Topeka ? Lt. Gov. Jeff Colyer said Wednesday Kansas must reform its Medicaid program in the face of rising costs and potentially staggering budget deficits.

Colyer, who is also a pediatric surgeon, told more than 300 people at a forum in Topeka that the state must retain access to quality health care even as it overhauls the program.

“We can’t just go cut 5 percent here or throw people off Medicaid. Those are unacceptable,” he said.

More than 200,000 Kansans receive Medicaid, including the elderly, the developmentally disabled, and low-income families and children. Kansas is budgeted to spend $1.2 billion on Medicaid services in the fiscal year beginning July 1. Total spending, including the federal match, is $2.8 billion.

Colyer is leading a task force on Medicaid reform. Wednesday’s forum was the first of several he will hold around the state. Gov. Sam Brownback had been expected to take part but did not attend because of new concerns about flooding along the Missouri River in northeast Kansas.

Dr. Robert Moser, secretary of the Kansas Department of Health and Environment, said the state was looking to reform Medicaid with a goal of improving health outcomes and services, such as coordination of care and delivery of pharmacy services. He also said the state would continue to work with the federal Health and Human Services agency to get maximum flexibility to make changes in the state system.

“If we have to push back on federal limits to fit our needs we will,” Moser said.

The Brownback administration said without reforms that Kansas could be facing budget deficits of close to $1 billion by 2016. Since the state constitutionally must have a balanced budget, Colyer said the expenditures must be balanced with challenges of funding public schools and reforming the state employee retirement system.

“We’re not looking at a single fix,” Moser added.

State Democratic leaders issued a news release saying they believe the Republican governor wants to cut Medicaid spending so that the state can cut taxes.

“The people of Kansas are compassionate. We value living in a state where we care for those in need,” said Democratic Party Chairwoman Joan Wagnon, a former legislator and secretary of revenue under Democratic Govs. Kathleen Sebelius and Mark Parkinson.

Wagnon was skeptical that Brownback and Colyer were serious about reforms to improve the system, noting that Brownback voted to cut Medicaid funding during his time in the U.S. Senate.

Colyer, while not responding directly to Wagnon’s comments, tried to assure the crowd that the administration didn’t already have a plan in mind that it was going to force on service providers and Kansas residents.

“We’re all involved. This affects all of us,” he said. “We want to work with people and not come up with a top-down program.

More forums are planned in Wichita and Dodge City. The administration has been collecting suggestions and visiting with consultants since February.

Wade Horn, of Deloitte Consulting and a former HHS assistant secretary, said Kansas wasn’t alone in its struggles with Medicaid and that states across the country were looking at reducing costs as state funding remained tight.

Horn said federal Medicaid funding would change July 1 when the lapse of a program under the stimulus packages that sent states additional dollars. States receive a federal match based on poverty, ranging from 50 percent of costs to 80 percent. Kansas gets about 60 percent from the federal government.

He said states have been forced to reduce spending for other programs, such as schools and social services, to comply with federal regulations.

“It has put tremendous pressure on states,” Horn said.