A group seeking to put Medicaid expansion to a vote in Idaho launched its Boise campaign on Saturday.

Reclaim Idaho will spend the next several weeks working to collect the more than 56,000 signatures needed to put the issue on the ballot for the November 2018 general election.

The text of the initiative is posted on the Idaho Secretary of State’s website, and can be read here.

For the initiative to be included on the November ballot, Idaho law requires that the number of verified signatures be equal to or greater than 6 percent of registered voters in each of at least 18 legislative districts, as well as equal to or greater than 6 percent of the registered voters in the state.

The deadline is four months before Election Day.

“Our goal for today is to get as many volunteers trained as possible, so that they can then go out and recruit more volunteers and train them,” said Sam Sandmire, Ada County co-leader of Medicaid for Idaho.

The state of Idaho opted out of Medicaid expansion under the 2010 Affordable Care Act, which would have required the state to provide Medicaid coverage for adults between the ages of 18 and 65 with incomes up to 133 percent of the federal poverty level, regardless of family status or health. The initiative directs the state to follow those guidelines.

Advocates for expansion say it’s needed to close the “coverage gap” affecting an estimated 78,000 Idahoans whose incomes are too high to qualify for the existing Medicaid program, and too low to receive subsidies for purchasing insurance on the Your Health Idaho exchange.

In past years, bills that would have authorized Medicaid expansion have stalled in the Idaho Legislature. A hearing was held in 2016, but Senate Health and Welfare Committee Chairman Lee Heider did not bring the bill up for a vote.

A more modest alternative proposed by Gov. C.L. “Butch” Otter, the Primary Care Access Program, was also defeated in the Legislature in 2016.

In his 2017 State of the State and Budget Address, Gov. C.L. “Butch” Otter noted that there was broad agreement in the Legislature on the need to help Idahoans in the coverage gap, but very little support for expanding Medicaid.

“I understand that,” Otter said in his 2017 speech. “It would mean subordinating our Idaho priorities to the siren song of federal dollars, and neither the national government nor taxpayers can afford it.”

On January 5, Gov. Otter, Lt. Gov. Brad Little, and Idaho Department of Insurance Director Dean Cameron signed an executive order saying that the state will provide more choices for health insurance.

Related story: Idaho to offer new health insurance options

The governor also spoke about the plan on January 8, in his 2018 State of the State and Budget Address.

Details are still being worked out, but Cameron said that the order essentially gives him the authority and responsibility to seek out and offer plans for Idahoans who cannot currently afford coverage.

If an insurance plan falls short of federal requirements under the ACA, it can be approved as long as the insurance provider also offers an “exchange-certified alternative.”

State officials said on January 5 that they hope the plans will be available for purchase by March of this year.