SALEM – Oregon is on the verge of extending Medicaid coverage to children brought to the country illegally, after the state Senate approved the plan on Monday.

The bill, which is among Democrats' top policy priorities in the last week of the session, heads next to the House. It's also a key bill for Gov. Kate Brown, who included it in her December budget proposal.

A handful of Republicans also voted for the bill, leading to passionate vote explanations on the Senate floor. The bill passed on a vote of 21-8 present.

"We could get wrapped up in sanctuary this, sanctuary that," said Sen. Jeff Kruse, R-Roseburg, who carried the bill. "Quite simply, our choice is to have these kids going to emergency rooms for their health care or going to a clinic for their health care."

Sen. Tim Knopp, R-Bend, questioned why the Legislature would add a new program when the state is cutting other social services to close a budget gap. "We had a crisis with our budget, but apparently that is over," Knopp said.

Sen. Alan DeBoer, R-Ashland, voted "no" on Senate Bill 558, saying he thought the money would be better spent on school nurses and community health care centers.

Supporters including health care executives said the bill will ensure kids who currently lack health coverage get the preventative care they need. They pointed out in testimony to the Legislature that although Oregon expanded health care for low-income children over the last decade, two percent of kids still lack insurance.

"This will ensure that all children have access to the health care services they need to be successful in school and in their lives," two employees of the Oregon Latino Health Coalition, executive director Alberto Moreno and director of health policy and government relations Linda Roman, wrote in a letter to lawmakers.

Tonia Hunt, executive director of Children First for Oregon, said in her testimony that kids' health coverage increases incomes, lowers high school drop-out rates and reduces emergency room visits. "It is measurable, a valuable return on investment and the right thing to do," Hunt wrote.

The health care expansion is expected to cost $36 million over the next two years, and $55 million per biennium when fully implemented in 2019. Oregon had faced a $900 million gap in its overall Medicaid budget at the start of the legislative session, which prompted warnings the state might be forced to throw more than 350,000 people off the plan. But lawmakers balanced the budget through a combination of cost cutting, shifting funds and a $550 million increase in health care taxes.

The state would begin covering kids who can't prove they're here legally in January 2018, and enrollment could eventually reach 15,000 children, according to a legislative report.

Non-citizen children who are in the United States legally can already qualify for Medicaid, if they're low-income or meet other guidelines. Oregon law currently requires children to be "lawfully present" in the country to qualify; the bill passed on Monday would remove that language.

For most of the state's Medicaid population, the federal government pays roughly 75 percent of the cost for health coverage. Oregon must pay 100 percent of the cost for these kids, however, since they do not meet the federal government's citizenship and immigration status requirements.

Some of the money will pay for the Oregon health authority to market the Medicaid expansion and do outreach to enroll immigrant kids.

Sen. Arnie Roblan, D-Coos Bay, worked as both a high school math teacher and principal. Roblan said that experience guided his "yes" vote on the bill. "They only learn when they're healthy," Roblan said.

-- Hillary Borrud

503-294-4034; @hborrud