MO HJR154

Proposes a constitutional amendment for the November 2026 ballot to impose work requirements on MO HealthNet (Medicaid) recipients ages 19-64 who are not pregnant, not enrolled in Medicare, and otherwise subject to federal work requirement provisions under 42 U.S.C. Section 1396a(xx)

Requires applicants to demonstrate compliance with work requirements for the month prior to application, with documentary evidence required rather than self-attestation

Prohibits the Department of Social Services from accepting self-attestation for exemptions, from implementing optional exemptions without express statutory authorization, and from accepting exemption determinations made by managed care organizations

Mandates disenrollment of any applicable individual who fails to comply with work requirements

Removes existing constitutional language that prohibited imposing greater eligibility burdens on Medicaid expansion recipients compared to other Medicaid populations, and requires state plan amendments be submitted to CMS by March 1, 2027