Democrats fell just short of a Medicaid-expanding majority.

When a Virginia elections official pulled a name out of bowl on Thursday, he didn’t only hand Republicans a 51-49 majority — the tiebreaker will also make it a little harder for the state to expand health coverage to 400,000 low-income Virginians.

Virginia Democrats won the governor’s seat on Election Night and very nearly swept to a shocking takeover of the state House. But they fell short after recounts and Thursday’s tiebreaker in the race between Republican David Yancey and Democrat Shelly Simonds (both got 11,608 votes) left the GOP hanging onto a bare majority.

Medicaid coverage for hundreds of thousands of low-income Virginians has been at stake throughout the campaign and the last month of recounts and bowl drawings.

Democratic Gov. Terry McAuliffe and Virginia Republicans in the statehouse have been locked in battle for years over expanding Medicaid under Obamacare. Virginia is one of the 19 states that has refused to expand its Medicaid eligibility as the health care law allows.

The state estimates that more than 400,000 people in and near poverty have been denied Medicaid coverage as a result.

Democrats — on the back of the landslide win by Ralph Northam to take the governor’s seat — very nearly won enough seats to take control of the Virginia House of Delegates. They could have voted as soon as January to expand Medicaid, which Northam pledged to do if he was elected.

But they came up just short. Here is Vox’s Andrew Prokop:

Incumbent Delegate David Yancey (R) led his challenger Shelly Simonds (D) by a mere 10 votes heading into a recount. That’s the sort of margin that often shifts during a recount, due to errors in the initial tally.

So the recount for the 94th District took place in December — with observers Read More Here