TOPEKA, Kan. (AP) — New budget-balancing proposals from Kansas Governor Sam Brownback would require hospitals to pay higher fees and capture savings from companies managing the state’s Medicaid program.

The Republican governor outlined proposed budget adjustments Thursday before a meeting of the House Appropriations Committee.

One proposal would require hospitals to pay an additional $19 million in fees during the fiscal year beginning July 1st. The fees help sustain the Medicaid program’s health coverage for 368,000 needy and disabled Kansas residents.

The state uses revenues from the fees to attract federal dollars that go back to the hospitals for caring for Medicaid participants.

Other proposals reduce projected Medicaid spending by almost $33 million between now and the end of June 2016 to reflect lower payments to the three health insurers managing the program.