Economic forces have put pressure on the budgets of Missouri and Kansas, putting health reforms in the backseat for 2009. Missouri Gov. Jay Nixon wants to restore some residents cut from Medicaid in 2005 and expand the State Children's Health Insurance Program with help from federal stimulus money, but it will be a tough sell with a Republican-led Legislature. With Kathleen Sebelius headed to Washington, the budget situation in Kansas has not changed. The Legislature is grappling with changes to Medicaid and a push to require health plan coverage of autism therapy. As for the state's employers, consumer-driven health plans are gaining a second look from businesses which previously avoided it. Others have expressed concerns that employer groups could face problems coming into the 2010 renewal cycle, because layoffs might have changed the makeup of their employee pool.