Virginia. This fulfilled one of his central campaign promises. Northam's predecessor, Terry McAuliffe, had tried to implement Medicaid expansion throughout his term, but was blocked by Republicans, who controlled the state legislature at the time and opposed the expansion. Following the 2017 election, which brought significant gains for Democrats in the Virginia House of Delegates, Republicans still held a narrow legislative majority, but opposition to Medicaid expansion had diminished among Republicans, and several crossed over in support of the bill. Once the bill was enacted on January 1, 2019, Virginia became the 33rd state to expand Medicaid and the first to do so since Louisiana in 2016. Enrollment in the expanded program began on November 1, 2018. By the beginning of 2019, more than 200,000 Virginians had enrolled in Medicaid as part of the expansion. As part of a compromise with Republican legislators, Northam agreed to a Medicaid expansion plan that would include a work requirement for most able-bodied, childless adults. The work requirement has not taken effect, as it cannot be implemented without a waiver from the federal government. Northam's administration initially sought such a waiver, but following Virginia's 2019 midterm elections, in which Democrats took control of the state legislature, Northam paused Virginia's request for the waiver, which at the time was still pending. Immigration In his 2007 campaign for state Senate, Northam "advocated for Virginia being 'even more stringent than we are now in fighting illegal immigration,' and said the state should act as 'strong partners' with federal law enforcement." Northam's rhetoric shifted in his 2017 gubernatorial campaign. In 2017 Northam pledged to "stand up against ICE" so that "people, especially immigrants, in Virginia aren't living in fear," saying: "Something that we are very proud of in Virginia is that we are inclusive." He continued by saying "We will do everything we can to make sure immigrants are comfortable living here." Northam opposed President Trump's decision to rescind Deferred Action for Childhood Arrivals (DACA), which offered temporary stay for unauthorized immigrants who came to the United States as minors. Northam said Trump's decision "lacks compassion, lacks moral sense, and lacks economic sense." Northam supports granting state driver's licenses and in-state tuition to undocumented immigrants. In February 2017, while serving as lieutenant governor, Northam cast a tie-breaking vote in the state Senate against a bill to ban sanctuary cities in Virginia. Northam said he was "proud to break