Some optional programs such as vision care, physical therapy, and speech and hearing would disappear, and an average 2 percent increase in provider inflation, which took effect in July, would be rolled back.

Qualifying for help also could become tougher. Pregnant women, except for those who are high risk, would see the amount of assets they can have drop to $3,000 from $5,000.

State Medicaid Director Michael Hales acknowledged some of the proposed changes could prompt a cost shift, putting pressure on premiums for the privately insured.

“Some cuts are better than others,” said Lincoln Nehring, of the Utah Health Policy Project. “Programs that help low-income Utahns get health care, keep housing, to put food on the table, are in great demand in times like this.”