Doctors and advocates suing the state used Florida officials' own words against them during opening arguments of a trial Monday by playing video clips of top health officials lamenting health care delays for Medicaid patients.

"The biggest problem our agency faces is access to specialty care for Medicaid recipients," former Florida health secretary Dr. Andrew Agwunobi said at a Medicaid conference in 2007.

He gave examples of children going to emergency rooms with broken bones unable to find orthopedic surgeons accepting Medicaid calling them "unacceptable delays." But a year later, during a deposition for a class-action lawsuit claiming about 1.2 million children on Medicaid are not getting access to critical medical care, Agwunobi repeatedly said he couldn't recall making those statements.

The suit, filed four years ago against the Department of Children and Family Services, the state Health Department and the Agency for Health Care Administration, claims 390,000 children did not get a medical checkup in 2007 and more than 750,000 received no dental care as reimbursement rates are among the lowest in the country.

Twenty of Florida's 67 counties have fewer than two dental providers for medicaid patients, according to AHCA's 2007-2008 budget request to increase reimbursement rates.

In 2005 e-mail former AHCA Secretary Alan Levine said "We have a system that is growing by-double digits, where providers are paid less and less each year. Access is limited, outcomes are not measured. ... I'd say that's a bad system."

The state's attorney, Marcos Jimenez, said Agwunobi's speech was referring to the entire state's Medicaid program, not just children's Medicaid. He said the entire country has a serious problem with access to health care, not just Florida.

The state has argued that the children and health providers don't have legal standing to pursue the claims because the Medicaid program promises money but not necessarily the delivery of health services, as the lawsuit contends.

If the plaintiffs succeed, it could cost Florida taxpayers tens of millions of dollars, but their attorneys argue it will save the state money in the long run by avoiding costs for children who didn't get adequate care early on. A mediation attempt earlier this year failed.

Rita Gorenflo, a former emergency room nurse and adoptive mother of seven children, said she joined the lawsuit after heartbreaking nights of comforting children who were in pain, but couldn't get in to see a doctor.