The next two years of federal Medicaid cuts will chop at least $150 million out of health care, affecting 1 out of 5 every  Hawaii residents, and state legislators are looking for an additional $30 million in savings, the head of the state Department of Human Services told groups attending simultaneous town hall meetings last night.

The loss of state and federal money for Quest and QExA over the next two years "will have an impact on the community, there’s no doubt about that," Patricia McManaman told about 75 people at the Waianae Coast Comprehensive Health Center in a presentation that was also seen via video conference in Waimanalo and Koolauloa.

"Any further additional cuts, as proposed by the Legislature, will clearly eviscerate Medicaid. … It’s a difficult task emotionally because we have an acute sense of the impact," McManaman said.

She said she wanted to hear ideas last night about where to cut.

Instead, she heard speakers plead not to reduce funding for Quest and QExA — while warning about the dangers of health care cuts to patients.

"There’s plenty of people out here on the Waianae Coast who won’t be taken care of," said Feiruz Garrison of Waianae. "Who’s going to monitor these patients that are running up and down the streets and are not being watched out for? … Who’s going to take care of me when I’m flipping out?"

McManaman urged residents to lobby their state lawmakers to back off on the $30 million in additional cuts "to let them know that the community cannot sustain further cuts to Medicaid."

But the $150 million that will be lost over the next two years will be absorbed by everyone involved with Quest and QExA, McManaman said.

Quest helps low-income families while Quest Expanded, or QExA, focuses on the elderly, blind and disabled.

"We understand that the burden cannot be borne solely by the recipients," McManaman said. Health care providers and insurance providers also "will be asked to give up a little."

Human services officials have no firm proposals for absorbing the cuts, said Dr. Kenneth Fink, administrator for the Med-Quest Division.

"We’re trying to figure out how to minimize that impact," he said.

But looking at the options, Fink said, "none of them are very attractive."

In an interview with the Star-Advertiser, Richard Bettini, president and chief executive officer of the Waianae Coast Comprehensive Health Center, said human services officials suggested to him that they are considering limiting doctors’ visits and reducing drug benefits, which Bettini said will adversely affect patients with chronic and serious ailments. McManaman told the audience that DHS officials are considering capping doctors’ visits at 24 per year.

"We’re playing with the numbers, talking to the actuaries," she said.

The Waianae Coast Comprehensive Health Center treats 28,000 patients each year, of whom 15,000 are on Quest, Bettini said.