Every odd-numbered year, the Texas health and human services commissioner appears before state lawmakers hungry to cut spending on Medicaid.
And at every meeting he or she shows them a chart of whose health services would suffer: impoverished children, senior citizens and the disabled.
That's the moment when even the most hard-hearted lawmaker realizes that cutting the program, which accounts for a quarter of state spending, will be tougher than they thought.
But the number of poor children and impoverished elderly continues to grow, and federal law requires the state to provide a basic level of services.
Texas lawmakers have promised to maintain support for the poor, but Medicaid has reached a quarter of state spending.
Republicans are looking for ways to reduce those costs without cutting services.
Copyright 2013 The Associated Press.