ATLANTA --- When Dr. Wayne Hodges says he might have to consider not seeing Medicaid patients at his Savannah, Ga.-based practice if the rates paid to doctors and hospitals continue to sink, it's not because he doesn't want to treat them.

Dr. Hodges has already stopped accepting new Medicaid patients. The reason is because the amount the state pays isn't enough to cover the cost of treating the patients, especially when overhead costs are factored in.

"I don't know of any doctor who really makes money on Medicaid," he said.

That is the thrust behind a new push by medical groups, the Georgia Chamber of Commerce and the Association County Commissioners of Georgia to raise the rates being paid to medical care providers.

Gov. Sonny Perdue put $40 million into his spending proposal for the coming fiscal year to try to increase those payments.

But the calculus for trying to get any spending increases through the General Assembly this year grew more calculated when Mr. Perdue announced Monday that he was reducing the amount of money lawmakers would be allowed to spend in the budget by $245 million.

Mr. Perdue made the announcement after sluggish growth in tax revenues in February that he said might indicate an oncoming recession.

He did suggest ways to trim the budget without cutting into the increased Medicaid payments, and lawmakers say they're determined to try to fit the initiative into the spending plan.

"We're going to figure out how to pass those rate increases through in spite of the reduced revenue estimate by the governor," said Rep. Mickey Channell, R-Greensboro, who heads the House panel that oversees spending on Medicaid.

The formal goal of the ACCESS Healthcare Coalition, the group formed by business, medical and government organizations, is to get the Medicaid rates up substantially over several years. That would end situations where hospitals earn just 84 cents for every dollar they spend on patients with Medicaid.