Susan Howe had planned a career in nursing before she was raped a decade ago. She later tested positive for HIV and now takes 18 medications a day.

A six-drug limit Gov. Ed Rendell proposed for the state's Medicaid program would be devastating for her.

"It would be very difficult for me to decide which drug I'm going to live without," Howe, 60, of Park Place, said yesterday in Shadyside at a rally against the proposed cuts.

Other speakers at the rally, sponsored by the Consumer Health Coalition, echoed her concerns. But to some extent, they already have been heard.

The governor now wants to use $150 million in surplus funds to avoid the limits he proposed early this year on prescription drugs, hospital stays and outpatient medical services. State lawmakers also are working to avoid those cuts and others in the 2005-06 state budget.

"Certainly, the momentum is moving in that direction," said Erik Arneson, chief of staff for Senate Republican leader David Brightbill of Lebanon.

The deadline for adopting a budget is tomorrow, but lawmakers often continue discussions into July.

While they want to soften the impact of the proposed cuts, Republicans and Democrats have not agreed on details.

Rendell and fellow Democrats generally have made a priority of lifting the proposed caps on drugs and other consumer services.

"Right now in our caucuses, lifting those caps is our primary goal," said Lawrence Clark, senior policy analyst for House Democratic Whip Mike Veon of Beaver Falls.

But Republicans, who control the Legislature, also are concerned about the effects of those and other Medicaid cuts on health care providers.

"Our priority has been to ensure the fiscal health of our hospitals," Arneson said.

For industry officials, a major concern has been a proposal that would eliminate supplemental payments to hospitals serving large numbers of poor people if their income exceeds their operating costs by more than 1 percent.

Arneson said that proposal will probably not be included in the budget, and neither will limiting Medicaid payments to a maximum of two hospital visits a year.

Those provisions alone would cost hospitals more than $300 million a year, said Paula Bussard, a senior vice president for the Hospital and Healthsystem Association of Pennsylvania.

Proposed limits on outpatient care and prescription drugs also may be lifted, Arneson said.

One provision that likely will remain in the budget, he said, would require some families to share in the cost of caring for their disabled children. Families would pay on a sliding scale based on income and family size.

While using some of the surplus to offset the cuts is "very likely to happen," Arneson said other potential funding sources are being explored, including interest the state earns from a settlement with tobacco companies.

Republicans also may identify funds by scaling back some of Rendell's spending proposals in other areas of the budget, he said.

Kate Robinson, executive director of the Consumer Health Coalition, said lawmakers should consider a tax on smokeless tobacco.

To remind lawmakers of the importance of Medicaid to many consumers, she said photos and comments from yesterday's meeting would be sent to them in Harrisburg.

In a resolution unanimously approved yesterday, Pittsburgh City Council urged that Medicaid cuts be avoided, noting that they would limit access to health care and adversely affect health care providers and other businesses.

Tom Andrews, press secretary for House Democratic leader H. William DeWeese of Waynesburg, said fully restoring funds to consumers and providers is unlikely, noting the cost of doing so could exceed $400 million.

Rising health care costs and federal budget cuts likely will make closing the budget gap a challenge next year as well, he said.