The outcomes of midterm elections could have a significant effect on health care policy, Modern Healthcare reports. In particular, whichever party controls the U.S. Senate after the election has the power to shape the future of the Affordable Care Act. Republicans must gain six seats to take control of the chamber, and most predictions indicate that will happen, though a few races are very close, according to Modern Healthcare. Beyond the senatorial races, the outcome of various state-level elections have the potential to strongly influence the future of Medicaid expansion (Demko, Modern Healthcare, 11/3). Six of the 23 states that have not yet expanded their Medicaid programs have contentious gubernatorial races according to a recent report at californiahealthline.org.