Florida Gov. Rick Scott, one of the most vocal critics of the federal health care overhaul, is dropping his staunch opposition to the law.
Scott said in an interview Tuesday with The Associated Press that he now wants to negotiate with the federal government. He said it's time for Republicans to offer solutions to help families after they lost their bid to defeat President Barack Obama.
"The election is over and President Obama won," Scott said. "I'm responsible for the families of Florida ... If I can get to yes, I want to get to yes."
Scott had previously stated that he would not go along with any parts of the health care overhaul that the state controls.
But his newfound willingness to have a "conversation" about putting it in place in Florida comes at a critical time.
States have until Friday to notify federal authorities whether they plan to set up health insurance exchanges, a marketplace where individuals and smalls businesses can shop for the most affordable coverage and where many will get help from the government to pay their premiums.
Florida so far has taken no steps to set up its own exchange.
Health and Human Services Secretary Kathleen Sebelius announced an extension last week. She still wants to hear if states will be setting up health insurance markets under the law. But governors can now take another month, until mid-December, to submit detailed blueprints.
Most states have been on the fence awaiting the election outcome. They now have three options: running their own exchanges, operating an exchange in partnership with the federal health officials, or letting the feds handle everything.
Scott said he still has concerns about the exchanges, including the cost of running one and whether it would increase the cost of health care for families. But he said he's sure federal officials want to find ways to provide affordable health care to people.
"I don't think anyone involved in trying to improve health care should say `no, no, no," said Scott "Let's have a conversation."
Scott's willingness to discuss the issue with federal officials in Washington aligns him closer to some other Republican leaders in Florida.
Incoming Florida House Speaker Will Weatherford, for example, said the state may be willing to set up an exchange if it gets some better answers from Washington about how they will work.
Weatherford said that in the short term the state may have to default to the federal government but he is leaving open the possibility that could change.
"To me Florida should control its own future," Weatherford said.
Scott made his fortune as a health care executive and once ran the nation's largest hospital chain. He made his first foray into politics by forming a group called Conservatives for Patients' Rights that ran TV ads criticizing health care reform before it was adopted by Congress.
Florida led the legal battle to stop the health care overhaul and shortly after the U.S. Supreme Court upheld the law Scott said that the state would not implement the exchanges or expand its Medicaid program to enroll more people in the program.
Florida had the nation's third-highest rate of residents without health insurance during the past three years, according to Census data released last year.
But the state also has some of the most stringent eligibility requirements in the country for Medicaid.
A family of three with income of $11,000 a year makes too much and single residents are not covered. The Obama administration wants those requirements loosened so that an estimated 2 million uninsured Floridians could be covered by Medicaid. But experts don't believe all those eligible will participate. Feds will pick up 100 percent of the tab for the first three years and at least 90 percent after, along with extra funding for technology costs.
Florida's Medicaid program currently costs more than $21 billion a year, with the federal government picking up roughly half the tab. It covers nearly 3 million people -- about half are children -- and consumes about 30 percent of the state budget.
Advocates who favor expanding the Medicaid rolls say it will save money in the long run by deterring people from emergency rooms -- the most expensive, least effective place to treat people.
The issue has been predictably polarizing with conservative groups urging states to dig in their heels and fight federal implementation.
"Governors should join the growing chorus in sending a strong message to Washington that their states will not implement these flawed health insurance exchanges" said Nicole Kaeding of Americans for Prosperity. "Exchanges raise prices on consumers and increase taxes on hardworking families.