Around 400,000 Virginians with low incomes will soon have access to Medicaid after Virginia lawmakers overcame years of Republican resistance to expanding the program under the Affordable Care Act, or Obamacare.

A state senate floor amendment was approved Wednesday afternoon, meaning Medicaid expansion will clear both chambers of the legislature as part of the state budget and head to the desk of Gov. Ralph Northam (D), a longtime backer of expansion.

State Sen. Frank Wagner (R-Virginia Beach) broke with his party to support expansion in committee. This comes a week after state Sen. Emmett Hanger Jr. (R-Augusta) reached an agreement with House Appropriations Chairman S. Chris Jones (R-Suffolk) on terms of Medicaid expansion.

The Senate Finance Committee has held up the budget process after the Republican-majority house approved a budget bill including Medicaid expansion during the regular session in February. Hanger on Tuesday offered amendments for expansion in committee, but they were voted down. Hanger reintroduced his proposals Wednesday on the state senate floor.

Democratic lawmakers in Virginia have tried to pass an expansion bill for six years. Former Gov. Bob McDonnell (R) rejected Medicaid expansion in 2013, and Gov. Terry McAuliffe (D), who served from 2014 until January 2018, couldn’t advance the issue with the GOP-led legislature.

Opposition to expansion has softened after Democratic gains in last November’s election. Virginia voters flipped 15 Republican seats in the house and elected Democrat Ralph Northam to the governor’s office. While the house saw its GOP-majority slip to a single seat, the state senate was not up for re-election last fall and sits at 21 Republicans and 19 Democrats.

More than a dozen Republicans in the house voted to include Medicaid expansion in the budget, with the caveat that expansion include work requirements.

Virginia’s Medicaid program covers more than 1.3 million Virginians, and enrollment would jump by 43 percent if lawmakers expanded Medicaid access. The federal government will pay 90 percent of the annual $2 billion price tag for expanding Medicaid in Virginia. The house’s budget proposal would pay the state’s 10 percent share by taxing hospitals. Under expansion, Medicaid would be available to people with incomes below 138 percent of the federal poverty level, which is about $16,753 for an individual and $28,676 for a family of three.

Likely voters in Virginia overwhelmingly support Medicaid expansion in every state house and state senate district, according to Data for Progress, an organization that examines political leanings at the local level. In some house districts, voter support for expanding Medicaid stands at more than 70 percent. Expanding Medicaid is even popular in Virginia’s most conservative districts, according to the data.

Thirty-two states and the District of Columbia have expanded Medicaid. Louisiana was the most recent state to do so in 2016. Last year Maine voters overwhelmingly approved Medicaid expansion via ballot initiative, though Gov. Paul LePage (R) has so far refused to implement it.

Eighteen mostly Republican-led states have refused to expand Medicaid under Obamacare, leaving an estimated 4 million people without health coverage. Virginia would be the first state to officially accept Medicaid expansion under President Trump.

The uninsured rate in the United States would plummet by 24-26 percent if Medicaid were expanded in every state, according to an analysis released last week by the Urban Institute and Robert Wood Johnson Foundation.