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After fighting it for four years, Virginia will soon adopt the Affordable Care Act's Medicaid expansion. Both chambers of the state legislature passed a budget bill last night that includes the expansion, which Gov. Ralph Northam is expected to sign.

Why it matters: Virginia is a big state — the expansion could cover as many as 400,000 people. And it's a reminder that, even after years of exhausting political fights, health care is still a salient issue: Medicaid expansion was a key part of Northam's campaign and helped propel Democrats' gains in the statehouse.

The catch: The plan Virginia lawmakers approved yesterday would include work requirements and premiums, similar to the restrictions other states have recently adopted.

  • Those rules could shave almost 20% off the number of people covered by the expansion, according to the Center on Budget and Policy Priorities.

Yes, but: Other states' work requirements have stirred more controversy because those states had already expanded, and are now seeking to trim their rolls.

  • An expansion with work requirements seems to be the best deal Democrats are going to get in Virginia, and that still shakes out to cover hundreds of thousands of uninsured people.

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