Alaska Gov. Bill Walker said Thursday that he would use his executive power to expand the Medicaid health care program to cover as many as 40,000 low-income residents.

The move comes after the Alaska Legislature earlier this year rejected Walker’s efforts to expand the program through the state budget process, then through a separate bill.

Walker made the announcement at a morning news conference at the Alaska Native Tribal Health Consortium building in Anchorage, an organization that has backed Medicaid expansion for years and whose former director of legal and intergovernmental affairs, Valerie Davidson, is now Walker’s health commissioner. Walker was flanked by his cabinet as he spoke.

“This is the final option for me—I’ve tried everything else,” Walker said.

“Thousands of Alaskans and more than 150 organizations, including chambers of commerce, local hospitals, and local governments, have been waiting long enough for Medicaid expansion,” Walker said in a prepared statement issued before the news conference. “It’s time to expand Medicaid so thousands of our friends, coworkers, neighbors, and family members don’t have to make the choice between health care or bankruptcy.”

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