Obamacare’s Medicaid expansion is set to grow by about a half-million after voters in three deeply red states rebuked Republican leaders to approve ballot measures joining the program and Democrats took back governors’ mansions Tuesday night.

The elections will usher in the program’s largest growth since Obamacare’s early days, after Republican leaders in those states resisted the optional program for years. Democratic victories in Kansas, Maine and Wisconsin gubernatorial races could soon put those states in the expansion column, and voters in Idaho, Nebraska and Utah easily approved initiatives adopting the program.

Obamacare supporters said the victories marked a strong reprimand of Republican efforts to roll back the Affordable Care Act. The Democrats’ House victory also represents a firewall against Republican efforts to repeal Obamacare or cap Medicaid spending for at least the next two years.

“This election proves that politicians who fought to repeal the Affordable Care Act got it wrong,” said Jonathan Schleifer, executive director of the Fairness Project, which bankrolled the Medicaid ballot initiatives. “Expanding access to health care isn’t a blue-state value or a red-state value; it’s an American value.”

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