Florida Governor Rick Scott backed a limited expansion of healthcare coverage for the poor on Wednesday, joining six other Republican governors who have agreed to the measure under President Barack Obama’s landmark reform law.

Scott, a wealthy former healthcare executive and vocal critic of the law known as Obamacare, had balked previously at expanding Medicaid.

His surprising about-face, seen by some as a crucial turning point in Republican opposition to the Affordable Care Act, came after the federal government granted Florida a conditional waiver to privatize Medicaid statewide.

Scott made the announcement at a news conference at the governor’s mansion in Tallahassee, where he said he would only agree to the expansion for three years while the federal government picks up all the costs.

The legislation would sunset after three years and need to be reauthorized, he said.

“Expanding access to Medicaid access services for three years is a compassionate, common sense step forward,” said Scott, reading from prepared remarks.

“It is not the end of our work to improve healthcare. And it is not a white flag of surrender to government-run healthcare,” he said.

Scott joins fellow Republican Governors Rick Snyder of Michigan and John Kasich of Ohio in making Medicaid expansion announcements this month. The Republican governors of Arizona, Nevada, New Mexico and North Dakota had previously said they would expand the program.

Scott got his start in politics by forming a group called Conservatives for Patients Rights to campaign against Obama’s healthcare reforms in 2009. In June last year the U.S. Supreme Court rejected efforts led by Florida and 25 other states to have Obama’s healthcare law declared unconstitutional.

Scott’s conditional agreement to expand Medicaid in Florida, a move that officials have said could add about 1 million people to the state’s Medicaid rolls, must still be approved by the Republican-dominated Florida Legislature. About 3.8 million Floridians have no health insurance, according to the health insurance industry.

Such approval seems far from certain. House Speaker Will Weatherford said the whole idea of expanding “a challenged system” through federal funding required “a big leap of faith” in Washington.

“The money is coming from a government that is having problems balancing its own budget every year - they’re about to have a debt-ceiling debate in the coming days to determine if they can pay their bills,” Weatherford said.

Medicaid primarily provides healthcare for U.S. citizens or legal residents with low incomes or certain disabilities.

Republican lawmakers have warned in the past that Medicaid’s annual costs, which they estimated to total $21 billion in the fourth most populous U.S. state, were putting too much of a burden on Florida’s budget.

That is why Scott proposed a privatized or managed care plan for Medicaid recipients to save money. Introduced through a pilot program in five Florida counties, the managed care program has faced criticism for problems including limited access to care, limited doctor participation and excessive red tape.

But the U.S. Department of Health and Human Services granted a conditional waiver to Florida on Wednesday, hours before Scott’s news conference, permitting the use of private managed care plans using public dollars on a statewide basis.

Healthcare advocates are reserving final judgment on the privatization plan. But they say some of the worst problems with the managed care program appear to have been addressed.

“Consumer health advocates have fought hard to ensure that access to care and consumer protections remain a top priority,” the Community Health Action Network, one statewide group, said in a news release.

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By Bill Cotterell