State officials will meet Wednesday with members of the S.C. House of Representatives to explain a proposal to overhaul the state’s $4.8 billion-a-year Medicaid program.

“We had a lot of members ask questions, and we want the chance to get out the information they need,” said Rep. Dan Cooper, R-Anderson, chairman of the House Ways and Means committee.

All House members have been invited to the meeting.

State Health and Human Services director Robbie Kerr, who oversees the state’s Medicaid program, started laying the groundwork for the meeting last week, meeting one-on-one with several legislators to explain the proposal.

In June, the Sanford administration asked the federal government for permission to change at least 30 provisions of Medicaid in South Carolina. Washington observers say South Carolina’s proposal to reduce Medicaid benefits is one of the most radical submitted by any state.

South Carolina’s Medicaid program provides health care coverage for up to 1 million low-income residents, more than half of them children.

Critics say Medicaid’s costs — paid for with state and federal taxpayer dollars — are out of control.

In 2001, Medicaid expenditures cost South Carolina taxpayers $562 million. In 2004, Medicaid cost the state $824 million.

However, South Carolina’s proposal to rein in rising costs has sparked concerns the state will cut medical benefits for children. For instance, the state wants to reclassify 19- and 20-year-olds as adults, eliminating preventive treatment and limiting their care to emergency or catastrophic needs.

The plan also would limit the amount of health care a Medicaid recipient could receive each year. Instead of unlimited care, each would get a personal health account with a specific amount of money in it. If the recipient’s medical costs exceeded that amount, they would have to pay the difference.

Co-payments also might be imposed on Medicaid recipients, who live below the federal poverty line, earning less than $2,000 a month for a family of three.

South Carolina’s proposal also has been criticized as secretive.

Critics say Gov. Mark Sanford sent the proposal to Washington for federal approval without fully airing it to legislators, beneficiaries or the public.

Legislators say Sanford and his Cabinet-level Health and Human Services Department do not need their blessings to get federal approval of the reform plan. But legislators could circumvent the proposal because they control the state’s budget.

“I’m hoping the governor is going to recognize that this is something that touches 25 percent of the people’s lives in South Carolina, and it should be done right,” said Sen. Linda Short, D-Chester.

The federal government is requiring states submit “budget neutral” reform proposals, meaning Medicaid cannot cost the federal government more money than it does now.

In return, the federal government has signaled it will give governors more flexibility in shaping their own Medicaid programs.

For Sanford, that means personal health accounts and a role for private insurers in Medicaid.

Kerr said political forces have taken aim at the S.C. Medicaid plan from all sides.

Democrats, including state Sen. Tommy Moore of Aiken, who plans to run against Sanford for governor next year, have called on the state to withdraw the proposal now before the federal government.

Others, including the S.C. Taxpayers Association, have offered their full-fledged support of Sanford’s initiative.

Kerr recently appointed a 10-person committee to help his agency re-examine, refine and reshape parts of the S.C. proposal.

“Very clearly they are ready to accept recommendations and proposals to make changes” in the proposal, said Short, who is on the committee.

Medical University of South Carolina president Sam Greenberg also is on Kerr’s advisory committee. His hospital works extensively with Medicaid patients.

Greenberg said he wants pertinent information from Health and Human Services; a chance to look at what other states have done; and a clearer understanding of what South Carolina is trying to achieve with Medicaid.

“I think we ought to use this as an opportunity to engage the provider community in a positive discussion about how we take the limited resources we have and provide the very best medical care we possibly can.”

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