The Nebraska Supreme Court has ruled that voters will decide in November whether to expand Medicaid in the state.

The court’s rejection of a Republican-led lawsuit Wednesday is a victory for advocates who say a vote favoring expansion would ensure coverage for about 90,000 low-income residents who earn too much to qualify for regular Medicaid but too little to be eligible for assistance under the Affordable Care Act.

Nebraska’s Republican-dominated Legislature rejected six previous attempts to expand Medicaid. Utah and Idaho have similar ballot measures pending. Maine became the first state to expand Medicaid by ballot measure last year.

The lawsuit was filed by state Sen. Lydia Brasch and former state Sen. Mark Christensen, both Republicans who helped derail similar bills in the Legislature.