A special commission that’s reviewing state spending says Iowa should change the way the Medicaid program dispenses drugs — something that’s not being embraced by Iowa pharmacists. The state Program Elimination Commission recommends cutting the amount it pays to fill Medicaid prescriptions. Commission chair Bob Rafferty says the state needs to reign in those costs. He says Iowa has one of the three or four highest rates for filling prescriptions in the U.S. He says the rate should be brought closer to the national average. Rafferty will also recommend the legislature require pharmacists to give out generic drugs whenever possible. Iowa Pharmacy Association spokesman Jerry Karbeling (Car-buh-ling) says that already happens.He says the numbers show a strong move by pharmacists toward dispensing generic drugs. Karbeling says he’s also worried about the proposal to lower the fee paid to pharmacists for Medicaid prescriptions.He says it would hit the rural and underserved areas in small communities the worst, as they could lose their pharmacies. Karbeling says rural pharmacies often have to charge a little more because they have fewer customers to cover the overhead of running their shops. The legislature will consider the commission’s proposal in its next session in January.