On Tuesday, Maine became the first state in the nation to expand Medicaid through a ballot initiative. Just after 10 p.m., the Associated Press called the race in favor of the measure expanding government health insurance to more than 80,000 low-income residents. Maine now joins the 31 states and the District of Columbia in the Medicaid expansion camp.

The campaign succeeded despite the staunch opposition of Gov. Paul LePage (R), who attempted to pressure the Secretary of State to label Medicaid as “welfare” on Tuesday’s ballot.

Allies of the governor also formed the “Welfare to Work” PAC that campaigned to defeat the ballot measure, funding ads and mailers like the one below warning without evidence that Medicaid expansion would lead to job losses, cuts to nursing home budgets, and the loss of benefits for existing Medicaid enrollees.

Some mighty deceptive fliers trying to scare Maine seniors into voting against Maine Question 2 (Medicaid Expansion). #mepolitics pic.twitter.com/5hVYrM0cRH — Laura Seay (@texasinafrica) November 6, 2017

David Farmer, one of the leaders of the pro-Medicaid campaign, told TPM just before Election Day that the never-ending health care battle on Capitol Hill this year—which centered in no small part on the future of Medicaid—has made voters in Maine especially engaged and more likely to turn out even in a non-presidential year.

“Senator Susan Collins was pivotal in the debate in Washington, helping protect health care for 30 million Americans,” he said. “And when she came back home she got a standing ovation spontaneously in the airport. So it’s our hope that the fact that we’ve had this debate so much already has helped to inoculate folks from some of the lies being thrown around at the end of this campaign.”

Since the passage of the Affordable Care Act in 2010, Maine’s state legislature has voted five times to expand Medicaid. Each time, LePage vetoed the measure.

Maine’s success will likely give a boost to efforts that have already begun in other states—including Utah and Missouri—to put Medicaid on the ballot in 2018.