Medicaid eats up 20 billion state dollars every year. That’s about a third of the state’s total budget. Lawmakers are looking for ways to lower the cost without drastically cutting services.

Four disabled Medicaid recipients greeted lawmakers, lobbyist and health care administrators with a sign Wednesday as they made their way to talk about Medicaid reform.

Inside a caseworker assisted Patrick Wells as he told state senators how Medicaid helps him out of a group home and living on his own. Lawmakers want to move Medicaid recipients into private managed care providers like HMOs to help cut the 20 billion dollar cost to the state.

Aaron Nangle runs a company helping disabled people find caregivers. He says the move would leave his customers without vital services. “Are they really going to put through the care, the effort? Are they going to advocate for the individuals with disabilities?”

Besides privatizing parts of the entitlement program, lawmakers also want to cut down on rampant Medicaid fraud, and protect doctors from malpractice lawsuits.

Federally funded health clinics, like Bond Community Health Center in Tallahassee, already enjoy protection from lawsuits. Dr. Temple Robinson, the center’s medical director, says eliminating the threat of being sued lets doctors practice more freely. “That was the physicians, the providers here do not pay malpractice premiums out of pocket.”

Whatever decisions are made by lawmakers will be met with criticism, but if the cost aren’t lowered, economist say over the next decade the state will go broke trying to pay them.

Medicaid reform died in the legislative process last year, but with a newly elected Republican supermajority legislative leaders are more confident they’ll be able to make changes.