Tuesday’s midterm elections weren’t nearly as awful as many people, including myself, feared they would be. Alongside other encouraging results for the Left, health care, including abortion rights, was a big winner.

South Dakota’s voters, chose by a large majority, to expand their state’s Medicaid coverage and add language to the state constitution barring additional restrictions on eligibility or enrollment. The state is controlled by Republicans and the awful governor, Kristi Noem, opposes the measure. Still, it drew support from 56 percent of the voters. Greater access to health care is needed everywhere in the United States, since unlike many rich countries, we don’t have socialized medicine. But it’s a matter of special urgency in a state like South Dakota, where incomes are lower than the national average and mothers are even more likely than other Americans to die while giving birth.

Before Tuesday, parents with almost any work income (more than $1,000 for a family of four) were ineligible for Medicaid in South Dakota, which is home to the US county with the shortest life expectancy: 66.8 years in Oglala Lakota County, which is the Pine Ridge Indian Reservation (that’s almost twelve years below the average American life expectancy of 78.6). South Dakota also has fourteen other counties whose life expectancy is below the current US average. The measure will likely add about forty thousand people to the state’s Medicaid program. South Dakota is the seventh state to expand Medicaid by popular vote in recent years, as majorities find ways to work around conservative governors and legislators ideologically opposed to ever making poor and working-class people’s lives any better (the previous states to do so were Maine, Utah, Nebraska, Idaho, Missouri, and Oklahoma).