A varied group of organizations and individuals on Tuesday urged Gov. Bobby Jindal to agree to the Medicaid expansion included in the federal health care overhaul.

“Medicaid expansion could provide health coverage to 400,000 Louisianians, most of whom are currently uninsured, and bring in billions of new federal dollars. It will benefit Louisiana’s families, businesses, health care providers and the economy — all at little cost to the state budget,” the open letter to Jindal said.

Jindal — like other Republican governors — has consistently declined to embrace the key part of the Affordable Care Act, referred to as Obamacare. He claims it would be too costly for the state in the long run and there is not enough flexibility to design a program that meets state needs.

But Republican governors of Ohio, Arizona, Nevada, New Mexico and North Dakota have altered their positions in recent days and announced their states would expand the Medicaid program to cover more working poor people.

When he made the announcement, Ohio Gov. John Kasich said: “Ohio taxpayers dollars are coming back to Ohio to support a significant need we have.”

Arizona Gov. Jan Brewer, who has clashed publicly with the Obama administration, also cited loss of federal funds and health care jobs if the state did not participate.

Jindal did not agree to be interviewed Tuesday, but his press office released a statement saying his position has not changed.

“Medicaid relies on an outdated model that costs taxpayers billions of dollars and produces poor outcomes,” Jindal said in the prepared statement. He said the expansion could cost Louisiana more than $1 billion in 10 years.

State Department of Health and Hospitals Secretary Bruce Greenstein said the state wants to see “some significant flexibility, the ability for Medicaid to be in a reform situation.” He wants federal officials to negotiate “in a meaningful way” waivers that would allow states to implement different ideas, he said.

The open letter to Jindal had among its signees the AARP, the Advocacy Center, the Greater New Orleans American Association of University Women, Louisiana AIDS Advocacy Network, the Louisiana Budget Project, the American Cancer Society Cancer Action Network (Mid South Division), and the National Association of Social Workers, Louisiana Chapter.

The groups were among 44 organizations on the letter, which also include about the same number of people signing as individuals.

The letter cites the success of another Medicaid expansion the state participated in that expanded care for children so that only 5 percent of Louisiana’s children are uninsured today — down from 20 percent.

“Medicaid expansion offers a chance to replicate this policy success and makes a significant investment in Louisiana’s people and workforce,” the letter continued.

The health care revamp expands Medicaid eligibility to anyone earning up to 133 percent of the federal poverty level — $15,282 for a single person this year. The program starts in 2014.

Nearly 20 percent of Louisiana’s workforce lack health insurance — one in four adults. Medicaid expansion would cut that number in half, according to proponents.

The expansion would also bring an estimated $15.7 billion into the Louisiana economy over the next decade “that will spur job creation, support local businesses and provide a more stable source of revenue for doctors, hospitals and other health care providers,” the letter said.

The Medicaid expansion would come at a modest cost to the state with the federal government initially paying 100 percent for the first three years and then a small portion after that — never more than 10 percent, proponents wrote.

They also said with the full implementation of the Affordable Care Act current federal funding for uninsured care on which the state relies will start to diminish with no replacement dollars in sight absent Medicaid expansion.