Bill > HJR154

This joint resolution proposes a constitutional amendment to be voted on by Missouri citizens at the general election in November 2026, or a special election. The amendment would repeal and replace Section 36(c) of Article IV of the Missouri Constitution to implement work requirements for individuals aged 19 to 64 who qualify for MO HealthNet (Missouri's Medicaid program) and have incomes at or below 133% of the federal poverty level plus 5% for family size. The resolution defines "applicable individual" as someone eligible for MO HealthNet, between the specified ages, not pregnant, and not eligible for Medicare, who is subject to work requirements. It also defines "health benefits service package" as the benefits covered by MO HealthNet that meet federal requirements, and "work requirements" as those established by federal law (42 U.S.C. Section 1396a(xx)). The Department of Social Services and the MO HealthNet Division would be responsible for implementing these work requirements, requiring documentary evidence of compliance and prohibiting self-attestation for both initial enrollment and ongoing eligibility, as well as for exemptions. The state would not be allowed to implement optional exemptions without express legislative authorization and would not accept exemption determinations from managed care organizations. Individuals failing to comply would be disenrolled. The state would need to submit necessary amendments to the federal government by March 1, 2027, and all references to federal or state laws would be to versions existing on January 1, 2027. The ballot summary for voters asks if the Constitution should be amended to remove a prohibition on new eligibility standards and add work requirements for MO HealthNet recipients.

Budget and Finance, Government Affairs

https://house.mo.gov/Bill.aspx?bill=HJR154&year=2026&code=R