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If Iowa Democrats can’t hang on to control of the state Senate, Gov. Terry Branstad (R) will be freer to pursue an ambitious agenda. If Arkansas Republicans keep control of the state House and win the governor’s mansion, the future of that state’s unique approach to Medicaid expansion under the Affordable Care Act is at risk. In Kentucky, Sen. Rand Paul (R) could take advantage of a Republican state legislature to change a law that prevents him from running for president and re-election to the U.S. Senate at the same time. (Wilson, 10/29)

An antiabortion referendum is turning into this state’s most contentious campaign this fall, as groups for and against the measure work to get out the vote in an otherwise ho-hum election season. (McWhirter, 10/29)

A year after the federal Affordable Care Act took effect, California voters are now considering another major change to health care: a ballot measure that would give state officials the authority to veto health insurance rate increases for individual and small group plans. Proposition 45 would hand broad new control of the individual health insurance market to the state insurance commissioner, who could reject rate increases deemed excessive. The measure is designed to keep costs down for consumers in a state where health care premiums have spiked in recent years, raising public ire. (Lovett, 10/29)

A new ad from the Republican Governors Association attacking Democratic gubernatorial candidate Mark Schauer over the Affordable Care Act is largely factual but includes key statements that are highly misleading. Claim: "Now Michigan seniors are facing higher costs, fewer benefits, and loss of their doctors." Reality: Partly false and highly misleading. Health care costs were rising dramatically prior to the passage of the Affordable Care Act and growth in per capita health care costs has slowed since its passage. Though some seniors on Medicare Advantage plans -- about a third of the total -- have lost access to their doctors, the ad's statement is too sweeping. Many seniors who were in the gap known as the "doughnut hole" are saving on prescription drugs as a result of the ACA. (Egan, 10/29)

If Republicans win control of the Senate next week, they will have a rare opportunity to design a unified congressional economic plan that reworks things like health-care spending, tax policy, labor rules, and adjustments to social-welfare programs. For the past few years, a number of states led by GOP governors have served as incubators for some of these ideas with mixed results. Those experiences could influence which strategy GOP lawmakers adopt. Many of these governors inherited large projected budget deficits and made tax and spending changes to balance the budget (as they are often required to do by law). Sometimes, the changes resonated well with voters. But the jury is still out in a number of states. (Paletta, 10/29)

The Los Angeles County Board of Supervisors ordered the public health department this week to provide an update on the nursing home inspection process, responding to a Kaiser Health News report that draft penalties in three patient deaths had been reduced without explanation. The supervisors unanimously approved the motion to have the acting public health director report back with a “detailed description” of procedures for reviewing nursing home penalties recommended by on-site inspectors. The vote followed an article published Saturday in the Los Angeles News Group newspapers, which described three fatal cases in which sources said inspectors’ draft citations had been downgraded. (Gorman, 10/29)

Louisiana Gov. Bobby Jindal on Saturday called congressional Republican leaders "fearful" of acting to fully repeal President Barack Obama's health care law. Jindal, a second-term Republican governor weighing a 2016 presidential candidacy, said the GOP had failed to act on their signature issue in the 2014 midterm elections. Republicans overtook Democrats in the Senate and broadened their majority in the House.

There is little doctors can do for those suffering serious brain injuries from car crashes, athletics and battle, other than wait and treat the symptoms, but a unique collaboration between those who study mental illness and those who treat the disorders offers hope for new therapies. The first goal of the new Towson-based institute formed by researchers at the Lieber Institute for Brain Development and doctors at Sheppard Pratt Health System is to reformulate an old Parkinson's drug to soothe aggression and aid memory in people suffering from such brain injuries. Officials expect the new institute, announced Wednesday, to eventually translate discoveries of their own and others in genetics and brain functioning into better treatments for those suffering not just head injuries but schizophrenia, bipolar disorder, autism and other mental illnesses affecting millions of Americans. (Cohn, 10/29)

A consultant hired to find a way to divert the mentally ill from Los Angeles County's jail system found that not enough law enforcement officers were trained to handle people undergoing a mental health crisis. In a report made public Wednesday, the consultant found that more resources were needed to train police officers, dispatchers and other criminal justice workers on how to deal with people with mental illness, and that law enforcement agencies should expand the use of special teams that respond to people in crisis. (Sewell, 10/29)