House Republican leaders say as a last resort they’ll raise the cigarette tax to bail out the snowballing state Medicaid budget that provides government-paid health care to the poor and elderly. House Speaker Christopher Rants, a republican from Sioux City, acknowledges the state Medicaid budget will run out of cash in the spring of 2005. But raising the state tax on cigarettes and other tobacco products — as was recommended by a Medicaid task force — is not the answer, according to Rants. Rants says he was disappointed that raising taxes was the only solution the task force offered. “I think you have to look first and foremost at controlling costs before you ask the taxpayers to pay more,” Rants says. Prescription drug costs are the single largest expense in the Medicaid program, and Rants says he’s convinced there are ways to find ways to save money. For example, he suggests requiring Medicaid recipients use generic drugs to fill prescriptions.