Maine voters say they want to join 31 other states in expanding Medicaid under the Affordable Care Act, the signature health bill of former President Barack Obama.
Tuesday's referendum represented the first time since the law took effect that the question of expansion had been put in front of U.S. voters.
Some 11 million people in the country have gotten coverage through the expansion of Medicaid, a health insurance program for low income people.
The vote in Maine was a rebuke of Republican Gov. Paul LePage, who vetoed five different attempts by the state Legislature to expand the program. It follows repeated failures by President Donald Trump and his fellow Republicans in Congress to repeal Obama's law.
Meanwhile, voters in Lewiston and Auburn decided against merging the two communities to become one large city, and York County residents voted against allowing the construction of a new casino.