Opposition to proposed major cuts in the state’s Medicaid program resurfaced Wednesday, as Democratic legislators said they were dismayed by Gov. Mark Sanford’s plan.

“I’ve never seen anything like this,” said Sen. Joel Lourie, D-Richland. “It’s one thing to propose changes, but then to run off to Washington and file a 46-page document with the federal government, to intentionally bypass what should have been an open process, it’s disturbing to me.”

Lourie and Sen. Darrell Jackson, D-Richland, sent Sanford a letter urging him to withdraw the South Carolina Medicaid Choice waiver plan to allow time for input from the public, the Legislature and health care providers.

“The governor may say, ‘I have the authority to do this,’” Jackson said, “but it’s bad politics and it’s bad public relations. We have constituents to answer to.”

Sanford spokesman Joel Sawyer said the governor’s plan has been public since October 2004, when the state sent a position paper on the proposal to Washington.

Sawyer said anyone can offer an opinion on the proposal by visiting the Department of Health and Human Services Web site — http://www.dhhs.state.sc.us/.

“We’re surprised they haven’t given their input to (HHS) director (Robbie) Kerr before now, which raises the question of whether they’re playing politics,” Sawyer said. “We welcome their input going forward.”

Sanford in June asked the Centers for Medicare and Medicaid Services for at least 30 waivers to the existing, 40-year-old Medicaid program, which delivers medical services to 850,000 of the state’s poorest residents, including children, the elderly and the disabled.

More than half the people on Medicaid in South Carolina are children.

Sanford proposes to require $10 co-pays for all Medicaid medical services for children and adults, a $100 fee for all in-patient hospital visits and a $25 fee for outpatient surgery.

The state Department of Health and Human Services wants to give Medicaid recipients health care accounts to pay for limited services, based on such factors as age and medical condition.

Critics say Sanford’s proposal would dismantle Medicaid, dropping unlimited medical services for 19- and 20-year-olds, while capping medical expenditures for all Medicaid recipients.

Sanford’s plan also would limit the amount of federal money that could come into the state.

“This is the most significant thing that will happen in the General Assembly,” Jackson said, portraying Sanford as more concerned about a “bureaucratic process” than people.

Others have taken aim at the Medicaid proposal.

• Sen. Tommy Moore, D-Aiken, has called on Sanford to withdraw the Medicaid waiver plan.

“This is yet another example of Mark Sanford using the people of South Carolina as guinea pigs for one of his political science experiments,” said Moore, who is running for governor in 2006. “It is tragic that his targets in this case are children in poverty and the most vulnerable among us.”

• Sen. Kent Williams, D-Marion, sent a July 26 letter to members of the state’s congressional delegation, asking them to stop the cuts outlined in Sanford’s plan.

“There’s no sense in talking to the state; the cat’s already out of the bag,” said Williams, whose district is home to the highest unemployment rate in South Carolina.

• The S.C. chapter of the NAACP is planning public hearings as it prepares to fight the proposed Medicaid changes, which the group says would unfairly cut services for those who need help the most.

Reach Burris at (803) 771-8398 or rburris@thestate.com.