Voters in Virginia and Kentucky sent a clear message on health care Tuesday night: Medicaid expansion and preexisting conditions are winning issues for Democrats, even as President Donald Trump and his allies try to undercut Obamacare. And strident GOP attacks on abortion weren’t enough to stave off Republican losses.

Democrat Andy Beshear, who claimed victory in Kentucky’s tight gubernatorial race, and Virginia Democrats who took back control of the state legislature promised to defend Obamacare’s popular insurance protections for preexisting conditions, and they railed against Republican plans to contract the law’s expansion of Medicaid to millions of poor adults.

Here are four takeaways on how health care pushed Democrats over the top Tuesday night…

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