The battle to convince California voters to approve a ballot initiative aimed at curbing prescription drug prices appears to be tightening as the pharmaceutical industry steps up its attacks, according to poll results released on Friday.

As many as 140 million Americans will have already voted for president, members of the U.S. House and Senate, governors and state legislators by the end of Monday in an election that will have a major impact on the future direction of U.S. health care.

The Affordable Care Act is in the midst of the death spiral critics have long predicted.

As open enrollment starts Tuesday on the Affordable Care Act exchanges, consumers in some parts of the country are bracing for huge rate hikes, while many others are preparing to change insurers and likely doctors.

Until this week, when big increases in insurance premiums were unveiled for next year, the federal health law has not been a major issue in the presidential election. In fact, fixing what ails the Affordable Care Act isn’t even among voters’ top priorities for health issues for next year, according to a new poll.

Americans in the health insurance markets created by President Barack Obama's law will have less choice next year than any time since the program started, a new county-level analysis for The Associated Press has found.