Oregon will be the first state in the nation to enshrine the right to affordable health care in its constitution.

Ballot Measure 111 narrowly passed, with nearly 50.7% of voters in favor and 49.3% of voters opposed. The measure’s long-term impact on Oregon health care is unclear because it doesn’t prescribe how the state should ensure that everyone has affordable health care.

Measure 111 amends the Oregon constitution by adding: “It is the obligation of the state to ensure that every resident of Oregon has access to cost-effective, clinically appropriate and affordable health care as a fundamental right.”