(AP) – Missouri Gov. Jay Nixon has made Medicaid expansion a priority for the legislative session that starts this week. But the prospects of that occurring appear slim.

The Republican-led Legislature repeatedly rejected a Medicaid expansion proposed by Democrats last year. And House Speaker Tim Jones remains opposed to it this year.

A Medicaid expansion under the terms of the federal health care law would bring billions of federal dollars to Missouri.

Some lawmakers want to couple a Medicaid expansion with “reform” measures for the health-care program for the poor. But there are divisions about what that “reform” should entail.

A Senate committee has recommended Missouri adopt a statewide managed-care format for parents and children in Medicaid. But Sen. Rob Schaaf, a Republican physician, said he opposes such managed care programs.