Indiana's Medicaid program spends nearly $6 billion a year to help about 1 million Hoosiers with health-care needs ranging from childbirth to nursing home care.

Others contend it is the stingiest -- and among the worst overall -- in the U.S., denying thousands of Hoosiers coverage they could get if they lived in many other states.

But advocates for the poor, elderly and disabled say there is little room to trim without cutting off critical lifelines for needy and deserving Hoosiers.

"How a society, how a state addresses its less fortunate tells a lot about the morality of that state," said Eleanor Kinney, co- director of the Hall Center for Law and Health at Indiana University School of Law-Indianapolis.