MONTGOMERY (AP) — Alabama Gov. Robert Bentley says Medicaid’s shift to managed care will be pushed back from July to October amid uncertainty about funding and what changes the Trump administration might bring to Medicaid.

The governor, a licensed doctor, said he is committed to moving forward with the switch to managed care, but said there are a few unknowns, including funding for next fiscal year and if the Trump administration will give states block grants allowing more flexibility to write the rules for their programs.

“The election changed things, but I think long-term funding is the real issue,” Bentley said this week. The brief delay, Bentley said, will allow the state to continue working on getting the program ready. “I believe a managed care system based on outcomes rather than on fee-for-service is the best way to go for our Medicaid patients.”

Alabama since 2013 has been working on a plan to shift some of the state’s 1 million Medicaid patients to managed care provided by Regional Care Organizations. The idea is managed care will, for example, make sure patients get check-ups and preventative care, and limit expensive medical emergencies and emergency room visits, down the line.

But it hasn’t been smooth sailing for what was dubbed the “transformation” of Medicaid.

The RCO’s which would manage patients’ care, were originally supposed to begin work on Oct. 1, 2016, but were delayed amid state budget concerns.

The plan hit “rough waters” when three of 11 RCO’s withdrew, said Jim Carnes, policy director at Arise Citizens’ Policy Project, an advocacy group for the state’s poor.

The change in the administration adds to the uncertainty, he said. Carnes said he is pleased the state will keep pushing forward, saying “the emphasis on preventive and primary care is the future of health care.”

“We’re just very glad at this point that there’s still seems to be a critical mass in favor of moving forward. We regret there has to be further delay. We’re eager to get started, but if that what it takes to maintain the commitment, that’s great,” Carnes said.

Alabama in its agreement with the federal government, promised to adequately fund Medicaid to make sure patients weren’t being shortchanged with the switch to managed care.

That funding appears to be the key question. Lawmakers will begin work on Medicaid’s 2017-2018 budget when the legislative session begins in February.

“The ability for us to implement them is questionable,” said Trip Pittman, chairman of the Senate budget committee. “We are still in a very difficult situation financially on the general fund side,” Pittman said.

Some lawmakers urged the governor to hit the pause button.

Sen. Bill Holtzclaw, the chairman of the Legislative Contract Review Committee, sent Bentley a letter this month asking him to delay signing a $1.3 million contract for the legal advice for the care organizations.

“While the RCO concept was widely supported and enacted by the Legislature, the increased costs associated with the program were not made apparent at the time,” Holtzclaw wrote in the November letter.