Alaska’s newly elected Gov. Bill Walker adamantly campaigned on a platform to expand Medicaid, but whether he’ll be able to meet his promise with a Republican-dominated legislature isn’t so clear.

If Walker, who took office December 1, is able to push Alaska to expand the public health insurance for low-income Americans, it will become the 28th state to do so under the Affordable Care Act. Medicaid expansion is a central reform of the federal health law, and makes millions of Americans newly eligible for free or low-cost health insurance.

“I support expanding Medicaid,” said Walker, an Independent, during his campaign for governor this year. “We achieve three objectives by doing so. First, we cover nearly 40,000 Alaskans who have little or no coverage. Second, we expand job growth in the health care field in Alaska. Third, we counter the impacts that uncovered Alaskans have on the insurance premiums of other Alaskans who must underwrite the costs of hospital and other medical care to the uninsured.”

Walker’s interest in expansion likely won’t be enough to actually push through the policy measure long opposed by Republicans on the state and federal levels. Most states have gotten legislative approval for Medicaid expansion, a feat that may not be so easy in Alaska, where the state government is controlled by conservative Republicans.

“There have been a few states where the governor has acted on his own through executive authority,” Laura Snyder, a spokesperson for the Kaiser Family Foundation, told NPR. “But most states [like Alaska] have generally incorporated it into state budgets, which usually require legislative sign-off.”

A conservative legislature has proven insurmountable for other governors seeking to push Medicaid expansion under the ACA. Florida’s Republican governor, Rick Scott, for example, has recently advocated for Medicaid expansion after initially decrying it. But Scott has been unable to bring his fellow Republicans in line, though critics say he has hardly tried.

Wyoming is among deep-red states that have slowly embraced the popular expansion of Medicaid to cover those who couldn’t obtain affordable health insurance before passage and implementation of the ACA.

Alaska’s current Medicaid system has technical problems that would make expansion difficult, even if Walker were to announce changes today. The state in September filed a complaint against the company it hired to manage Medicaid, due to the number of defects in the system, which last totaled a whopping 870, according to the Associated Press.

Walker recently hired a new state health commissioner, Valerie Davidson, to look over the system and the possibilities of expansion. Davidson told NPR that Alaskans are going to have to compromise on the issue if they want to get anything done.

“It may not be something everyone’s 100 percent happy with,” she said, “but we may be able to find middle ground that we can all live with.”