Republicans Take Senate, Will Take on ACA Again

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Nov. 5, 2014 -- In a midterm election with many implications for health care, Republicans pulled off their expected takeover of the Senate, which they hope will enable them to rewrite the Affordable Care Act (ACA), even if they can't repeal it outright.

Republicans already were in control of the House before Election Day, and election results showed them gaining even more seats. But even though Republicans will rule the Senate as well as the House, their legislative agenda will run up against not only the veto power of President Barack Obama, but also enough Senate votes, as projected, for Democrats to play filibuster.

In the Senate, the GOP needed a net gain of six seats for a 51-vote majority. By midnight, Republicans had picked up those six seats in Arkansas, Colorado, Montana, North Carolina, South Dakota, and West Virginia, plus a seventh seat in Iowa.

Democratic Sen. Mary Landrieu of Louisiana was forced into a Dec. 6 runoff with her opponent, Republican Bill Cassidy, which will leave the final composition of the Senate unknown for a month.

Health care reform figured into gubernatorial races in which challengers such as Democrat Charlie Crist in Florida vowed to expand their states' Medicaid programs under the ACA. Those candidates didn’t fare well. Incumbent Republican Rick Scott, who recently reversed his opposition to Medicaid expansion, kept the Florida governorship. And in Wisconsin, Medicaid expansionist Mary Burke, a Democrat, lost to Republican incumbent Scott Walker.

Medical Marijuana Fails in Florida

A ballot measure in Florida that would legalize medical marijuana failed at the polls. With 99%% of precincts reporting, the measure -- taking the form of a constitutional amendment -- had received 58% of the vote, but it needed 60% to pass.

Before Tuesday’s election, Florida law allowed the medicinal use of cannabis oil with a very low level of tetrahydrocannabinol (THC), the plant's main active ingredient, and then for only three conditions: epilepsy, cancer, and ALS, or Lou Gehrig's disease.

Voters in Alaska, Oregon, and Washington, DC, approved measures to legalize marijuana solely for recreational purposes.

In Tennessee, a constitutional amendment authorizing the state legislature to enact, amend, or repeal statutes on abortion cruised to an easy victory. The ballot measure is designed to give lawmakers more power to regulate abortion -- and, opponents contend, restrict abortion rights. The Tennessee constitution would be amended to say that "nothing in this constitution secures or protects a right to abortion or requires the funding of an abortion."

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Voters in Colorado and North Dakota also considered constitutional amendments that would have advanced the anti-abortion cause, but both failed. The Colorado measure would have recognized unborn children as persons under the state's criminal code. The North Dakota measure essentially said that human life begins at conception and must be protected at that stage of development.

In another reproductive health dust-up, Illinois voters said the state should require health insurance plans with prescription drug benefits to cover prescription birth control. The ballot measure is advisory in nature; state lawmakers are not obliged to act on it.

Supporters say the advisory is needed if mandated coverage of birth control in the ACA, or the law itself, is ever overturned. Opponents counter that Illinois law already requires insurance coverage of birth control, and that Democrats put the measure on the ballot merely to boost voter turnout.

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Medscape News: "Republicans Take Senate, Will Take on ACA Again."

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