States head to DC with questions about health insurance exchanges

President Obama is set to release deficit-reduction proposals that will include cuts to Medicare and Medicaid, while state officials head to Washington to discuss the centerpiece of healthcare reform — and that’s just Monday’s agenda.

This promises to be another busy week in healthcare, beginning with the gathering of state and federal officials to talk about insurance exchanges. Leaders from the Health and Human Services (HHS) Department will discuss exchanges with representatives from 46 states, Washington, D.C., and the territories.

HHS has been tight-lipped about the two-day, closed-door meeting. But there’s plenty to talk about.

Many states want more information about the federal fallback exchange that HHS can set up in states that don’t establish their own, and HHS is eager to sell reluctant states on a partnership model. And even states that are eager to implement healthcare reform want to see regulations on essential health benefits. States will have a much better idea of how to build their exchanges once HHS releases those rules.

There are also myriad unanswered questions about the logistics of an exchange and who will handle which pieces of the massive technical operation. States and the federal government must somehow end up with a system that can process enrollment and tax subsidies and integrate seamlessly with Medicaid.

Medicaid is also central to the other big healthcare story of this week — the supercommittee. Obama is set to release his deficit-reduction plan Monday, and Medicare and Medicaid cuts will be included. Obama has previously backed Medicaid changes that states strongly oppose, and stakeholders close to the program aren’t sure whether that policy is still on Obama’s radar.

The Senate Finance Committee is holding a Wednesday hearing on patients who receive both Medicare and Medicaid benefits. That follows a Tuesday hearing on tax reform and incentives for innovation. Also on Tuesday, the Senate Appropriations Health subcommittee marks up its 2012 spending bill.

In the House, a Judiciary Committee panel has scheduled a Tuesday hearing on pharmacy benefit managers. Also on Tuesday, Republicans on the Energy and Commerce Committee will team up with the medical device industry for a “jobs and innovation” event. And the Ways and Means Health subcommittee looks into expiring Medicare payments on Wednesday.

Off Capitol Hill, the Brookings Institution will release new data Tuesday on healthcare costs and utilization. Wednesday, the National Academy for State Health Policy is holding a webinar on the status of exchange implementation.

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