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EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
and is intended to be omitted in the law.
SECOND REGULAR SESSION
SENATE JOINT RESOLUTION NO. 108
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR HUDSON.
6124S.01I KRISTINA MARTIN, Secretary
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 Senate, the House of Representatives concurring therein:
That at the next general election to be held in the 1
state of Missouri, on Tuesday next following the first Monday 2
in November, 2026, or at a special election to be called by 3
the governor for that purpose, there is hereby submitted to 4
the qualified voters of this state, for adoption or 5
rejection, the following amendment to article IV of the 6
Constitution of the state of Missouri:7
Section A. Section 36(c), article IV, Constitution of 1
Missouri, is repealed and one new section adopted in lieu 2
thereof, to be known as section 36(c), to read as follows:3
Section 36(c). 1. Notwithstanding any provision of 1
law to the contrary, beginning July 1, 2021, individuals 2
nineteen years of age or older and under sixty-five years of 3
age who qualify for MO HealthNet services under 42 U.S.C. 4
Section 1396a(a)(10)(A)(i)(VIII) and as set forth in 42 5
C.F.R. 435.119, and who have income at or below one hundred 6
thirty-three percent of the federal poverty level plus five 7
percent of the applicable family size as determined under 42 8
U.S.C. Section 1396a(e)(14) and as set forth in 42 C.F.R. 9
435.603, shall be eligible for medical assistance under MO 10
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HealthNet and shall receive coverage for the health benefits 11
service package. 12
2. For purposes of this section, the following terms 13
mean: 14
(1) "Health benefits service package" [shall mean], 15
benefits covered by the MO HealthNet program as determined 16
by the department of social services to meet the benchmark 17
or benchmark-equivalent coverage requirement under 42 U.S.C. 18
Section 1396a(k)(1) and any implementing regulations; 19
(2) "Applicable individual", an individual who is 20
eligible to enroll in MO HealthNet pursuant to 42 U.S.C. 21
Section 1396a(10)(A)(i)(VII) or who is otherwise eligible to 22
enroll, or is enrolled, under a waiver of such plan that 23
provides coverage that is equivalent to minimum essential 24
coverage; who has attained the age of nineteen and is under 25
sixty-five years of age; who is not pregnant; who is not 26
entitled to, or enrolled for, benefits under Part A of Title 27
XVIII of the Social Security Act, or enrolled for benefits 28
under Part B of Title XVIII of the Social Security Act, and 29
who is not otherwise eligible to enroll under such plan; and 30
who is subject to work requirements; 31
(3) "Work requirements", the requirements established 32
in 42 U.S.C. Section 1396a(xx). 33
3. The department of social services and the MO 34
HealthNet division shall implement work requirements for 35
applicable individuals. 36
(1) No applicable individual shall be enrolled in MO 37
HealthNet unless, at the time of application, the individual 38
demonstrates compliance with work requirements for the three 39
consecutive months immediately preceding the month during 40
which the individual applies. The department of social 41
services and the MO HealthNet division shall require 42
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documentary evidence and shall not accept self-attestation 43
at the time of application. 44
(2) No applicable individual shall remain enrolled in 45
MO HealthNet in any month unless the individual has 46
demonstrated compliance with work requirements. 47
(3) The department of social services and the MO 48
HealthNet division shall not seek or implement any 49
additional optional exemptions under 42 U.S.C. Section 50
1396a(xx)(3)(B) or any other optional exemption without 51
obtaining express approval from the legislature. Such 52
approval shall be provided in a duly enacted statute. 53
(4) The department of social services and the MO 54
HealthNet division shall not accept exemption designations, 55
approvals, or determinations by a managed care organization. 56
(5) The department of social services and the MO 57
HealthNet division shall disenroll any applicable individual 58
who fails to comply with work requirements. 59
4. No later than March 1, [2021] 2027, the Department 60
of Social Services and the MO HealthNet Division shall 61
submit all state plan amendments necessary to implement this 62
section to the United States Department of Health and Human 63
Services, Centers for Medicare and Medicaid Services. 64
[4. The Department of Social Services and the MO 65
HealthNet Division shall take all actions necessary to 66
maximize federal financial participation in funding medical 67
assistance pursuant to this section. 68
5. No greater or additional burdens or restrictions on 69
eligibility or enrollment standards, methodologies, or 70
practices shall be imposed on persons eligible for MO 71
HealthNet services pursuant to this section than on any 72
other population eligible for medical assistance. 73
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6.] 5. All references to federal or state statutes, 74
regulations or rules in this section shall be to the version 75
of those statutes, regulations or rules that existed on 76
January 1, [2019] 2027. 77
Section B. Pursuant to chapter 116, and other 1
applicable constitutional provisions and laws of this state 2
allowing the general assembly to adopt ballot language for 3
the submission of this joint resolution to the voters of 4
this state, the official summary statement of this 5
resolution shall be as follows: 6
"Shall the Missouri Constitution be amended to 7
remove language regarding the prohibition on 8
creating new eligibility or enrollment standards 9
for persons eligible for MO HealthNet services 10
and to add language to impose work requirements 11
for persons eligible for MO HealthNet services?". 12
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