State House hearings begin at 10 a.m. today on an agreement that would release the state from long-standing federal mandates for government-financed health care for 180,000 elderly, poor and disabled Rhode Islanders.

Today’s hearing on the Medicaid “waiver” agreement, to be held before the House Finance Committee in Room 35, is open to the public and is expected to be well attended, said House spokesman Larry Berman.

Governor Carcieri, who is scheduled to testify in favor of the plan, has said the state’s Medicaid program is too expensive and needs to be overhauled to help balance the state budget.

Opponents say the agreement, which includes a five-year cap on Medicaid spending, could lead to people being denied needed health-care services, and cost the state more in the long run if spending exceeds the levels anticipated.

Joan Alker, deputy executive director of the Georgetown Center for Children and Families, said the waiver is a “high stakes gamble” given Rhode Island’s high unemployment rate, deep-ening recession and escalating health-care costs.

No other state has agreed to such a cap on virtually its entire Medicaid program, according to a new report coauthored by the Georgetown Center and the Center for Budget and Policy Priorities. The report says that Rhode Island’s waiver agreement is “a bad deal for the state” because it fails to take into account the impact of the recession.

The five-year cap on federal funds is “too low,” which means the state will likely have to cut benefits, provider payments or eligibility to stay within the cap, the report said.

The agreement comes as the federal government is about to release an economic recovery package which is expected to bring $500 million to $600 million in federal Medicaid funding to Rhode Island over the next two years –– “far more than any short- term gain the state might get from the waiver,” according to the report.

The report’s coauthor, Judy Solomon, a senior fellow at the Center on Budget and Policy Priorities, said the state “should step back and consider other options before locking the state into a financially risky deal with the outgoing Bush administration.”

The Medicaid waiver, first announced in April, was approved by federal officials on Dec. 19. State lawmakers have until the end of next week to decide whether to rescind the agreement or allow it to become law.

Representatives from nursing homes and advocates for the poor and disabled are among those who are expected to testify against the plan.

Medicaid, which provides health-care coverage to 180,000 Rhode Islanders, cost about $1.8 billion in state and federal funds and represents about 27 percent of the state budget.

The state Department of Human Service’s director, Gary Alexander, is expected to present details of the waiver plan at today’s hearing.

larditi@projo.com