Nebraska joined the likes of several other states who approved Medicaid expansion Tuesday, with more than 53 percent of the vote in favor with 90 percent of precincts reporting.

As many as 90,000 newly eligible residents will gain coverage and the uninsured rate could fall from to 9.6% from 12.4% next year, according to an independent study by the Urban Institute.

Along with the new Medicaid patients, the state will also see a cash flow of federal dollars—as much as $68 million annually—to help cover the program’s costs.

The approval is a big win for advocates who have watched attempts to expand Medicaid fail six times in the state’s legislature. Advocates successfully petitioned and got the initiative added to the ballot in July.

Voters also said yes despite heavy opposition from the Republican-controlled state representatives and Gov. Pete Ricketts, who saw it as a “government entitlement program.”

Depending on when Nebraska’s Medicaid expansion program is officially implemented, the state could see a new wave of job opportunities in the travel healthcare market in 2019. Studies have shown that Medicaid expansion states have increased patient demands and healthier hospital budgets, which can lead to a higher volume of traveler needs.

We will update this story with the final election totals when they are made available.