House approves proposed constitutional amendment that would add work requirements to Missouri Medicaid expansion

The House approved the committee substitute to House Joint Resolution 1‑54 on third reading after a floor exchange over whether the amendment would effectively undermine the Medicaid expansion passed by voters and whether it would increase administrative cost and cut coverage for vulnerable residents.

The gentleman from Green moved the committee substitute and framed the proposal as encouraging workforce participation and offering options like community service, work programs, or half‑time educational enrollment as alternatives to uncompensated coverage. "It is to encourage people who are capable of reentering the workforce to do so," the sponsor said.

Opponents warned that states that have implemented similar policies saw higher administrative costs and limited benefit to coverage, and they said the amendment risks shifting money away from direct care to administration. "This is nothing more than an attack on Medicaid expansion," one critic said, urging colleagues to vote against the change and predicting it would fail with voters if adopted.

Other speakers asked whether education could count as the activity and whether safeguards exist to protect medically vulnerable people; the sponsor said the text allows part‑time educational participation and other activities as options. The House adopted the committee substitute by roll call; the clerk announced 99 yeas and 48 nays.