The governor of Kentucky, Republican Matt Bevin, has won a waiver to institute work requirements for Medicaid recipients to continue being covered, and although there has already been talk of court challenges—Democrats feel that imposing a work requirement on some of the poorest and sickest in the U.S.—Bevin is determined to proceed.

In fact, according to The Hill, he’s already issued an executive order declaring that if any part of his waiver is struck down—it not only imposes a work requirement on “able-bodied” Medicaid recipients, but also imposes premium payments and will lock beneficiaries out of coverage if they don’t pay up—he’ll end the whole Medicaid expansion.

Medicaid was expanded by Bevin’s Democratic predecessor Steve Beshear, and Bevin ran on a platform that promised to end it. The hitch is that if he does so, about 480,000 people could stand to lose their coverage—and as it stands, if the waiver goes unchallenged, a McClatchy report says that 100,000 could lose coverage just based on the work requirement.