HARRISBURG -- Gov. Ed Rendell is warning the state's congressional delegation that the state will face serious budget consequences if Pennsylvania doesn't get an additional $850 million in federal Medicaid assistance.

He wrote to members of the U.S. Senate and House last week, urging them to approve a six-month extension of the American Recovery and Reinvestment Act to give Pennsylvania the additional federal stimulus funds for medical aid to low-income people. Other states also would benefit from the extension.

As of now, the stimulus money is due to expire Dec. 31. Mr. Rendell, along with 46 other governors, is trying to get a six-month extension, until June 30, 2011, the end of the state's fiscal year.

Mr. Rendell has proposed a $29 billion spending package for the upcoming fiscal year, which starts July 1. His budget proposal, which still needs General Assembly approval, counts on receiving the additional $850 million from the feds.

Without it, he warned, there will be a number of negative consequences:

• Eliminating of some state aid to 90 percent of the hospitals in the state, including "the 189 hospitals that care for the most indigent" people and eliminate of payments for uninsured people.

• Cutting 25 percent of the funds that go to all 67 counties for child welfare services, which he said would "leave thousands of children without protection from abuse, as well as cut services for persons with mental retardation and mental health services." That could affect 162,000 state residents.

• Eliminating all state-funded services for substance-abuse programs and services for the homeless, and reducing state social services for up to 500,000 poor adults and families.

• Cutting in half state funds for domestic violence and rape crisis services, affecting at least 100,000 people.

• Reducing by 6 percent the reimbursements paid to doctors, labs and hospitals for Medicaid services, plus cuts in funds paid to people caring for those with special needs, such as autistic people or very young children.

• Reducing by 18 percent the reimbursements paid to nursing homes, plus cuts to home-care and community-care providers.

"The impacts would be severe in terms of both job losses and the delivery of health and human services," Mr. Rendell said.

Even if the additional $850 million in federal funds is approved, a budget fight is still expected between Democrat Rendell and the Republican-controlled Senate. Many GOP legislators seek to reduce his $29 billion budget proposal by up to $1 billion, since state revenues in the current fiscal year are already coming in more than $700 million below estimates.

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