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Stunned by massive losses in last fall’s state legislative races, some Virginia Republicans — enough of them, at least — this year began to acknowledge the senselessness of their opposition to extending Medicaid health insurance to some 400,000 citizens under the Affordable Care Act. That shift, after four years of groupthink GOP obstruction, at last yielded a breakthrough Wednesday, when both houses of Richmond’s Republican-controlled legislature passed a budget expanding Medicaid. The irony was that it is precisely in some of the state’s most heavily Republican counties — rural areas of Southside and Southwest Virginia — where a lack of health insurance was most widespread, in many areas amounting to 20 percent of adults under the age of 65. (6/2)

Congratulations to the Virginia legislature for voting this week to expand the state’s Medicaid rolls. As the White House and Congress do all they can to pare health insurance coverage nationwide, Virginia’s move will push the other way, extending medical security to 400,000 more people. In November, voters in Idaho, Nebraska and Utah, where Medicaid expansion is expected to be on the ballot, will have an opportunity to do the same — and, if they do, raise to 36 the number of states taking advantage of the Affordable Care Act’s generous Medicaid deal. (6/1)

Virginia's expansion of Medicaid this week is giving hope to advocates in other states. After Virginia overcame years of Republican opposition to pass the expansion under ObamaCare, supporters are giving renewed attention to what could be the next states to expand: Utah and Idaho, where initiatives are set to be on the ballot this November. Activists in Nebraska are also gathering signatures and say they are on track to get the issue on the ballot there. (Peter Sullivan, 6/2)

It’s very hard to feel good about any part of American politics today, I realize. When it isn’t a circus starring Roseanne Barr or Dinesh D’Souza, it’s a nightmare, with President Trump separating immigrant families, obstructing justice and damaging American interests abroad. I never expected to live through so dark of a period in Washington. Outside of Washington, however, the picture really is different. In many cities and states, people aren’t only trying to minimize Trump’s damage. They’re actively using politics to improve lives. (David Leonhardt, 6/3)

Despite great progress, the (Gov. John) Kasich Administration recently asked the federal government for permission to add new regulations that will put more than 300,000 Ohioans at risk of losing health care, including more than 50,000 in the Cleveland area. These rules would let Ohio rip away peoples' health care if they don't work or do a county work program for 80 hours a month. Withholding treatment for chronic health conditions or mental health services will NOT help people get or keep a job. (Amanda Woodrum, 6/2)

Huge news out of Virginia Wednesday: The State Senate approved expanding Medicaid to cover 400,000 low income residents, putting an end to years of Republican intransigence and opposition. As health care advocate Topher Spiro put it, “This is a major victory that will transform the lives of thousands of families.” ...Indeed, it’s possible Utah will become the 34th to do so. On Tuesday, state election officials said a voter initiative to expand Medicaid collected enough signatures to appear on the ballot in November. Polls show that two thirds of Utah voters support the Medicaid expansion in their state. So it’s unlikely to be close. At least, that’s what will happen if the voters get to decide. (Helaine Olen, 5/31)