COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.:1890H.02C Bill No.:HCS for HJR 54 Subject:Abortion; Health Care Professionals Type:Original Date:April 2, 2025Bill Summary:This joint resolution proposes a constitutional amendment establishing
provisions relating to reproductive health care.
FISCAL SUMMARY
ESTIMATED NET EFFECT ON GENERAL REVENUE FUNDFUND AFFECTEDFY 2026FY 2027FY 2028
General Revenue*
$0 to or (More than
$8,000,000)$0 to (Unknown)$0 to (Unknown)
Total Estimated Net
Effect on General
Revenue
$0 or (More than
$8,000,000)$0 to (Unknown)$0 to (Unknown)
*The potential fiscal impact of “(More than $8,000,000)” would be realized only if a special
election were called by the Governor to submit this joint resolution to voters. Oversight also
assumes the impact to the Office of the State Courts Administrator will be under $250,000
annually.
ESTIMATED NET EFFECT ON OTHER STATE FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on Other State
Funds $0$0$0
Numbers within parentheses: () indicate costs or losses. L.R. No. 1890H.02C
Bill No. HCS for HJR 54
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ESTIMATED NET EFFECT ON FEDERAL FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on All Federal
Funds $0$0$0
ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)FUND AFFECTEDFY 2026FY 2027FY 2028Total Estimated Net
Effect on FTE 000
☒ Estimated Net Effect (expenditures or reduced revenues) expected to exceed $250,000 in any
of the three fiscal years after implementation of the act or at full implementation of the act.
☐ Estimated Net Effect (savings or increased revenues) expected to exceed $250,000 in any of
the three fiscal years after implementation of the act or at full implementation of the act.
ESTIMATED NET EFFECT ON LOCAL FUNDSFUND AFFECTEDFY 2026FY 2027FY 2028Local Government*$0$0$0
*The potential fiscal impact to local election authorities (reimbursed by the state) would be
realized only if a special election were called by the Governor to submit this joint resolution to
voters. L.R. No. 1890H.02C
Bill No. HCS for HJR 54
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FISCAL ANALYSIS
ASSUMPTION
HJR - Provisions relating to reproductive health care
Officials from Office of the Secretary of State assume, each year, a number of joint resolutions
that would refer to a vote of the people a constitutional amendment and bills that would refer to a
vote of the people the statutory issue in the legislation may be considered by the General
Assembly.
Unless a special election is called for the purpose, Joint Resolutions proposing a constitutional
amendment are submitted to a vote of the people at the next general election. Article XII section
2(b) of the Missouri Constitution authorizes the governor to order a special election for
constitutional amendments referred to the people. If a special election is called to submit a Joint
Resolution to a vote of the people, section 115.063.2 RSMo requires the state to pay the costs.
The cost of the special election has been estimated to be $8 million based on the cost of the 2022
primary and general election reimbursements.
The Secretary of State’s office is required to pay for publishing in local newspapers the full text
of each statewide ballot measure as directed by Article XII, Section 2(b) of the Missouri
Constitution and Section 116.230-116.290, RSMo. Funding for this item is adjusted each year
depending upon the election cycle. A new decision item is requested in odd numbered fiscal
years and the amount requested is dependent upon the estimated number of ballot measures that
will be approved by the General Assembly and the initiative petitions certified for the ballot. In
FY 2014, the General Assembly changed the appropriation so that it was no longer an estimated
appropriation.
For the FY26 petitions cycle, the SOS estimates publication costs at $60,000 per page. This
amount is subject to change based on number of petitions received, length of those petitions and
rates charged by newspaper publishers.
The Secretary of State’s office will continue to assume, for the purposes of this fiscal note, that it
should have the full appropriation authority it needs to meet the publishing requirements.
Because these requirements are mandatory, the SOS reserves the right to request funding to meet
the cost of the publishing requirements if the Governor and the General Assembly again change
the amount or continue to not designate it as an estimated appropriation.
Oversight has reflected, in this fiscal note, the state potentially reimbursing local political
subdivisions the cost of having this joint resolution voted on during a special election in fiscal
year 2026. This reflects the decision made by the Joint Committee on Legislative Research that
the cost of the elections should be shown in the fiscal note. The next scheduled statewide general L.R. No. 1890H.02C
Bill No. HCS for HJR 54
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election is in November 2026 (FY 2027). It is assumed the subject within this proposal could be
on this ballot; however, it could also be on a special election called for by the Governor (a
different date). Therefore, Oversight will reflect a potential election cost reimbursement to local
political subdivisions in FY 2026.
Officials from the Office of State Courts Administrator (OSCA) state there may be some
impact but there is no way to quantify that currently. Any significant changes will be reflected in
future budget requests.
Oversight notes OSCA assumes this proposal may have some impact on their organization
although it can’t be quantified at this time. As OSCA is unable to provide additional information
regarding the potential impact, Oversight assumes the proposed legislation will have a $0 to
(Unknown) cost to the General Revenue Fund. For fiscal note purposes, Oversight also assumes
the impact will be under $250,000 annually. If this assumption is incorrect, this would alter the
fiscal impact as presented in this fiscal note. If additional information is received, Oversight will
review it to determine if an updated fiscal note should be prepared and seek approval to publish a
new fiscal note.
In response to a previous version, officials from the Office of Attorney General (AGO)
assumed any potential litigation costs arising from this proposal can be absorbed with existing
resources. However, the AGO may seek additional appropriations if the proposal results in a
significant increase in litigation or investigation.
Oversight does not have any information to the contrary. Therefore, Oversight assumes the
AGO will be able to perform any additional duties required by this proposal with current staff
and resources and will reflect no fiscal impact to the AGO for fiscal note purposes.
Officials from the St. Louis City Board of Elections state there will be no fiscal impact unless a
special election is called. The cost of a city-wide election is approximately $500,000.
Oversight notes that officials from the SOS have included reimbursement costs to local election
boards in their estimate of total costs for a special election. Therefore, Oversight will not reflect a
separate special election cost for the St. Louis City Board of Elections.
Officials from the Department of Commerce and Insurance, the Department of Health and
Senior Services, the Department of Public Safety - Missouri Highway Patrol, the
Department of Social Services, the Missouri Department of Conservation, the Missouri
Department of Transportation, the Missouri Consolidated Health Care Plan, the Office of
Administration - Administrative Hearing Commission, the Office of the Governor
Platte County Board of Elections and the St. Louis County Board of Elections, each assume
the proposal will have no fiscal impact on their respective organizations. Oversight does not
have any information to the contrary. Therefore, Oversight will reflect a zero impact in the fiscal
note for these agencies. L.R. No. 1890H.02C
Bill No. HCS for HJR 54
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In response to a previous version, officials from the Jackson County Board of Election
Commissioners, and the Kansas City Election Board, each assume the proposal will have no
fiscal impact on their respective organizations. Oversight does not have any information to the
contrary. Therefore, Oversight will reflect a zero impact in the fiscal note for these agencies.
Oversight only reflects the responses received from state agencies and political subdivisions;
however, other local election authorities and hospitals were requested to respond to this proposed
legislation but did not. A listing of political subdivisions included in the Missouri Legislative
Information System (MOLIS) database is available upon request.
Rule Promulgation
Officials from the Office of the Secretary of State (SOS) note many bills considered by the
General Assembly include provisions allowing or requiring agencies to submit rules and
regulations to implement the act. The SOS is provided with core funding to handle a certain
amount of normal activity resulting from each year's legislative session. The fiscal impact for
this fiscal note to the SOS for Administrative Rules is less than $5,000. The SOS recognizes that
this is a small amount and does not expect that additional funding would be required to meet
these costs. However, the SOS also recognizes that many such bills may be passed by the
General Assembly in a given year and that collectively the costs may be in excess of what the
office can sustain with its core budget. Therefore, the SOS reserves the right to request funding
for the cost of supporting administrative rules requirements should the need arise based on a
review of the finally approved bills signed by the governor.
FISCAL IMPACT – State GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028GENERAL REVENUETransfer Out - SOS - reimbursement of
local election authority election costs if
a special election is called by the
Governor p. 3-4
$0 or (More
than
$8,000,000)$0$0
Cost – OSCA (§506.403) Potential cost
relating to reproductive health care p. 4
$0 to
(Unknown)
$0 to
(Unknown)
$0 to
(Unknown)ESTIMATED NET EFFECT ON
GENERAL REVENUE
$0 or (More
than
$8,000,000)
$0 to
(Unknown)
$0 to
(Unknown)
*The potential fiscal impact of “(More than $8,000,000)” would be realized only if a special
election were called by the Governor to submit this joint resolution to voters. L.R. No. 1890H.02C
Bill No. HCS for HJR 54
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FISCAL IMPACT – Local GovernmentFY 2026
(10 Mo.)
FY 2027FY 2028LOCAL POLITICAL
SUBDIVISIONS
Transfer In – Local Election Authorities
- reimbursement of election costs by the
State for a special election p. 3-4
$0 or More
than
$8,000,000$0$0
Costs – Local Election Authorities -
cost of a special election if called for
by the Governor p. 3-4
$0 or (More
than
$8,000,000)$0$0
ESTIMATED NET EFFECT ON
LOCAL POLITICAL
SUBDIVISIONS$0$0$0
FISCAL IMPACT – Small Business
No direct fiscal impact to small businesses would be expected as a result of this proposal.
FISCAL DESCRIPTION
Upon voter approval, this constitutional amendment prohibits abortions, except in cases of
medical emergencies, fetal anomalies, rape, or incest. In the case of abortions performed or
induced because of rape or incest, the abortion may be performed or induced no later than 12
weeks gestational age of the unborn child.
The amendment also prohibits public funds from being used to pay for abortions; prohibits the
use of surgeries, hormones, or drugs to assist a child with a gender transition; specifies which
circuit court challenges shall be brought to; and holds that any person who intentionally or
negligently causes damage to another person relating to the provision of reproductive health care
or the performance or inducement of an abortion is liable for damages and subject to suspension
or revocation of his or her medical license. Under this constitutional amendment, a woman's
right to reproductive freedom includes the right to health care in cases of miscarriages, ectopic
pregnancies, and other medical emergencies. The General Assembly will have the authority to
enact laws to carry out these provisions.
This legislation is not federally mandated, would not duplicate any other program and would not
require additional capital improvements or rental space. L.R. No. 1890H.02C
Bill No. HCS for HJR 54
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SOURCES OF INFORMATION
Attorney General’s Office
Office of Administration - Administrative Hearing Commission
Department of Commerce and Insurance
Department of Health and Senior Services
Department of Public Safety - Missouri Highway Patrol
Department of Social Services
Office of the Governor
Missouri Consolidated Health Care Plan
Missouri Department of Conservation
Missouri Department of Transportation
Office of the Secretary of State
Office of the State Courts Administrator
Jackson County Board of Election Commissioners
Kansas City Election Board
Platte County Board of Elections
St. Louis City Board of Elections
St. Louis County Board of Elections
Julie MorffJessica HarrisDirectorAssistant DirectorApril 2, 2025April 2, 2025