State proposes cuts to close $307 million MassHealth shortfall

"What other states are doing is eliminating services," Dougherty said. "What we are charged with doing" is to keep as many necessary services as we can, "and to realize that people won't get every single thing they got in the past.”

Dougherty said the recession and widespread job losses have swelled the number of residents seeking assistance through the Medicaid program, a phenomenon the Patrick administration could not forecast when it put this year's budget together a year ago.

Today, more than 1.2 million residents are receiving Medicaid assistance.

He said the cuts identified so far, which also include some reduced payments to hospitals for patients who stay beyond 20 days, add up to only about a third of the savings needed to close the gap. Dougherty said his agency will also be scouring its budget to make sure the federal government is reimbursing Massachusetts for the full amount it is owed. Additionally, he said, he intends to ask state lawmakers for a "modest" cash infusion, though he declined to elaborate.

Dougherty said the proposed increases in patient co-payments and cuts in dental services likely won't go into effect until April because state lawmakers must first approve the measures and then there must be public hearings. He said he expects state lawmakers to vote next week.

Health Care For All, a Boston-based consumer group, criticized the cuts. "We appreciate the Administration's thoughtfulness in trying to address the deficit in these difficult economic times; however a compassionate Commonwealth does not balance the budget on the backs of some of the most vulnerable among us," the group said in a statement. "Increased co-pays and program cuts are essentially a tax on the poorest and sickest."