Yesterday, the people of Maine voted overwhelmingly to extend Medicaid coverage to 70,000 low-income Mainers. This finally ends the five-year-long battle to close the coverage gap in the state.  Maine’s legislature has passed Medicaid expansion with broad support five times only to be vetoed five times by Governor Paul LePage. This victory in Maine is a fitting end to the year in which health care and social justice advocates built a national grassroots movement that stopped the most powerful political actors from repealing the Affordable Care Act and taking coverage away from millions.

As we process what happened yesterday in Maine and turn toward what’s next for the health justice movement in 2018, there are two key lessons we should draw.

First is the power of smart, persistent advocacy. Mainers For Health Care led a multi-year legislative campaign to close the coverage gap, which laid the groundwork for the success of this issue at the ballot box. By the time advocates began collecting signatures to put this issue on the ballot, they had already built a powerful grassroots movement by canvassing door-to-door and holding countless community meetings and forums; grown a powerful and bipartisan coalition of stakeholders, including the medical community, sheriffs, and local elected officials; authored and commissioned studies about how expanded Medicaid coverage would benefit Mainers, the state budget and economy; and educated the local media about the benefits of expanded health coverage, connecting them with stories of real Mainers who live in the coverage gap, and built editorial support on the issue. This hard work clearly paid off over the past seven months and on election day lined them up for yesterday’s win.

Second, is the clear message about what real people want: a fairer health care system that increases access to coverage, lowers out-of-pocket costs, and addresses inequities. Yesterday’s win at the ballot box was an important reminder that the American people reject the cynical efforts by elected officials – whether in Washington, D.C. or in state capitols – to halt and roll back access to quality, affordable health care. Policymakers in D.C. and in states across the country should heed this message, and work on bipartisan solutions to fix what’s not working in our health care system and build upon the progress made under the Affordable Care Act.

In many states, this starts with acting immediately to close the coverage gap. Eighteen states have not yet accepted the federal funding available to provide health care coverage to some of the lowest-income workers in their states, despite the evidence from expansion states that it helps state budgets, boosts local economies, helps struggling rural hospitals, and improves access to important preventive services. Several states, including Georgia, Idaho, Tennessee and North Carolina, were well on their way to closing the coverage gap before the 2016 presidential election stalled this progress. Now that it’s clear the ACA is here to stay, it’s time for policymakers in these states to respond to the clear will of the people – and the message resonating from Maine yesterday – and find a path forward to close the coverage gap.