I wish I had a nickel for every time I heard someone say that this election is about the economy.  Yes, it is.  But a closely related topic is health policy.  It goes without saying, but this year's election has huge implications for the future of ObamaCare, Medicare, and Medicaid.

As I emphasized recently, the presidential race is influential, but not the be-all, end-all of health policy.  Much is riding on state-level leaders who will decide not only what will happen to Medicaid, but whether states decide to create their own health insurance "exchanges," one of part of ObamaCare's implementation.  So far, fewer than 10 states have decided for certain that they will participate by creating their own exchange.

One state – Missouri – has a ballot initiative that asks voters to decide whether or not the state will create an exchange.  Some background information: Missouri's state legislature has not approved an exchange via legislation, meaning the state's governor would like to create an exchange by executive order.  This ballot initiative will tell the MO governor if he is allowed to do this.

Several other states – Wyoming, Alabama, Florida, Louisiana – have ballot initiatives generally aimed at prohibiting mandatory participation in a health care system. 

But of course, the presidential candidates have dramatically different ideas on health policy, and voters will remember this tomorrow.

Romney says he will repeal ObamaCare.  Under President Obama, we can expect his administration to move forward with the law's implementation, including the continued writing of regulations that today are behind schedule and incomplete.

When it comes to Medicare, President Obama supports the creation of the Independent Payment Advisory Board, authorized by the Affordable Care Act.  Romney supports reforming Medicare by introducing market forces to make the program more competitive and efficient.

Oh, and don't forget about the Supreme Court.  Four of today's nine justices are over 70 years old.  What does this have to do with health policy?  If you don't know the answer, I assume you were out of the country or asleep all summer.

Much is at stake for health policy in this election.  Declaring a winner for the White House will tell us a lot, but not everything, about the future of the ObamaCare, Medicare, and Medicaid.