States Propose Sweeping Changes to Trim Medicaid by Billions

By ROBERT PEAR

WASHINGTON, May 8 - Governors and state legislators have devised proposals for sweeping changes in Medicaid to curb its rapid growth and save billions of dollars.

Under the proposals, some beneficiaries would have to pay more for care, and states would have more latitude to limit the scope of services.

The proposals, drafted by separate working groups of governors and state legislators, provide guidance to Congress, which 10 days ago endorsed a budget blueprint that would cut projected Medicaid spending by $10 billion over the next five years.