Medicaid Executive Director Robert L. Robinson says Mississippi’s health care program for the needy will have to cut services if it doesn’t get all the funding it’s requesting next legislative session.

Medicaid is asking for $168 million more in funding for fiscal year 2009. In addition, Medicaid needs $86 million to continue operations for the current fiscal year. Lawmakers would have to approve a deficit appropriation early next session.

At the same time, Robinson said Gov. Haley Barbour asked him and other agency heads to provide a spending proposal for the fiscal year that begins July 1 that is 2.5 percent less than this year’s budget.

“That’s just in case. Now, if the money’s available, he wants to fund Medicaid. If the money’s not available, we have to be prepared,” Robinson said Tuesday.

When asked if a reduced budget would mean service cuts, Robinson responded: “There’s no other place for the money to come from.”

The situation creates a quandary for lawmakers who have said they’ll have less than $200 million to address more than $500 million in funding requests that are over what’s being spent this budget year.

Robinson’s comments came after a meeting with key Mississippi House members, who were hoping to find ways to streamline Medicaid’s budget without cutting services that range from hospital visits to prescription drug coverage to home health care. The program serves about 568,000 people.

House Public Health Committee Chairman Steve Holland, D-Plantersville, said cutting Medicaid services is not an option.

Holland said lawmakers will look at health care providers and how the agency can better deliver services. He also said creating a revenue source, through taxes or fee assessments, also will be considered.

“The tobacco tax would not solve this problem, but it would come close better than anything else,” Holland said, referring to an unsuccessful legislative proposal to raise the state’s tobacco excise tax and reduce the grocery tax.

Part of Medicaid’s funding problem stems from the use of nonrecurring funds. Medicaid’s current budget includes $47.6 million in Hurricane Katrina funds and $40 million from the state’s health care trust fund — all onetime money.

Lawmakers have said that the spending plan approved for next fiscal year will be austere based on the moderate anticipated revenue growth. The Joint Legislative Budget Committee will release its spending recommendations Wednesday. Barbour will release his budget proposal later.

Barbour spokesman Pete Smith said the governor asked agency heads to prepare various contingency budget plans based on the $5.1 billion revenue estimate adopted last month.