The midterm elections abruptly shifted the health care landscape across the country, strengthening the position of the Affordable Care Act while resulting in a divided Congress that could mean most changes unfold on the state level. Health care was the No. 1 issue among voters this election, according to an AP survey of about 90,000 people. The voting results suggested a rebuke to repeated Republican efforts to roll back the health law, and that many Americans care deeply about issues such as coverage for preexisting medical conditions. (Stephanie Armour, Wall Street Journal)

Obamacare’s Medicaid expansion is set to grow by about a half-million after voters in three deeply red states rebuked Republican leaders to approve ballot measures joining the program and Democrats took back governors' mansions Tuesday night. The elections will usher in the program’s largest growth since Obamacare’s early days, after Republican leaders in those states resisted the optional program for years. Democratic victories in Kansas, Maine, and Wisconsin gubernatorial races could soon put those states in the expansion column, and voters in Idaho, Nebraska, and Utah easily approved initiatives adopting the program. (Rachana Pradhan and Alice Miranda Ollstein, Politico)

With Tuesday night's victories in the House of Representatives, Democrats are set to make a run at a long-held goal of giving Medicare the authority to negotiate lower drug prices when they assume control. (Robert King, Washington Examiner)

The Democratic takeover of the House is giving new life to efforts to fight high drug prices with bipartisan action, a worrying prospect for the pharmaceutical industry. It’s a top priority for House Democrats, who now have powers to press the issue and put the drug industry on the hot seat. It’s also an issue where Democrats believe there is potential to reach a deal with President Trump. (Peter Sullivan, The Hill)

Pharma giants have been quick to tout their efforts to help the Trump administration rein in runaway drug prices, but behind the scenes the industry has been lobbying furiously to roll back recently mandated medicine discounts for U.S. seniors. Drug companies are focusing lobbying efforts to use a possible lame-duck session of Congress to peel back a legislative loss they suffered earlier this year, according to people familiar with the efforts. (Cynthia Koons and Ben Brody, Bloomberg News)

A nonpartisan government commission on Medicaid is calling on the Trump administration to pause the practice of revoking Medicaid coverage for people in Arkansas who fail to meet the state’s new work requirements. The letter from the Medicaid and CHIP Payment and Access Commission (MACPAC) states that the commission is “highly concerned” that 8,462 people have lost their health coverage through Medicaid this year for failing to meet the state’s new work requirement. (Peter Sullivan, The Hill)

Medicare is experimenting with a new direction in health care. Starting next year, seniors in many states will be able to get additional services such as help with chores and respite for caregivers through private Medicare Advantage insurance plans. There’s a growing recognition that such practical help can have a meaningful impact on patients’ well-being — and reduce some costs for taxpayers. (Ricardo Alonso-Zaldivar, Associated Press)

A 2016 study found that physicians spent about two hours doing computer work for every hour spent face to face with a patient—whatever the brand of medical software. In the examination room, physicians devoted half of their patient time facing the screen to do electronic tasks. And these tasks were spilling over after hours. The University of Wisconsin found that the average workday for its family physicians had grown to eleven and a half hours. The result has been epidemic levels of burnout among clinicians. (Atul Gawande, The New Yorker)