Rep. Paul Ryan (R-WI) questions Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services, during a House Ways and Means Committee hearing on "Affordable Care Act Implementation"... more 
Rep. Paul Ryan (R-WI) questions Marilyn Tavenner, administrator of the Centers for Medicare & Medicaid Services, during a House Ways and Means Committee hearing on "Affordable Care Act Implementation" on Capitol Hill in Washington, October 29, 2013. REUTERS/Yuri Gripas less 
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Reuters | Photo By � Yuri Gripas / Reuters / Reuters
Wed, Oct 30, 2013 11:38 AM EDT