Colorado voters rejected a ballot measure that would have created a first-in-the-nation single-payer health insurance system, a significant setback for progressive proponents of universal health care.

Tuesday’s defeat of Amendment 69 was decisive, as predicted. Polling ahead of Election Day showed that two-thirds of residents opposed the measure, which would have established a program called ColoradoCare to cover most people in the state.

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Hillary Clinton reaffirmed her support on Saturday for creating a “public option” within Obamacare and allowing people to enroll in Medicare at age 55.

The presumptive Democratic presidential nominee also called for a substantial increase in funding in medical clinics that serve low-income Americans, fully embracing a proposal from Sen. Bernie Sanders (I-Vt.).

While Clinton has long supported the creation of new government-run insurance options and reiterated that support several times this year, Saturday’s statement comes three days before she is scheduled to make her first joint campaign appearance with Sanders ― who has championed government-run insurance and federally financed clinics throughout his career and during his own bid for the presidency.

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Fewer than 1 million new customers nationwide will have health insurance from the Obamacare exchanges next year, according to a federal report published Thursday.

The Department of Health and Human Services estimates that 10 million people will be covered by private health insurance policies obtained via the Affordable Care Act’s exchange marketplaces in 2016, an increase of just 900,000 from the 9.1 million people the department estimates will have such plans by the end of this year.