FIRSTREGULARSESSION
HOUSECOMMITTEESUBSTITUTEFOR
HOUSEJOINT
RESOLUTION NO.54
103RDGENERALASSEMBLY
1890H.02C JOSEPHENGLER,ChiefClerk
JOINTRESOLUTION
SubmittingtothequalifiedvotersofMissourianamendmentrepealingSection36ofArticleI
oftheConstitutionofMissouri,andadoptingonenewsectioninlieuthereofrelating
toreproductivehealthcare.
BeitresolvedbytheHouseofRepresentatives,theSenateconcurringtherein:
ThatatthenextgeneralelectiontobeheldinthestateofMissouri,onTuesdaynext
2followingthefirstMondayinNovember,2026,orataspecialelectiontobecalledbythe
3governorforthatpurpose,thereisherebysubmittedtothequalifiedvotersofthisstate,for
4adoptionorrejection,thefollowingamendmenttoArticleIoftheConstitutionofthestateof
5Missouri:
SectionA.Section36,ArticleI,ConstitutionofMissouri,isrepealedandonenew
2sectionadoptedinlieuthereof,tobeknownasSection36(a),toreadasfollows:
Section36(a).1.Thestate'sdutytoprotectpublichealthandwelfareincludes
2protectingtheintegrityandethicsofthemedicalprofession.Thestate'sinterestin
3regulatingthepracticeofmedicineisevengreaterinareasofmedicalandscientific
4uncertaintyorinareasthatraisegravemoralandethicalconcerns,includingabortion
5andgendertransitionprocedures.
6 2.Anabortionmaybeperformedorinduceduponawomanincasesofmedical
7emergency,fetalanomaly,rape,orincest.Inthecaseofabortionsperformedorinduced
8incasesofrapeorincest,theabortionmaybeperformedorinducednolaterthan
9twelveweeksgestationalageoftheunbornchild.
10 3.Thegeneralassemblymayenactlawsthatregulatetheprovisionofabortions,
11abortionfacilities,andabortionproviderstoensurethehealthandsafetyofthe
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 12pregnantmother.Theselawsshallinclude,butnotbelimitedto,lawsrequiring
13physiciansprovidingabortioncaretohaveadmittingprivilegesatanearbyhospital;
14lawsrequiringfacilitieswhereabortionsareperformedorinducedtobelicensedand
15inspectedforcleanandsafeconditionsandadequateinstrumentstotreatany
16emergenciesarisingfromanabortionprocedure;lawsrequiringphysicianstoperform
17asufficientexaminationofthewomantodeterminetheunbornchild'sgestationalage
18andanypreexistingmedicalconditionsthatmayinfluencetheprocedure;andlaws
19requiringultrasoundstobeperformedonlybyphysiciansorlicensedmedical
20technicians.
21 4.NotwithstandinganyprovisionofthisConstitutionoranyotherlawtothe
22contrary,itshallbeillegalinthisstatetoprovidereproductivehealthcare,oranyother
23healthcarerelatingtoreproductivehealthcare,toaminorchildwithouttheprior
24notificationandinformedconsentofthechild'sparentorguardian,exceptinthecaseof
25medicalemergency.
26 5.Noabortionshallbeperformedorinduceduponawomanbasedonaprenatal
27diagnosis,test,orscreeningindicatingadisabilityinanunbornchild,exceptincasesof
28afetalanomaly.
29 6.Nopublicfundsshallbeexpendedforthepurposeofperforming,inducing,or
30otherwiseassistinganyabortion,exceptincasesofmedicalemergency,fetalanomaly,
31rape,orincest,orasotherwiseauthorizedbylaw.
32 7.Exceptincasesofamedicalemergencyinwhichconsentcannotbeobtained,
33noabortionshallbeperformedorinduceduponawomanwithouthervoluntaryand
34informedconsent,givenfreelyandwithoutcoercion.Inthecaseofaminorunderthe
35ageofeighteenyears,nopersonshallknowinglyperformorinduceanabortion,except
36incasesofamedicalemergencyinwhichconsentcannotbeobtained,unlessthe
37attendingphysicianhasobtained:(1)thewrittenconsentoftheminorandaparent,
38managingconservator,orlegalguardian;and(2)documentationoftheconsentis
39retainedintheminor'smedicalrecord.Thegeneralassemblymayenactlawstoprovide
40fortherightofaminortoconsenttoanabortionasgrantedbyacourtorder.
41 8.Fetalorganharvestingafteranabortionisnotpermittedunderany
42circumstances.
43 9.Awoman'sabilitytoaccesshealthcareincasesofmiscarriages,ectopic
44pregnancies,andothermedicalemergenciesshallnotbeinfringedbythestate.
45 10.Nogendertransitionsurgeriesshallbeknowinglyperformedonchildren
46undereighteenyearsofage,andnocross-sexhormonesorpuberty-blockingdrugsshall
47beknowinglyprescribedoradministeredforthepurposeofgendertransitionto
48childrenundereighteenyearsofage.Theprovisionsofthissectionshallnotapplyto
HCSHJR54 2 49theuseofsuchsurgeries,drugs,orhormonestotreatchildrenbornwithamedically
50verifiabledisorderofsexdevelopmentortotreatanyinfection,injury,disease,or
51disorderunrelatedtothepurposeofagendertransition.
52 11.Anyactionchallengingthevalidityofanystatelawrelatingtoreproductive
53healthcareshallbebroughtintheCircuitCourtofColeCounty,Missouri.Ifa
54pleading,writtenmotion,orotherpaperdrawingintoquestiontheconstitutionalityofa
55statestatutedoesnotincludethestate,oneofitsagencies,oroneofitsofficersor
56employeesinanofficialcapacity,thepartybringingtheactionshallfileanoticeof
57constitutionalquestionandserveitontheattorneygeneralandtheattorneygeneral
58shallhavetherighttointerveneinthelitigation.
59 12.Thegeneralassemblyshallhavetheauthoritytoenactlawstocarryoutthe
60provisionsofthissection.
61 13.Asusedinthissection,thefollowingtermsmean:
62 (1)"Cross-sexhormones",testosterone,estrogen,orotherandrogensgiventoan
63individualinamountsthataregreaterormorepotentthanwouldnormallyoccur
64naturallyinahealthyindividualofthesameageandsex;
65 (2)"Fetalanomaly",astructuralorfunctionalabnormalityintheunborn
66child'sgestationaldevelopmentthatwouldmakelifeoutsidethewombimpossible;
67 (3)"Fetalorganharvesting",collectionoffetaltissue,organs,orfluids,
68includinganybiologicalmaterial,forthepurposeofsellingorcollectingforscientific
69purposes,butshallnotincludetheutilizationoffetaltissue,organs,orfluidsto
70determinethecauseorcausesofanyanomaly,illness,death,orgeneticconditionofthe
71unbornchild,thepaternityoftheunbornchild,orforlawenforcementpurposes;
72 (4)"Gendertransitionsurgery",asurgicalprocedureperformedforthe
73purposeofassistinganindividualwithidentifyingwithandlivingasagenderdifferent
74fromhisorherbiologicalsex;
75 (5)"Medicalemergency",aconditionthat,basedonreasonablemedical
76judgment,socomplicatesthemedicalconditionofapregnantwomanastonecessitate
77theimmediateterminationofherpregnancytoavertthedeathofthepregnantwoman
78orforwhichadelaywillcreateaseriousriskofsubstantialandirreversiblephysical
79impairmentofamajorbodilyfunctionofthepregnantwoman.Amedicalemergency
80shallinclude,butnotbelimitedto,anectopicpregnancyatanypointfollowingthe
81diagnosisofsuchandtreatmentforamiscarriage;
82 (6)"Puberty-blockingdrugs",gonadotropin-releasinghormoneanaloguesor
83othersyntheticdrugsusedtostopluteinizinghormonesecretionandfolliclestimulating
84hormonesecretion,syntheticantiandrogendrugstoblocktheandrogenreceptor,orany
HCSHJR54 3 85otherdrugusedtodelayorsuppresspubertaldevelopmentinchildrenforthepurpose
86ofassistinganindividualwithagendertransition;
87 (7)"Reasonablemedicaljudgment",amedicaljudgmentthatwouldbemadeby
88areasonablyprudentphysician,knowledgeableaboutthecaseandthetreatment
89possibilitieswithrespecttothemedicalconditionsinvolved.
90 14.Allprovisionsofthissectionareseverable.Ifanyprovisionofthissectionis
91foundbyacourtofcompetentjurisdictiontobeunconstitutionalorunconstitutionally
92enacted,theremainingprovisionsofthissectionshallbeandremainvalid.
[Section36.1.ThisSectionshallbeknownas"TheRightto
2 ReproductiveFreedomInitiative".
3 2.TheGovernmentshallnotdenyorinfringeuponaperson's
4 fundamentalrighttoreproductivefreedom,whichistherighttomakeand
5 carryoutdecisionsaboutallmattersrelatingtoreproductivehealthcare,
6 includingbutnotlimitedtoprenatalcare,childbirth,postpartumcare,birth
7 control,abortioncare,miscarriagecare,andrespectfulbirthingconditions.
8 3.Therighttoreproductivefreedomshallnotbedenied,interfered
9 with,delayed,orotherwiserestrictedunlesstheGovernmentdemonstratesthat
10 suchactionisjustifiedbyacompellinggovernmentalinterestachievedbythe
11 leastrestrictivemeans.Anydenial,interference,delay,orrestrictionofthe
12 righttoreproductivefreedomshallbepresumedinvalid.Forpurposesofthis
13 Section,agovernmentalinterestiscompellingonlyifitisforthelimited
14 purposeandhasthelimitedeffectofimprovingormaintainingthehealthofa
15 personseekingcare,isconsistentwithwidelyacceptedclinicalstandardsof
16 practiceandevidence-basedmedicine,anddoesnotinfringeonthatperson's
17 autonomousdecision-making.
18 4.Notwithstandingsubsection3ofthisSection,thegeneralassembly
19 mayenactlawsthatregulatetheprovisionofabortionafterFetalViability
20 providedthatundernocircumstanceshalltheGovernmentdeny,interfere
21 with,delay,orotherwiserestrictanabortionthatinthegoodfaithjudgmentof
22 atreatinghealthcareprofessionalisneededtoprotectthelifeorphysicalor
23 mentalhealthofthepregnantperson.
24 5.Nopersonshallbepenalized,prosecuted,orotherwisesubjectedto
25 adverseactionbasedontheiractual,potential,perceived,orallegedpregnancy
26 outcomes,includingbutnotlimitedtomiscarriage,stillbirth,orabortion.Nor
27 shallanypersonassistingapersoninexercisingtheirrighttoreproductive
28 freedomwiththatperson'sconsentbepenalized,prosecuted,orotherwise
29 subjectedtoadverseactionfordoingso.
30 6.TheGovernmentshallnotdiscriminateagainstpersonsprovidingor
31 obtainingreproductivehealthcareorassistinganotherpersonindoingso.
32 7.IfanyprovisionofthisSectionortheapplicationthereoftoanyone
33 ortoanycircumstanceisheldinvalid,theremainderofthoseprovisionsand
34 theapplicationofsuchprovisionstoothersorothercircumstancesshallnotbe
35 affectedthereby.
36 8.ForpurposesofthisSection,thefollowingtermsmean:
HCSHJR54 4 37 (1)"FetalViability",thepointinpregnancywhen,inthegoodfaith
38 judgmentofatreatinghealthcareprofessionalandbasedontheparticular
39 factsofthecase,thereisasignificantlikelihoodofthefetus'ssustained
40 survivaloutsidetheuteruswithouttheapplicationofextraordinarymedical
41 measures.
42 (2)"Government",
43 a.thestateofMissouri;or
44 b.anymunicipality,city,town,village,township,district,authority,
45 publicsubdivisionorpubliccorporationhavingthepowertotaxorregulate,or
46 anyportionoftwoormoresuchentitieswithinthestateofMissouri.]
SectionB.Pursuanttochapter116,andotherapplicableconstitutionalprovisionsand
2lawsofthisstateallowingthegeneralassemblytoadoptballotlanguageforthesubmissionof
3thisjointresolutiontothevotersofthisstate,theofficialsummarystatementofthis
4resolutionshallbeasfollows:
5 "ShalltheMissouriConstitutionbeamendedto:
6 •Guaranteeaccesstocareformedicalemergencies,ectopicpregnancies,and
7miscarriages;
8 •Ensurewomen'ssafetyduringabortions;
9 •Ensureparentalconsentforminors;
10 •Allowabortionsformedicalemergencies,fetalanomalies,rape,andincestand
11repealArticleI,Section36;and
12 •Protectchildrenfromgendertransitions?".
✔
HCSHJR54 5