Florida ? Gov. Jeb Bush signed into law Friday the nation’s most sweeping overhaul of Medicaid, a measure that would shift many of Florida’s recipients into private managed care to help curb the rising costs of health care for the poor.

Bush called the legislation “the single biggest change and the boldest reform that any state has embarked on for the Medicaid program.”

Under the plan, Medicaid recipients in some counties will choose a managed care group to coordinate their care. The government will pay a premium to the group. Companies will get more money for sicker patients.

The changes will take effect in Broward and Duval counties and will later be phased in statewide. Several states have experimented with moving Medicaid patients into managed care plans, but none has overhauled an entire system as Bush envisions.