Given the midterm elections, it looks like Medicaid will be expanded in Utah, Nebraska, and Idaho. Plus, with Dems taking the house the chances of an ACA repeal are slim for now. On top of that, Maine and Kansas elected governors who support Medicaid expansion.
In other words, Medicaid expansion under the ACA did really well and with a Democratic majority in the house, it now nearly impossible for the GOP to do a full repeal of the ACA in Congress, and the wins for Medicaid and Democrats at the state level could mean more states passing Medicaid Expansion in the coming years.
Further, although the Supreme Court now has more conservative judges due to Trump appointments, and although the executive office still has a lot of power to make changes to the healthcare system, Democrats did flip four Attorney General seats. This makes it harder for the GOP to go after the ACA, and also makes the GOP’s current state-led lawsuit against the ACA harder to pull off.