Terry McAuliffe has never suffered from a lack of confidence.

"You know I’m the ultimate optimist," he told us, "I always say I’m not a half full glass, I’m overflowing."

As he prepares for take the oath office as Virginia’s 72nd Governor, McAuliffe says he’s convinced he and lawmakers in both parties can work together on important issues.

And despite the concerns of conservative Republicans, he predicts lawmakers will approve Medicaid expansion, and clear the way for billions in federal aid.

"The goal is to provide health care for the 400- thousand Virginians, bring Virginians tax dollars back to Virginia and do it in the way that we protect ourselves on the back end that’s the key," McAuliffe said in a one-on-one interview with WDBJ7.  "I am very confident that we will get the expansion this year."

But moments after members of the House of Delegates reelected Speaker Bill Howell Wednesday afternoon, the Fredericksburg Republican said the state should take a cautious approach, and many of his Republican colleagues agree.

"I believe Virginia should chart a course that provides health care to the neediest among us," Howell said in remarks to lawmakers, "without growing government or becoming entangled in Washington’s health care mess." Republicans in the chamber applauded.

If Virginia rejects Medicaid expansion, McAuliffe warns some rural hospitals will likely close.

"So it’s jobs, losses," McAulilffe said. "I’m talking about job gains, so we can get there. I really believe we can get there and do it in the way that we protect ourselves. Let’s do it in the Virginia way. Let’s find common ground."

Right now, it’s hard to see what will soften Republican opposition, but Terry McAuliffe, "the ultimate optimist," says he certainly intends to try.