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With help from three Republicans, the state Senate voted 23-17 to pass a budget that includes the expansion of the low-income health care program.

In comments before the final vote, Vogel, who has been mum on about her position on Medicaid in recent months, said she remains concerned about whether the federal government will renege on that funding - a main point of contention among Republicans - and about the growth of the existing Medicaid program, which has averaged about 8 percent a year.

One of Northam's major campaign goals was to expand Medicaid for Virginia - a goal his predecessor, Terry McAuliffe, had but could not achieve with Republican majorities in the General Assembly.

The budget still needs final approval House and from Democratic Gov. Ralph Northam. "Health insurance coverage for autism spectrum disorder that I have fought for year after year and have been crushed when it failed, is in this budget".

"This budget is the culmination of five years of effort to bring our taxpayer dollars home from Washington and expand Medicaid".

"There's always talk of repealing Obamacare; that did not happen", Cox said. Obama's health care overhaul gave states the option of expanding Medicaid to cover more low-income adults. The other would be to seek a waiver from President Donald Trump's administration to impose a series of conditions on eligibility, including a work requirement and cost-sharing provisions for recipients.

Correction: A prior version of this story misstated the party that controls the Virginia House of Delegates.

The bill will now go to the desk of Gov. Ralph Northam, who has openly voiced his support for Medicaid expansion. Rick Santorum, the Republican from Pennsylvania, who left office in 2007 and has been out of politics since his unsuccesful run for the presidency in 2012.

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Later, he said the Senate rules forbid a legislative proposal to be raised a third time after being defeated twice on the floor, unless the entire body agrees. "By passing this budget, the Senate made a clear statement that Virginia is a place where leaders still work together to get things done for the people who send us here".

The moment was an irresistible opportunity for Corey Stewart, the Prince William County supervisor running for the Republican nomination for U.S. Senate, to descend on the Capitol and denounce the "weak" Republicans who voted with Democrats to expand Medicaid.

"The verbal abuse I took yesterday. was unbelievable".

"I'm thrilled that today, Virginia has finally moved to expand Medicaid, which will help hundreds of thousands of people get the care they need".

"This is not just about helping this group of people", Wagner said.

LaRock said he is concerned the Trump administration will make moves to pass the associated costs of federal health care laws along to the states.

Health care advocacy groups praised the move and said low income Virginians who can not afford health care coverage will finally receive access to care without jeopardizing their financial future. The funds coming to Virginia would not add to the national debt because of the tax funding included in the Affordable Care Act to support the program.