PORTLAND, Maine — Maine’s governor said Wednesday that residents of his state made an expensive mistake when they voted to expand access to Medicaid under the federal health care law, and he’s hesitant to implement it.

Gov. Paul LePage, an opponent of “Obamacare” like his ally and fellow Republican, President Donald Trump, has vetoed five different attempts by the state Legislature to expand the program. But Maine voters decided the issue at the polls Tuesday, approving a Medicaid expansion under former President Barack Obama’s signature Affordable Care Act.

LePage said a previous Medicaid expansion in the state created yawning hospital debts and failed to reduce emergency room use. He said he won’t implement the new expansion until it’s fully funded by the state Legislature.

“Credit agencies are predicting that this fiscally irresponsible Medicaid expansion will be ruinous to Maine’s budget,” LePage said, adding that he will “not support increasing taxes on Maine families, raiding the rainy day fund or reducing services to our elderly or disabled.”

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Tuesday’s vote was the first time since the law took effect that the question of expansion had been put in front of U.S. voters. Maine has now joined 31 other states in expanding Medicaid. Its allot question became a referendum on one of the most important pieces of the Affordable Care Act.

Republicans, including Trump, have tried numerous times to repeal the law, failing every time.

Democrats in Maine immediately pushed back at LePage’s statement that he will hesitate to implement the will of voters. State Sen. Troy Jackson said Medicaid expansion is now “the law of the land in Maine” and Democrats will fight to implement it fully.

Jackson is an ally of 2016 presidential candidate and U.S. Sen. Bernie Sanders, who is one of the most vocal proponents of expanding public health care coverage.

“Democrats will not give an inch in this fight because it is a matter of life and death,” Jackson said. “We will give no quarter to anyone who tries to take health care away from those hardworking Mainers who have been allowed to fall through the cracks for too long.”

Maine voters’ passage of ballot questions hasn’t always immediately led to changes of state law in recent memory. Voters last year approved referendums about school taxes, legalized marijuana, minimum wage and a ballot change that allows voters to rank their candidate choices, and none has been fully implemented a year later.

LePage has said many times that he opposes extending Medicaid to able-bodied workers. He has reached the term limit allowed for Maine governor and will leave office at the end of next year. But at least one of the Republicans vying to replace him, former Maine Department of Health and Human Services Commissioner Mary Mayhew, also has expressed skepticism about the wisdom of expanding Medicaid.

Mayhew said during a radio appearance Wednesday morning that she doesn’t think state residents were aware of the price tag of expansion. LePage has said he would have to divert $54 million from other programs to pay for the state’s share of the expansion cost.

“It does not absolve the Legislature’s and the governor’s responsibility to comprehensively evaluate and do the right thing for Mainers,” she said of passage.

Passage of the Medicaid proposal means an estimated 70,000 people in Maine can gain health coverage. About 268,000 people currently receive Medicaid in the state. Medicaid backers in Idaho and Utah have started similar efforts to get the question on their ballots in 2018.

About 11 million people in the country have gotten health coverage through the expansion of Medicaid.