HOUSE JOINT RESOLUTION NO. 154 103RD GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVE CHAPPELL.
6310H.01I JOSEPH ENGLER, Chief Clerk
JOINT RESOLUTION Submitting to the qualified voters of Missouri an amendment repealing Section 36(c) of Article IV of the Constitution of Missouri, and adopting one new section in lieu thereof relating to MO HealthNet.
Be it resolved by the House of Representatives, the Senate concurring therein:
That at the next general election to be held in the state of Missouri, on Tuesday next 2 following the first Monday in November, 2026, or at a special election to be called by the 3 governor for that purpose, there is hereby submitted to the qualified voters of this state, for 4 adoption or rejection, the following amendment to Article IV of the Constitution of the state 5 of Missouri: Section A. Section 36(c), Article IV, Constitution of Missouri, is repealed and one 2 new section adopted in lieu thereof, to be known as Section 36(c), to read as follows: Section 36(c). 1. Notwithstanding any provision of law to the contrary, beginning 2 July 1, 2021, individuals nineteen years of age or older and under sixty-five years of age who 3 qualify for MO HealthNet services under 42 U.S.C. Section 1396a(a)(10)(A)(i)(VIII) and as 4 set forth in 42 C.F.R. 435.119, and who have income at or below one hundred thirty-three 5 percent of the federal poverty level plus five percent of the applicable family size as 6 determined under 42 U.S.C. Section 1396a(e)(14) and as set forth in 42 C.F.R. 435.603, shall 7 be eligible for medical assistance under MO HealthNet and shall receive coverage for the 8 health benefits service package. 9 2. For purposes of this section, the following terms mean:
EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language. HJR 154 2
10 (1) "Applicable individual", an individual: 11 (a) Who either: 12 a. Is eligible to enroll in MO HealthNet under the state Medicaid plan under 42 13 U.S.C. Section 1396a(a)(10)(A)(i)(VIII); or 14 b. Both: 15 (i) Is otherwise eligible to enroll or is enrolled under a waiver of such plan that 16 provides coverage that is equivalent to minimum essential coverage; and 17 (ii) Is nineteen years of age or older and under sixty-five years of age; is not 18 pregnant; is not entitled to, or enrolled for, benefits under Part A of Title XVIII of the 19 Social Security Act, or enrolled for benefits under Part B of Title XVIII of the Social 20 Security Act; and is not otherwise eligible to enroll under such plan; and 21 (b) Who is subject to work requirements; 22 (2) "Health benefits service package" [shall mean], benefits covered by the MO 23 HealthNet program as determined by the department of social services to meet the benchmark 24 or benchmark-equivalent coverage requirement under 42 U.S.C. Section 1396a(k)(1) and any 25 implementing regulations; 26 (3) "Work requirements", the requirements established by 42 U.S.C. Section 27 1396a(xx). 28 3. The department of social services and the MO HealthNet division shall 29 implement work requirements for applicable individuals in accordance with the 30 following provisions: 31 (1) No applicable individual shall be enrolled in MO HealthNet unless, at the 32 time of application, the individual demonstrates compliance with the work requirements 33 for the three consecutive months immediately preceding the month during which the 34 individual applies. The department of social services and the MO HealthNet division 35 shall require documentary evidence and shall not accept self-attestation at the time of 36 application; 37 (2) No applicable individual shall remain enrolled in MO HealthNet in any 38 month unless the individual has demonstrated compliance with the work requirements; 39 (3) An applicable individual seeking an exemption from work requirements shall 40 provide documentation for the exemption sought. The department of social services and 41 the MO HealthNet division shall verify all exemptions. The department of social 42 services and the MO HealthNet division shall not accept self-attestation from individuals 43 seeking exemptions; 44 (4) The department of social services and the MO HealthNet division shall not 45 seek or implement any additional optional exemptions under 42 U.S.C. Section 1396a HJR 154 3
46 (xx)(3)(B) or any other optional exemption unless a general statute law expressly 47 authorizes the implementation of the exemption; 48 (5) The department of social services and the MO HealthNet division shall not 49 accept exemption designations, approvals, or determinations by a managed care 50 organization; and 51 (6) The department of social services and the MO HealthNet division shall 52 disenroll any applicable individual who fails to comply with the work requirements. 53 4. No later than March 1, [2021] 2027, the [Department of Social Services and the 54 MO HealthNet Division] department of social services and the MO HealthNet division 55 shall submit all state plan amendments necessary to implement this section to the United 56 States Department of Health and Human Services, Centers for Medicare and Medicaid 57 Services. 58 [4. The Department of Social Services and the MO HealthNet Division shall take all 59 actions necessary to maximize federal financial participation in funding medical assistance 60 pursuant to this section. 61 5. No greater or additional burdens or restrictions on eligibility or enrollment 62 standards, methodologies, or practices shall be imposed on persons eligible for MO 63 HealthNet services pursuant to this section than on any other population eligible for medical 64 assistance. 65 6.] 5. All references to federal or state statutes, regulations or rules in this section 66 shall be to the version of those statutes, regulations or rules that existed on January 1, [2019] 67 2027. Section B. Pursuant to chapter 116, and other applicable constitutional provisions and 2 laws of this state allowing the general assembly to adopt ballot language for the submission of 3 this joint resolution to the voters of this state, the official summary statement of this 4 resolution shall be as follows: 5 "Shall the Constitution of the State of Missouri be amended to remove language 6 regarding the prohibition on creating new eligibility or enrollment standards for persons 7 eligible for MO HealthNet services and to add language to impose work requirements for 8 persons eligible for MO HealthNet services?". ✔