In a special election two days ago, Oregonians voted overwhelmingly in support of their Medicaid program. Over 60 percent of voters cast their ballot in favor of keeping the provider taxes that cover the state’s share of Medicaid expansion costs. Had voters rejected the initiative, which was filed by lawmakers who oppose the state’s Medicaid expansion, Oregon lawmakers would have had to scramble to fill the resulting budget hole; and coverage for hundreds of thousands of low-income Medicaid enrollees would have been put at risk. Instead, voters sent a clear message about what people want: a strong Medicaid program. They also sent a clear message about what they don’t want: more cynical efforts by elected officials to halt progress and roll back access to quality, affordable health care.

Does this storyline sound familiar? Maybe because a few months back, voters in Maine handily approved a ballot measure to extend Medicaid coverage to 70,000 low-income Mainers, a decisive rejection of their governor who had vetoed Medicaid expansion five times. And that same day, voters in Virginia turned their off-cycle election into a referendum in support of Medicaid. They surprised analysts by ousting over a dozen Republican incumbents in the Virginia House of Delegates who had been instrumental in blocking the state from closing the coverage gap.

These election results in Oregon, Maine and Virginia build on a wave of support for Medicaid that emerged during congressional Republicans’ efforts last year to repeal the Affordable Care Act.  Across the country, people living with disabilities, parents of children with special health care needs, working families, and communities devastated by our nations’ opioid epidemic raised their collective voices against these repeal bills’ devastating cuts to Medicaid, and shared powerful stories with policymakers and the media about how their lives and communities depend on this program. And even Republican governors from states that have expanded Medicaid bucked their party’s congressional leadership, and spoke out against cuts to Medicaid. In the end, Medicaid surprised many of us by emerging from the repeal debate with more political power and public support than ever.

Yet three state election results in support of Medicaid later, some policymakers still haven’t gotten the message. Eighteen states continue to reject the Affordable Care Act’s Medicaid expansion, and congressional leaders are still scheming ways to pass devastating cuts to Medicaid. Meanwhile, people in states across the country, like Utah, Idaho, and others, are exploring ballot measures to expand and strengthen Medicaid. And new polls, like this one from last week in Virginia, keep emerging in non-expansion states to confirm that voters overwhelmingly want their leaders to close the coverage gap. How many times do voters have to confirm their support for Medicaid before policymakers listen?