Making real and effective changes to Utah's Medicaid program, which provides health-care coverage for 170,000 people, is going to require much more time than has been allotted to a legislative committee, a state lawmaker says.

Rep. Gregg Buxton, R-Roy, is a member of the Medicaid Interim Committee, which was created earlier this year with the task of examining the state's Medicaid program and making policy recommendations for the 2007 legislative session.

"To get your arms around Medicaid is a big deal," Buxton said. "It's a big job, and I don't believe this committee can do that in just the next three meetings."

The group has met three times and will meet three more times before a November deadline for submitting its recommendations.

"I don't see that happening, personally," Buxton said Friday during a panel discussion on the future of Medicaid at Utah Issues' annual Poverty Solutions Conference at the downtown library.

Overall, panelists agreed that the government-sponsored insurance program for low-income and disabled Americans has seen better days. Federal budget cuts continue to strain the program, leaving states left to fill gaps and maintain continuity in service amid rising health-care costs.

"The outlook for Medicaid is not so good," said Judi Hilman with the Utah Health Policy Project.

The costs of health care continue to grow at a rate faster than state revenues, said state Medicaid director Michael Hales, forcing the Utah Department of Health to ask lawmakers each year for anywhere between $30 million and $50 million in new general fund monies to sustain the program.

"It needs to be remembered that the problem is not unique to Medicaid," Hales said. "The broader health insurance costs of our economy, that is a real issue to be dealt with."

In order to revitalize Medicaid, which Hilman called the "most cost-effective way to deliver health care to low-income people," advocates believe policy makers must re-evaluate how they administer the program and deliver services to recipients.

"I think as a state we need a paradigm shift," said Sheila Walsh-McDonald, health care advocate for the Salt Lake Community Action Program. "We need to think more clearly about some of the cost-containing strategies that have been modeled again and again by other states."

Some solutions include the establishment of a preferred drug list for Medicaid patients, a move that has been strongly supported by David Sundwall, executive director of the Utah Department of Health, and participating in bulk purchasing of prescription drugs, which was recently recommended by legislative auditors who examined ways to reduce state drug spending.

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