MIAMI (AP) — More than three million Medicaid recipients around the state are transitioning into managed care under Florida’s massive overhaul to privatize its Medicaid program.

The change comes three years after the Legislature voted to privatize the program, saying the roughly $23 billion a year bill was consuming the state budget. Enrollment for the majority of Medicaid recipients, more than half of whom are children, started in Miami-Dade, Broward and Monroe counties Tuesday and has already completed in 54 of 67 counties. The long term care population, which includes those 65 and over who reside in nursing homes, recently completed enrollment.