State Question 802 went down to the wire in Oklahoma with the 'yes' votes leading the 'no' votes with at 50.5%.
SQ 802 will provide health care to more than 200,000 low-income Oklahomans without health insurance.
The vote is largely a referendum on the Affordable Care Act, also known as Obamacare. It was approved by Congress a decade ago, and it's been eight years since a Supreme Court ruling made expansion optional, an option that Oklahoma's Republican governors and legislative majorities repeatedly rejected.
"We won't shy away from bringing home federal dollars for transportation or federal dollars for storm damage, but for whatever reason, we've said, 'No, no, no, we don't want to bring these dollars home for health care,'" said Amber England, the SQ 802 campaign manager.
England said the frustration of watching more and more states be able to provide more people with health care, while Oklahoma, with the nation's second-highest uninsured rate did nothing is what launched the SQ 802 effort.
"This movement has been about Oklahomans coming together to do something that politicians simply didn't have the courage to do," she said.
Supporters overcame a state Supreme Court challenge and then collected a record number of signatures, arguing the state was losing out on a billion in federal matching dollars each year -- and that's the state's share, $100M to $200M -- would easily be made up for in improved overall health and new jobs.
Opponents including Gov. Stitt argued forcefully against it, as recently as Tuesday afternoon, saying the state can't afford it.
"We actually have a $1B deficit we're facing next year, so you're either going to raise taxes, which I'm never going to be for that. The only other option would be to take that out of other state agencies," Stitt said.
For a full list of election results, click here.
State Question 802 will amend the Oklahoma Constitution to expand Medicaid health insurance to those earning up to 138% of the federal poverty level, which is about $17,200 for an individual or $35,500 for a family of four.
Oklahoma is one of 14 states — along with neighboring Texas and Kansas — that have not expanded Medicaid under the 2010 federal Affordable Care Act, mostly because Oklahoma’s Republican governors and Legislature have resisted. Residents instead petitioned to put the measure on the ballot.