In the Kentucky governor's race, tea party favorite Matt Bevin (R) defied expectations and defeated state Attorney General Jack Conway (D), becoming the second Republican governor in more than 40 years. Bevin, a businessman, previously challenged Senate Majority Leader Mitch McConnell (R-Ky.) in a 2014 primary, but was trounced.
The GOP victory baffled many political observers in a state that, despite its conservative reputation nationally, often elects Democrats to local and state offices.
Voters also selected Republican Mike Harmon for auditor, though Democrats eked out victories in two other statewide races: Andrew Beshear narrowly won the race to succeed Conway for attorney general, and incumbent Secretary of State Alison Lundergan Grimes, who unsuccessfully challenged McConnell in 2014, was re-elected.
Bevin's victory jeopardizes the fate of hundreds of thousands of Kentucky residents who have gotten health insurance under President Barack Obama's landmark health care law.
The current Democratic governor, Steve Beshear, became an unlikely champion of Obamacare, establishing Kynect, the state's successful health care exchange, and expanding Medicaid.
But with Bevin pledging to repeal and replace Kynect, the 400,000 Kentucky residents who qualified for Medicaid through the recent expansion may lose their coverage, as well as about 100,000 who obtained insurance through the state exchange.
Virginia, which held elections for its state legislature on Tuesday, saw major GOP wins.
The party retained control of the state Senate, despite the efforts of state Democratic leaders, including Gov. Terry McAuliffe, who fought tirelessly to turn some of the more competitive districts blue.
With both of the state's legislative chambers controlled by Republicans, McAuliffe faces an uphill battle in passing progressive legislation, such as his recent push for gun control laws.
In another victory for conservatives, voters in Ohio failed to approve a ballot measure that would have legalized marijuana, though most pro-marijuana advocates did not openly lend their support because it would have restricted marijuana production to a few wealthy individuals.
On the local level, voters rejected several progressive ballot initiatives. Read More: