Florida Gov. Jeb Bush plans to ask the Centers for Medicare & Medicaid Services and his state’s legislature to allow huge changes to the state’s $14 billion Medicaid program, according to a published report. Bush has said he plans to look for “reforms rather than cuts,” but consumer advocates are treating his words cautiously.

Changes could include caps on federal Medicaid funding and expansion of a pilot program that gives beneficiaries responsibility of their own healthcare dollars, according to the South Florida Sun-Sentinel. The state’s Medicaid program is expected to grow by 20% next year after five years of 12% annual grown, the newspaper reported.

Bush and his advisors say they are still gathering input from stakeholders and will not unveil reform ideas until next year out of concern that early opposition would mount, the newspaper said.