ALBANY — In a relatively short time span for Albany, the Medical Aid in Dying bill went from stuck in third gear to a fast-track passage by the State Legislature.

Now, the action will shift to back-channel wooing of Gov. Kathy Hochul, who hasn’t given any clues whether she will sign or veto it.

Advocates and opponents were weighing next steps Tuesday, one day after the State Senate gave final passage to the controversial end-of-life bill that opponents call physician-assisted suicide.

"The fight is not over," Assemb. Amy Paulin (D-Scarsdale), the leading legislative advocate of the bill, told Newsday.

On that, opponents agree.

"All our hope lies with the governor," Dennis Poust, executive director of the New York State Catholic Conference, said.

As with any legislation approved by the Senate and Assembly, the legislature in practice has until the end of the year to formally advance the bill to the governor. When that happens, the governor has 10 days to sign or veto.

Because thousands of bills are passed each calendar session, legislators informally manage the flow of bills up the chain so as to not flood the governor with so many bills that she has little choice but to veto them because the clock is ticking. In practice, the governor "calls for the bill," signaling legislators to move a certain bill or wave of bills to her.

That means, for now, there’s no telling whether the Medical Aid in Dying Act will reach Hochul’s desk next week or the end of December.

For its part, the Hochul administration isn’t showing any cards for now.

"The governor will review the legislation," Hochul spokesman Avi Small said Tuesday.

Monday’s Senate vote — the Assembly voted in April — was the culmination of a decade of work by lawmakers and scores of activists.

The bill seemed to have momentum in the early years but appeared to stall. Paulin said the start of the turning point occurred about 12 months ago.

Assembly Speaker Carl Heastie (D-Bronx) told her he personally favored the legislation "and told me ‘If [you] can show me you have the votes,’" he’d let the bill move to the full Assembly for a vote, Paulin said Tuesday.

At that point, she gauged that a little more than 70 of the 150 Assembly members would support the bill. Paulin was told she needed to get the number into the 80s, so the bill wouldn’t hang on one or two members’ votes, a state official said.

Paulin said the 2024 elections brought new, younger members to the chamber who might be open to supporting the legislation. That 11 other states enacted similar laws also created momentum.

In April, the Medical Society of the State of New York, an influential physicians’ lobby, reversed its long-standing opposition.

And advocates shared personal stories. Paulin herself often has talked of her sister dying of cancer in "screaming pain" and asking "when am I going to die?"

In the end, 81 Assembly members voted for the bill on April 29; 67 opposed.

The Senate approved it, 35-27. Somewhat like the Assembly, Senate backers numbered only around 20 just 12 months earlier, Sen. Brad Hoylman-Sigal (D-Manhattan), the Senate bill sponsor, said.

The bill would allow a "mentally competent, terminally ill adult," age 18 or older, who has a prognosis of six months or less to live, to request self-administered, life-ending medication from a physician. The measure also would provide certain protections and immunities for the prescribing health care providers, for example, for not resuscitating qualified patients who have self-administered the mediation.

No Republican in either house supported the bill. Most Democrats did, although there were exceptions including Long Island, Sens. Monica Martinez (D-Brentwood), Siela Bynoe (D-Westbury), and Assemb. Michaelle Solages (D-Elmont).

Echoing other critics, Martinez said she opposed because she thought the bill had too many loopholes and uncertainties — for instance, in what medications could be used or what physicians could vouch for a person having the "mental capacity" to request terminal medication.

"I wasn’t comfortable with the way it was written," Martinez said Tuesday. "I don’t think the guardrails are fully in place. Plus, I heard a lot from my community and they weren’t supportive either."