As a candidate for Missouri governor, Attorney General Jay Nixon told anyone who’d listen about his plans to restore Medicaid coverage to the more than 100,000 poor, elderly and disabled people who lost it in 2005.
On Tuesday, voters responded, sweeping Mr. Nixon into office by landslide margins. He received  nearly 60 percent of the vote in his race against Republican U.S. Rep. Kenny Hulshof of Columbia.
But the blue tide that lifted Mr. Nixon barely budged other Democrats. Although his party scored some key wins in St. Louis-area legislative races, Republicans managed to hold their advantage in the House and even added seats to solidify GOP control in the state Senate.
Missouri, long called a bellwether for national elections, this year proved to be something of a lost sheep. While the rest of the country turned sharply toward the center, the legislative character of the Show-Me State kept drifting to the right.

On Wednesday, Governor-elect Nixon spoke confidently about the “strong and direct” message voters sent. “Clearly, yesterday, the people of Missouri called for a new direction,” Mr. Nixon said in a conference call with reporters. “I’ve laid out my vision in the past, and I’m going to do everything possible to make it happen.”
But Republican legislators, who meet today to elect their leaders, don’t see the same call for a new direction and have been equally clear about their resistance to restoring Medicaid coverage to those who lost it in 2005.
Mr. Nixon seemed to acknowledge that reality on Wednesday, saying he will “work within the constraints we have to get health care restored.”
And those constraints involve more than just the unwillingness of Republican leaders to undo their cuts. The nonpartisan Missouri Budget Project warned last May that the state could face a budget shortfall of at least $500 million next year.
Since then, the national and state economies have faltered badly. The group reported last month that state revenue has fallen by about 1 percent over the past three months.

As if to underscore the precarious state of the economy, Piramal Glass Co. in Park Hills, a St. Francois County town not too far from where Mr. Nixon grew up in De Soto, announced Wednesday that it’s laying off 190 employees. As workers lose jobs or have their hours cut, more and more qualify for state assistance programs such as Medicaid. That increases the state’s costs even without expanding eligibility.
The Missouri Department of Social Services reported a 33 percent increase in the number of people applying for Medicaid during September compared to the same month in 2007. It showed a 17 percent hike in the number of applications approved. At least some of the remaining applications are awaiting paperwork to prove eligibility.
Mr. Nixon has said restoring coverage to those cut in 2005 would cost $265 million in state funds, but the state money would generate an additional $431 million in federal matching funds. The combination would provide a vital financial stimulus to the state. And it would help prevent thousands more state residents from losing their homes and health.
Still, finding that $265 million — while also figuring out how to come up with some $500 million that might be needed to meet mandatory expenses — will prove a real challenge.
As attorney general, Mr. Nixon and Republican Gov. Matt Blunt and GOP legislative leaders existed in a perpetual state of war. But on Wednesday, he said that as governor, he expects “less strident partisanship” in his relationship with the Legislature. He said he’s counting on “the message sent by voters” to help forge compromise.
Before that can happen, though, Mr. Nixon and Republican legislative leaders will have to agree on something even more fundamental: the precise nature of the message voters sent.