ATLANTA — Gov. Nathan Deal presented Georgia lawmakers with a wide-ranging but cautious agenda Thursday, asking the new General Assembly not to diverge from the path set during the Republican governor’s first two years in office.

“We have made communities safer, improved educational opportunities, provided for infrastructure improvements, driven workforce development, generated a better business environment and created jobs,” Deal said during a 30-minute State of the State Address.  “I challenge you to join me as we go forward with a focus on progress.”

The Republican governor’s priority list, presented to a joint session of the House and Senate, includes public safety, education, health care and economic development, all pursued within tight financial constraints.

He presented a budget proposal that would trim most state agencies’ budgets but cover higher costs from increased enrollment in K-12 schools. The latter detail is called for under the state’s school financing formula. Deal also emphasized new money to return pre-kindergarten programs to a full 180-day calendar, after cutbacks in lean budget years.

The governor urged lawmakers to ratify his plan for an appointed state health policy board to assess fees on Georgia hospitals as a way to avert steep cuts to the Medicaid health insurance program for low-income residents, most of them children or disabled adults. That plan would replace a direct tax that expires at the end of the current fiscal year.

The Senate approved the plan — which is designed to spare lawmakers from having to vote explicitly on renewing a tax — in a 46-9 vote about four hours after Deal concluded his remarks.

Deal said the threat of Medicaid payment cuts to hospitals and other health care providers is dire. Still, he stood by his decision not to accept federal dollars to expand the Medicaid program to cover thousands more individuals and families, as part of President Barack Obama’s 2010 health insurance overhaul. Deal maintains that the state cannot afford its future share for expanding eligibility, though part of current Medicaid expenditures involves paying hospitals to treat uninsured patients who would become insured under an expanded Medicaid program.

Rep. Stacey Abrams, the Democratic majority leader, said getting more of the uninsured enrolled in Medicaid would produce long-term savings.

“Every child, every parent, every citizen who can get preventative care becomes someone who’s not in our emergency room, someone who doesn’t have diabetes that goes out of control, and so I think it’s incredibly important that if we are going to think like a business that we invest in the long-term return... that is, good health care in the state of Georgia,” Abrams said in an interview after Deal’s speech.

The new fiscal year begins July 1. Legislators will debate the budget in the coming weeks of a session that is expected to last until early or mid-April.

The Deal administration is backing proposals from a juvenile justice commission to increase financial support for and emphasis on community programs intended to divert minor offenders from imprisonment in the adult system. Deal said the plan tracks previous sentencing changes and other policy shifts in the adult criminal law system.

Meanwhile, he said, lawmakers should reduce the blood-alcohol level that triggers a citation for boat operators from 0.1 percent to .08 percent. “If you’re too drunk to drive an automobile, then you’re too drunk to drive a boat,” he said. That policy proposal follows an increase in boating accidents and fatalities on Georgia waterways.

Deal reserved perhaps his most spirited tone to discuss ethics, though he offered no specific policy proposal. House and Senate leaders are embroiled in a back-and-forth over how to tighten regulations on who must register as a lobbyist and how much those registered individuals can spend on interactions with elected officials.

“There will always be those in the media and elsewhere who thrive on sowing the seeds of doubt and distrust and who will never recant their sinister innuendos and malicious accusations even when they are vanquished by truth,” Deal said. “And while you will never silence those voices of discord, nor should you try to do so, you can bolster the confidence of the public that might be tempted to listen to them by simply establishing clear rules under which you and those who deal with you in your capacity as elected officials must operate.”

Deal agreed last year to pay $3,350 to settle three ethics complaints filed against him over his 2010 gubernatorial campaign. The state ethics commission also dismissed four additional complaints against him.

Before he was elected governor, Deal was the focus of an investigation by the Office of Congressional Ethics. The review focused on his meetings with the state’s revenue commissioner to preserve a lucrative arrangement with his Gainesville auto salvage business. A report released in 2010 by the independent, non-partisan entity said Deal may have violated House rules. But he left Congress before any action could be taken and he was never charged with any wrongdoing.

Deal praised Georgia voters for approving a 2012 constitutional amendment that will result in more independent public charter schools. “The message they sent was this: They are not satisfied with the status quo. And neither am I,” he said.

The governor’s education agenda this year, however, is relatively thin. Besides the pre-kindergarten boost, his budget adds money to the HOPE scholarship program. But his agenda does not include any policy favorites of the school-choice movement that has pushed private-school tuition vouchers and charter school expansion. Deal said he wants Georgia to continue to monitor progress under curriculum tweaks and other policy changes — many of them part of winning federal grants from the Obama administration.