Review and approval of the legal content and form of the fair ballot language prepared for an initiative petition submitted by Heidi Miller amending Article IV of the Missouri Constitution (2020-063).

INVIDED ATTORNEY GENERAL OF MISSOURI ERIC SCHMITT May 26, 2020 OPINION LETTER NO. 14-2020 The Honorable John R. Ashcroft Missouri Secretary of State James C. Kirkpatrick State Information Center 600 West Main Street Jefferson City, MO 65101 Dear Secretary Ashcroft: This opinion letter responds to your request dated May 15, 2020, for our review under § 116.025, RSMo, of a proposed fair ballot language statement for the initiative petition submitted by Heidi Miller, relating to an amendment to Article IV, Section 36(c) of the Missouri Constitution (2020-063). The proposed fair ballot language statement is as follows: A "yes" vote will amend the Missouri Constitution to adopt Medicaid Expansion for persons 19 to 64 years old with an income level at or below 133% of the federal poverty level, as set forth in the Affordable Care Act. Currently, Medicaid eligibility is set forth in state statute, but this amendment adds Medicaid Expansion to our constitution. This amendment prohibits placing greater or additional burdens on eligibility or enrollment standards, methodologies or practices on persons covered under Medicaid Expansion than on any other population eligible for Medicaid. The amendment requires state agencies to take all actions necessary to maximize federal Supreme Court Building 207 W. High Street P.O. Box 899 Jefferson City, MO 65102 Phone: (573) 751-3321 Fax: (573) 751-0774 www.ago.mo.gov The Honorable John R. Ashcroft Page 2 financial participation in funding medical assistance under Medicaid Expansion. Federal law requires states to fund a portion of the program in order to receive federal funding (state match). This amendment does not provide new state funding or specify existing funding sources for the required state match. A "no" vote will not amend the Missouri Constitution to adopt Medicaid Expansion. If passed, this measure has no direct impact on taxes. Pursuant to § 116.025, RSMo, we approve the legal content and form of the proposed fair ballot language statement. Because our review of the fair ballot language statement is mandated by statute, no action we take with respect to such review should be construed as an endorsement of the initiative petition, nor as the expression of any view regarding the objectives of its proponents. Very truly yours, Eric S. Eric S. Jchnist ERIC S. SCHMITT Attorney General OP-2020-0026