Supporters of Medicaid expansion celebrate their victory, in Portland, Maine in this Nov. 7, 2017 photo. Voters decided they wanted Maine to expand Medicaid to 70,000 citizens in a public referendum. (AP Photo/Robert F. Bukaty, File)

Campaigns to expand Medicaid via ballot initiative are gaining momentum in several Republican-leaning states where GOP lawmakers or governors have been roadblocks to providing healthcare to more low income Americans.

In Nebraska, supporters of Medicaid expansion Friday launched their campaign to gather enough signatures to get an initiative on the November general election ballot. Nebraska’s petition drive joins those of other Republican-leaning states, including Idaho, Missouri and Utah that are working to place Medicaid expansion on the November ballot.

“Our neighbors in Iowa and Colorado and 30 other states have already made the right choice,” Nebraska Sen. Adam Morfeld , a Democrat, said Friday.

The expansion of Medicaid benefits under the Affordable Care Act has come a long way since the U.S. Supreme Court in 2012 gave states a choice in the matter. There were initially only about 20 states that sided with then President Barack Obama’s effort to expand the health insurance program for poor Americans. That number of states that have expanded Medicaid under the Affordable Care Act has since grown to 32 including Maine, which was the first to approve Medicaid expansion via a ballot measure when state voters overwhelmingly approved the initiative in November.

“Last fall, voters in Maine made the choice to expand Medicaid, to bring their tax dollars home to improve their own health care system and let our doctors and nurses do their jobs and provide top-quality care,” Morfeld said. “And now it’s time for the people of Nebraska to be able to choose.”

If successful, the Nebraska ballot measure would expand Medicaid benefits to 90,000 people in the Cornhusker state. The vote of the people would come after the Republican-led legislature and GOP Gov. Pete Ricketts have rejected several efforts to expand Medicaid in the state’s unicameral legislature.

“With our unicameral, Nebraska is a unique place,” Morfeld said in a speech to Medicaid expansion supporters on Friday.

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Medicaid Expansion Via Ballot Measure Gains Momentum In Red States