Eric Kayne / for NBC News

Brandi DeFrank's son Gabriel, 3 months old, is covered under Medicaid, but the program's coverage for the Texas mom herself ended when she gave birth.

By Maggie Fox, NBC News

As Mitt Romney and President Barack Obama pack in some last-minute campaigning before Tuesdays election, polls show voters are split just about down the middle on who they prefer: Romney, who has promised to do everything he can do repeal the 2010 health reform law, and Obama, who says its benefits are just beginning to take hold.

But while the presidential race gets most of theattention,the choices voters make to fill governors mansions and state legislatures mayhave just as big an effect on what kind of health coverage they will have in coming years.

Thats in part because the Affordable Care Act sets it up that way, but even more so because the Supreme Court says its up to states to decide whether and how to expand the Medicaid health insurance plan for the poor.

One thing the voters should be aware of is what are their governors are going to be doing. Will more people have access to Medicaid or access to a state-run exchange? says John Poelman of healthcare consulting firm Leavitt Partners and a former health policy analyst at the Department of Health and Human Services.

Two states at the two extremes of health care coverageare Texas, with a free-market, bare-bones approach, and Vermont, which is unabashedly going for a European-style, government-supported system.

Brandi DeFrank is one of the 6.3 million people in Texas who lack health insurance. That'sa quarter of the state's population and the highest percentage of uninsured peoplein the country.

Like millions of women across the country, DeFrank,20, was fully covered under Medicaid, the state-federal health insurance plan for low-income people, while she was pregnant. The birth of her 3-month-old son, Gabriel, was also covered, but after that, her own coverage ended. The baby remains on Medicaid -- all states make some provision for children whose parents lack insurance -- but now DeFrank is on her own and gambling that she wont get sick.

Originally posted here:

State elections decide health care's future