Results from the state elections held Tuesday in Maine, New Jersey and Virginia could add to the headwinds facing policymakers who want to repeal or block the Affordable Care Act.
The results could also nudge the U.S. Senate a little further to the left on Affordable Care Act battles.
Here's a state-by-state look at what happened, and what the election outcomes could mean.
Maine
In Maine, residents voted 59% to 41% in favor of "Question 2," a ballot measure that calls for the state to apply for Affordable Care Act Medicaid expansion, according to a preliminary vote tally posted by the Bangor Daily News.
Maine is the first state to put a decision about taking Affordable Care Act Medicaid expansion money on a state ballot, and health law supporters across the country hailed the vote as a victory for Medicaid expansion.
In Maine, however, Paul LePage, a Republican who opposes the Affordable Care Act and the Affordable Care Act Medicaid expansion program, is still the government.
Democrats control the Maine House by a margin of 77 to 72, but Republicans still control the Maine Senate by a margin of 18 to 17.
LePage put out a statement noting that, in 2002, Maine set up state-organized Medicaid expansion program that failed because of lack of a dedicated funding source.
The 2002 Medicaid expansion program "created a $750 million debt to hospitals, resulted in massive budget shortfalls every year, did not reduce emergency room use, did not reduce the number of uninsured Mainers and took resources away from vulnerable residents," LePage said in the statement.
Credit agencies have predicted that adopting the Affordable Care Act Medicaid expansion program "will be ruinous to Maine's budget," LePage said.
(Image: Centers for Medicare and Medicaid Services)
LePage said his administration will not implement Affordable Care Act Medicaid expansion until lawmakers provide adequate funding for expansion. "I will not support increasing taxes on Maine families, raiding the rainy day fund or reducing services to our elderly or disabled" to fund expansion, LePage added.
Whether or not the ballot measure vote actually leads to Medicaid expansion in Maine, it could put wind in the sails of Sen. Susan Collins, R-Maine.