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This may be a small victory party, but it's a victory party nonetheless. Photo: Robert F. Bukaty / AP

Last night, Maine became the first state to expand Medicaid via referendum and the 33rd state (counting D.C.) to adopt the Affordable Care Act's expansion one way or another. And in Virginia, Democrats' unexpectedly large gains in the state's House of Delegates made expansion a much more realistic prospect there, too.

The big picture: Last night was a huge night for Democrats, and health care was a huge part of it.

  • Exit polls in Virginia showed that health care was the No. 1 issue for a plurality of voters — and 78% of those voters broke for Democrat Ralph Northam.
  • Virginia already had a Democratic governor. The party's immense gains in the state legislature, where past efforts to expand Medicaid failed, are what move it closer to reality.
  • Maine's Medicaid expansion might be somewhat delayed. Some expansion advocates expect Gov. Paul LePage, a fierce expansion opponent, to run out the clock and leave the actual implementation for whoever takes over after he's term-limited in 2018. Even so, last night's referendum will bind his successor, too. It's happening eventually.

The emotional win might be the most important. The main takeaway for Democrats across the ideological spectrum last night: They can, in fact, win, and win big, and win on health care issues. Even, or maybe especially, when President Trump and congressional Republicans are still fixated on some form of ACA repeal.

  • The results from Maine, whenever they actually take effect, have already mobilized Democrats to try to get similar initiatives on the ballot next year in more non-expansion states.
  • Look for Idaho, Kansas and Utah to be at the forefront of those efforts.
  • And if last night does turn out to be a sign of what's to come in 2018, don't expect any more ACA repeal bills to pass the House. Whatever provisions Republicans think they can actually agree to repeal, delay or weaken, they'd better repeal, delay or weaken soon.

One last thing: Ohio voters overwhelmingly rejected a ballot initiative to cap what state-run health programs would pay for prescription drugs.

The bottom line: Governing majorities come and go, but pharma always wins.

Go deeper

Biden will reverse Trump's attempt to lift COVID related travel restrictions

Photo: Tasos Katopodis via Getty

The incoming Biden administration will reverse President Trump's last-minute order to lift COVID-19 related travel restrictions, Jen Psaki, the incoming White House press secretary, tweeted.

Why it matters: President Trump ordered entry bans lifted for travelers from the U.K., Ireland, Brazil and much of Europe to go into effect Jan. 26, but the Biden administration will "strengthen public health measures around international travel in order to further mitigate the spread of COVID-19," Jen Psaki said. Biden will be inaugurated on Wednesday, Jan. 20 and Trump will no longer be president by the time the order is set to go into effect.

Dominion sends cease and desist letter to My Pillow CEO Mike Lindell

Photo: Stephen Maturen/Getty Images

Dominion Voting Systems on Monday sent a cease and desist letter to My Pillow CEO Mike Lindell over his spread of misinformation related to the 2020 election.

Why it matters: Trump and several of his allies have pushed false conspiracy theories about the company, leading Dominion to take legal action. It's suing pro-Trump lawyer Sidney Powell for defamation and $1.3 billion in damages, and a Dominion employee has sued Trump himself, OANN and Newsmax.

Off the Rails

Episode 5: The secret CIA plan

Photo illustration: Aïda Amer, Sarah Grillo/Axios. Photo: Zach Gibson/Getty Images

Beginning on election night 2020 and continuing through his final days in office, Donald Trump unraveled and dragged America with him, to the point that his followers sacked the U.S. Capitol with two weeks left in his term. This Axios series takes you inside the collapse of a president.

Episode 5: Trump vs. Gina — The president becomes increasingly rash and devises a plan to tamper with the nation's intelligence command.

In his final weeks in office, after losing the election to Joe Biden, President Donald Trump embarked on a vengeful exit strategy that included a hasty and ill-thought-out plan to jam up CIA Director Gina Haspel by firing her top deputy and replacing him with a protege of Republican Congressman Devin Nunes.