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.