Obamacare had a good showing on Election Day

Best of Ralph Northam's victory speech
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  • Maine decisively supported expanding Medicaid
  • Virginia elected a staunch Obamacare supporter as governor

(CNN)Obamacare had a very good night on Tuesday after having a really rough year.

While many Republicans on the federal and state level have sought to dismantle the health care law, voters in two states showed that coverage matters to them.
Maine voters decisively supported expanding Medicaid, the first time the issue has been decided at the ballot box. And in Virginia, voters elected Democrat Ralph Northam, a staunch Obamacare supporter, as governor and sent more Democratic lawmakers to the statehouse, which is sure to restart the debate over expanding Medicaid there.
    Obamacare, officially the Affordable Care Act, gave states the option to expand Medicaid to cover low-income adults. The federal government picks up nearly all of the tab.
    With the effort to repeal Obamacare stalled in Congress, the battle has moved to the state level. Several states are looking to use waivers to loosen Obamacare's rules as much as possible, while also tailoring the program to their residents' needs. The federal government has signaled it will grant states more flexibility. Seema Verma, the administrator of the Centers for Medicare and Medicaid, said Tuesday her agency will approve applications to add work requirements for able-bodied Medicaid expansion enrollees.
    Tuesday's election results, however, show that Obamacare still has its defenders.
    In Maine, where Republican Gov. Paul LePage vetoed legislation to broaden Medicaid five times, expansion supporters collected enough signatures to put the question on the ballot. They argued that expansion would provide health insurance for up to 80,000 residents and inject $490 million in federal funds into the economy.
    Despite LePage's contention that expansion would cost taxpayers $315 million over the next five years and hurt the state's ability to care for the most vulnerable, the measure passed by 59% to 41%, according to results collected by the Portland Press Herald and Associated Press.
    Maine would become the 32nd state to broaden the program to cover low-income adults. However, expansion may not happen right away. LePage, who can't run next year because of term limits, blasted the election results as giving "free" health care to working age, able-bodied adults.
    "My administration will not implement Medicaid expansion until it has been fully funded by the legislature at the levels [the Department of Health and Human Services] has calculated, and I will not support increasing taxes on Maine families, raiding the rainy day fund or reducing services to our elderly or disabled," LePage said. He cited the state's attempt to broaden Medicaid in 2002, which he said resulted in massive budget shortfalls and did not reduce the number of uninsured.
    Medicaid expansion advocates are likely to jump on the success in Maine to push ballot measures in other states. Even before Tuesday's results, one grassroots activist group, Reclaim Idaho, had already launched a petition campaign to put the issue on the ballot next November, according to an op-ed in the Idaho Statesman penned by the group's co-founder Luke Mayville in October.
    In Virginia, the health care influence was striking.
    Health care was the issue that mattered most to voters by an overwhelming margin. Some 39% said it was the most important issue, and they split in Northam's favor by a 77% to 23% margin.
    When Democratic Gov. Terry McAuliffe took office in 2014, he made Medicaid expansion one of his top priorities. However, he has been repeatedly blocked by the Republican majority in the state legislature. As of Wednesday afternoon, Democrats had gained 13 seats in the House of Delegates with several close races still to be decided that could determine control of the chamber.