JUNEAU, Alaska Alaska's governor said on Thursday he would use his executive powers to expand the state's Medicaid health program for the poor, in a bid to sidestep political opponents and bring coverage to more than 20,000 uninsured residents the first year. 
 
 Governor Bill Walker said Alaska would accept $146 million in federal funds made available under President Barack Obama's signature healthcare reform law, citing nearly 30 other states that have expanded Medicaid coverage. 
 
 "(They) have already made the commonsense decision to accept Medicaid expansion. Why? Because it helps their residents, their economies and their budgets," Walker told reporters in Anchorage. 
 
 Walker, an independent, has already had several expansion efforts blocked by the Republican-led state legislature since he took office after winning the November 2014 election. On Thursday, he said bypassing the legislature and accepting the funds was a final option. 
 
 Obamacare envisions major expansions to the Medicaid program, though about 20 U.S. states, many Republican-controlled, have rejected that part of the law, according to Kaiser Family Foundation figures. 
 
 Political divides have stalled the expansion of Medicaid coverage in states concentrated in the South and central West. 
 
 In Alaska, the Legislative Budget and Audit Committee has the authority to review requests for federal funds when the legislature is not in session. 
 
 The committee has until Sept. 1 to vote whether or not to support the state's request for money, or to recommend a special session of the legislature to review expansion options. 
 
 After Walker's announcement, the committee's chairman, Representative Mike Hawker, said the panel’s role is a formality and simply influences how quickly the money is made available. 
 
 In a letter to Hawker, Walker's budget director, Pat Pitney, cited as benefits an estimated $1 billion in new federal healthcare dollars for the next six years, $100 million in savings to the state treasury and 4,000 new jobs. 
 
 Expansion opponents have said Alaska should not risk the possibility the federal government would pull the program and leave the state committed to something it cannot afford. 
 
 "Today's spending will be paid for by tomorrow's taxpayers," said Republican state Senator John Coghill. 
 
 (Reporting by Steve Quinn; Editing by Eric M. Johnson and Eric Beech) ||||| Senate Republicans and the White House pressed ahead Tuesday with their suddenly resurgent effort to undo former president Barack Obama's signature health-care law, even as their attempt was dealt a setback when a bipartisan group of governors and several influential interest groups came out against the proposal. 
 
 Powerful health-care groups continued to rail against the bill, including AARP and the American Hospital Association, both of which urged a no vote. But it was unclear whether the opposition would ultimately derail the attempt, as key Republican senators including Lisa Murkowski of Alaska said they had yet to make up their minds. 
 
 The measure marks the last gasp of Republican attempts to dramatically gut Obama's Affordable Care Act, which has added millions of people to the ranks of the insured through a combination of federally subsidized marketplaces and state-level expansions of Medicaid, leading to record lows in the number of those without health insurance. The Graham-Cassidy bill — named for Sens. Lindsey O. Graham (S.C.) and Bill Cassidy (La.) — would convert funding for the ACA into block grants for the states and would cut Medicaid dramatically over time. 
 
 The bill — coming two months after a previous failed repeal effort in the Senate — is the subject of a last-ditch lobbying push by Senate Majority Leader Mitch McConnell (R-Ky.) and the Trump administration, led by Vice President Pence, ahead of a Sept. 30 deadline for Senate action. 
 
 In a letter to Senate leaders, the group of 10 governors argued against the Graham-Cassidy bill and wrote that they prefer the bipartisan push to stabilize the insurance marketplaces that Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) had been negotiating before talks stalled Tuesday evening. 
 
 The governors who signed the letter are particularly notable, since some are from states represented by Republican senators who are weighing whether to back the bill. Among the signers were Alaska Gov. Bill Walker (I), who holds some sway over Murkowski, a potentially decisive vote who opposed a previous Republican effort to repeal and replace the Affordable Care Act. 
 
 Nevertheless, Murkowski said Tuesday afternoon that she was still weighing her options and explained how her position on the bill might ultimately differ from her opposition to the repeal effort that failed dramatically in July. 
 
 "If it can be shown that Alaska is not going to be disadvantaged, you gain additional flexibility. Then I can go back to Alaskans, and I can say, 'Okay, let's walk through this together.' That's where it could be different," she said. 
 
 But Murkowski, who has been in close contact with Walker, said she did not yet have the data to make such a determination. Alaska's other Republican senator, Dan Sullivan, said he was still mulling whether to support the bill. 
 
 [Reminder: It’s very unusual to vote on a health-care bill before Congress knows what it will do] 
 
 On the other side, a group of 15 Republican governors announced their support for the Senate bill Tuesday evening. The list includes Kentucky Gov. Matt Bevin (R), whose backing could help influence Sen. Rand Paul (R-Ky.), who has frequently criticized the legislation for failing to fully repeal the ACA. 
 
 On Tuesday, Pence traveled from New York, where he was attending the annual United Nations General Assembly session, to Washington with Graham in a sign of the White House's support for the proposal. 
 
 "My message today is I want to make sure that members of the Senate know the president and our entire administration supports Graham-Cassidy," Pence told reporters on the flight. "We think the American people need this." 
 
 Graham added that President Trump called him at 10:30 p.m. Monday. 
 
 "He says, 'If we can pull this off, it'll be a real accomplishment for the country,' " he recalled. 
 
 Trump has played a limited role in building support among senators in recent days, but it is possible that his participation will increase as a potential vote nears. He has, however, been in touch with some governors, including a weekend call with Arizona Gov. Doug Ducey (R), according to aides. 
 
 Pence attended the weekly Senate Republican policy luncheon, where he said the current health-care system is collapsing and the bill fulfills key GOP promises to return control to states and rein in federal entitlement programs, according to several GOP senators. 
 
 Afterward, McConnell declined to ensure a vote on the bill but said his team is working to secure sufficient support. 
 
 "We're in the process of discussing all of this. Everybody knows that the opportunity expires at the end of the month," said McConnell, referring to the limited window Republicans have to take advantage of a procedural tactic to pass a broad health-care bill without any Democratic support. 
 
 Democrats say the ACA needs modest improvements by Congress but is working well overall, and they have railed against a process in which Republicans are pressing ahead with few hearings on legislation that would affect an industry that accounts for about a sixth of the U.S. economy. 
 
 The current bill would give states control over billions in federal health-care spending and enact deep cuts to Medicaid. The Medicaid cuts in particular are a major source of concern to the governors, both in terms of imposing a per capita limit on what states would receive and putting restrictions on how they could spend any federal aid on their expanded Medicaid populations. 
 
 Medicaid was expanded under the ACA to provide states with generous funding if they opted to cover adults earning up to 138 percent of the poverty level. Many Republican-led states decided against an expansion following a Supreme Court decision allowing them to opt out. 
 
 The fact that the bill also would restrict states' abilities to tax health-care providers to fund their Medicaid programs posed a problem for several governors, as well. 
 
 In a sign of how alarmed state officials are about the prospect of funding cuts, Louisiana's health secretary sent a letter to Cassidy on Monday saying that their state could see disproportionate cuts with significant impacts on people with preexisting or complex and costly conditions. 
 
 "This would be a detrimental step backwards for Louisiana," wrote Rebekah Gee, who posted her letter on Twitter on Monday. 
 
 And although Walker has not played a visible role in the national health-care debate until now, certain aspects of the new bill pose an even bigger challenge for Alaska than previous proposals did. Health-care premiums are particularly expensive in the state, given its many remote areas. Premiums on the ACA market average roughly $1,000 a month for an individual, according to the most recent federal data. 
 
 Since federal tax credits over time would be equalized and based on the number of low-income people in a given state, that new calculation would eliminate the more generous subsidies Alaska enjoys. 
 
 Given the complex nature of the Graham-Cassidy proposal, it is difficult for state officials and health-care analysts to predict exactly how much money a given state would gain or lose if the legislation were enacted. But early estimates suggest that states with expanded Medicaid programs and active participation in the ACA markets could face major cuts. 
 
 An initial estimate for Colorado, according to state officials, suggests it could lose at least $700 million in annual federal funding by 2025. Since the state has roughly 450,000 people in its Medicaid expansion program and another 100,000 receiving premium tax credits on its health-care exchange, that could translate into hundreds of thousands of Coloradans losing coverage. 
 
 The governors who have been most outspoken in their criticism of the bill negotiated behind the scenes to bring as many state executives on board as possible, according to aides, tweaking the language of Tuesday's letter over the past couple of days to get maximum support. 
 
 Others who signed the letter in opposition to Graham-Cassidy included John Kasich (R-Ohio) and Brian Sandoval (R-Nev.). Sandoval's positioning puts him at odds with Sen. Dean Heller (R-Nev.), who has been touting the bill as another co-sponsor. 
 
 Pence said Trump told him to reach out to some Democrats, and he spoke to Sen. Joe Manchin III (D-W.Va.) over the weekend. But after reviewing the bill, Manchin said, he told Pence's aides he could not support the legislation. 
 
 Senate Minority Leader Charles E. Schumer (D-N.Y.) said he's confident no Democrat will vote for the legislation, because "it hurts people in every state." 
 
 Democrats had been working furiously since Monday to advance talks between Alexander and Murray on a deal to immediately stabilize ACA insurance marketplaces with federal subsidies. The negotiations rapidly escalated after weeks of slow but consistent talks once it became clear that Senate GOP leaders were serious about holding a health-care vote before the end of the month, according to several Senate aides. 
 
 Alexander on Tuesday played down expectations of reaching an agreement this week, telling reporters the pair had reached an impasse. 
 
 "During the last month, we have worked hard and in good faith but have not found the necessary consensus among Republicans and Democrats to put a bill in the Senate leaders' hands that could be enacted," Alexander said in a statement. 
 
 Democrats denied that the talks had fallen apart, accusing Republicans of walking away despite making progress on areas of disagreement. Schumer spokesman Matt House said Democrats offered to accept a number of GOP requests, including waivers to give states more latitude in how they spend federal dollars and the creation of new low-cost plans under the ACA. 
 
 "This is not about substance," House said in a statement. "The Republican leadership is so eager to pass Graham-Cassidy that they're scuttling a balanced, bipartisan negotiation." 
 
 Many Democrats, including Murray, said they hoped the talks could still be salvaged despite roadblocks from Republicans. 
 
 "I am disappointed that Republican leaders have decided to freeze this bipartisan approach," Murray said in a statement. "But I am confident that we can reach a deal if we keep working together." 
 
 Ed O'Keefe and Ashley Parker contributed to this report. ||||| (CNN) Congressional Republicans struggling over how to repeal Obamacare are stuck on a key problem: what to do with the millions of people in 31 states covered under the dramatic expansion of Medicaid the law enabled. 
 
 So they have privately turned to a handful of governors to help resolve the issue -- including Wisconsin's Scott Walker and Ohio's John Kasich, according to several sources involved in the talks. The hope, according to congressional sources, is to let the governors cut a deal on an issue that directly impacts their states and let the White House and Republican leaders endorse the plan that eventually emerges. 
 
 The discussions underscore another key point: While President Donald Trump promises to soon unveil his own health care plan, lawmakers on Capitol Hill are drafting the bill -- while the Republican governors are likely to be the driving force behind the major entitlement reform over Medicaid coverage. 
 
 The stakes for Republicans are already high. At town halls this week, GOP lawmakers are getting earfuls from voters unhappy with possible rollbacks to Obamacare, and at times struggling to defend a replacement bill that doesn't yet exist. 
 
 At the center of the talks are four governors who have taken different approaches to Medicaid: Walker and Gov. Bill Haslam of Tennessee, whose states did not expand Medicaid under the law; and two governors from states that did: Kasich and Nevada Gov. Brian Sandoval. The discussions are likely to continue at the National Governors Association meeting in Washington this week, and as Kasich privately meets later this week with Trump at the White House. 
 
 "There are 700,000 Ohioans who now get care who didn't have it before," Kasich told CNN's Jim Sciutto on Sunday's "State of the Union," defending his state's Medicaid expansion. "And to turn our back on them makes no sense." 
 
 The thinking is that if these four can cut a deal, it will help resolve an issue that GOP leaders say is currently the biggest hurdle in putting together a plan to repeal President Barack Obama's Affordable Care Act. But they have a monumental task: resolving concerns from conservatives who want to turn Medicaid into a block grant program and alleviate fears from politicians who hail from states that accepted federal dollars to expand coverage for low-income adults under Obamacare. 
 
 "We're going to have to find a solution that accommodates those concerns," House Speaker Paul Ryan said last week. 
 
 Republicans are hoping to unveil a plan in March that could be voted on within the next several weeks. They are under a time constraint because they are using fast-track budget rules that will allow them to avoid a filibuster in the Senate and pass a repeal bill on a party-line vote. 
 
 The party is still divided over key issues -- including how far to take the repeal bill. Conservatives in the House Freedom Caucus want to pass a full-blown repeal bill that mirrors a plan that Congress approved in 2015 -- and Obama vetoed -- which would also repeal the Medicaid expansion. 
 
 Yet top Senate Republicans privately say that such an approach would not pass their chamber. 
 
 Tax credits and health savings accounts 
 
 Moreover, a number of Republicans are demanding that the repeal bill also include some new provisions to help replace the law. As part of that approach, Republicans want to include in the repeal bill tax credits to help people purchase health insurance and reforms to Health Savings Accounts that would allow families to put more money into the accounts. 
 
 Yet, Senate budget rules limit how much of the health care law can be replaced through the process known as "reconciliation," meaning that the GOP will have to rely on skeptical Democrats to pass other health care bills and on Health and Human Services Secretary Tom Price to take executive action on other fronts. 
 
 But several people involved in the discussions say the biggest challenge right now is how to resolve the Medicaid dilemma. The fear among many Republicans is that gutting the program could leave many low-income individuals in their states without health care coverage if there's no viable alternative to replace it. Republicans are considering a plan -- advocated by Ryan -- where states would receive federal funding based on a formula created by a state's per capita Medicaid population. 
 
 While it's uncertain where they'll come down, Walker's support is seen as critical since he could presumably help sell the deal to conservatives who want to gut the entitlement program altogether. 
 
 "Gov. Walker and other governors around the country are on the front lines of this effort," said Tom Evenson, a Walker spokesman. "And they want to partner with the federal government to provide affordable and accessible health care." 
 
 The talks on the Hill over health care are being driven by five key Republicans: Ryan, Senate Finance Chairman Orrin Hatch, Senate Health Chairman Lamar Alexander, House Energy and Commerce Chairman Greg Walden and Ways and Means Chairman Kevin Brady. 
 
 And the Energy and Commerce Committee met in January with more than a dozen GOP governors from states that expanded Medicaid and those that did not, and discussions are continuing between the governors and the lawmakers, a committee aide said. 
 
 How the four GOP governors go along with the plan also could influence key senators from those states -- including Nevada Sen. Dean Heller, who is up for re-election in 2018 and whose governor is involved in the talks. And if Kasich cuts a deal, it could influence key Ohio Republicans in both chambers.
– Alaska's legislature didn't move to expand Medicaid, so Gov. Bill Walker is doing it on his own. Walker says he plans to accept $146 million in federal funds that his state has access to under the Affordable Care Act in order to cover some 42,000 residents who qualify under the program, Reuters and the New York Times report. Walker, who is just seven months into his term, had made expanding Medicaid a campaign priority. "This is the final option for me," he says. The Legislative Budget and Audit Committee will now have 45 days to act before Walker accepts the funds; he says he can proceed regardless of how the committee responds. The federal government will take on the full cost of the expansion at first, then shave its cut to 90% by 2020. Some 28 other states have expanded Medicaid under the law, but just Kentucky, West Virginia, and Ohio did so without legislative consent. Walker, who calls the move a "common-sense decision," says his bills seeking expansion approval were all blocked by Republicans worried about the tab Alaska would have to pick up in the future. "Regardless of federal funding, we cannot afford the Medicaid system we have now," says Republican state Sen. Pete Kelly. "Our current system is broken." Walker hopes to begin enrollment in September and have 20,000 signed up within one year. The Wall Street Journal observes that the move will "bring the number of states opting into the law's expansion close to 30 and make it more likely other states would follow."