Alaska is deciding whether to adopt the idea as the state that did first sees how many more people it brings to the polls.
One of the goals of President Obama's signature health reform is to focus more on population health, but the programs are off to a slow start.
The victors in down-ballot races could determine what approaches states take toward fixing up rundown roads and infrastructure in the years to come.
Judges are starting to strike down the laws, calling them racist. But their survival depends on the outcome of the November election.
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