By Sy Mukherjee
November 7, 2018

Good afternoon, readers.

An extraordinarily divisive midterm election campaign came to a close on Tuesday night. Democrats are projected to take solid control of the House of the Representatives after nearly a decade out of power in the chamber, while Republicans will extend their grip on the Senate. A number of key governorships and state legislatures also swung to Democrats, including in multiple states that President Donald Trump carried handily in the 2016 presidential election.

Health care was front and center in many of the Congressional, gubernatorial, and other campaigns. (Strikingly, House Minority Leader and incoming House Speaker favorite Nancy Pelosi specifically cited “pre-existing conditions” as a major factor leading to the Democratic wave during a victory speech on Tuesday night.)

Here’s how the elections may have changed the face of health care policy in the near future.

Obamacare—and Medicaid expansion—were the biggest winners

The very fact that the House will be controlled by Democrats essentially nixes any chance that the Affordable Care Act will be repealed (and, well, even a unified Republican government was unable to nix the stubbornly persistent health law over the past two years).

And one of Obamacare’s most popular provisions, its optional state-by-state expansion of the Medicaid program for low-income Americans, was a big winner in several traditionally conservative states. Voters in Idaho, Nebraska, and Utah overwhelmingly endorsed ballot initiatives to approve Medicaid expansion. What’s more, Kansas, Maine, and Wisconsin all elected Democratic governors who are gung-ho expansion proponents, possibly setting up a significant rise in coverage for poor, working residents. (Of note—Utah also elected former Massachusetts governor and 2012 GOP presidential candidate Mitt Romney, who enacted the earliest form of Obamacare in MA, as its next U.S. Senator.)

However, Democrats’ inability to capture a hotly-contested gubernatorial race in Florida means that state will almost certainly continue to remain outside the Medicaid expansion column. Florida and Texas are the two biggest remaining states not to take part in the program.

One thing to keep an eye on: An ongoing multi-state lawsuit supported by the Trump administration that would nix Obamacare’s protections for people with pre-existing medical conditions and could wind up at the Supreme Court.

The dialysis industry staved off disaster in California

Over in California, a state bluer than the Pacific Ocean itself, an unlikely consortium of patient advocates, medical associations, and business industries (including health giants DaVita and Fresenius) successfully squashed Proposition 8. On first glance, the proposal seems like it would be a bona fide success in a liberal bastion, capping the revenues reaped by dialysis centers (ostensibly with the purpose of helping patients deal with high costs).

But the National Kidney Foundation, Renal Support Network, and nursing and doctors’ groups around the state roundly slammed the proposition for its potential to shut down community dialysis clinics without doing much in the way of lowering prices or boosting competition. Dialysis companies poured more than $110 million into the race.

Health care stocks are on a high

So just how are investors reacting to the election results? With vigorous enthusiasm, if the market is any sign.

Insurers rejoiced as the Affordable Care Act was poised to remain the law of the land and Medicaid was expanded in several states. UnitedHealth Group, Humana, Anthem, Cigna, and Obamacare specialist Centene’s stock were all up anywhere from 3% to 9% in Wednesday trading.

DaVita rose nearly 10% following California’s Prop 8 defeat, while Fresenius was up 9%. The S&P and NASDAQ Biotech indices were both up about 2.5%.

Read on for the day’s news.

Sy Mukherjee
@the_sy_guy
sayak.mukherjee@fortune.com

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