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In an early preview of the hurdles Mr. McConnell would confront, conservative activists in recent days criticized the Kentucky senator for saying it was unrealistic to think the 2010 health law could be repealed. They demanded that he commit to using controversial budget rules, which would allow him to skirt 60-vote procedural hurdles, to erase the Affordable Care Act. Mr. McConnell’s response suggested he is already trying to manage conservatives’ expectations. In a radio address over the weekend, he said that “a new Republican majority wouldn’t mean we’d be able to get everything you want from Washington. But it would mean we’d be able to bring the current legislative gridlock to a merciful end.” (Hughes and O'Connor, 11/4)

The prospect of such deals could be complicated, though, by the chamber’s new composition and the 2016 presidential campaign. Several senators will be seeking to burnish their credentials for possible White House bids. Some older, experienced hands, including four committee chairmen, are retiring. On the right, Sen. Ted Cruz (R., Texas) is eager to reprise a fight to repeal the Affordable Care Act—a battle that many of his Republican colleagues say has been litigated and lost, and that they need to move beyond. (Hughes, 11/5)

With two chambers of Congress under GOP control, the budget process could give the party its best chance to alter Obamacare, particularly if Senate Republicans try to use budget reconciliation, which requires just 51 votes. Congress will also try to fix the Sustainable Growth Rate, a pricey formula by which the government reimburses doctors who treat Medicare patients. (Sherman and Everett, 11/5)

Republican Thom Tillis unseated Democratic Sen. Kay Hagan on Tuesday, winning a lengthy, expensive race in North Carolina after linking Hagan to President Barack Obama and highlighting his own record of accomplishments while leading the state legislature. Democrat Liz Sorrell of Cary, a retired N.C. State University employee, said she voted for Tillis because of Obama's signature health care law, which Hagan supported. She said a relative with a heart condition is paying much more for insurance since the law took effect. "I don't think that the Affordable Care Act for instance covered the small business people," Sorrell said. "I was going to vote for her before I ran into this." (Robertson, 11/4)

Republican Tom Cotton, a conservative tea party congressman, Army veteran and Harvard Law School graduate, ousted two-term Sen. Mark Pryor on Tuesday as Arkansas joined its Southern neighbors in becoming an all-red state. Cotton capitalized on voter opposition to President Obama and fended off Pryor’s attacks on his support for conservative policies, including changes to Medicare and Social Security. (Mascaro, 11/4)

Republican Dave Brat defeated Democrat Jack Trammell on Tuesday to win Virginia’s 7th Congressional District seat in a match of two Randolph-Macon College professors that neither could have predicted when they first decided to seek office. ... Trammell ran in support of Obamacare, immigration reform, women’s reproductive rights and protecting Medicare and Social Security. Trammell accused Brat of threatening Social Security and taking a harsh stance on immigrants in the country, while Brat cast Trammell as a Barack Obama clone on health care who would not hold the line on tax increases. (Nolan, 11/4)

Sen. Mark R. Warner, D-Va., is maintaining a lead of about 12,000 votes over Republican challenger Ed Gillespie Wednesday morning with all but three precincts reporting, according to The Associated Press. ... Gillespie has been a GOP strategist, a lobbyist and an adviser to President George W. Bush. He attempted to define Warner as a Democrat marching in lockstep with his party who has voted with President Barack Obama “97 percent of the time,” most notably for the Affordable Care Act. But Gillespie waited until three weeks before the election to unveil a replacement plan that would give a tax credit to everyone who buys health insurance in the individual market, and other market-oriented measures. (Schmidt and Ramsey, 11/5)

A fresh blast of public discontent reshaped American politics yet again in the 2014 midterm elections, handing the Republican Party control of the Senate and its largest house majority in 86 years. Its source: Seemingly unending economic woe – and the political discord it fuels. ... Still, as they celebrate their showing, the Republican Party’s leadership may also contemplate the following results – among the selfsame electorate that boosted them so high: ... While 48 percent said Obamacare went too far, 46 percent said it didn’t go far enough, or has it about right. (Langer, 11/5)

Overall, the Republicans' advantages abounded. Concerns about terrorism, health care and the economy all provided them with a national vote edge. Among the nearly half of voters who said the health care law went too far, 83 percent supported Republican candidates. (McDermott and Feldman, 11/5)

Dissatisfaction with President Obama, along with concern about the future of the economy and a sense the country is on the wrong track, contributed to a wave of Republican pickups, including Republican control of the U.S. Senate and additional gains in the U.S. House of Representatives. ... Health care voters went for the Democrat by 60-38 percent, while immigration voters backed the Republican by 73-25 percent. (Shiman, Campbell and Donahue, 11/5)

The CNN exit poll showed that 45% of the electorate named the economy as the most important issue facing the country, followed by health care 25%, illegal immigration 14% and foreign policy 13%. (Preston, 11/5)

The tension represented something more fundamental than money — it was indicative of a wider resentment among Democrats in the Capitol of how the president was approaching the election and how, they felt, he was dragging them down. All year on the trail, Democratic incumbents would be pounded for administration blunders beyond their control — the disastrous rollout of the health-care law, problems at the Department of Veterans Affairs, undocumented children flooding across the border, Islamic State terrorism and fears about Ebola. As these issues festered, many Senate Democrats would put the onus squarely on the president — and they were keeping their distance from him. (Rucker and Costa, 11/4)

Voters didn't just pick who they're sending to Congress and their state legislatures Tuesday — they also spoke up on a staggering range of fiercely debated issues, from abortion and legal pot to gun rights and hiking the minimum wage. (Arkin, 11/5)

Voters on Tuesday soundly defeated a proposal to lift a decades-old cap on courtroom damages for medical negligence, after a multimillion-dollar political duel pitting trial lawyers against doctors and insurers. The defeat of Proposition 46 came after a cascade of negative advertising financed by insurance and physician groups. They warned the change would send medical costs soaring and drive doctors from the state. (Blood, 11/5)

Californians Tuesday overwhelmingly voted down Proposition 46, an initiative that would have raised a cap on medical malpractice awards and required routine drug and alcohol testing for hospital doctors. (Lazo, 11/5)

Proposition 45, a ballot measure that would have allowed regulation of some health insurance premiums, has failed, AP reports. The measure was targeted by a $57-million opposition campaign. The initiative would have given California's elected insurance commissioner the power to review proposed health insurance rates for the individual and small-employer markets. Premium hikes, if deemed excessive after an actuarial analysis, could have been denied under the measure. (Lifsher, 11/4)

Voters rejected Prop. 45, a measure that would have given the state insurance commissioner the power to approve or reject health insurance rate changes. ... Voters also rejected Prop. 46, one of the most controversial initiatives on the ballot. It sought to require drug testing for doctors and increased payouts in medical malpractice lawsuits. (Gutierrez and Garofoli, 11/5)

On the heels of an advertising blitz funded by health insurance companies, California voters on Tuesday tanked a proposal to give the state's insurance commissioner veto authority over health insurance premiums. About 60 percent of voters cast ballots against the plan to give the elected commissioner expanded authority over small group and individual health plans. (Taxin, 11/4)

The anti-abortion personhood movement failed key tests Tuesday in North Dakota and Colorado, with voters rejecting amendments to grant the unborn constitutional rights. In North Dakota — a strongly anti-abortion state considered the personhood movement’s best chance of victory — the proposed ballot measure would have amended the state constitution to say the “inalienable right to life of every human being at any stage of development must be recognized and protected.” The Associated Press reported that with 91 percent of precincts reporting, it was losing by about a 2 to 1 margin. (Pradhan and Haberkorn, 11/5)

Arizona voters easily approved Proposition 303, a measure to allow terminally ill patients to potentially access experimental drugs not fully vetted by federal regulators. Voters also approved Proposition 480, a $935 million bond measure to renovate and expand Maricopa County's public-health-care system. (Hansen, 11/4)

Voters have approved a ballot question that supporters say will give Massachusetts the nation’s strongest requirement for providing paid sick time to workers, according to the Associated Press. (11/5)

The Berkeley measure levies a penny per ounce for sugar-sweetened beverages sold in the city, including soda, sports and energy drinks, juice with added sugar and syrups that go into sugary drinks at cafes, like Starbucks' Frappucinos, the measure's backers say. Diet sodas and alcohol won't be taxed under the law. About 75% of Berkeley voters backed Measure D. The measure was backed by public health advocates and the city's elected leaders, who said the tax would reduce consumption of sugary drinks and raise awareness of the link between sugary drinks, diabetes and other diseases. The measure's backers say a national soda tax in Mexico has caused people there to consume fewer sugary drinks. (Lin, 11/5)

Brown's bid for governor came after serving eight years in the Maryland General Assembly and two terms as O'Malley's lieutenant governor. In the June primary election, Brown cruised to victory by a 27-point margin, having earned the endorsement of nearly every major Democratic official in the state. In both the primary and general, he came under fire for Maryland's botched health insurance website, a centerpiece of health care reform that Brown oversaw as lieutenant governor. Brown said he, like everyone else involved, bore responsibility for its failure. (Cox and Dresser, 11/5)

Mr. Hogan defeated Lt. Gov. Anthony Brown, the Democratic nominee, in a landslide. Final results showed Maryland voters went for the Republican 54 percent to 45 percent. ... One of many Democrats to face defeat late Tuesday, Mr. Brown was weighed down in part by criticism over Maryland’s rollout of Obamacare. Mr. Brown was the O’Malley administration’s point-man on the reforms, so he took the fall when Maryland’s insurance exchange failed upon launch last fall. The portal had to be overhauled with new technology ahead of the second round of enrollment, which starts in less than two weeks. (Howell Jr., 11/5)

Hammering Brown over O’Malley’s tax increases, Hogan unleashed a roiling undercurrent of voter discontent that flared not only in Maryland, but also against Obama and Democratic incumbents across the country. ... In the current campaign cycle, [public policy professor Donald] Norris said, “it’s a Republican year, nationwide,” with GOP candidates benefitting from voter anxiety and dissatisfaction with Obama over immigration and the rollout of the Affordable Care Act, among other issues. (Schwartzman, 11/5)

After hesitating to take a stance on Gov. Jan Brewer's Medicaid expansion, [Doug] Ducey took a hard line against it. He has said he will make sure the federal government lives up to its funding promises over the next several years but has not said what he would do if federal financial support for the program declined. (Sanchez, 11/5)

Wrapping up Gov. Tom Corbett's first year in office, the administration dropped tens of thousands of people, the majority children, from Medicaid rolls. And as he headed into his second budget, the governor advocated rollbacks in programs for the poor and disabled, including eliminating a Depression-era General Assistance cash benefit for poor single adults. His administration also imposed a controversial asset test for food stamps. These and other moves shocked some of the GOP's more moderate members, and were not popular. Perhaps the electorate was not as conservative as it seemed in 2010, and the governor had misread it. (Fitzgerald and Couloumbis, 11/5)

Georgia Gov. Nathan Deal handily won reelection on Tuesday, avoiding a possible runoff against Democrat Jason Carter. ... Deal said “Cartercare” Medicaid expansion would mean a tax hike. But for Carter, the push to expand Medicaid to 650,000 Georgians was a central part of his appeal to the state’s black voters. (Wheaton, 11/5)

Republican Gov. Scott Walker defeated Democrat Mary Burke Tuesday, ensuring himself a second term in Madison and raising the prospect of a political future at the national level. ... Walker turned down federal tax dollars for building an $810 million train line between Milwaukee and Madison and for expanding the state's BadgerCare health programs for the needy, saying that taking the help now could lead to more state spending in future years. The BadgerCare decision meant forgoing more than $100 million in federal funds in the current two-year budget to expand health care for the needy under Medicaid. But Walker said that he doesn't trust the federal government to continue the payments in the future and that could leave state taxpayers holding the bag. (Stein, 11/5)

Florida Republican Gov. Rick Scott came out victorious in a nasty and expensive campaign against Democrat and former Gov. Charlie Crist. (Rafferty, 11/4)

The fortunes of each Republican incumbent in a left-leaning state will be parsed in the days ahead as part of the party’s internal debate over whether it does better by appealing to moderates, or by hewing to conservative fundamentals. Mr. Snyder carved out a moderate profile by expanding Medicaid in Michigan and aiding Detroit. Mr. Walker refused the Medicaid expansion, an option under the federal health care law, and argued that what independent voters crave is leadership. In Maine, Mr. LePage, one of the most conservative governors, vetoed the Legislature’s expansion of Medicaid five times while becoming a lightning rod over his incendiary statements. Although the spotlight was trained mainly on the battle for Senate control, because of how it will affect the president’s final two years, the outcomes of governors’ races in many ways matter more to people’s lives. State governments raise or lower taxes, fund or defund classroom teachers, strengthen or weaken environmental regulations, and embrace or resist the Affordable Care Act. (Gabriel, 11/4)

Mr. LePage’s first term in office was both consequential and controversial. His welfare-reform changes made it more difficult for people to collect food stamps, cash assistance, and Medicaid, a move that he argued would force more people to find jobs and contribute to the economy. He cut spending, erased the state’s debt to hospitals, and blocked a move by the state legislature, controlled by Democrats, to expand Medicaid, the federal-state health care program for the poor. (Paletta, 11/5)

With more than 78 percent of the vote in, [Mark] Dayton had defeated his Republican challenger, Hennepin County Commissioner Jeff Johnson. ... Johnson offered voters the prospect of spending cuts, but he did not say what he would cut. He also called for making changes to MNsure, the state's online health insurance exchange. But his solution -- asking the federal government to allow the state to opt out of the Affordable Care Act -- seemed unlikely to succeed. (Scheck, 11/4)

In ads and stump speeches, [Greg Abbott] vowed to strengthen border security, invest in roads and work to improve public education. But his biggest applause line was always an attack on the unpopular policies of President Barack Obama: He had sued Obama 30 times as attorney general, he would say, and as governor he would carry on the battle against “federal overreach” on issues such as the environment and health care. (Hoppe, 11/5)

California voters decisively elected Gov. Jerry Brown to a historic fourth term Tuesday, a rare bright spot for Democrats on a night when Republicans celebrated huge victories in the rest of the nation. ... But they rejected Proposition 45, which would have given the state insurance commissioner oversight over some health insurance rate increases. Proposition 46, which would have increased the cap on medical malpractice awards, was also defeated. (Mehta, 11/5)

California Insurance Commissioner Dave Jones has won a second term, AP reports. The Sacramento Democrat ran well ahead of Republican challenger Ted Gaines, a state senator from Rocklin. The commissioner is the state's top elected consumer regulator, overseeing the $123-billion-a-year insurance industry that includes automobile, homeowner and dozens of other types of coverage. (Lifsher, 11/5)

The Oklahoma Supreme Court on Tuesday blocked two new laws that critics say may have made it difficult for women to obtain abortions in the state. The measures, approved by the State Legislature and signed into law by Gov. Mary Fallin, took effect Nov. 1. But in a unanimous decision released Tuesday, the State Supreme Court voted to prevent enforcement of the rules until lawsuits challenging their constitutionality are settled by a lower court. (Williams, 11/4)

The Oklahoma Supreme Court on Tuesday temporarily put on hold a state law restricting abortions while the issue is argued in a lower court. The unanimous action by the high court means that women in Oklahoma can continue to use the prescription drugs mifepristone and misoprostol, which induce abortion in the early weeks of pregnancy. Oklahoma had sought to prohibit such abortions in a law known as House Bill 2684. (Muskal, 11/4)

The top court in Oklahoma is temporarily halting two harsh abortion laws that went into effect this weekend, a decision that has been hailed as “a crucial victory” by abortion rights activists. The state Supreme Court ruled Tuesday that abortions could continue in the state until a bevy of legal challenges against the laws are “fully and finally litigated.” (Ferris, 11/4)

A federal appeals court has scheduled oral arguments about the constitutionality of Texas’ tough new abortion law for the first week of January, setting up a rapid timeline that may accelerate the case’s expected trip to the U.S. Supreme Court. Solicitor General Jonathan Mitchell and lawyers representing abortion providers are planning to appear in front of the 5th U.S. Circuit Court of Appeals in New Orleans during the week of Jan. 5, the state disclosed in a legal brief filed Monday. (Rosenthal, 11/4)

The recent surge in Texas energy production has brought a new set of hazards to communities facing the bulk of the drilling — including an increase in traffic accidents and chemical spills. That means more work for already understaffed emergency response units across small-town Texas. In the West Texas city of Midland, which has seen its fair share of booms and busts over the years, firefighters face an additional set of off-the-clock challenges. Due to rising housing prices, those at the bottom of the department’s pay scale say they’ve been forced to work part-time jobs or room together just to make rent. That’s made it difficult for the department to attract and keep first responders. (Rocha, 11/4)

Now that the elections have passed, area lawmakers going to Washington, D.C., Jefferson City and Topeka in 2015 should read a Kansas City area report released this year on the untreated costs of mental illness. In Missouri it’s $2.5 billion and $1.17 billion in Kansas, reports the Health Care Foundation of Greater Kansas City in partnership with the HSM Group. The estimate is based on one in 10 adults in Missouri and Kansas having a serious mental illness and almost 40 percent of those going untreated. (Diuguid, 11/4)

On Monday, the state's largest health care agency announced a system-wide effort to "free the data" -- opening up non-confidential health data for use by entrepreneurs, researchers and reporters. (Gorn, 11/4)

Jeanne Patterson has battled breast, bone and brain cancer, carrying suitcase-size bags of her paper health records to about 20 locations around the country. Her husband, Cerner Corp. co-founder and chief executive Neal Patterson, intends to get rid of Jeanne’s bags. A rapt audience of about 11,000 Tuesday morning at the annual Cerner Health Conference heard Patterson emotionally invoke personal experience to illustrate his passion for what his company does. The North Kansas City-based company is an industry leader in digitizing patient health records and working with other providers to make that information “interoperable” across health care information technology providers. (Stafford, 11/4)

For patients who walk into one of the physician offices run by Triad HealthCare Network, not a lot seems different from other practices: You get weighed and your blood pressure checked. The nurse will ask about your most recent mammogram, your blood sugar; you might get some instruction about how to lose weight or stop smoking. All of these activities are typical in doctors’ offices. But for patients at Triad, the difference is that no matter which of their clinics you walk into you’ll be asked the same questions, the record of your medications will always be the same and up-to-date, you’ll get encouragement and reminders from every provider you see to get that mammogram or be offered nicotine patches to help you stop smoking, and you’ll get help navigating a health care system that often can seem overwhelming in its complexity. (Hoban, 11/4)

The Iowa Board of Pharmacy, which has said the state should move toward allowing medical uses of marijuana, is considering whether to make a new recommendation on the issue to legislators. A committee of the board will meet Nov. 17 to hear testimony on the issue. The pharmacy board voted unanimously in 2010 to recommend that legislators reclassify marijuana in a way that could make it easier to use legally for medical purposes. Iowa law now classifies marijuana both as a Schedule I drug, impermissible for almost any use, and a Schedule II drug, which could be used for closely controlled medical purposes. (Leys, 11/4)

Closing what many see as a loophole that could trap millions of people in sub-standard insurance, the Obama administration said Tuesday that large-employer medical plans lacking hospital coverage will not qualify under the Affordable Care Act’s toughest standard. It also offered relief to workers who may be enrolled in those plans next year. The administration will rule that plans without “substantial coverage for in-patient hospitalization services” do not meet the law’s “minimum value” threshold, the Treasury Department said in a notice Tuesday morning. It will issue final regulations saying so next year, it said. (Hancock, 11/4)

An employer health plan that doesn’t cover hospital care won’t quite cut it under the health law, according to federal regulators. A new notice issued Tuesday by the Department of Health and Human Services and the Treasury Department says they believe that “plans that fail to provide substantial coverage for in-patient hospitalization services or for physician services” or both don’t meet the law’s standard for minimum value. That means a big employer offering such a plan to workers could still be subject to one of the law’s two penalties for failing to provide adequate coverage. Also, an employee offered such a plan could potentially still qualify for federal subsidies to buy coverage through one of the law’s marketplaces. (Wilde Mathews, 11/4)

Federal regulators Tuesday announced plans to close a loophole in the Affordable Care Act that allows large employers to offer plans that don't cover in-patient hospital stays. ... To meet the ACA's "minimum value" test, health plans for individuals and those working for smaller employers must include coverage within at least 10 categories of "essential health benefits" that include maternity care, prescription drugs and hospitalization.The health care law is much more stringent about what health insurance must cover for these people than it is for those working at large employers. (O'Donnell, 11/4)

Health plans offered by large, self-insured employers that do not include inpatient hospital services as a standard benefit will soon be a thing of the past, according to a notice released Tuesday by HHS and the Treasury Department. The federal government said many healthcare industry stakeholders raised questions and concerns about the viability of these types of “skinny plans,” and hospitals are hailing the latest guidance. Many companies have been building health benefits packages for employees to avoid paying a penalty under the Patient Protection and Affordable Care Act. But some of those plans have excluded hospitalization benefits. (Herman, 11/4)

Technology gaps in HealthCare.gov are expected to cause consumers and insurers a fresh batch of complications after the site reopens for health-plan enrollment this month, insurance-industry officials say. Millions of Americans are expected to buy or change plans using the federal portal when the second year of enrollment under the Affordable Care Act begins Nov. 15. ... Consumers who bought policies on the exchange for 2014 and switch to a different insurer for 2015 could end up enrolled in two plans, with bills for both, in January, according to two industry officials. Others who stopped paying premiums for their plans this year could find themselves automatically re-enrolled. (Radnofsky, 11/4)

Brian Adams, who sells fireplaces in Indianapolis, is like many of the nation’s small-business owners. As the cost of providing health benefits has climbed, he has struggled to afford coverage for his employees — a problem the new health care law was designed, in part, to address. But a year after the law’s introduction of the insurance exchanges, provisions that were supposed to help small businesses offer employee health benefits are largely seen as a failure. And Mr. Adams, like many of his fellow business owners, is sending employees to the exchanges to buy their own coverage instead. (Abelson, 11/4)

On Nov. 15, you’ll have the chance to shop for health insurance plans through “marketplaces” established by your state or the federal government, as the second year of the Affordable Care Act, or Obamacare, begins. (Renter, 11/5)

Yet the one issue that has been on the ballot everywhere this year is President Obama and his record. ... Democrats in turn studiously avoided appearing with Mr. Obama, much less having him campaign for them, and the Senate challenger in Kentucky famously wouldn’t even say if she’d voted for him. Georgia Democrat Michelle Nunn identified herself explicitly with George H.W. Bush. Mr. Obama was consigned to campaigning in heavily Democratic states, like Maryland. Democratic incumbents claimed their votes for the President’s agenda were mostly “procedural,” but the problem is that all of them were with the White House on every vote that mattered. Each of them provided the last “aye” to get ObamaCare through the Senate. Most Democrats barely defended ObamaCare while promising vaguely to fix it, and GOP Senate candidates ran more ads against ObamaCare in October than on any other issue, according to Kantar Media/CMAG. (11/4)

The most important promises that winning Republicans made were negative in nature. They will repeal health care reform. They will roll back new regulations on banks and Wall Street. They will stop the Obama administration’s plans to curb coal emissions and reform immigration and invest in education. Campaigning on pure negativity isn’t surprising for a party that has governed that way since Mr. Obama was first sworn in. (11/5)

Arkansas, Kentucky and West Virginia — states that saw substantial drops in the proportion of their residents without insurance — all elected Republican Senate candidatess who oppose the Affordable Care Act. Control of the West Virginia state House of Delegates flipped from Democrats to Republicans. And Arkansas elected Republican supermajorities to both houses of its legislature along with a Republican governor, a situation that could imperil the Medicaid expansion that helped more than 200,000 of its poorest residents get health insurance. (Margot Sanger-Katz, 11/5)

Exhibit A was last fall's disastrous rollout of the federal health care exchanges, a blunder for which Obama justifiably gets the blame. There's just no excuse for a chief executive who doesn't stay on top of his single most important initiative. Other failures weren't solely Obama's fault, but they added to the impression of a president who couldn't handle the day-to-day job of managing the bureaucracy, or didn't care: lost e-mails and political targeting at the IRS, outrageous wait times Veterans Affairs facilities, bumbling on Ebola by the Centers for Disease Control and Prevention, and the Secret Service allowing a deranged man to get deep inside the White House. ... The most obvious way for Obama and his party to compete [again in 2016] is to display more competence in governing. A good way to start would be by making sure the second rollout of the health exchanges, which begins Nov. 15, goes smoothly. (11/5)

Most recent presidents achieved little, domestically at least, in their last two years as their clout diminished and the nation's attention shifted to the next presidential election. In the next two years, Tea Party Republicans will continue to push for more polarizing confrontation, particularly over President Obama's signature health care law. But there are reasons not to give up hope this time. (11/5)

Granted, voters have sent mixed signals about what they want. Polls show growing support for elected officials willing to compromise, yet voters didn't penalize Republicans for shutting down much of the federal government last year in a vain attempt to “defund Obamacare.” The public seems to expect the majority to govern, regardless of what the minority does. With Republicans taking the Senate, Democrats may have little interest in tamping down the voter anger that has led to these “change” elections. ... It would be naive to expect the election to end the polarization between the parties. Nevertheless, its results suggest that voters are tired of watching policymakers dig themselves more deeply into their ideological trenches. (11/4)

What about health care? Votes to repeal Obamacare may be inevitable, but they will not have sufficient support to override the inevitable presidential veto. Republicans may do better with targeted legislation aimed at provisions that are unpopular with a number of Democrats. On that list are the medical device tax and the Independent Payment Advisory Board. I am a supporter of both, and believe the Independent Payment Advisory Board in particular has been widely misunderstood, but they are politically vulnerable. The White House would be wise to start defending them now -- or at least limit the damage any changes might impose. The best thing that could happen would be for Congress and the White House to agree to improve the Affordable Care Act by passing legislation such as the Better Care, Lower Cost Act. (Peter R. Orszag, 11/4)

Two and a half years ago, the Supreme Court upheld the Affordable Care Act by a single vote. This year alone, between 8 million and 11 million Americans have been able to get health insurance that they did not have before, according to a new analysis by The Times. But this remarkable success has endured relentless attacks by the law’s dogged opponents, who will not stop until they have destroyed it. They lost in their efforts to gut the law in 2012. They could get another chance as early as Monday. That is when the justices are expected to announce whether they have agreed to hear the latest challenge, which takes aim at four words — “established by the State” — buried deep within the 900-page law. (11/4)

Dr. Arnold Relman, the former New England Journal of Medicine editor-in-chief who died of cancer in June, sought the same type of physician aid in dying that Brittany Maynard received in Oregon last Saturday. But the famed physician's doctors in Massachusetts turned him down, said his widow, Dr. Marcia Angell, also a former NEJM editor-in-chief. “He wanted to bring about death in a peaceful and fast way, and he couldn't have that,” said Angell, who campaigned for passage of a “death with dignity” ballot initiative in Massachusetts that was narrowly defeated in 2012, in an interview with Modern Healthcare. ... “He died of breathlessness, with his lungs filled with tumor,” she said. “Pain is the least of the symptoms for dying patients, it's the easiest to relieve. But breathlessness, nausea, clouding of thinking, these things are much harder to deal with.” (Harris Meyer, 11/4)

A federal judge in Minneapolis on Monday refused to block Honeywell International from imposing penalties on workers who refuse to participate in a workplace "wellness" program, denying a request for an injunction by the Equal Employment Opportunity Commission. This can be seen as a victory for the cause of workplace health, for the goal of the Honeywell program was to discourage smoking, obesity and other bad health behaviors and outcomes in its workforce. It can also be seen as a defeat for worker privacy and independence, for the EEOC saw the program as intrusive and coercive. (Michael Hiltzik, 11/ 4)