The rejection surprised lawmakers, who now say they will retool the plan "first thing" during the 2008 legislative session, which begins in January.

But even then, federal approval could take six to nine months. That means another year without eyeglasses and contact lenses for the elderly, disabled and poor, say low-income advocates, who want the problem remedied now.

"Five years is a long time to go without updating your prescription," said Bill Tibbitts, Anti-Hunger Action Committee Director.

Medicaid vision benefits were cut in 2003 following a statewide recession; advocates have been fighting to restore them ever since.

Last winter, lawmakers agreed to spend $174,000 of the state's budget surplus on vision. The plan, as spelled out in intent language in the budget bill, called for contracting with an eye-care company under a managed-care arrangement.

Reached late in the session, the plan aimed to spare taxpayer dollars by charging beneficiaries a $10 co-payment. But that was rejected by the federal government, which sets the bar at $3.

The Deficit Reduction Act gave states more flexibility for crafting their Medicaid programs, but not for populations that fall below the federal poverty level, said state Medicaid Director Michael Hales. "There was some confusion about this," he said.

Hales asked legislative budget leaders for permission last week to use the budgeted money to provide eye care the traditional way, with a smaller co-payment.

But Sen. John Valentine, R-Orem, said the Executive Appropriations Committee doesn't have the authority to override a decision made by the full body of the Legislature.

"The statute does say what it says," said Valentine. "We have to get back into session to change the statute."

Advocates argue, however, that health officials have the power to spend the money as they see fit.

"Intent language is not binding in the same way that other parts of a statute are," said Tibbitts. "The governor should be able to authorize health officials to proceed as close to the spirit of the intent language as possible. Otherwise you'd need to have a special session every time the anticipated price for purchasing land for a road or certain building supplies changed in some way."

Gov. Jon Huntsman Jr.'s legal advisers, however, believe intent language is binding, said the governor's spokeswoman Lisa Roskelley. The governor has no plans to call a special session to make changes before January, Roskelley said.

kstewart@sltrib.com