Text of MO HJR 73 (2025)

FIRST REGULAR SESSION HOUSE JOINT RESOLUTION NO. 73 103RD GENERAL ASSEMBLY INTRODUCED BY REPRESENTATIVE LEWIS. 2454H.01I JOSEPH ENGLER, Chief Clerk JOINT RESOLUTION Submitting to the qualified voters of Missouri an amendment repealing Section 36 of Article I of the Constitution of Missouri, and adopting one new section in lieu thereof relating to reproductive health care. Be it resolved by the House of Representatives, the Senate concurring therein: That at the next general election to be held in the state of Missouri, on Tuesday next 2 following the first Monday in November, 2026, or at a special election to be called by the 3 governor for that purpose, there is hereby submitted to the qualified voters of this state, for 4 adoption or rejection, the following amendment to Article I of the Constitution of the state of 5 Missouri: Section A. Section 36, Article I, Constitution of Missouri, is repealed and one new 2 section adopted in lieu thereof, to be known as Section 36(a), to read as follows: Section 36(a). 1. No abortion shall be performed or induced upon a woman, 2 except in cases of medical emergency, rape, or incest. In the case of abortions 3 performed or induced in cases of rape or incest, the abortion may be performed or 4 induced no later than twelve weeks gestational age of the unborn child and only if 5 documentation is presented to the attending physician that the rape or incest has been 6 reported to a law enforcement agency that has jurisdiction to investigate the complaint 7 at least forty-eight hours prior to the abortion. 8 2. No public funds shall be expended for the purpose of performing or inducing, 9 or otherwise assisting, any abortion. EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language. 10 3. No gender transition surgeries shall be knowingly performed on children 11 under eighteen years of age, and no cross-sex hormones or puberty-blocking drugs shall 12 be knowingly prescribed or administered for the purpose of gender transition to 13 children under eighteen years of age. The provisions of this section shall not apply to 14 the use of such surgeries, drugs, or hormones to treat children born with a medically 15 verifiable disorder of sex development or to treat any infection, injury, disease, or 16 disorder unrelated to the purpose of a gender transition. 17 4. Any person who intentionally or negligently causes damage to another person 18 relating to the provision of prenatal care, childbirth, postpartum care, miscarriage care, 19 or for the performance or inducement of an abortion shall be liable for damages and 20 shall be subject to the suspension or revocation of his or her medical license. 21 5. A woman's right to reproductive freedom shall include the right to health care 22 in cases of miscarriages, ectopic pregnancies, and other medical emergencies, and the 23 provisions of this section shall not be construed to limit a woman's access to such health 24 care. 25 6. The general assembly shall have the authority to enact laws to carry out the 26 provisions of this section. 27 7. As used in this section, the following terms mean: 28 (1) "Cross-sex hormones", testosterone, estrogen, or other androgens given to an 29 individual in amounts that are greater or more potent than would normally occur 30 naturally in a healthy individual of the same age and sex; 31 (2) "Gender transition surgery", a surgical procedure performed for the 32 purpose of assisting an individual with identifying with and living as a gender different 33 from his or her biological sex; 34 (3) "Medical emergency", a condition that, based on reasonable medical 35 judgment, so complicates the medical condition of a pregnant woman as to necessitate 36 the immediate termination of her pregnancy to avert the death of the pregnant woman 37 or for which a delay will create a serious risk of substantial and irreversible physical 38 impairment of a major bodily function of the pregnant woman. A "medical emergency" 39 shall include, but not be limited to, an ectopic pregnancy at any point following the 40 diagnosis of such; 41 (4) "Puberty-blocking drugs", gonadotropin-releasing hormone analogues or 42 other synthetic drugs used to stop luteinizing hormone secretion and follicle-stimulating 43 hormone secretion, synthetic antiandrogen drugs to block the androgen receptor, or any 44 other drug used to delay or suppress pubertal development in children for the purpose 45 of assisting an individual with a gender transition. HJR 73 2 [Section 36. 1. This Section shall be known as "The Right to 2 Reproductive Freedom Initiative". 3 2. The Government shall not deny or infringe upon a person's 4 fundamental right to reproductive freedom, which is the right to make and 5 carry out decisions about all matters relating to reproductive health care, 6 including but not limited to prenatal care, childbirth, postpartum care, birth 7 control, abortion care, miscarriage care, and respectful birthing conditions. 8 3. The right to reproductive freedom shall not be denied, interfered 9 with, delayed, or otherwise restricted unless the Government demonstrates that 10 such action is justified by a compelling governmental interest achieved by the 11 least restrictive means. Any denial, interference, delay, or restriction of the 12 right to reproductive freedom shall be presumed invalid. For purposes of this 13 Section, a governmental interest is compelling only if it is for the limited 14 purpose and has the limited effect of improving or maintaining the health of a 15 person seeking care, is consistent with widely accepted clinical standards of 16 practice and evidence-based medicine, and does not infringe on that person's 17 autonomous decision-making. 18 4. Notwithstanding subsection 3 of this Section, the general assembly 19 may enact laws that regulate the provision of abortion after Fetal Viability 20 provided that under no circumstance shall the Government deny, interfere 21 with, delay, or otherwise restrict an abortion that in the good faith judgment of 22 a treating health care professional is needed to protect the life or physical or 23 mental health of the pregnant person. 24 5. No person shall be penalized, prosecuted, or otherwise subjected to 25 adverse action based on their actual, potential, perceived, or alleged pregnancy 26 outcomes, including but not limited to miscarriage, stillbirth, or abortion. Nor 27 shall any person assisting a person in exercising their right to reproductive 28 freedom with that person's consent be penalized, prosecuted, or otherwise 29 subjected to adverse action for doing so. 30 6. The Government shall not discriminate against persons providing or 31 obtaining reproductive health care or assisting another person in doing so. 32 7. If any provision of this Section or the application thereof to anyone 33 or to any circumstance is held invalid, the remainder of those provisions and 34 the application of such provisions to others or other circumstances shall not be 35 affected thereby. 36 8. For purposes of this Section, the following terms mean: 37 (1) "Fetal Viability", the point in pregnancy when, in the good faith 38 judgment of a treating health care professional and based on the particular 39 facts of the case, there is a significant likelihood of the fetus's sustained 40 survival outside the uterus without the application of extraordinary medical 41 measures. 42 (2) "Government", 43 a. the state of Missouri; or 44 b. any municipality, city, town, village, township, district, authority, 45 public subdivision or public corporation having the power to tax or regulate, or 46 any portion of two or more such entities within the state of Missouri.] HJR 73 3 Section B. Pursuant to chapter 116, and other applicable constitutional provisions and 2 laws of this state allowing the general assembly to adopt ballot language for the submission of 3 this joint resolution to the voters of this state, the official summary statement of this 4 resolution shall be as follows: 5 "Shall the Missouri Constitution be amended to: 6 • Guarantee the right to reproductive freedom, which shall include a woman's right to 7 health care for miscarriages, ectopic pregnancies, and medical emergencies; 8 • Prohibit surgeries, hormones, and drugs used on children for gender transitions; 9 • Prohibit taxpayer-funded abortions; and 10 • Prohibit abortions except for medical emergencies, rape, or incest?". ✔ HJR 73 4

FIRST REGULAR SESSION [TRULY AGREED TO AND FINALLY PASSED] HOUSE COMMITTEE SUBSTITUTE FOR HOUSE JOINT RESOLUTION NO. 73 103RD GENERAL ASSEMBLY 2454H.05T 2025 JOINT RESOLUTION Submitting to the qualified voters of Missouri an amendment repealing Section 36 of Article I of the Constitution of Missouri, and adopting one new section in lieu thereof relating to reproductive health care. Be it resolved by the House of Representatives, the Senate concurring therein: That at the next general election to be held in the state of Missouri, on Tuesday next 2 following the first Monday in November, 2026, or at a special election to be called by the 3 governor for that purpose, there is hereby submitted to the qualified voters of this state, for 4 adoption or rejection, the following amendment to Article I of the Constitution of the state of 5 Missouri: Section A. Section 36, Article I, Constitution of Missouri, is repealed and one new 2 section adopted in lieu thereof, to be known as Section 36(a), to read as follows: Section 36(a). 1. The state's duty to protect public health and welfare includes 2 protecting the integrity and ethics of the medical profession. The state's interest in 3 regulating the practice of medicine is even greater in areas of medical and scientific 4 uncertainty or in areas that raise grave moral and ethical concerns, including abortion 5 and gender transition procedures. 6 2. An abortion may be performed or induced upon a woman in cases of medical 7 emergency, fetal anomaly, rape, or incest. In the case of abortions performed or induced 8 in cases of rape or incest, the abortion may be performed or induced no later than 9 twelve weeks gestational age of the unborn child. EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language. 10 3. The general assembly may enact laws that regulate the provision of abortions, 11 abortion facilities, and abortion providers to ensure the health and safety of the 12 pregnant mother. These laws shall include, but not be limited to, laws requiring 13 physicians providing abortion care to have admitting privileges at a nearby hospital; 14 laws requiring facilities where abortions are performed or induced to be licensed and 15 inspected for clean and safe conditions and adequate instruments to treat any 16 emergencies arising from an abortion procedure; laws requiring physicians to perform 17 a sufficient examination of the woman to determine the unborn child's gestational age 18 and any preexisting medical conditions that may influence the procedure; and laws 19 requiring ultrasounds to be performed only by physicians or licensed medical 20 technicians. 21 4. No abortion shall be performed or induced upon a woman based on a prenatal 22 diagnosis, test, or screening indicating a disability in an unborn child, except in cases of 23 a fetal anomaly. 24 5. No public funds shall be expended for the purpose of performing, inducing, or 25 otherwise assisting any abortion, except in cases of medical emergency, rape, or incest, 26 as otherwise authorized by law. 27 6. Except in cases of a medical emergency in which consent cannot be obtained, 28 no abortion shall be performed or induced upon a woman without her voluntary and 29 informed consent, given freely and without coercion. In the case of a minor under the 30 age of eighteen years who is not emancipated, no person shall knowingly perform or 31 induce an abortion, except in cases of a medical emergency in which consent cannot be 32 obtained, unless the attending physician has obtained: (1) the written consent of the 33 minor and a parent or legal guardian; and (2) documentation of the consent is retained 34 in the minor's medical record. Licensed medical physicians shall be required to provide 35 women with medically accurate information. The general assembly may enact laws to 36 provide for the right of a minor to consent to an abortion as granted by a court order. 37 7. Fetal organ harvesting after an abortion is not permitted under any 38 circumstances. 39 8. A woman's ability to access health care in cases of miscarriages, ectopic 40 pregnancies, and other medical emergencies shall not be infringed by the state. 41 9. No gender transition surgeries shall be knowingly performed on children 42 under eighteen years of age, and no cross-sex hormones or puberty-blocking drugs shall 43 be knowingly prescribed or administered for the purpose of gender transition to 44 children under eighteen years of age. The provisions of this section shall not apply to 45 the use of such surgeries, drugs, or hormones to treat children born with a medically HCS HJR 73 2 46 verifiable disorder of sex development or to treat any infection, injury, disease, or 47 disorder unrelated to the purpose of a gender transition. 48 10. Any action challenging the validity of any state law relating to reproductive 49 health care shall be brought in the Circuit Court of Cole County, Missouri. If a 50 pleading, written motion, or other paper drawing into question the constitutionality of a 51 state statute does not include the state, one of its agencies, or one of its officers or 52 employees in an official capacity, the party bringing the action shall file a notice of 53 constitutional question and serve it on the attorney general and the attorney general 54 shall have the right to intervene in the litigation. 55 11. The general assembly shall have the authority to enact laws to carry out the 56 provisions of this section. 57 12. As used in this section, the following terms mean: 58 (1) "Cross-sex hormones", testosterone, estrogen, or other androgens given to an 59 individual in amounts that are greater or more potent than would normally occur 60 naturally in a healthy individual of the same age and sex; 61 (2) "Fetal anomaly", a structural or functional abnormality in the unborn 62 child's gestational development that would make life outside the womb impossible; 63 (3) "Fetal organ harvesting", collection of fetal tissue, organs, or fluids, 64 including any biological material, for the purpose of selling or collecting for scientific 65 purposes, but shall not include the utilization of fetal tissue, organs, or fluids to 66 determine the cause or causes of any anomaly, illness, death, or genetic condition of the 67 unborn child, the paternity of the unborn child, or for law enforcement purposes; 68 (4) "Gender transition surgery", a surgical procedure performed for the 69 purpose of assisting an individual with identifying with and living as a gender different 70 from his or her biological sex; 71 (5) "Medical emergency", a condition that, based on reasonable medical 72 judgment, so complicates the medical condition of a pregnant woman as to necessitate 73 the immediate termination of her pregnancy to avert the death of the pregnant woman 74 or for which a delay will create a serious risk of substantial and irreversible physical 75 impairment of a major bodily function of the pregnant woman. A medical emergency 76 shall include, but not be limited to, an ectopic pregnancy at any point following the 77 diagnosis of such and treatment for a miscarriage; 78 (6) "Puberty-blocking drugs", gonadotropin-releasing hormone analogues or 79 other synthetic drugs used to stop luteinizing hormone secretion and follicle stimulating 80 hormone secretion, synthetic antiandrogen drugs to block the androgen receptor, or any 81 other drug used to delay or suppress pubertal development in children for the purpose 82 of assisting an individual with a gender transition; HCS HJR 73 3 83 (7) "Reasonable medical judgment", a medical judgment that would be made by 84 a reasonably prudent physician, knowledgeable about the case and the treatment 85 possibilities with respect to the medical conditions involved. 86 13. All provisions of this section are severable. If any provision of this section is 87 found by a court of competent jurisdiction to be unconstitutional or unconstitutionally 88 enacted, the remaining provisions of this section shall be and remain valid. [Section 36. 1. This Section shall be known as "The Right to 2 Reproductive Freedom Initiative". 3 2. The Government shall not deny or infringe upon a person's 4 fundamental right to reproductive freedom, which is the right to make and 5 carry out decisions about all matters relating to reproductive health care, 6 including but not limited to prenatal care, childbirth, postpartum care, birth 7 control, abortion care, miscarriage care, and respectful birthing conditions. 8 3. The right to reproductive freedom shall not be denied, interfered 9 with, delayed, or otherwise restricted unless the Government demonstrates that 10 such action is justified by a compelling governmental interest achieved by the 11 least restrictive means. Any denial, interference, delay, or restriction of the 12 right to reproductive freedom shall be presumed invalid. For purposes of this 13 Section, a governmental interest is compelling only if it is for the limited 14 purpose and has the limited effect of improving or maintaining the health of a 15 person seeking care, is consistent with widely accepted clinical standards of 16 practice and evidence-based medicine, and does not infringe on that person's 17 autonomous decision-making. 18 4. Notwithstanding subsection 3 of this Section, the general assembly 19 may enact laws that regulate the provision of abortion after Fetal Viability 20 provided that under no circumstance shall the Government deny, interfere 21 with, delay, or otherwise restrict an abortion that in the good faith judgment of 22 a treating health care professional is needed to protect the life or physical or 23 mental health of the pregnant person. 24 5. No person shall be penalized, prosecuted, or otherwise subjected to 25 adverse action based on their actual, potential, perceived, or alleged pregnancy 26 outcomes, including but not limited to miscarriage, stillbirth, or abortion. Nor 27 shall any person assisting a person in exercising their right to reproductive 28 freedom with that person's consent be penalized, prosecuted, or otherwise 29 subjected to adverse action for doing so. 30 6. The Government shall not discriminate against persons providing or 31 obtaining reproductive health care or assisting another person in doing so. 32 7. If any provision of this Section or the application thereof to anyone 33 or to any circumstance is held invalid, the remainder of those provisions and 34 the application of such provisions to others or other circumstances shall not be 35 affected thereby. 36 8. For purposes of this Section, the following terms mean: 37 (1) "Fetal Viability", the point in pregnancy when, in the good faith 38 judgment of a treating health care professional and based on the particular 39 facts of the case, there is a significant likelihood of the fetus's sustained HCS HJR 73 4 40 survival outside the uterus without the application of extraordinary medical 41 measures. 42 (2) "Government", 43 a. the state of Missouri; or 44 b. any municipality, city, town, village, township, district, authority, 45 public subdivision or public corporation having the power to tax or regulate, or 46 any portion of two or more such entities within the state of Missouri.] Section B. Pursuant to chapter 116, and other applicable constitutional provisions and 2 laws of this state allowing the general assembly to adopt ballot language for the submission of 3 this joint resolution to the voters of this state, the official summary statement of this 4 resolution shall be as follows: 5 "Shall the Missouri Constitution be amended to: 6 • Guarantee access to care for medical emergencies, ectopic pregnancies, and 7 miscarriages; 8 • Ensure women's safety during abortions; 9 • Ensure parental consent for minors; 10 • Allow abortions for medical emergencies, fetal anomalies, rape, and incest; 11 • Require physicians to provide medically accurate information; and 12 • Protect children from gender transition?". ✔ HCS HJR 73 5