They are calling it a life and death situation for thousands of South Dakotans.
Democrats are turning up the heat on the governor and other Republican lawmakers to sign onto the Affordable Care Act. In fact, democrats say it's their number one budget priority for the next legislative session.
Democrats estimate that 48,000 South Dakotans are uninsured and thousands more can't get adequate health care coverage. That's why they want to expand Medicaid in the state.
"Every once in awhile, a real opportunity comes along, with all my heart I believe this is a real opportunity," State Representative Suzy Blake of Sioux Falls said.
The Affordable Care Act also known as Obama Care will provide $2 billion over the next ten years to help those people get coverage.
"The federal government is offering 100 percent of coverage to those newly eligible people, which means they would put in 200 million a year, we put in nothing for the first three years, nothing," Blake said.
But according to the Center on Budget and Policy Priorities, the state would eventually have to pay nearly $16 million a year. Republican State Senator Deb Peters sits on the Appropriations Committee and says it's premature to talk numbers right now.
"We don't know how many individuals if we do expand Medicaid benefit on the federal guidelines, we don't know how many folks that's going to be, we've heard 48 thousand, but we don't have anything definitive," Peters said.
Peters says once the governor gives his budget address and announces how much money is available to the state, lawmakers can begin to set priorities.
"Until we know exactly what the parameters are, I think it's too soon to jump on board yet and until we have the whole story and all of the information not only federal guidelines," Peters said. "But also the information from the executive branch, I think that's when we can make the decision what our plan should go from."
The governor will give his state budget address on Tuesday.