Idaho residents will decide this fall whether to expand Medicaid in this state.

A ballot initiative to make more Idahoans eligible for Medicaid has qualified for the November general election, the Idaho Secretary of State’s Office confirmed Tuesday.

It’s the second citizen initiative to qualify under additional requirements Idaho legislators passed in 2013. Organizers had to get at least 56,192 valid petition signatures, including a certain amount from at least 18 of Idaho’s 35 legislative districts.

General election ballots will also list a measure that would legalize machines that allow gambling on recordings of past horse races.

Supporters say expanding Medicaid eligibility is the most straightforward way to help an estimated 50,000 to 60,000 of the working poor who don’t qualify for Medicaid now, but also can’t get subsidies on Idaho’s health insurance exchange. These people are described as in the “Medicaid gap.”

Most Idaho politicians have long opposed the idea, part of the Affordable Care Act; they see it as expanding a welfare program and extending Idaho’s reliance on the federal government, as much of the cost would be covered through federal funds. Multiple attempts at the Statehouse to find another way to aid the gap population have all failed in recent years.

The Medicaid initiative, like many others, relied to a certain extent on paid signature gatherers. But it drew attention earlier this year for its large volunteer effort that procured most of the signatures submitted to election officials.

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Idaho voters will decide whether to expand Medicaid this fall