That delicate balance is now at risk. Congress began its budget reconciliation process on Feb. 25, and Medicaid is in their crosshairs. Any changes will inevitably trickle down to Florida, so will state lawmakers’ response be nimble enough to avoid leaving federal dollars on the table?

A budget blueprint approved by the House this week is expected to cut billions in federal Medicaid spending as part of a plan to help renew and fund new and existing tax cuts. Republicans in Congress say there won’t be direct cuts to the millions of low-income adults and children in the U.

Florida doesn’t have as many residents on Medicaid as it could because it hasn’t implemented an Obamacare provision that would allow more low-income people to enroll in the program. Even so, Floridians could be affected by cuts to Medicaid, which is funded jointly by the state and federal government.