Rep. Janice McGeachin, R-Idaho Falls, is presenting HB 221, the Medicaid budget-cuts bill, to a joint hearing of the House and Senate Health & Welfare committees. "Basically, the only way to reduce general-fund spending in Medicaid is a combination of a variety of things," she told the committee. Among them, she said, are changes in the price structure for services, and "the idea of moving away from pay-for-service in Medicaid to more of a managed care. That's what we're attempting to do in the legislation."

She's going over a list of 29 changes the bill proposes to Medicaid, including major cuts in services for the disabled and new assessments on some providers. They seek to slice $39 million from Idaho's Medicaid costs, which would mean giving up $81 million in federal matching funds for a total reduction in Medicaid services in Idaho of $120 million.