Whoever is elected president today could have a profound impact on the future of the U.S. health care system.

However, the future of health care will also largely be shaped by thousands of races for state offices around the country.

There are a number of very clear opportunities for voters to choose a specific direction on health care, such as in Colorado, where a ballot initiative that faces an uphill battle proposes establishing the first state-run single-payer health care system, or in Arizona and Washington state, where ballot initiatives that are likely to succeed will require businesses to provider workers with paid sick leave.