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Stories about Missouri

Missouri Medicaid Expansion Initiative certified for the ballot

On May 22, 2020, the Missouri Secretary of State issued a statement certifying the Missouri Medicaid Expansion Initiative for the ballot. This qualified the initiative for the November ballot unless the governor called for it to go on the August ballot by the May 26 deadline. On May 26, Governor Mike Parson (R) announced that the amendment will appear on the August 4 primary election ballot.

The initiative would amend the state constitution to do the following:

  • expand Medicaid eligibility in Missouri to adults who are between the ages of 19 and 65 and whose income is at or below 133% of the federal poverty level, which would effectively expand Medicaid to those with incomes at or below 138% of the federal poverty level under the Affordable Care Act;
  • prohibit any additional restrictions or requirements for the expanded population to qualify for Medicaid coverage than for other populations that qualify for Medicaid coverage; and
  • require the state to seek maximum federal funding of Medicaid expansion.

In Missouri, the number of signatures required to qualify an initiated constitutional amendment for the ballot is equal to 8% of the votes cast for governor in the previous gubernatorial election in six of the eight state congressional districts. Healthcare for Missouri submitted 341,440 signatures to the Missouri Secretary of State on May 1, 2020. The secretary of state used a random sample method, which projected enough valid signatures in congressional districts 1, 2, 3, 5, 6, and 7, to qualify the measure for the ballot. In those six districts, a total of 172,015 valid signatures were required; 258,686 signatures were projected to be valid.

Medicaid is a government program that provides medical insurance to groups of people with income below certain levels and individuals with disabilities. The Affordable Care Act (ACA), also known as Obamacare, provided for the expansion of Medicaid to cover all individuals earning incomes up to 138% of the federal poverty level. In 2012, the U.S. Supreme Court ruled in NFIB v. Sebelius that the federal government could not withhold funds from states that refused to expand Medicaid. The ruling had the practical effect of making Medicaid expansion optional for states. In 2018, the federal government financed 94% of the costs of state Medicaid expansion. For 2020 and subsequent years, the federal government was set to cover 90% of the costs.

Voters in Oklahoma will also decide a Medicaid expansion initiative in November.

As of 2019, a total of 36 states and Washington, D.C., had expanded or voted to expand Medicaid, while 14 states had not.

In 2017, voters in Maine approved a ballot initiative to expand Medicaid. The measure was the first time a citizen initiative to expand Medicaid appeared on any statewide ballot.

In November 2018, voters in Idaho, Montana, Nebraska, and Utah decided ballot initiatives concerning Medicaid expansion and the funding of expanded Medicaid coverage. The Idaho and Utah measures were approved by voters and later altered by the states’ legislatures. The measure in Nebraska was approved, and the measure in Montana was defeated. In January 2018, voters in Oregon approved Measure 101, thereby upholding 2017 legislation to provide funding for the state’s portion of costs for expanded Medicaid coverage through a tax on healthcare insurance and the revenue of certain hospitals.


Missouri legislature sends redistricting, campaign finance, and lobbying measure to voters with changes to 2018 citizen initiative

On Wednesday, the Missouri House approved Senate Joint Resolution 38 that would amend Article III of the Missouri Constitution to change or repeal certain provisions of Missouri Amendment 1 passed in 2018. The House approved the amendment in a vote of 98-56. The Senate approved the amendment in a vote of 22-9 on February 10. The amendment will go be for Missouri voters in November.

The amendment would enact the following changes:
• eliminate the nonpartisan state demographer and instead use a bipartisan redistricting commission appointed by the governor again;
• alter the criteria used to draft district maps;
• change the threshold of lobbyist gifts from $5 to $0; and
• lower the contribution limit for state senate campaigns from $2,500 to $2,400.

Missouri Amendment 1 (2018) was a citizen initiative approved with 62 percent of the vote. Amendment 1 created a position called the non-partisan state demographer, which was tasked with drawing state legislative districts. Amendment 1 required the state demographer and commissions to consider specific criteria, including what the initiative calls partisan fairness and competitiveness, contiguousness, compactness, and the boundaries of political subdivisions. SJR 38 would require that population size, adherence to voting rights laws, compactness, and county unity have a higher priority than partisan fairness and competitiveness in the criteria used for redistricting.

Amendment 1 also prohibited the Missouri State Legislature from passing laws allowing for unlimited campaign contributions to candidates for the state legislature. Amendment 1 established campaign contribution limits for legislative candidates and their committees for a single election cycle to $2,500 per person to a state Senate candidate and $2,000 per person to a state House candidate.

The 2018 initiated constitutional amendment was sponsored by Clean Missouri. The coalition of committees in support of the amendment raised $5.63 million, including $1.01 million from the Action Now Initiative and $1.00 million from the National Education Association. The Missourians First and Advance Missouri PACs, which registered to oppose Amendment 1, raised $343,201.

In Missouri, the state legislature can refer state statutes and constitutional amendments to the ballot for voter consideration. Both amendments and statutes require a simple majority vote of legislators to be placed on the ballot.

Between 1996 and 2018, about 63 percent (52 of 82) of the total number of measures that appeared on statewide ballots were approved, and about 37 percent (30 of 82) were defeated.

Between 2006 and 2019, 73.33 percent of the 30 constitutional amendments on Missouri ballots were approved.

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Missouri Medicaid Expansion Initiative was lone citizen initiative for which signatures were submitted by May 3 deadline

Healthcare for Missouri, the sponsor of the Missouri Medicaid Expansion Initiative, was the only campaign targeting the Missouri 2020 ballot to submit signatures by the May 3 deadline. The campaign reported submitting over 350,000 signatures to the Missouri Secretary of State. A total of 160,199 valid signatures are required to make the ballot.

The Medicaid Expansion Initiative would amend the Missouri Constitution to require the state government to provide Medicaid for persons whose income is 133 percent of the federal poverty level or below and who are not eligible for other state insurance coverage, which would effectively increase the coverage level to 138 percent under the provisions of the Affordable Care Act.

Medicaid is a government program that provides medical insurance to groups of low-income people and individuals with disabilities. The Affordable Care Act (ACA), also known as Obamacare, provided for the expansion of Medicaid to cover all individuals earning incomes up to 138 percent of the federal poverty level. In 2012, the U.S. Supreme Court ruled in NFIB v. Sebelius that the federal government could not withhold funds from states that refused to expand Medicaid. The ruling had the practical effect of making Medicaid expansion optional for states. As of January 2020, a total of 36 states and Washington, D.C., had expanded or voted to expand Medicaid, while 14 states had not.

In Missouri, the signature requirement totals for initiatives are based on the number of votes cast for governor in the state’s most recent gubernatorial election. In two-thirds of Missouri’s congressional districts, proponents must collect signatures equal to 5 percent of the gubernatorial vote for initiated state statutes and veto referendums and 8 percent of the gubernatorial vote for initiated constitutional amendments. Therefore, the total number of signatures required is less than 5 percent or 8 percent of the total votes cast for governor. For 2020, petitioners needed to collect at least 160,199 valid signatures for initiated constitutional amendments and at least 100,126 valid signatures for initiated state statutes and veto referendums.

There is one legislatively referred constitutional amendment certified for the November ballot in Missouri. The State Executive Term Limits Amendment would limit the lieutenant governor, secretary of state, state auditor, and attorney general, along with the governor and state treasurer, to two terms of office. In Missouri, the state legislature can refer state statutes and constitutional amendments to the ballot for voter consideration during its legislative session. The 2020 legislative session was scheduled to convene on January 8, 2020, and adjourn on May 15, 2020.

A total of 82 measures appeared on statewide ballots in Missouri from 1996 to 2018. About 63 percent (52 of 82) of the total number of measures that appeared on Missouri ballots were approved, and about 37 percent (30 of 82) were defeated. Between 1996 and 2018, an average of seven measures appeared on the ballot in Missouri during even-numbered election years.

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One Missouri Supreme Court justice faces retention election in November

Missouri Supreme Court Justice Patricia Breckenridge will face a retention election on November 3, 2020. She is the only member of the court facing a retention election this year. She was originally appointed by a Republican governor in 2007 and won a retention election in 2008.

Currently, two justices on the court were appointed by a Republican governor while five were appointed by a Democratic governor.

The governor appoints the seven justices of the supreme court through a hybrid nominating commission where neither the governor nor the Missouri State Bar Association has majority control over the judicial nominating commission. The governor selects three non-lawyer members, while the state bar selects three lawyer members. The Missouri Appellate Judicial Commission is chaired by the chief justice of the Missouri Supreme Court.

When a vacancy occurs, the Missouri Appellate Judicial Commission compiles a list of candidates and narrows that list to three choices. The governor must appoint a new judge from that list of three choices. After new justices have been appointed, the must face retention elections in the next general election occurring one to three years after they take office. They serve twelve-year terms if they are retained.



Filing deadline for St. Louis special elections is April 20

St. Louis, Missouri, is holding special elections for two of the city’s 29 board of aldermen seats on May 19, 2020. The filing deadline is April 20. Winners of the special elections will serve until the next regularly-scheduled general election on April 6, 2021. The two seats are up for special election due to the resignation of one board member and the death of another.

The Ward 4 seat was previously held by Democrat Samuel Moore. He was first elected to the seat in 2007 and held it until his death on February 25, 2020. When Moore was last up for election in 2019, he defeated three challengers in the Democratic primary with 53.5% of the vote. He won the general election unopposed.

The Ward 12 seat was previously held by Democrat Larry Arnowitz. He was first elected to the seat in 2011 and held it until his resignation on March 3, 2020. When Arnowitz was last up for election in 2019, he defeated two challengers in the Democratic primary with 74.3% of the vote. He went on to win the general election unopposed.

St. Louis is the second-largest city in Missouri and the 57th-largest city in the U.S. by population.



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