Here is a recap of some of the bigger election issues across the U.S., and the results of Tuesday's vote.
Kentucky: Governor's race
Kentucky voters on Tuesday elected just the second Republican in four decades to hold the governor's office, in a race that hinged largely on President Barack Obama's signature legislation, the Affordable Care Act.
The result was a potentially troubling sign for Democrats ahead of next year's presidential election and represented a big win for the GOP as it continues to consolidate political power across the South. The governor's race in Kentucky was the highest profile contest in Tuesday's off-year elections.
Republican businessman Matt Bevin had waged a campaign to scale back the state's Medicaid expansion that was made possible under the federal health care overhaul. Some 400,000 lower-income people who gained health coverage under the expansion could be affected.
Bevin ran as an outsider, emphasizing his Christian faith along with his support for Kim Davis, the Rowan County clerk jailed for refusing to issue marriage licenses to same-sex couples. His Democratic opponent, two-term Attorney General Jack Conway, embraced Obama's health care reforms, saying hundreds of thousands of residents could lose access to taxpayer-funded insurance if Bevin won.
"The degree to which the national party is out of step with mainstream Kentuckians has created an environment where it's extraordinarily difficult for a Democrat to win statewide," said state Auditor Adam Edelen, who lost his re-election bid to a little-known Republican state representative.
Mississippi: Governor's race, public schools funding
Republican Gov. Phil Bryant easily won re-election. The governor's race was overshadowed by a fight over a constitutional amendment that would allow people to sue the state to increase funding for public schools. Voters defeated the proposed amendment. Critics say it would have taken budget decisions away from Mississippi lawmakers and given the courts too much power.
Texas: Houston non-discrimination protections, mayoral race
Efforts to secure non-discrimination protections for gay and transgender people failed by a 2-to-1 margin. Now that same-sex marriage is legal, such laws have become a priority for gay, lesbian, bisexual and transgender groups. Opponents, including a coalition of conservative pastors, said the measure would have infringed on their religious beliefs.
Texas Gov. Greg Abbott praised the voters who defeated the measure, saying they "showed values still matter."
In the race for Houston's next mayor, veteran state Rep. Sylvester Turner and Bill King, a former mayor of a Houston suburb, will meet in a Dec. 12 runoff. It was one of more than 300 mayoral races happening across the country.
Former longtime Councilman Jim Kenney was elected mayor on a promise to fight poverty and push for universal pre-kindergarten education.
Ohio: Marijuana legalization issue
Ohio voters rejected an initiative that sought to legalize the recreational and medicinal use of marijuana.
Virginia: State senate race
Democrats failed in an expensive bid to take control of the state Senate and empower Democratic Gov. Terry McAuliffe in negotiations with Republicans who control the state House. With the losses in Virginia and Kentucky, it was a rough Election Day for Democrats.
"I don't think you can point to one singular issue as to why these defeats happened tonight, but it's an opportunity for Democrats to recalibrate and continue to develop a plan and a strategy to win in 2016," said Tharon Johnson, who led Obama's 2012 re-election effort in the South and helps oversee finances for the Democratic National Committee.
Utah: Salt Lake City mayor's race
The Salt Lake City mayoral race featured a tight race between two-term incumbent Ralph Becker, one of President Barack Obama's appointees on a climate change task force, and former state lawmaker Jackie Biskupski. The race remained too close to call, as thousands of mail-in ballots that were dropped off at polling places Tuesday remain to be counted. If Biskupski wins, she will be the city's first openly gay mayor.
California: Airbnb restrictions
San Francisco voters rejected a citizen-backed initiative to restrict the operations of Airbnb, the room-rental site. A separate measure to authorize a $310 million bond package for affordable housing in the city required a two-thirds vote and had yet to be decided.
Washington: Penalties for animal product imports
Voters overwhelmingly approved a measure to add state penalties for anyone who imports certain animal products for commercial purposes, such as elephant ivory or rhino horns
Colorado: Marijuana tax issue
Colorado voters decided to let the state keep $66 million in tax revenue generated from the sale of recreational marijuana. An existing state law requires excess tax revenue to be returned to taxpayers, but on Tuesday voters agreed to make an exception with the marijuana revenue and direct it instead toward public education and drug-prevention programs.
Associated Press writer Adam Beam in Frankfort, Kentucky, contributed to this report.