Medicaid is headed toward a "fiscal train wreck" in terms of federal funding and states will be expected to pick up more and more of the burden over the coming years, lawmakers learned Wednesday in a rather gloomy outlook of the future of the government-sponsored health insurance program for the poor and disabled.

"The message here, I think, is that double-digit growth in Medicaid (spending) is not an exception, it's the rule," Mark Andrews, policy analyst from the Office of Legislative Research and General Counsel, told members of the newly-formed Medicaid Interim Committee.

Between now and November, the group intends to examine all facets of the massive Medicaid program and make policy recommendations for the 2007 legislative session.

"It's no small feat that we're trying to accomplish in a very short period of time," said committee co-chairman Sen. Sheldon Killpack, R-Syracuse. "We're probably not going to find the silver bullet for 100 percent of the issues."

Killpack is optimistic, however, that the 12-member body will make "significant headway" on its top two priorities — cost management and accountability within the state's Medicaid program.

"We'll be looking far and wide at solutions that are a good match for our state," he said.

Over the past five years, Medicaid spending has increased 12 percent, more than five times the rate of growth in other areas of state spending. The program now represents one-fifth of the state's total $8.9 billion state budget, coming in second only to public education. It provides health care coverage for 7 percent of Utahns, including 229,000 low-income adults and children, 34,000 people with disabilities and 14,000 seniors.

More than half of Utah's Medicaid budget goes toward providing services considered optional under the federal program, such as vision and dental care, prescription drugs, mental health or chiropractic care. Cutting optional services is one way to reduce overall program costs, although they generally aid the most vulnerable Medicaid recipients, Andrews said.

"If you're interested in tinkering with optional services, you're straight into the elderly or persons with a disability," he said.

Lawmakers have taken a serious public-relations hit lately for their refusal to fund adult dental-care services for the aged, blind and disabled. They declined to appropriate the funds during the general session and again refused a request from Gov. Jon Huntsman Jr. to appropriate $2 million for the services during a special session last month.

Health care advocates have expressed concern that the Medicaid Interim Committee is a way for lawmakers to significantly scale down the state's program and drastically cut services to the most needy of Utah's citizens. At least one legislator tried to appease those concerns Wednesday.

"We need to make sure that whatever we put in policy is based truly upon services and not just on budget alone," said Sen. Gene Davis, D-Salt Lake. "There's a quality-of-life issue here that we need to embrace for the elderly, the disabled and others."

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