JEFFERSON CITY - The Missouri Senate advanced a bill Monday that would reduce in-home services for those on the state's Medicaid program, over the objections of some Senators who said it would cut benefits without saving money.

Legislative staff estimated the bill, as written, would save the state $11 million in 2011. Sen. Tom Dempsey, R-St. Charles, who sponsored the bill, said this would be achieved in part by reducing reimbursements to those on Medicaid and allowing the state to privatize its assessments of who is eligible for in-home health care. Currently, the state's health department is responsible for all assessments.

As of September, 42,827 Missourians on Medicaid received some kind of in-home health care treatment.  Dempsey said reducing services is just one step towards balancing the state's budget, a process he said Gov. Jay Nixon made more painful.

"The governor's lack of a blueprint is why we got to where we are," Dempsey said.

Sen. Wes Shoemyer, D-Clarence, said he questioned whether the move would even save the state money. He added that privatizing in-home assessments would be damaging to a state workforce that he said is already underpaid and underappreciated enough.

"We are in some pretty tight budgetary times and some sacrifices need to be made by all people," Shoemyer said. "The last people that should have to sacrifice are our state employees."

Sen. Chuck Purgason, R-Caulfield, one of the state's leading deficit hawks, said he supported the bill, but said additional cuts need to be made across the state budget in order for cuts to be effective.

"When you talk budget, everything needs to be on the table," he said. "Everyone needs to feel the pain."