While today’s elections include several landmark statewide initiatives ranging from marriage equality to marijuana legalization, five states have also tacked purely symbolic measures onto their ballots purely to oppose Obamacare.

The Washington Post’s Sarah Kliff notes that — despite federal law’s supremacy over state law, and despite the fact that the Supreme Court upheld Obamacare’s constitutionality this summer — five states’ ballots include measures to invalidate Obamacare provisions. Wyoming’s Amendment A, Florida’s Amendment 1, Alabama’s Amendment 6, and Montana’s Measure LR-122 would all prohibit state residents and employers from being forced to purchase insurance or participate in any externally-imposed health care system. In Missouri, Proposition E seeks to prevent the state from instituting its own health insurance exchange.

But even if any of the first four measures to amend those states’ constitutions passed, all Americans would still be subject to federal Obamacare provisions, including the individual and employer mandates. And Obamacare already accounts for states that choose not to create their own statewide exchanges by requiring the federal government to set up “federally-facilitated exchanges” for them in 2014.

All five initiatives are totally ineffective, amounting to little more than political posturing against President Obama’s health reform law.

Throughout the presidential campaign, there’s been a lot of talk about either keeping or repealing Obamacare — but the fact is, no matter who wins today’s election, the implementation of some pieces of President Obama’s health care reform law will have to move forward.

The Obama administration — which has been steadily issuing final “rules” for implementing Obamacare components as the different pieces of the health law take effect — will likely unleash a flood of new regulations after tonight’s election results. If President Obama wins a second term, that process could extend into 2014. But if Mitt Romney wins, the regulations will be issued at a much faster pace in an effort to get as many Obamacare rules finalized before a Romney administration would have the chance to potentially undo them. This means that HHS would have to finalize those rules before November 22nd, 60 days before Romney’s inauguration.

Regardless of who wins the presidency, HHS is almost guaranteed to issue new rules on these three core Obamacare elements in the coming month or so:

1) Statewide health insurance exchanges. States have until November 16th to decide if they plan to establish their own exchange, an exchange created in partnership with the federal government, or an exchange created entirely by the federal government. Although HHS has some guidelines for the basic structure of the exchanges, it still has to finalize the details on how it will partner with states to create “federally-facilitated” exchanges without confusing Americans.

2) Essential health benefits. After setting up the rules for how the health exchanges will function, HHS will have to specify which insurance policies will be covered under them. Insurance plans under the exchanges will have to meet federal standards across ten “essential benefit” categories, including preventive care, emergency services, maternity care, and prescription drugs. But states have leeway to decide what benefits should fall under those categories, and the federal government may have to provide states with more guidance about the minimum coverage they need to be offering to their residents.

3) Part-time workers and employer-provided health benefits. Obamacare requires large employers to offer full-time employees a minimum level of health benefits or pay a fine — but some companies have been toying with the idea of shifting more workers to part-time status in order to avoid the extra coverage costs. This would be a devastating labor practice for the low-wage workers who cannot afford private insurance but are not poor enough to qualify for Medicaid — and often work nearly as many hours as their full-time co-workers. HHS will likely issue rules to either prevent this kind of benefit-dodging or encourage large employers to insure part-time workers.

These are only some of the rules that HHS will have to consider very soon — others include instructions for states’ Medicaid expansions and contraception requirements for religious institutions. No matter who reaches 270 electoral votes tonight, states and health care providers across the country still need more details from HHS to effectively implement the health reform law’s various moving parts.

Throughout this campaign season, “women’s votes” have become hotly contested as both candidates have vied for support from the female half of the country’s population. As President Obama pointed out in the second presidential debate, policies to ensure affordable access to contraception and close the wage gap are not just women’s issues, but actually family issues and middle-class issues. Nevertheless, some of the presidential candidates’ proposed policies do have an outsized impact on women, and the outcome of today’s election will determine the future of these ten issues:

1) Health care costs. Women tend to have higher medical expenses than men do, and insurers often practice “gender rating” to charge women more than men for the exact same health services. Forty three percent of women report that high costs have led them to skip some of the health care services they need. Under Obamacare, gender rating will be illegal and a wide range of important preventative health services for women — such as contraceptive services, cancer screenings, STI testing and counseling, and annual check-ups — will be covered at no additional cost. Issues of gender-based discrepancies in health care costs could reemerge, however, if the health reform law is repealed.

2) Pay equity. The average woman in the United States still makes just 77 cents for every dollar earned by a man, a wage gap that emerges in the very first year of full-time work after college. President Obama signed the Lilly Ledbetter Fair Pay Act in 2009 to empower women to challenge wage discrimination — but Romney has declined to clarify whether or not he supports that legislation. Romney has also dodged questions about his stance on the Paycheck Fairness Act, which would close additional loopholes in existing pay equity laws.

3) The Supreme Court. Since four of the nine current justices are over the age of 74, the winner of this election could have the chance to appoint several new members. Romney has said he would appoint judges to overturn Roe v. Wade and revoke women’s legal access to abortion, and his appointments could also chip away at women’s rights in other areas. Justice Antonin Scalia does not believe that the Constitution guarantees protection from gender discrimination, and Justices John Roberts and Samuel Alito have suggested they may share that view — so the Supreme Court could be just one vote away from ruling against women who bring forth gender-based discrimination cases.

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A federal appeals court panel on Monday considered Arizona’s stringent abortion ban, which has the distinction of being the most restrictive in the nation because it criminalizes almost all abortions after just 20 weeks. Arizona already bans abortion after viability — which is generally considered to occur around week 23 or 24 of pregnancy — but the bill in question would go even further, redefining gestation in a way that would ban abortion at least two weeks before other states do, potentially as early as week 18.

The judges on the panel questioned HB 2036′s potential to harm the women who do not realize the medical risks of their pregnancies until after the arbitrary cut-off, when they are no longer permitted to seek abortions. But Arizona officials brushed aside those concerns, saying that those medical emergencies are “the woman’s problem”:

Judge Andrew Kleinfeld, a panel member appointed by former President George H.W. Bush, repeatedly expressed concern that the law might not afford women the opportunity to abort a fetus with birth defects in cases where the defects are not apparent until just before 20 weeks.

He also questioned the need to prohibit abortions at that stage of the pregnancy, especially for fetuses bound to develop “horrible birth defects.”

“They’re basically born into hell and then die,” Kleinfeld said. “I don’t see how the courts could act before viability” of the fetus.

“With due respect, that’s the woman’s problem,” responded David Cole, Arizona’s solicitor general. “She should have made that decision earlier.”

However, in some cases, women cannot actually make that decision earlier because it is too difficult to detect fetal abnormalities before the medically accepted point of viability. And the American Civil Liberties Union, which is suing Arizona to block HB 2036 from going into effect, told Reuters that Arizona’s ban has a “truly, horrifically narrow” medical exception that will prevent many women from getting abortions even when it is medically necessary for them to end a pregnancy. Even though about 100 pregnancies are terminated after 20 weeks in Arizona each year, the law would criminally prosecute the doctors who perform abortion services after the cut-off.

The three-judge panel has yet to make a final ruling. A federal judge upheld HB 2036 at the end of July, but a 9th Circuit Court of Appeals panel temporarily blocked the law from going into effect just a few days later so that the court could more fully consider the case.