Democrats scored major victories in state and local elections across the country on Tuesday night, winning marquee governorships in Virginia and New Jersey and making strong inroads in mayoral and state legislature races. But one of the other big winners in election 2017 was Obamacare—especially the health care law’s Medicaid expansion.

Maine approves Obamacare Medicaid expansion

Maine is one of just 19 states that hasn’t expanded Medicaid, the free public health care program for poor and disabled Americans, under Obamacare (aka the Affordable Care Act). Republican Gov. Paul LePage is a staunch conservative who has long opposed the expansion and vetoed the Maine legislature’s bills to enact it five times.

Frustrated advocates helped put the question to the wider Maine electorate. Its response was clear: About 60% of Maine voters approved the Medicaid ballot measure, which would extend health insurance coverage to about 70,000 low-income state residents and their families.

Medicaid expansion has consistently been one of Obamacare’s most popular measures. LePage, however, is already signaling that he won’t implement it despite the overwhelming popular referendum results. “Credit agencies are predicting that this fiscally irresponsible Medicaid expansion will be ruinous to Maine’s budget,” he said in a statement Wednesday. “Therefore, 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.”

But state lawmakers are also spoiling for a renewed fight with LePage given Medicaid expansion’s popular support.

“We will be fully and faithfully implementing this law. The legislature will move swiftly to fund Medicaid expansion as required by law. The governor and [Department of Health and Human Services] commissioner will implement its requirements as well, as they are obligated to do,” said Maine’s Speaker of the House in a statement.

Virginia voters emphasize health care

The Virginia gubernatorial election was the most hotly-anticipated race of Tuesday night. Democratic candidate Ralph Northam didn’t just win it—he shattered expectations by defeating Republican opponent Ed Gillespie by nearly nine percentage points.

President Donald Trump’s deep unpopularity in the state, where nearly 60% disapprove of his performance, certainly didn’t help the GOP candidate. But exit polls suggest that the general slash-and-burn, repeal-or-bust approach Congressional Republicans and the Trump administration have taken to Obamacare (and Medicaid) also hurt Gillespie’s chances.

Nearly four in 10 Virginia voters listed health care as their top policy issue, according to CNN—and 77% of those voters broke for Northam.

Medicaid expansion’s chances grow Virginia

Northam had a fairly consistent polling edge in Virginia going into Tuesday night. But the more surprising element of the Virginia election results may be that Democrats flipped about a dozen seats in the Republican-dominated Virginia House of Delegates. Several of those races are still too close to call or may require recounts, but when all the votes are tallied, it appears the makeup of the House will be much closer to 50-50.

While it’s far too early to tell, that—on top of a fairly evenly matched Democrat-Republican split in the state Senate and the Democratic victories for governor, lieutenant governor, and attorney general—could reshape the politics of Obamacare’s Medicaid expansion in Virginia. Outgoing Virginia Democratic Gov. Terry McAuliffe has tried multiple times to strike a Medicaid deal with the GOP state legislature but as been consistently rebuffed; expanding the program would extend health coverage to an estimated 400,000 poor Virginians.

“All the folks who fought me on Medicaid expansion, they all got blown out,” McAuliffe said at Northam’s election night victory party, predicting that Virginia would become the next state to expand Medicaid under Obamacare.