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Voters in four red states will decide Tuesday whether to expand Medicaid to thousands of low-income adults, potentially circumventing GOP legislators who for years have blocked one of ObamaCare's key provisions. Ballot initiatives in Idaho, Montana, Nebraska and Utah aim to bring those states in line with the 32 that have already embraced Medicaid expansion. (Hellmann, 11/4)

Last year’s failed attempt by Trump and congressional Republicans to unravel Obamacare revealed the popularity of the ACA with voters. Health policy experts said it also helped educate the public about the benefits of Medicaid, prompting activists in the four states to circumvent their Republican-led legislatures and take the matter directly to the voters. Activists also were encouraged by the example of Maine, where nearly 60 percent of voters last year approved Medicaid expansion after the state’s Republican governor vetoed expansion bills five times. (Ollove, 11/5)

Kaiser Health News: Tobacco Tax Battle Could Torch Montana Medicaid Expansion

Montana legislators expanded Medicaid by a very close vote in 2015. They passed the measure with an expiration date: It would sunset in 2019, and all who went onto the rolls would lose coverage unless lawmakers voted to reapprove it. Fearing legislators might not renew funding for Medicaid’s expanded rolls, Montana’s hospitals and health advocacy groups came up with a ballot measure to keep it going — and to pay for it with a tobacco tax hike. (Whitney, 11/5)

In the run-up to Election Day, residents of Washington and Oregon have been bombarded with similar messages from groups with names like Yes! To Affordable Groceries. The organizations have spent more than $25 million on commercials that feature plain-spoken farmers and penny-pinching moms urging support of ballot measures that would prohibit municipalities from taxing food sales. But what most voters don’t know is that Coca-Cola, PepsiCo and other American beverage companies are largely financing the initiatives — not to block taxes on staples like milk and vegetables but to choke off a growing movement to tax sugary drinks. (Jacobs, 11/2)

Opposition to Proposition 8, a California ballot measure that would cap revenue at the state’s dialysis clinics, has broken a record for the most money raised to support or oppose a single ballot measure in recent state history. The opposition is being bankrolled by two of the nation’s largest dialysis companies, DaVita and Fresenius Medical Care, which have financed a vast majority of the record-high $111.4 million raised to defeat the initiative. (Ho, 11/3)

Both sides of a contentious ballot question to regulate nurse staffing levels in Massachusetts are stoking fears of a doomsday scenario, either if the measure passes or if it fails. But in California, where a more lenient version of the law has been in effect for almost 15 years, the results seem to undercut the panic on both sides, proving to be neither a panacea for improving patient care nor a fatal blow to hospitals’ finances. (Dayal McCluskey, 11/2)

Ohio's controversial Issue 1 has driven debate on criminal justice reform for months – and led to some heated exchanges in the governor's race, too. With less than a week until Election Day, supporters and opponents of the constitutional amendment are making their final pitches to voters. ... Issue 1, the sole statewide ballot initiative, would [reduce] penalties for some drug offenses. Fourth- and fifth-degree drug possession charges would become misdemeanors, punishable with county jail time instead of prison time. Issue 1 also would prohibit jail time for these offenses until the third conviction within 24 months. (Balmert, 11/4)

Gov. Scott Walker and Democrat Tony Evers doubled down Sunday on new policy stances as they traded charges over health care and taxes during a final sprint in their close and dramatic race. Speaking to supporters in Glendale, Walker hit back at claims that he was not a longtime backer of covering those with pre-existing health conditions, even though he authorized Wisconsin to join a federal lawsuit against the Affordable Care Act. (Marley, Glauber and Hauer, 11/4)

Republican treasurer Walker Stapleton has attacked his opponent in the race for Colorado governor, Democratic U.S. Rep. Jared Polis, as too radical and extreme for the rapidly growing state as the GOP tries to prevent a complete Democratic takeover of the Statehouse. ... Polis and his supporters largely view the race as a referendum on President Donald Trump, whom [Republican treasurer Walker] Stapleton has embraced. Trump’s efforts to dismantle former President Barack Obama’s health care law top the list of issues. “Health care is on the ballot. Social Security and Medicare are on the ballot,” Tom Perez, chairman of the Democratic National Committee, told activists while campaigning with Polis at Servicios de la Raza, a Denver community center. “You need guardrails here in Colorado.” (Anderson, 11/3)