Louisiana's Medicaid program is more than $250 million over budget this year, as swine flu made costs rise and Medicaid rolls grew amid the national recession, the state health secretary said.

Health and Hospitals Secretary Alan Levine said Thursday he'll give lawmakers on Monday a formal estimate of the midyear deficit for the $6.5 billion program that cares for the poor, elderly and disabled, but said it is "well in excess of $250 million."

The shortfall will have to be closed before the 2009-10 fiscal year ends on June 30.

Levine said swine flu cases have caused more than $100 million of the deficit, driving up emergency room visits, trips to the doctor's office and medication needs _ and, therefore, billing costs in the Medicaid program.

In addition, the economic downturn has pushed thousands of new people onto Medicaid for health care, with more than 20,000 new recipients added since July.

Millions of dollars in planned cost-cutting moves also took longer to begin than Levine had hoped, he said. For example, cuts to the rates paid to doctors and hospitals who care for Medicaid patients were delayed by a month because of the bureaucracy for making rate changes.

Levine said he hopes to have a plan for closing the gap and making budget cuts by Monday.

Medicaid, a government-run insurance program, is funded with a mix of state and federal dollars.

This year's deficit, though significant, is far less than the more than $600 million shortfall projected for next year, when the federal government's share of Louisiana's Medicaid costs is expected to drop significantly due to adjustments in the funding formula. Levine has been warning that could be devastating to the program and force the elimination of services.