Yesterday afternoon, the Virginia Senate approved a bipartisan measure to expand Medicaid. Now Gov. Ralph Northam (D), who campaigned extensively on Medicaid expansion, is expected to sign expansion into law. Advocates secured expansion despite attempts from the White House and conservative activists to stop it, paving the way for Virginia to become the 34th state, including the District of Columbia, to expand Medicaid – with Utah, Idaho, and Nebraska seeking to follow suit through ballot measures this fall.

Here’s a roundup of reactions:

Washington Post: “It’s Another Nail In The Coffin For Efforts To Repeal Obamacare.” “As Joe Biden put it a little differently when Barack Obama signed the Affordable Care Act eight years ago, Virginia’s expansion of Medicaid on Wednesday is a big dang deal. And not just because 400,000 low-income citizens will now have access to government health insurance. It’s another nail in the coffin for efforts to repeal Obamacare… Years of obstruction in the commonwealth gave way because key Republicans from rural areas couldn’t bear to deny coverage for their constituents any longer, moderates wanted to cut a deal and, most of all, Democrats made massive gains in November’s off-year elections.” [Washington Post, 5/31]

Republican State Senator Ben Chafin: “I Came To The Conclusion That ‘No’ Just Wasn’t An Answer Anymore.” “In the final hours, Sen. Ben Chafin, a Republican lawmaker from Virginia’s economically depressed southwest coal country, announced his support for expansion on the Senate floor. He said his rural area needs expansion to bolster its hospitals and provide care for constituents. ‘I came to the conclusion that no just wasn’t the answer anymore,’ Chafin said.” [USA Today, 5/31]

Republican State Senator Frank Wagner: “It Is The Number One Issue On Our Voters’ Minds.” “‘This is not just about helping this group of people,’ said Sen. Frank Wagner (Virginia Beach), one of four Republicans in the Senate who split from their party to join Democrats and pass the measure by a vote of 23 to 17. ‘This is about getting out there and helping to bend the cost of health care for every Virginian. . . . It is the number one issue on our voters’ minds. By golly, it ought to be the number one issue on the General Assembly’s mind.’” [Washington Post, 5/30]

Richmond Times-Dispatch: GOP State Senators “Defended Their Decisions As Necessary,” Supported Expanding Coverage “To People Who Need It And Hospitals That Provide It.” “In the end, three other Republican senators — Frank Wagner of Virginia Beach, Ben Chafin of Russell County and Jill Vogel of Fauquier County — joined Hanger and the Senate’s 19 Democrats in adopting the pair of budget bills to end a standoff that has been watched closely by national bond-rating agencies and institutional investors who hold the state’s AAA-rated bonds… But Chafin and Vogel defended their decisions as necessary to invest in core public services, while expanding health coverage to people who need it and the hospitals that provide it.” [Richmond Times-Dispatch, 5/31]

Wall Street Journal: “The Growing Interest In Medicaid Expansion, Even In Some Conservative States, Suggests The Program Is Becoming More Accepted.” “Virginia is poised to expand Medicaid after a hard-fought legislative battle, making it one of a growing number of states where there is interest in expanding the program after Republicans failed to repeal the Affordable Care Act last year… Organizers who support Medicaid expansion in Utah learned this week that they had obtained enough signatures to put the initiative on the ballot in November, potentially expanding coverage to more than 100,000 people… A push is also under way to get expansion on the ballot in Idaho, where voters will select a new governor this fall. Democratic nominee Paulette Jordan supports an expansion and Lt. Gov. Brad Little, who claimed the GOP nomination in the primary, has said he would follow the will of the people if the initiative passes… The growing interest in Medicaid expansion, even in some conservative states, suggests the program is becoming more accepted as it appears less likely congressional Republicans will successfully revive efforts to repeal the ACA.” [Wall Street Journal, 5/30]

New York Magazine: “For A Health Care Law That Donald Trump Has Been Declaring ‘Dead’ Or ‘Dying’ Since 2013, Obamacare Seems To Have A Lot Of Life Left In It.” “One of the nation’s longest and bitterest battles over implementation of the Affordable Care Act looks likely to end very soon as the Virginia Senate approved a budget that included funds to expand Medicaid… For a health-care law that Donald Trump has been declaring ‘dead’ or ‘dying’ since 2013, Obamacare seems to have a lot of life in it yet, no thanks to his administration. Obama himself is probably sharing a bit of the good feelings among Democrats in Virginia.” [New York Magazine, 5/30]

CNN: “Despite Years Of Resistance, The State Will Become The Latest To Expand Access To Medicaid.” “Virginia lawmakers crossed an important hurdle Wednesday, ensuring that, despite years of resistance, the state will become the latest to expand access to Medicaid. The move to broaden the federal health care program for low-income Americans comes as a direct result of the political fallout from last November’s election.” [CNN, 5/31]

Los Angeles Times: Medicaid Vote “Serves As Something Of A Retort To President Trump And His Republican Allies In Congress.” “The breakthrough — made possible by a coalition of Democrats and a handful of Republicans in the statehouse — continues the expansion of the government safety net made possible by the 2010 healthcare law, often called Obamacare. Virginia’s move also serves as something of a retort to President Trump and his Republican allies in Congress, who have called for sweeping cuts in federal aid to states for Medicaid… Medicaid, the half-century-old government health plan for the poor, is a pillar of the 2010 healthcare law’s program for guaranteeing coverage, and it has helped drive a historic drop in the nation’s uninsured rate.” [Los Angeles Times, 5/30]

Business Insider: Medicaid Expansion “A Move That Shows The Resiliency Of The Landmark Healthcare Law.” “Virginia’s state Senate voted Wednesday in favor of a plan that would expand the state’s Medicaid program under the Affordable Care Act, or Obamacare, in a move that shows the resiliency of the landmark healthcare law. The Virginia Senate voted 23 to 17 to pass a budget that included Medicaid expansion, which could extend healthcare coverage to roughly 400,000 low-income Virginians. The House must re-vote on the Senate package, but a similar measure already made it through that chamber and the second vote is expected to follow suit.” [Business Insider, 5/31]

Politico: “Trump Administration Officials And Conservative Activists Had Tried To Derail” Expansion.” “Trump administration officials and conservative activists had tried to derail the Virginia plan. White House budget director Mick Mulvaney in March urged the state to reject Medicaid expansion, and White House health care aide Brian Blase joined phone calls with Americans for Prosperity as the Koch brothers-supported group tried to rally opposition. Former Sen. Rick Santorum, who is pushing for another Obamacare repeal vote in Congress this summer, was spotted in the Virginia Statehouse on Wednesday before the vote to brief Republicans on the status of that effort.” [Politico, 5/31]

Talking Points Memo: “Lobbying Against The Expansion By Trump Administration Officials” Was “Not Successful.” “After years of political battles and weeks of procedural delays, the Virginia House and Senate voted Wednesday to expand Medicaid to cover between 300,000 and 400,000 more low-income residents. Four Republicans joined every Senate Democrat in voting for the expansion Wednesday afternoon. Later Wednesday evening, the House followed suite, passing a multi-year budget including the expansion by an overwhelming majority. Last-minute lobbying against expansion by Trump administration officials, former Sen. Rick Santorum (R-PA) and the Koch brothers’ group Americans for Prosperity was not successful.” [TPM, 5/30]

The Daily Beast: Law To Be Signed By Gov. Ralph Northam, Who “Campaigned On Expansion.” “The Virginia Senate on Wednesday voted to approve Medicaid expansion, which would impact the lives of up to 400,000 citizens in the state. As such, Virginia becomes just the second state during the Donald Trump presidency to approve such a program, following only Maine. Yet even there, Republican Gov. Paul LePage faces a lawsuit for his refusal to actually implement the program. Virginia’s Democratic Gov. Ralph Northam, who handily won election last November sweeping in enough Democrats to nearly flip the state’s House of Delegates, campaigned on expansion and will undoubtedly sign it into law.” [Daily Beast, 5/30]

Vox: Medicaid Expansion “Top Item On The State’s Agenda.” “In political terms, expansion is a huge victory for the state’s Democratic governor, Ralph Northam, who made expansion a key campaign priority, and for the many Democrats who swept into the state legislature last November and came extraordinarily close to securing a majority in the House of Delegates… Even since Northam won the governor’s mansion in November and down-ballot Democrats narrowed the GOP’s House majority dramatically, Medicaid expansion became the top item on the state’s agenda.” [Vox, 5/30]