Under this amendment, any medical assistance provided under Medicaid shall be subject to appropriations made by the General Assembly for that express purpose and no provisions in the Constitution shall convey any rights, expectations, or entitlements to such benefits in the absence of such appropriations.

Additionally, the state shall not provide any payments, add-ons, or reimbursements to health care providers through Medicaid for medical assistance services to persons who are not considered Missouri residents under federal Medicaid regulations.

Finally, this amendment requires able-bodied adult Medicaid participants, ages 19 to 64, to participate in work and community engagement requirements. Participants shall complete at least 80 hours a month of any combination of specified work, education, job search, child care, and volunteer services. The Department of Social Services shall provide reasonable accommodations for individuals with disabilities who are not otherwise exempt from the work and community engagement requirements under this amendment to ensure that the participants are able to comply with the requirements, including exemptions, modifications of hours, and the provision of necessary support services. Medicaid participants who shall not be required to comply with the work and community engagement requirements include: (1) those under 19 and over 64; (2) those who are medically frail, as defined in the amendment, including those with certain disabilities; (3) those who are pregnant or caring for a child under one year of age; (4) those who are primary caregivers of a dependent child under the age of six or a dependent adult; and (5) those who are also participants of Temporary Assistance for Needy Families or the Supplemental Nutrition Assistance Program and are exempt from work requirements under those programs. The Department may permit further exemptions in areas of high unemployment, limited economies or educational opportunities, or lack of public transportation, or for good cause, as defined in this amendment.

This provision is substantially similar to SJR 32 (2020).

SARAH HASKINS