FRANKFORT — Kentucky's medical care program for poor and disabled people, swelled by additional patients and costly services, will run out of money this year and be short next year unless action is taken, officials said Thursday.

        Among the options under consideration are cuts in payments to doctors and hospitals, cuts in the services not required by the federal Medicaid program, eliminating some people from Medicaid eligibility and new management initiatives.

        “Right now, we don't see any easy solutions. We don't see any painless solutions,” state Budget Director James Ramsey told the legislature's interim Health and Welfare Committee.

        Instead of the approximately 567,000 Medicaid recipients expected this year, the total has grown to more than 580,000. Next year, about 570,000 Medicaid recipients were expected when the budget was put together and the total is now expected to reach nearly 594,000.

        In addition, drug costs and programs such as long-term care are pushing up the overall cost of care. Drug costs alone grew from $347 million last year to an estimated $433 million this year.

        Health Services Secretary Jimmy Helton said some “optional” programs or recipient groups cannot really be cut.

        For example, the federal government does not require Medicaid to cover prescription drugs, but Mr. Helton said it would not really be a health-care program without them.

        And cutting off payments to people who use some community medical services would actually just shift costs to hospitalization.

        Individual perspectives of legislators also put a spin on the spiraling Medicaid budget.

        Sen. Dick Roeding, R-Lakeside Park, a former lobbyist for the pharmaceutical industry, argued higher-priced drugs are actually saving money elsewhere in medical care, such as hospitalization.

        Sen. Daniel Mongiardo, D-Hazard, a medical doctor, said all of the Medicaid program except drug costs is a direct benefit to the state's economy.

        Rep. Bob DeWeese, R-Louisville, the only other physician in the legislature, said the Medicaid program itself is broken.

        “We're trying to make a dinosaur from the late '60s and '70s work in the 21st century and it cannot do that,” Dr. DeWeese said.

        Some legislators had their own idea of how to make up the difference.

        Sen. Tom Buford, R-Nicholasville, said such a shortfall is exactly what the state created its rainy-day fund to cover. The budget reserve has about $278 million, though administration officials are loath to dip into it.

        Rep. Steve Nunn, R-Glasgow, said he still wants the state to spend a part of its share of the national tobacco settlement on Medicaid, a proposal he made during the writing of the budget last year without success.

        The state is not on the hook for the whole sum. The state actually pays about 30 cents of each Medicaid dollar with the federal government picking up the rest.

        But compounding the Medicaid budget problem is the likelihood that overall state revenue receipts will fall short of estimates this year and next.

        Mr. Ramsey said some ideas about what to do should be surfacing in a week to 10 days.

        The legislature's short session resumes Tuesday and legislators said they want to be kept informed of developments.

Carrie's relatives win $3.75M award
Delta was dismal in December
Gen X politicians push for change
Tip led police to house where wanted man died
Corryville fighting negative image
RADEL: Police shooting
Workers suspended in abuse case
Hamilton cleans up its act
Third area school in shutdown; too many out sick
Bill aimed at telemarketing loopholes
CG&E bills add details this month
Chili cooks all fired up
County tax increase advised
Embezzler's husband indicted on new charges
Fairfield operating levy on ballot
Fired Villa Hills workers not getting unemployment aid
Hearing on light rail along I-71 corridor finds support
Judge OKs settlement over corneas removed at morgue
Kentucky's Medicaid budget said to be in critical condition
Lebanon may buy land atop aquifer
Lebanon ponders project
Mason judge to step down after 5 terms
Now, 'A' is for all-year schooling
Parents' godsend closes
Professor hospitalized after rescue from cave
Senator armed for 2002 challenge
Study trumpets benefits of light rail
Tristaters hurrying to aid quake victims
UK business school looking at new location
Kentucky News Briefs
Tristate A.M. Report