MO HJR188

Proposes a constitutional amendment to be placed on the November 2026 general election ballot (or a special election called by the governor)

Removes the constitutional protection that prohibits imposing "greater or additional burdens or restrictions on eligibility or enrollment standards" for Medicaid expansion recipients compared to other MO HealthNet populations

Removes the provision freezing federal/state statute references to their January 1, 2019 versions, allowing current and future federal law changes to apply

Authorizes the General Assembly to determine MO HealthNet eligibility requirements consistent with federal law, rather than having standards locked in the constitution

Retains Medicaid expansion eligibility for adults ages 19-64 with income at or below 138% of the federal poverty level (133% plus 5% income disregard)