A statehouse committee was briefed today on a controversial Republican proposal to save the state millions of dollars in health care costs for indigent, disabled, and elderly people.

Under the plan, needy patients could no longer get care paid for right away, while waiting to be approved for government help.

Currently, Medicaid will pay for three months of retroactive coverage.

"We're a little bit stuck." -DHS Administrator Wendy Rickman

DHS Administrator Wendy Rickman briefed the legislature’s Administrative Rules Review Committee on the proposal.

“If you or I applied to Blue Cross today and they approved to cover me, I couldn’t say I had surgery in June, will you pick that up?” Rickman said. “So we're a little bit stuck in the conversation on aligning with commercial coverage and the issues we have with clients who are indigent.”

“Indigent and disabled and other issues that you and I don’t have,” replied Sen. Pam Jochum (D-Dubuque).

The state would save $6 million or more with the change, but critics say many patients would still get care right away, so health care providers would absorb the cost.

"They're operating on a shoestring now." -Sen. Pam Jochum

“I'm looking at the community providers that deal with the intellectually disabled,” Jochum said. “They’re operating on a shoestring now.”

The proposal is one of several changes in the Republican health care budget designed to rein in the growing costs of Medicaid.

Under the Republican budget bill, the change would go into effect October 1. However, the federal government must sign off, and officials say no other state has been allowed to drop the retroactive coverage.

“We don’t know what they’re going to do at this point,” Rickman said. “Everything is fluid at that level.”

The proposal also eliminates the three-month retroactive benefit for new household members applying for Medicaid.