Over the past few weeks, as the health care battled unfolded in dramatic fashion and then flamed out (for now), I’ve been writing about the ways in which regular citizens are stepping up to secure their health care using ballot initiatives while Washington falls down on the job.

There’s Alaska, where local groups are campaigning for a pair of ballot initiatives to lock in Medicaid expansion and secure popular insurance market reforms like coverage for pre-existing conditions.

And there’s Maine, where voters will consider a ballot proposal this November to expand Medicaid coverage to 70,000 additional Mainers who are currently uninsured.

This week comes the third statewide ballot effort — this is a trend.

Local advocates in Utah filed paperwork to put a ballot initiative before voters in November 2018 to expand Medicaid to an additional 127,000 people. This comes after local lawmakers repeatedly resisted efforts to expand coverage under the ACA and both Republican senators voted in favor of repeal.

Utahns themselves will get the final say on their health care.

As Karina Brown, an attendee at the kick-off announcement pointed out:

“It’s (about) being able to access primary care without fear of exorbitant costs and receive the care they need to be productive.”

Brown’s uninsured mother died of a stroke in 2013 — months before becoming eligible for Medicare.

Health care, more than any other issue, has become a flashpoint this year in the debate over what our democracy stands for. It’s one of those issues that literally every American cares about. Our physical health is fundamental to thriving in our lives and when we need care we are at our most vulnerable — physically, emotionally, and financially. Everyone will need a doctor at some point.

Often it has felt like regular citizens like Brown are in a tug of war with their own elected representatives — one side pulling hard for government to give everyone a fair shot while the other side tries to pull away from its responsibilities.

If politicians can’t or won’t get the job done, Americans have always shown a willingness to do it by ourselves — for ourselves, our families, and our communities .

If Maine, Alaska, and Utah — three very different states — are any indication, the ballot box will increasingly be a place they turn to realize their vision of what America should be.