Who writes the ballot question text Missouri voters actually read on a constitutional initiative, and what does the Attorney General check before it's used?

Plain-English summary

Under § 116.334, RSMo, the Secretary of State prepares a "summary statement" for each initiative petition. The summary statement is the actual ballot question voters will see if the petition makes it to the ballot. The AG then reviews the legal content and form of that proposed summary statement.

In this letter, AG Eric Schmitt approved the form of the summary statement the Secretary of State had drafted for Heidi Miller's initiative petition 20-063, a proposed constitutional amendment to Article IV. The approved ballot question, verbatim, asked voters whether they wanted to amend the Missouri Constitution to:

• adopt Medicaid expansion for persons 19 to 64 with incomes at or below 133% of the federal poverty level, as set forth in the Affordable Care Act;
• prohibit greater or additional burdens on eligibility, enrollment standards, methodologies, or practices for persons covered under Medicaid expansion than for any other Medicaid population; and
• require state agencies to take all actions necessary to maximize federal financial participation in funding Medicaid expansion.

A later, similar Medicaid-expansion measure did reach the ballot in 2020 and was approved by Missouri voters as Amendment 2, codified at Article IV, § 36(c) of the Missouri Constitution. The proposal in petition 20-063 (the one this opinion approved) was one of multiple proponent-side variants filed for that election cycle.

As with the related fiscal-note opinion (Opinion 91-2019), the AG's approval here is procedural: "Because our review of the statement is mandated by statute, no action that we take with respect to such review should be construed as an endorsement of the petition, nor as the expression of any view regarding the objectives of its proponents."

Currency note

This opinion was issued in 2019. 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.

Common questions

Q: What is a "summary statement" and how is it different from the ballot title?
A: In Missouri the summary statement, prepared under § 116.334, is the brief question voters see on the ballot. The "ballot title" is the combination of the summary statement and the fiscal note summary, both of which appear on the ballot together. Practitioners use the terms loosely. The legal vehicle for challenging either is the same statutory ballot-title contest.

Q: Who writes the words voters actually read?
A: For most initiatives, the Secretary of State drafts the summary statement and the State Auditor drafts the fiscal note summary. The AG reviews both for legal content and form. None of those officials is the petition's proponent; the proponent gets to weigh in by filing suit if they think the summary or fiscal note misrepresents the measure.

Q: Why does the wording matter so much?
A: Because what voters read at the moment of decision is often the only description of the measure they have seen. Missouri courts have rewritten or struck summary statements that they found to be argumentative, materially misleading, or that omitted a key effect of the measure. Both opponents and proponents have used ballot-title litigation aggressively.

Q: Is this the same Medicaid expansion that Missouri voters later passed?
A: The 2020 ballot eventually carried "Amendment 2," which voters approved on August 4, 2020. Amendment 2 adopted Medicaid expansion to adults 19-64 at incomes up to 133% of the federal poverty level. That ultimately ratified measure originated from this family of 2019-filed petitions, though the specific text on the August 2020 ballot was based on a slightly different variant than the one approved in this opinion letter.

Background and statutory framework

Missouri's initiative process is in Chapter 116 of the Missouri Revised Statutes. Section 116.334 governs preparation of the summary statement: the Secretary of State drafts it, the AG reviews it for legal content and form. Article III, § 50 of the Missouri Constitution is the underlying grant of initiative power. Article IV, the target of the proposed amendment, addresses the executive branch (the petition would add Medicaid expansion obligations to the executive department's responsibilities).

The Medicaid expansion petition cluster of 2019 reflected proponent strategy after Missouri's legislature repeatedly declined to expand Medicaid via statute. The constitutional initiative path was chosen so that future legislatures could not as easily reverse course; once written into the Missouri Constitution, the expansion can be undone only by another constitutional amendment.

Citations

• § 116.334, RSMo (Secretary of State prepares summary statement, AG reviews legal content and form)
• Mo. Const. art. III, § 50 (initiative power)
• Mo. Const. art. IV (executive department; later, art. IV, § 36(c) added by Amendment 2 in 2020)

Source

• Landing page: https://ago.mo.gov/other-resources/ag-opinions/
• Original PDF: https://ago.mo.gov/wp-content/uploads/attachments/92-2019.pdf?sfvrsn=2

Original opinion text

ATTORNEY GENERAL OF MISSOURI
ERIC SCHMITT
June 13, 2019
OPINION LETTER NO. 92-2019
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 June 3, 2019, for our review under
§ 116.334, RSMo, of a proposed summary statement prepared for the petition submitted by Heidi
Miller regarding a proposed constitutional amendment to amend Article IV of the Missouri
Constitution. The proposed summary statement is as follows:
Do you want to amend the Missouri Constitution to:
• adopt Medicaid Expansion for persons 19 to 64 old with an income level at or
below 133% of the federal poverty level, as set forth in the Affordable Care Act;
• prohibit 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; and
• require state agencies to take all actions necessary to maximize federal financial
participation in funding medical assistance under Medicaid Expansion?
Pursuant to § 116.334, RSMo, we approve the legal content and form of the proposed
statement. Because our review of the statement is mandated by statute, no action that we take with
respect to such review should be construed as an endorsement of the 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-2019-0104