Nearly 2.5 million people could gain access to Medicaid coverage if Democrats win gubernatorial elections in six states next Tuesday and expand the program to cover more low-income adults, according to a new analysis released Tuesday. 

If Republicans lose competitive gubernatorial races in Florida, Georgia, Kansas, South Dakota, Maine and Wisconsin next Tuesday, it would present Democrats with the rare opportunity to expand Medicaid in those states to 2.4 million people, according to the analysis by Avalere health, a consulting firm in Washington. 

{mosads}ObamaCare allowed states to expand Medicaid to low-income adults not previously eligible for the federal insurance program for the poor. 

But 18 states, mostly run by Republican governors and legislatures, held out in protest of the health care law. 

Six of those states have gubernatorial elections Tuesday that are rated as a toss up by the Cook Political Report. 

“In states with competitive gubernatorial races, many candidates are making Medicaid expansion a key differentiator,” said Elizabeth Carpenter, senior vice president at Avalere.

“Depending on the election results, we could see Medicaid expansion on the agenda again in states across the country.” 

For example, the issue of Medicaid expansion has played a role in the campaign of Stacey Abrams, the Democrat running for governor of Georgia. 

She has said she would expand the program if she wins. 

Andrew Gillum, who is running for governor in Florida, also said he supports expanding Medicaid. 

But even if Democrats win in those six states, expansion would still have to be approved by state legislatures, some of which are controlled by Republicans. 

“The popularity of Medicaid expansion has risen, particularly in states with high rates of uninsured,” said Chris Sloan, director at Avalere.

“Although state legislatures can restrict the governor’s authority to expand Medicaid unilaterally in certain states, changing voter preferences around expansion may put pressure on legislators, many of whom also face reelection in November.”

Another three states have questions on their ballots to expand Medicaid to more low-income individuals. 

If voters in Idaho, Nebraska and Utah approve Medicaid expansion next Tuesday, 325,000 would receive coverage, according to Avalere’s analysis.