Today’s midterm elections in the U.S. are, understandably, dominating the news cycle. And health care is on the ballot in ways small and large across the nation (and a definitive issue for voters this year, according to multiple polls).

Perhaps the most obvious way that the election results could shift the health care policy landscape rests on the balance of Congressional power itself. The Trump administration and the GOP-controlled Congress has been hacking and slashing away at the Affordable Care Act (ACA), aka Obamacare, through both legislative and regulatory means. The ACA’s individual mandate has been nixed—but the law itself still stands, if hobbled. If Republicans hold on to the House and Senate, a full-on Obamacare repeal becomes significantly more likely.

Democrats, for their part, have made health care a front-and-center issue. The reason? The prospect of disappearing protections for people with pre-existing medical conditions (ensured by the ACA) has put GOP lawmakers on the defensive and forced many candidates and President Trump himself to insist any upending of Obamacare will preserve those protections.

And then there’s Medicaid expansion—another key element of Obamacare that significantly expands public health coverage for some of the country’s poorest working families. This is a state-by-state issue, and it’s one that’s transcended traditional partisan bounds. Just 17 states have yet to expand Medicaid; Idaho, Nebraska, and Utah could dwindle that figure via popular referenda tonight. And Florida, which is hosting one of the most hotly-contested gubernatorial races in the nation, may inch toward expansion if Democrat Andrew Gillum pulls out a victory. Florida and Texas are the largest remaining states to not expand Medicaid.

Even beyond those hot button issues, a number of states are considering important health care-related ballot initiatives. California voters are fielding a controversial proposal to cap dialysis company profits—one that medical giants like DaVita have poured millions into defeating because of the devastating effect it could have on the firm’s bottom line. Elsewhere, Big Soda is trying its hardest to make sure locales in Washington and Oregon aren’t allowed to implement sugary beverage taxes.

We’ll make sure to update you on how it all shakes out once the votes are tallied and the smoke has cleared.

Read on for the day’s news.

DIGITAL HEALTH

Health care and the blockchain. In a report well worth reading, PricewaterhouseCoopers finds that a huge swath of health care organizations are toying with blockchain technology in one way or another. To what extent? "49 percent of health care technology executives surveyed by PwC in its 2018 global blockchain survey said their companies were developing blockchain solutions." That may strike some as a shocking number. But the inevitable caveat: "Many also said they understood they would need to work through challenges on the way to implementation." (PwC)

INDICATIONS

Sanofi, Regeneron's Dupixent gets more FDA blessings. Sanofi and partner Regeneron's blockbuster hopeful eczema drug Dupixent received more favorable feedback from the Food and Drug Administration (FDA), according to the companies. The agency is now reportedly considering expanding its approval to include certain atopic dermatitis patients between the ages of 12 and 17 (that's on top of a recent approval in a form of asthma issued last month). The multi-faceted drug could become a key sales driver for both companies. (Reuters)

THE BIG PICTURE

Bill Gates on the 'Reinvented Toilet.' Former tech mogul and current philanthropic giant Bill Gates spoke at the "Reinvented Toilet" Expo in China on Tuesday, tackling a critical issue to development in poorer nations: Proper sanitation in order to prevent the spread of disease. Gates made his point in a singularly dramatic fashion—he placed literal jar of human waste on a pedestal next to him. "You might guess what's in this beaker, and you'd be right. Human feces," said Gates. "This small amount of feces could contain as many as 200 trillion rotavirus cells, 20 billion Shigella bacteria, and 100,000 parasitic worm eggs." (CBS News)

REQUIRED READING

CEOs Should Be Worried About Automation, Populism, and Data Manipulation, by Erika Fry

Commentary: Trump Is Undermining the Fight Against Childhood Obesity, by Michael Rosenbaum

Millennials Might Finally Turn Out in Huge Numbers for the 2018 Midterms, by Natasha Bach

Amazon Isn't Picking an HQ2 Anymore—More Like a Couple of Regional Outposts, by Adam Lashinsky