Virginia is on the verge of expanding Medicaid after years of partisan battle.
The GOP-controlled General Assembly is set to pass a state budget Wednesday that's expected to expand Medicaid eligibility to about 400,000 low-income adults.
The vote comes after anti-expansion Republican senators failed Tuesday to block expansion in a last-ditch parliamentary effort.
After a Senate committee made up of mostly anti-expansion Republican lawmakers rejected amendments to expand Medicaid, Senate Majority Leader Tommy Norment tried to get the panel to reject them a second time.
The move could have blocked pro-expansion lawmakers from reviving the amendments during a full Senate floor vote, where they have a majority. No measure can be reconsidered more than once during a General Assembly session under Senate rules.
Norment's motion brought audible gasps from the audience once it was clear what he was trying to accomplish. But after a few moments of confusion, the panel's chairman, Republican Sen. Emmett Hanger, ruled Norment's motion out of order and quickly adjourned. Hanger is one of two Republican senators who publicly support Medicaid expansion.
Hanger said he wasn't sure if Norment's motion would have effectively blocked a full vote on Medicaid expansion but didn't want to take any chances.
"Just to be certain, I'm leaving," he said right after the vote as he hurried out of the committee room.
Norment appeared shocked when Hanger adjourned, and downplayed the failed motion when talking to reporters.
"It's over my head, I don't understand it," he said.
The House has already passed Medicaid expansion and Democratic Gov. Ralph Northam is a strong proponent.
Wednesday's upcoming vote will mark the end of a more than four-year battle over expanding the publicly funded health care program for the poor in Virginia. The fight led to a standoff over the state budget in 2014 and again this year.
Democrats have pushed for years to expand Medicaid, saying Virginia should not pass up the roughly $2 billion in extra federal funding the program will bring to the state. Republicans had previously blocked past expansion efforts, calling the long-term costs unsustainable.
A federal-state collaboration originally meant for poor families and severely disabled people, Medicaid has grown to become the largest government health insurance program, now covering 1 in 5 people. Former President Barack Obama's health care overhaul gave states the option of expanding Medicaid to cover more low-income adults.
A GOP-led Congress' failure to repeal and replace the health law, as well as unexpectedly large gains by Democrats in last year's election, helped spur several of Virginia's Republican state legislators to flip positions. Virginia was the first state to see its state legislature reshaped by an anti-Trump wave.
A tally from the Kaiser Family Foundation shows that Virginia will become the 33rd state to approve Medicaid expansion.