was calm in championing average people and industry thate served those people. >> the first of a kid of-par of arsation -- the first two-part conversation with one of the world's best-known technology predictors. >> i believe we will see in the next five to 10 years a big -- virtualw stuff reality, augmented reality, artificial intelligence, and i think all kinds of new ways of driving cars. we have a little taste of it, but we are going to see a lot more of it. >> monday night at 8:00 eastern on c-span two. >> republican representative jim sensenbrenner recently met with constituents at a town hall in

lake mills, wisconsin. many of the questions focused on republican efforts to repeal and replace the affordable care. this runs an hour and a half. coming. you all for state representative joe cleavage is here to listen to your questions -- state ch issentative joel kleefis here to listen to your questions and i want to do the same on the national level. i want to publicly thank the city for its cooperation in setting up this meeting and also local law enforcement officials for their service this evening. i appreciate the opportunity to hear your concerns. in fact, this is the 78th public meeting i've held since january. you probably know some of these meetings have become very contentious. i want to be sure to review the rules that we need to adhere to so that we have an orderly environment in which to exchange ideas. first, i ask all of you to sign in with my staff. if you would like an opportunity to speak, you need to check the

speaking box that appears in the sign-in slips, that way i know to call on you during the first portion of the meeting. i will be giving priority to those of you who reside in the lake mills and water lou area and then if time permits, i will continue to call out residents of the fifth congressional district who live elsewhere. if additional time is available, i will call on those who don't reside in the fifth district. this portion of the meeting will last about 11 hour 20 minutes. it should be over with about 8:20. i expect participants to be respectful and to allow the person who is recognized and has the floor the opportunity to speak without interruptions as well as when i respond to each comment. further, if the question you would like to ask or the comment that you would like to make is already -- has already been made, please refrain from asking it again. we should try to hear from as many of you as we can within the time constraints. if at any time participants become rude or disruptive, i

will immediately adjourn the meeting. because there's nothing positive to be gained from continuing with a meeting that is disorderly. last thursday night in west dallas, the meeting became so disorderly and there were so many interruptions that i had to adjourn the meeting. i don't what to do that tonight. it's up to the audience to be respectful of everybody who is speaking, including mystically h and memr. kleefisc when i respond. we can all be -- we can all disagree without being disagreeable. the second portion of the meeting is devoted to those of you who seek my help with personal problems they are experiencing with the federal government. the way i know you like to speak this part of the meeting is opportunity for us to have a one

on one private conversation any and it is not the time to continue general discussions. any filming or recording is prohibited during this part of the meeting. so without any further adieu, first up is anita martin, pinnacle drive in lake mills. just stand up where you are and speak out. this is being televised on sure their i'm audience would like to hear your question in your words rather than in my translation. >> good evening. thank you for the opportunity to speak about important issues our state and nation now face. my name is anita and i'm a resident of city of lake mills. please protectto our environment and our valuable natural resources in wisconsin and throughout the united states. the great lakes hold more than

80% of north america's first service water and 20% of entire world's fresh surface water. please do not let the great lakes compact go by the wayside. all of the eight great states lakes states approve this vital commitment which president george w. bush signed into law almost a decade ago. we must protect our water. also can you approve the corporate energy standards to reduce energy consumption. please also vote for budget that supports staff to ensure science based decisions are made at the epa, as well as an asset. representative kleefisch, i'm asking you and our other state legislatures, please do not cut $90 million out of governor walker's proposed education budget.

this is the cut that discussed suggested for the 2017/2019 state budget. you simply cannot afford to lose the $200 minimum increase in per student funding. the future of our children, the strength of our community and the economy of the state are depending on these funds. in addition, please pass state budget or last minute changes in policy that are not subject to public input. thank you both for your consideration and for your leadership on these issues that impact all of us as residents of wisconsin. representative sensenbrenner: thank you very much, ms. martin. first of all, let me say regardless of what happens with this budget, the great lakes compact will stay. interstate compacts are allowed by the constitution. they do have to be approved by congress as well as by all of the states involved and there is nothing that congress can do or

should do to undo this compact. you should note that i have sent a letter, both to the president and to the omb asking for full funding of the great lakes initiative, which is about $300 million in which it zeroed out in the president's budget. i agree with you that the great lakes are a resource that have to be protected, you know, not only from pollution, but also from invasive species like asian sieber -- zebra mussels, and i don't know who ate them, but they're not around anymore. with respect to the fuel economy, i have to respectfully disagree with you. every time the cafe standards have been increased, what detroit has done is followed the law of physics and made the vehicles lighter and that way they're able to have more miles to the gallon. that's good until you get into

an accident and when there's an , accident, there is a much greater likelihood of death or serious injury as, you know, as well as more expensive repairs to the cars, which increase insurance rates for everybody, even including those who do not have accidents and who don't make claims. so i think that the cafe standards should be left alone the way they are and they should not be increased. joel. representative kleefisch: only to say that i have signed a letter supporting the increase in funding for public education. many don't know that my parents are life long public schoolteachers and i'm a public school substitute teacher myself. i have two daughters in the public school system. this has always been a top priority for the budget and for revenue expenditure in the state of wisconsin, we spend more than 50 cents of every tax revenue dollar on education, so it is priority and it will continue to be and i will strongly continue to support the increase for

funding in k education. sensenbrenner:ve next up is nathan miles, lake shore drive. piles, i'm sorry. >> your choice. >> [inaudible] they have the opportunity to change way district applying failed to do so. [inaudible] strengthens the basic democratic principle of one person, one bill. [inaudible]

representative sensenbrenner: my answer to you is that the founding fathers of this state determined the way in which we would be redistricted. i sat in the minority. i've always been known as someone who works strongly across the aisle. i've had 22 bills signed into law last session. 16 of them were lead authored by democrats, and all 22 are coauthored by democrats. i did not participate in one meeting in the redistricting that was done over the past two sessions ago. the reason i did not is so when people asked questions like the one you're asking, i could honestly say i had zero part in the redistricting process. i think our founding fathers had a very good idea and there are consequences to elections to the

way the redistricting is set up with the majority party involved is under scrutiny right now in the courts and the courts have determined that some of the redistricting must be redone. so, of course, we'll take a look at any potential bill that comes up, but as it stands right now it's in the hands of the courts , and worked well so far. if it's wrong, the courts are going to tell us it was done wrong. >> respectfully disagree -- [inaudible question] >> i think you know any time lawyers are involved, it's never neutral. >> first of all, taking -- thank you for taking the time to hold

these meetings. leading up to the passage of the american health care act the , house of representatives with leadership of your party failed to hold a single hearing on this bill which impacts 1/6 of our economy, nearly every u.s. citizen in some way at some time. [inaudible] the american medical association says that the ahca will become law millions of americans health will lose health insurance provided by medicaid. the american academy of pediatricians issued a statement saying that ahca is dangerous policy for our country and finally the aarp said that it poses this legislation that

medicare and shift cost in this. legislation would make health care less fair. my question to you is why did you vote for the bill? representative sensenbrenner well, if it's bad for doctors' : bottom line, it's bad and let me say this, obama care and if we do nothing, obama care is exchange collapses. you have to remember that obama care only has the potential of covering people who are not on medicare or medicaid or do not have any kind of health insurance that is upon sorried -- sponsored by their employers. it is a relatively small percentage of the american public that is covered by obamacare and won't be covered by anybody when no insurance

company will end up underwriting policies through the exchanges. we're told that will be in three to five years. the exchanges have collapsed and in other parts of the country, even in our state in the northwestern part of the state, which is very thinly populated. all but one of the insurance carriers have pulled out, and when there's no competition , the remaining carrier is free to raise premiums at will. we're going to see significant increase in premiums when they're announced and finalized which should be coming up pretty soon. that will continue as it's more expensive for young people who usually do not have high medical costs, that means that older people who do have higher medical costs are going to have because anyden

insurance scheme is to post to spread out the cost between high risk and low risk people, and obamacare has already failed in many respects in that because many younger people choose to violate the individual mandate that is contained in obamacare and pay the fine that the irs assesses on people who do not have any health insurance. that's the box on the form 1040 . i'm not here to say the hca -- ca is perfect. there's no legislation that is perfect. but it is a start that dealing with the fact that if congress does nothing and allows obamacare to collapse then the , coverage is going to be worse or nonexistent to the people who are not covered by medicare or medicaid or covered through their health insurance that's sponsored by their employers. i think we have to look down the somethinge have to do before the wolf is at the door,

and there isn't anything that is available for the people who are currently getting policies through the obamacare exchanges. we're looking forward on that. i know there are a lot of people who think things are fine with obama care. that might be the case for some, but not all people now, but they're going to be fewer and fewer people that are going to have an acceptable form of health insurance available as time goes on. that's why the repealing and replacing i think is very important. now, having said that, let me say that, you know, there are a lot of people that say why don't you pick up the good parts of obamacare? we have listened to them and we have done that. you know, for example, prohibits the ahca companies from not offering policies to people with

pre-existing conditions. they will be covered. the ahca also allows no caps -- either annual caps or lifetime caps. finally the ahca keeps the kids who are under 26 on their parents' health insurance policy. a complete repeal of obamacare would have had none of these areas in it. these are three areas where we republicans amended our proposal to make sure that the coverage was there because we were listening to people who had concerns at meetings like this. >> i just have a couple of comments, and then i will let somebody else take over. things that you stated were not completely accurate or not the whole story. [inaudible] [applause]

representative sensenbrenner: ok, remember what i said at the beginning of the meeting. let him speak. don't interrupt him, if you agree with him or disagree with him. >> [inaudible] that is simply not true. rep. sensenbrenner: you know, first of all, the age tax was in

obamacare at a three to one ratio. the "age tax" as stated by the aarp in the ahca it goes from three to one to five to one. going two figures going up to $14,000 simply cannot be done with that kind of a restriction. the other point i would like to make is that there's no changes to the benefits under medicare. you know, a lot of people will say that the ahca doesn't touch -- that the ahca wrecks medicare. it doesn't touch the benefits under medicare. what it does do is it gets rid of the bias against the medicare plans that are replacements, they're called medicare advantage plans. obamacare -- what it does is it tries to make it unprofitable for insurance companies to offer medicare advantage plans. the ahca repeals that. there are over 12 million americans that are on medicare

advantage plans. it's all voluntary and they went on medicare advantage because they thought it was a better deal for them in terms of coverage and costs than the traditional medicare. nobody has been forced to take medicare advantage. you know, that is a voluntary position that the people who have chosen to take medicare advantage have taken advantage of. jeannie tyler of lake mills. yeah? >> thank you very much for coming. i really appreciate it. [inaudible] is main cost of disability emotional and financial. i've been diagnosed with cerebral palsy.

[inaudible]

rep. sensenbrenner: with all the respect, i think that's an overstatement. now, having said that, my wife has had a spinal cord injury since before we met. she, you know, through some good

doctoring a therapist -- s hasring and therapist been a very productive member of society. she was the chair of the american association of people with disabilities, whose primary function is to get people who are disabled into the work force paying taxes and getting off benefits, which i think is something that is a win-win-win for everybody. i was the one who brokered the deal to pass the americans with disability act in 1990. i introduced the bill to over turn four supreme court decisions where the court misconstrued the intent of congress and to restore protections for people with disabilities. and i have recently introduced with senator schumer, the disability integration act. and when you have senator introduce the

same piece of legislation it's , either very very good, which i think so, or it completely rapes the public interest, which i hope people don't accuse of it doing. but it's something, you know, that i agree on. now, you know, with respect to health care, we had a fairly good high risk pool in the state before obamacare made it illegal. it wasn't a perfect high risk pool. you know, nothing is and the , insurance company basically had a signed risk, so they all kicked in money to pay for this. now, if we did not have a high-risk pool in the ahca, it would end up increasing the premiums to people who are very low risk, largely younger people, so that they couldn't be able to afford health insurance , and not having health insurance i think is completely irresponsible, but, you know, at the same time i don't think it's congress' job to tell people to spend their money in a way that they might not want to spend

their money. so the high risk pools, you know, end up taking care of high risk people. there is $108 billion a year that is a federal subsidy. into the high risk pool to lower the premiums for the high risk pool. what we want to do is for people who are low risk or medium risk or maybe semi high risk is to make sure that those premiums are low enough that people will say that they can afford to buy the policy and it is a prudent investment of their own money. and if we have high-risk people with major claims in the same pool as the other people, then you'll see fewer low risk people ending up buying the insurance and, you know, again insurance is a risk sharing scheme. you know, where, you know, if you -- we all have homeowner's insurance policies.

we pray to god that our house will never catch on fire in which case we're paying premiums to rebuild the houses that do catch on fire. but we have got that safety net that if our house does catch on fire, you know, the insurance company will have the money to rebuild it and thus we have bought that insurance largely to protect our assets and someone's home is probably the biggest asset that they have. i am a practicing catholic. i make no bones about that. the bible that i read, you know, is the same that everybody else one reads, and i try to live out my faith and love my neighbor as myself. but to say that if we let things go the way they are with obama obamacare and five years from now it completely collapses and the wolf is at the door and he's very hungry, you know, then i think that i am being irresponsible to the people that i represent rather than looking ahead and trying to come up with

some kind of an alternative. i guess the frustration that i have is that the people who are for obamacare don't even want to look at the long-range finances of obamacare and accept any kind of an alternative. what we've done is with the three things that i mentioned earlier, is we accepted the input that we've gotten at meetings like this and amended our bill to protect those three areas. kevin hicks of west lake and lake mills. >> thanks for being here and addressing our concerns. i also have a question about health care. i'm a business owner. i employ 15 people, three of which are in california. i do offer health insurance through my company to pay for half the amount of the insurance premiums for the employees. now, this just having this be an

insurance thing, it's trouble troublesome to me, like you said, it's a scheme of health insurances something that we all purchase, basically, odds are just made at the casino game as to whether we're going to get something that happens to us or not. but besides that, i know that there's a lot more that goes into the process and i want to explain my situation specifically. i was interested in the conservative insurance and what was going to replace obamacare but i thought it was going to , hopefully be helpful to small businesses, i think that's part of what you say your agenda is. so, again i've had this business for 21 years, every year i have to come up and deal with health insurance on a yearly basis and decide what i'm going to do. i always have these situations where i have one employee that's turning the age of 50 or 60, and

and that changes the way our insurance is going to turn out, based how many people are on it, and then it becomes -- it's a group dynamic and one person gets terrible insurance and another person it might be ok. but it's kind of a one-size fits all system. and it never works out great for anybody. i don't see this as something that is really sustaining itself as a good system ongoing. so, let's see. the other problem i have is we do have employees that have special health concerns. we have, you know, an employee that maybe get sick. if we have an employee that gets sick it's going to blow up our , health insurance coverage, so one person getting sick in a small group makes it so none of us afford health insurance. it's a concern of mine that we have group health insurance that once someone does get sick, we

can be supported in a bigger group and i don't know that that works in the current system, as well. rep. sensenbrenner: let me respond. >> sure. rep. sensenbrenner: one of the things that we are doing is allowing trade associations like chambers of commerce or, you know, a trade association, you know, like the roofers or people like that, to put association health plans together. and that's a way of spreading the risk and having a much much bigger pool, rather than your 15 employees being a pool of its own. i think this will be extremely helpful in that. the other thing is the house is already passed and the senate is considering a bill to repeal the antitrust exception that they -- antitrust exemption that health insurance companies have. they can get together and conspire to do things that very few people in our economy can do. that makes them monopolistic and anticompetitive.

once this bill is passed, and there are very few no votes in the house of representatives health insurance company mergers collusion'sties in and, you know, attempt to fix prices and things like that will be subject to review by the antitrust division of the justice department just like mergers and acquisitions in other areas of the economy are, you know. this is designed to increase competition because it's competition that keeps the price down. >> i think that that's one good step. i think that can help. as you're kind of saying, these insurance companies are trying to work the system and they're a middleman between us and our health care healthcare provider. health care provider. and it doesn't matter how much money i make, i get to a point where i have a mother that's in a health care facility right now and it's small amount for most of these facilities for long-term memory care and $4,000 a month.

there's people paying double that and maybe more than that as time goes by. rep. sensenbrenner: well, you know, let me say that, you know, beginning in the 1960's, you know, we went to a third-party payment for health insurance. used to be you go to the doctor and get a bill and pay it. you go to the hospital get a bill and pay it. going to the hospital is a lot cheaper than going to the hospital now. you know, now, you know what you stated is right, where patient goes to the doctor, you know, the doctor sends the bill to the health insurance company and the health insurance company pays it. you know, that way, you know, number one you take away the doctor-patient relationship. number two, you'll have doctors in many instances say i'm going to run this test on you, but don't worry about how much it cost, because the insurance will pay for it, which means we pay for it in the end, you know, with higher insurance premiums. you know, and it also takes away

the ability of patients to shop around for prices. you know, practically every other area in the economy we can shop around to see, you know, where we can get what we need for the lowest cost. that's not the case in health care. now, you know, if anybody is having a heart attack, you're not going to shop for around for to shop around for -- shop around for which hospital has the best emergency room, you're emt's to takehe you to the closer hospital. but there are a lot of things that are, you know, elected when they're discovered and, you know, if we had -- even a modification of the third-party payment system, we would have patients being asking questions about, you know, does it really have to cost this much, you know, and then when you get the bill from the hospital and you see tylenol costing $4 a tablet, you know, or more, you know, at least there will be a way to object to that before you get the bill and it says pay this amount by this date on the bottom of it.

>> i guess one of the things that concerns me is like all this insurance gets funneled through my business and in order for me to be competitive with the big companies i have to have health care. most people have people that deal with their -- i am the personnel director. i am the president. i'm the this and that. rep. sensenbrenner: the association health plans, you know, you could have the lake mills chamber of commerce, or all the chambers of commerce in jefferson county end upcoming up with an association health plan. and that way you've got the risks spread much further than the 15 employees. >> i agree, but why are we going through companies for that? i have a hard time getting quality employees. they might have someone that has a sick kid. they have to work for a big company that has a specific health policy that will help them. why do i go get my car insurance

through an insurance provider, why do i get my health insurance through my company? what sense does that make? it's just a system that i think i would like to see looked at and it would help me as a business owner spend time on my business making my business more profitable and i can pay my people more in that way. rep. sensenbrenner: the thing is you're absolutely right. , you know, first of all, you know, the big companies have a big pool of employees. you know, you don't. and most small business people don't, so, you know, that's why association health plans, i think, are, you know, really the way to go. now you can't go self insured. there are a lot of organizations that have gone self-insured. but if you go self-insured, one of your employees has a million dollar claim, you're bankrupt. that's not right, either. what i can see is really we -- what i can say is really we didn't start having employer-sponsored health care

plans until the late 1950's or early 1960's. that started out in a lot of big manufacturing firms because the way the tax law works, the thing is that health insurance is a tax free benefit. so the collective bargaining that went on between the management and the union in these big companies, the union said, don't give us wages increase because they're all taxable to our membership. we get a good deal by having cadillac plan health insurance on that because that way the company can deduct it and is more profitable and it's a tax free benefit tr thefor the -- benefit for the members of the union. so they don't have to pay anything out of pocket and there's no skin off their nose. the thing is it's just growing by leaps and bounds over the last 50 years. we're not going to go back on that. you know, the reason it is what it is, you know, is because

that's the way it started out and then smaller and smaller firms like yours, you know, ended up having to offer health insurance so that you could be competitive and get good employees. >> that's the problem. you've got it. i think just letting it spiral further out of control, we've got to get this back -- rep. sensenbrenner: hey, you know, i agree. you know, what's happened, you know, is with the employer mandate under obamacare if an , employer ends up and you have to have more than 50 employees so it doesn't end up applying to you, but if the employer of 50 or more employees doesn't offer health insurance, then they're fined $2,500 per year per employee. now, most family health insurance plans, you know, are in the five figure range starting about $12,000, you

know, per employee and going way , way up, you know, after that. and the impact of that would be that the way for a business to improve its bottom line is simply to dump its employee health insurance and pay the fine and leave the employees on their own. that's not responsible. it's not good personnel practice, but some businesses have done it. >> i'll leave it at that, we think we should not be rushing through a new plan that's not as thought out. >> he said what i had to say. but i want to know, why don't you just have a single-payer -- [applause] rep. sensenbrenner: now, remember what i said in the beginning of the meeting, and that is is that interruptions, you know, are not going to be tolerated.

>> [inaudible] rep. sensenbrenner: ok. would you please sit down, sir. she has the floor. you do not. would you please sit down? would you please sit down or go out in the hallway? thank you for leaving. [applause] >> we pay taxes. why can't we pay premiums on how much we can afford? have a single payer plan and be done with it. rep. sensenbrenner: obama rejected the single-payer plan when he submitted -- [crowd boos] ok. ok. >> because of the insurance company. rep. sensenbrenner: let me say that if we had a single payer plan, we would probably see a limit on how much the government would pay for that national health insurance plan.

there's a cap in canada of 9% of gdp. one of the biggest issues in the british election that's going to be held next thursday is the fact that the national health service in the united kingdom, apparently is rationing people , based upon how severe their illness is and what their age is and things like that. i don't want that to ever to -- that ever to happen here. that's what's going to happen with the single payer plan because i think we really won't be able to afford, you know, the cost of it. and i think that we've got a $20 trillion debt and spending an awful lot of money on ourselves and sending the bill to our kids and grandkids and people aren't going the lend us money indefinitely if the debt keeps on going up and up. and president obama almost doubled the debt and almost borrowed more money than his 43 predecessors combined and that's a fact.

>> [inaudible] can you say that when we buy the most expensive bomb there is to blow up somebody? >> blow up nobody. >> wouldn't you rather save people's lives? rep. sensenbrenner: of course i'd like to save people's lives but i'd point out about 60% of what the federal government spends is on the so-called entitlement or mandatory spending programs, the three largest are social security, medicare and medicaid. medicare and medicaid are both health care plans mostly for elderly americans -- in the case of medicaid, not all elderly americans -- and social security is for people who are over age 62. so you know, the fact is that -- >> [inaudible] rep. sensenbrenner: excuse me. now, this is the sixth interruption and i don't want to -- want to do what i did in west

allis. if you want to continue the meeting, then listen to the speakers, don't interrupt them and listen to my response. so you know, the thing is that the military is about 16% of total federal spending. and over half of that is on personnel costs to pay the salaries and the training and housing, you know, expenses of the people who volunteered to serve their country. so whacking away at the military is not going to solve the problem and the single payer plan, i'll be the first to admit is too expensive. it hasn't worked in canada with the caps the canadian government has put on it and there are severe funding shortages in the united kingdom. the fact is, we don't have the money. >> we have the money to give $664 billion in tax cuts for millionaires. >> yeah. >> yeah. >> yeah.

>> yeah. rep. sensenbrenner: now this is strike seven in terms of interrupting. even ryan brown also gets three strikes before he's out. so let's keep it down. let's listen rather than clap or hiss or boo or things like that and we will be able to get through this meeting and talk about it because democracy is not served by shouting down people you don't agree with or screaming applause at people that you do. it is served by a reasonable debate amongst reasonable people. now, you know, in terms of tax breaks, people who pay taxes get the break. people who do not pay taxes do not get the break. [crowd boos] rep. sensenbrenner: ok, that's number eight. and i'm keeping track up here. 47% of the american public does not pay a federal income tax.

you can't give people who pay no taxes a break. donna -- i answered the question. >> you guys are giving that break to millionaires. how about health care? rep. sensenbrenner: number nine. >> are you afraid? rep. sensenbrenner: i'm not afraid. >> why don't you answer the question? rep. sensenbrenner: what i'm saying is that with all of obama's taxes the rich got richer and that's the fact. you know, you look at the 1% of the 1% end up having more of america's wealth after obama put two tax bills through congress and signed them saying this is tax fairness. that's a bunch of bunk. sir, you have -- >> she asked the question. rep. sensenbrenner: those were obama's tax breaks. you want the meeting to be adjourned? it will be your fault if i have

to adjourn it for interrupting. do you want it to be adjourned or not? >> most of what i was going to say has been stated already and most of that had to do with the affordable care act. but one point just to get back to what you were talking about the people who make the money get the tax breaks. i'm an average middle class person and i don't get any tax breaks and i see very wealthy people get those breaks in all due respect. the other couple of things i wanted to stay, first of all just an observation, and kind of anecdotal, when the house passed its health care bill, i was really, really disturbed when i saw the fact that the republicans were celebrating. i just don't know how you can

celebrate and -- i don't know how you can celebrate when 23 million people, that's kids, that's elderly, that's disabled, that's, you know, people living in poverty -- i just don't get it. rep. sensenbrenner: the answer to your question was i was not. there. -- i was not there. i went to the airport to fly back here the have some of these meetings. >> good move. >> thank you for that. i wanted to make that statement. it comes across horribly to middle class people like myself and it's disrespectful. and the other -- the second thing kind of closing, is the cure for the bloated budget is to cut medicaid and food stamps.

that's what i'm hearing, for children, elderly, disabled, those living in poverty. and a lot of people living in poverty and paid below minimum wage aren't there because they want to be. they'd like to be making money and contributing but all i have to say about that is i see that 14 million people will lose their medicaid coverage in the next decade if those cuts go through. rep. sensenbrenner: well, i'll answer your question this way. the explosion in medicaid has been of concern and even bill clinton during his presidency which was 20 years ago said something has to be done to slow down the growth rate many medicaid. medicaid is paid 60% by the feds and 40% by the states. we can print up and borrow money and do all kinds of things like that because we're the federal government. mr. kleefisch and his colleagues in medicine and in the other 49 capitals can't do that. you know, and as a result, you know, if the medicaid costs go

out of control, you know, they basically, you know, have got to find the money elsewhere and he said earlier today that 50% of the state budget goes for education so if there are unexpectedly high medicaid expenses the first place i think you get cut would end up being in education. now there is not a cut many in medicaid in ahca. there is a slower growth rate in medicaid in ahca but we are not going to be spending less on medicaid at the end of the ten-year budget cycle than we are now and that's a fact. now the other thing that has to go into this is that the extra money that was in obamacare for medicaid only runs through 2020. if congress did nothing those states that took the extra money -- wisconsin did not -- are going to end up having a cut in the federal reimbursement for medicaid because they signed up for it and knew it would end in

2020 and i think it is unlikely that congress, given our current fiscal situation is going to , extend that. the question is what to do about medicaid. what the ahca does is it gives the states a choice. they can either continue on with the current program but a cap -- but with a cap that is based on the number of people who live in the state, or they can choose that the program would be block granted and that way there would be a federal grant equal to what the feds are paying for their 60% share that would be sent to the states that decided to go for a block grant and then they could set up their medicaid program to meet the needs of their people, rather than having a one-size-fits-all type plan that the medicaid program currently is. this isn't going to be a choice that my colleagues and i are

going to make on whether to go this route if the ahca passes in its present form. it is going to be a choice that mr. kleefisch and his colleagues and the governor are going to have to make. i think that you know, i am for federalism but i think that what you're going to see is, you know, you're going to see a more responsive medicaid program if they go the block grant route because state legislators are closer to the people than congress people are. and a lot of these decisions are made by federal bureaucrats who aren't close to the people at all and have civil service jobs and they don't have to run for election and go to meetings like this. so that will be a choice. >> i personally fear what our governor will do. because the steps he has taken

to this point have been punitive toward people with less. that's my opinion. to this point have been punitive rep. sensenbrenner: tom -- >> [inaudible] [laughter] yeah, all the questions and comments have been pretty much what i've been feeling. one thing i would say and you kind of hit it a couple of times, when we talked about the idea of single payer, you know, that's very not received very well. but i also think that i visit ed canada and several countries that do have some form of social insurance and they're extremely well received. when i would say something like a single payer, what i would be talking about and promoting would be something like medicare. and anybody here on medicare knows, it doesn't pay everything. you need to have a supplement.

and i believe the form of a single payer plan should be basic coverage for everybody. when you talk about pools, what bigger pool is there than to be a citizen of this country? you put everybody in the pool and we spread the risk. and the idea in the republican current version it doesn't require people to have insurance, and again, that's what a lot of people didn't like about the affordable care act which is the name of the act, as , you know, not obamacare. it's the affordable care act was the idea, right, that everybody needs to have it. and by having it, you pay a premium. young people, i know they didn't like it, but young people were also the one exception that could get the -- what do you call it, the catastrophic risk type plan to keep their premiums low but the concept is get them in, have them participating and

have coverage. and when they have coverage as , they get older and that payment they make when they're young and healthy helps me and a lot of other people like me because we're older, right? so i just think that's a very important thing. i know the point that was also raised about the taxes in the new version that gave the breaks and the rub is always the breaks go to the high end, and i know you did say of course that was in the obama tax law that caused that. but that's, again i think we have to somehow have that cost shared and it is the people at the top that do have the money to help. and that would be -- i think a very important thing. >> i vote for that guy. >> me too. rep. sensenbrenner: well, you

know, you know -- when i started out in this business, somebody told me that the only fair tax is one that somebody else pays. the problem is it doesn't work that way. i want to talk a little bit about canada. canada has a very -- that's number 11. let me answer. about canada, the canadian government limits the amount that it spends on health care to 9% of canadian gdp. we pay about 18% of gdp on health care. under our current system. we spend twice as much of our national wealth than the canadian government allows that to happen. the canadian health care system is very good for very common types of ailments.

once you need a high degree of specialization or expensive drugs and medication the canadian health care system completely falls apart. rep. sensenbrenner: once you need a high degree of specialization or expensive drugs and medication the canadian health care system completely falls apart. and that is why health care facilities and pharmacies close to the canadian border end up treating a lot of canadians , because they cannot get the type of care that they need in their own country because the government will not pay for it. now in the case of prescription drugs, the canadian government has a formulary. if the drug you need is on the formulary, great. you get it in canada. if it isn't on the formulary, you hop across the border and you get it in the united states at full cost. and that's a form of rationing. you know, based upon, you know, what kind of drug you need. and that ends up having the government end up being between the patient and their doctor in

determining what the best way is , you know to treat a patient. , and in some cases, the way things work is that it's too late. you know, i'm familiar, you know, with a boarding school that is close to the border in canada. prime minister's granddaughter went there. our cdc said that it was a good thing to have all these kids in dorms get meningitis vaccine. good medicine. i don't think anybody could disagree with that. the doctor at that school asked for 800 doses of meningitis vaccine and was told that the niagara regional medical authority refused to give it to him even though the prime minister's granddaughter was there. and they refused to give it to him even -- >> you said it was your son who was getting the meningitis shot.

and that was how long ago? [laughter] rep. sensenbrenner: you want to be personal, go and be personal. i'm making -- ok, you bring my son into it, i'll make the yeah, my son was going to that point. school, and he asked the doctor for the meningitis shot, and he was told he couldn't get it because the government wouldn't give the vaccine until there was a confirmed case of meningitis at that school. we found out that it takes about two weeks from the time you get the shot until it becomes effective and the incubation period for bacterial meningitis is much shorter than that. to show you the difference for my son, but everybody else who was there, the other 799 kids were there. my son is an american and came home for thanksgiving and went to the pediatrician and 20 minutes and $20 later, he had

the shot in the united states he couldn't get in canada until it was too late after he was exposed. now, that is one of the flaws of this system, and it is something that hits me personally. and you know, the fact that my kid went to school in canada is not really relevant to this issue. it is the fact that there are all the other kids who were there. americans, canadians, and everybody else, that had an unnecessary risk because the government health care system was too bureaucratic to give the kids the vaccine they needed, you know, and practically every responsible doctor realizes that when you got that many kids in that close quarters and how contagious bacterial meningitis is, it's better to give the kids the shot than for them to get sick and die. >> my only additional comment as you were speaking about canada. my experience has been, in

canada, speaking to canadians about their system, everybody talks about the problems they've had, but you try and take it away from any of them they wouldn't want to lose it in any way, shape, or form. lastly, three children that studied abroad. one in ireland, one in england , and one in germany, all three had occasion while being there to be part of and get care under their various programs. it was all excellent care. all right? and the last thing you were talking about, chambers getting together, and whatever. this community got together with three other chambers 10, 12 years ago for that very purpose of making the pool bigger and buying insurance. one company in madison went ahead and underwrote the plan. it lasted one year. and part of the problem was you took everybody in. so that's also a problem. but we also have to understand

when you cover everybody and you , cover people who have not had insurance, if you don't think you're going to have claims , you are absolutely goofy. [laughter] >> you're going to have claims, but the situation will smooth out over time. and that's the same deal i believe with the affordable care act. we can be very critical of everything, but if given time, hopefully, we're going to get some of these higher problems taken care of. and lastly, i'm not saying we're the perfect system, but i believe it should be done across -- done on an across the aisle basis to work on the problems . improve it and make it better. rep. sensenbrenner: what i can say is when obama gave a state of the union message on obamacare and he called it obamacare in the 2012 campaign. i'll quote him on that. so, you know, he asked us to send our suggestions in.

and i sent him a page and a half letter the next day on how we have to reform medical liability laws because that will be a cost saver and probably stop a lot of unnecessary tests. i never got a response to it. we asked the democrats to give us their input, and they said we want to keep obamacare, and every one voted to keep obamacare even after the last election when the republicans ended up getting the trifecta from the voters. so you know, you got to realize that bipartisanship is a two-way street. you have to have both sides wanting to be bipartisan. i think we've made an effort. scott? >> sign. i am sorry. sorry about that. >> thank you for coming.

>> one problem with the american health care act is there is a loophole that lets the states to decide whether or not they want to deny coverage or charge more for preexisting conditions. this is a human issue. i don't care if you are republican or democrat, we need to think about how it's going to effect people. people are going to die. cancer treatment is extremely expensive. my husband has pancreatic cancer. every time he goes for a treatment, $26,000. that is twice a month. i have insurance through my but underhat i got, this act, if i have a lapse in coverage, i may not be able to afford payment. this is troublesome for everyone. rep. sensenbrenner: well you , know, before obamacare became effective, which was in 2012, which was two years after it was passed, the states regulated insurance and the state legislatures decided what had to be covered mandatorily and what

did not have to be covered mandatorily. so any kind of a mandatory requirement for health insurance or for that matter, any other kind of insurance, is relatively new. you know, i think the insurance policies that were sold in the state of wisconsin to our people before 2012 were adequate. and i have a great faith in the state legislature and the state insurance commissioner to provide for adequate coverage. now, you know, with respect to your -- >> at what cost, sir? at what cost? d, youensenbrenner: an know, the thing is, with the high-risk pools and the ahca, there is $108 billion a year of a federal subsidy to lower the premiums for high -- for high-risk people, and that's a lot of money, ma'am, and you

know, it's a subsidy that people are not high-risk don't get. >> there's a lot of money on that table. rep. sensenbrenner: that is now. now, we're up to number 13. randy -- same address. >> i'm the person she was talking about here. did you vote for the affordable health care act? rep. sensenbrenner: i did. >> did you read it first? rep. sensenbrenner: i read relevant parts of it, yes. >> what was the first? rep. sensenbrenner: what was the first? >> what was the hurry to pass it ? why vote on it so quickly before reading it? rep. sensenbrenner: the house rules do require a copy to be on the internet 72 hours before a bill is voted on. that was more time than obamacare was public before it was voted on. the republicans changed the

rules, folks, on this, so that we wouldn't have a bill come up like obamacare did, where speaker pelosi said we have to pass it so we can find out what's in it. and she said that. >> so, to me, it seems like divisive politics in washington and health care aren't a good mix right now. this is a human issue. it's not something that we can just say, you know, "we don't like obamacare. we're republicans and we're going the repeal it and put something else in place. we just voted for something just to get obamacare out of here. [indiscernible] " in 2014, i was diagnosed with cancer. i paid my taxes before that. made a great salary. and did all the right things. now, today, you want to discriminate against me and put me in some pool and say this person might get charged more or maybe he won't get coverage.

this isn't my own fault. i live healthy, i exercise, eat right and voted republican. , i'm challenged today to do the same thing the next election. rep. sensenbrenner: well -- >> because of your attitude when you say "you don't pay taxes, you don't get service." rep. sensenbrenner: i didn't say that. >> you did, you said people who don't pay taxes don't deserve the breaks. rep. sensenbrenner: i didn't say that. >> we weren't saying -- rep. sensenbrenner: i didn't say that. >> i didn't say insurance, but i'm telling you i paid my insurance and taxes and did all the right things, and now you want to potentially take away what aca set up as protection for people that have preexisting conditions, and i don't want to i now- i think -- washington is doing more to

, protect the insurance companies than to protect the american people. and i don't know, why is that? why do i feel like that? rep. sensenbrenner: while many , of the insurance companies are opposed to the ahca. let me answer you this way, first of all, the initial draft of the republican bill did not protect people with preexisting conditions. we listened. and the ahca does protect people with preexisting conditions , provided they don't let their insurance lapse for more than 63 days. there is guaranteed availability for insurance for everybody in the ahca. so you -- >> [inaudible question] rep. sensenbrenner: let me finish, please. the reason there are high-risk pools is to keep the insurance premiums down for people who are not high risk so that they will get insurance and they will expand the pool. if you make it too expensive for them, then they won't get it. and that's one of the problems with obamacare.

you know, is that, you know, the insurance costs a lot more than the fine that the irs gives you if you don't get insurance and check the box on the tax return. there are a lot of younger people who are deciding to pay the fine because they save money as a result of that. that's human nature and congress can't pass a law to repeal human nature. that's something beyond our effectiveness. we are trying to take care of people who have high risks. you know, in the way that it is possible to do so. we want to avoid things happening like obamacare people in arizona having an over 100% increase in their premiums from one year to the next. that's also unsustainable. and i think we're due for a double-digit increase this year

, but the exact amounts in wisconsin, you know have not , been announced. you know, this is a very complicated issue on this. and you know, you're not being segregated out. you are the people who are going to be getting the government subsidy, the $108 billion a year because you are high risk and , you have high medical bills. other people will not be getting a subsidy. they will be getting a tax credit that goes up with age but not be getting a direct subsidy. and you know, we think that, you know, this is a better way of going about it and targeting people for the subsidies that really need it, meaning people who are high risk rather than using income as a determination of whether you get a subsidy or not. >> these matters are not political. like i said, if someone is

diagnosed -- one of the only good things that has happened to me since 2014 is i have not had to worry about medical bills being paid and our family losing our house or losing our portfolio in the stock market or something like that. i was covered. and that, to me, is more important than getting a subsidy. i don't know what that means. how much am i going to be getting care of, my family going to be taken care of? $108 billion to all the people in my situation, how much does that equal per person? rep. sensenbrenner: we don't have the statistics for that. but again, the high-risk pools -- the high-risk pools, you know, are designed to keep the premiums for people who are not high risk affordable so that they will sign up and get insurance and broaden the pool. i'm a cancer survivor as well. you know, i've been through it all and looked at the bills and

this was before obamacare and i was on the federal employees health benefit program, which is not free, by the way. and i had to pay quite a bit out of pocket. but you know, what you're seeing with obamacare is that you know, the medium size coverage plan, you know, the premiums are about $800 a month and the deductible is $5000 a year. so someone has to pay $15,000 out of pocket before they get the first dime of insurance. are people going to go along with that? that is not a very good deal, either. and that is going to get worse rather than better. >> to me it's a personal issue , for me like you are talking about your son. my respect to the average person who hasn't gone through this is a little different but

preexisting conditions, when you read the ones mentioned in here, some of them are, you know, they don't seem like they are really human. there is pregnancy, rape, or stuff like this, when we got obamacare, it was a step forward in america. we were doing something right. got rid of something that is potentially harmful and now you are bringing it back and letting the insurance companies do it. i don't understand why we don't regulate them versus change what is right and what is wrong with obamacare. rep. sensenbrenner: the insurance companies are strictly regulated by each of the 50 states. we have an insurance commissioner in this state that has vast powers. and most of the other 49 states do. so to make a claim that insurance is basically an unregulated area of business simply is not true. >> i'm not -- there's some

insurance companies with record and [inaudible question] losing money. and you know -- rep. sensenbrenner: you know let , me go back to the beginning when i said, you know, they currently have got an antitrust exemption. they're one of the few areas of the economy that is exempt from the antitrust laws and deal with monopolistic practices and price-fixing, predatory pricing, and a lot of things. i supported when the house of representatives passed a bill to get rid of that antitrust exemption for insurance companies. it's currently pending in the senate, and i hope they get to it and pass it because much of what you complain about comes with the fact they can hide behind an antitrust exemption , and basically, you know, give the one-finger salute to the american public as well as the people who pay premiums to their company.

>> my last comment is that to you and washington that we start working together more and get rid of some of the divisiveness and some of the current culture in washington right now that's just democrats over here and republicans over here, and we can't come together on anything. for me, health care is too important to not get together , and as an american, as my wife was saying, it's a human thing. it's not something we can say, you know, let's just -- it's obamacare and anything except obamacare on top of that. and my request to you is please consider that when you are working on these bills and other people that are working in the background just trying to , sweep away democratic things because this is what was done years and let's

, put our stamp on it. we didn't read the bill or let it get scored, we pushed it through. the senate is sitting on it and they don't want to vote on it. we want to do what's right for americans. rep. sensenbrenner: i want to do what's right for america, too. to the best of my ability. and there are a lot of factors that i have to look at. that's 15. i'm very patient today, particularly, with you. but you know, let me say this, one of the things i am most proud of is there was a nonpartisan group that rid of the bipartisan ness of other groups. there were two members of the wisconsin who were bipartisan, myself and ron kline of lacrosse movement record shows i'm bipartisan more than anybody else. now, you know, in terms of

health care, you know, let me say that we know that whatever comes out of this congress because the republicans control the presidency and both the senate and the house we're going to have our stamp on it and we're going to stand or fall on it, just like the democrats stood and fell when they passed obamacare when they had all three of the elected branches of government. and you know, i've run against repealing and replacing obamacare, president trump did, senator johnson did. we all won on that. and that means we know we have a pretty awesome responsibility on that. the decision to make health care a partisan issue was made back in 2009 and 2010 when pelosi and obama refused to have any type of republican input because they

wanted this to be a democratic program. it was passed that way. i think it was unfortunate that it was passed that way and all i can say is i can look at practically every social program that has been passed in this country in the last 100 years they've been bipartisan in , nature. medicare, social security, medicaid. they were all bipartisan because the authors chose to make them bipartisan. this time, in 2009, the authors of obamacare or the aca, no matter what you call it, chose not to make it bipartisan because they thought they could get a partisan advantage out of it.

now yes, we know that we can't -- we asked them to participate. they have refused to participate and have consistently voted no on every kind of thing that has come up to try to improve obamacare. we know that our stamp is going to be on it and we have an incentive to do it right. and the last one up will be deb stine, because we are about at 8:20, south main street lake mills. >> thank you. i'm a small business owner and also republican. so, i'll give the other side of things and i and most republicans are happy with everything you doing both in the state of wisconsin and president trump. we are ecstatic. >[laughter] >> and if you don't think that that's true across the nation look at the stock market. and probably all of you have something in the stock market. the stock market wouldn't be going up every time trump does something or they vote on something because -- it's obviously good for america. and i would encourage you to keep supporting things that he's doing.

the other thing is i'd like to -- i want you to get rid of obamacare. i'm one who voted for that and i want to give you the other side of the story. i run a small business so i don't qualify for the subsidies. $24,200 a month in premiums for my husband and i with an $11,000 deductible. that's a lot of money. no subsidies. how long should we let that go before we fix it? there's a lot of us out there like this. how long should we let that go before we fix it? i think it's got to be fixed now. before obamacare, my premium was $600 a month with a $500 deductible. the other thing i just want to mention because our main street is going to be going through a reconstruction project and putting in bike lanes on both sides of that road, which means

every house on that road are going to have itty bitty little lawns, huge sidewalks, bike lanes, no parking, taking away parking from downtown lake mills for bike lanes. i am in downtown lake mills every day. there are few bikes that go through town. it's certainly not where we have to have two bike lanes. that they have to do because it's a federal program. i drive on highway 26, the bypass, there are two huge bike lanes on both sides of that road. again, a federal mandate. i have never seen anybody on their bike. and i drive a a lot -- drive it a lot. i saw someone walking a dog one day, but that's it. that's a lot of wasted land and a lot of wasted money, in my opinion, that could easily be an area to save. and the other thing -- a lot of

these things i come to everybody is screaming about the roads. so this is more for you. screaming about the roads and screaming about raising the gas taxes. this crowd wants to seem to raise the gas tax i would say one thing to do is maybe look at the cars people are driving and with all the priuses on the road, let's raise the money -- they're using the roads. so they should be paying something for that too. instead of just us paying for the gas tax. that's it. thank you. >> do you want to answer that? [laughter] >> you had it easy tonight. >> i will defer to your, congressman. just to say that the infrastructure funding for the roads is an important issue for the state of wisconsin. i don't know how we're going to solve that yet. when we made the determination, and i was part of the

legislature that voted to end gas tax indexing, i think that that's part of the reason that we're having trouble funding the infrastructure we are right now. we have to fund infrastructure in the state. it is the way goods and services gets throughout the state from the smallest of the largest farms in the industry. we are going to have a decision that comes to fruition here, but i don't think that increases in taxes is the answer. rep. sensenbrenner: in terms of -- first of all, you know, there shouldn't be a federal mandate on this. i'm not sure that every major street has got to have a bike lane on it through the federal mandate. but i think that's something to ask the folks here in the city to show you the regulation that requires there to be a bike lane on that street, and if it's not

required, ask why is one being put in. now, that being said, until the highway bill was passed last year with my support, there was a mandatory requirement that 10% all the federal funds that each state got was for bike paths and bike lanes. the last highway bill repealed that. so, it will be up to each state legislature to decide how much of the federal money in that 10% will be used for bike lanes and how much will be used for something else. the federal mandate, in my opinion, has resulted in a lot of unnecessary spending. if you drive up i-43 north of milwaukee there is a bike bridge that goes across the interstate. it cost $1.8 million and had to be redesigned because the bike ramps were too steep. in the fifth district, i was up and down that road all the time.

i never saw a bike on the bridge. i saw bikes on the regular highway bridges a half mile north and a half mile south but why did we have to spend $1.8 million on a bridge that nobody uses? and that's because the federal government required us to spend 10% of our highway money on that. the legislature can decide to use all of that money or part of that money to repair and -- roads and bridges in the state or maybe plot out a new highway or add lanes on highways, but i think that's something that we in the state and through our elected officials here are much better equipped to do than someone sitting in washington deciding that bridges to nowhere -- and i described one of them in our state -- have to be built. so thank you for coming this part of the meeting. i'm going to adjourn now and i

would like to see people who have got individual problems with federal agencies one-on-one here rather than continuing the general issues discussion. and cameras off, please, folks. [applause] history unfolds daily. in 1979, c-span was created as a public service by america's cable television companies and is brought to you today by your cable or satellite provider. tonight on c-span, q&a with paul sparrow, who oversees the franklin d. roosevelt presidential library and museum in hyde park, new york.

after that, a look back at recent events from the australian parliament. later, canadian foreign minister, christoph, talks about future relations with the u.s.. >> this week on q&a, paul sparrow, director of the franklin d. roosevelt presidential library and museum in hyde park, new york. he talks about the papers and artifacts housed there and provides a rare look at fdr's personal book collection. this interview was conducted at the museum. director ofparrow, the fdr library. what is this room, and will cut of history was made here? guest: this room is totally unique in the presidential library system because it was the only room ac