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It's never too early to start thinking about the upcoming 2018 elections. And while a lot of the focus so far has been on the House, a handful of hotly contested gubernatorial races could have higher stakes for health care — specifically, for the Affordable Care Act's Medicaid expansion.

A raft of open governors' races next year will give Democrats a chance to replace some of the most stridently anti-expansion governors in the country — and, if they win even a few of those races, the chance to cover millions of currently uninsured people even as the Trump administration drags its heels on so much of the ACA.

Expand chart
Data: Kaiser Family Foundation, The Cook Political Report; Note: Maine, a toss up state, was not included due to insufficient Medicaid data; Chart: Andrew Witherspoon / Axios
  • 15 non-expansion states will hold gubernatorial elections this year or in 2018. Ten of those will be open seats.
  • Democrats won't win all of those races. But several of their best political opportunities are in the states where Medicaid expansion would cover the most people.
  • One of the biggest battlegrounds: Florida, where Gov. Rick Scott will be term-limited next year. The Cook Political Report considers Florida a toss-up. And if Scott's successor is more amenable to the Medicaid expansion, nearly 800,000 Floridians could gain coverage, according to the Kaiser Family Foundation's estimates.
  • Maine Gov. Paul LePage — one of the ACA's loudest critics — is also leaving office, and one of the expansion's biggest defenders — Sen. Susan Collins — might run to replace him.
  • Virginia's state legislature has previously come up just a few votes shy of adopting the expansion, which would cover some 225,000 people.

Why it matters: There's not much the Trump administration could do to stop more states from signing on to the Medicaid expansion, especially if those states don't seek waivers from certain structural rules as part of the process. And that means Democrats, already energized by the health-care fight, have a real chance to build on the ACA's coverage gains, even under a hostile administration — if they can get their act together at the state level.

Go deeper

Updated 5 hours ago - Politics & Policy

1 dead after pickup truck hits Pride spectators in Florida

Police investigate the scene where a pickup truck drove into a crowd of people at a Pride parade in Wilton Manors, Florida, on Saturday. Photo: Jason Koerner/Getty Images

A driver in a pickup truck hit spectators at a Pride festival in Wilton Manors, Florida, killing a man and leaving another person hospitalized Saturday, authorities said.

Details: Fort Lauderdale Mayor Dean Trantalis told reporters police had "apprehended the driver" and that the vehicle missed a parade car carrying Rep. Debbie Wasserman Schultz (D-Fla.) "by inches."

Updated 8 hours ago - Sports

Uganda Olympic team member tests positive for COVID in Tokyo

The Uganda National boxing team's Catherine Nanziri (L) and others arrive for check-in at Entebbe international airport in Wakiso, Uganda on Friday, ahead of their departure to participate in the Tokyo Olympic Games. Photo: Badru Katumba/AFP via Getty Images

A Uganda Olympic team member tested positive for COVID-19 upon arrival in Japan late Saturday, officials said.

Why it matters: Japan's government has faced criticism for vowing to host the Tokyo Games next month as coronavirus cases rise. The Ugandan team is the second to arrive in Japan after the Australian women's softball players, and this is the first COVID-19 infection detected among the Olympic athletes, Al Jazeera notes.

Updated 12 hours ago - World

In photos: Brazilians rally against Bolsonaro as COVID deaths top 500,000

A June 19 protest in São Paulo, Brazil, against the administration of Brazilian President Jair Bolsonaro, who has railed against precautionary health measures despite the soaring COVID-19 death rate and cases. Photo: Rodrigo Paiva/Getty Images

Demonstrators took to the streets in at least 22 of Brazil’s 26 states to protest President Jair Bolsonaro's handling of the pandemic — as deaths from COVID-19 in the country surged past 500,000 Saturday, per AP.

The big picture: Brazil has the world's second-highest coronavirus death toll and third-highest number of reported cases. Only 12% of the country's population has been vaccinated against the virus, AP notes.