The nation’s Republican governors on Tuesday released a detailed list of policies that would give them greater control over their Medicaid programs, one of states’ biggest expenditures.

The 31 recommendations include longtime Republican priorities such as repealing the healthcare reform law’s “maintenance of effort” requirement that forbids states from cutting their Medicaid rolls. The proposal doesn’t go as far as the House Republican budget, however, which would have cut federal Medicaid spending by more than $700 billion over 10 years by turning the program into a federal block grant.

“Cost-shifting and cost-saving are not the same,” Virginia Secretary of Health and Human Resources Bill Hazel told reporters at a briefing. “We do as states have concerns that federal savings will turn into cost-shifting to states; there’s no doubt that that is a legitimate tension point here.”

The Health and Human Services Department hasn’t adequately addressed the needs of small insurance companies — and small employers — as it implements the healthcare reform law, Rep. Renee Ellmers (R-N.C.) said in a letter to Health and Human Services Secretary Kathleen Sebelius.

Ellmers, chairwoman of the House Small Business Committee’s healthcare subcommittee, said Health and Human Services (HHS) deserves credit for giving states significant flexibility over their health insurance exchanges. But regulations on the exchanges haven’t answered key questions about small insurers, Ellmers said.

Her letter, dated Tuesday, also raised concerns about the impact other parts of the healthcare law will have on small insurers and small employers.

Small insurers likely will have a harder time meeting new limits on the amount of money plans can use for profits and administrative expenses, Ellmers said. The law also requires all plans sold through an exchange to offer a package of “essential” health benefits, which could be harder for smaller carriers to put together.

“If the Exchanges are to truly foster competition and reduce the cost of health insurance for small businesses, the many standards that small insurers must meet should be realistic, and not result in their exclusion from the market or from health insurance altogether,” Ellmers wrote.

HHS has issued two rounds of regulations on the exchanges but still hasn’t defined essential benefits. And Ellmers said employers need more information about exchanges specifically designed for small businesses.

States have the option of running separate exchanges for individuals and small employers, or they can combine the two into a single marketplace.

Senators from both parties praised the Medicare agency Tuesday after a new report gave it plaudits for making better use of fraud-fighting dollars.

The report from the Government Accountability Office found that the agency has been doing a better job allocating resources to fight fraud. Whereas spending used to be allocated based on previous years’ patterns, the GAO reported, the agency is now factoring in priorities and performance goals.

“I am encouraged that the Centers for Medicare and Medicaid Services has greatly improved in its efforts to get better results for less money by targeting their program-integrity dollars to more effectively fight waste and fraud,” Sen. Tom Carper (D-Del.) said in Tuesday in a news release.

Sen. John McCain (R-Ariz.) likewise said he was “pleased” with the report, which the two senators ordered as part of their assignments on the Homeland Security & Governmental Affairs subcommittee on Federal Financial Management, Government Information, Federal Services and International Security. Carper is the subcommittee’s chairman.

Despite their praise, they urged the Medicare agency to do more to combat fraud, which still costs the government billions of dollars a year.

Even in a climate as politically charged and divided as in Washington D.C., every once in a while there is an issue that has the ability to unite our two parties around a common goal. Last year, every member of the Senate came together to support the Healthy, Hunger-Free Kids Act. By unanimously passing this legislation to revise outdated nutrition standards for school meals, Congress took a giant step toward improving our children’s nutrition, curbing our nation’s growing obesity crisis and improving the wellbeing of our children. 

Unfortunately, some members of Congress are turning their backs on our students and trying to undo those important changes in order to please powerful D.C. lobbyists.

State insurance regulators might challenge an estimate from the Congressional Budget Office (CBO) that they fear is giving the supercommitee an inflated view of certain healthcare savings.

A subgroup of the National Association of Insurance Commissioners is looking at potential options for supplemental Medicare coverage known as Medigap plans. And though its charge was part of the healthcare reform law, the subgroup is also looking closely at Medigap changes that will likely be on the table as the supercommittee begins looking for more than $1 trillion in deficit reduction.

Among those proposals is a plan to bar Medigap plans from offering coverage without cost-sharing. CBO has said the change would save the government $53 billion over 10 years. Although CBO is Congress’s official budget scorekeeper, the NAIC subgroup is skeptical enough about the estimate that it’s considering ways to suggest that CBO might be wrong.

“Decision-makers may be making decisions based on numbers that can’t really be verified,” subgroup chairman Guenther Ruch said during a conference call Tuesday.

The American Lung Association urged members of the debt supercommittee this week to reject policy riders and protect key public health programs as part of their deal to cut the deficit by at least $1.2 billion.

The public health group warned the 12 members of the supercommittee not to make major cuts to the Environmental Protection Agency's budget, as well as those of the Centers for Disease Control and Prevention and the National Institutes of Health.

“EPA plays a critical role in protecting the public health from life-threatening air pollution that can cause asthma attacks, heart attacks, strokes, cancer and shorten lives,” the American Lung Association said in a letter Monday to members of the panel.

A panel of experts tasked with reviewing decades-old experiments on Guatemalans recommended Tuesday that the U.S. create a system for compensating people harmed by medical research.

The panel was formed after it was revealed last year that the federal government in the 1940s supported unethical research on sexually transmitted diseases. Doctors involved in the research sought to infect hundreds of Guatemalan prisoners, soldiers and mental patients to test the effectiveness of penicillin for treating syphilis and other diseases.

"The United States should implement a system to compensate research subjects for research-related injuries," the panel concluded. "One promising model might be based on the U.S. National Vaccine Injury Compensation Program, a no-fault alternative to the traditional tort system that provides compensation to people found to be injured by certain vaccines."

The panel points out that many countries — and some U.S. research institutions — already have compensation systems in place for research-related injuries.

Committee co-chairmen Patty Murray and Jeb Hensarling announced Tuesday that Mark Prater will serve as the panel’s staff director.

The Republican members of the debt supercommittee met for the first time Tuesday in Washington.