"He's a very good communicator," said Lt. Gov. Casey Cagle, a Republican. "He lets us know the strategy, and he's willing to take other viewpoints in order to make it something we can all be comfortable with."

Medicaid, meanwhile, also provided Deal with an opportunity to assuage tea party conservatives who might otherwise mistrust an establishment politician who was elected to the General Assembly and Congress as a Democrat.

Under the 2010 health care law, Washington would pay 100 percent of the costs of expanding Medicaid from 2014 to 2016. The federal share would gradually decrease to 90 percent by 2020, with the states paying the remaining 10 percent. The law could extend health coverage to hundreds of thousands of Georgians who lack it.

But Deal joined other Southern Republican governors in steadfastly refusing to expand Medicaid, saying it would cost the state too much down the road. Since his announcement, several GOP governors have backed the Medicaid expansion, saying it's a good deal for their states.

Deal also has declined a second anchor of Obama's new law: state-run insurance exchanges where consumers can shop for policies from private insurers. He has left it to the federal government to craft and run the Georgia marketplace.

Those stands earned Deal a "constitutional defender" award from the Atlanta-based Tea Party Patriots.

"Governor Deal stood strong," said Atlanta tea party organizer Debbie Dooley. She added that she "visited with him personally" this week after Ohio's Republican governor agreed to expand Medicaid.

Added Dooley: "He assured me we weren't going down that road here."