House approves HJR 154, a proposed constitutional amendment adding work/community expectations for some MoHealthNet recipients

The House approved the committee substitute for House Joint Resolution 154 on Feb. 18 by a recorded vote (99 yea, 48 nay). Sponsor the Gentleman from Green said the proposed amendment encourages capable individuals to reenter the workforce and reduces reliance on government programs; opponents warned it would grow administrative costs and potentially strip coverage from vulnerable Missourians.

The Lady from Saint Louis called the measure “nothing more than an attack on Medicaid expansion,” saying work requirements are ineffective and would embed new constitutional restrictions with long-term consequences. The Gentleman from Jackson and others argued the policy risks shifting federal and state administrative costs away from healthcare and toward eligibility monitoring, citing other states’ experiences in which similar policies increased administrative overhead.

The sponsor described the requirement as 80 hours per month of work, community service, participation in a work program, or half-time educational efforts for those who can participate, and said it was intended to give recipients “the pride of the fruit of their own labors.” The sponsor and several supporters said the policy aims to promote work while opponents said federal guidance and operational details are insufficient and that the state cannot safely implement such a change without additional planning.

By voice and recorded vote, the House moved HJR 154 forward; the proposal would require further steps to appear on a ballot if the constitutional amendment process continues.