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Virginia’s historic Medicaid expansion caused headaches for the handful of Republicans who voted for it during this year’s primaries. But now, with candidates looking towards November’s general election, Republicans who didn’t support expansion might be the ones paying for their votes.

State Sen. Siobhan Dunnavant (R-Henrico) could be one of those Republicans. Her district has been trending blue in recent years, with Hillary Clinton getting 48% of votes versus President Trump’s 46%, according to the Virginia Public Access Project. That was a marked shift from the 2014 Senate election in the district, where Republican Ed Gillespie beat Sen. Mark Warner (D-Va.), 53% to 44%.

That movement makes Dunnavant a target for Democrats this year as she runs for re-election in Virginia’s 12th Senate District. Her opponent, Debra Rodman, voted to expand Medicaid while in the House of Delegates, and has criticized Dunnavant for her opposition to the expansion.

Dunnavant repeatedly voted against the program, even though it would have benefited an estimated 6,600 of her constituents, according to research from The Commonwealth Institute, a non-partisan economic think tank.

During her 2015 Senate campaign, Dunnavant criticized those who supported expansion as “crybaby politicians.”

Dunnavant also said she wanted to repeal the Affordable Care Act, according to American Bridge 21st Century, a left-wing Super PAC. If that happened up to 685,000 Virginians would lose their healthcare, according to the Center on Budget and Policy Priorities. It would also cost the state $18 billion in federal healthcare spending over ten years, and lead to the loss of over 10,000 healthcare-related jobs.

It’s unclear how big of a role Dunnavant’s opposition to Medicaid will play in November, but with Democrats hoping to win control of the Senate, her past votes and comments on Medicaid are likely to get close scrutiny.

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