It starts with a trim to reimbursement rates, which individuals might not see or feel directly. Suddenly a nursing home goes from getting $200 a day per patient to, say, $185, and at the same time, the facility is bound by regulations to keep the same staffing standards.

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.

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.