1. United States
2. Mo.
3. Letter

I urge you to reject HJR154 (Chappell). This proposed constitutional amendment would inflict cruel and counterproductive work requirements on Missourians who depend on MO HealthNet. It also strips away critical protections and the state’s duty to maximize federal funding. In 2020, voters approved the creation of a constitutional amendment to expand the Medicaid program. The people have already spoken on this issue. Since Medicaid expansion became the law in Missouri, over 360,000 new individuals have been enrolled in the program. The U.S. Department of Health and Human Services already requires Medicaid work requirements under the new federal rules in H.R. 1. HJR 154 interrupts this implementation and would impose costly bureaucratic complications for the Department of Social Services and Missouri Medicaid enrollees. Work requirements do not meaningfully increase employment. Instead, they create punishing red tape that causes people to lose health coverage for simple paperwork errors or temporary lapses. People with disabilities, chronic illnesses, unstable housing, or caregiving responsibilities often cannot meet monthly documentation demands. The requirement to prove compliance for the month before applying means someone could be healthy and working in March, lose a job in April, and be denied care in May when they need it most. This is not a path to self sufficiency. It is a path to preventable suffering and medical debt. The bill repeals the current mandate that the Department take all actions necessary to maximize federal financial participation. That is a reckless gift to anti government ideologues. Turning away available federal dollars will shift costs onto state taxpayers while delivering no benefit to public health or the economy. Missourians deserve leaders who bring federal resources home, not ones who leave them on the table. Worst of all, the amendment eliminates the existing restriction that no greater burdens be imposed on MO HealthNet recipients than on other medical assistance populations. This singles out the poorest residents for harsher treatment. It is discrimination written into our constitution. Combined with the ban on accepting additional federal exemptions and the prohibition on managed care organizations making exemption determinations, this measure ensures that thousands of eligible people will be kicked off coverage for reasons that have nothing to do with their actual need for health care. Health care is a human right. It should not be a reward for labor. I ask you to oppose HJR154 and defend the health and dignity of all Missourians.