The Medicaid debate continues between the Governor and Republican leaders in the House and Senate. Gov. Jay Nixon has met with the Republican caucus leaders from both chambers, as well as Senate Democrats.

Nixon indicates the talks about whether to expand Medicaid have been positive. However, Republican leadership says they made no indication they’re willing to budge on the expansion.

At issue is whether to increase Medicaid to provide coverage for those making up to 138 percent of the federal poverty level, which the federal government mandates. Republicans aren’t willing to stretch it beyond 100 percent.

After meeting with GOP leaders, he spoke to the press, followed by meetings with Democrat leadership and finally, with Director of U.S. Health and Human Services Kathleen Sebelius.

“The Secretary and I had a positive and productive conversation this afternoon about strengthening and reforming Medicaid,” Nixon said. “It is clear that moving forward and strengthening Medicaid will give us the flexibility we need to give Missourians the health system they deserve: one that protects taxpayers, rewards work, promotes personal responsibility and brings the tax dollars they send to Washington back here to Missouri.”

Democrat proposals to expand Medicaid have been squashed in committee with Republican leadership at the helm. Rep. Jay Barnes (R-Jefferson City) has written a counter proposal that would reform Medicaid to include those who make 100 percent of the federal poverty level. Meanwhile, fellow Republicans have said Missouri should seek a waiver from the federal government so the 138 percent mandate would be excused.

Nixon at first said he would not seek such a waiver, taking a hard position against doing so. However, after recent talks with Republican legislators, he has indicated that might be a possibility down the road.