– Democratic Gov. Jay Nixon announced on Tuesday that he has called a meeting to reengage lawmakers in the debate over Medicaid expansion in Missouri.

Nixon, who spent much of his time after the past legislative session campaign to sustain his veto of House Bill 253, has remained largely silent on the Medicaid issue since his failed attempt earlier this year to fully expand the program under the federal health care law. But on Tuesday, he sent a letter to members of both the House and Senate panels addressing the issue asking for a meeting later this month.

“As the interim committees begin to wrap up their work, it is my hope that this meeting will give us an opportunity to engage in a thoughtful, productive discussion about charting the best course forward on one of the most pressing issues we will face next session,” he wrote. “In addition to presenting my ideas for making our health care system more efficient and effective, I look forward to taking your questions and hearing about what you have learned through this process.”

In his news release and letter, however, Nixon did not once use the word “expansion,” as he did during the spring debate. This time, Nixon’s office said the meeting would be about “reforming the state’s health care system to provide better outcomes for patients and better returns for taxpayers.” 

For the six months following the 2012 election, Nixon engaged in a campaign urging lawmakers to expand the program to some 300,000 using federal funds made available to states through 2017. After 2017, the federal government would begin to reduce its share to 90 percent by 2020. Expansion’s opponents have expressed concerns that at that point the federal share might decrease further, leaving the state of Missouri directly responsible for a significantly larger population of recipients.

Currently, nearly 894,000 Missourians are enrolled in the program. Nixon’s previous plan, completely opposed by the GOP, would expand Medicaid to those making 138 percent of the federal poverty level, or just over $32,000 a year for a family of four. Nixon had support from some 200 business groups, including the Missouri Chamber of Commerce (often an ally of Republican-backed policies), but that was not enough to tip the scale in his favor.

Those involved with the coalition to expand Medicaid have privately expressed concern about the apparent lack of a real game plan from the Missouri Hospital Association. Within the association are a handful of factions, including one wanting to move forward with advocating for full expansion, one that thinks the legislature will ultimately do it on their own without their pressure, and another that has essentially given up on the proposal.

Nixon and his allies may have hope that public pressure in favor of expansion – as was seen at the series of hearings over the summer hosted by the a panel of legislators and citizens commissioned by House Speaker Tim Jones – could renew his shot at passage. Republicans have made clear that flat expansion is off the table, but passage of a plan to “transform” the program could be plausible, they have said.

Nixon has requested members of the committee to meet on November 26 in Jefferson City.