MO Opinion No. 14-2020 2020-05-26

What did the Missouri AG approve about the ballot language voters would see for the 2020 Medicaid expansion constitutional amendment?

Short answer: AG Eric Schmitt approved, under § 116.025, RSMo, the legal content and form of the fair ballot language statement that the Secretary of State drafted for petition 2020-063, the Heidi Miller initiative that became Amendment 2 (Medicaid expansion). Approval is statutorily mandated review and not an endorsement of the measure.

Disclaimer: This is an official Missouri Attorney General opinion. AG opinions are persuasive authority but not binding precedent. This summary is for informational purposes only and is not legal advice. Consult a licensed Missouri attorney for advice on your specific situation.

Plain-English summary

In May 2020, the Missouri Secretary of State sent the Attorney General a proposed "fair ballot language statement" for an initiative petition submitted by Heidi Miller. The petition (assigned number 2020-063) proposed adding Medicaid expansion to Article IV, Section 36(c) of the Missouri Constitution. The fair ballot language statement is the explanatory text that appears on the ballot itself next to the actual ballot title, telling voters in plain terms what a "yes" vote and a "no" vote will do.

Section 116.025, RSMo, requires the Secretary of State to send the proposed fair ballot language to the Attorney General for review of legal content and form. AG Eric Schmitt approved the statement. The opinion stressed that statutory review is not an endorsement of the petition or its objectives.

The petition went on to qualify for the August 2020 primary ballot as Amendment 2 and was approved by Missouri voters that summer.

Currency note

This opinion was issued in 2020. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Background and statutory framework

Missouri's ballot-information process has multiple layers. The ballot title (the question voters see) and the summary statement (the longer description that appears on the petition) come out of one statutory track tied to §§ 116.155 and 116.334, RSMo. The fair ballot language statement reviewed here is a separate, parallel artifact created under § 116.025, RSMo: a "yes vote will... / no vote will..." explanation distributed with sample ballots and posted in polling places.

The Attorney General's role under § 116.025 is the same as under § 116.334: review the Secretary of State's draft for legal content and form, then either approve it or return it for revision. The AG does not write the language and does not decide whether the underlying initiative is good policy.

Petition 2020-063, the Heidi Miller petition reviewed here, would amend Article IV, Section 36(c) of the Missouri Constitution to require Medicaid coverage for adults aged 19 to 64 with income up to 133% of the federal poverty level, in line with the Medicaid expansion option created by the Affordable Care Act. The proposed fair ballot language statement covered three points that the AG approved as legally adequate:

the "yes" effect: adopt Medicaid expansion at the constitutional level for the 19-to-64 / 133%-FPL population, with a non-discrimination clause prohibiting greater eligibility or enrollment burdens than apply to other Medicaid populations
a clarifying note that federal law requires states to fund a share of Medicaid (the state match) and that the amendment did not provide new state funding or specify funding sources for that match
the "no" effect: no constitutional Medicaid expansion
a tax statement: the measure had no direct impact on taxes

Common questions

Why does the Missouri ballot use both a "ballot title" and a separate "fair ballot language" statement?
They serve different purposes. The ballot title is the short question voters mark yes or no on. The fair ballot language statement is a longer explanatory note that goes with sample ballots and is posted in polling places, designed to give voters a fuller plain-English account of what each vote means. Sections 116.025 and 116.334, RSMo, treat them separately.

What did approving "legal content and form" mean here?
It meant the AG concluded the Secretary of State's draft fair ballot language accurately described the petition's effect, did not contain misleading characterizations, and met the statutory drafting requirements. It did not mean the AG agreed Medicaid expansion was a good idea.

What happened to the petition after this opinion?
The opinion does not say. As a matter of public record, petition 2020-063 was placed on the August 2020 primary ballot as Constitutional Amendment 2 and was approved by voters.

Did the AG flag the funding gap?
The fair ballot language itself, drafted by the Secretary of State and approved here, told voters that the amendment "does not provide new state funding or specify existing funding sources for the required state match." The AG approved that as a fair description, but did not separately editorialize on the policy question.

Citations

Section 116.025, RSMo, governing AG review of fair ballot language statements
Article IV, Section 36(c) of the Missouri Constitution (the section the petition proposed to amend)

Source

Landing page: https://ago.mo.gov/other-resources/ag-opinions/
Original PDF: https://ago.mo.gov/wp-content/uploads/attachments/14-2020.pdf?sfvrsn=2

Original opinion text

Best-effort transcription from a scanned PDF. Minor errors may remain — the linked PDF is authoritative.

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 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. SCHMITT
Attorney General

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

OP-2020-0026