:rollup2
SERVICES PUT ON CLICK PUT IN
02:47:43.520 --> 02:47:48.592 region:rollup2
PLACE ON A VERY SHAKY LEGAL
02:47:46.490 --> 02:47:49.893 region:rollup2
FOUNDATION WHICH IS PROBABLY NOT
02:47:48.592 --> 02:47:52.195 region:rollup2
WHERE THE LEGISLATURE WOULD WANT
02:47:49.893 --> 02:47:55.098 region:rollup2
TO BE WHEN IT'S ATTEMPTING UP TO
02:47:52.195 --> 02:47:56.600 region:rollup2
PROVIDE. A RANGE OF ROBUST OF
02:47:55.098 --> 02:47:58.936 region:rollup2
SERVICES IN THE HEALTH CARE AND
02:47:56.600 --> 02:48:01.905 region:rollup2
ARENA TO CALIFORNIA AND SO.
02:47:58.936 --> 02:48:03.674 region:rollup2
JUST THE BOTTOM LINE HERE.
02:48:01.905 --> 02:48:05.509 region:rollup2
IF IT ASKING CALIFORNIA VOTERS
02:48:03.674 --> 02:48:07.444 region:rollup2
TO REMOVE THESE CONSTRAINTS
02:48:05.509 --> 02:48:08.078 region:rollup2
WOULD PROBABLY BE A BETTER WAY
02:48:07.444 --> 02:48:12.115 region:rollup2
FORWARD AND I'LL CONCLUDE THEIR
02:48:08.078 --> 02:48:14.251 region:rollup2
THANK YOU.
02:48:12.115 --> 02:48:15.786 region:rollup2
I THINK IT'S OKAY WOULD LIKE TO.
02:48:14.251 --> 02:48:17.654 region:rollup2
YOU DON'T TIRE FAN ALL OF THAT
02:48:15.786 --> 02:48:20.123 region:rollup2
IF YOU'RE GOOD WITH THAT SO.
02:48:17.654 --> 02:48:21.558 region:rollup2
OUR NEXT AND I AM SORRY I AM.
02:48:20.123 --> 02:48:23.460 region:rollup2
BEN BEN JOHNSON IS GOING TO
02:48:21.558 --> 02:48:25.095 region:rollup2
SPEAK TO US A. BEEN IS A.
02:48:23.460 --> 02:48:26.496 region:rollup2
OF FISCAL POLICY IN THEM
02:48:25.095 --> 02:48:28.365 region:rollup2
ANALYST WITH THE LEGISLATIVE
02:48:26.496 --> 02:48:28.966 region:rollup2
ANALYST'S OFFICE BEEN PLEASE.
02:48:28.365 --> 02:48:30.767 region:rollup2
THANK YOU.
02:48:28.966 --> 02:48:31.535 region:rollup2
YEAH SO A BEN JOHNSON AT THE LA
02:48:30.767 --> 02:48:33.337 region:rollup2
AUTO.
02:48:31.535 --> 02:48:35.038 region:rollup2
AND TO BRIEFLY TOUCH ON MY
02:48:33.337 --> 02:48:35.772 region:rollup2
AGENDA OUR ARE ACTUALLY HERE I
02:48:35.038 --> 02:48:37.674 region:rollup2
HAVE A HANDOUT THAT I BELIEVE
02:48:35.772 --> 02:48:38.909 region:rollup2
WAS DISTRIBUTED YOUR PACKETS AND
02:48:37.674 --> 02:48:40.210 region:rollup2
IT'LL FORM THE BASIS OF MY
02:48:38.909 --> 02:48:41.845 region:rollup2
REMARKS.
02:48:40.210 --> 02:48:43.780 region:rollup2
BRIEFLY GO OVER MY OUR OUR
02:48:41.845 --> 02:48:45.315 region:rollup2
AGENDA HERE TODAY OF FIRST IN
02:48:43.780 --> 02:48:46.650 region:rollup2
OPEN BY TOUCHING BRIEFLY ON
02:48:45.315 --> 02:48:48.619 region:rollup2
HEALTH CARE COVERAGE AND
02:48:46.650 --> 02:48:50.253 region:rollup2
EXPENDITURES UNDER THE EXISTING
02:48:48.619 --> 02:48:50.921 region:rollup2
SYSTEM. IN THE STATE THEN
02:48:50.253 --> 02:48:53.490 region:rollup2
PRESENT.
02:48:50.921 --> 02:48:55.225 region:rollup2
ARE ELIA ANALYSIS OF A PUBLICLY
02:48:53.490 --> 02:48:57.260 region:rollup2
FINANCED STATEWIDE HEALTH CARE
02:48:55.225 --> 02:48:58.862 region:rollup2
PROGRAM. AND THEN FINALLY
02:48:57.260 --> 02:49:00.097 region:rollup2
CONCLUDE ACTUALLY MY PORTION OF
02:48:58.862 --> 02:49:01.398 region:rollup2
THEIR MUCH OF OUR REMARKS
02:49:00.097 --> 02:49:03.200 region:rollup2
WITHOUT BY INTRODUCING
02:49:01.398 --> 02:49:05.202 region:rollup2
ASSORTMENT OF POLICY APPROACHES
02:49:03.200 --> 02:49:06.937 region:rollup2
TO EXTENDING COVERAGE TO THE
02:49:05.202 --> 02:49:08.438 region:rollup2
REMAINING HONORS ON IN SHARED.
02:49:06.937 --> 02:49:09.806 region:rollup2
THROUGH THE EXISTING HEALTH
02:49:08.438 --> 02:49:10.841 region:rollup2
CARE SYSTEM THEN I'LL TURN IT
02:49:09.806 --> 02:49:12.442 region:rollup2
OVER TO MY COLLEAGUE BRIAN
02:49:10.841 --> 02:49:13.977 region:rollup2
MILLER TO DISCUSS VARIOUS
02:49:12.442 --> 02:49:15.278 region:rollup2
FINANCING CONSIDERATIONS AND
02:49:13.977 --> 02:49:17.047 region:rollup2
OPTIONS.
02:49:15.278 --> 02:49:17.848 region:rollup2
SO TURNING TO PAGE ONE OF THE
02:49:17.047 --> 02:49:20.484 region:rollup2
HAND OUT.
02:49:17.848 --> 02:49:22.319 region:rollup2
WOULD JUST THEM INITIALLY NOTE
02:49:20.484 --> 02:49:24.187 region:rollup2
THAT NINETY THREE PERCENT.
02:49:22.319 --> 02:49:25.822 region:rollup2
WELL WHICH OF A QUICKER.
02:49:24.187 --> 02:49:27.357 region:rollup2
GREAT TURNING TO PAGE ONE.
02:49:25.822 --> 02:49:28.458 region:rollup2
AT NINETY THREE PERCENT OF
02:49:27.357 --> 02:49:30.227 region:rollup2
CALIFORNIANS.
02:49:28.458 --> 02:49:32.396 region:rollup2
WE ESTIMATE ARE CURRENTLY
02:49:30.227 --> 02:49:33.930 region:rollup2
INSURED AND THIS MARKS AN
02:49:32.396 --> 02:49:36.066 region:rollup2
INCREASE FROM ABOUT EIGHTY THREE
02:49:33.930 --> 02:49:37.501 region:rollup2
PERCENT OF CALIFORNIANS WHO HAVE
02:49:36.066 --> 02:49:39.936 region:rollup2
HEALTH INSURANCE.
02:49:37.501 --> 02:49:41.872 region:rollup2
IN TWENTY THIRTEEN CHANGES THAT
02:49:39.936 --> 02:49:43.674 region:rollup2
ARE LARGELY RELATED WE THINK TO
02:49:41.872 --> 02:49:45.842 region:rollup2
THE AFFORDABLE CARE ACT.
02:49:43.674 --> 02:49:48.478 region:rollup2
I MEAN ACTUALLY FLIP AHEAD TO
02:49:45.842 --> 02:49:51.314 region:rollup2
THE FIGURE ON PAGE TWO HERE.
02:49:48.478 --> 02:49:52.082 region:rollup2
TO BREAK BRIEFLY DESCRIBE WHERE
02:49:51.314 --> 02:49:53.517 region:rollup2
CALIFORNIANS OBTAIN THEIR
02:49:52.082 --> 02:49:55.552 region:rollup2
COVERAGE
02:49:53.517 --> 02:49:56.086 region:rollup2
SO JUMPING DOWN ACTUALLY TO THE
02:49:55.552 --> 02:49:57.988 region:rollup2
BOTTOM.
02:49:56.086 --> 02:49:59.556 region:rollup2
WE ESTIMATE THAT THE LARGEST
02:49:57.988 --> 02:50:01.324 region:rollup2
PORTION OF CALIFORNIANS PROBABLY
02:49:59.556 --> 02:50:03.460 region:rollup2
A LITTLE OVER FIFTEEN MILLION.
02:50:01.324 --> 02:50:04.728 region:rollup2
INDIVIDUALS OBTAIN COVERAGE
02:50:03.460 --> 02:50:05.595 region:rollup2
THROUGH THEIR EMPLOYERS OR
02:50:04.728 --> 02:50:07.197 region:rollup2
THROUGH EMPLOYER SPONSORED
02:50:05.595 --> 02:50:09.199 region:rollup2
INSURANCE.
02:50:07.197 --> 02:50:10.333 region:rollup2
ANOTHER AN ADDITIONAL THIRTEEN
02:50:09.199 --> 02:50:11.835 region:rollup2
TO FOURTEEN MILLION OBTAIN
02:50:10.333 --> 02:50:13.570 region:rollup2
COVERAGE THROUGH MEDICAID OUT
02:50:11.835 --> 02:50:15.205 region:rollup2
THE STATE'S MEDICAID PROGRAM FOR
02:50:13.570 --> 02:50:16.807 region:rollup2
LOW INCOME RESIDENTS AND THEN
02:50:15.205 --> 02:50:18.642 region:rollup2
FOUR TO FIVE MILLION OBTAIN
02:50:16.807 --> 02:50:19.843 region:rollup2
COVERAGE THROUGH MEDICARE WHICH
02:50:18.642 --> 02:50:21.144 region:rollup2
IS FOR THE ELDERLY AND.
02:50:19.843 --> 02:50:23.313 region:rollup2
AND CERTAIN DISABLED
02:50:21.144 --> 02:50:24.915 region:rollup2
POPULATIONS.
02:50:23.313 --> 02:50:26.650 region:rollup2
FINALLY THE INDIVIDUAL MARKET.
02:50:24.915 --> 02:50:29.252 region:rollup2
PROVIDES COVERAGE TO TWO TO
02:50:26.650 --> 02:50:31.655 region:rollup2
THREE MILLION CALIFORNIANS AND
02:50:29.252 --> 02:50:33.590 region:rollup2
THEN WE LEFT AFTER SOME SMALLER
02:50:31.655 --> 02:50:36.026 region:rollup2
INSURANCE PROGRAMS WITH A
02:50:33.590 --> 02:50:37.761 region:rollup2
RESIDUAL UNINSURED POPULATION OF
02:50:36.026 --> 02:50:40.163 region:rollup2
ABOUT THREE MILLION PEOPLE WHICH
02:50:37.761 --> 02:50:44.434 region:rollup2
I WILL. GO INTO NEXT
02:50:40.163 --> 02:50:46.203 region:rollup2
TO DESCRIBE A LITTLE FURTHER.
02:50:44.434 --> 02:50:48.472 region:rollup2
SO THERE ABOUT THREE MILLION
02:50:46.203 --> 02:50:51.007 region:rollup2
REMAINING UNINSURED AND WE WOULD
02:50:48.472 --> 02:50:52.776 region:rollup2
DIVIDE THESE INDIVIDUALS AND TO.
02:50:51.007 --> 02:50:54.978 region:rollup2
PROBABLY TWO CATEGORIES THE
02:50:52.776 --> 02:50:56.213 region:rollup2
FIRST WHICH ACCOUNTS FOR LESS
02:50:54.978 --> 02:50:58.215 region:rollup2
THAN TO MILLION OF THEIR
02:50:56.213 --> 02:50:59.549 region:rollup2
REMAINING AND THEN SHARED ARE
02:50:58.215 --> 02:51:01.251 region:rollup2
UNDOCUMENTED ENCOURAGE
02:50:59.549 --> 02:51:03.553 region:rollup2
IMMIGRANTS THE MAJORITY OF WHOM
02:51:01.251 --> 02:51:04.221 region:rollup2
ARE LOW INCOME. LOW INCOME SO
02:51:03.553 --> 02:51:06.790 region:rollup2
THAT THEY WOULD.
02:51:04.221 --> 02:51:08.091 region:rollup2
QUALIFY FOR MEDI CAL OR SUB
02:51:06.790 --> 02:51:09.226 region:rollup2
FEDERAL HEALTH INSURANCE
02:51:08.091 --> 02:51:10.727 region:rollup2
SUBSIDIES THROUGH COVERED
02:51:09.226 --> 02:51:13.196 region:rollup2
CALIFORNIA IF THEY HAD
02:51:10.727 --> 02:51:14.931 region:rollup2
DOCUMENTED IMMIGRATION STATUS.
02:51:13.196 --> 02:51:16.566 region:rollup2
THE SECOND CATEGORY COMPRISING A
02:51:14.931 --> 02:51:18.034 region:rollup2
LITTLE MORE THAN MILLION
02:51:16.566 --> 02:51:19.736 region:rollup2
INDIVIDUALS ACROSS THE STATE.
02:51:18.034 --> 02:51:21.071 region:rollup2
COMPRISES CITIZENS AND
02:51:19.736 --> 02:51:22.205 region:rollup2
IMMIGRANTS WITH DOCUMENTED
02:51:21.071 --> 02:51:24.407 region:rollup2
STATUS.
02:51:22.205 --> 02:51:25.041 region:rollup2
AND WE ESTIMATE THAT ABOUT TWO
02:51:24.407 --> 02:51:32.382 region:rollup2
THIRDS OF THESE SHARON SUBSIDIES
02:51:25.041 --> 02:51:33.316 region:rollup2
THROUGH
02:51:32.382 --> 02:51:35.752 region:rollup2
COVERED CALIFORNIA.
02:51:33.316 --> 02:51:39.089 region:rollup2
BUT THEY'VE ELECTED NOT TO
02:51:35.752 --> 02:51:40.891 region:rollup2
ENROLL THE REMAINING THIRD OF
02:51:39.089 --> 02:51:42.359 region:rollup2
THE REMAINING ANY CHAIRED OUR
02:51:40.891 --> 02:51:44.561 region:rollup2
RESIDENTS THAT WE ESTIMATE HAVE
02:51:42.359 --> 02:51:46.563 region:rollup2
INCOMES TOO HIGH TO QUALIFY FOR
02:51:44.561 --> 02:51:48.298 region:rollup2
FEDERAL INSURANCE SUBSIDIES TO
02:51:46.563 --> 02:51:50.467 region:rollup2
RECOVER CALIFORNIA. CLOSER
02:51:48.298 --> 02:51:51.434 region:rollup2
INDIVIDUALS WHO ARE IN ABOUT
02:51:50.467 --> 02:51:53.770 region:rollup2
FOUR HUNDRED PERCENT OF THE
02:51:51.434 --> 02:51:54.671 region:rollup2
FEDERAL POVERTY LINE WHICH FOR A
02:51:53.770 --> 02:51:56.540 region:rollup2
FAMILY FOR WOULD BE.
02:51:54.671 --> 02:51:59.142 region:rollup2
ABOUT A HUNDRED THOUSAND
02:51:56.540 --> 02:51:59.976 region:rollup2
DOLLARS.
02:51:59.142 --> 02:52:01.411 region:rollup2
NEXT I'M GONNA TOUCH JOHN
02:51:59.976 --> 02:52:03.380 region:rollup2
STATEWIDE HEALTHCARE
02:52:01.411 --> 02:52:05.148 region:rollup2
EXPENDITURES HERE STILL BONTA AT
02:52:03.380 --> 02:52:05.782 region:rollup2
THE BOTTOM OF PAGE THREE. WE
02:52:05.148 --> 02:52:06.750 region:rollup2
ESTIMATE THAT THERE FOR THERE'S
02:52:05.782 --> 02:52:07.651 region:rollup2
FOUR HUNDRED BILLION DOLLARS IN
02:52:06.750 --> 02:52:09.152 region:rollup2
TOTAL HEALTHCARE SPENDING IN
02:52:07.651 --> 02:52:10.420 region:rollup2
CALIFORNIA IN THE FISCAL YEAR
02:52:09.152 --> 02:52:11.988 region:rollup2
TWENTY SEVENTEEN EIGHTEEN AND
02:52:10.420 --> 02:52:14.357 region:rollup2
THIS IS FROM ALL PUBLIC AND
02:52:11.988 --> 02:52:17.194 region:rollup2
PRIVATE SOURCES SO IT INCLUDES.
02:52:14.357 --> 02:52:18.828 region:rollup2
I NUMBER OF DIFFERENT PROGRAMS
02:52:17.194 --> 02:52:21.031 region:rollup2
ARE SOURCES THAT OUT TOUCH ON.
02:52:18.828 --> 02:52:23.633 region:rollup2
HERE VERY SHORTLY.
02:52:21.031 --> 02:52:25.068 region:rollup2
FOR ON BEEN TERMS OF PER CAPITA
02:52:23.633 --> 02:52:29.806 region:rollup2
EXPENDITURES THIS COMES TO ABOUT
02:52:25.068 --> 02:52:31.808 region:rollup2
TEN THOUSAND DOLLARS PER PERSON.
02:52:29.806 --> 02:52:34.044 region:rollup2
FIGURED CHIU HERE BREAKS DOWN
02:52:31.808 --> 02:52:36.346 region:rollup2
THE EXPENDITURES BY PAYER OR
02:52:34.044 --> 02:52:37.814 region:rollup2
PAYER TYPE AND AS WE CAN SEE
02:52:36.346 --> 02:52:40.951 region:rollup2
EMPLOYER SPONSORED INSURANCE
02:52:37.814 --> 02:52:41.818 region:rollup2
THAT COVERS THE MOST INDIVIDUALS
02:52:40.951 --> 02:52:43.220 region:rollup2
AND IT WROTE WE THINK IT
02:52:41.818 --> 02:52:44.354 region:rollup2
ACCOUNTS FOR MOST THIS.
02:52:43.220 --> 02:52:44.854 region:rollup2
THE HIGHEST PROPORTION OF
02:52:44.354 --> 02:52:47.157 region:rollup2
SPENDING.
02:52:44.854 --> 02:52:49.359 region:rollup2
IN TERMS OF SPECS MANAGERS
02:52:47.157 --> 02:52:52.329 region:rollup2
ACROSS THE STATE AT BETWEEN
02:52:49.359 --> 02:52:54.397 region:rollup2
HUNDRED HUNDRED FIFTY BILLION
02:52:52.329 --> 02:52:56.132 region:rollup2
ARE YEAH SOME AND MEDIAN
02:52:54.397 --> 02:52:57.133 region:rollup2
ESTIMATE OF HUNDRED TWENTY FIVE
02:52:56.132 --> 02:52:58.168 region:rollup2
HUNDRED AND THIRTY BILLION
02:52:57.133 --> 02:53:00.136 region:rollup2
DOLLARS.
02:52:58.168 --> 02:53:01.037 region:rollup2
IN TWENTY SEVENTEEN EIGHTEEN
02:53:00.136 --> 02:53:02.772 region:rollup2
THE NEXT.
02:53:01.037 --> 02:53:04.708 region:rollup2
LARGEST SOURCE OF.
02:53:02.772 --> 02:53:06.977 region:rollup2
HEALTHCARE SPENDING IN THE
02:53:04.708 --> 02:53:09.646 region:rollup2
STATE IS MEDI CAL AT.
02:53:06.977 --> 02:53:11.915 region:rollup2
ABOUT A HUNDRED BILLION DOLLARS
02:53:09.646 --> 02:53:14.184 region:rollup2
AND THEN MEDICARE AT ABOUT
02:53:11.915 --> 02:53:17.487 region:rollup2
SEVENTY FIVE BILLION DOLLARS.
02:53:14.184 --> 02:53:20.490 region:rollup2
YOU HAVE ALSO SEE OTHER THAN.
02:53:17.487 --> 02:53:22.259 region:rollup2
IN TERMS OF PREMIUMS THERE IS A
02:53:20.490 --> 02:53:25.128 region:rollup2
PORTION THAT IS SOME FORM OF OUT
02:53:22.259 --> 02:53:26.830 region:rollup2
OF POCKET EXPENDITURES AND THE
02:53:25.128 --> 02:53:28.231 region:rollup2
BACK COMPRISES COPAYS AND
02:53:26.830 --> 02:53:30.934 region:rollup2
DEDUCTIBLES THAT PEOPLE
02:53:28.231 --> 02:53:32.202 region:rollup2
INDIVIDUALS PAY WHEN THEY VISIT
02:53:30.934 --> 02:53:33.770 region:rollup2
THE DOCTOR.
02:53:32.202 --> 02:53:34.371 region:rollup2
TURNING TO PAGE FIVE.
02:53:33.770 --> 02:53:35.472 region:rollup2
WE ESTIMATE THAT ABOUT TWO
02:53:34.371 --> 02:53:36.406 region:rollup2
HUNDRED BILLION DOLLARS IN TOTAL
02:53:35.472 --> 02:53:37.340 region:rollup2
HEALTHCARE SPENDING IN THE STATE
02:53:36.406 --> 02:53:38.575 region:rollup2
COMES FROM PUBLIC AS OPPOSED TO
02:53:37.340 --> 02:53:39.809 region:rollup2
PRIVATE SOURCES WITH THE MAJOR
02:53:38.575 --> 02:53:41.278 region:rollup2
PROGRAMS MEDI CAL MEDICARE AND
02:53:39.809 --> 02:53:42.579 region:rollup2
THE FEDERAL HEALTH INSURANCE
02:53:41.278 --> 02:53:43.880 region:rollup2
SUBSIDIES THAT ARE AVAILABLE
02:53:42.579 --> 02:53:46.149 region:rollup2
THROUGH COVERED CALIFORNIA.
02:53:43.880 --> 02:53:48.184 region:rollup2
REALLY COMPRISING THE BULK OF
02:53:46.149 --> 02:53:49.986 region:rollup2
PUBLIC SPENDING. THERE IS ALSO
02:53:48.184 --> 02:53:51.154 region:rollup2
AN INDIRECT FORM OF PUBLIC
02:53:49.986 --> 02:53:52.622 region:rollup2
SUPPORT FOR.
02:53:51.154 --> 02:53:54.658 region:rollup2
HEALTHCARE INSURANCE AND THAT
02:53:52.622 --> 02:53:56.226 region:rollup2
IS THE TAX EXCLUSION OF EMPLOYER
02:53:54.658 --> 02:53:57.894 region:rollup2
SPONSORED HEALTH INSURANCE
02:53:56.226 --> 02:53:58.962 region:rollup2
FEDERAL AND STATE GOVERNMENTS
02:53:57.894 --> 02:54:01.665 region:rollup2
EXCLUDE.
02:53:58.962 --> 02:54:02.265 region:rollup2
FROM INCOME TAXES INCOMES THAT
02:54:01.665 --> 02:54:03.867 region:rollup2
EMPLOYEES RECEIVE IN THE FORM
02:54:02.265 --> 02:54:06.102 region:rollup2
OF.
02:54:03.867 --> 02:54:07.504 region:rollup2
INSURANCE BENEFITS AND WE
02:54:06.102 --> 02:54:09.172 region:rollup2
ESTIMATE THIS BENEFIT TO BE
02:54:07.504 --> 02:54:10.840 region:rollup2
WORTH BETWEEN FORTY AND FIFTY
02:54:09.172 --> 02:54:11.541 region:rollup2
BILLION DOLLARS IN FOREGONE
02:54:10.840 --> 02:54:13.476 region:rollup2
REVENUE.
02:54:11.541 --> 02:54:14.711 region:rollup2
TO THE FEDERAL AND STATE
02:54:13.476 --> 02:54:16.112 region:rollup2
GOVERNMENT ABOUT SEVENTY FIVE
02:54:14.711 --> 02:54:19.783 region:rollup2
PERCENT OF WHICH.
02:54:16.112 --> 02:54:20.250 region:rollup2
IS IN IS IN TERMS OF FOREGONE
02:54:19.783 --> 02:54:20.817 region:rollup2
REVENUE TO THE FEDERAL
02:54:20.250 --> 02:54:22.285 region:rollup2
GOVERNMENT.
02:54:20.817 --> 02:54:23.787 region:rollup2
ALL TOLD FEDERAL SPENDING
02:54:22.285 --> 02:54:24.888 region:rollup2
ACCOUNTS FOR ABOUT THREE FOURTHS
02:54:23.787 --> 02:54:25.588 region:rollup2
OF THE TWO HUNDRED BILLION
02:54:24.888 --> 02:54:29.125 region:rollup2
DOLLARS IN.
02:54:25.588 --> 02:54:30.126 region:rollup2
IN TOTAL PUBLIC SPENDING ON
02:54:29.125 --> 02:54:31.995 region:rollup2
MEDICARE OUT FORM IT.
02:54:30.126 --> 02:54:34.431 region:rollup2
FEDERAL SPENDING COMPRISE A
02:54:31.995 --> 02:54:35.832 region:rollup2
LARGE PORTION MEDI CAL HOUGHTON
02:54:34.431 --> 02:54:36.800 region:rollup2
YOU KNOW ALL OF MEDICARE THAT'S
02:54:35.832 --> 02:54:38.301 region:rollup2
NOT INCLUDE THAT'S NOT INCURRED
02:54:36.800 --> 02:54:39.502 region:rollup2
BY THE INDIVIDUAL PARTICIPANTS
02:54:38.301 --> 02:54:41.271 region:rollup2
OF THE PROGRAM.
02:54:39.502 --> 02:54:42.605 region:rollup2
AND AS WELL AS THE FEDERAL
02:54:41.271 --> 02:54:44.607 region:rollup2
HEALTH INSURANCE SUBSIDIES TO
02:54:42.605 --> 02:54:46.242 region:rollup2
COVER CALIFORNIA AND THEN THE
02:54:44.607 --> 02:54:47.644 region:rollup2
STATE AND LOCAL GOVERNMENTS THEY
02:54:46.242 --> 02:54:49.779 region:rollup2
PROVIDE THE REMAINING FIFTY
02:54:47.644 --> 02:54:52.582 region:rollup2
BILLION DOLLARS MEDI CAL BEING.
02:54:49.779 --> 02:54:54.384 region:rollup2
I THINK SIGNIFICANTLY THE
02:54:52.582 --> 02:54:55.752 region:rollup2
LARGEST SOURCE THEIR.
02:54:54.384 --> 02:54:57.954 region:rollup2
AND THEN THE MAJOR PRIVATE
02:54:55.752 --> 02:54:59.255 region:rollup2
SOURCES OF HEALTH CARE SPUR OF
02:54:57.954 --> 02:55:01.257 region:rollup2
PRIVATE HEALTHCARE SPENDING IN
02:54:59.255 --> 02:55:03.626 region:rollup2
THE STATE ARE EMPLOYER SPONSORED
02:55:01.257 --> 02:55:05.495 region:rollup2
INSURANCE PREMIUMS INDIVIDUAL
02:55:03.626 --> 02:55:06.730 region:rollup2
MARKET PREMIUMS NET OF ANY OF
02:55:05.495 --> 02:55:08.732 region:rollup2
FEDERAL SUBSIDIES THAT
02:55:06.730 --> 02:55:10.166 region:rollup2
INDIVIDUALS PAY. AND THE OUT OF
02:55:08.732 --> 02:55:11.768 region:rollup2
POCKET EXPENSES WHICH WE
02:55:10.166 --> 02:55:13.203 region:rollup2
ESTIMATE OF BETWEEN THIRTY FIVE
02:55:11.768 --> 02:55:15.038 region:rollup2
OR TWENTY FIVE AND THIRTY FIVE
02:55:13.203 --> 02:55:17.040 region:rollup2
BILLION DOLLARS IN COSTS IN THE
02:55:15.038 --> 02:55:18.508 region:rollup2
STATE A IN THE FORM OF COPAYS
02:55:17.040 --> 02:55:20.543 region:rollup2
AND DEDUCTIBLES ANOTHER HEALTH
02:55:18.508 --> 02:55:21.911 region:rollup2
CARE COSTS. NOT PAID BY INSURERS
02:55:20.543 --> 02:55:24.647 region:rollup2
AND AND THIS THIS FIGURE
02:55:21.911 --> 02:55:29.052 region:rollup2
EXCLUDES ANY PREMIUMS THAT
02:55:24.647 --> 02:55:30.253 region:rollup2
INDIVIDUALS WOULD PAY.
02:55:29.052 --> 02:55:32.389 region:rollup2
NOW I'M GONNA TURN AWAY FROM
02:55:30.253 --> 02:55:34.224 region:rollup2
DESCRIBING HEALTH CARE COVERAGE
02:55:32.389 --> 02:55:36.192 region:rollup2
IN EXPENDITURES UNDER OUR
02:55:34.224 --> 02:55:38.395 region:rollup2
EXISTING SYSTEM AND TALK ABOUT
02:55:36.192 --> 02:55:40.230 region:rollup2
OUR ANALYSIS OF A PUBLICLY
02:55:38.395 --> 02:55:42.165 region:rollup2
FINANCED HEALTH CARE PROGRAM.
02:55:40.230 --> 02:55:44.734 region:rollup2
IN TWENTY SEVENTEEN THE L. ILIO
02:55:42.165 --> 02:55:46.302 region:rollup2
ANALYZE THE COST OF A STATEWIDE
02:55:44.734 --> 02:55:47.871 region:rollup2
PUBLICLY FINANCE HEALTHCARE
02:55:46.302 --> 02:55:49.539 region:rollup2
PROGRAM THAT WOULD REPLACE THE
02:55:47.871 --> 02:55:51.074 region:rollup2
EXISTING MULTI PAYER HEALTHCARE
02:55:49.539 --> 02:55:52.041 region:rollup2
SYSTEM.
02:55:51.074 --> 02:55:53.977 region:rollup2
THEY WERE GENERALLY PROVIDE
02:55:52.041 --> 02:55:55.478 region:rollup2
EXCLUSIVE FINANCING OF
02:55:53.977 --> 02:55:57.113 region:rollup2
HEALTHCARE SERVICES ACROSS THE
02:55:55.478 --> 02:55:58.915 region:rollup2
STATE AND WOULD NOT DIRECTLY
02:55:57.113 --> 02:56:00.150 region:rollup2
OPERATE HOSPITALS WERE EMPLOYED
02:55:58.915 --> 02:56:02.152 region:rollup2
THE WORK FIRST BUT INSTEAD
02:56:00.150 --> 02:56:03.553 region:rollup2
PRIMARILY BE FOCUSED WITHOUT
02:56:02.152 --> 02:56:05.221 region:rollup2
FOCUSED ON FINANCING THE
02:56:03.553 --> 02:56:06.823 region:rollup2
HEALTHCARE SERVICES THAT ARE
02:56:05.221 --> 02:56:08.758 region:rollup2
CURRENT.
02:56:06.823 --> 02:56:10.293 region:rollup2
WE JUST NOTE SO WE'LL GO
02:56:08.758 --> 02:56:12.061 region:rollup2
THROUGH OUR ESTIMATES BUT A
02:56:10.293 --> 02:56:13.329 region:rollup2
PROGRAM STRUCTURED DIFFERENTLY
02:56:12.061 --> 02:56:15.565 region:rollup2
THE ONE THAN THE ONE THAT WE
02:56:13.329 --> 02:56:16.933 region:rollup2
ANALYZE AND TWENTY SEVENTEEN
02:56:15.565 --> 02:56:18.635 region:rollup2
COULD COST TENS OF BILLIONS OF
02:56:16.933 --> 02:56:20.804 region:rollup2
DOLLARS MORE OR TENS OF BILLIONS
02:56:18.635 --> 02:56:22.439 region:rollup2
OF DOLLARS LESS THAN. THE ONE
02:56:20.804 --> 02:56:24.841 region:rollup2
THAT WE ANALYZED
02:56:22.439 --> 02:56:25.408 region:rollup2
IN ANALYZING THE DATA PROGRAM WE
02:56:24.841 --> 02:56:27.677 region:rollup2
MADE UP.
02:56:25.408 --> 02:56:29.679 region:rollup2
SAID OF MAJOR ASSUMPTIONS
02:56:27.677 --> 02:56:31.614 region:rollup2
INCLUDING THAT IT WOULD COVER
02:56:29.679 --> 02:56:33.183 region:rollup2
NEARLY ALL CALIFORNIANS BY
02:56:31.614 --> 02:56:34.484 region:rollup2
INCORPORATING THE EXISTING
02:56:33.183 --> 02:56:36.653 region:rollup2
FEDERAL AND STATE FUNDING
02:56:34.484 --> 02:56:38.688 region:rollup2
STREAMS REDIRECTING THOSE TO BE
02:56:36.653 --> 02:56:40.290 region:rollup2
ABLE TO PAY FOR. A A SINGLE
02:56:38.688 --> 02:56:42.292 region:rollup2
STATEWIDE PUBLICLY FINANCED
02:56:40.290 --> 02:56:44.227 region:rollup2
PROGRAM SUCH AS MEDICARE AND
02:56:42.292 --> 02:56:45.562 region:rollup2
MEDICAID WHICH PREVIOUS SPEAKERS
02:56:44.227 --> 02:56:46.229 region:rollup2
DESCRIBED SOME OF THE CHALLENGES
02:56:45.562 --> 02:56:48.431 region:rollup2
OF.
02:56:46.229 --> 02:56:50.033 region:rollup2
.
02:56:48.431 --> 02:56:51.801 region:rollup2
AND WE ASSUME THAT THE SYSTEM
02:56:50.033 --> 02:56:54.237 region:rollup2
WOULD BE A FEE FOR SERVICE
02:56:51.801 --> 02:56:56.573 region:rollup2
DELIVERY SYSTEM WHERE INDIVIDUAL
02:56:54.237 --> 02:56:57.874 region:rollup2
SERVICES THAT AND GOT US THE
02:56:56.573 --> 02:57:00.043 region:rollup2
SERVICES THAT INDIVIDUALS.
02:56:57.874 --> 02:57:02.545 region:rollup2
UTILIZE WOULD BE SEPARATELY
02:57:00.043 --> 02:57:03.847 region:rollup2
PAID FOR ON THEIR OWN AND THAT
02:57:02.545 --> 02:57:04.848 region:rollup2
THE SYSTEM WOULD PAY.
02:57:03.847 --> 02:57:08.418 region:rollup2
PROVIDER RATES THAT ARE
02:57:04.848 --> 02:57:09.219 region:rollup2
COMPARABLE TO WHAT MEDICARE PAYS
02:57:08.418 --> 02:57:10.653 region:rollup2
WHICH ARE LITTLE ALONE WHAT WE
02:57:09.219 --> 02:57:12.155 region:rollup2
THINK HIGHER THAN WHAT MEDI CAL
02:57:10.653 --> 02:57:14.491 region:rollup2
PAYS IN FEE FOR SERVICE.
02:57:12.155 --> 02:57:15.925 region:rollup2
BUT NOT NECESSARILY AS HIGH AS
02:57:14.491 --> 02:57:20.497 region:rollup2
THE COMMERCIAL RATES THAT.
02:57:15.925 --> 02:57:23.032 region:rollup2
PRIVATE INSURERS TEND TO PAY.
02:57:20.497 --> 02:57:24.400 region:rollup2
WITH THE SYSTEM THAT WE ALSO
02:57:23.032 --> 02:57:26.302 region:rollup2
THAT WE ANALYZED OUGHT WOULD
02:57:24.400 --> 02:57:28.004 region:rollup2
OFFER A COMPREHENSIVE PACKAGE OF
02:57:26.302 --> 02:57:29.706 region:rollup2
BENEFITS INCLUDING CERTAIN
02:57:28.004 --> 02:57:30.640 region:rollup2
BENEFITS THAT ARE NOT OFFERED
02:57:29.706 --> 02:57:32.575 region:rollup2
THROUGH TRADITIONAL HEALTH
02:57:30.640 --> 02:57:33.776 region:rollup2
INSURANCE PROJECT PRODUCTS IN
02:57:32.575 --> 02:57:36.012 region:rollup2
THROUGH EMPLOYER SPONSORED
02:57:33.776 --> 02:57:38.314 region:rollup2
INSURANCE FOR EXAMPLE. SUCH AS
02:57:36.012 --> 02:57:40.116 region:rollup2
LONG TERM CARE BENEFITS DENTAL
02:57:38.314 --> 02:57:41.518 region:rollup2
INVENTED VISION BENEFITS.
02:57:40.116 --> 02:57:43.219 region:rollup2
AND THEN FINALLY WE ASSUME THAT
02:57:41.518 --> 02:57:44.721 region:rollup2
THIS PROGRAM WOULD HAVE NO COST
02:57:43.219 --> 02:57:46.489 region:rollup2
SHARING THAT BAD THERE'D BE NO
02:57:44.721 --> 02:57:48.424 region:rollup2
CO PAYS OR DEDUCTIBLES FOR THE
02:57:46.489 --> 02:57:49.526 region:rollup2
INDIVIDUALS ARE FOR INDIVIDUAL
02:57:48.424 --> 02:57:52.862 region:rollup2
SERVICES THAT.
02:57:49.526 --> 02:57:54.731 region:rollup2
THE STATE RESIDENTS UTILIZE.
02:57:52.862 --> 02:57:54.964 region:rollup2
WE ESTIMATED THAT THIS COST
02:57:54.731 --> 02:57:56.833 region:rollup2
WOULD.
02:57:54.964 --> 02:57:58.768 region:rollup2
THIS PROGRAM WOULD COST ABOUT
02:57:56.833 --> 02:58:00.537 region:rollup2
FOUR HUNDRED BILLION DOLLARS ON
02:57:58.768 --> 02:58:02.272 region:rollup2
IN TWENTY SEVENTEEN EIGHTEEN
02:58:00.537 --> 02:58:03.606 region:rollup2
TERMS BUT WE WOULD NOTE THAT
02:58:02.272 --> 02:58:05.175 region:rollup2
THERE IS SIGNIFICANT UNCERTAINTY
02:58:03.606 --> 02:58:07.844 region:rollup2
SURROUNDING THAT ESTIMATE.
02:58:05.175 --> 02:58:09.312 region:rollup2
GIVEN THAT IT WOULD BE SUCH A A
02:58:07.844 --> 02:58:10.380 region:rollup2
LARGE TRANSFORMATION AND HOW THE
02:58:09.312 --> 02:58:11.748 region:rollup2
STATE DELIVERS HEALTHCARE
02:58:10.380 --> 02:58:13.850 region:rollup2
SERVICES.
02:58:11.748 --> 02:58:15.652 region:rollup2
WE SOON THE HEALTH CARE SERVICES
02:58:13.850 --> 02:58:16.719 region:rollup2
A SUCH AS DOCTORS VISITS
02:58:15.652 --> 02:58:18.755 region:rollup2
SERVICES THE HOSPITAL IN
02:58:16.719 --> 02:58:20.056 region:rollup2
PHARMACEUTICALS.
02:58:18.755 --> 02:58:21.524 region:rollup2
WOULD REALLY COMPRISE THE TO
02:58:20.056 --> 02:58:23.826 region:rollup2
THE BULK OF SPENDING IN THE
02:58:21.524 --> 02:58:25.361 region:rollup2
PROGRAM THAT ADMINISTRATIVE OUR
02:58:23.826 --> 02:58:26.663 region:rollup2
STATE OPERATIONS SPENDING WHAT
02:58:25.361 --> 02:58:28.031 region:rollup2
ACCOUNT FOR LESS THAN TEN
02:58:26.663 --> 02:58:29.799 region:rollup2
PERCENT OF TOTAL PROGRAM
02:58:28.031 --> 02:58:31.534 region:rollup2
EXPENDITURES.
02:58:29.799 --> 02:58:33.536 region:rollup2
WE ALSO ASSUMED THAT THE TWO
02:58:31.534 --> 02:58:34.003 region:rollup2
HUNDRED BILLION DOLLARS IN TOTAL
02:58:33.536 --> 02:58:34.504 region:rollup2
PUBLIC SPENDING COULD
02:58:34.003 --> 02:58:37.941 region:rollup2
BEREDIRECTED TO FUND THE
02:58:34.504 --> 02:58:39.742 region:rollup2
PROGRAM.
02:58:37.941 --> 02:58:41.744 region:rollup2
AND JUST NOTE THAT THERE IS
02:58:39.742 --> 02:58:43.346 region:rollup2
UNCERTAINTY AS WAS PREVIOUSLY
02:58:41.744 --> 02:58:45.014 region:rollup2
DISCUSSED ON WHETHER IN FACT NOT
02:58:43.346 --> 02:58:46.749 region:rollup2
WHETHER OR NOT THAT COULD BE THE
02:58:45.014 --> 02:58:48.284 region:rollup2
CASE.
02:58:46.749 --> 02:58:49.586 region:rollup2
THIS LEAVES ABOUT TWO HUNDRED
02:58:48.284 --> 02:58:51.054 region:rollup2
BILLION DOLLARS IN ADDITIONAL
02:58:49.586 --> 02:58:52.188 region:rollup2
STATE REVENUE THAT WOULD BE
02:58:51.054 --> 02:58:53.089 region:rollup2
NEEDED TO FULLY FUND THE PROGRAM
02:58:52.188 --> 02:58:55.458 region:rollup2
HOPE.
02:58:53.089 --> 02:58:57.293 region:rollup2
.
02:58:55.458 --> 02:58:58.628 region:rollup2
I AND THIS REVENUE WOULD LIKELY
02:58:57.293 --> 02:59:01.965 region:rollup2
HAVE TO BE REYES THROUGH THE
02:58:58.628 --> 02:59:04.500 region:rollup2
STATE'S TAX SYSTEM.
02:59:01.965 --> 02:59:06.803 region:rollup2
TO CONCLUDE MY PORTION.
02:59:04.500 --> 02:59:09.906 region:rollup2
IF THE LA OWES REMARKS I'M
02:59:06.803 --> 02:59:11.174 region:rollup2
GONNA TURN TO A SET OF PROPOSALS
02:59:09.906 --> 02:59:13.343 region:rollup2
THAT DOUR REALLY POLICY
02:59:11.174 --> 02:59:15.211 region:rollup2
APPROACHES THAT WE'VE BEEN ASKED
02:59:13.343 --> 02:59:16.713 region:rollup2
BY THE COMMITTEE DISCUSS. TO
02:59:15.211 --> 02:59:17.747 region:rollup2
EXTEND COVERAGE TO THE REMAINING
02:59:16.713 --> 02:59:19.849 region:rollup2
AND THEN SHARED.
02:59:17.747 --> 02:59:21.951 region:rollup2
THROUGH REALLY THE EXISTING
02:59:19.849 --> 02:59:23.686 region:rollup2
HEALTH CARE SYSTEM.
02:59:21.951 --> 02:59:26.022 region:rollup2
CERTAIN APPROACHES WOULD BE
02:59:23.686 --> 02:59:28.324 region:rollup2
DESIGNED TO TARGET THIS FIRST
02:59:26.022 --> 02:59:30.093 region:rollup2
GROUP ARE UNINSURED LOW INCOME
02:59:28.324 --> 02:59:32.095 region:rollup2
DOT AND I UNDOCUMENTED
02:59:30.093 --> 02:59:33.830 region:rollup2
IMMIGRANTS PA WHO WE ESTIMATE
02:59:32.095 --> 02:59:35.632 region:rollup2
ARE ABOVE ABOUT ALMOST TWO
02:59:33.830 --> 02:59:36.866 region:rollup2
THIRDS OF THE REMAINING ON AND
02:59:35.632 --> 02:59:38.735 region:rollup2
SHARE.
02:59:36.866 --> 02:59:40.236 region:rollup2
WE DEFINE AGAIN LOW INCOME AS
02:59:38.735 --> 02:59:41.504 region:rollup2
THOSE INDIVIDUALS WHO ARE
02:59:40.236 --> 02:59:43.039 region:rollup2
EARNING LESS THAN FOUR HUNDRED
02:59:41.504 --> 02:59:44.407 region:rollup2
PERCENT OF THE FEDERAL POVERTY
02:59:43.039 --> 02:59:46.275 region:rollup2
LINE THE CUT OFF FOR FEDERAL
02:59:44.407 --> 02:59:47.710 region:rollup2
HEALTH INSURANCE SUBSIDIES TO
02:59:46.275 --> 02:59:50.113 region:rollup2
COVERED CALIFORNIA.
02:59:47.710 --> 02:59:52.282 region:rollup2
FIRST POLICY APPROACH WOULD BE
02:59:50.113 --> 02:59:54.117 region:rollup2
OUT TO EXTEND FULL SCOPE MEDICAL
02:59:52.282 --> 02:59:56.119 region:rollup2
COVERAGE FOR INCOME ELIGIBLE
02:59:54.117 --> 02:59:57.854 region:rollup2
UNDOCUMENTED IMMIGRANT ADULTS
02:59:56.119 --> 02:59:59.722 region:rollup2
THAT IS IMMIGRANT ADULTS EARNING
02:59:57.854 --> 03:00:01.924 region:rollup2
LESS THAN MY ONE HUNDRED AND
02:59:59.722 --> 03:00:03.660 region:rollup2
THIRTY PER A PERCENT GENERALLY
03:00:01.924 --> 03:00:05.495 region:rollup2
OF THE FEDERAL POVERTY LEVEL.
03:00:03.660 --> 03:00:07.397 region:rollup2
AND THIS TRANSLATES INTO ABOUT
03:00:05.495 --> 03:00:09.232 region:rollup2
THIRTY FOUR THOUSAND DOLLARS FOR
03:00:07.397 --> 03:00:11.100 region:rollup2
A FAMILY OF FOUR.
03:00:09.232 --> 03:00:12.502 region:rollup2
MORE AND PREVIOUSLY A COUPLE OF
03:00:11.100 --> 03:00:14.604 region:rollup2
YEARS AGO THE STATE ACTUALLY
03:00:12.502 --> 03:00:16.239 region:rollup2
EXTENDED A FULL SCOPE MEDICAL
03:00:14.604 --> 03:00:18.107 region:rollup2
COVERAGE TO CHILDREN
03:00:16.239 --> 03:00:20.443 region:rollup2
UNDOCUMENTED IMMIGRANT CHILDREN
03:00:18.107 --> 03:00:22.612 region:rollup2
UP TO AGE NINETEEN.
03:00:20.443 --> 03:00:24.914 region:rollup2
BUT ADULTS REMAIN ONLY ELIGIBLE
03:00:22.612 --> 03:00:25.982 region:rollup2
FOR WHAT IS KNOWN AS RESTRICTED
03:00:24.914 --> 03:00:28.184 region:rollup2
SCOPE MEDICAID OUR.
03:00:25.982 --> 03:00:30.353 region:rollup2
IN WHICH MEDI CAL PAYS FOR THE
03:00:28.184 --> 03:00:32.355 region:rollup2
EMERGENCY AND PREGNANCY RELATED
03:00:30.353 --> 03:00:34.190 region:rollup2
SERVICES BUT IT WOULDN'T FUNDS
03:00:32.355 --> 03:00:36.459 region:rollup2
NIGHT OF THE.
03:00:34.190 --> 03:00:38.461 region:rollup2
THE PREVENTIVE VISITS ARE OTHER
03:00:36.459 --> 03:00:39.829 region:rollup2
OTHER TYPES OF SERVICES THAT
03:00:38.461 --> 03:00:41.564 region:rollup2
MEDI CAL COVERS.
03:00:39.829 --> 03:00:43.733 region:rollup2
WE ESTIMATE WE ESTIMATE THAT
03:00:41.564 --> 03:00:45.268 region:rollup2
THIS APPROACH COULD EXTEND
03:00:43.733 --> 03:00:46.602 region:rollup2
COVERAGE TO ABOUT A MILLION
03:00:45.268 --> 03:00:49.072 region:rollup2
ADDITIONAL UNDOCUMENTED
03:00:46.602 --> 03:00:50.773 region:rollup2
IMMIGRANTS ACROSS THE STATE MOST
03:00:49.072 --> 03:00:52.575 region:rollup2
OF WHOM ARE WE DO ESTIMATE ARE
03:00:50.773 --> 03:00:56.746 region:rollup2
ALREADY ENROLLED IN RESTRICTED
03:00:52.575 --> 03:00:59.215 region:rollup2
SCOPE MEDI CAL.
03:00:56.746 --> 03:01:00.116 region:rollup2
THE SECOND APPROACH TO.
03:00:59.215 --> 03:01:01.984 region:rollup2
TARGET.
03:01:00.116 --> 03:01:03.619 region:rollup2
REMAINING UNINSURED
03:01:01.984 --> 03:01:05.455 region:rollup2
UNDOCUMENTED IMMIGRANTS.
03:01:03.619 --> 03:01:07.290 region:rollup2
WOULD BE TO PROVIDE HEALTH
03:01:05.455 --> 03:01:08.991 region:rollup2
INSURANCE IN DIVIDEND OF VISUAL
03:01:07.290 --> 03:01:09.258 region:rollup2
MARKET HEALTH INSURANCE
03:01:08.991 --> 03:01:10.960 region:rollup2
SUBSIDIES.
03:01:09.258 --> 03:01:12.662 region:rollup2
FOR.
03:01:10.960 --> 03:01:14.464 region:rollup2
INCOME I SAID OF INCOME ELIGIBLE
03:01:12.662 --> 03:01:16.499 region:rollup2
UNDOCUMENTED IMMIGRANTS IF THIS
03:01:14.464 --> 03:01:17.934 region:rollup2
WERE MODELED AFTER THE FEDERAL
03:01:16.499 --> 03:01:19.402 region:rollup2
HEALTH INSURANCE SUBSIDIES FOR
03:01:17.934 --> 03:01:22.071 region:rollup2
EXAMPLE THIS WOULD.
03:01:19.402 --> 03:01:24.240 region:rollup2
THIS WOULD PROVIDE STATE FUNDED
03:01:22.071 --> 03:01:25.641 region:rollup2
TAX CREDITS TO UNDOCUMENTED
03:01:24.240 --> 03:01:27.076 region:rollup2
IMMIGRANTS EARNING BETWEEN ONE
03:01:25.641 --> 03:01:29.011 region:rollup2
HUNDRED AND THIRTY EIGHT PERCENT
03:01:27.076 --> 03:01:30.680 region:rollup2
AND FOUR HUNDRED PERCENT OF THE
03:01:29.011 --> 03:01:31.981 region:rollup2
FEDERAL POVERTY LEVEL. AND WE
03:01:30.680 --> 03:01:33.783 region:rollup2
ESTIMATE THAT THIS COULD HELP AN
03:01:31.981 --> 03:01:35.518 region:rollup2
ESTIMATED THREE HUNDRED TO FIVE
03:01:33.783 --> 03:01:37.720 region:rollup2
HUNDRED THOUSAND AND UNINSURED
03:01:35.518 --> 03:01:38.788 region:rollup2
UNDOCUMENTED IMMIGRANTS OBTAIN
03:01:37.720 --> 03:01:40.957 region:rollup2
COVERAGE.
03:01:38.788 --> 03:01:43.426 region:rollup2
ONE WAY TO MODEL IT WOULD BE TO
03:01:40.957 --> 03:01:45.161 region:rollup2
THESE TAX CREDITS WOULD BE TO.
03:01:43.426 --> 03:01:47.630 region:rollup2
MODEL THEM AFTER THE FEDERAL
03:01:45.161 --> 03:01:52.502 region:rollup2
TAX CREDITS WHICH LIMIT PREMIUMS
03:01:47.630 --> 03:01:53.302 region:rollup2
THAT INDIVIDUALS PAY TO A
03:01:52.502 --> 03:01:53.536 region:rollup2
CERTAIN PERCENTAGE OF THEIR
03:01:53.302 --> 03:01:55.104 region:rollup2
INCOME.
03:01:53.536 --> 03:01:56.773 region:rollup2
NEXT TO HER I'LL TURN TO.
03:01:55.104 --> 03:01:58.908 region:rollup2
POLICY APPROACHES THAT COULD
03:01:56.773 --> 03:02:01.010 region:rollup2
TARGET THE OTHER REMAINING
03:01:58.908 --> 03:02:02.845 region:rollup2
UNINSURED SO PRIMARILY STATE REP
03:02:01.010 --> 03:02:03.713 region:rollup2
CITIZENS AND AND IMMIGRANTS WITH
03:02:02.845 --> 03:02:05.348 region:rollup2
DOCUMENTS STATUS.
03:02:03.713 --> 03:02:07.583 region:rollup2
.
03:02:05.348 --> 03:02:09.886 region:rollup2
ONE APPROACH HERE WOULD BE TO
03:02:07.583 --> 03:02:12.221 region:rollup2
OFFER STATE WRAPAROUND TAX
03:02:09.886 --> 03:02:13.723 region:rollup2
CREDITS IN THE INDIVIDUAL MARKET
03:02:12.221 --> 03:02:15.291 region:rollup2
UP FOR INDIVIDUALS.
03:02:13.723 --> 03:02:16.859 region:rollup2
WITH IT WITH INCOMES THAT ARE
03:02:15.291 --> 03:02:18.294 region:rollup2
TOO HIGH TO QUALIFY FOR MEDICAID
03:02:16.859 --> 03:02:20.096 region:rollup2
ALSO ABOVE ONE HUNDRED AND
03:02:18.294 --> 03:02:22.598 region:rollup2
THIRTY EIGHT PERCENT.
03:02:20.096 --> 03:02:24.033 region:rollup2
THESE PROTESTS PROPOSAL SORT OF
03:02:22.598 --> 03:02:25.802 region:rollup2
OR THE SET OF PROPOSALS COULD
03:02:24.033 --> 03:02:27.236 region:rollup2
POTENTIALLY HELP AROUND ONE
03:02:25.802 --> 03:02:30.306 region:rollup2
MILLION UNINSURED.
03:02:27.236 --> 03:02:31.207 region:rollup2
CALIFORNIANS OBTAIN COVERAGE
03:02:30.306 --> 03:02:33.609 region:rollup2
NOW THERE TO.
03:02:31.207 --> 03:02:35.678 region:rollup2
COMPLEMENTARY BUT SEPARATE.
03:02:33.609 --> 03:02:37.447 region:rollup2
SORT OF.
03:02:35.678 --> 03:02:40.183 region:rollup2
APPROACHES UNDER THIS MORE
03:02:37.447 --> 03:02:41.851 region:rollup2
GENERAL APPROACH ONE WOULD BE TO
03:02:40.183 --> 03:02:42.718 region:rollup2
OFFER STATE FUNDED HEALTH
03:02:41.851 --> 03:02:44.387 region:rollup2
INSURANCE SUBSIDIES FOR
03:02:42.718 --> 03:02:45.688 region:rollup2
INDIVIDUALS WHO ACTUALLY EARN
03:02:44.387 --> 03:02:48.191 region:rollup2
MORE THAN THE CUT OFF FOR
03:02:45.688 --> 03:02:49.959 region:rollup2
FEDERAL ELIGIBILITY SO. COULD BE
03:02:48.191 --> 03:02:52.428 region:rollup2
STRUCTURED TO FOR EXAMPLE.
03:02:49.959 --> 03:02:53.529 region:rollup2
PROVIDE STATE TAX CREDITS FOR
03:02:52.428 --> 03:02:55.431 region:rollup2
INDIVIDUALS EARNING.
03:02:53.529 --> 03:02:56.332 region:rollup2
BETWEEN FOUR HUNDRED PERCENT IN
03:02:55.431 --> 03:02:58.034 region:rollup2
FIVE HUNDRED PERCENT OF THE
03:02:56.332 --> 03:03:00.002 region:rollup2
FEDERAL POVERTY LINE.
03:02:58.034 --> 03:03:01.838 region:rollup2
BUT COULD BE MODELED IN A SORT
03:03:00.002 --> 03:03:04.407 region:rollup2
OF SIMILAR FASHION WHERE.
03:03:01.838 --> 03:03:05.208 region:rollup2
THESE INDIVIDUALS.
03:03:04.407 --> 03:03:06.209 region:rollup2
TAKE HOMES OR NOT SORT OF
03:03:05.208 --> 03:03:08.244 region:rollup2
PREMIUM PAY.
03:03:06.209 --> 03:03:09.645 region:rollup2
WOULD BE LIMITED TO A CERTAIN
03:03:08.244 --> 03:03:10.213 region:rollup2
AMOUNT OF THEIR INCOME OR A
03:03:09.645 --> 03:03:13.549 region:rollup2
CERTAIN PERCENTAGE OF THEIR
03:03:10.213 --> 03:03:15.017 region:rollup2
INCOME.
03:03:13.549 --> 03:03:17.920 region:rollup2
THE STATE COULD ALSO.
03:03:15.017 --> 03:03:20.223 region:rollup2
OFFER STATE SUBSIDIES THAT.
03:03:17.920 --> 03:03:21.457 region:rollup2
ACTUALLY JUST COMPLEMENT THE
03:03:20.223 --> 03:03:22.892 region:rollup2
FEDERAL SUBSIDIES FOR
03:03:21.457 --> 03:03:24.260 region:rollup2
INDIVIDUALS WHO ARE CURRENTLY
03:03:22.892 --> 03:03:25.895 region:rollup2
ELIGIBLE FOR FEDERAL HEALTH
03:03:24.260 --> 03:03:27.330 region:rollup2
INSURANCE SUBSIDIES AND WHAT
03:03:25.895 --> 03:03:29.799 region:rollup2
THESE COULD DO IS THEY COULD
03:03:27.330 --> 03:03:31.300 region:rollup2
LOWER THE PERCENTAGE OF INCOME
03:03:29.799 --> 03:03:34.036 region:rollup2
THAT INDIVIDUALS PAY.
03:03:31.300 --> 03:03:35.972 region:rollup2
FOR PREMIUMS ON THE INSURANCE
03:03:34.036 --> 03:03:37.406 region:rollup2
ON THE INDIVIDUAL MARKET ABOUT
03:03:35.972 --> 03:03:38.941 region:rollup2
FOR EXAMPLE SOMEBODY WHO'S ON
03:03:37.406 --> 03:03:40.476 region:rollup2
WHO EARNS ABOUT FOUR HUNDRED
03:03:38.941 --> 03:03:42.345 region:rollup2
PERCENT OF THE FEDERAL POVERTY
03:03:40.476 --> 03:03:43.479 region:rollup2
LINE LIMITED TO TEN PERCENT OF
03:03:42.345 --> 03:03:45.581 region:rollup2
THEIR INCOME IN TERMS OF THE
03:03:43.479 --> 03:03:47.350 region:rollup2
PREMIUMS THEY PAY. A STATE TAX
03:03:45.581 --> 03:03:49.819 region:rollup2
CREDIT COULD FOR EXAMPLE LOWER
03:03:47.350 --> 03:03:52.188 region:rollup2
LOWER THAT PERCENTAGE TO MAYBE
03:03:49.819 --> 03:03:53.789 region:rollup2
EIGHT PERCENT OF THEIR INCOME.
03:03:52.188 --> 03:03:56.025 region:rollup2
AND THEN I'LL FINALLY TOUCH ON A
03:03:53.789 --> 03:03:56.926 region:rollup2
STATE INDIVIDUAL MANDATE STATE
03:03:56.025 --> 03:03:58.728 region:rollup2
INDIVIDUAL MANDATE WOULD DO
03:03:56.926 --> 03:04:00.296 region:rollup2
CRIER RESIDENTS STATE RESIDENTS
03:03:58.728 --> 03:04:02.498 region:rollup2
TO MAINTAIN HEALTH INSURANCE
03:04:00.296 --> 03:04:05.234 region:rollup2
COVERAGE OR OTHERWISE PAY A
03:04:02.498 --> 03:04:06.669 region:rollup2
PENALTY SIMILAR TO THE ACA'S
03:04:05.234 --> 03:04:07.837 region:rollup2
INDIVIDUAL MANDATE.
03:04:06.669 --> 03:04:09.739 region:rollup2
BUT WHICH WAS.
03:04:07.837 --> 03:04:11.741 region:rollup2
RECENTLY THE PENALTY OF WHICH
03:04:09.739 --> 03:04:14.176 region:rollup2
WAS RECENTLY SET TO ZERO IN THE
03:04:11.741 --> 03:04:16.579 region:rollup2
MOST RECENT FEDERAL TAX BILL.
03:04:14.176 --> 03:04:18.548 region:rollup2
BEGINNING IN TWENTY NINETEEN.
03:04:16.579 --> 03:04:20.383 region:rollup2
THE BENEFIT OF A STATE TAX
03:04:18.548 --> 03:04:22.418 region:rollup2
CREDIT IT WOULD COULD THAT COULD
03:04:20.383 --> 03:04:24.887 region:rollup2
REPLACE THE EXPIRING FEDERAL
03:04:22.418 --> 03:04:25.421 region:rollup2
MANDATE PENALTY WOULD BE THAT IT
03:04:24.887 --> 03:04:27.323 region:rollup2
COULD.
03:04:25.421 --> 03:04:29.058 region:rollup2
PROVIDE AN INCENTIVE FOR
03:04:27.323 --> 03:04:31.093 region:rollup2
INDIVIDUALS ESPECIALLY THE
03:04:29.058 --> 03:04:32.428 region:rollup2
RELATIVELY YOUNG AND HEALTHY A
03:04:31.093 --> 03:04:33.629 region:rollup2
TO MAIN HATE MAINTAIN HEALTH
03:04:32.428 --> 03:04:35.565 region:rollup2
CARE COVERAGE.
03:04:33.629 --> 03:04:36.799 region:rollup2
TO GIVE SOME CONTEXT ON THE
03:04:35.565 --> 03:04:38.000 region:rollup2
PENALTIES THAT WERE PAID BY
03:04:36.799 --> 03:04:40.536 region:rollup2
CALIFORNIA RESIDENTS ARE.
03:04:38.000 --> 03:04:42.972 region:rollup2
UNDER THE FEDERAL MANDATE.
03:04:40.536 --> 03:04:44.373 region:rollup2
ALMOST EIGHT HUNDRED THOUSAND
03:04:42.972 --> 03:04:46.108 region:rollup2
CALIFORNIANS PAID THE FEDERAL
03:04:44.373 --> 03:04:48.210 region:rollup2
INDIVIDUAL MANDATE PENALTY IN
03:04:46.108 --> 03:04:49.946 region:rollup2
TWENTY FIFTEEN AT A TOTAL
03:04:48.210 --> 03:04:52.848 region:rollup2
PENALTY AMOUNT OF THREE HUNDRED
03:04:49.946 --> 03:04:55.084 region:rollup2
AND EIGHTY MILLION DOLLARS.
03:04:52.848 --> 03:04:57.286 region:rollup2
AND THAT CONCLUDES MY PORTION.
03:04:55.084 --> 03:04:58.087 region:rollup2
OF OUR REMARKS HAPPY TO TAKE
03:04:57.286 --> 03:05:02.525 region:rollup2
QUESTIONS BUT I'LL TURN OVER TO
03:04:58.087 --> 03:05:03.426 region:rollup2
RYAN MILLER.
03:05:02.525 --> 03:05:04.994 region:rollup2
AND RYAN MILLER FROM THE LA NOW.
03:05:03.426 --> 03:05:06.762 region:rollup2
.
03:05:04.994 --> 03:05:08.597 region:rollup2
BEFORE WE DIVE INTO SOME OF THE.
03:05:06.762 --> 03:05:10.299 region:rollup2
FRONT FINANCING OPTIONS THAT
03:05:08.597 --> 03:05:12.301 region:rollup2
WE'VE PREPARED I WANTED TO HIT A
03:05:10.299 --> 03:05:13.736 region:rollup2
COUPLE OF INTRODUCTORY POINTS.
03:05:12.301 --> 03:05:15.037 region:rollup2
FIRST WHILE WHILE WE WALK
03:05:13.736 --> 03:05:17.807 region:rollup2
THROUGH VARIOUS TAXES WE
03:05:15.037 --> 03:05:19.508 region:rollup2
PROVIDED ESTIMATES OF WHAT RATES
03:05:17.807 --> 03:05:21.877 region:rollup2
WOULD BE NECESSARY TO RAISE AN
03:05:19.508 --> 03:05:23.446 region:rollup2
ADDITIONAL. TEN BILLION DOLLARS
03:05:21.877 --> 03:05:25.348 region:rollup2
ON THE LOW END AND TWO HUNDRED
03:05:23.446 --> 03:05:27.583 region:rollup2
BILLION DOLLARS ON THE HIGH END.
03:05:25.348 --> 03:05:29.685 region:rollup2
AND WE WE PICKED THOSE NUMBERS
03:05:27.583 --> 03:05:31.454 region:rollup2
BECAUSE THEY REPRESENT.
03:05:29.685 --> 03:05:31.787 region:rollup2
MANY OF THE PROPOSALS BEING
03:05:31.454 --> 03:05:33.522 region:rollup2
THROWN AROUND.
03:05:31.787 --> 03:05:34.423 region:rollup2
.
03:05:33.522 --> 03:05:36.492 region:rollup2
SOME OF THE PROPOSALS THAT.
03:05:34.423 --> 03:05:37.493 region:rollup2
MISTER JOHNSON DISCUSSED IN
03:05:36.492 --> 03:05:38.594 region:rollup2
KIND OF THE SEVERAL BILLION
03:05:37.493 --> 03:05:39.996 region:rollup2
DOLLAR RANGE AND MORE
03:05:38.594 --> 03:05:42.064 region:rollup2
SUBSTANTIAL CHANGES TO THE
03:05:39.996 --> 03:05:44.600 region:rollup2
HEALTHCARE SYSTEM IN THE. TWO
03:05:42.064 --> 03:05:46.802 region:rollup2
HUNDRED BILLION DOLLAR RANGE.
03:05:44.600 --> 03:05:48.738 region:rollup2
AS MISTER GRAVES MENTIONED.
03:05:46.802 --> 03:05:49.905 region:rollup2
TAX INCREASES GENERALLY REQUIRE
03:05:48.738 --> 03:05:50.940 region:rollup2
A TWO THIRDS VOTE OF THE
03:05:49.905 --> 03:05:52.475 region:rollup2
LEGISLATURE.
03:05:50.940 --> 03:05:54.410 region:rollup2
HOWEVER IN SOME CASES.
03:05:52.475 --> 03:05:55.544 region:rollup2
CHANGES WOULD REQUIRE GOING TO
03:05:54.410 --> 03:05:57.313 region:rollup2
THE VOTERS
03:05:55.544 --> 03:05:59.415 region:rollup2
I GENERALLY SPEAKING MODIFYING
03:05:57.313 --> 03:06:01.283 region:rollup2
THE PROPERTY TAX FOR EXAMPLE.
03:05:59.415 --> 03:06:02.151 region:rollup2
WOULD REQUIRE AMENDING THE
03:06:01.283 --> 03:06:04.186 region:rollup2
CONSTITUTION AND A AND A
03:06:02.151 --> 03:06:06.956 region:rollup2
STATEWIDE VOTE.
03:06:04.186 --> 03:06:09.291 region:rollup2
AND I WANTED ALSO HAD ON.
03:06:06.956 --> 03:06:10.826 region:rollup2
FEDERAL TAX CHANGES THAT WERE
03:06:09.291 --> 03:06:13.362 region:rollup2
RECENTLY MADE.
03:06:10.826 --> 03:06:14.964 region:rollup2
ITS IT THE THE THE THE FEDERAL
03:06:13.362 --> 03:06:15.665 region:rollup2
BILL IS VERY COMPLEX THERE'S A
03:06:14.964 --> 03:06:17.533 region:rollup2
LOT OF.
03:06:15.665 --> 03:06:19.301 region:rollup2
PROVISIONS THAT WERE WORKING
03:06:17.533 --> 03:06:20.436 region:rollup2
FOR A LOT OF THE FRANCHISE TAX
03:06:19.301 --> 03:06:21.037 region:rollup2
BOARD IS TAKING A LOOK AT THE
03:06:20.436 --> 03:06:23.105 region:rollup2
EFFECTS.
03:06:21.037 --> 03:06:24.940 region:rollup2
.
03:06:23.105 --> 03:06:25.174 region:rollup2
BUT ONE OF THE PROVISIONS THAT
03:06:24.940 --> 03:06:27.843 region:rollup2
SEEMS.
03:06:25.174 --> 03:06:28.844 region:rollup2
PARTICULARLY NOTABLE FOR THIS
03:06:27.843 --> 03:06:31.580 region:rollup2
CONVERSATION IS THE.
03:06:28.844 --> 03:06:33.616 region:rollup2
BUT IS THE CAP ON THE STATE AND
03:06:31.580 --> 03:06:34.216 region:rollup2
LOCAL TAX DEDUCTIONS.
03:06:33.616 --> 03:06:35.251 region:rollup2
I'M SURE THAT YOU'VE HEARD OF
03:06:34.216 --> 03:06:36.485 region:rollup2
IT.
03:06:35.251 --> 03:06:38.320 region:rollup2
.
03:06:36.485 --> 03:06:39.388 region:rollup2
I TAXPAYERS CAN DEDUCT UP TO TEN
03:06:38.320 --> 03:06:41.123 region:rollup2
THOUSAND DOLLARS OF EITHER
03:06:39.388 --> 03:06:43.059 region:rollup2
PERSONAL INCOME TAX OR SALES TAX
03:06:41.123 --> 03:06:44.827 region:rollup2
PLUS PROPERTY TAXES.
03:06:43.059 --> 03:06:45.327 region:rollup2
SO WHERE AS LAST YEAR.
03:06:44.827 --> 03:06:47.029 region:rollup2
MANY OF THE OPTIONS WILL
03:06:45.327 --> 03:06:49.432 region:rollup2
DISCUSS.
03:06:47.029 --> 03:06:51.467 region:rollup2
WOULD HAVE ALLOWED A TAXPAYERS
03:06:49.432 --> 03:06:53.135 region:rollup2
TO DEDUCT THE INCREASE ON THEIR
03:06:51.467 --> 03:06:54.770 region:rollup2
FEDERAL TAX BILLS.
03:06:53.135 --> 03:06:55.304 region:rollup2
MANY TAXPAYERS.
03:06:54.770 --> 03:06:56.005 region:rollup2
NO LONGER WOULD HAVE THAT
03:06:55.304 --> 03:06:57.106 region:rollup2
OPTION.
03:06:56.005 --> 03:07:00.042 region:rollup2
.
03:06:57.106 --> 03:07:01.510 region:rollup2
SO.
03:07:00.042 --> 03:07:02.812 region:rollup2
FIRST WE'LL DISCUSS THE PERSONAL
03:07:01.510 --> 03:07:05.548 region:rollup2
INCOME TAX THE PERSONAL INCOME
03:07:02.812 --> 03:07:06.182 region:rollup2
TAXES THE MAIN STATE TAX.
03:07:05.548 --> 03:07:07.983 region:rollup2
PROVIDES.
03:07:06.182 --> 03:07:09.852 region:rollup2
ROUGHLY SEVENTY PERCENT OF THE
03:07:07.983 --> 03:07:11.320 region:rollup2
STATE'S GENERAL FUND.
03:07:09.852 --> 03:07:13.322 region:rollup2
IT'S LEVIED ON.
03:07:11.320 --> 03:07:14.724 region:rollup2
HOUSEHOLD INCOME LIKE WAGES AND
03:07:13.322 --> 03:07:16.292 region:rollup2
SALARIES RETIREMENT INCOME
03:07:14.724 --> 03:07:17.827 region:rollup2
BUSINESS INCOME.
03:07:16.292 --> 03:07:19.929 region:rollup2
I AND THE STATE ASSESSES.
03:07:17.827 --> 03:07:21.564 region:rollup2
MARGINAL RATES THAT RANGE FROM
03:07:19.929 --> 03:07:24.066 region:rollup2
ONE PERCENT TO TWELVE POINT
03:07:21.564 --> 03:07:25.868 region:rollup2
THREE PERCENT. AND THEY INCREASE
03:07:24.066 --> 03:07:27.336 region:rollup2
WITH INCREASES IN INCOME.
03:07:25.868 --> 03:07:30.172 region:rollup2
AS WE KNOW THE HAND OUT THERE
03:07:27.336 --> 03:07:32.241 region:rollup2
IS ALSO A ONE PERCENT SURCHARGE.
03:07:30.172 --> 03:07:33.876 region:rollup2
FROM PROPOSITION SIXTY THREE
03:07:32.241 --> 03:07:36.145 region:rollup2
RELATED TO MENTAL HEALTH.
03:07:33.876 --> 03:07:37.580 region:rollup2
BUT WE GENERALLY DON'T I HAVE
03:07:36.145 --> 03:07:39.648 region:rollup2
THOSE REFLECTED IN OUR.
03:07:37.580 --> 03:07:41.350 region:rollup2
ESTIMATES AND TABLES HERE.
03:07:39.648 --> 03:07:42.985 region:rollup2
SO THE TWO MAIN WAYS THAT YOU
03:07:41.350 --> 03:07:43.419 region:rollup2
CAN INCREASE PERSONAL INCOME TAX
03:07:42.985 --> 03:07:45.855 region:rollup2
REVENUE.
03:07:43.419 --> 03:07:46.689 region:rollup2
ARE TO EITHER INCREASE RATES
03:07:45.855 --> 03:07:49.158 region:rollup2
AND OR.
03:07:46.689 --> 03:07:50.826 region:rollup2
ELIMINATE OR MODIFY TAX
03:07:49.158 --> 03:07:52.194 region:rollup2
EXPENDITURES LIKE THE MORTGAGE
03:07:50.826 --> 03:07:54.830 region:rollup2
INTEREST DEDUCTION.
03:07:52.194 --> 03:07:56.465 region:rollup2
FOR THIS HAND OUT WE LOOKED AT
03:07:54.830 --> 03:07:57.633 region:rollup2
WHAT TYPES OF RATE INCREASES
03:07:56.465 --> 03:08:00.002 region:rollup2
WOULD BE NECESSARY.
03:07:57.633 --> 03:08:01.370 region:rollup2
.
03:08:00.002 --> 03:08:03.005 region:rollup2
TO RAISE OTHER TENANT TO HONOR
03:08:01.370 --> 03:08:03.539 region:rollup2
BILLION DOLLARS IN LOOK AND
03:08:03.005 --> 03:08:05.274 region:rollup2
ASSUMING THAT.
03:08:03.539 --> 03:08:06.509 region:rollup2
THERE WOULD BE AT ACROSS THE
03:08:05.274 --> 03:08:08.778 region:rollup2
BOARD.
03:08:06.509 --> 03:08:10.179 region:rollup2
INCREASE IN ALL RATES NOW.
03:08:08.778 --> 03:08:12.214 region:rollup2
YOU KNOW YOU WOULD HAVE OPTIONS
03:08:10.179 --> 03:08:13.616 region:rollup2
TO SORT OF CONCENTRATE THAT TAX
03:08:12.214 --> 03:08:15.284 region:rollup2
INCREASE ON DIFFERENT PARTS OF
03:08:13.616 --> 03:08:16.986 region:rollup2
THE INCOME DISTRIBUTION.
03:08:15.284 --> 03:08:17.520 region:rollup2
BUT AGAIN WE WE KIND OF LOOKED
03:08:16.986 --> 03:08:20.256 region:rollup2
AT A. AN ACROSS THE BOARD
03:08:17.520 --> 03:08:25.060 region:rollup2
OPTION.
03:08:20.256 --> 03:08:25.794 region:rollup2
.
03:08:25.060 --> 03:08:27.630 region:rollup2
SIR ALL KNOW THAT.
03:08:25.794 --> 03:08:28.898 region:rollup2
THAT THE HANDOUTS THAT THEN THE
03:08:27.630 --> 03:08:31.066 region:rollup2
COMMITTEE HAVE.
03:08:28.898 --> 03:08:32.201 region:rollup2
ARE UPDATED TO REFLECT THE A
03:08:31.066 --> 03:08:33.435 region:rollup2
PROBLEM THAT WE FOUND IN IN
03:08:32.201 --> 03:08:34.537 region:rollup2
THEIR TABLE.
03:08:33.435 --> 03:08:35.838 region:rollup2
EARLIER THIS MORNING BUT
03:08:34.537 --> 03:08:37.640 region:rollup2
ANYBODY WHO HAD PICKED UP THE
03:08:35.838 --> 03:08:40.009 region:rollup2
HAND OUT FROM OUTSIDE THE ROOM.
03:08:37.640 --> 03:08:40.743 region:rollup2
CAN FIND THE CORRECTED VERSION
03:08:40.009 --> 03:08:43.646 region:rollup2
ON OUR WEBSITE.
03:08:40.743 --> 03:08:45.080 region:rollup2
.
03:08:43.646 --> 03:08:46.482 region:rollup2
SO WE ESTIMATE THAT IT THAT IT
03:08:45.080 --> 03:08:47.616 region:rollup2
INCREASE REQUIRED FOR TEN
03:08:46.482 --> 03:08:49.151 region:rollup2
BILLION DOLLARS WOULD REQUIRE A
03:08:47.616 --> 03:08:50.619 region:rollup2
TEN PERCENT
03:08:49.151 --> 03:08:52.688 region:rollup2
INCREASE IN RATES ACROSS THE
03:08:50.619 --> 03:08:54.390 region:rollup2
BOARD SO FOR EXAMPLE. I THE TOP
03:08:52.688 --> 03:08:55.724 region:rollup2
TWELVE POINT THREE PERCENT RATE
03:08:54.390 --> 03:08:57.226 region:rollup2
WOULD HAVE TO INCREASE TO
03:08:55.724 --> 03:08:59.695 region:rollup2
THIRTEEN POINT FIVE PERCENT.
03:08:57.226 --> 03:09:01.096 region:rollup2
.
03:08:59.695 --> 03:09:02.298 region:rollup2
I DON'T IN ORDER TO RAISE TWO
03:09:01.096 --> 03:09:03.933 region:rollup2
HUNDRED BILLION DOLLARS HOWEVER
03:09:02.298 --> 03:09:05.634 region:rollup2
THE RATES WOULD HAVE TO BE ABOUT
03:09:03.933 --> 03:09:07.803 region:rollup2
THREE TIMES HIGHER.
03:09:05.634 --> 03:09:09.605 region:rollup2
I AM IS REFLECTED ON THE TABLE
03:09:07.803 --> 03:09:11.540 region:rollup2
THE CORRECTED VERSION THAT IS.
03:09:09.605 --> 03:09:12.508 region:rollup2
THE TOP MARGINAL RATE ON THE
03:09:11.540 --> 03:09:13.776 region:rollup2
TWO HUNDRED BILLION DOLLAR
03:09:12.508 --> 03:09:16.412 region:rollup2
OPTION WOULD BE.
03:09:13.776 --> 03:09:17.846 region:rollup2
ABOUT THIRTY SIX PERCENT.
03:09:16.412 --> 03:09:18.881 region:rollup2
AND TO PROVIDE A LITTLE BIT OF
03:09:17.846 --> 03:09:21.183 region:rollup2
CONTEXT THERE.
03:09:18.881 --> 03:09:21.684 region:rollup2
WHEN COMBINED WITH THE NEW TOP
03:09:21.183 --> 03:09:25.120 region:rollup2
FEDERAL RATE.
03:09:21.684 --> 03:09:26.088 region:rollup2
IN THE IN THE RECENT FEDERAL.
03:09:25.120 --> 03:09:28.123 region:rollup2
BILL.
03:09:26.088 --> 03:09:29.358 region:rollup2
THAT WOULD RESULT IN A COMBINED
03:09:28.123 --> 03:09:31.393 region:rollup2
STATE AND FEDERAL RATED OVER
03:09:29.358 --> 03:09:33.295 region:rollup2
SEVENTY PERCENT.
03:09:31.393 --> 03:09:33.562 region:rollup2
THIS SEEMS LIKE A GOOD TIME TO
03:09:33.295 --> 03:09:35.831 region:rollup2
MENTION.
03:09:33.562 --> 03:09:38.234 region:rollup2
THAT SOME OF THESE OPTIONS
03:09:35.831 --> 03:09:39.768 region:rollup2
WOULD WOULD HAVE LARGE TAXPAYER
03:09:38.234 --> 03:09:41.370 region:rollup2
BEHAVIORAL RESPONSES IN IN FOR
03:09:39.768 --> 03:09:43.305 region:rollup2
EXAMPLE HERE.
03:09:41.370 --> 03:09:44.673 region:rollup2
ONE CAN IMAGINE THAT WITH.
03:09:43.305 --> 03:09:45.908 region:rollup2
COMBINED RATE OF OVER SEVENTY
03:09:44.673 --> 03:09:47.042 region:rollup2
PERCENT THERE WOULD LIKELY BE
03:09:45.908 --> 03:09:49.278 region:rollup2
MANY PEOPLE.
03:09:47.042 --> 03:09:51.947 region:rollup2
FINDING ANOTHER PLACE TO LIVE.
03:09:49.278 --> 03:09:53.315 region:rollup2
AND AND I MENTION THAT AS WELL
03:09:51.947 --> 03:09:54.883 region:rollup2
BECAUSE WE HAVE PRODUCED.
03:09:53.315 --> 03:09:55.584 region:rollup2
STATIC ESTIMATES THE DON'T
03:09:54.883 --> 03:09:58.587 region:rollup2
ASSUME.
03:09:55.584 --> 03:10:00.222 region:rollup2
CHANGES IN THE ECONOMY CHANGES
03:09:58.587 --> 03:10:02.524 region:rollup2
AND HOW TAXPAYERS RESPOND.
03:10:00.222 --> 03:10:04.093 region:rollup2
AND SO PARTICULARLY AT THE HIGH
03:10:02.524 --> 03:10:05.527 region:rollup2
END OF OF WHAT WE'RE TALKING
03:10:04.093 --> 03:10:08.163 region:rollup2
ABOUT THIS PRESENTATION.
03:10:05.527 --> 03:10:09.665 region:rollup2
THERE WOULD BE HUGE UNCERTAINTY.
03:10:08.163 --> 03:10:11.233 region:rollup2
RESULTING FROM FROM THESE
03:10:09.665 --> 03:10:13.135 region:rollup2
FACTORS.
03:10:11.233 --> 03:10:14.603 region:rollup2
AND IT'S QUITE POSSIBLE THAT
03:10:13.135 --> 03:10:16.605 region:rollup2
THE AMOUNT OF REVENUE THAT WOULD
03:10:14.603 --> 03:10:18.307 region:rollup2
BE RAISED IF YOU DID UP PURSUE
03:10:16.605 --> 03:10:18.540 region:rollup2
SOME OF THESE OPTIONS WOULD.
03:10:18.307 --> 03:10:20.909 region:rollup2
WOULD.
03:10:18.540 --> 03:10:21.410 region:rollup2
VERY FROM THESE ESTIMATES BY
03:10:20.909 --> 03:10:24.146 region:rollup2
MANY TENS OF BILLIONS OF
03:10:21.410 --> 03:10:25.414 region:rollup2
DOLLARS.
03:10:24.146 --> 03:10:27.283 region:rollup2
SO NEXT WILL DESCRIBE THE
03:10:25.414 --> 03:10:28.284 region:rollup2
PROPERTY TAX AND IT'S THE MAIN
03:10:27.283 --> 03:10:30.085 region:rollup2
LOCAL TAX SOURCE.
03:10:28.284 --> 03:10:32.988 region:rollup2
.
03:10:30.085 --> 03:10:33.155 region:rollup2
.
03:10:32.988 --> 03:10:35.291 region:rollup2
THE.
03:10:33.155 --> 03:10:37.026 region:rollup2
THE PROPOSITION THIRTEEN.
03:10:35.291 --> 03:10:38.727 region:rollup2
MAILED A NUMBER OF CHANGES TO
03:10:37.026 --> 03:10:39.762 region:rollup2
THE PROPERTY TAX IT CAPS THE.
03:10:38.727 --> 03:10:41.463 region:rollup2
PROPERTY TAX RATE AT ONE
03:10:39.762 --> 03:10:42.531 region:rollup2
PERCENT.
03:10:41.463 --> 03:10:43.365 region:rollup2
AND ALSO.
03:10:42.531 --> 03:10:45.934 region:rollup2
AFFECTS HOW.
03:10:43.365 --> 03:10:47.336 region:rollup2
HOW ASSESSED VALUES CAN GROW?
03:10:45.934 --> 03:10:48.637 region:rollup2
IT LIMITS.
03:10:47.336 --> 03:10:50.372 region:rollup2
GROWTH NEXT BEEN ASSESSED
03:10:48.637 --> 03:10:52.141 region:rollup2
VALUES TO THE GREATER INFLATION
03:10:50.372 --> 03:10:53.375 region:rollup2
AND TWO PERCENT AND SO. THAT
03:10:52.141 --> 03:10:54.276 region:rollup2
KIND OF USMOVES OUT THE TAX
03:10:53.375 --> 03:10:56.345 region:rollup2
BASE.
03:10:54.276 --> 03:10:58.247 region:rollup2
.
03:10:56.345 --> 03:10:59.581 region:rollup2
SO FOR OPTIONS FOR ATTACKS THAT
03:10:58.247 --> 03:11:01.250 region:rollup2
THE PARTY TAX YOU CAN EITHER
03:10:59.581 --> 03:11:02.484 region:rollup2
INCREASE THE TAX RATE OR YOU CAN
03:11:01.250 --> 03:11:04.753 region:rollup2
MAKE CHANGES TO THAT ASSESSMENT
03:11:02.484 --> 03:11:07.957 region:rollup2
SYSTEM FOR EXAMPLE SOME HAVE UP
03:11:04.753 --> 03:11:09.525 region:rollup2
PROPOSED A SPLIT ROLE WHEREBY. A
03:11:07.957 --> 03:11:11.493 region:rollup2
RESIDENTIAL PROPERTIES ARE
03:11:09.525 --> 03:11:12.761 region:rollup2
CONTINUING TO BE TAXED AT THE IN
03:11:11.493 --> 03:11:14.563 region:rollup2
THE UNDER THE CURRENT SYSTEM THE
03:11:12.761 --> 03:11:15.831 region:rollup2
COMMERCIAL PROPERTIES WILL BE
03:11:14.563 --> 03:11:18.133 region:rollup2
TAXED AT MARKET VALUES.
03:11:15.831 --> 03:11:18.767 region:rollup2
.
03:11:18.133 --> 03:11:21.370 region:rollup2
FOR THIS.
03:11:18.767 --> 03:11:23.305 region:rollup2
HEARING HOWEVER WE LOOKED AT.
03:11:21.370 --> 03:11:25.507 region:rollup2
JUST AN INCREASE IN TAX RATES
03:11:23.305 --> 03:11:27.509 region:rollup2
WITHOUT A CHANGE IN THE TAX BASE
03:11:25.507 --> 03:11:29.244 region:rollup2
OR IN THE ASSESSMENT SYSTEM.
03:11:27.509 --> 03:11:31.013 region:rollup2
NOW WE ESTIMATED THAT A POINT
03:11:29.244 --> 03:11:32.181 region:rollup2
TWO PERCENT INCREASE WOULD BE
03:11:31.013 --> 03:11:33.882 region:rollup2
NEEDED FOR AN ADDITIONAL TEN
03:11:32.181 --> 03:11:35.417 region:rollup2
BILLION DOLLARS WHICH WOULD
03:11:33.882 --> 03:11:36.518 region:rollup2
BRING THE STATEWIDE AVERAGE.
03:11:35.417 --> 03:11:37.653 region:rollup2
TAX RATE TO.
03:11:36.518 --> 03:11:39.188 region:rollup2
I BELIEVE ONE POINT THREE
03:11:37.653 --> 03:11:40.856 region:rollup2
PERCENT.
03:11:39.188 --> 03:11:42.091 region:rollup2
BUT IT BUT A TWO HUNDRED
03:11:40.856 --> 03:11:43.158 region:rollup2
BILLION DOLLAR INCREASE ON THE
03:11:42.091 --> 03:11:44.693 region:rollup2
OTHER HAND WOULD REQUIRE AN
03:11:43.158 --> 03:11:45.961 region:rollup2
INCREASE OF THREE POINT SEVEN
03:11:44.693 --> 03:11:46.729 region:rollup2
PERCENT WHICH WOULD BRING THE
03:11:45.961 --> 03:11:50.466 region:rollup2
AVERAGE RATES ALMOST FIVE
03:11:46.729 --> 03:11:50.833 region:rollup2
PERCENT.
03:11:50.466 --> 03:11:53.302 region:rollup2
NEXT.
03:11:50.833 --> 03:11:55.070 region:rollup2
IS THE SALES AND USE TAX.
03:11:53.302 --> 03:11:57.272 region:rollup2
THIS IS ATAXES COLLECTED BY
03:11:55.070 --> 03:11:59.475 region:rollup2
THE STATE AND IS DISTRIBUTED TO
03:11:57.272 --> 03:12:01.243 region:rollup2
THE STATE AND LOCAL GOVERNMENTS.
03:11:59.475 --> 03:12:02.277 region:rollup2
THE STATEWIDE AVERAGE RATE IS
03:12:01.243 --> 03:12:03.879 region:rollup2
CURRENTLY EIGHT POINT FIVE
03:12:02.277 --> 03:12:04.279 region:rollup2
PERCENT THE LOCAL GOVERNMENTS
03:12:03.879 --> 03:12:06.582 region:rollup2
CAN.
03:12:04.279 --> 03:12:08.016 region:rollup2
CHOOSE TO ADD ON RATES.
03:12:06.582 --> 03:12:09.284 region:rollup2
SO THAT TELLS TAX CAN VARY
03:12:08.016 --> 03:12:10.619 region:rollup2
CONSIDERABLY IN SOME PARTS OF
03:12:09.284 --> 03:12:12.654 region:rollup2
THE STATE.
03:12:10.619 --> 03:12:13.822 region:rollup2
.
03:12:12.654 --> 03:12:15.057 region:rollup2
NOW IN THE SALES TAX.
03:12:13.822 --> 03:12:16.959 region:rollup2
ANOTHER OPTION THAT YOU CAN
03:12:15.057 --> 03:12:17.659 region:rollup2
CONSIDER IS TO CHANGE THE TAX
03:12:16.959 --> 03:12:18.961 region:rollup2
BASE FOR EXAMPLE.
03:12:17.659 --> 03:12:19.895 region:rollup2
SOME PEOPLE HAVE TALKED ABOUT
03:12:18.961 --> 03:12:21.730 region:rollup2
EXTENDING THE SALES TAX
03:12:19.895 --> 03:12:23.399 region:rollup2
SERVICES.
03:12:21.730 --> 03:12:25.934 region:rollup2
WE ALSO NOTE.
03:12:23.399 --> 03:12:27.403 region:rollup2
THAT. THAT THE SALES TAX COULD
03:12:25.934 --> 03:12:29.605 region:rollup2
ALSO BE EXTENDED TO.
03:12:27.403 --> 03:12:31.140 region:rollup2
BE APPLIED TO A CANDY SNACK
03:12:29.605 --> 03:12:31.974 region:rollup2
FOODS AND BOTTLED WATER BUT THAT
03:12:31.140 --> 03:12:33.275 region:rollup2
WOULD BE ANOTHER OPTION THAT
03:12:31.974 --> 03:12:35.310 region:rollup2
REQUIRE GOING THE VOTERS BECAUSE
03:12:33.275 --> 03:12:37.880 region:rollup2
THERE'S A SPECIFIC. PROVISION IN
03:12:35.310 --> 03:12:40.783 region:rollup2
THE CONSTITUTION ABOUT THAT.
03:12:37.880 --> 03:12:42.518 region:rollup2
.
03:12:40.783 --> 03:12:43.519 region:rollup2
SO WE AGAIN.
03:12:42.518 --> 03:12:44.853 region:rollup2
MADE NO.
03:12:43.519 --> 03:12:46.321 region:rollup2
ASSUME NO CHANGE IN THE TAX
03:12:44.853 --> 03:12:47.923 region:rollup2
BASE.
03:12:46.321 --> 03:12:49.758 region:rollup2
AND JUST LOOK AT WHAT KINDS OF
03:12:47.923 --> 03:12:51.393 region:rollup2
RATES WOULD BE NEEDED TO RAISE
03:12:49.758 --> 03:12:53.061 region:rollup2
THE ADDITIONAL AYE REVENUE.
03:12:51.393 --> 03:12:54.396 region:rollup2
FOR TEN BILLION DOLLARS WE
03:12:53.061 --> 03:12:55.731 region:rollup2
ESTIMATE THAT IT WOULD REQUIRE
03:12:54.396 --> 03:12:57.199 region:rollup2
AN ADDITIONAL ONE POINT FOUR
03:12:55.731 --> 03:12:59.501 region:rollup2
PERCENT. AND THAT WOULD BRING
03:12:57.199 --> 03:13:01.503 region:rollup2
THE STATEWIDE AVERAGE SALES TAX
03:12:59.501 --> 03:13:02.838 region:rollup2
RATE TO ABOUT TEN PERCENT.
03:13:01.503 --> 03:13:04.506 region:rollup2
THAT ON THE OTHER HAND.
03:13:02.838 --> 03:13:05.607 region:rollup2
TWO HUNDRED BILLION DOLLARS
03:13:04.506 --> 03:13:06.742 region:rollup2
WOULD REQUIRE AN INCREASE OF
03:13:05.607 --> 03:13:08.077 region:rollup2
ROUGHLY TWENTY EIGHT PERCENTAGE
03:13:06.742 --> 03:13:09.778 region:rollup2
POINTS.
03:13:08.077 --> 03:13:11.146 region:rollup2
I WHICH WOULD BRING THE AVERAGE
03:13:09.778 --> 03:13:15.117 region:rollup2
SALES TAX RATE TO ABOUT THIRTY
03:13:11.146 --> 03:13:16.018 region:rollup2
SEVEN PERCENT.
03:13:15.117 --> 03:13:18.654 region:rollup2
ANOTHER OPTION.
03:13:16.018 --> 03:13:20.456 region:rollup2
THAT WE INCLUDE IS IS A PAYROLL
03:13:18.654 --> 03:13:22.491 region:rollup2
TAX ON THE STATE HAS A FEW SMALL
03:13:20.456 --> 03:13:24.226 region:rollup2
PAYROLL TAXES FOR EXAMPLE THAT
03:13:22.491 --> 03:13:26.795 region:rollup2
ARE LEVIED FOR. REALLY DONE
03:13:24.226 --> 03:13:28.931 region:rollup2
EMPLOYMENT ASSURANCE.
03:13:26.795 --> 03:13:30.732 region:rollup2
THE FEDERAL GOVERNMENT ALSO
03:13:28.931 --> 03:13:32.668 region:rollup2
LEVEES PAYROLL TAXES FOR EXAMPLE
03:13:30.732 --> 03:13:34.837 region:rollup2
FOR SOCIAL SECURITY AND THEY
03:13:32.668 --> 03:13:36.672 region:rollup2
LOVE IT UP TO A CERTAIN AMOUNT.
03:13:34.837 --> 03:13:38.173 region:rollup2
I BELIEVE IN. AND.
03:13:36.672 --> 03:13:39.608 region:rollup2
TWENTY SEVENTEEN IT WAS A
03:13:38.173 --> 03:13:40.409 region:rollup2
HUNDRED AND TWENTY THOUSAND FOUR
03:13:39.608 --> 03:13:42.377 region:rollup2
HUNDRED.
03:13:40.409 --> 03:13:44.513 region:rollup2
BUT THE STATE COULD CHOOSE TO
03:13:42.377 --> 03:13:45.147 region:rollup2
APPLY IT TO ALL INCOME IT
03:13:44.513 --> 03:13:45.781 region:rollup2
DOESN'T ACTUALLY HAVE TO HAVE A
03:13:45.147 --> 03:13:46.615 region:rollup2
CAP.
03:13:45.781 --> 03:13:48.183 region:rollup2
ON THE STATE WOULD BE ABLE TO
03:13:46.615 --> 03:13:49.952 region:rollup2
MAKE CHOICES ABOUT WHAT RATE TO
03:13:48.183 --> 03:13:51.420 region:rollup2
CHARGE IN COULD CONCEIVABLY
03:13:49.952 --> 03:13:53.856 region:rollup2
CHARGE DIFFERENT RATES.
03:13:51.420 --> 03:13:56.291 region:rollup2
DIFFERENT INCOME LEVELS.
03:13:53.856 --> 03:13:57.559 region:rollup2
WE ESTIMATED THAT AN INCREASE
03:13:56.291 --> 03:13:59.228 region:rollup2
OF TEN BILLION DOLLARS WOULD
03:13:57.559 --> 03:14:01.530 region:rollup2
REQUIRE PAYROLL TAX RATE OF ZERO
03:13:59.228 --> 03:14:02.965 region:rollup2
POINT EIGHT PERCENT.
03:14:01.530 --> 03:14:03.799 region:rollup2
AND THAT IS INCREASE OF TWO
03:14:02.965 --> 03:14:04.933 region:rollup2
HUNDRED BILLION DOLLARS WOULD
03:14:03.799 --> 03:14:07.769 region:rollup2
REQUIRE RATE OF ROUGHLY FIFTEEN
03:14:04.933 --> 03:14:09.438 region:rollup2
PERCENT.
03:14:07.769 --> 03:14:10.339 region:rollup2
FINALLY AN OPTION THAT WE
03:14:09.438 --> 03:14:11.640 region:rollup2
INCLUDED.
03:14:10.339 --> 03:14:13.675 region:rollup2
HAS BEEN MENTIONED BY.
03:14:11.640 --> 03:14:15.744 region:rollup2
SOME RESEARCHERS.
03:14:13.675 --> 03:14:18.046 region:rollup2
GROSS RECEIPTS TAX.
03:14:15.744 --> 03:14:19.481 region:rollup2
A GROSS RECEIPTS TAXES A LITTLE
03:14:18.046 --> 03:14:21.149 region:rollup2
BIT SIMILAR TO A SALES TAX ITS
03:14:19.481 --> 03:14:22.885 region:rollup2
ITS ASSESSED ON ALL BUSINESS
03:14:21.149 --> 03:14:24.953 region:rollup2
SALES ENDING AND INCLUDES GOODS
03:14:22.885 --> 03:14:26.889 region:rollup2
AND SERVICES.
03:14:24.953 --> 03:14:28.490 region:rollup2
BUT WHEREAS THE SALES TAX IS
03:14:26.889 --> 03:14:30.192 region:rollup2
COLLECTED AT THE RETAIL LEVEL
03:14:28.490 --> 03:14:31.860 region:rollup2
YOU KNOW LIKE AT A STORE.
03:14:30.192 --> 03:14:32.728 region:rollup2
THE GROSS RECEIPTS TAX IS
03:14:31.860 --> 03:14:34.530 region:rollup2
COLLECTED AT ALL STAGES OF
03:14:32.728 --> 03:14:35.964 region:rollup2
PRODUCTION.
03:14:34.530 --> 03:14:36.498 region:rollup2
AND SO YOU COULD IMAGINE FOR
03:14:35.964 --> 03:14:39.201 region:rollup2
EXAMPLE.
03:14:36.498 --> 03:14:42.037 region:rollup2
A CAR MANUFACTURER THAT IS.
03:14:39.201 --> 03:14:43.138 region:rollup2
SOURCING SEAT BELTS AND BRAKE
03:14:42.037 --> 03:14:45.174 region:rollup2
PADS AND ALL KINDS OF PARTS IN
03:14:43.138 --> 03:14:46.275 region:rollup2
ASSEMBLING A CAR THERE THEIR
03:14:45.174 --> 03:14:47.743 region:rollup2
SOURCING THESE PRODUCTS FROM
03:14:46.275 --> 03:14:50.612 region:rollup2
OTHER COMPANIES.
03:14:47.743 --> 03:14:52.147 region:rollup2
AT EACH STAGE OF THAT PROCESS
03:14:50.612 --> 03:14:53.415 region:rollup2
WHEN THEY PREPARE THE SEAT BELTS
03:14:52.147 --> 03:14:54.783 region:rollup2
AND OTHER PARTS THE GROSS
03:14:53.415 --> 03:14:57.219 region:rollup2
RECEIPTS TAX WOULD BE ASSESSED
03:14:54.783 --> 03:14:59.621 region:rollup2
EVERY SINGLE TIME.
03:14:57.219 --> 03:15:01.557 region:rollup2
AND THIS CAUSES SOME.
03:14:59.621 --> 03:15:03.592 region:rollup2
POTENTIALLY NEGATIVE ECONOMIC
03:15:01.557 --> 03:15:05.661 region:rollup2
EFFECTS BECAUSE IT WOULD PROVIDE
03:15:03.592 --> 03:15:06.028 region:rollup2
AN INCENTIVE FOR FIRMS.
03:15:05.661 --> 03:15:08.730 region:rollup2
TO.
03:15:06.028 --> 03:15:10.899 region:rollup2
STAR INSTEAD TO PRODUCE ALL OF
03:15:08.730 --> 03:15:12.100 region:rollup2
THOSE MATERIALS THEMSELVES SO AS
03:15:10.899 --> 03:15:13.735 region:rollup2
TO AVOID THE TAX NEXT
03:15:12.100 --> 03:15:16.672 region:rollup2
PARTICULARLY A PROBLEM WITH A
03:15:13.735 --> 03:15:18.574 region:rollup2
LARGER TAX RATE.
03:15:16.672 --> 03:15:20.809 region:rollup2
WE ESTIMATED THAT A GROSS
03:15:18.574 --> 03:15:22.444 region:rollup2
RECEIPTS TAX OF ZERO POINT TWO
03:15:20.809 --> 03:15:22.945 region:rollup2
FIVE PERCENT WOULD BE NECESSARY
03:15:22.444 --> 03:15:25.047 region:rollup2
TO RAISE THE TEN BILLION
03:15:22.945 --> 03:15:27.316 region:rollup2
DOLLARS.
03:15:25.047 --> 03:15:28.483 region:rollup2
BUT IN ORDER TO RAISE TWO
03:15:27.316 --> 03:15:29.851 region:rollup2
HUNDRED BILLION DOLLARS WE
03:15:28.483 --> 03:15:32.854 region:rollup2
ESTIMATED THAT WOULD HAVE TO BE
03:15:29.851 --> 03:15:34.423 region:rollup2
ROUGHLY FIVE PERCENT.
03:15:32.854 --> 03:15:36.058 region:rollup2
SO IN THE END OF THE.
03:15:34.423 --> 03:15:37.726 region:rollup2
PRESENTATION HERE WE HAD ON A
03:15:36.058 --> 03:15:39.962 region:rollup2
NUMBER OF.
03:15:37.726 --> 03:15:41.630 region:rollup2
CONSIDERATIONS TWO WAY.
03:15:39.962 --> 03:15:42.731 region:rollup2
.
03:15:41.630 --> 03:15:43.165 region:rollup2
AS YOU CONSIDER VARIOUS
03:15:42.731 --> 03:15:45.467 region:rollup2
PROPOSALS.
03:15:43.165 --> 03:15:47.035 region:rollup2
.
03:15:45.467 --> 03:15:48.937 region:rollup2
I'M NOT GOING TO COVER EVERYONE
03:15:47.035 --> 03:15:50.973 region:rollup2
BUT I DID WANT TO MENTION.
03:15:48.937 --> 03:15:52.474 region:rollup2
NEAR THE BOTTOM OF PAGE
03:15:50.973 --> 03:15:54.676 region:rollup2
SEVENTEEN HERE.
03:15:52.474 --> 03:15:56.411 region:rollup2
REVENUE VOLATILITY AND WHICH
03:15:54.676 --> 03:15:57.779 region:rollup2
HAS BEEN A BIG HOT ISSUE IN THE
03:15:56.411 --> 03:15:58.747 region:rollup2
STATE BUDGET FOR THE LAST TWENTY
03:15:57.779 --> 03:16:01.016 region:rollup2
YEARS OR SO.
03:15:58.747 --> 03:16:02.384 region:rollup2
.
03:16:01.016 --> 03:16:03.885 region:rollup2
AS YOU PROBABLY KNOW WITH THE
03:16:02.384 --> 03:16:05.387 region:rollup2
GENERAL FUND OF THE GENERAL FUND
03:16:03.885 --> 03:16:06.755 region:rollup2
RELYING SO MUCH IN THE PERSONAL
03:16:05.387 --> 03:16:08.256 region:rollup2
INCOME TAX WHICH IS A HIGHLY
03:16:06.755 --> 03:16:10.058 region:rollup2
VOLATILE SOURCE.
03:16:08.256 --> 03:16:12.227 region:rollup2
HAS MADE BUDGETING CHALLENGING
03:16:10.058 --> 03:16:13.829 region:rollup2
BECAUSE REVENUES CAN CAN KIND OF
03:16:12.227 --> 03:16:15.731 region:rollup2
BOOM AND BUST.
03:16:13.829 --> 03:16:17.265 region:rollup2
AND IN THE PAST.
03:16:15.731 --> 03:16:18.500 region:rollup2
THE STATE HAS COMMITTED TO AN
03:16:17.265 --> 03:16:20.135 region:rollup2
UNSUSTAINABLE LEVEL OF SPENDING
03:16:18.500 --> 03:16:21.870 region:rollup2
AND THAT'S.
03:16:20.135 --> 03:16:22.638 region:rollup2
PART OF THE REASON THAT THE
03:16:21.870 --> 03:16:23.805 region:rollup2
STATE HAD.
03:16:22.638 --> 03:16:27.309 region:rollup2
SUCH SIGNIFICANT BUDGET
03:16:23.805 --> 03:16:29.177 region:rollup2
PROBLEMS IN THE TWO THOUSANDS.
03:16:27.309 --> 03:16:30.612 region:rollup2
PROPOSITION TWO THAT WERE OF
03:16:29.177 --> 03:16:31.980 region:rollup2
THAT WAS APPROVED BY VOTERS IN
03:16:30.612 --> 03:16:33.882 region:rollup2
TWENTY FOURTEEN ESTABLISH A
03:16:31.980 --> 03:16:34.416 region:rollup2
RAINY DAY FUND.
03:16:33.882 --> 03:16:35.083 region:rollup2
WITH.
03:16:34.416 --> 03:16:37.252 region:rollup2
WITH.
03:16:35.083 --> 03:16:39.721 region:rollup2
WITH A TARGET OF TEN PERCENT OF
03:16:37.252 --> 03:16:41.657 region:rollup2
GENERAL FUND TAXES.
03:16:39.721 --> 03:16:43.058 region:rollup2
AND THE THE POINT OF THE RAINY
03:16:41.657 --> 03:16:45.027 region:rollup2
DAY FUND WAS TO.
03:16:43.058 --> 03:16:46.361 region:rollup2
ON THE ONE HAND KEEP SPENDING
03:16:45.027 --> 03:16:47.896 region:rollup2
LOWER BECAUSE YOU'RE TAKING SOME
03:16:46.361 --> 03:16:48.430 region:rollup2
OF WHAT COULD OTHERWISE BE SENT
03:16:47.896 --> 03:16:49.965 region:rollup2
AND YOU'RE PUTTING IN THE
03:16:48.430 --> 03:16:50.532 region:rollup2
RADIATOR FINE BUT ALSO HAVE
03:16:49.965 --> 03:16:52.501 region:rollup2
RESOURCES AVAILABLE SO THAT
03:16:50.532 --> 03:16:54.436 region:rollup2
WHEN.
03:16:52.501 --> 03:16:56.305 region:rollup2
WHEN THERE'S AN ECONOMIC
03:16:54.436 --> 03:16:57.973 region:rollup2
DOWNTURN IN THE STATE BUDGET IS
03:16:56.305 --> 03:16:59.741 region:rollup2
FACING BUDGET PROBLEMS YOU CAN
03:16:57.973 --> 03:17:02.010 region:rollup2
DRAW ON THAT RAINY DAY FUND TO
03:16:59.741 --> 03:17:05.080 region:rollup2
TO AVOID SPENDING CUTS AND TAX
03:17:02.010 --> 03:17:05.981 region:rollup2
INCREASES AND OTHER ACTIONS.
03:17:05.080 --> 03:17:08.417 region:rollup2
NOW IN THE CONTEXT OF.
03:17:05.981 --> 03:17:09.351 region:rollup2
OF OTHER HEALTH CARE.
03:17:08.417 --> 03:17:12.154 region:rollup2
AUGMENTATION.
03:17:09.351 --> 03:17:14.356 region:rollup2
.
03:17:12.154 --> 03:17:16.024 region:rollup2
YOU. THE THE VARIOUS OPTIONS
03:17:14.356 --> 03:17:17.359 region:rollup2
THAT WE MENTION HERE WOULD WOULD
03:17:16.024 --> 03:17:19.094 region:rollup2
VARY CONSIDERABLY IN TERMS OF
03:17:17.359 --> 03:17:20.929 region:rollup2
REVENUE VOLATILITY FOR EXAMPLE.
03:17:19.094 --> 03:17:23.765 region:rollup2
.
03:17:20.929 --> 03:17:25.033 region:rollup2
A A PERSONAL INCOME TAX US ROUTE
03:17:23.765 --> 03:17:27.602 region:rollup2
BY RATE INCREASE THAT'S FOLKS
03:17:25.033 --> 03:17:28.737 region:rollup2
AND HIGH INCOME TAXPAYERS WOULD
03:17:27.602 --> 03:17:30.605 region:rollup2
BE VERY VOLATILE.
03:17:28.737 --> 03:17:32.507 region:rollup2
AND AND GENERALLY SPEAKING.
03:17:30.605 --> 03:17:34.476 region:rollup2
ALL THINGS EQUAL WOULD REQUIRE
03:17:32.507 --> 03:17:37.145 region:rollup2
A LARGER BUDGET RESERVE.
03:17:34.476 --> 03:17:38.880 region:rollup2
THAN SAY PROBABLY A PAYROLL TAX
03:17:37.145 --> 03:17:41.049 region:rollup2
WHICH IS LIKE WE DON WAGES AND
03:17:38.880 --> 03:17:45.120 region:rollup2
SALARIES WHICH IS A RELATIVELY.
03:17:41.049 --> 03:17:47.522 region:rollup2
STABLE I INCOME SOURCE.
03:17:45.120 --> 03:17:49.491 region:rollup2
SO SO THOSE THOSE TWO.
03:17:47.522 --> 03:17:51.293 region:rollup2
CONSIDERATIONS REALLY SHOULD BE
03:17:49.491 --> 03:17:53.428 region:rollup2
THOUGHT OF TOGETHER TO THE TO IN
03:17:51.293 --> 03:17:55.230 region:rollup2
GENERAL TO THE EXTENT THAT THE
03:17:53.428 --> 03:17:57.132 region:rollup2
THAT A PROPOSAL RELIES ON A MORE
03:17:55.230 --> 03:17:58.433 region:rollup2
VOLATILE REVENUE SOURCE.
03:17:57.132 --> 03:17:59.267 region:rollup2
YOU HAVE A GREATER NEED FOR A
03:17:58.433 --> 03:18:01.770 region:rollup2
BUDGET RESERVE AND THERE IS
03:17:59.267 --> 03:18:03.572 region:rollup2
REALLY NO ONE RIGHT NUMBER.
03:18:01.770 --> 03:18:05.474 region:rollup2
FOR WHAT IT TARGET SHOULD BE.
03:18:03.572 --> 03:18:06.208 region:rollup2
AS THE LEGISLATIVE ANALYST'S
03:18:05.474 --> 03:18:08.176 region:rollup2
DISCUSSED.
03:18:06.208 --> 03:18:08.744 region:rollup2
IN THE OVERVIEW OF THE BUDGET
03:18:08.176 --> 03:18:10.679 region:rollup2
HEARING IT FROM THE ASSEMBLY
03:18:08.744 --> 03:18:11.813 region:rollup2
BUDGET COMMITTEE.
03:18:10.679 --> 03:18:13.982 region:rollup2
TO SOME EXTENT IT RISE.
03:18:11.813 --> 03:18:15.717 region:rollup2
RELY A LOT DEPENDS ON THE SORT
03:18:13.982 --> 03:18:17.185 region:rollup2
OF RISK TOLERANCE YOU HAVE.
03:18:15.717 --> 03:18:19.755 region:rollup2
BUT ESPECIALLY IN A PROGRAM OF.
03:18:17.185 --> 03:18:20.989 region:rollup2
IT IF THE LEGISLATURE CONSIDERS
03:18:19.755 --> 03:18:21.223 region:rollup2
MAJOR CHANGES TO THE HEALTHCARE
03:18:20.989 --> 03:18:23.925 region:rollup2
SYSTEM.
03:18:21.223 --> 03:18:25.927 region:rollup2
.
03:18:23.925 --> 03:18:27.829 region:rollup2
THIS YOU KNOW STABILITY AND
03:18:25.927 --> 03:18:29.498 region:rollup2
PROVIDING SERVICES BOB IS
03:18:27.829 --> 03:18:30.565 region:rollup2
DESIRABLE AND SO LARGER BUDGET
03:18:29.498 --> 03:18:33.301 region:rollup2
RESERVE WILL HAVE THE
03:18:30.565 --> 03:18:34.336 region:rollup2
LEGISLATURE REALIZE THAT.
03:18:33.301 --> 03:18:36.905 region:rollup2
SO THAT CONCLUDES.
03:18:34.336 --> 03:18:38.740 region:rollup2
MY REMARKS AND.
03:18:36.905 --> 03:18:41.643 region:rollup2
WHERE MY HABIT ANSWER QUESTIONS
03:18:38.740 --> 03:18:44.079 region:rollup2
IF YOU HAVE THEM?
03:18:41.643 --> 03:18:44.713 region:rollup2
THREE QUESTIONS MISCHIEF.
03:18:44.079 --> 03:18:47.249 region:rollup2
I THINK IT'S CHAIR IT BRIGITTE.
03:18:44.713 --> 03:18:48.984 region:rollup2
ALL THE PRESENTATIONS TODAY
03:18:47.249 --> 03:18:50.719 region:rollup2
ARMED. THREE CATEGORIES OF
03:18:48.984 --> 03:18:52.954 region:rollup2
QUESTIONS AROUND THE IMPACT OF
03:18:50.719 --> 03:18:54.589 region:rollup2
TRUMP TAX PLAN. UP THROUGH THE
03:18:52.954 --> 03:18:56.191 region:rollup2
COST OF SOME THE OPTIONS YOU
03:18:54.589 --> 03:18:56.792 region:rollup2
LAID OUT AND THEN.
03:18:56.191 --> 03:18:58.794 region:rollup2
SOME OF THE ESTIMATES YOU PAT
03:18:56.792 --> 03:18:59.661 region:rollup2
AROUND A WATER PUBLICLY FINANCED
03:18:58.794 --> 03:19:01.563 region:rollup2
SINGLE PAYER SYSTEM MIGHT LOOK
03:18:59.661 --> 03:19:03.131 region:rollup2
LIKE SPEAKING FIRST AROUND THE
03:19:01.563 --> 03:19:04.433 region:rollup2
IMPACT OF THE TRUMP TAX PLAN I.
03:19:03.131 --> 03:19:06.301 region:rollup2
I APPRECIATE THE VARIOUS TAX
03:19:04.433 --> 03:19:08.637 region:rollup2
OPTIONS THAT YOU HAVE LAID OUT
03:19:06.301 --> 03:19:10.005 region:rollup2
HERE. UP OBVIOUSLY THESE WERE IN
03:19:08.637 --> 03:19:10.572 region:rollup2
CONSIDERATION I THINK LAST YEAR
03:19:10.005 --> 03:19:13.208 region:rollup2
WHEN.
03:19:10.572 --> 03:19:15.076 region:rollup2
THIS WAS AND AND DISCUSSION IN
03:19:13.208 --> 03:19:16.344 region:rollup2
THE SENATE. OF BUT SINCE THEN
03:19:15.076 --> 03:19:18.046 region:rollup2
WE'VE OBVIOUSLY HAD A VERY
03:19:16.344 --> 03:19:19.815 region:rollup2
SIGNIFICANT.
03:19:18.046 --> 03:19:21.016 region:rollup2
FEDERAL.
03:19:19.815 --> 03:19:22.150 region:rollup2
SAID OF CHANGES OF OUR TAX
03:19:21.016 --> 03:19:24.553 region:rollup2
POLICY AND.
03:19:22.150 --> 03:19:26.388 region:rollup2
YOU ALLUDED TO SOMEONE ELSE'S
03:19:24.553 --> 03:19:27.789 region:rollup2
THAT YOU'RE STARTING ARE ON WHAT
03:19:26.388 --> 03:19:28.924 region:rollup2
IT WOULD TAKE TO BRING BACK SOME
03:19:27.789 --> 03:19:30.091 region:rollup2
OF THE REVENUES BUT GIVEN THE
03:19:28.924 --> 03:19:30.625 region:rollup2
SIGNIFICANT CUTS AT THE FEDERAL
03:19:30.091 --> 03:19:32.928 region:rollup2
LEVEL OF CERTAIN.
03:19:30.625 --> 03:19:34.496 region:rollup2
TAXES.
03:19:32.928 --> 03:19:36.798 region:rollup2
IS THE LA O. ARE YOU GUYS
03:19:34.496 --> 03:19:38.266 region:rollup2
ANALYZING WHAT IT MIGHT TAKE TO
03:19:36.798 --> 03:19:39.935 region:rollup2
US FOR US TO REVERSE SOME OF
03:19:38.266 --> 03:19:41.703 region:rollup2
THAT TO BRING IN STATE REVENUES.
03:19:39.935 --> 03:19:42.304 region:rollup2
ARE IN A WAY THAT MIGHT BE TAX
03:19:41.703 --> 03:19:44.072 region:rollup2
REVENUE NEUTRAL OR TAX MUTUAL
03:19:42.304 --> 03:19:45.874 region:rollup2
TO.
03:19:44.072 --> 03:19:47.142 region:rollup2
AT SOME OF THE CORPORATIONS OR
03:19:45.874 --> 03:19:49.277 region:rollup2
THE WEALTHY YOUR.
03:19:47.142 --> 03:19:51.079 region:rollup2
CALIFORNIANS THAT HAVE JUST
03:19:49.277 --> 03:19:53.815 region:rollup2
SEEN SIGNIFICANT TAX CUTS AND
03:19:51.079 --> 03:19:55.917 region:rollup2
WHAT DO THOSE NUMBERS LOOK LIKE.
03:19:53.815 --> 03:19:57.719 region:rollup2
ENSURE WE HAVE NOT PRODUCED ANY
03:19:55.917 --> 03:19:59.221 region:rollup2
ANALYSIS LIKE THAT.
03:19:57.719 --> 03:20:00.355 region:rollup2
AS I MENTIONED THE FRANCHISE TAX
03:19:59.221 --> 03:20:01.456 region:rollup2
BOARD IS CURRENTLY WORKING
03:20:00.355 --> 03:20:03.225 region:rollup2
THROUGH.
03:20:01.456 --> 03:20:04.993 region:rollup2
THE MANY PROVISIONS OF THE
03:20:03.225 --> 03:20:06.261 region:rollup2
FEDERAL TAX BILL ON AND SOME OF
03:20:04.993 --> 03:20:08.897 region:rollup2
THEM ESPECIALLY ON THE BUSINESS
03:20:06.261 --> 03:20:10.932 region:rollup2
TAX SIDE ARE QUITE COMPLICATED.
03:20:08.897 --> 03:20:12.033 region:rollup2
FOR EXAMPLE THERE'S A NEW LOVE
03:20:10.932 --> 03:20:14.336 region:rollup2
A DEDUCTION OF.
03:20:12.033 --> 03:20:16.004 region:rollup2
PASSED THROUGH INCOME FROM
03:20:14.336 --> 03:20:16.938 region:rollup2
BUSINESSES TO INDIVIDUALS AND.
03:20:16.004 --> 03:20:18.773 region:rollup2
I THINK THERE'S A LOT OF
03:20:16.938 --> 03:20:19.407 region:rollup2
UNCERTAINTY RIGHT NOW IN TERMS
03:20:18.773 --> 03:20:20.108 region:rollup2
OF WHAT THAT'S GOING TO MEAN FOR
03:20:19.407 --> 03:20:21.042 region:rollup2
THE STATE.
03:20:20.108 --> 03:20:23.979 region:rollup2
.
03:20:21.042 --> 03:20:26.915 region:rollup2
SO.
03:20:23.979 --> 03:20:28.283 region:rollup2
IT WE COULD OR IS HE LEN GONNA
03:20:26.915 --> 03:20:29.985 region:rollup2
LOOK AT THIS HEARD IS THIS
03:20:28.283 --> 03:20:30.552 region:rollup2
REALLY ENHANCE OF FOR THE
03:20:29.985 --> 03:20:31.286 region:rollup2
FRANCHISE TAX BOARD AT THIS
03:20:30.552 --> 03:20:32.921 region:rollup2
POINT.
03:20:31.286 --> 03:20:33.989 region:rollup2
WELL I I BELIEVE FTP IS PLANNING
03:20:32.921 --> 03:20:35.523 region:rollup2
TO PRESENTER A PORTS OF THE
03:20:33.989 --> 03:20:37.092 region:rollup2
LEGISLATURE IN APRIL ABOUT
03:20:35.523 --> 03:20:39.094 region:rollup2
CONFORMITY ISSUES.
03:20:37.092 --> 03:20:42.130 region:rollup2
AND THE ADMINISTRATION HAS.
03:20:39.094 --> 03:20:44.065 region:rollup2
NOTED THAT IT PLANS TO TRY TO
03:20:42.130 --> 03:20:45.934 region:rollup2
REFLECT THE REVENUE IMPACTS IN
03:20:44.065 --> 03:20:48.003 region:rollup2
ITS MAY REVISION.
03:20:45.934 --> 03:20:49.638 region:rollup2
WE'LL OF COURSE SPEECH TRYING
03:20:48.003 --> 03:20:51.940 region:rollup2
TO ESTIMATE THOSE AFFECTS AS
03:20:49.638 --> 03:20:53.575 region:rollup2
PART OF OUR FUTURE WILL FUTURE I
03:20:51.940 --> 03:20:55.977 region:rollup2
REVENUE ESTIMATING EFFORTS.
03:20:53.575 --> 03:20:59.014 region:rollup2
BUT ULTIMATELY IT'S GOING TO BE
03:20:55.977 --> 03:21:00.448 region:rollup2
AT LEAST ANOTHER YEAR BEFORE. WE
03:20:59.014 --> 03:21:02.050 region:rollup2
START TO GET ANY DATA ON THE ONE
03:21:00.448 --> 03:21:03.985 region:rollup2
HAND.
03:21:02.050 --> 03:21:05.487 region:rollup2
ABOUT HOW MUCH I INCOME HAS BEEN
03:21:03.985 --> 03:21:06.788 region:rollup2
SHIFTED FROM YEAR TO YEAR
03:21:05.487 --> 03:21:08.757 region:rollup2
BECAUSE OF SOME OF THE
03:21:06.788 --> 03:21:10.725 region:rollup2
INCENTIVES THAT TAXPAYERS SPACE.
03:21:08.757 --> 03:21:12.494 region:rollup2
BUT MOREOVER IT'S UNDERSTAND
03:21:10.725 --> 03:21:13.628 region:rollup2
KIND OF THE ONGOING AFFECTS
03:21:12.494 --> 03:21:15.196 region:rollup2
IT'S REALLY GOING TO TAKE A FEW
03:21:13.628 --> 03:21:16.932 region:rollup2
YEARS TO GET ENOUGH DATA TO HAVE
03:21:15.196 --> 03:21:18.700 region:rollup2
A GOOD SENSE OF THAT.
03:21:16.932 --> 03:21:20.368 region:rollup2
SO I GUESS IN SHORT IT WOULD BE
03:21:18.700 --> 03:21:21.636 region:rollup2
DIFFICULT TO ESTIMATE.
03:21:20.368 --> 03:21:22.737 region:rollup2
SOME OF THOSE A FAX.
03:21:21.636 --> 03:21:24.806 region:rollup2
IN ORDER TO.
03:21:22.737 --> 03:21:25.774 region:rollup2
TO LOOK AT.
03:21:24.806 --> 03:21:26.975 region:rollup2
WHAT SORT OF?
03:21:25.774 --> 03:21:28.610 region:rollup2
OFFSETTING MEASURES THE STATE
03:21:26.975 --> 03:21:29.444 region:rollup2
COULD TAKE.
03:21:28.610 --> 03:21:30.779 region:rollup2
AND I WOULD JUST SAY THIS IS FOR
03:21:29.444 --> 03:21:31.947 region:rollup2
COLLEAGUES I'M CERTAINLY
03:21:30.779 --> 03:21:34.316 region:rollup2
INTERESTED IN AND TRYING TO
03:21:31.947 --> 03:21:36.351 region:rollup2
THINK ABOUT HOW OUR STATE COULD.
03:21:34.316 --> 03:21:37.018 region:rollup2
REVERSE SOME OF WHAT I THINK OF
03:21:36.351 --> 03:21:38.687 region:rollup2
AS THE.
03:21:37.018 --> 03:21:40.088 region:rollup2
NOT NOT PARTICULAR HELPFUL
03:21:38.687 --> 03:21:41.089 region:rollup2
POLICY DECISIONS MADE BY
03:21:40.088 --> 03:21:43.091 region:rollup2
CONGRESS THAT HER GIVING
03:21:41.089 --> 03:21:44.526 region:rollup2
SIGNIFICANT TAX BREAKS TO
03:21:43.091 --> 03:21:46.328 region:rollup2
CORPORATIONS AND AND THE
03:21:44.526 --> 03:21:48.363 region:rollup2
WEALTHIEST AMERICANS.
03:21:46.328 --> 03:21:49.464 region:rollup2
EN AND I'D BE VERY INTERESTED
03:21:48.363 --> 03:21:51.633 region:rollup2
IN THINKING ABOUT WHAT TYPE OF
03:21:49.464 --> 03:21:54.402 region:rollup2
TAX OPTIONS WOULD HELP TO.
03:21:51.633 --> 03:21:56.204 region:rollup2
TO TO ADDRESS THAT WHEN YOU ARE
03:21:54.402 --> 03:21:57.605 region:rollup2
SLASHING CORPORATE TAX RATE OR
03:21:56.204 --> 03:21:59.307 region:rollup2
IMPACTING SALTS OR.
03:21:57.605 --> 03:22:01.209 region:rollup2
OR INCREASING QUALIFIED
03:21:59.307 --> 03:22:02.477 region:rollup2
BUSINESS INCOME OF THESE ALL
03:22:01.209 --> 03:22:03.912 region:rollup2
SEEM TO ME BE THINGS THAT WE
03:22:02.477 --> 03:22:05.447 region:rollup2
NEED TO BE LOOKING AT AS A WAY
03:22:03.912 --> 03:22:07.782 region:rollup2
TO POTENTIALLY FUND. NEW
03:22:05.447 --> 03:22:08.416 region:rollup2
PROGRAMS THAT WE MAY WANT TO
03:22:07.782 --> 03:22:09.884 region:rollup2
CONSIDER PARTICULAR IN THE AREA
03:22:08.416 --> 03:22:11.386 region:rollup2
OF HEALTHCARE.
03:22:09.884 --> 03:22:12.954 region:rollup2
FROM MY SECOND SET OF QUESTIONS
03:22:11.386 --> 03:22:13.788 region:rollup2
I WAS. LOOKING AT THE DIFFERENT
03:22:12.954 --> 03:22:17.726 region:rollup2
OPTIONS THAT.
03:22:13.788 --> 03:22:18.793 region:rollup2
I THINK THAT THE MISTER.
03:22:17.726 --> 03:22:20.095 region:rollup2
THE MISTER JOHNSON YOU WERE
03:22:18.793 --> 03:22:23.231 region:rollup2
PRESENTED AROUND.
03:22:20.095 --> 03:22:26.001 region:rollup2
HOW WE TARGET VARIOUS STE ON
03:22:23.231 --> 03:22:27.335 region:rollup2
UNINSURED POPULATIONS AND I BOTH
03:22:26.001 --> 03:22:30.872 region:rollup2
IN THE UNDOCUMENTED IMMIGRANTS?
03:22:27.335 --> 03:22:32.640 region:rollup2
CATEGORY AS WELL AS WITH A LOT
03:22:30.872 --> 03:22:34.175 region:rollup2
WITH WITH ON IT OTHER UNDER AND
03:22:32.640 --> 03:22:36.011 region:rollup2
UNINSURED CALIFORNIANS DO ANY
03:22:34.175 --> 03:22:38.079 region:rollup2
COST ESTIMATES ON WHAT THESE
03:22:36.011 --> 03:22:39.681 region:rollup2
DIFFERENT OPTIONS WOULD. ENTAIL
03:22:38.079 --> 03:22:42.550 region:rollup2
I'M THAT IS SOMETHING THAT THE
03:22:39.681 --> 03:22:43.451 region:rollup2
OFFICE IS WORKING ON AND IN
03:22:42.550 --> 03:22:45.320 region:rollup2
TERMS OF THE.
03:22:43.451 --> 03:22:47.122 region:rollup2
LET ME GO THROUGH THE
03:22:45.320 --> 03:22:49.491 region:rollup2
INDIVIDUAL ITEMS THEN TERMS OF
03:22:47.122 --> 03:22:50.658 region:rollup2
THE EXTENDING MEDICAL COVERAGE.
03:22:49.491 --> 03:22:53.028 region:rollup2
FULL SCOPE.
03:22:50.658 --> 03:22:54.929 region:rollup2
TO UNDOCUMENTED IMMIGRANTS WHO
03:22:53.028 --> 03:22:56.598 region:rollup2
WOULD BE OTHERWISE ELIGIBLE BUT
03:22:54.929 --> 03:22:58.133 region:rollup2
FOR THEIR UNDOCUMENTED STATUS WE
03:22:56.598 --> 03:23:00.468 region:rollup2
DO THINK THAT THAT WOULD LIKELY
03:22:58.133 --> 03:23:02.037 region:rollup2
COST IN THE LOW AND THE SEVERAL
03:23:00.468 --> 03:23:03.805 region:rollup2
BILLIONS OF DOLLARS THAT WE'RE
03:23:02.037 --> 03:23:05.240 region:rollup2
STILL WORKING ON REFINING THOSE
03:23:03.805 --> 03:23:08.076 region:rollup2
ESTIMATES BUT THOSE ARE SORT OF
03:23:05.240 --> 03:23:11.813 region:rollup2
OUR PRELIMINARY. GENERAL NUMBERS
03:23:08.076 --> 03:23:13.381 region:rollup2
IN TERMS OF PROVIDE EXTENDING
03:23:11.813 --> 03:23:15.884 region:rollup2
INSURANCE TO UNDOCUMENTED
03:23:13.381 --> 03:23:16.818 region:rollup2
IMMIGRANTS THROUGH SUCH A THING
03:23:15.884 --> 03:23:17.752 region:rollup2
AS A.
03:23:16.818 --> 03:23:21.423 region:rollup2
AS.
03:23:17.752 --> 03:23:23.591 region:rollup2
HEALTH INSURANCE SUBSIDY
03:23:21.423 --> 03:23:26.394 region:rollup2
PERHAPS TO COVERED CALIFORNIA OF
03:23:23.591 --> 03:23:27.896 region:rollup2
THAT WAS POSSIBLE WELL WE HAVE
03:23:26.394 --> 03:23:29.964 region:rollup2
SOME PRELIMINARY ESTIMATES THAT
03:23:27.896 --> 03:23:32.434 region:rollup2
OF THAT AS WELL AND WE THINK
03:23:29.964 --> 03:23:34.402 region:rollup2
THAT WOULD BE. IN THE LOW
03:23:32.434 --> 03:23:35.236 region:rollup2
BILLIONS OF DOLLARS.
03:23:34.402 --> 03:23:36.805 region:rollup2
BUT WE ARE NOT SURE SALES EVER
03:23:35.236 --> 03:23:38.406 region:rollup2
BILLIONS VERSUS LOW BILLIONS SO
03:23:36.805 --> 03:23:39.307 region:rollup2
SEVERAL BILLIONS ON THE MEDI CAL
03:23:38.406 --> 03:23:40.775 region:rollup2
SIGNED FOR THE.
03:23:39.307 --> 03:23:41.476 region:rollup2
FOR THE UNDOCUMENTED ADULTS WHO.
03:23:40.775 --> 03:23:42.143 region:rollup2
WHO ARE REALLY BELOW ONE
03:23:41.476 --> 03:23:43.611 region:rollup2
HUNDRED AND THIRTY EIGHT PERCENT
03:23:42.143 --> 03:23:44.813 region:rollup2
OF THE FEDERAL POVERTY LEVEL AND
03:23:43.611 --> 03:23:46.281 region:rollup2
THEN FOR IN FRONT DOCUMENTED
03:23:44.813 --> 03:23:46.981 region:rollup2
IMMIGRANTS WHO ARE OVER ONE
03:23:46.281 --> 03:23:48.450 region:rollup2
THIRTY EIGHT BUT?
03:23:46.981 --> 03:23:50.452 region:rollup2
ABOUT FOUR HUNDRED.
03:23:48.450 --> 03:23:52.420 region:rollup2
PERCENT OF THE FEDERAL POVERTY
03:23:50.452 --> 03:23:54.556 region:rollup2
LINE THAT WOULD BE.
03:23:52.420 --> 03:23:55.790 region:rollup2
THAT THE LOW BILLION TAKE AND I
03:23:54.556 --> 03:23:57.992 region:rollup2
AND I KNOW YOU CAN HEAR SIZE.
03:23:55.790 --> 03:24:00.462 region:rollup2
IN MY MIND SEVERAL BILLION LOW
03:23:57.992 --> 03:24:01.496 region:rollup2
BILLION SOUNDS AROUND THE SAME.
03:24:00.462 --> 03:24:03.431 region:rollup2
SINCE I WAS ABSOLUTELY HIGHER
03:24:01.496 --> 03:24:04.299 region:rollup2
ESTIMATE ON THE MEDI CAL SIGNED
03:24:03.431 --> 03:24:05.867 region:rollup2
IN ON THE THAN ON THE.
03:24:04.299 --> 03:24:06.901 region:rollup2
COVER ART ON THE HEALTH
03:24:05.867 --> 03:24:08.169 region:rollup2
INSURANCE SUBSIDY SIDE AND THEN
03:24:06.901 --> 03:24:09.370 region:rollup2
HOW ABOUT TARGETING OTHER
03:24:08.169 --> 03:24:11.673 region:rollup2
REMAINING ON A SHARED THOSE WE
03:24:09.370 --> 03:24:12.507 region:rollup2
ARE LOOKING INTO BUT WE DO NOT
03:24:11.673 --> 03:24:13.808 region:rollup2
HAVE ANY ESTIMATES THAT WE CAN
03:24:12.507 --> 03:24:14.142 region:rollup2
CHAT THE SOCKET WHEN YOU EXPECT
03:24:13.808 --> 03:24:15.977 region:rollup2
HAVE THAT'S.
03:24:14.142 --> 03:24:18.246 region:rollup2
OR WE ARE GOING TO BE WORKING
03:24:15.977 --> 03:24:19.114 region:rollup2
ON THEM OVER THE SPRING AND WE
03:24:18.246 --> 03:24:21.182 region:rollup2
HOPE TO BE ABLE TO.
03:24:19.114 --> 03:24:22.884 region:rollup2
PROVIDE LEGISLATURE WITH SOME
03:24:21.182 --> 03:24:25.587 region:rollup2
TECHNICAL ASSISTANCE ON THOSE.
03:24:22.884 --> 03:24:26.921 region:rollup2
AT THAT AT THAT POINT OKAY AND
03:24:25.587 --> 03:24:28.256 region:rollup2
THEN MY MY LHASA QUESTIONS HAVE
03:24:26.921 --> 03:24:29.657 region:rollup2
TO DO WITH SOME OF THE COMMENTS
03:24:28.256 --> 03:24:31.392 region:rollup2
HE MADE AROUND WHAT A PUBLICLY
03:24:29.657 --> 03:24:32.927 region:rollup2
FINANCES TIM WOULD WOULD COST
03:24:31.392 --> 03:24:34.596 region:rollup2
AND. THERE'S BEEN A LOT THAT'S
03:24:32.927 --> 03:24:36.364 region:rollup2
BEEN MADE OF THE FOUR HUNDRED
03:24:34.596 --> 03:24:38.333 region:rollup2
BILLION DOLLAR NUMBER AND. AS A
03:24:36.364 --> 03:24:39.534 region:rollup2
READ ON PAGE EIGHT YOU ESTIMATE
03:24:38.333 --> 03:24:41.469 region:rollup2
FOR HER BILLION DOLLARS IN TOTAL
03:24:39.534 --> 03:24:42.470 region:rollup2
COSTS TO RUN A PUBLICLY FINANCED
03:24:41.469 --> 03:24:45.940 region:rollup2
HEALTH CARE PROGRAM.
03:24:42.470 --> 03:24:46.407 region:rollup2
NOW WHAT'S INTERESTING TO ME IS
03:24:45.940 --> 03:24:47.709 region:rollup2
THAT AS.
03:24:46.407 --> 03:24:48.943 region:rollup2
EXACTLY HOW MUCH
03:24:47.709 --> 03:24:50.278 region:rollup2
WE USE HAVE SPENT IN TWO
03:24:48.943 --> 03:24:52.514 region:rollup2
THOUSAND SEVENTEEN TO TWO
03:24:50.278 --> 03:24:54.649 region:rollup2
THOUSAND EIGHTEEN. ARE ON HEALTH
03:24:52.514 --> 03:24:55.917 region:rollup2
EXPENDITURES RIGHT SO THAT
03:24:54.649 --> 03:24:57.485 region:rollup2
NUMBER IS NOT COINCIDENTAL IT'S
03:24:55.917 --> 03:24:58.119 region:rollup2
IT'S MEANT TO BE THE SAME.
03:24:57.485 --> 03:24:59.487 region:rollup2
OR DID YOU CALCULATE A
03:24:58.119 --> 03:25:00.655 region:rollup2
DIFFERENT WE CALCULATED IT QUITE
03:24:59.487 --> 03:25:03.925 region:rollup2
A BIT DIFFERENTLY.
03:25:00.655 --> 03:25:05.393 region:rollup2
SO WE WE. WE CHECKED OUR NUMBER
03:25:03.925 --> 03:25:07.095 region:rollup2
AGAINST EXISTING HEALTH CARE
03:25:05.393 --> 03:25:09.063 region:rollup2
EXPENDITURES TO SEE IF IT WAS IN
03:25:07.095 --> 03:25:10.999 region:rollup2
THE BALLPARK OR SOMETHING AROUND
03:25:09.063 --> 03:25:13.034 region:rollup2
WHAT OUR EXPECTATIONS WOULD BE.
03:25:10.999 --> 03:25:14.235 region:rollup2
HOWEVER OUR APPROACH WAS REALLY
03:25:13.034 --> 03:25:17.071 region:rollup2
TO.
03:25:14.235 --> 03:25:18.940 region:rollup2
LOOK AT HEALTHCARE EXPENDITURES
03:25:17.071 --> 03:25:20.441 region:rollup2
FROM THE MOST SORT OF ANALOGOUS
03:25:18.940 --> 03:25:21.376 region:rollup2
PROGRAM THAT WE COULD THINK OF
03:25:20.441 --> 03:25:23.344 region:rollup2
TO.
03:25:21.376 --> 03:25:25.547 region:rollup2
THE ONE THAT WE'RE ANALYZING IN
03:25:23.344 --> 03:25:27.882 region:rollup2
THIS WAS AND SO WE USED MEDI CAL
03:25:25.547 --> 03:25:30.885 region:rollup2
AS A SORT OF BASE LEVEL.
03:25:27.882 --> 03:25:31.719 region:rollup2
BASE LEVEL POGRAM BY WHICH WE
03:25:30.885 --> 03:25:33.621 region:rollup2
COULD.
03:25:31.719 --> 03:25:35.657 region:rollup2
TEND TO SEE WHAT WHAT WOULD
03:25:33.621 --> 03:25:37.292 region:rollup2
HAPPEN IF ADDITIONAL PEOPLE
03:25:35.657 --> 03:25:38.693 region:rollup2
ENROLLED IN MEDICAID OUT AND THE
03:25:37.292 --> 03:25:41.429 region:rollup2
SORT OF COVERAGE.
03:25:38.693 --> 03:25:43.031 region:rollup2
YOU KNOW THE POPULATION TIED
03:25:41.429 --> 03:25:44.899 region:rollup2
THE TYPES OF POPULATIONS THAT
03:25:43.031 --> 03:25:46.835 region:rollup2
WERE ENROLLED CHANGE THE RATES
03:25:44.899 --> 03:25:48.136 region:rollup2
CHANGE FROM THE RATES THAT MEDI
03:25:46.835 --> 03:25:49.537 region:rollup2
CAL PAY TO THE RATES THAT
03:25:48.136 --> 03:25:51.706 region:rollup2
MEDICARE PAY.
03:25:49.537 --> 03:25:53.374 region:rollup2
TO CHANGE THEM TO TO CHANGE THE
03:25:51.706 --> 03:25:57.478 region:rollup2
ASSUMPTIONS TO A MORE.
03:25:53.374 --> 03:26:00.048 region:rollup2
BROADER SET OF COVERED BENEFITS.
03:25:57.478 --> 03:26:02.150 region:rollup2
AND SO ON AND SO WE REALLY
03:26:00.048 --> 03:26:05.386 region:rollup2
CONSTRUCTED IT FROM THE GROUND
03:26:02.150 --> 03:26:08.523 region:rollup2
UP USING SORT OF MEDI CAL PER
03:26:05.386 --> 03:26:10.258 region:rollup2
CAPITA EXPENDITURES THAT COMES
03:26:08.523 --> 03:26:13.528 region:rollup2
WITH ITS OWN CAVEATS WHICH I'M
03:26:10.258 --> 03:26:15.897 region:rollup2
HAPPY TO GO INTO.
03:26:13.528 --> 03:26:17.599 region:rollup2
AND THEN BUILT THAT ESTIMATE
03:26:15.897 --> 03:26:19.534 region:rollup2
FROM THE GROUND UP BILL TO
03:26:17.599 --> 03:26:21.236 region:rollup2
SEPARATE ESTIMATE IN TERMS OF
03:26:19.534 --> 03:26:25.073 region:rollup2
WATER THE ADMINISTRATIVE
03:26:21.236 --> 03:26:28.142 region:rollup2
EXPENDITURES OF OF MEDI CAL AS
03:26:25.073 --> 03:26:28.576 region:rollup2
WELL AS OTHER SO AS MEDICARE AND
03:26:28.142 --> 03:26:30.278 region:rollup2
OTHER SORT OF STATE
03:26:28.576 --> 03:26:34.849 region:rollup2
ADMINISTERED.
03:26:30.278 --> 03:26:38.653 region:rollup2
HEALTHCARE SYSTEMS AND SO.
03:26:34.849 --> 03:26:41.489 region:rollup2
BY AND LARGE WE JUST ABOUT A
03:26:38.653 --> 03:26:44.759 region:rollup2
WEEK CAME AT IT FROM A DIFFERENT
03:26:41.489 --> 03:26:47.795 region:rollup2
DIRECTION BUT SETTLED ON A
03:26:44.759 --> 03:26:51.099 region:rollup2
SIMILAR NUMBER TWO EXISTING
03:26:47.795 --> 03:26:56.404 region:rollup2
HEALTHCARE EXPENDITURES IN THE
03:26:51.099 --> 03:26:56.971 region:rollup2
STATE. OKAY WELL THAT ON IT DO
03:26:56.404 --> 03:27:05.046 region:rollup2
YOU HAVE MORE DATA ON AND IF
03:26:56.971 --> 03:27:07.348 region:rollup2
THERE IS A WAY TO TAKE
03:27:05.046 --> 03:27:08.783 region:rollup2
THAT FOUR HUNDRED BILLION AND
03:27:07.348 --> 03:27:09.384 region:rollup2
SET UP A PUBLICLY FINANCED
03:27:08.783 --> 03:27:10.918 region:rollup2
ESTIMATE OBVIOUSLY THERE ARE A
03:27:09.384 --> 03:27:11.653 region:rollup2
LOT OF.
03:27:10.918 --> 03:27:13.321 region:rollup2
CHALLENGES WITH THAT BUT IF
03:27:11.653 --> 03:27:14.889 region:rollup2
THERE'S A WAY TO DO IT IT WOULD
03:27:13.321 --> 03:27:15.490 region:rollup2
NOT COST US ANY MORE THAN WHAT
03:27:14.889 --> 03:27:17.992 region:rollup2
WORK CURRENTLY SPENDING TODAY
03:27:15.490 --> 03:27:19.394 region:rollup2
RIGHT.
03:27:17.992 --> 03:27:20.461 region:rollup2
IT IS NOT A TO THE THAT ADDED
03:27:19.394 --> 03:27:22.030 region:rollup2
REVENUE THAT IS NEEDED.
03:27:20.461 --> 03:27:23.398 region:rollup2
IS NOT ON TOP OF THE ADDITIONAL
03:27:22.030 --> 03:27:25.733 region:rollup2
HEALTHCARE SPENDING IN THE
03:27:23.398 --> 03:27:25.900 region:rollup2
ECONOMY SO LARGELY WHAT IT WOULD
03:27:25.733 --> 03:27:27.101 region:rollup2
BE.
03:27:25.900 --> 03:27:28.536 region:rollup2
ENACTING SUCH A PUBLICLY
03:27:27.101 --> 03:27:30.805 region:rollup2
FINANCED PROGRAM WOULD INVOLVED
03:27:28.536 --> 03:27:33.174 region:rollup2
TRANSFERRING EXISTING PRIVATE
03:27:30.805 --> 03:27:35.043 region:rollup2
HEALTHCARE SPENDING AYE INTO OF
03:27:33.174 --> 03:27:38.546 region:rollup2
PUBLICLY FINANCED.
03:27:35.043 --> 03:27:39.814 region:rollup2
STATE RUN SYSTEM CONSUMMATE
03:27:38.546 --> 03:27:40.415 region:rollup2
SURE HAVE THEIR CLEAR AND THEN.
03:27:39.814 --> 03:27:41.049 region:rollup2
THE OTHER THING I WAS CURIOUS
03:27:40.415 --> 03:27:42.984 region:rollup2
ABOUT THE FACT THAT THE NUMBERS
03:27:41.049 --> 03:27:44.419 region:rollup2
WERE THE SAME.
03:27:42.984 --> 03:27:44.752 region:rollup2
AGAIN MAYBE COINCIDENTLY THE.
03:27:44.419 --> 03:27:45.486 region:rollup2
IS.
03:27:44.752 --> 03:27:46.888 region:rollup2
THERE DON'T SEEM TO BE ANY
03:27:45.486 --> 03:27:48.890 region:rollup2
SAVINGS
03:27:46.888 --> 03:27:50.792 region:rollup2
FROM WHAT ONE WOULD THINK WOULD
03:27:48.890 --> 03:27:52.060 region:rollup2
BE THE. THEY STREAMLINED
03:27:50.792 --> 03:27:54.028 region:rollup2
ADMINISTRATIVE.
03:27:52.060 --> 03:27:55.296 region:rollup2
OF NATURE OF A PUBLICLY FINANCE
03:27:54.028 --> 03:27:56.464 region:rollup2
SYSTEM RATHER THAN HAVING
03:27:55.296 --> 03:27:57.632 region:rollup2
MULTIPLE.
03:27:56.464 --> 03:27:59.400 region:rollup2
PAYERS.
03:27:57.632 --> 03:28:00.535 region:rollup2
AND AND THE COMPLEXITY OF THE
03:27:59.400 --> 03:28:02.270 region:rollup2
PUBLIC HEALTH SYSTEM OR THE
03:28:00.535 --> 03:28:04.005 region:rollup2
HEALTH CARE SYSTEM WE HAVE TODAY
03:28:02.270 --> 03:28:07.008 region:rollup2
IT WOULD JUST BE ONE PAIR. OF
03:28:04.005 --> 03:28:09.477 region:rollup2
BUT THERE DON'T SEEM TO BE ANY
03:28:07.008 --> 03:28:13.147 region:rollup2
SAVINGS FROM THAT DID YOU ASSUME
03:28:09.477 --> 03:28:13.881 region:rollup2
THAT IN YOUR MOM รณ WE ASSUMED.
03:28:13.147 --> 03:28:16.250 region:rollup2
WE ASSUMED.
03:28:13.881 --> 03:28:17.919 region:rollup2
OR WE CREATED SEPARATE SORT OF
03:28:16.250 --> 03:28:20.421 region:rollup2
ESTIMATES OF THE ADMINISTRATIVE
03:28:17.919 --> 03:28:21.489 region:rollup2
COSTS OF SUCH A PROGRAM AND I I
03:28:20.421 --> 03:28:23.558 region:rollup2
THINK THIS WOULD BE.
03:28:21.489 --> 03:28:26.394 region:rollup2
THAT ESTIMATE WOULD BE LESS
03:28:23.558 --> 03:28:29.897 region:rollup2
THAN IN THE EXISTING MULTI PAYER
03:28:26.394 --> 03:28:30.264 region:rollup2
SYSTEM UP FOR EXAMPLE TO THE
03:28:29.897 --> 03:28:33.401 region:rollup2
TUNE.
03:28:30.264 --> 03:28:34.635 region:rollup2
WHAT BECAUSE WE OFTEN HEAR THAT
03:28:33.401 --> 03:28:35.536 region:rollup2
ADMINISTRATIVE COSTS?
03:28:34.635 --> 03:28:37.238 region:rollup2
PARTS OF THE SYSTEM OR TWENTY TO
03:28:35.536 --> 03:28:39.707 region:rollup2
THIRTY PERCENT BUT.
03:28:37.238 --> 03:28:41.242 region:rollup2
WE'RE NOT SEEN THOSE SAVINGS
03:28:39.707 --> 03:28:42.010 region:rollup2
UNRESTORED TO HEAR IT FOR OUR
03:28:41.242 --> 03:28:42.777 region:rollup2
ESTIMATE WE ASSUME TOTAL
03:28:42.010 --> 03:28:44.379 region:rollup2
ADMINISTRATIVE EXPENDITURES
03:28:42.777 --> 03:28:44.912 region:rollup2
WOULD BE LESS THAN TEN PERCENT
03:28:44.379 --> 03:28:46.381 region:rollup2
SO.
03:28:44.912 --> 03:28:47.248 region:rollup2
WE DID I WE WE MODELED SOME
03:28:46.381 --> 03:28:48.549 region:rollup2
SAVINGS ON THE ADMINISTRATIVE
03:28:47.248 --> 03:28:49.050 region:rollup2
SIDE IF YOU INCLUDE THE SAVING
03:28:48.549 --> 03:28:49.917 region:rollup2
SAY THAT.
03:28:49.050 --> 03:28:50.385 region:rollup2
IN THE EXISTING HEALTHCARE
03:28:49.917 --> 03:28:52.053 region:rollup2
SYSTEM THAT IS REALLY
03:28:50.385 --> 03:28:52.620 region:rollup2
DISTRIBUTED ACROSS SAY THE STATE
03:28:52.053 --> 03:28:53.888 region:rollup2
ADMINISTRATING.
03:28:52.620 --> 03:28:55.123 region:rollup2
ADMINISTRATING ENTITIES SUCH AS
03:28:53.888 --> 03:28:56.457 region:rollup2
AN MEDI CAL AND THE
03:28:55.123 --> 03:28:57.291 region:rollup2
ADMINISTRATIVE ACTIVITIES THAT
03:28:56.457 --> 03:28:59.660 region:rollup2
ARE OCCURRING.
03:28:57.291 --> 03:29:01.529 region:rollup2
IN THAT COMMERCIAL HEALTH
03:28:59.660 --> 03:29:02.697 region:rollup2
INSURANCE PLANS AND SO FORTH.
03:29:01.529 --> 03:29:04.365 region:rollup2
SO IN OTHER WORDS SAY YOU'RE
03:29:02.697 --> 03:29:06.300 region:rollup2
SEEN SOME ADMINISTRATIVE SAVINGS
03:29:04.365 --> 03:29:08.536 region:rollup2
DUE TO THE STREAMLINING BUT
03:29:06.300 --> 03:29:09.937 region:rollup2
YOU'RE ASSUMING THAT IN A PUBLIC
03:29:08.536 --> 03:29:12.440 region:rollup2
FINANCE SYSTEM MORE PEOPLE WOULD
03:29:09.937 --> 03:29:13.674 region:rollup2
BE COVERED. IS THAT HOW IT ALL
03:29:12.440 --> 03:29:15.276 region:rollup2
BALANCES OUT MOVIE GET MORE
03:29:13.674 --> 03:29:15.943 region:rollup2
INDIVIDUALS WOULD BE WOULD BE
03:29:15.276 --> 03:29:17.979 region:rollup2
COVERED THERE BE A MORE
03:29:15.943 --> 03:29:19.680 region:rollup2
COMPREHENSIVE SET OF BENEFITS.
03:29:17.979 --> 03:29:21.716 region:rollup2
THAT ARE COVERED THROUGH THE
03:29:19.680 --> 03:29:23.484 region:rollup2
INSURANCE SYSTEM AND THEN I I AN
03:29:21.716 --> 03:29:25.686 region:rollup2
ADDITIONAL.
03:29:23.484 --> 03:29:27.955 region:rollup2
AND THEN AND AND THAT LACK OF
03:29:25.686 --> 03:29:29.590 region:rollup2
SAY ANY COST SHARING AS IS IN
03:29:27.955 --> 03:29:30.825 region:rollup2
THE EXISTING HEALTH CARE SYSTEM
03:29:29.590 --> 03:29:32.827 region:rollup2
RIGHT AYE IT'S A SORT OF
03:29:30.825 --> 03:29:34.061 region:rollup2
TRANSFER FROM. THE COPAYS AND
03:29:32.827 --> 03:29:35.630 region:rollup2
DEDUCTIBLES THAT WE PAY AS
03:29:34.061 --> 03:29:37.231 region:rollup2
INDIVIDUALS WHO ARE UTILIZING
03:29:35.630 --> 03:29:39.133 region:rollup2
THE SYSTEM AN INSTEAD WE WOULD
03:29:37.231 --> 03:29:41.402 region:rollup2
NEED THAT FUNDING TO BE IN THE
03:29:39.133 --> 03:29:41.769 region:rollup2
FORM OF TAX REVENUES WHICH HELPS
03:29:41.402 --> 03:29:44.806 region:rollup2
TO.
03:29:41.769 --> 03:29:47.041 region:rollup2
AYE WHICH INCREASES THE AMOUNT
03:29:44.806 --> 03:29:49.577 region:rollup2
OF REVENUES THAT WOULD BE NEEDED
03:29:47.041 --> 03:29:51.279 region:rollup2
TO FUND THE PROGRAM.
03:29:49.577 --> 03:29:52.880 region:rollup2
OKAY SOME I LOVE TO SEE THE
03:29:51.279 --> 03:29:55.983 region:rollup2
UNDERLYING ASSUMPTIONS.
03:29:52.880 --> 03:29:56.584 region:rollup2
WHAT YOU USED TO GET TO THAT
03:29:55.983 --> 03:29:57.051 region:rollup2
FORMER BILLION DOLLAR NUMBER
03:29:56.584 --> 03:29:58.419 region:rollup2
IT'S IT IS AMAZINGLY
03:29:57.051 --> 03:30:01.055 region:rollup2
COINCIDENTAL THAT IT IS SO
03:29:58.419 --> 03:30:01.789 region:rollup2
EXACTLY WHAT WE SPEND TODAY SO?
03:30:01.055 --> 03:30:02.857 region:rollup2
ON PAT AND I KNOW YOU'RE
03:30:01.789 --> 03:30:04.525 region:rollup2
BASICALLY SENATE WAS COMPLETELY
03:30:02.857 --> 03:30:05.860 region:rollup2
COINCIDENTAL BUT.
03:30:04.525 --> 03:30:07.028 region:rollup2
JUST LOVE LOVE TO SEE THAT AND
03:30:05.860 --> 03:30:08.329 region:rollup2
THEN A FINAL QUESTION I KNOW
03:30:07.028 --> 03:30:10.631 region:rollup2
THERE'S BEEN A LOT OF.
03:30:08.329 --> 03:30:12.100 region:rollup2
BACK AND FORTH ABOUT THE
03:30:10.631 --> 03:30:12.700 region:rollup2
ASSUMPTIONS OF WATER BUT. A
03:30:12.100 --> 03:30:14.602 region:rollup2
PUBLICLY FINANCED HEALTHCARE
03:30:12.700 --> 03:30:16.404 region:rollup2
SYSTEM WOULD WOULD COST AND THE
03:30:14.602 --> 03:30:18.439 region:rollup2
SO CALLED POLLEN STUDY THAT WAS
03:30:16.404 --> 03:30:19.841 region:rollup2
OUT THERE THAT SUGGESTS THAT.
03:30:18.439 --> 03:30:20.475 region:rollup2
THESE NUMBERS ARE ARE TENS OF
03:30:19.841 --> 03:30:21.709 region:rollup2
BILLIONS OF DOLLARS LAST YEAR
03:30:20.475 --> 03:30:22.977 region:rollup2
ANY COMMENT ON. THAT PARTICULAR
03:30:21.709 --> 03:30:24.912 region:rollup2
STUDY AND.
03:30:22.977 --> 03:30:25.480 region:rollup2
ANY ANALYSIS OF HOW YOUR
03:30:24.912 --> 03:30:27.014 region:rollup2
ASSUMPTIONS DIFFER FROM THAT
03:30:25.480 --> 03:30:28.416 region:rollup2
STUDY.
03:30:27.014 --> 03:30:29.884 region:rollup2
YEAH AND AND JUST IN THAT WE WE
03:30:28.416 --> 03:30:31.285 region:rollup2
WE DID WORK WITH THAT DOCTOR
03:30:29.884 --> 03:30:32.820 region:rollup2
POLLAND A LITTLE BIT AND AND
03:30:31.285 --> 03:30:34.689 region:rollup2
COMING UP WITH OUR ESTIMATE AND
03:30:32.820 --> 03:30:36.524 region:rollup2
WE'RE HAPPY TO SHARE MANY OF THE
03:30:34.689 --> 03:30:38.126 region:rollup2
ASSUMPTIONS THAT WE ARE USING IN
03:30:36.524 --> 03:30:39.527 region:rollup2
OUR ESTIMATE OF WHAT DOES. THIS
03:30:38.126 --> 03:30:41.963 region:rollup2
PUBLICLY FINANCED HEALTH CARE
03:30:39.527 --> 03:30:43.431 region:rollup2
PROGRAM WOULD COST AND THERE
03:30:41.963 --> 03:30:44.832 region:rollup2
WERE A COUPLE SORT OF THINGS AND
03:30:43.431 --> 03:30:47.401 region:rollup2
LATER WELL AREAS WHERE WE DIDN'T
03:30:44.832 --> 03:30:48.102 region:rollup2
AGREE. ON THE SAY ON THE COST
03:30:47.401 --> 03:30:50.705 region:rollup2
SIDE THE.
03:30:48.102 --> 03:30:52.974 region:rollup2
PERRY ANALYSIS TO THE POLLEN
03:30:50.705 --> 03:30:55.009 region:rollup2
ANALYSIS ASSUMED A SET OF
03:30:52.974 --> 03:30:57.478 region:rollup2
SAVINGS AS A RESULT OF.
03:30:55.009 --> 03:31:00.414 region:rollup2
DECREASED UTILIZATION OF SAY
03:30:57.478 --> 03:31:03.384 region:rollup2
UNNECESSARY MA MEDICAL SERVICES
03:31:00.414 --> 03:31:06.888 region:rollup2
OF REDUCED FRAUD AND SO FORTH
03:31:03.384 --> 03:31:11.192 region:rollup2
THAT WE DIDN'T NECESSARILY.
03:31:06.888 --> 03:31:12.994 region:rollup2
SEE AS BEING AS BEING A SORT OF
03:31:11.192 --> 03:31:14.495 region:rollup2
NECESSARY OUTCOME FROM THE
03:31:12.994 --> 03:31:16.130 region:rollup2
LEGISLATION THAT WE WERE
03:31:14.495 --> 03:31:18.533 region:rollup2
ANALYZING SO THERE WAS A
03:31:16.130 --> 03:31:21.102 region:rollup2
DIFFERENCE BETWEEN US AND AND
03:31:18.533 --> 03:31:23.738 region:rollup2
THE POLLEN ANALYSIS THERE IS
03:31:21.102 --> 03:31:26.374 region:rollup2
ALSO A DIFFERENCE ON.
03:31:23.738 --> 03:31:29.176 region:rollup2
THE REVENUES AVAILABLE SIDE.
03:31:26.374 --> 03:31:33.548 region:rollup2
WHEREAS THE POLLEN ANALYSIS
03:31:29.176 --> 03:31:38.152 region:rollup2
ASSUMES THAT THE STATE COULD USE
03:31:33.548 --> 03:31:40.521 region:rollup2
OF THE AS THE TAX BENEFIT DUE TO
03:31:38.152 --> 03:31:43.958 region:rollup2
THE EXCLUSION OF EMPLOYER
03:31:40.521 --> 03:31:46.727 region:rollup2
SPONSORED INSURANCE TO FUND THE
03:31:43.958 --> 03:31:49.230 region:rollup2
PROGRAM WE DIDN'T IDENTIFY AWAY
03:31:46.727 --> 03:31:52.333 region:rollup2
THAT THE STATE COULD ACTUALLY.
03:31:49.230 --> 03:31:55.937 region:rollup2
OBTAIN THAT FUNDING AND USE IT
03:31:52.333 --> 03:31:57.505 region:rollup2
TO FUND THE PROGRAM AND SO THERE
03:31:55.937 --> 03:32:00.107 region:rollup2
WERE DIFFERENCES BOTH ON THE
03:31:57.505 --> 03:32:03.477 region:rollup2
TOTAL COST SIDE AND ON THE
03:32:00.107 --> 03:32:05.880 region:rollup2
AMOUNT OF AVAILABLE FUNDING SIDE
03:32:03.477 --> 03:32:09.517 region:rollup2
THAT NETTED OUT TO A DIFFERENCE.
03:32:05.880 --> 03:32:10.084 region:rollup2
IN TERMS OF HOW MUCH ADDITIONAL
03:32:09.517 --> 03:32:11.552 region:rollup2
FUNDING WE THOUGHT WOULD BE
03:32:10.084 --> 03:32:13.054 region:rollup2
NEEDED.
03:32:11.552 --> 03:32:13.988 region:rollup2
GREAT THANK YOU APPRECIATE THAT
03:32:13.054 --> 03:32:14.589 region:rollup2
AND AND AGAIN I'D LOVE TO SEE
03:32:13.988 --> 03:32:14.755 region:rollup2
THE INFORMATION WHEN YOU HAVE
03:32:14.589 --> 03:32:16.257 region:rollup2
IT.
03:32:14.755 --> 03:32:17.091 region:rollup2
THANKS.
03:32:16.257 --> 03:32:17.725 region:rollup2
UP THANK YOU THANK YOU VERY MUCH
03:32:17.091 --> 03:32:25.1000 region:rollup2
FOR THE INFORMATION WELL IF THE
03:32:17.725 --> 03:32:27.268 region:rollup2
LEGISLATURE DECIDED
03:32:25.1000 --> 03:32:29.470 region:rollup2
TO PUT A MEASURE BEFORE THE
03:32:27.268 --> 03:32:30.671 region:rollup2
VOTERS IT IT COULD GO RELATIVELY
03:32:29.470 --> 03:32:32.139 region:rollup2
QUICKLY I MEAN I KNOW YOU'RE
03:32:30.671 --> 03:32:33.608 region:rollup2
AWARE THAT THE LEGISLATURE HAS.
03:32:32.139 --> 03:32:34.208 region:rollup2
CAN SPEED UP THE PROCESS CAN
03:32:33.608 --> 03:32:35.509 region:rollup2
MAKE IT HAPPEN WITHIN A MATTER
03:32:34.208 --> 03:32:37.478 region:rollup2
OF MONTHS.
03:32:35.509 --> 03:32:39.614 region:rollup2
IF IT WERE UP TO.
03:32:37.478 --> 03:32:40.881 region:rollup2
ORGANIZATIONS OUTSIDE OF THE
03:32:39.614 --> 03:32:42.950 region:rollup2
LEGISLATURE TO PUT A MEASURE ON
03:32:40.881 --> 03:32:44.819 region:rollup2
THE BALLOT. THEN YOU'RE TALKING
03:32:42.950 --> 03:32:47.989 region:rollup2
PROBABLY AT LEAST A YEAR
03:32:44.819 --> 03:32:49.123 region:rollup2
SIGNATURE GATHERING. YOU KNOW
03:32:47.989 --> 03:32:50.691 region:rollup2
GATHERING UP THE MONEY NOT OF IT
03:32:49.123 --> 03:32:52.393 region:rollup2
IS CHEAP MILLIONS OF DOLLARS TO
03:32:50.691 --> 03:32:53.728 region:rollup2
GATHER SIGNATURES MILLIONS OF
03:32:52.393 --> 03:32:56.197 region:rollup2
DOLLARS POTENTIAL DEFIED A
03:32:53.728 --> 03:33:02.069 region:rollup2
BALLOT. A CAMPAIGN.
03:32:56.197 --> 03:33:03.671 region:rollup2
SO I AT A MINIMUM A YEAR.
03:33:02.069 --> 03:33:05.039 region:rollup2
YOU ALSO SAID IT.
03:33:03.671 --> 03:33:06.440 region:rollup2
YOUR ANNOUNCES THAT IT PRIME
03:33:05.039 --> 03:33:07.274 region:rollup2
MAKES MORE SENSE TO GO TO THE
03:33:06.440 --> 03:33:08.809 region:rollup2
VOTERS RATHER THAN RELY ON THE
03:33:07.274 --> 03:33:11.479 region:rollup2
LEGISLATURE TO APPROVE SOME OF
03:33:08.809 --> 03:33:13.147 region:rollup2
THESE POTENTIAL CHANGES LIKE.
03:33:11.479 --> 03:33:14.081 region:rollup2
THE UP TO PROP NINETY EIGHT OR
03:33:13.147 --> 03:33:15.950 region:rollup2
THE GANG LIMIT.
03:33:14.081 --> 03:33:17.918 region:rollup2
WITH THAT BIGGER PICTURE.
03:33:15.950 --> 03:33:19.253 region:rollup2
.
03:33:17.918 --> 03:33:20.321 region:rollup2
WITH THE ORIGINAL POLICY GOALS
03:33:19.253 --> 03:33:20.955 region:rollup2
OF THESE INITIATIVE SAY ABOUT
03:33:20.321 --> 03:33:21.422 region:rollup2
THE APPROPRIATE ROLES OF VOTERS
03:33:20.955 --> 03:33:24.458 region:rollup2
VERSUS.
03:33:21.422 --> 03:33:26.027 region:rollup2
THE LEGISLATURE.
03:33:24.458 --> 03:33:27.028 region:rollup2
SAY THAT CAN CAN YOU REPEAT THE
03:33:26.027 --> 03:33:28.396 region:rollup2
LAST PART OF QUESTION.
03:33:27.028 --> 03:33:29.830 region:rollup2
WHAT TO THE ORIGINAL POLICY
03:33:28.396 --> 03:33:32.433 region:rollup2
GOALS OF THOSE INITIATIVES?
03:33:29.830 --> 03:33:34.168 region:rollup2
SAY ABOUT THE APPROPRIATE ROLES
03:33:32.433 --> 03:33:35.803 region:rollup2
OF FOR VOTERS VERSUS THE AND
03:33:34.168 --> 03:33:38.639 region:rollup2
LEGISLATURE.
03:33:35.803 --> 03:33:39.874 region:rollup2
WELL IT'S HARD IT THAT'S A
03:33:38.639 --> 03:33:41.208 region:rollup2
TOUGH ONE TO ANSWER BECAUSE.
03:33:39.874 --> 03:33:42.376 region:rollup2
WE HAVE A PROCESS IN CALIFORNIA
03:33:41.208 --> 03:33:44.145 region:rollup2
THAT MAKES THE CONSTITUTION
03:33:42.376 --> 03:33:48.149 region:rollup2
RELATIVELY EASY.
03:33:44.145 --> 03:33:49.383 region:rollup2
TO AMEND SO ON THAT. WHEN THE
03:33:48.149 --> 03:33:50.851 region:rollup2
VOTERS AMEND THE CONSTITUTION.
03:33:49.383 --> 03:33:52.019 region:rollup2
THEY MAY THINK THAT THEY'RE
03:33:50.851 --> 03:33:53.320 region:rollup2
VOTING FOR ON AN ISSUE FOR THE
03:33:52.019 --> 03:33:55.623 region:rollup2
VERY LAST TIME.
03:33:53.320 --> 03:33:58.225 region:rollup2
BUT OUR PROCESS BY DEFINITION.
03:33:55.623 --> 03:33:59.760 region:rollup2
IS OPEN TO CHANGE AND YOU KNOW
03:33:58.225 --> 03:34:01.562 region:rollup2
SOME PEOPLE WOULD ARGUE PERHAPS
03:33:59.760 --> 03:34:02.963 region:rollup2
WE SHOULD NOT BE LIVING WITH THE
03:34:01.562 --> 03:34:06.233 region:rollup2
STATE APPROPRIATIONS LIMIT
03:34:02.963 --> 03:34:10.271 region:rollup2
THAT'S BASED ON. YOU KNOW.
03:34:06.233 --> 03:34:12.340 region:rollup2
SPENDING WHEN I WAS BACK IN THAT
03:34:10.271 --> 03:34:13.841 region:rollup2
JUNIOR HIGH OR SOMETHING SO YOU
03:34:12.340 --> 03:34:16.010 region:rollup2
KNOW WE'RE GOING FORTY YEARS
03:34:13.841 --> 03:34:17.578 region:rollup2
BACK IN TIME OR SELL DO WE
03:34:16.010 --> 03:34:19.346 region:rollup2
REALLY WANT TO TIE OURSELVES UP
03:34:17.578 --> 03:34:20.581 region:rollup2
IN KNOTS SO.
03:34:19.346 --> 03:34:22.883 region:rollup2
I THINK THERE'S ALWAYS A
03:34:20.581 --> 03:34:25.586 region:rollup2
PRESUMPTION THAT EITHER THE
03:34:22.883 --> 03:34:30.124 region:rollup2
LEGISLATURE OR THE VOTERS
03:34:25.586 --> 03:34:32.693 region:rollup2
THEMSELVES. CAN GO BACK TO THE
03:34:30.124 --> 03:34:35.529 region:rollup2
BALLOT AND RE VISIT DECISIONS
03:34:32.693 --> 03:34:36.063 region:rollup2
THAT WERE MADE IN PRIOR YEARS
03:34:35.529 --> 03:34:37.732 region:rollup2
NONE OF THIS IS WRITTEN IN
03:34:36.063 --> 03:34:40.134 region:rollup2
STONE.
03:34:37.732 --> 03:34:42.203 region:rollup2
IT SIMPLY REQUIRES FIFTY
03:34:40.134 --> 03:34:45.740 region:rollup2
PERCENT PLUS ONE TO AMEND OUR
03:34:42.203 --> 03:34:49.477 region:rollup2
CONSTITUTION OUT WHICH IS WHY IT
03:34:45.740 --> 03:34:51.579 region:rollup2
HAPPEN SO FREQUENTLY.
03:34:49.477 --> 03:34:53.047 region:rollup2
IS IT BECAUSE THAT HELP FORGET
03:34:51.579 --> 03:34:57.151 region:rollup2
THAT'S THAT'S OKAY VERY HOPEFUL
03:34:53.047 --> 03:34:58.953 region:rollup2
SO HONORED FOR OUR FOLKS EMILIO.
03:34:57.151 --> 03:35:00.187 region:rollup2
DO YOU HAVE AN ESTIMATE OF OF
03:34:58.953 --> 03:35:01.155 region:rollup2
WHAT CURRENT EMPLOYER PAYMENTS
03:35:00.187 --> 03:35:03.891 region:rollup2
FOR HEALTH INSURANCE ARE AS A.
03:35:01.155 --> 03:35:05.960 region:rollup2
AS A PERCENTAGE OR FRACTIONAL
03:35:03.891 --> 03:35:06.427 region:rollup2
PAYROLL.
03:35:05.960 --> 03:35:08.129 region:rollup2
AS A.
03:35:06.427 --> 03:35:09.830 region:rollup2
PERCENTAGE OF PAYROLL.
03:35:08.129 --> 03:35:11.499 region:rollup2
WELL I SORT OF MEDIAN ESTIMATE
03:35:09.830 --> 03:35:12.867 region:rollup2
OF EMPLOYER SPONSORED PREMIUM SO
03:35:11.499 --> 03:35:14.034 region:rollup2
SHARE BOTH BY EMPLOYERS AND
03:35:12.867 --> 03:35:15.536 region:rollup2
EMPLOYEES IS. ABOUT A HUNDRED
03:35:14.034 --> 03:35:16.904 region:rollup2
AND THIRTY BILLION DOLLARS.
03:35:15.536 --> 03:35:18.038 region:rollup2
WE ESTIMATE TOTAL WAGES AND
03:35:16.904 --> 03:35:19.273 region:rollup2
SALARIES IN THE STATE TO BE
03:35:18.038 --> 03:35:22.309 region:rollup2
ABOUT ONE POINT THREE TRILLION
03:35:19.273 --> 03:35:22.810 region:rollup2
DOLLARS SO IT'S ABOUT. TEN
03:35:22.309 --> 03:35:24.879 region:rollup2
PERCENT OF.
03:35:22.810 --> 03:35:25.346 region:rollup2
WAGES AND SALARIES THAT IS PAID
03:35:24.879 --> 03:35:28.182 region:rollup2
ON.
03:35:25.346 --> 03:35:30.317 region:rollup2
ENSURE EMPLOYER SPONSORED
03:35:28.182 --> 03:35:30.851 region:rollup2
BENEFITS AS A WHOLE INDIA HERE
03:35:30.317 --> 03:35:32.286 region:rollup2
YOU GREATLY SAID THAT.
03:35:30.851 --> 03:35:34.121 region:rollup2
SOME OF THE EMPLOYER BENEFITS
03:35:32.286 --> 03:35:35.456 region:rollup2
TAX BENEFITS FOR PROVIDING
03:35:34.121 --> 03:35:36.557 region:rollup2
INSURANCE.
03:35:35.456 --> 03:35:37.992 region:rollup2
THERE'S THERE'S NO WAY FOR US TO
03:35:36.557 --> 03:35:39.160 region:rollup2
REALLY RECAPTURE THAT FROM THE
03:35:37.992 --> 03:35:41.629 region:rollup2
FEDERAL GOVERNMENT I GUESS. WE
03:35:39.160 --> 03:35:42.730 region:rollup2
DIDN'T IDENTIFY NECESSARILY AWAY
03:35:41.629 --> 03:35:44.331 region:rollup2
TO BE A TO BE ABLE TO REALLY
03:35:42.730 --> 03:35:45.866 region:rollup2
CAPTURE THAT. AS REVENUES TO BE
03:35:44.331 --> 03:35:48.569 region:rollup2
ABLE TO FINANCE THE PROGRAM.
03:35:45.866 --> 03:35:50.871 region:rollup2
IT'S IT POTENTIALLY DEPENDING
03:35:48.569 --> 03:35:51.505 region:rollup2
ON AYE AYE MY COLLEAGUE RYAN
03:35:50.871 --> 03:35:52.573 region:rollup2
MILLER COULD TOUCH AND MORE IT
03:35:51.505 --> 03:35:53.741 region:rollup2
POTENTIALLY COULD BE SORT OF
03:35:52.573 --> 03:35:55.509 region:rollup2
IMPLICIT AND.
03:35:53.741 --> 03:35:57.812 region:rollup2
IN IN DIFFERENT WAYS THAT WE
03:35:55.509 --> 03:35:59.447 region:rollup2
FUND THE PROGRAM GOING FORWARD
03:35:57.812 --> 03:36:00.448 region:rollup2
I'M I DON'T KNOW IF YOU WANT
03:35:59.447 --> 03:36:01.415 region:rollup2
TOUCH ON THE PAPER.
03:36:00.448 --> 03:36:02.683 region:rollup2
THOSE TAXES.
03:36:01.415 --> 03:36:03.951 region:rollup2
.
03:36:02.683 --> 03:36:04.785 region:rollup2
WELL IT'S CERTAINLY A
03:36:03.951 --> 03:36:05.486 region:rollup2
CONSIDERATION BECAUSE AS I
03:36:04.785 --> 03:36:07.154 region:rollup2
MENTIONED.
03:36:05.486 --> 03:36:08.656 region:rollup2
WITH THE SALES TAX PROCLAIMS
03:36:07.154 --> 03:36:10.958 region:rollup2
PROPERTY TAX.
03:36:08.656 --> 03:36:11.959 region:rollup2
OVER THE NEW FEDERAL LAW HAS A
03:36:10.958 --> 03:36:13.093 region:rollup2
TEN THOUSAND LIKE CAPS OF FOR
03:36:11.959 --> 03:36:14.562 region:rollup2
MANY TAXPAYERS.
03:36:13.093 --> 03:36:15.663 region:rollup2
THERE WOULDN'T BE SORT OF A
03:36:14.562 --> 03:36:17.164 region:rollup2
FEDERAL OFFSET TO THE TAX
03:36:15.663 --> 03:36:18.499 region:rollup2
INCREASE HERE.
03:36:17.164 --> 03:36:18.799 region:rollup2
I BELIEVE HOWEVER THAT.
03:36:18.499 --> 03:36:21.235 region:rollup2
EMPLOYER.
03:36:18.799 --> 03:36:23.070 region:rollup2
PAYROLL TAX PAYMENTS.
03:36:21.235 --> 03:36:25.339 region:rollup2
CONTINUE TO BE DEDUCTIBLE ON
03:36:23.070 --> 03:36:26.640 region:rollup2
THE FEDERAL LEVEL HOWEVER AND SO
03:36:25.339 --> 03:36:28.442 region:rollup2
IF IF THE LEGISLATURE PURSUED
03:36:26.640 --> 03:36:30.478 region:rollup2
THAT OPTION.
03:36:28.442 --> 03:36:31.779 region:rollup2
THERE WOULD BE A SOURCE OF
03:36:30.478 --> 03:36:34.114 region:rollup2
FEDERAL TAX BENEFIT.
03:36:31.779 --> 03:36:36.183 region:rollup2
BUT IN TERMS OF THE STATE BEING
03:36:34.114 --> 03:36:37.818 region:rollup2
ABLE TO COLLECT LIKE REVENUE
03:36:36.183 --> 03:36:39.220 region:rollup2
THAT IS.
03:36:37.818 --> 03:36:40.788 region:rollup2
I AT REDUCED REVENUE FROM THE
03:36:39.220 --> 03:36:41.622 region:rollup2
FEDERAL GOVERNMENT I THINK
03:36:40.788 --> 03:36:42.189 region:rollup2
THAT'S WHAT MY COLLEAGUE WAS
03:36:41.622 --> 03:36:44.725 region:rollup2
SAYING WHERE WE DON'T REALLY
03:36:42.189 --> 03:36:45.893 region:rollup2
KNOW HOW THAT WOULD.
03:36:44.725 --> 03:36:47.561 region:rollup2
THAT THE FEDERAL GOVERNMENT
03:36:45.893 --> 03:36:49.396 region:rollup2
COULD DECIDE TO BLOCK GRANTED
03:36:47.561 --> 03:36:51.632 region:rollup2
BUT WE DIDN'T FEEL THAT THAT WAS
03:36:49.396 --> 03:36:52.233 region:rollup2
AN ASSUMPTION THAT WE COULD MAKE
03:36:51.632 --> 03:36:54.468 region:rollup2
IN ESTIMATING THE COST OF THE
03:36:52.233 --> 03:36:55.302 region:rollup2
PROGRAM.
03:36:54.468 --> 03:36:56.170 region:rollup2
WELL THANK YOU VERY MUCH ALL
03:36:55.302 --> 03:36:56.971 region:rollup2
THREE OF YOU REALLY APPRECIATE
03:36:56.170 --> 03:36:59.607 region:rollup2
CRESCENTA.
03:36:56.971 --> 03:37:00.875 region:rollup2
EXPERIMENTS.
03:36:59.607 --> 03:37:01.375 region:rollup2
AT THIS POINT WE'D LIKE TO GO
03:37:00.875 --> 03:37:03.043 region:rollup2
AHEAD AND MOVE TO PUBLIC
03:37:01.375 --> 03:37:05.513 region:rollup2
COMMENT.
03:37:03.043 --> 03:37:06.747 region:rollup2
LIKE TO. ASK THAT YOU LIMIT
03:37:05.513 --> 03:37:07.515 region:rollup2
YOUR COMMENTS TO TWO MINUTES
03:37:06.747 --> 03:37:10.284 region:rollup2
PIECE AND.
03:37:07.515 --> 03:37:10.451 region:rollup2
WE HAVE TWO MICROPHONES SET UP
03:37:10.284 --> 03:37:12.286 region:rollup2
SO.
03:37:10.451 --> 03:37:13.454 region:rollup2
PLEASE WHOEVER.
03:37:12.286 --> 03:37:24.532 region:rollup2
I THINK YOU WERE I THINK YOUR
03:37:13.454 --> 03:37:26.934 region:rollup2
FIRST OVER HERE.
03:37:24.532 --> 03:37:28.569 region:rollup2
PLEASE.
03:37:26.934 --> 03:37:29.803 region:rollup2
HI MY NAME IS KEITH MCALLEN I'M
03:37:28.569 --> 03:37:30.704 region:rollup2
WITH PHYSICIANS FOR A NATIONAL
03:37:29.803 --> 03:37:32.573 region:rollup2
HEALTH PROGRAM HEALTHY
03:37:30.704 --> 03:37:33.941 region:rollup2
CALIFORNIA CAMPAIGN HEALTH CARE
03:37:32.573 --> 03:37:35.509 region:rollup2
FOR ALL. I'M GONNA SAY THIS
03:37:33.941 --> 03:37:37.011 region:rollup2
QUICKLY BECAUSE I HAVE TO GET MY
03:37:35.509 --> 03:37:38.846 region:rollup2
DAUGHTER TO BASKETBALL PRACTICE
03:37:37.011 --> 03:37:40.447 region:rollup2
ENOUGH I DON'T UP I'M GONNA NEED
03:37:38.846 --> 03:37:43.417 region:rollup2
HEALTH CARE WHICH I CAN AFFORD.
03:37:40.447 --> 03:37:44.418 region:rollup2
THE LAW PROFESSOR FROM MISSOURI.
03:37:43.417 --> 03:37:46.086 region:rollup2
STATED.
03:37:44.418 --> 03:37:48.522 region:rollup2
A COUPLE OF TIMES THAT THE
03:37:46.086 --> 03:37:49.123 region:rollup2
DETAILS THAT NOBODY KNOWS BUT
03:37:48.522 --> 03:37:50.891 region:rollup2
THEY LEARN QUICKLY WHEN THEY
03:37:49.123 --> 03:37:52.192 region:rollup2
HAVE TO I KEPT WAITING THE WHOLE
03:37:50.891 --> 03:37:53.861 region:rollup2
TIME FOR HER TALK TO GIVE THE
03:37:52.192 --> 03:37:55.796 region:rollup2
DETAILS OF WHAT OF. PRECISELY
03:37:53.861 --> 03:37:57.998 region:rollup2
WHAT THAT IS HERE'S WHAT SHE WAS
03:37:55.796 --> 03:37:59.800 region:rollup2
TALKING ABOUT EMPLOYEE SPONSORED
03:37:57.998 --> 03:38:01.568 region:rollup2
PROGRAMS THAT ARE SELF FUNDED
03:37:59.800 --> 03:38:03.704 region:rollup2
HAVE NO RECOURSE IN THE COURTS
03:38:01.568 --> 03:38:05.673 region:rollup2
WHEN RIGHT FULL BENEFITS ARE
03:38:03.704 --> 03:38:07.641 region:rollup2
DENIED BY GATEKEEPERS SO SAID
03:38:05.673 --> 03:38:09.009 region:rollup2
THE SUPREME COURT. SO WHAT DOES
03:38:07.641 --> 03:38:10.945 region:rollup2
THAT MEAN SOMEONE GOES INTO THE
03:38:09.009 --> 03:38:13.013 region:rollup2
E. ARE THEY HAVE A LITTLE BITTY
03:38:10.945 --> 03:38:16.517 region:rollup2
BRAIN BLEED THEY NEED AN MRI
03:38:13.013 --> 03:38:18.452 region:rollup2
DENIED VIBES REFLEXIVELY.
03:38:16.517 --> 03:38:19.386 region:rollup2
A THE PERSON THEN DIES.
03:38:18.452 --> 03:38:20.688 region:rollup2
SO WHAT ARE THEY HAVE A RIGHT TO
03:38:19.386 --> 03:38:22.957 region:rollup2
AT THAT POINT WHAT THEY HAVE A
03:38:20.688 --> 03:38:26.894 region:rollup2
RIGHT TO IT THAT. IS THE COST OF
03:38:22.957 --> 03:38:29.630 region:rollup2
THE MRI THAT WAS DENIED.
03:38:26.894 --> 03:38:31.899 region:rollup2
SO REGARDING THAT POINT.
03:38:29.630 --> 03:38:33.033 region:rollup2
THREE THINGS PLEASE.
03:38:31.899 --> 03:38:34.969 region:rollup2
INSURANCE COMPANIES ARE GAMING
03:38:33.033 --> 03:38:36.270 region:rollup2
THE SYSTEM DENY DENY DENY FOR
03:38:34.969 --> 03:38:38.372 region:rollup2
DOLLARS.
03:38:36.270 --> 03:38:39.640 region:rollup2
A.
03:38:38.372 --> 03:38:41.408 region:rollup2
PLEASE KEEP THIS IN MIND WHEN
03:38:39.640 --> 03:38:43.510 region:rollup2
THE EARNEST UNDERWRITERS STAND
03:38:41.408 --> 03:38:44.144 region:rollup2
BEFORE YOU AND TELL YOU THAT
03:38:43.510 --> 03:38:44.612 region:rollup2
THEY'RE A BEAUTIFUL PART OF THE
03:38:44.144 --> 03:38:46.914 region:rollup2
COMMUNITY.
03:38:44.612 --> 03:38:48.449 region:rollup2
.
03:38:46.914 --> 03:38:50.184 region:rollup2
THIS ALSO GOES BACK TO WHAT BILL
03:38:48.449 --> 03:38:51.986 region:rollup2
CLINTON SAID IN TWENTY SIXTEEN
03:38:50.184 --> 03:38:53.654 region:rollup2
WITH HIS GAFFE OF IT'S THE
03:38:51.986 --> 03:38:54.989 region:rollup2
CRAZIEST THING. WE MAKE THE
03:38:53.654 --> 03:38:56.991 region:rollup2
ASSUMPTION HERE THAT EVERYONE
03:38:54.989 --> 03:38:58.659 region:rollup2
THAT HAS EMPLOYEE BASED
03:38:56.991 --> 03:39:00.327 region:rollup2
INSURANCE IS DOING JUST FINE CAN
03:38:58.659 --> 03:39:01.629 region:rollup2
WE WE CAN'T TOUCH THAT. IT'S NOT
03:39:00.327 --> 03:39:03.731 region:rollup2
TRUE.
03:39:01.629 --> 03:39:06.200 region:rollup2
IT ALSO GOES TO WHAT ASSEMBLY
03:39:03.731 --> 03:39:07.468 region:rollup2
MEMBER FRIEDMAN SAID.
03:39:06.200 --> 03:39:09.570 region:rollup2
YEAH BACK IN LOS ANGELES.
03:39:07.468 --> 03:39:11.772 region:rollup2
THAT.
03:39:09.570 --> 03:39:14.241 region:rollup2
WHAT IF THE ANTS ARE IS THAT WE
03:39:11.772 --> 03:39:14.742 region:rollup2
CALIFORNIA HAVE TO GET IT THE
03:39:14.241 --> 03:39:16.844 region:rollup2
FIGHT WITH THE FEDERAL
03:39:14.742 --> 03:39:17.945 region:rollup2
GOVERNMENT TO GET ANYTHING DONE
03:39:16.844 --> 03:39:23.584 region:rollup2
SHE'S RIGHT SHE'S RIGHT SHE'S
03:39:17.945 --> 03:39:25.285 region:rollup2
RIGHT? THANK YOU.
03:39:23.584 --> 03:39:26.353 region:rollup2
OUR I'M HENRY ABRAMS I'M A
03:39:25.285 --> 03:39:27.655 region:rollup2
PHYSICIAN.
03:39:26.353 --> 03:39:29.056 region:rollup2
WITH PHYSICIANS FOR A NATIONAL
03:39:27.655 --> 03:39:32.459 region:rollup2
HEALTH PROGRAM.
03:39:29.056 --> 03:39:33.694 region:rollup2
A COUPLE POINTS AND ONE IS THAT
03:39:32.459 --> 03:39:35.295 region:rollup2
THE WORD COVERAGE HAS BEEN USED
03:39:33.694 --> 03:39:36.930 region:rollup2
A LOT BUT.
03:39:35.295 --> 03:39:38.532 region:rollup2
BY I THINK THAT IT WAS ASSEMBLY
03:39:36.930 --> 03:39:40.501 region:rollup2
MEMBER ARE WALDRON WHOM MADE THE
03:39:38.532 --> 03:39:42.236 region:rollup2
POINT. THAT WE ARE REALLY
03:39:40.501 --> 03:39:44.605 region:rollup2
TALKINGABOUT ACCESS AND I THINK
03:39:42.236 --> 03:39:46.974 region:rollup2
THAT WHEN WE TALK ABOUT COVERAGE
03:39:44.605 --> 03:39:49.643 region:rollup2
THAT IS NOT IN ANY WAY. A CLOSE
03:39:46.974 --> 03:39:52.713 region:rollup2
TO THE INDIVIDUAL WHO'S COVERED
03:39:49.643 --> 03:39:54.581 region:rollup2
RECEIVING. A TIMELY APPROPRIATE
03:39:52.713 --> 03:39:56.583 region:rollup2
HIGH QUALITY IS COMPREHENSIVE
03:39:54.581 --> 03:39:58.152 region:rollup2
AND AFFORDABLE CARE I THINK ALL
03:39:56.583 --> 03:39:59.720 region:rollup2
OF THOSE THINGS NEED TO BE KEPT
03:39:58.152 --> 03:40:01.855 region:rollup2
IN THE FOREFRONT. AND THEY'RE
03:39:59.720 --> 03:40:03.257 region:rollup2
ALL INTERLINKED AND THAT'S WHY
03:40:01.855 --> 03:40:05.626 region:rollup2
PHYSICIANS FOR A NATIONAL HEALTH
03:40:03.257 --> 03:40:07.828 region:rollup2
PROGRAM ARE STRONG ADVOCATES FOR
03:40:05.626 --> 03:40:10.698 region:rollup2
A SINGLE PAYER PROGRAM BECAUSE
03:40:07.828 --> 03:40:13.100 region:rollup2
THAT IS THE POLICY. THAT LINKS
03:40:10.698 --> 03:40:15.636 region:rollup2
THOSE ESSENTIAL ELEMENTS WITHOUT
03:40:13.100 --> 03:40:16.737 region:rollup2
WHICH WE DON'T REALLY. PRODUCE
03:40:15.636 --> 03:40:19.306 region:rollup2
MEANINGFUL REFORM.
03:40:16.737 --> 03:40:20.374 region:rollup2
THE SECOND THING IS THAT I THINK
03:40:19.306 --> 03:40:22.142 region:rollup2
WHEN DOCTOR POLLAND HAS AN
03:40:20.374 --> 03:40:24.078 region:rollup2
OPPORTUNITY TO TESTIFY ON
03:40:22.142 --> 03:40:25.179 region:rollup2
WEDNESDAY. ON MY HOPE THE
03:40:24.078 --> 03:40:27.648 region:rollup2
COMMITTEE MEMBERS WILL KEEP AN
03:40:25.179 --> 03:40:30.250 region:rollup2
OPEN MIND. ABOUT.
03:40:27.648 --> 03:40:33.387 region:rollup2
WHAT I CONSIDER TO BE SOME GAPS
03:40:30.250 --> 03:40:35.923 region:rollup2
IN THE LA JOH ANALYSIS WHEN ONE
03:40:33.387 --> 03:40:37.391 region:rollup2
ELIMINATES PROFIT SEEKING
03:40:35.923 --> 03:40:39.893 region:rollup2
COMMERCIAL?
03:40:37.391 --> 03:40:42.963 region:rollup2
INVESTOR OWNED HEALTH INSURANCE
03:40:39.893 --> 03:40:45.966 region:rollup2
AND AND HEALTH CARE PROVIDERS.
03:40:42.963 --> 03:40:46.700 region:rollup2
AND CAPTURES THE MAXIMUM SAVINGS
03:40:45.966 --> 03:40:48.535 region:rollup2
FROM COORDINATED.
03:40:46.700 --> 03:40:51.138 region:rollup2
.
03:40:48.535 --> 03:40:52.506 region:rollup2
DASH SIMPLIFIED CARE MY I THINK
03:40:51.138 --> 03:40:54.541 region:rollup2
THAT THE COST OF THE PROGRAM
03:40:52.506 --> 03:40:56.477 region:rollup2
WILL COME DOWN A LOT FROM THE
03:40:54.541 --> 03:40:59.880 region:rollup2
FOUR HUNDRED BILLION DOLLARS.
03:40:56.477 --> 03:41:01.448 region:rollup2
AND THE THIRD THING IS THAT I
03:40:59.880 --> 03:41:03.650 region:rollup2
HOPE THE COMMITTEE BUT HASN'T
03:41:01.448 --> 03:41:05.619 region:rollup2
GOTTEN LOST IN THE ENORMOUS
03:41:03.650 --> 03:41:06.987 region:rollup2
WEEDS AND DETAILS THAT THEY'VE
03:41:05.619 --> 03:41:10.824 region:rollup2
HEARD.
03:41:06.987 --> 03:41:13.360 region:rollup2
THAT SEEM TO BE OBSTACLES.
03:41:10.824 --> 03:41:15.496 region:rollup2
IN THE FOR GROUND.
03:41:13.360 --> 03:41:17.698 region:rollup2
TO GETTING TO UNIVERSAL COVERAGE
03:41:15.496 --> 03:41:20.167 region:rollup2
BUT KEEP YOUR EYES ON THE PRIZE
03:41:17.698 --> 03:41:22.302 region:rollup2
THE PRIZE IS UNIVERSAL COVERAGE.
03:41:20.167 --> 03:41:24.271 region:rollup2
ONLY A PUBLICLY FINANCED
03:41:22.302 --> 03:41:26.206 region:rollup2
PUBLICLY ADMINISTERED NONPROFIT
03:41:24.271 --> 03:41:28.809 region:rollup2
HEALTH CARE PROGRAM.
03:41:26.206 --> 03:41:29.710 region:rollup2
I CAN ACHIEVE THAT AND I I
03:41:28.809 --> 03:41:32.079 region:rollup2
REALLY.
03:41:29.710 --> 03:41:35.182 region:rollup2
FEAR THAT THE THE COMMITTEE
03:41:32.079 --> 03:41:36.917 region:rollup2
WILL GET BOGGED DOWN. AND.
03:41:35.182 --> 03:41:38.685 region:rollup2
SHE AS AN OBSTACLE.
03:41:36.917 --> 03:41:40.654 region:rollup2
THAT WE HAVE A DYSFUNCTIONAL
03:41:38.685 --> 03:41:43.090 region:rollup2
BROKEN HEALTHCARE SYSTEM AND SO
03:41:40.654 --> 03:41:45.692 region:rollup2
IT'S NO SURPRISE THAT WE HAVE A
03:41:43.090 --> 03:41:48.729 region:rollup2
DYSFUNCTIONAL AND BROKEN LEGAL
03:41:45.692 --> 03:41:49.563 region:rollup2
AND ADMINISTRATIVE SYSTEM. THAT.
03:41:48.729 --> 03:41:51.131 region:rollup2
PREVENTION US FROM GETTING
03:41:49.563 --> 03:41:52.699 region:rollup2
ACCESS TO THE MONEY THAT THE
03:41:51.131 --> 03:41:54.601 region:rollup2
FEDERAL GOVERNMENT IS CUSTODIAN
03:41:52.699 --> 03:41:58.839 region:rollup2
FOR BUT IT'S OUR MONEY AND
03:41:54.601 --> 03:42:02.009 region:rollup2
CALIFORNIA NEEDS TO CLAIM IT.
03:41:58.839 --> 03:42:03.277 region:rollup2
THOUGH I'M JEFF CARTAGIA.
03:42:02.009 --> 03:42:04.945 region:rollup2
ADVOCATES. OF.
03:42:03.277 --> 03:42:06.513 region:rollup2
CAR.
03:42:04.945 --> 03:42:08.515 region:rollup2
DOG FIGHT.
03:42:06.513 --> 03:42:12.619 region:rollup2
OTHER REPRESENTATIONS
03:42:08.515 --> 03:42:13.187 region:rollup2
TWO CHAIRMAN WOULD I WILL SAY.
03:42:12.619 --> 03:42:16.023 region:rollup2
ABSTAINING IS NOT A NEUTRAL
03:42:13.187 --> 03:42:18.091 region:rollup2
VOTE.
03:42:16.023 --> 03:42:19.793 region:rollup2
BUT FOR A YEAR YOU GUYS HAVE
03:42:18.091 --> 03:42:22.896 region:rollup2
BEEN PUSHING.
03:42:19.793 --> 03:42:24.765 region:rollup2
AND WHERE IS SINGLE PAYER
03:42:22.896 --> 03:42:26.800 region:rollup2
IT'S BEEN AROUND HERE A LONG
03:42:24.765 --> 03:42:28.936 region:rollup2
TIME BEING ASKED OR WHICH.
03:42:26.800 --> 03:42:31.371 region:rollup2
YOU PRESENTED EVERYTHING.
03:42:28.936 --> 03:42:33.640 region:rollup2
DOESN'T HAVE TO DO WITH HOW IN
03:42:31.371 --> 03:42:35.642 region:rollup2
THE WORLD KEN'S SINGLE PAYER.
03:42:33.640 --> 03:42:37.244 region:rollup2
WORK.
03:42:35.642 --> 03:42:40.047 region:rollup2
I HOPE WEDNESDAY'S WILL BE
03:42:37.244 --> 03:42:42.182 region:rollup2
BETTER AND BE MORE ON POINT
03:42:40.047 --> 03:42:42.749 region:rollup2
ABOUT HOW THE SINGLE PAYER
03:42:42.182 --> 03:42:44.451 region:rollup2
BECAUSE OUR CURRENT MEDICAL
03:42:42.749 --> 03:42:50.958 region:rollup2
SYSTEM.
03:42:44.451 --> 03:42:53.827 region:rollup2
HE NOT DOING ITS JOB.
03:42:50.958 --> 03:42:54.728 region:rollup2
I THINK YOU AYE I'M BRIAN STOMP
03:42:53.827 --> 03:42:57.231 region:rollup2
OF FROM THE BOTTLE.
03:42:54.728 --> 03:42:57.497 region:rollup2
CALIFORNIA I'M RETIRED SMALL
03:42:57.231 --> 03:42:58.932 region:rollup2
BUSINESS.
03:42:57.497 --> 03:43:00.767 region:rollup2
OWNER.
03:42:58.932 --> 03:43:02.669 region:rollup2
I'VE ATTENDED THREE IF YOU'RE
03:43:00.767 --> 03:43:05.105 region:rollup2
HEARINGS AND THE I THINK YOU'RE
03:43:02.669 --> 03:43:07.107 region:rollup2
DOING A GOOD JOB ASSESSING THE
03:43:05.105 --> 03:43:08.642 region:rollup2
THE NEED. FOR A SINGLE PAYER
03:43:07.107 --> 03:43:11.311 region:rollup2
SYSTEM. AND.
03:43:08.642 --> 03:43:13.013 region:rollup2
THE COMPLEXITY OF GETTING THERE.
03:43:11.311 --> 03:43:14.715 region:rollup2
SOME PEOPLE HAVE SUGGESTED THAT
03:43:13.013 --> 03:43:16.250 region:rollup2
THIS IS A WAY TO PARK THIS THING
03:43:14.715 --> 03:43:17.484 region:rollup2
GET NOTHING DONE.
03:43:16.250 --> 03:43:18.151 region:rollup2
I'M COMING AROUND TO THE
03:43:17.484 --> 03:43:19.052 region:rollup2
THOUGHT THAT.
03:43:18.151 --> 03:43:20.754 region:rollup2
PERHAPS.
03:43:19.052 --> 03:43:22.723 region:rollup2
YOU PEOPLE ARE.
03:43:20.754 --> 03:43:24.758 region:rollup2
EXPOSING A LOT OF THE PROBLEMS
03:43:22.723 --> 03:43:25.726 region:rollup2
AND SOME OF THE SOLUTIONS. AND
03:43:24.758 --> 03:43:27.661 region:rollup2
ARE GIVING THIS.
03:43:25.726 --> 03:43:29.429 region:rollup2
A FAIR HEARING BUT OF COURSE
03:43:27.661 --> 03:43:32.399 region:rollup2
THE NEXT STEP IS TO GET OUT OUT
03:43:29.429 --> 03:43:33.433 region:rollup2
THERE AND DO SOMETHING WITH IT.
03:43:32.399 --> 03:43:36.103 region:rollup2
UNITED STATES IS SPENDING OVER
03:43:33.433 --> 03:43:37.537 region:rollup2
SEVENTEEN PERCENT OF US GDP. ON
03:43:36.103 --> 03:43:38.739 region:rollup2
HEALTH CARE AMOUNTING TO NINETY
03:43:37.537 --> 03:43:40.474 region:rollup2
FIVE HUNDRED DOLLARS A PERSON
03:43:38.739 --> 03:43:43.443 region:rollup2
THAT'S OVER THREE TRILLION
03:43:40.474 --> 03:43:45.145 region:rollup2
DOLLARS THAT WE SPEND ON. OTHER
03:43:43.443 --> 03:43:46.947 region:rollup2
HEALTHCARE IN THIS COUNTRY.
03:43:45.145 --> 03:43:50.117 region:rollup2
IF WE HAD THE FIFTY FIVE
03:43:46.947 --> 03:43:50.117 region:rollup2
HUNDRED DOLLAR PER PERSON
03:43:50.183 --> 03:43:53.687 region:rollup2
WITH A SINGLE PAYER SYSTEM AND
03:43:52.219 --> 03:43:55.689 region:rollup2
WE SAVED THE FOUR THOUSAND
03:43:53.687 --> 03:43:59.726 region:rollup2
DOLLARS PER PERSON.
03:43:55.689 --> 03:44:01.728 region:rollup2
WE WOULD HAVE A SAVED A MILLION
03:43:59.726 --> 03:44:04.531 region:rollup2
AND A ONE I'M STORY. A ONE AND A
03:44:01.728 --> 03:44:05.666 region:rollup2
QUARTER TRILLION DOLLARS A YEAR
03:44:04.531 --> 03:44:07.868 region:rollup2
ONE A QUARTER TRILLION DOLLARS A
03:44:05.666 --> 03:44:09.469 region:rollup2
YEAR. WE ONLY SPENT THREE AND A
03:44:07.868 --> 03:44:10.904 region:rollup2
HALF PERCENT OF OUR GDP.
03:44:09.469 --> 03:44:12.806 region:rollup2
ON DEFENSE.
03:44:10.904 --> 03:44:13.807 region:rollup2
AND WE SPEND MORE THAN THE NEXT
03:44:12.806 --> 03:44:15.475 region:rollup2
SEVEN COUNTRIES IN THE WORLD. ON
03:44:13.807 --> 03:44:16.043 region:rollup2
DEFENSE
03:44:15.475 --> 03:44:19.146 region:rollup2
SO THIS IS A HUGE PROBLEM IN
03:44:16.043 --> 03:44:21.348 region:rollup2
YOU.
03:44:19.146 --> 03:44:21.915 region:rollup2
INDIVIDUALS ARE IN CALIFORNIA
03:44:21.348 --> 03:44:24.084 region:rollup2
ARE DOING A VERY IMPORTANT A
03:44:21.915 --> 03:44:25.986 region:rollup2
JOB.
03:44:24.084 --> 03:44:27.788 region:rollup2
NOT ONLY IN REDUCING OUR
03:44:25.986 --> 03:44:28.989 region:rollup2
OUTLANDISH HEALTH CARE COSTS.
03:44:27.788 --> 03:44:31.024 region:rollup2
BUT IN PROVIDING A BETTER
03:44:28.989 --> 03:44:33.093 region:rollup2
HEALTH.
03:44:31.024 --> 03:44:35.028 region:rollup2
AND I HOPE BECAUSE THESE
03:44:33.093 --> 03:44:38.198 region:rollup2
POSITIONS OF MENTION. I THAT YOU
03:44:35.028 --> 03:44:40.133 region:rollup2
NEVER CONFUSE INSURANCE.
03:44:38.198 --> 03:44:42.169 region:rollup2
WITH HEALTH CARE INSURANCE IS
03:44:40.133 --> 03:44:43.870 region:rollup2
NOT HEALTH CARE INSURANCE IS A
03:44:42.169 --> 03:44:46.073 region:rollup2
WAY TO MAKE MONEY.
03:44:43.870 --> 03:44:47.941 region:rollup2
IT'S A GOOD WAY TO MAKE MONEY IF
03:44:46.073 --> 03:44:49.609 region:rollup2
A PERSON CAN'T AFFORD THE RISK
03:44:47.941 --> 03:44:52.346 region:rollup2
THE NEED INSURANCE.
03:44:49.609 --> 03:44:54.514 region:rollup2
CALIFORNIA CAN AFFORD THE RISK.
03:44:52.346 --> 03:44:55.415 region:rollup2
THANK YOU AND I HOPE THAT.
03:44:54.514 --> 03:44:59.886 region:rollup2
WERE SUCCESSFUL IN GETTING
03:44:55.415 --> 03:45:01.021 region:rollup2
SINGLE PAYER.
03:44:59.886 --> 03:45:02.055 region:rollup2
MONDALE FOUNTAIN WITH ENACT
03:45:01.021 --> 03:45:03.357 region:rollup2
UNIVERSAL HEALTH CARE FOR
03:45:02.055 --> 03:45:05.092 region:rollup2
CALIFORNIA.
03:45:03.357 --> 03:45:07.227 region:rollup2
THANKS AGAIN FOR THESE HEARINGS.
03:45:05.092 --> 03:45:09.429 region:rollup2
AND I'VE FIRST OFF I JUST WANT
03:45:07.227 --> 03:45:10.564 region:rollup2
TO CONGRATULATE THE ASSEMBLY ON
03:45:09.429 --> 03:45:12.599 region:rollup2
PASSING THE WHISTLEBLOWER
03:45:10.564 --> 03:45:14.301 region:rollup2
PROTECTIONS I'M BELIEVE THAT'S
03:45:12.599 --> 03:45:16.136 region:rollup2
WHAT I SAW ON THE FLOOR.
03:45:14.301 --> 03:45:17.704 region:rollup2
NEVIS ALMOST UNANIMOUS.
03:45:16.136 --> 03:45:19.406 region:rollup2
IT WAS.
03:45:17.704 --> 03:45:21.007 region:rollup2
I THINK THAT'S AMAZING WHEN
03:45:19.406 --> 03:45:22.776 region:rollup2
EVERYBODY CAN COME TOGETHER.
03:45:21.007 --> 03:45:25.212 region:rollup2
TO.
03:45:22.776 --> 03:45:26.546 region:rollup2
TO PASADENA PROTECTS PEOPLE.
03:45:25.212 --> 03:45:28.248 region:rollup2
LIKE THE WAY YOU GUYS DID.
03:45:26.546 --> 03:45:29.983 region:rollup2
I THINK THAT'S KIND OF
03:45:28.248 --> 03:45:31.118 region:rollup2
ANALOGOUS TO WE'RE TRYING TO DO
03:45:29.983 --> 03:45:32.052 region:rollup2
HERE.
03:45:31.118 --> 03:45:34.054 region:rollup2
ALSO.
03:45:32.052 --> 03:45:36.490 region:rollup2
ALTHOUGH SHE ISN'T IN THE ROOM.
03:45:34.054 --> 03:45:38.592 region:rollup2
ASSEMBLY MEMBER FRIEDMAN.
03:45:36.490 --> 03:45:38.892 region:rollup2
SHE'S HELPED OUT A LOT AND I
03:45:38.592 --> 03:45:40.994 region:rollup2
KNOW THAT.
03:45:38.892 --> 03:45:43.263 region:rollup2
SHE PUSHED.
03:45:40.994 --> 03:45:44.664 region:rollup2
TO GET THE CONSTITUTIONAL.
03:45:43.263 --> 03:45:46.266 region:rollup2
ISSUES OF RAISED.
03:45:44.664 --> 03:45:48.702 region:rollup2
AND.
03:45:46.266 --> 03:45:49.636 region:rollup2
THANK YOU DOCTOR WOULDN'T AND
03:45:48.702 --> 03:45:50.404 region:rollup2
WELL DOCTOR RANDALL IS NOT HERE
03:45:49.636 --> 03:45:50.937 region:rollup2
RIGHT NOW.
03:45:50.404 --> 03:45:53.874 region:rollup2
BUT.
03:45:50.937 --> 03:45:58.111 region:rollup2
THANKS ALL OF YOU AND I WILL
03:45:53.874 --> 03:45:58.678 region:rollup2
SEE YOU ON WEDNESDAY.
03:45:58.111 --> 03:46:00.380 region:rollup2
HELLO CRISCO IN FROM THE
03:45:58.678 --> 03:46:01.548 region:rollup2
CALIFORNIA IMMIGRANT POLICY
03:46:00.380 --> 03:46:03.183 region:rollup2
CENTER WE ARE A STATEWIDE
03:46:01.548 --> 03:46:04.584 region:rollup2
IMMIGRANT RIGHTS ORGANIZATION
03:46:03.183 --> 03:46:06.586 region:rollup2
THAT ADVANCES AND SUPPORTS AYE
03:46:04.584 --> 03:46:08.088 region:rollup2
IMMIGRATION HEALTH POLICIES.
03:46:06.586 --> 03:46:10.090 region:rollup2
JUST WANTED TO THANK THE
03:46:08.088 --> 03:46:10.824 region:rollup2
COMMITTEE ARE FOR HOLDING THAT
03:46:10.090 --> 03:46:12.526 region:rollup2
TODAY'S HEARING ON
03:46:10.824 --> 03:46:14.461 region:rollup2
IMPLEMENTATION OF CHALLENGES AS
03:46:12.526 --> 03:46:15.862 region:rollup2
IT RELATES TO UNIVERSAL COVERAGE
03:46:14.461 --> 03:46:17.297 region:rollup2
OUR CONSIDERATIONS.
03:46:15.862 --> 03:46:18.298 region:rollup2
AND JUST WANTED TO REITERATE
03:46:17.297 --> 03:46:19.599 region:rollup2
THE IMPORTANCE OF SOME OF OUR
03:46:18.298 --> 03:46:20.934 region:rollup2
WHAT THE LA A DISCUSSES IT
03:46:19.599 --> 03:46:22.269 region:rollup2
RELATES TO THE.
03:46:20.934 --> 03:46:24.171 region:rollup2
COVERING THE UNINSURED
03:46:22.269 --> 03:46:25.172 region:rollup2
POPULATION I'M I KNOW MY
03:46:24.171 --> 03:46:26.807 region:rollup2
COLLEAGUE WILL SPEAK MORE TO
03:46:25.172 --> 03:46:27.874 region:rollup2
THIS AYE ON WEDNESDAY BUT JUST
03:46:26.807 --> 03:46:30.010 region:rollup2
WANT TO REITERATE.
03:46:27.874 --> 03:46:31.978 region:rollup2
SOME OF THE ONE OF THE POINTS
03:46:30.010 --> 03:46:33.013 region:rollup2
THAT FIFTY PERCENT OF THOSE WHO
03:46:31.978 --> 03:46:34.748 region:rollup2
REMAIN ON THE SHIRT IN THE STATE
03:46:33.013 --> 03:46:36.249 region:rollup2
ARE UNDOCUMENTED AND SO.
03:46:34.748 --> 03:46:38.618 region:rollup2
WE DO LOOK FORWARD TO.
03:46:36.249 --> 03:46:39.519 region:rollup2
SPEAKING ABOUT WAYS IN AND ONE
03:46:38.618 --> 03:46:39.920 region:rollup2
OF THEM BEING THE HEALTH FOR OUR
03:46:39.519 --> 03:46:41.721 region:rollup2
PROPOSAL.
03:46:39.920 --> 03:46:42.989 region:rollup2
THAT WOULD EXPAND ACCESS TO
03:46:41.721 --> 03:46:44.658 region:rollup2
FULL SCOPE MEDICAL TO THE
03:46:42.989 --> 03:46:46.159 region:rollup2
UNDOCUMENTED POPULATION IN
03:46:44.658 --> 03:46:47.727 region:rollup2
DISCUSSING HOW THAT CAN BE ONE
03:46:46.159 --> 03:46:48.829 region:rollup2
OF THE WAYS IN WHICH WE LOWER
03:46:47.727 --> 03:46:50.897 region:rollup2
THE UNINSURED RATE HERE IN THE
03:46:48.829 --> 03:46:54.734 region:rollup2
STATE OF CALIFORNIA. THANK YOU
03:46:50.897 --> 03:46:55.769 region:rollup2
VERY MUCH.
03:46:54.734 --> 03:46:56.837 region:rollup2
HAVE THEIR EYES STEPHANIE BERGER
03:46:55.769 --> 03:46:57.637 region:rollup2
PRESIDENT OF THE CALIFORNIA
03:46:56.837 --> 03:46:58.905 region:rollup2
ASSOCIATION OF HEALTH
03:46:57.637 --> 03:47:00.440 region:rollup2
UNDERWRITERS ARE TWENTY FIVE
03:46:58.905 --> 03:47:02.542 region:rollup2
HUNDRED MEMBERS ARE EXTREMELY
03:47:00.440 --> 03:47:04.044 region:rollup2
PROUD OF THE WORK AS LEADING IN
03:47:02.542 --> 03:47:05.345 region:rollup2
ROLLERS IN COVERED CALIFORNIA.
03:47:04.044 --> 03:47:06.880 region:rollup2
COUPLED WITH THEIR ENROLLMENTS
03:47:05.345 --> 03:47:08.281 region:rollup2
IN MEDICARE MEDICAL AND OTHER
03:47:06.880 --> 03:47:10.150 region:rollup2
PROGRAMS OUR MEMBERS ARE
03:47:08.281 --> 03:47:11.852 region:rollup2
ENSURING CALIFORNIA CONTINUES TO
03:47:10.150 --> 03:47:13.286 region:rollup2
LEAD WITH THE MOST SUCCESSFUL
03:47:11.852 --> 03:47:14.187 region:rollup2
EXCHANGE IN THE NATION.
03:47:13.286 --> 03:47:15.689 region:rollup2
WE KNOW THAT THERE'S A LOT MORE
03:47:14.187 --> 03:47:16.623 region:rollup2
HARD WORK AHEAD OF US.
03:47:15.689 --> 03:47:17.824 region:rollup2
WE REMAIN COMMITTED TO
03:47:16.623 --> 03:47:19.860 region:rollup2
PARTNERING WITH THIS COMMITTEE
03:47:17.824 --> 03:47:21.228 region:rollup2
AND ALL STAKEHOLDERS TO ENSURE
03:47:19.860 --> 03:47:22.929 region:rollup2
THAT THE REMAINING SIX POINT
03:47:21.228 --> 03:47:24.431 region:rollup2
EIGHT PERCENT OF CALIFORNIANS
03:47:22.929 --> 03:47:26.566 region:rollup2
THAT HAVE NOT YET BEEN SHIRT
03:47:24.431 --> 03:47:29.503 region:rollup2
ACHIEVE THE RIGHT TO CHOICE AND
03:47:26.566 --> 03:47:30.437 region:rollup2
QUALITY HEALTHCARE. THINK YOU.
03:47:29.503 --> 03:47:32.439 region:rollup2
GOOD EVENING MISTER CHAIR
03:47:30.437 --> 03:47:33.640 region:rollup2
NUMBERS TAM LA WITH HEALTHAXIS
03:47:32.439 --> 03:47:35.041 region:rollup2
CALIFORNIA IS ONE OF THANK YOU
03:47:33.640 --> 03:47:36.576 region:rollup2
FOR HOLDING AND THIS HEARING
03:47:35.041 --> 03:47:38.044 region:rollup2
TODAY AND IT.
03:47:36.576 --> 03:47:39.346 region:rollup2
OF THEM WONDERFUL PRESENTERS
03:47:38.044 --> 03:47:40.447 region:rollup2
HAVE GIVEN US A LOT OF OF REALLY
03:47:39.346 --> 03:47:42.149 region:rollup2
GOOD INFORMATION AND FOOD FOR
03:47:40.447 --> 03:47:43.483 region:rollup2
THOUGHT ABOUT LOVE THE
03:47:42.149 --> 03:47:44.551 region:rollup2
SIGNIFICANT CHALLENGES THAT.
03:47:43.483 --> 03:47:46.052 region:rollup2
THIS LEGISLATURE.
03:47:44.551 --> 03:47:48.088 region:rollup2
AND POLICY MAKERS NEED TO
03:47:46.052 --> 03:47:49.623 region:rollup2
GRAPPLE WITH AS WE LOOK FOR A
03:47:48.088 --> 03:47:51.525 region:rollup2
PATH TOWARD A UNIVERSAL COVERAGE
03:47:49.623 --> 03:47:52.092 region:rollup2
AND PARTICULARLY THE OF THE
03:47:51.525 --> 03:47:53.126 region:rollup2
FEDERAL HURDLES THAT EXISTS
03:47:52.092 --> 03:47:55.395 region:rollup2
WITH.
03:47:53.126 --> 03:47:57.397 region:rollup2
BOTH LIKE FEDERAL FINANCING AND
03:47:55.395 --> 03:47:57.631 region:rollup2
FEDERAL LAWS AND WAIVERS.
03:47:57.397 --> 03:47:59.733 region:rollup2
I THINK.
03:47:57.631 --> 03:48:01.801 region:rollup2
IT'LL LAST WEEK ON THE THIRTY
03:47:59.733 --> 03:48:03.537 region:rollup2
FIRST UNCOVERED CALIFORNIA
03:48:01.801 --> 03:48:05.005 region:rollup2
CLOSED ITS OPEN WORLD AND OPEN A
03:48:03.537 --> 03:48:06.206 region:rollup2
ROAD PERIOD AND WE SAW A LOT
03:48:05.005 --> 03:48:06.740 region:rollup2
MORE PEOPLE SIGNED UP FOR
03:48:06.206 --> 03:48:08.208 region:rollup2
COVERAGE.
03:48:06.740 --> 03:48:09.142 region:rollup2
AND WHAT THIS IS REALLY GREAT
03:48:08.208 --> 03:48:09.476 region:rollup2
NEWS.
03:48:09.142 --> 03:48:11.545 region:rollup2
PARTICULARLY.
03:48:09.476 --> 03:48:13.346 region:rollup2
GIVEN ALL OF THE CONFUSION THAT
03:48:11.545 --> 03:48:14.714 region:rollup2
HAS BEEN SOWED OVER THE LAST
03:48:13.346 --> 03:48:14.881 region:rollup2
YEAR AT THE FEDERAL LEVEL ABOUT
03:48:14.714 --> 03:48:16.683 region:rollup2
THE.
03:48:14.881 --> 03:48:18.785 region:rollup2
.
03:48:16.683 --> 03:48:20.220 region:rollup2
OF AFFORDABLE CARE ACT AND IT'S
03:48:18.785 --> 03:48:21.855 region:rollup2
A VERY EXISTENCE.
03:48:20.220 --> 03:48:23.857 region:rollup2
WE AT HEALTH ACCESS HAVE A LOT
03:48:21.855 --> 03:48:25.258 region:rollup2
OF IDEAS ON HOW CALIFORNIA CAN'T
03:48:23.857 --> 03:48:26.493 region:rollup2
GET UNIVERSAL COVERAGE AND WE
03:48:25.258 --> 03:48:27.794 region:rollup2
LOOK FORWARD TO SHARING THOSE
03:48:26.493 --> 03:48:30.597 region:rollup2
WITH THE COMMITTEE ON WEDNESDAY
03:48:27.794 --> 03:48:31.765 region:rollup2
THANK YOU.
03:48:30.597 --> 03:48:32.766 region:rollup2
THANK YOU.
03:48:31.765 --> 03:48:34.000 region:rollup2
AYMERIC LEAN XIN ON THE CO
03:48:32.766 --> 03:48:35.735 region:rollup2
DIRECTOROF THE BUSINESS
03:48:34.000 --> 03:48:37.470 region:rollup2
ALLIANCE FOR HEALTHY CALIFORNIA
03:48:35.735 --> 03:48:39.105 region:rollup2
A BUSINESS ORGANIZATION OF THREE
03:48:37.470 --> 03:48:40.607 region:rollup2
HUNDRED MEMBERS AND GROWING.
03:48:39.105 --> 03:48:44.010 region:rollup2
THAT SUPPORTS THE SINGLE PAYER
03:48:40.607 --> 03:48:44.945 region:rollup2
SOLUTION. WHAT STRIKES ME IS THE
03:48:44.010 --> 03:48:47.047 region:rollup2
FACT THAT?
03:48:44.945 --> 03:48:47.948 region:rollup2
WE'RE TALKING ABOUT.
03:48:47.047 --> 03:48:49.616 region:rollup2
THE MONEY ALREADY BEING IN THE
03:48:47.948 --> 03:48:51.718 region:rollup2
SYSTEM
03:48:49.616 --> 03:48:53.353 region:rollup2
YOU FORGETTING IT OBEYED ABOUT
03:48:51.718 --> 03:48:54.287 region:rollup2
WHICH THE COSTS AND SINGLE PAYER
03:48:53.353 --> 03:48:55.622 region:rollup2
LET'S JUST SAY YOU HAVE FOUR
03:48:54.287 --> 03:48:56.356 region:rollup2
HUNDRED BILLION DOLLARS HERE
03:48:55.622 --> 03:48:58.024 region:rollup2
YOUR FOUR HUNDRED BILLION
03:48:56.356 --> 03:48:59.693 region:rollup2
DOLLARS THERE WITH A MUCH BETTER
03:48:58.024 --> 03:49:01.928 region:rollup2
SYSTEM. IN PLACE THE MONEY'S
03:48:59.693 --> 03:49:04.664 region:rollup2
THERE SO WE SHOULD BE CREATIVE
03:49:01.928 --> 03:49:06.766 region:rollup2
ENOUGH TO FIGURE OUT HOW TO GET
03:49:04.664 --> 03:49:09.803 region:rollup2
IT INTO THE RIGHT PLACE.
03:49:06.766 --> 03:49:10.904 region:rollup2
FOR ME AS A BUSINESS PERSON.
03:49:09.803 --> 03:49:12.706 region:rollup2
HEALTHCARE HEALTH INSURANCE
03:49:10.904 --> 03:49:14.908 region:rollup2
IS TAX
03:49:12.706 --> 03:49:17.110 region:rollup2
OKAY WE EVER THINK ABOUT THAT
03:49:14.908 --> 03:49:18.578 region:rollup2
ASPECT I KNOW SEMANTICALLY AND
03:49:17.110 --> 03:49:20.714 region:rollup2
IN WEBSTER'S DICTIONARY IT WON'T
03:49:18.578 --> 03:49:22.649 region:rollup2
BE THAT WAY. BUT IN REALITY WHAT
03:49:20.714 --> 03:49:24.451 region:rollup2
COMES OUT OF MY POCKET TO PAY
03:49:22.649 --> 03:49:26.553 region:rollup2
FOR EMPLOYEES IS A TAX.
03:49:24.451 --> 03:49:28.622 region:rollup2
I SAME TIME NOT ONLY GOT TO
03:49:26.553 --> 03:49:30.557 region:rollup2
SPEND THE MONEY BUT I HAVE TO
03:49:28.622 --> 03:49:31.324 region:rollup2
SPEND ALL THE TIME WORRYING
03:49:30.557 --> 03:49:32.759 region:rollup2
ABOUT GETTING IT FOR MY
03:49:31.324 --> 03:49:34.261 region:rollup2
EMPLOYEES.
03:49:32.759 --> 03:49:37.130 region:rollup2
IT SEEMS LIKE WE REALLY NEED A
03:49:34.261 --> 03:49:38.665 region:rollup2
SIMPLIFICATION IN THE SYSTEM AND
03:49:37.130 --> 03:49:40.233 region:rollup2
BY THE WAY I THINK WE ALL SAW
03:49:38.665 --> 03:49:42.168 region:rollup2
THE HEADLINES LAST WEEK ABOUT
03:49:40.233 --> 03:49:44.070 region:rollup2
THE NEW FORMATION OF A COMPANY.
03:49:42.168 --> 03:49:46.306 region:rollup2
A NONPROFIT COMPANY.
03:49:44.070 --> 03:49:47.774 region:rollup2
BY JEFF BEZOS WARREN BUFFETT AND
03:49:46.306 --> 03:49:50.276 region:rollup2
JAMIE DIMON.
03:49:47.774 --> 03:49:52.279 region:rollup2
BECAUSE OF THE FRUSTRATION LEVEL
03:49:50.276 --> 03:49:54.047 region:rollup2
WITH OUR SYSTEM THAT'S BROKEN.
03:49:52.279 --> 03:49:56.349 region:rollup2
I THINK BUSINESS
03:49:54.047 --> 03:49:57.417 region:rollup2
WILL COME AROUND UNDERSTANDING
03:49:56.349 --> 03:49:58.685 region:rollup2
THAT THEY'RE GOING TO PAY
03:49:57.417 --> 03:50:00.787 region:rollup2
SOMETHING FOR HEALTH CARE
03:49:58.685 --> 03:50:02.689 region:rollup2
WHETHER IT'S A PAYROLL TAX WORK
03:50:00.787 --> 03:50:04.024 region:rollup2
OR HEALTH INSURANCE.
03:50:02.689 --> 03:50:05.325 region:rollup2
WE GOT A LOOK AT WHAT'S
03:50:04.024 --> 03:50:06.893 region:rollup2
REASONABLE AND WHAT WAS GONNA
03:50:05.325 --> 03:50:08.261 region:rollup2
REALLY COST.
03:50:06.893 --> 03:50:09.996 region:rollup2
WHO'S GOING TO BENEFIT AND THINK
03:50:08.261 --> 03:50:12.299 region:rollup2
ABOUT THE FUTURE.
03:50:09.996 --> 03:50:13.967 region:rollup2
BECAUSE I BELIEVE UNDER SINGLE
03:50:12.299 --> 03:50:15.635 region:rollup2
PAYER SYSTEM WILL BEER CONTAIN
03:50:13.967 --> 03:50:17.303 region:rollup2
COSTS A LOT BETTER THEIR
03:50:15.635 --> 03:50:18.471 region:rollup2
SKYROCKETING LOOK AT PROBLEM
03:50:17.303 --> 03:50:19.673 region:rollup2
WE'RE HAVING WITH PENSION FUNDS
03:50:18.471 --> 03:50:21.408 region:rollup2
NOW.
03:50:19.673 --> 03:50:24.978 region:rollup2
PART BECAUSE OF RISING HEALTH
03:50:21.408 --> 03:50:26.379 region:rollup2
INSURANCE COSTS THANK YOU.
03:50:24.978 --> 03:50:28.615 region:rollup2
I MY NAME IS DON BACKROOM FROM
03:50:26.379 --> 03:50:29.983 region:rollup2
SINGLE PAYER NOW. LA I QUESTION
03:50:28.615 --> 03:50:31.351 region:rollup2
THE LA OWES ASSUMPTION OF TEN
03:50:29.983 --> 03:50:33.253 region:rollup2
PERCENT OVERHEAD TO RUN THE
03:50:31.351 --> 03:50:34.187 region:rollup2
SYSTEM. MEDICARE DOESN'T
03:50:33.253 --> 03:50:36.089 region:rollup2
NATIONALLY FOR TWO TO THREE
03:50:34.187 --> 03:50:37.524 region:rollup2
PERCENT MEDICAID DOESN'T FOR
03:50:36.089 --> 03:50:39.426 region:rollup2
FIVE PERCENT THAT'S BECAUSE THEY
03:50:37.524 --> 03:50:40.694 region:rollup2
DO MEANS TESTING. OR THEY HAVE
03:50:39.426 --> 03:50:42.529 region:rollup2
TO HIRE SOME SOCIAL WORKERS TO
03:50:40.694 --> 03:50:43.897 region:rollup2
LOOK AT YOUR BANK ACCOUNTS NOW
03:50:42.529 --> 03:50:45.932 region:rollup2
ME HOME JONES.
03:50:43.897 --> 03:50:48.034 region:rollup2
SO I QUESTION THAT ASSUMPTION A
03:50:45.932 --> 03:50:50.070 region:rollup2
WHOLE LOT. BOMB TODAY'S
03:50:48.034 --> 03:50:52.839 region:rollup2
DISCUSSION. WAS ABOUT HOW TO GET
03:50:50.070 --> 03:50:54.040 region:rollup2
MEDICARE MONEY INTO THE SYSTEM.
03:50:52.839 --> 03:50:55.742 region:rollup2
WAIVERS IS NOT THE ONLY WAY TO
03:50:54.040 --> 03:50:57.577 region:rollup2
DO IT.
03:50:55.742 --> 03:50:59.379 region:rollup2
NOT JUST MENTAL NEW IDEA WE HAD
03:50:57.577 --> 03:51:00.980 region:rollup2
THIS IN THE NINETEEN NINETY FOUR
03:50:59.379 --> 03:51:02.582 region:rollup2
INITIATIVE IN CALIFORNIA.
03:51:00.980 --> 03:51:04.884 region:rollup2
WHERE DOCTORS COULD SEND THEIR
03:51:02.582 --> 03:51:06.586 region:rollup2
MEDICARE BILLS TO?
03:51:04.884 --> 03:51:07.821 region:rollup2
TO THE COMMISSIONER.
03:51:06.586 --> 03:51:09.355 region:rollup2
ALL THE CALIFORNIA HEALTH CARE
03:51:07.821 --> 03:51:11.458 region:rollup2
SYSTEM OR WHATEVER GOVERNING BUT
03:51:09.355 --> 03:51:14.260 region:rollup2
WE HAVE IT. AND THEN THEY WOULD
03:51:11.458 --> 03:51:16.363 region:rollup2
BUNDLES UP. AND BILL THEM DO
03:51:14.260 --> 03:51:18.498 region:rollup2
THAT THE FUNCTION OF BILLING
03:51:16.363 --> 03:51:19.666 region:rollup2
THEM TO THE FEDERAL GOVERNMENT.
03:51:18.498 --> 03:51:21.167 region:rollup2
THAT WAS FEVER SERVICE HAD THE
03:51:19.666 --> 03:51:22.702 region:rollup2
FEVER SERVICE IN BELUM ONE BY
03:51:21.167 --> 03:51:25.238 region:rollup2
ONE BUT THEY WOULD BILL THAT THE
03:51:22.702 --> 03:51:26.339 region:rollup2
FEDERAL GOVERNMENT. FOR EVERY
03:51:25.238 --> 03:51:28.007 region:rollup2
OPERATION THAT YOU'RE A
03:51:26.339 --> 03:51:30.076 region:rollup2
PROCEDURE THAT A DOCTOR HOSPITAL
03:51:28.007 --> 03:51:30.643 region:rollup2
VISITS ANOTHER WAY OF GETTING
03:51:30.076 --> 03:51:31.578 region:rollup2
THE MEDICARE MONEY INTO THE
03:51:30.643 --> 03:51:32.979 region:rollup2
SYSTEM.
03:51:31.578 --> 03:51:34.581 region:rollup2
I ALSO FOUGHT IT WAS INTERESTING
03:51:32.979 --> 03:51:36.649 region:rollup2
THAT THE KANSAS PROFESSOR.
03:51:34.581 --> 03:51:37.617 region:rollup2
.
03:51:36.649 --> 03:51:40.954 region:rollup2
THAT'S A LOT OF TIME ONE MINUTE.
03:51:37.617 --> 03:51:41.588 region:rollup2
.
03:51:40.954 --> 03:51:42.789 region:rollup2
I ALSO WAS VERY ANDERSON SHE
03:51:41.588 --> 03:51:44.724 region:rollup2
SAID THAT FIFTY TO SIXTY TO
03:51:42.789 --> 03:51:47.994 region:rollup2
SEVENTY PERCENT. OF BUSINESSES.
03:51:44.724 --> 03:51:49.195 region:rollup2
ARM.
03:51:47.994 --> 03:51:50.797 region:rollup2
MAYBE ARE INVOLVED WITH
03:51:49.195 --> 03:51:52.198 region:rollup2
THEORISTS OF THING. THAT MEANS
03:51:50.797 --> 03:51:54.033 region:rollup2
THAT WE PASSED A TAX IN THE
03:51:52.198 --> 03:51:55.034 region:rollup2
STATE FOR HEALTH CARE.
03:51:54.033 --> 03:51:56.536 region:rollup2
THEY COULDN'T CLAIM WE WERE
03:51:55.034 --> 03:51:58.605 region:rollup2
TARGETING ANY ONE OF THEM.
03:51:56.536 --> 03:51:59.172 region:rollup2
THAT MUCH BUSINESS IN CALIFORNIA
03:51:58.605 --> 03:52:02.842 region:rollup2
WHO PROVIDES HEALTH CARE IS.
03:51:59.172 --> 03:52:04.277 region:rollup2
ARM.
03:52:02.842 --> 03:52:05.478 region:rollup2
WHAT WE'RE NOT TARGETING AND
03:52:04.277 --> 03:52:06.746 region:rollup2
WE'RE JUST IT'S AND OVERALL TAX
03:52:05.478 --> 03:52:07.347 region:rollup2
FOR EVERYTHING THAT WE DO FOR?
03:52:06.746 --> 03:52:10.350 region:rollup2
EVERYTHING IN THE STATE THANK
03:52:07.347 --> 03:52:12.085 region:rollup2
YOU.
03:52:10.350 --> 03:52:13.987 region:rollup2
HI FOLKS I'M PAUL ROCKED AB I'M.
03:52:12.085 --> 03:52:15.855 region:rollup2
LONG TERM NURSE PRACTITIONER
03:52:13.987 --> 03:52:17.290 region:rollup2
INSTEAD OF CALIFORNIA ALSO
03:52:15.855 --> 03:52:19.926 region:rollup2
MEMBER OF P. IN HP.
03:52:17.290 --> 03:52:21.694 region:rollup2
AND I WANT TO REMIND ALL OF YOU
03:52:19.926 --> 03:52:23.730 region:rollup2
IN TERMS OF COMMITMENT VALUE
03:52:21.694 --> 03:52:25.498 region:rollup2
HERE. THAT IN THE EIGHT MONTHS
03:52:23.730 --> 03:52:28.301 region:rollup2
THAT SENATE BILL FIVE SIXTY TWO
03:52:25.498 --> 03:52:29.869 region:rollup2
HAS NOT HAD ANY ACTION OR BEEN
03:52:28.301 --> 03:52:31.237 region:rollup2
FILLED IN IN ANY WAY.
03:52:29.869 --> 03:52:33.173 region:rollup2
THOUSANDS OF CALIFORNIANS HAVE
03:52:31.237 --> 03:52:35.141 region:rollup2
DIED.
03:52:33.173 --> 03:52:36.743 region:rollup2
AS A RESULT OF NO ACCESS TO
03:52:35.141 --> 03:52:39.546 region:rollup2
HEALTH CARE FOR NOT BEING ABLE
03:52:36.743 --> 03:52:41.414 region:rollup2
TO AFFORD INSURANCE.
03:52:39.546 --> 03:52:43.116 region:rollup2
AND LOOKING AT THIS IN TERMS OF
03:52:41.414 --> 03:52:46.186 region:rollup2
THE UNINSURED.
03:52:43.116 --> 03:52:47.921 region:rollup2
SIGNIFICANTLY UNDER ESTIMATES
03:52:46.186 --> 03:52:49.756 region:rollup2
THE CONSEQUENCES TO PEOPLE IN
03:52:47.921 --> 03:52:51.658 region:rollup2
TERMS OF MORBIDITY.
03:52:49.756 --> 03:52:53.092 region:rollup2
THE UNDER INSURED AND THIS STATE
03:52:51.658 --> 03:52:54.494 region:rollup2
OF SOMETHING THAT I CAN'T EVEN
03:52:53.092 --> 03:52:56.029 region:rollup2
FIND ON THE INTERNET. THE
03:52:54.494 --> 03:52:57.230 region:rollup2
NUMBERS OF THOSE PEOPLE THERE
03:52:56.029 --> 03:52:58.832 region:rollup2
ARE MILLIONS AND MILLIONS AND
03:52:57.230 --> 03:53:01.134 region:rollup2
MILLIONS OF PEOPLE BEING
03:52:58.832 --> 03:53:03.770 region:rollup2
AFFECTED. BY THE SYSTEM THAT WE
03:53:01.134 --> 03:53:06.039 region:rollup2
HAVE IT'S VERY CLEAR THAT THE
03:53:03.770 --> 03:53:07.607 region:rollup2
COMMITMENT HERE HAS TO BE A
03:53:06.039 --> 03:53:10.109 region:rollup2
FIGHT AWAY. SO I HAVE A
03:53:07.607 --> 03:53:12.078 region:rollup2
COMMITMENT TO FIND A WAY.
03:53:10.109 --> 03:53:13.680 region:rollup2
THROUGH THE COMPLICATIONS THAT
03:53:12.078 --> 03:53:14.414 region:rollup2
WE'RE HEARING ABOUT TODAY IN
03:53:13.680 --> 03:53:14.914 region:rollup2
TERMS OF FINANCING AND IT'S
03:53:14.414 --> 03:53:16.483 region:rollup2
THEIR.
03:53:14.914 --> 03:53:17.784 region:rollup2
THANK YOU.
03:53:16.483 --> 03:53:21.421 region:rollup2
VERY MUCH.
03:53:17.784 --> 03:53:23.056 region:rollup2
ANYONE ELSE.
03:53:21.421 --> 03:53:25.124 region:rollup2
SEEING NO ONE WORLD GO AHEAD.
03:53:23.056 --> 03:53:26.559 region:rollup2
BEFORE WE CLOSE I JUST WANNA
03:53:25.124 --> 03:53:27.594 region:rollup2
ANNOUNCE THAT. THERE IS AN
03:53:26.559 --> 03:53:30.129 region:rollup2
ADDITIONAL HEARING IT'S ON
03:53:27.594 --> 03:53:32.398 region:rollup2
WEDNESDAY BEGINS HERE AT TEN AM
03:53:30.129 --> 03:53:33.900 region:rollup2
AND WE'LL BE HEARING. A VARIETY
03:53:32.398 --> 03:53:35.201 region:rollup2
OF PROPOSALS ABOUT.
03:53:33.900 --> 03:53:36.336 region:rollup2
HOW WE GET TO UNIVERSAL
03:53:35.201 --> 03:53:36.736 region:rollup2
HEALTHCARE?
03:53:36.336 --> 03:53:38.938 region:rollup2
SO.
03:53:36.736 --> 03:53:40.607 region:rollup2
WE WILL WE WILL LIKELY HAVE A
03:53:38.938 --> 03:53:42.141 region:rollup2
AT LUNCH BREAK IN THE MIDDLE OF
03:53:40.607 --> 03:53:43.376 region:rollup2
THAT SOME AT SOME POINT. BUT
03:53:42.141 --> 03:53:44.644 region:rollup2
THERE WILL BE A COUPLE OF PANELS
03:53:43.376 --> 03:53:46.946 region:rollup2
IN THE FIRST WILL BEGIN AT TEN
03:53:44.644 --> 03:53:48.214 region:rollup2
AM ON ON WEDNESDAY MORNING SO
03:53:46.946 --> 03:53:49.849 region:rollup2
THANK YOU VERY MUCH FOR BEING
03:53:48.214 --> 03:53:51.284 region:rollup2
HERE. AND I'LL SEE SOME OF YOU
03:53:49.849 --> 03:53:53.686 region:rollup2
ON WEDNESDAY I SUSPECT.
03:53:51.284 --> 03:53:53.686 region:rollup2
MEETING ADJOURNED