Voters in three traditionally Republican states supported ballot measures to extend Medicaid benefits to more low-income adults.

The results highlight the divide between voters, even in conservative states, who generally support providing health benefits to the poor, and conservative politicians who have rejected the expansion, which is a central part of the Affordable Care Act.

With the approval of the measures in Idaho, Utah and Nebraska, about 300,000 low-income people will gain access to health care coverage, according to estimates from government agencies and advocacy groups in those states.

“People are enthusiastic about Medicaid expansion because they recognize that it’s both good for health care but it’s also a compassionate thing to do,” says Jonathan Schleifer, executive director of The Fairness Project, which worked to get the questions on the ballots of the four states. “And it’s a financially sound thing to do. It’s a fiscally responsible thing to do.”

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