Three states that are considered mostly Republican-leaning (aka “red states”) approved the expansion of Medicaid at the ballot box Tuesday. Idaho, Nebraska and Utah all said yes, while Montana rejected permanent Medicaid expansion after embracing the program in 2015.

Utah was one of three states where voters approved Medicaid expansion on Tuesday.

Idaho voters gave the largest measure of support to their ballot measure, with 61 percent saying “yes.” Utah came in at 54 percent favorable, followed by Nebraska at 53 percent. As a result, some 325,000 additional Americans will now be covered by Medicaid, which was expanded (optionally, by state) under the Affordable Care Act (ACA).

The Montana “no” vote follows the state’s earlier expansion, which added some 129,000 citizens to the ranks of Medicaid, but funding has run out, so voters put the kibosh on the program by a vote of 55 percent to 45 percent in Tuesday’s election.

Three other states saw their governorships shift from Republican to Democrat hands, so Medicaid expansion could well occur in the future in Kansas, Maine and Wisconsin. In Maine, where voters approved expansion in 2017 but the governor rejected its implementation, incoming governor Janet Mills, a Democrat, will likely carry out the voters’ wishes.