Visual studio still feels like the only real option to me. I would consider switching to windows if it meant I could use it.

There is a gigantic difference between "technically possible", "practical" and "enjoyable". I had some junior engineers hounding my ass about using ORMs and the liability of manual schema management until they saw how sqlproj and sql compare work in VS proper. You can certainly string this along with 3rd party and custom using other IDEs, but then you don't have as much time and energy to focus on the actual problem. Maintaining a stack just to maintain your stack is pretty crazy to me. I'll happily pay the idiot tax at Home Depot for the Milwaukee option so I can place an invariant on this part of the problem space. I never want to be in a position where I can blame my tools for a bad work product.