CHARLESTON, W.Va. -- Soaring Medicaid costs will be the 800-pound gorilla in the state's $4.55 billion 2012-13 budget, Tomblin administration officials warned Wednesday.

With a decline in federal Medicaid funds from a 4-to-1 to a 3-to-1 match of state dollars, and with federal health-care mandates that will add 170,000 West Virginians to the health-care coverage for the poor, elderly and disabled, Medicaid will require $111 million of new funding in the new budget, to a total of more than $500 million, and will be a prime contributor to a projected $389 million budget shortfall in the 2013-14 budget, Tomblin aides advised.

"Fundamental adjustments, changes will have to be made in Medicaid, or all our money's going to end up there," state budget director Mike McKown warned during a budget briefing Wednesday.

Growth in Medicaid funding aside, the proposed 2012-13 budget includes only about $15 million of spending increases over the current state-spending plan.