Later this year Missourians will vote on one statewide ballot issue at the polls on Aug. 4, and will cast votes on two other statewide ballot issues on Nov. 3.

The Aug. 4 issue (on the ballot as Amendment 2) was the result of a successful initiative petition signature-gathering campaign that puts Missouri Medicaid Expansion before voters. Healthcare for Missouri, the sponsor of the Missouri Medicaid Expansion initiative petition, was the only campaign submitting signatures to the Secretary of State’s Office by the May 3 deadline.

The Medicaid Expansion initiative, if approved by voters, would amend the Missouri Constitution to adopt Medicaid Expansion for a person 19 to 64 years old with an income level at or below 133 percent of the federal poverty level, as set forth in the Affordable Care Act. Currently, Medicaid eligibility is covered in state law, but this amendment adds Medicaid Expansion to the state constitution.

The amendment prohibits placing greater or additional burdens on eligibility or enrollment standards, methodologies or practices on persons covered under Medicaid Expansion than on any other persons eligible for Medicaid. The amendment requires state agencies to take all actions necessary to maximize federal financial participation in funding medical assistance under Medicaid Expansion.

Federal law requires states to fund a portion of the program in order to receive federal funding (state match). This amendment does not provide new state funding or specify existing funding sources for the required state match. State government entities are estimated to have one-time costs of about $6.4 million and an unknown annual net fiscal impact by 2026 ranging from increased costs of at least $200 million to savings of $1 billion. Local governments expect costs to decrease by an unknown amount.

The two ballot issues to be decided on Nov. 3 include the topics of state redistricting and statewide officeholder term limits. Both issues were placed on the ballot by the General Assembly.

One proposal (Amendment 3 on the ballot), passed by legislators in May 2020 as Senate Joint Resolution 38, is a constitutional amendment that would regulate the General Assembly and change redistricting methods by making modifications to Article III of the state constitution (also known as “Clean Missouri” which was approved by voters statewide in November 2018).

Included among the amendment’s proposals, if approved by voters: A total ban (currently $5) on gifts from lobbyists or lobbyist principals to a member, staff member or employee of the General Assembly. A campaign contribution limit to any State Senate candidate or committee of $2,400 or less (currently $2,500 or less). Removal of the post of “nonpartisan state demographer,” and giving all redistricting responsibility to existing commissions, renamed as the House Independent Bipartisan Citizens Commission and the Senate Independent Bipartisan Citizens Commission. Redistricting criteria would include that districts shall be as nearly equal as practicable in population and as compact as they can be; communities must be preserved; and districts must be drawn to achieve partisan fairness and competitiveness. Timelines for filing tentative redistricting plans and proposed maps with the Secretary of State would be set. Actions challenging redistricting plans must be filed in the Cole County Circuit Court in Jefferson City, according to the amendment.

The other constitutional amendment on the Nov. 3 ballot (to be known as Amendment 1) would extend the two-term restriction that currently only applies to the Missouri Governor and to the State Treasurer. The constitutional amendment, if approved by voters, would prohibit any person from being elected to the office of Governor, Lieutenant Governor, Secretary of State, State Auditor, State Treasurer, or Attorney General more than twice. Any person who holds such an office for more than two years of a term for which another person was elected shall not be elected more than once to that office. Service in the offices of Governor and State Treasurer resulting from an election or appointment prior to December 3, 2020 shall count towards the term limitations.

The term limit proposal was passed by the General Assembly in 2019 as Senate Joint Resolution 14 & 9.