Today, President Obama signed the Ryan White HIV/AIDS Treatment Extension Act of 2009.  It represents our ongoing commitment to ensuring access to needed HIV/AIDS care and treatment.  The White House and the Department of Health and Human Services (HHS) worked very closely with Congress on this bipartisan legislation, and the consensus document developed by the HIV/AIDS advocacy community was an important part of the process.  We were so pleased that Jeanne White-Ginder, Ryan White’s mother, was here at the bill signing. 

The Ryan White Program is the largest federal program specifically dedicated to providing HIV care and treatment.  It funds heavily impacted metropolitan areas, states, and local community-based organizations to provide life-saving medical care, medications, and support services to more than half a million people each year:  the uninsured and underinsured, racial and ethnic minorities, people of all ages.

The President also announced today the elimination of the HIV entry ban.  Since 1987, HIV-positive travelers and immigrants have been banned from entering or traveling through the United States without a special waiver.  In July 2008, Congress removed all legislative barriers to repealing the ban and paved the way for HHS to repeal the ban.  A final rule will be published in the Federal Register on Monday, November 2nd and will take effect in early January 2010.  That means that people who have HIV and are not U.S. citizens will be able to enter the U.S. starting in January next year.  This is a major step in ending the stigma associated with HIV.

While I have been traveling across the country during the past several weeks for our HIV/AIDS Community Discussions, I am hearing from people living with HIV, nurses, case managers, doctors, community-based service providers, and others about how important the program is to ensure access to care and treatment.  As we continue our work on developing the National HIV/AIDS Strategy, we have many important lessons from the Ryan White Program for increasing access to treatment, helping retain people in care, and improving health outcomes.  Addressing the epidemic in the U.S. is a priority for President Obama, and we are renewing our focus on prevention as well as treatment.

As we prepare to mark the 20th anniversary of the Ryan White Program next August, the legacy of Ryan White continues to endure.

Participants at the event:

• Jeanne White-Ginder, Ryan White's mother
• Senator Tom Harkin, D-IA
• Senator Mike Enzi, R-WY
• Senator Tom Coburn, R-OK, not confirmed
• Representative Henry Waxman, D-CA
• Representative Frank Pallone, D-NJ
• Representative Joe Barton, R-TX
• Speaker Nancy Pelosi, D-CA, not confirmed
• Ernest Hopkins, Policy Chair, Communities Advocating for Emergency AIDS Relief (CAEAR); Federal Affairs Director, San Francisco AIDS Foundation
• Frank Oldham, Jr., President and CEO, National Association of People with AIDS (NAPWA)
• Julie Scofield, Executive Director, National Alliance of State and Territorial AIDS Directors (NASTAD)

More photos from the event:

President Barack Obama has an event briefing with Jeffrey Crowley, right, in the Oval Office, prior to the signing of the Ryan White HIV/AIDS Treatment Extension Act of 2009. October 30, 2009. (Official White House Photo by Pete Souza)

President Barack Obama poses with Jeanne White Ginder, Ryan White's mother. October 30, 2009. (Official White House Photo by Pete Souza)

President Barack Obama, surrounded by Members of Congress and other officials, signs the Ryan White HIV/AIDS Treatment Extension Act of 2009 in the Diplomatic Reception Room of the White House October 30, 2009. (Official White House Photo by Chuck Kennedy)

Jeanne White Ginder, Ryan White’s mother, displays the signed reauthorization. October 30, 2009. (Official White House Photo by Chuck Kennedy)

Jeffrey Crowley is the Director of the Office of National AIDS Policy and Senior Advisor on Disability Policy at the White House

Today marks a major milestone in government transparency -- and an important lesson in the unintended consequences of such vigorous disclosure.

We previously announced that the White House in December of this year would -- for the first time in history -- begin posting all White House visitor records under the terms of our new voluntary disclosure policy.  As part of that initiative, we also offered to look back at the records created before the announcement of the policy and answer specific requests for visitor records created earlier in the year. 

So far we’ve processed 110 disclosure requests from September that yielded nearly 500 visitor records. All of these are now available on the White House website in accessible, searchable format for anyone to browse or download.  Consistent with our earlier announcement that we will only release records 90 days or older, this first batch covers the period of time between January 20, 2009 to July 31, 2009.  Future batches will be posted on an ongoing basis.  (You can submit a request here.)

This first release is only the latest in a series of unprecedented steps by the President to increase openness in government.  They include putting up more government information than ever before on data.gov and recovery.gov, reforming the government’s FOIA processes, providing on-line access to White House staff financial reports and salaries, adopting a tough new state secrets policy, reversing an executive order that previously limited access to presidential records, and web-casting White House meetings and conferences.  The release also compliments our new lobbying rules, which in addition to closing the revolving door for lobbyists who work in government have also emphasized expanding disclosure of lobbyist contacts with the government.

There’s an important lesson here as well.  This unprecedented level of transparency can sometimes be confusing rather than providing clear information.

A lot of people visit the White House, up to 100,000 each month, with many of those folks coming to tour the buildings. Given this large amount of data, the records we are publishing today include a few “false positives” – names that make you think of a well-known person, but are actually someone else.  In September, requests were submitted for the names of some famous or controversial figures (for example Michael Jordan, William Ayers, Michael Moore, Jeremiah Wright, Robert Kelly ("R. Kelly"), and Malik Shabazz).  The well-known individuals with those names never actually came to the White House.  Nevertheless, we were asked for those names and so we have included records for those individuals who were here and share the same names.

Norm Eisen is special counsel to the president for ethics and government reform

It's no secret that institutions of all stripes focus their communications on certain messages day to day. We thought it would all be a little more open and transparent if we went ahead and published what our focus will be for the day, along with any related articles, documents, or reports.

Supporting bill description: "The Affordable Health Care for America Act," Speaker.gov

Talking Points: Introduction of the Affordable Health Care for America Act

• The introduction of the Affordable Health Care for America Act is another critical milestone in the effort to bring about reform that will provide stability and security for Americans with insurance, affordable options for those without insurance, and lower costs for American families, businesses, and the nation as a whole.
• This legislation is the product of unprecedented cooperation and countless hours of hard work by Speaker Pelosi, Chairmen Waxman, Rangel, and Miller, Congressman Dingell, and scores of House members who share the conviction that we can’t wait another year for health insurance reform.
• The House legislation includes critical reforms to the insurance industry, so that Americans will no longer have to worry that they will be denied coverage, or that their coverage will be dropped or watered down when they need it most.
• It also includes a public option that competes with private insurers, which the President has repeatedly said he believes is the best way to ensure choice and competition that are so badly needed in today’s market.
• Finally, it is fully paid for and will reduce the deficit in the long term.
• This is an historic step forward and we are confident that members will continue to work together to deliver meaningful reform for America’s families and businesses.

Good news, folks.  The Recovery Act is working, and so are over one million people whose jobs have been saved or created by the American Recovery and Reinvestment Act.

But why take it from me when you can see it for yourself?  Thanks to unprecedented real-time data collection by the independent Recovery, Accountability, and Transparency Board (RATB), you will soon (as in this afternoon) be able to visit Recovery.gov and learn about the approximately 650,000 jobs directly created by part—and I emphasize that these 650,000 or so jobs are a subset of the more than one million—of the Recovery Act dollars at work in our economy.

Since that 650,000 is based off of about half the bucks at work in the economy so far, you can double it to get a rough estimate of the total jobs impact so far, getting you to over a million jobs, saved or created.

Can’t wait until this afternoon?  Then watch this new video of real people doing real jobs supported by the Recovery Act.

Here are the details.  As of last month, there was about $340 billion in Recovery Act dollars at work in the economy, through fiscal relief to states, committed infrastructure projects (some in progress, some yet to start), tax cuts, unemployment benefits, small biz loans, and much more.  According to both our estimates and those of independent analysts, this ramp up of the Act has created or saved about one million jobs so far.

Now, a little less than half that amount applies to direct spending projects for which recipients are required by Congress to report job information to the independent RATB.  As you can see in the video above, we’re talking everything from construction workers, teachers, scientists, and more.  After cleaning the data, and summing it all up, the board tells us that these direct jobs amount to about 650,000, located throughout the country.  

The other half of the spending includes subsidized loans to small businesses, unemployment compensation, tax cuts, and other forms of Recovery Act support that doesn’t lend itself to direct job reporting so easily.  The recipient reports also omit indirect jobs—those created when the directly hired contractor orders some cement, the school teacher orders classroom supplies, or when both of them spend their paychecks in the economy, generating more economic activity and jobs than would have occurred if they were unemployed (econo-types will recognize these as “multiplier effects”).

So that’s the story today, but there’s a lot more to come from the Recovery Act.  Given that more than half of the Act’s funds have yet to be obligated or reflected in tax cuts, the fact that many funded projects have a lot more hiring to do, and the fact that these recipient reports account for around 650,000 jobs through the end of September despite all the omissions just noted, we are solidly on track to meet our goal of 3.5 million jobs saved or created by the end of next year.

So, a major hat-tip to the RATB for their path-breaking work and we thank all the recipients for providing us with this information.

But as we applaud these unprecedented efforts in transparency and this new confirmation that the Recovery Act is successfully creating jobs across America, we are also acutely aware that even the highest estimates of jobs created or saved by the Act only partially offset the extent of job losses since the recession took hold last year.  For this reason, we plan to continue to squeeze every job out of every dollar left to spend in the Recovery Act, and to do so with the same level of transparency achieved thus far.

And we’ll keep you posted of our progress.

Jared Bernstein is Chief Economist to Vice President Biden, and Executive Director of the Middle Class Task Force

 --------------------------------------------------

(Traducción al español - Spanish Translation)

La ley en acción: un nuevo reporte demuestra que la Ley de Recuperación produce empleos a través de la nación

Buenas noticias, amigos. La Ley de Recuperación está funcionando y más de un millón de personas están trabajando gracias a que se han podido salvar sus empleos o porque se han creado nuevos trabajos gracias a la Ley de Recuperación (en inglés) e Inversión de los Estados Unidos.

¿Pero porque creer en lo que digo si lo puede ver por usted mismo? Gracias a una recopilación sin precedente de datos en tiempo real de la Junta Independiente para la Recuperación, Responsabilidad y Transparencia (RATB, por su sigla en inglés), usted pronto podrá (esta misma tarde) visitar el sitio web Recovery.gov y aprender acerca de los aproximadamente 650,000 empleos (en inglés) creados con una parte – y enfatizo que estos 650,000 empleos o más son un subconjunto de más de un millón – del dinero de la Ley de Recuperación en vigencia para mejorar nuestra economía. 

Ya que el número 650,000 está basado en más o menos la mitad del dinero que se está poniendo a trabajar en la economía hasta el momento, duplíquelo para obtener un estimado del total de empleos impactados hasta el momento y el resultado será más de un millón de empleos que han sido creados o salvados.

¿No puede esperar hasta esta tarde? Entonces mire el video arriba (con subtítulos en español) que muestra personas de la vida real realizando trabajos de la vida real apoyados por la Ley de Recuperación.

Aquí están los detalles. Hasta el mes pasado, había cerca de 340 mil millones de dólares de la Ley de Recuperación en función por la economía, a través de alivios fiscales para los estados, proyectos comprometidos con la infraestructura (algunos en progreso, otros que aún están por empezar), reducción en los impuestos, beneficios por desempleo, préstamos para pequeñas empresas y mucho más. De acuerdo con nuestros estimados y los estimados de analistas independientes, este empujón de la Ley ha creado o salvado cerca de un millón de empleos hasta el momento.

Ahora, poco menos de la mitad de esa cantidad aplica a proyectos de presupuesto directo para los cuales los beneficiarios están obligados por el Congreso a reportar información sobre el empleo a la RATB. Como puede ver en el video arriba, nos referimos a todo, desde trabajadores de la construcción hasta maestros, científicos y más. Luego de haber definido y resumido los datos, la junta nos informa que la cantidad de estos empleos directos suman la cantidad de 650,000, a través de todo el país.

La otra mitad de la inversión incluye préstamos subsidiados a pequeñas empresas, compensaciones por desempleo, reducción de impuestos y otras formas de ayuda de la Ley Para la Recuperación que no se presta para reportes de empleos directos tan fácilmente. Los reportes de beneficiarios también omiten los empleos indirectos – esos creados cuando el empleado contratado directamente solicita que se le envíe cemento, el maestro ordena artículos para el salón de clases o cuando ambos utilizan su salario en la economía, generando más actividad económica y empleos de los que ocurrirían si estuvieran desempleados (los economistas reconocerán esto como el “efecto multiplicador”).

Entonces, esa es la historia de hoy, pero todavía queda más por venir sobre la Ley de Recuperación. Dado que más de la mitad de los fondos de la ley están por reflejarse o sentirse en la reducción de impuestos, el hecho de que muchos proyectos financiados todavía tienen muchos más contratos por hacer y el hecho de que esos reportes de beneficiarios son responsable de cerca de 650,000 empleos reportados hasta finales de septiembre a pesar de todas las omisiones que acabo de describir, estamos firmemente encaminados a cumplir nuestra meta de 3.5 millones de empleos salvados o creados para finales del siguiente año.

Me quito el sombrero ante RATB por abrir camino con su trabajo y les agradecemos a todos lo beneficiarios por brindarnos esta información.

Pero aunque aplaudimos estos esfuerzos de transparencia sin precedente y esta nueva confirmación de que la Ley de Recuperación está exitosamente creando empleos a través de los Estados Unidos, también estamos sumamente consientes que aun los cálculos más altos de empleos creados o salvados por la Ley solo compensan parcialmente la gran pérdida de empleos desde que la recesión comenzó el año pasado. Por esta razón, tenemos planes de continuar creando trabajos de cada dólar que quede para invertir en la Ley de Recuperación y hacerlo con el mismo nivel de transparencia alcanzado hasta ahora. 

Y lo mantendremos informado sobre nuestro progreso.

Jared Bernstein es el principal asesor económico del vicepresidente Biden y director ejecutivo del Equipo de Trabajo para la Clase Media

This afternoon the President took to the South Court of the Eisenhower Executive Office Building to speak about small business. And as important to the identity and history of America as small businesses are in their own right, it is also the case that they are at the heart of the two issues dominating the news today. 

The first issue is today’s encouraging news regarding the growth in Gross Domestic Product, as discussed by CEA Chair Christina Romer this morning. As stark a turnaround as this news represents from the past year, it will be in large part small business who convert this growth into actual jobs over the coming months, and indeed it can’t be said enough how much work there is left to do.

The second issue is the one we have heard so much about over the past months: health insurance reform. But now, with the smoke of the partisan attacks and bickering having begun to clear, it is worth thinking again about the very real and very positive impact reform can have on small business – an impact also fleshed out this morning in a new report posted here.

The President’s word on the GDP numbers:

I am gratified that our economy grew in the third quarter of this year.  We've come a long way since the first three months of 2009, when our economy shrunk by an alarming 6.4 percent.  In fact, the 3.5 percent growth in the third quarter is the largest three-month gain we have seen in two years.  This is obviously welcome news and an affirmation that this recession is abating and the steps we've taken have made a difference.

But I also know that we got a long way to go to fully restore our economy and recover from what's been the longest and deepest downturn since the Great Depression.  And while this report today represents real progress, the benchmark I use to measure the strength of our economy is not just whether our GDP is growing, but whether we're creating jobs, whether families are having an easier time paying their bills, whether our businesses are hiring and doing well.  And that's what I'm here to talk with you about today.

And an excerpt on health insurance reform:

We all know that family premiums have skyrocketed more than 130 percent over the past decade.  They have more than doubled.  But small businesses have been hit harder than most.  A story in the paper just the other day said that many small businesses may see their premiums rise about 15 percent over the coming year -- twice the rate they rose last year.  And in part because small businesses pay higher administrative costs than larger ones, your employees pay up to 18 percent more in premiums for the very same health insurance.

In one national survey, nearly three-quarters of small businesses that don't offer benefits cited high premiums as the reason -- and that's not surprising.

The bottom line is that too many Americans like you can't afford to build the kinds of businesses you'd been hoping to build.  Too many budding entrepreneurs can't afford to take a gamble on a smart idea because they can't give up the health insurance they get in their current job.  Too many of you not only can't afford to provide health insurance to your employees, too many of you are having a tough time just affording health insurance for yourselves.  That's bad for our economy, it's bad for our country, and that's what we'll change when health insurance reform becomes law.

Just this morning, the House of Representatives released its version of health reform legislation, and I want to commend Nancy Pelosi and the Democratic Caucus for their leadership in achieving this critical milestone.  They forged a strong consensus that represents a historic step forward.  This bill includes reforms that will finally help make quality insurance affordable.  Importantly, this bill is also fully paid for and will reduce the deficit in the long term. 

Now, there is no doubt that this legislation, and the legislation that's being drafted in the Senate, would benefit millions of small businesses.  It's being written with the interests of Americans like you and your employees in mind.

And yet, there are those who have a vested interest in the status quo who are claiming otherwise, and they're using misleading figures and disingenuous arguments.  So I want to try to explain as clearly as I can exactly what health reform would mean for small business owners like you and the workers you employ.

The first thing I want to make clear is that if you are happy with the insurance plan that you have right now, if the costs you're paying and the benefits you're getting are what you want them to be, then you can keep offering that same plan.  Nobody will make you change it.

What we will do is make the coverage that you're currently providing more affordable by offering a tax credit to small businesses that are trying to do the right thing and provide coverage for their employees.  Under the House and Senate bills, millions of small businesses would be eligible for a tax credit of up to 50 percent of their premiums.  That's in the legislation that's already been proposed.

President Barack Obama remarks on his Administration's plans to help small businesses while speaking to members of the U.S. Chamber of Commerce, National Federation of Independent Business, and small business owners and organizations from across the country at the White House, Oct. 29, 2009. Official White House Photo by Samantha Appleton. October 29, 2009. (Official White House Photo by Samantha Appleton)

On Tuesday President Obama announced the largest single power-grid modernization investment in U.S. history.  Under the Recovery Act, the Department of Energy is funding 100 grants totaling $3.4 billion to help companies, utilities and cities build a nation-wide smart grid.

Yesterday, I was in Houston, Texas – the Energy Capital of the World - visiting CenterPoint Energy Houston. CenterPoint is a regional utility that received $200 million of this grant to spur its deployment of a smart grid to improve efficiency and help area consumers manage and control their electricity usage. Investments like this one will create jobs, save energy, and empower consumers to cut their electric bills, as I explained in this video:

These grants are just some of the many ways federal agencies are working together to bring about a new energy frontier.  I also announced a Memorandum of Understanding with eight other federal agencies that will expedite the siting and permitting of electric transmission projects on federal lands.

Ken Salazar is Secretary of the Interior

At 2 p.m. EDT  today, watch the H1N1 briefing by the Centers for Disease Control and Prevention (CDC) live on Flu.gov. Today’s update will include updated information about vaccine availability and anti-viral medications.

Flu.gov continues to be the one-stop clearinghouse for flu information.  Updated information on how to find vaccination clinics in your area will continue to be added to Flu.gov, as it becomes available. Visitors can use an interactive widget to search for fraudulent H1N1 flu products and detailed information is available for:

• Parents and Pregnant Women
• Caregivers
• People with Health Conditions
• Seniors
• Travelers

Watch the live briefing on Flu.gov.

The President and his team have discussed this problem with small business owners from across the country and we know they don’t want to stop providing coverage to their employees. Small businesses are like families and small business owners want to give their employees the coverage they deserve. Unfortunately, the high cost of health care is making it impossible for many small businesses to provide health benefits.

Today, HHS Secretary Kathleen Sebelius has released a new report, Lower Premiums, Stronger Businesses: How Health Insurance Reform Will Bring Down Costs for Small Businesses. The report looks at the current status quo and outlines how reform will help solve this problem and bring costs down for small businesses. Specifically, reform will.

• Create an insurance exchange. Health insurance reform will create a health insurance exchange that pools small businesses and their employees with millions of other Americans to increase purchasing power and competition in the insurance market (a luxury only large firms currently enjoy).  Increased purchasing power and competition, in turn, make premiums more affordable.  The exchange will also reduce administrative costs for small businesses and their employees by enabling them to easily and simply compare the prices, benefits, and quality of health plans.
• Provide a small business tax credit.  On top of the potential savings created by the health insurance exchange, an estimated 3.6 million small businesses nationwide could qualify for a tax credit to make coverage for their employees even more affordable. For example, a firm with 9 employees and an average wage of less than $20,000 per employee could receive a credit of 35 percent off its premium costs in 2011 under the amended Senate Finance bill, or a credit of 50 percent off its premium costs under both the Senate Finance and House Tri-Committee bills in 2013.
• End the “hidden tax” on small businesses that provide health insurance.  Premiums are high, in part, because of a “hidden insurance tax” of more than $1,000 added onto every family policy that covers the cost of care for those without insurance.  Health insurance reform will benefit small businesses that already provide health care by expanding health care coverage to all Americans and removing this hidden tax.  These reforms will enable streamlined, efficient coverage for all Americans.
• Prevent arbitrary premium hikes. In the current health insurance system, small businesses can see their premiums skyrocket if just one or two workers fall ill and accumulate high medical costs.  Health insurance reform will prevent insurance discrimination based on health status, meaning that small businesses will no longer be unfairly penalized if a worker falls ill.

These are just some of the ways health insurance reform will support small businesses and help ensure all Americans get the secure, stable coverage they need. To learn more, read the full report by visiting www.HealthReform.gov.

Linda Douglass is Communications Director for the Office of Health Reform

Today, the Health IT Standards Committee within the Department of Health and Human Services will begin an unprecedented effort to get the public’s view on how our work might "pull forward" the benefits of healthcare information technology (IT).  Specifically, we’re interested in uncovering new strategies to accelerate the adoption of health IT standards.  This effort began with the passage of the American Recovery and Reinvestment Act of 2009, calling for recommendations on standards to promote safe, secure, healthcare information exchange.

“Standards” are really the guardians of quality, consistency, and interoperability.  Without thoughtful, clear and uniform standards, we cannot enable the seamless and secure exchange of electronic health information (or the benefits that accrue to providers and patients from such protected exchanges).

So, while the exploration of technical standards may seem mundane to some, it is foundational to electronic health records (EHRs) and electronic health information exchange more broadly.  In other words, it’s worth paying some attention to, and voicing your opinions.

Our process continues with a public hearing today in Washington, DC. Find out how to participate via phone and webcast here. We are convening four panels of experts with on-the-ground experience in interoperability standards - providers, quality stakeholders, health IT vendors, and a group with lessons drawn outside of healthcare. Thanks to HIT Standards Committee member Judy Murphy for her leadership on this effort.

The public hearing draws to a close this afternoon but we will continue the conversation through an Online Forum over the next two weeks.  Thanks to Committee Member Cris Ross for his leadership on this effort.  Given the breadth of interests, we have arranged a series of Committee Member blog posts to begin the dialogue, starting with HIT Standards Committee Vice-Chair John Halamka's summary of our work to date, which will post on Friday.  We will concurrently enable ongoing discussion threads on the following topics:

1. Proposed Standards (General Discussion)
2. Interoperability
3. Vocabularies
4. Privacy
5. Security
6. Quality
7. Implementation Case Studies (Your Story - the good, bad and
   in-between)

We have also enabled a "voting" feature on submissions to allow you - the public - an opportunity to emphasize points raised in a given post. Our goal is to harness the shared wisdom of our community to inform the work of the HIT Standards Committee in the weeks and months ahead.

The tight schedule of this process is designed to ensure that your ideas inform the HIT Standards Committee at its November 19th meeting.  However, your ongoing feedback on our efforts is also encouraged via written submission or public comment at any of the subsequent monthly meetings of the HIT Standards Committee.

The process of accelerating the adoption of health IT standards will not end this week, this month, or this year. This is an ongoing effort, and your participation will continue to be essential to its success.

Aneesh Chopra is U.S. Chief Technology Officer