Missouri House Approves Medicaid Work Requirement, Sending Measure to Voters
JEFFERSON CITY, Mo. – The Missouri House of Representatives has passed a bill that would empower voters to amend the state constitution, potentially requiring individuals to demonstrate employment or volunteer work to maintain Medicaid coverage. The legislation, which passed along party lines, now proceeds to the Missouri Senate for consideration. If approved by the Senate, Missouri residents will decide the fate of the measure in a statewide vote this November.
The proposed constitutional amendment, championed by Rogersville Republican Representative Darin Chappell, mirrors federal Medicaid work requirements initially implemented under President Trump’s administration. This move aims to permanently enshrine these requirements within the Missouri constitution, regardless of future federal policy changes.
Under the proposal, Medicaid recipients would be obligated to engage in 80 hours of work or volunteer activities each month, or be actively enrolled in a university or trade school program, to remain eligible for benefits. Exceptions would be made for pregnant women, individuals with disabilities, and children.
Representative Chappell articulated that the bill’s intent is to foster self-sufficiency and provide a pathway out of poverty, while simultaneously safeguarding the Medicaid program against potential alterations by future administrations. “The goal is to get people to find a way to extricate themselves from the cycle of poverty,” Chappell stated. “We’re not trying to ignore the fact that people need help, but at the same time it ought not become a lifestyle.”
The vote fell largely along party lines, with Democratic lawmakers voicing strong opposition. Columbia Democratic Rep. David Tyson Smith reportedly criticized the measure as an attempt to “humiliate and degrade people” and promote the idea that Medicaid recipients are “lazy.”
Federal work requirements are already slated to take effect in January 2027, leading some Democratic lawmakers to question the necessity of the state constitutional amendment. However, proponents argue that enshrining the requirements in the state constitution would protect them from being overturned by future administrations that might oppose federal work requirements.
Concerns have also been raised by advocacy groups regarding the potential impact on vulnerable populations. Emily Kalmer of the American Cancer Society expressed worry that the proposal could lead some cancer patients and survivors to lose coverage, noting that the state amendment would not include short-term hardship exemptions available under federal law. “We want to make sure that people have access to health insurance because that’s the most important thing for someone to survive a diagnosis like cancer,” Kalmer said. “The federal law provides some exemptions for short-term hardship, and this joint resolution is saying that Missouri won’t have those short-term hardship exemptions.”
The amendment reflects federal work requirements that were passed last year and must be in place next year, according to reports. If passed by Missouri voters, the amendment would require Medicaid recipients in an expansion group who are ages 19 to 64 to work or undertake a different approved activity for 80 hours a month. Other approved activities include job training, enrollment in an educational program and community service.
The House passed the proposed amendment 99-48. It now goes to the Senate, where its fate remains uncertain. The outcome of the Senate vote will determine whether Missouri voters will have the opportunity to weigh in on the future of Medicaid work requirements in the state this November.
