ST. LOUIS -- Tension is building over the role and makeup of a state committee set up to keep tabs on Gov. Matt Blunt's new health-care program for the poor.

The group, which debuts today, is charged with overseeing Blunt's transformation of Medicaid into a prevention-oriented system called MOHealthNet.

State law says the committee must "advise and approve" the system's health improvement plans, but Blunt's administration sees a more limited role for the group.

Deborah Scott, director of the Department of Social Services, told the St. Louis Post-Dispatch that the panel was to "give advice on the expansion of new health plans." She said the law went too far by using the word "approve."

Rep. Rob Schaaf, R-St. Joseph, who helped write the law, said it should be read literally.

"When it says 'advise and approve,' that means they can't do it unless we approve it," said Schaaf, one of four legislators on the committee.

But Blunt may get his way, Schaaf said, because the governor "pretty well stacked" the 18-member committee with his supporters.

The governor's spokeswoman, Jessica Robinson, said the committee is diverse by region and experience.

MOHealthNet replaced Medicaid in August. Like Medicaid, the new program pays health-care bills for about 830,000 low-income elderly people, disabled people and some families with children. The state and federal governments share the cost.

Blunt and the Republican-led legislature tightened eligibility for Medicaid in 2005, cutting about 100,000 people, most of them single mothers, from the rolls. Blunt said the program was not affordable without the changes.

This year, the legislature approved the framework for MOHealthNet, which is aimed at promoting healthy lifestyles, providing individualized plans of care and giving every patient a "health-care home."

The committee charged with overseeing the program consists of 11 Blunt appointees; four legislators chosen by House and Senate leaders; and three Cabinet directors from the departments of Social Services, Mental Health, and Health and Senior Services.

The law required that Blunt's appointees include four doctors, two "patient advocates," a hospital official, a dentist, an insurance representative, a public member and a consumer representative.

Schaaf questioned whether some of the members fit those categories.

For example, one of the patient advocates is Joe Pierle, 37, executive director of the Missouri Primary Care Association, which represents a network of community health care centers that primarily serve low-income and uninsured people.

Schaaf, a doctor, has tangled with Pierle's group because the state pays doctors at the nonprofit centers at higher rates than it pays private physicians. Schaaf said that because Pierle represents the centers, he is "certainly biased."

Pierle said he viewed himself as a patient advocate because "we look at ourselves as representing local communities and the patients who receive services."

For the consumer spot, Blunt chose Gwendolyn Crimm, 57, placement coordinator at the Construction Careers Center, a charter school in St. Louis.

Ruth Ehresman, health policy specialist for the Missouri Budget Project, said she had expected that "'consumer' would mean someone who's insured by MoHealthNet."

Crimm said she used Medicaid in the past and has family members on the state program.

The appointments are subject to Senate confirmation.