The Utah House of Representatives approved a Republican bill on Friday to scale back a voter-approved Medicaid expansion in the state over activists’ concerns it could limit access to health care and supplant the will of the voters.

The House bill would insure about 50,000 fewer people under Medicaid, triggering an unprecedented need for federal approval. Republicans say that while the state’s most impoverished residents will still be covered, the new plan is needed to curtail health-care costs.

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Republican leaders in the state Senate said they are prepared to support the House bill, which includes some changes from a previous Senate version, according to The Associated Press.

About 53 percent of Utah voters in the November midterm election approved Proposition 3, which would fully expand Medicaid to people making up to 138 percent of the poverty line, extending health-care benefits to about 150,000 people.

The House-passed legislation brings that rate back to 100 percent of the poverty line, while allowing people who earn more to buy subsidized insurance on the federal exchanges. It also includes work requirements and spending limits.

The plan still hinges on a waiver the state would have to get from the federal government to allow it to collect increased money under the Obama-era Medicaid expansion law even though it is covering fewer people than required.

The debate surrounding the legislation sparked protests in the state legislature Friday, with demonstrators carrying signs reading, “Respect democracy, our vote matters.”

The Group Utah Decides also called the vote “a shocking display of disrespect for Utah voters.”

Outside the chamber, protestors are continuing to demonstrate over the @utahreps’ vote on SB96 #utpol pic.twitter.com/p3HK0h29gV — Benjamin Wood (@BjaminWood) February 8, 2019

Counter-protesters also gathered to argue the state could not afford full Medicaid expansion.