Advocates who have spent years unsuccessfully pushing Utah’s Republican Legislature to expand Medicaid under the Affordable Care Act filed paperwork on Monday for a ballot initiative.

If the initiative makes it on the November ballot and is approved by voters in 2018, it would cover residents earning up to 138 percent of the poverty line. That is about $34,000 a year for a family of four.

There are about 127,000 people in Utah who would be eligible for the program.

Utah lawmakers chose not to expand Medicaid under President Barack Obama’s signature health care law, citing concerns about the state’s ability to pay for the program and questions about whether the federal government could afford to pay its share of the cost.

Organizers of the push must get 113,000 signatures and hold seven public hearings across the state to get the initiative on the ballot. The push is backed by a number of state and local nonprofits, including Utah Health Policy Project, a group that advocates affordable health care,

Karina Brown of Logan, Utah, was one of several people to speak at a news conference Monday after the group filed the paperwork. Her mother died of a stroke in 2013 when she didn’t have insurance was a few months away from qualifying for Medicare, The Salt Lake Tribune reports ( ).

“It was really gratifying because I know what that could mean for people,” Brown said “It’s being able to access primary care without fear of exorbitant costs and receive the care they need to be productive.”

The initiative calls for Utah’s share to be paid by raising the state sales tax rate to 4.8 percent or 4.86 percent, up from its current rate of 4.7 percent.

Utah’s Medicaid-expansion initiative is estimated to cost about $70 million to $80 million, with the federal government kicking in about $700 million.

Greg Hughes, the GOP House Speaker, said last week he’s worried about where Utah will get additional money to pay for added costs. Hughes pointed to the many states that expanded Medicaid and saw costs rise faster than expected, straining their budgets as far more people signed up than anticipated.

Under the Affordable Care Act, the U.S. government pays at least 90 percent of the cost of expanding Medicaid while states picked up the rest. So far, 31 other states have expanded their program.

Instead of expanding Utah’s program, Utah lawmakers passed a pared-down proposal that insures a sliver of the state’s poorest: homeless people making less than about $600 a year or those who need mental health or substance abuse treatment, particularly those in the criminal justice system.

The state has also proposed capping the number of people covered by the program at 25,000 and stopping their coverage after five years.

The Trump administration has not yet approved that program.

Matthew Slonaker, executive director of the Utah Health Policy Project, said he’s optimistic.

“We want to maximize Medicaid expansion and give those dollars to Utah to make sure folks are covered,” he said.

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Utah Medicaid expansion backers file ballot initiative