Topeka ? States across the nation are grappling with skyrocketing Medicaid costs and Kansas lawmakers were told Monday there could be some savings, but they would require “tough decisions.”

The warning came from Legislative Post Auditor Barb Hinton as she reviewed recent studies of Medicaid, the federal-state program that provides health care to low-income Kansans.

“There are a lot of policy options that involve a lot of tough decisions,” Hinton told the newly formed Special Committee on Medicaid Reform.

“This is a huge topic, obviously,” Sen. Derek Schmidt, R-Independence, chairman of the House-Senate committee, said.

Medicaid provides health coverage to more than 10 percent of Kansans, including 140,000 children, or 19 percent of all children in the state.

States across the nation are struggling with rapidly increasing costs that have been fueled by an increase in recipients, services and health care and drug costs.

In Kansas, Medicaid has increased an average of 12 percent per year since 1991 and now costs $2.2 billion.

Schmidt said he hoped the committee would provide a list of “doable” recommendations when the legislative session starts in January.

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Committee members said they would like to focus on whether it was possible for the state to provide incentives to get people to buy long-term care insurance.

The committee also appeared interested in looking at ways to better monitor Medicaid claims and consider whether to tighten regulations that allow Kansans to shelter portions of their assets in order to become eligible for services.

Ernest Kutzley, advocacy director for AARP Kansas, however, urged lawmakers to reject proposals that would jeopardize services or shift costs to beneficiaries.

“Clearly, some change is needed to alleviate the pressure on Medicaid and to make the program as effective as possible,” Knutzley said.

But, he added, “Changes should be based on sound policies rather than an arbitrary budget target.”