Missouri Amendment 3 (November 3, 2026)

On November 3, 2026, Missouri’s general-election ballot includes Amendment 3. The Missouri Secretary of State lists it as a measure proposed by the 103rd General Assembly (First Regular Session) as HCS HJR 73.

In plain terms: the official title asks whether to replace the 2024 constitutional section on reproductive healthcare rights with a different set of rules. A yes (as the Secretary of State wrote it) would repeal that 2024 section and put new limits and permissions in the constitution. A no would leave the 2024 section in place.

One yes or no covers both topics. The official title lists abortion-rule changes and a prohibition on gender-transition procedures for minors. You cannot split them. One mark does both.

This page quotes the official yes and no language and walks through what that language says. It does not tell you how to vote. Titles and full text can be updated through the state’s own process. Verify the live title, fair-ballot language, and full text on the Secretary of State’s 2026 ballot-measures page before you mark a ballot.

The starting point is already in the Missouri Constitution.

In November 2024, Missouri voters adopted Article I, Section 36, titled “The Right to Reproductive Freedom Initiative.” The official text is published by the Missouri Revisor of Statutes. The Revisor lists it as adopted November 5, 2024, and effective December 5, 2024.

Here is what that official section says:

• It says the government shall not deny or infringe a person’s “fundamental right to reproductive freedom.” It defines that as the right to make and carry out decisions about reproductive health care. The listed examples include prenatal care, childbirth, postpartum care, birth control, abortion care, miscarriage care, and respectful birthing conditions. (Revisor, Art. I § 36.2)
• Limits on that right have to meet a high bar the section itself writes down: a “compelling governmental interest” achieved by the “least restrictive means,” and only for improving or maintaining the health of the person seeking care, consistent with accepted clinical standards, without taking away that person’s own decision. Denials or delays are “presumed invalid.” (Revisor, Art. I § 36.3)
• The General Assembly may pass laws that regulate abortion after “fetal viability,” but the section says the government still may not block an abortion that a treating health-care professional, in good-faith judgment, says is needed to protect the pregnant person’s life or physical or mental health. (Revisor, Art. I § 36.4)
• “Fetal viability” is defined in the same section as the point when, in that professional’s good-faith judgment for that pregnancy, the fetus has a significant likelihood of sustained survival outside the uterus without extraordinary medical measures. (Revisor, Art. I § 36.8)
• The section says people shall not be penalized or prosecuted based on pregnancy outcomes (it lists miscarriage, stillbirth, or abortion). It also says the government shall not discriminate against people who provide, obtain, or assist with reproductive health care. (Revisor, Art. I § 36.5–36.6)

That is the baseline the 2026 measure talks about. If you want the exact wording, read the Revisor page — it is the official constitution text, not a summary.

The Secretary of State’s 2026 listing describes that 2024 amendment, in the official ballot title, as the “voter-approved Amendment providing reproductive healthcare rights, including abortion through fetal viability.” (SOS 2026 Ballot Measures)

The Secretary of State publishes fair ballot language that tells voters what a yes does. This is the official yes text from the 2026 Ballot Measures page:

A “yes” vote will repeal Article I, Section 36, of the Missouri Constitution approved by the voters in 2024 which provided reproductive healthcare rights, including abortion through fetal viability; continue to ensure women’s ability to access medical care for medical emergencies, ectopic pregnancies, and miscarriages; allow legislation to regulate abortion providers and facilities to ensure health and safety; require informed and voluntary consent for an abortion, including parental or judicial consent for minors; allow restriction of abortions to cases of medical emergency, rape and incest under twelve weeks gestation, and fetal anomalies; prohibit public funding of abortions except in limited circumstances; and prohibit gender transition procedures for minors including gender transition surgeries, cross-sex hormones or puberty-blocking drugs, with exceptions for specific medical conditions.

The same SOS page also prints the official ballot title a yes is answering:

Shall the Missouri Constitution be amended to:

• Repeal the 2024 voter-approved Amendment providing reproductive healthcare rights, including abortion through fetal viability;
• Allow abortions for rape and incest (under twelve-weeks’ gestation), emergencies, and fetal anomalies;
• Allow legislation regulating abortion;
• Ensure parental consent for minors’ abortions;
• Prohibit gender transition procedures for minors?

Here is what that official language is saying:

1. The 2024 section would come out of the constitution. A yes, as the SOS wrote it, “will repeal Article I, Section 36.” That is the section described above.
2. Emergency, ectopic, and miscarriage care stays available in the yes description. The SOS yes language says it will “continue to ensure women’s ability to access medical care for medical emergencies, ectopic pregnancies, and miscarriages.”
3. The legislature could write more rules about abortion providers and facilities for “health and safety.”
4. Consent rules would be in the constitution. The SOS yes language requires “informed and voluntary consent for an abortion, including parental or judicial consent for minors.”
5. The title’s “Allow abortions for…” is a narrow remaining list, not a new broad legalization. The official title says “Allow abortions for rape and incest (under twelve-weeks’ gestation), emergencies, and fetal anomalies.” The SOS yes language says the same thing as a restriction: “allow restriction of abortions to cases of medical emergency, rape and incest under twelve weeks gestation, and fetal anomalies.” After the 2024 “through fetal viability” section is repealed, those are the narrow remaining cases the SOS lists — not a newly legalized, statewide opening.
6. Public funding. The SOS yes language says it will “prohibit public funding of abortions except in limited circumstances.” The SOS page does not spell those circumstances out in the fair-ballot paragraph. The referred resolution’s legislative summary does — see Related questions and the House summary.
7. Gender-transition care for minors. The SOS yes language says it will prohibit “gender transition procedures for minors including gender transition surgeries, cross-sex hormones or puberty-blocking drugs, with exceptions for specific medical conditions.”

The SOS also prints a fiscal line for this measure: state entities estimate no costs or savings; Greene County estimates an unknown increase in tax revenue; other local entities estimate no costs or savings. Separately, the fair-ballot block says: “If passed, this measure will not increase or decrease taxes.” (SOS 2026 Ballot Measures)

A yes is a vote to adopt the amendment the General Assembly referred. The full legal text is HCS HJR 73, posted as the truly agreed House PDF. If a sentence on this page and that PDF ever differ, the official instrument and the SOS listing win.

This is the official no text from the same SOS 2026 Ballot Measures page:

A “no” vote will leave Article I, Section 36, of the Missouri Constitution approved by voters in 2024 in place; will not limit abortion to cases of medical emergency, rape and incest under twelve weeks gestation, and fetal anomalies, but leave access to abortion available through fetal viability; will not prohibit gender transition procedures for minors.

Here is what that official no language is saying:

1. The 2024 constitution section stays. Article I, Section 36 remains the rule. You can read it on the Revisor’s page.
2. The new limit list would not be added. The SOS no language says a no “will not limit abortion to cases of medical emergency, rape and incest under twelve weeks gestation, and fetal anomalies,” and instead “leave access to abortion available through fetal viability.” “Fetal viability” here is the phrase the SOS uses to describe the 2024 baseline (the Revisor defines that term inside Section 36).
3. The new minor gender-transition prohibition would not be added. The SOS no language says a no “will not prohibit gender transition procedures for minors.”

A no does not, in the SOS text, invent a new healthcare system. It leaves the 2024 section where it is. Later legislatures, courts, or future ballots could still change the law another way. This page only describes this measure’s official yes and no.

This section is about who can do what if the official language is what happens — not about who “wins.”

If Amendment 3 is adopted (the SOS yes path):

• The 2024 rights section goes away. People would no longer be relying on Article I, Section 36 as the constitutional baseline for reproductive-freedom decisions (including the birth-control and miscarriage-care examples that section lists). That is a repeal, not a small edit. (SOS yes language; Revisor Art. I § 36)
• Abortion access, as the SOS describes it, narrows to listed cases: medical emergency; rape or incest under twelve weeks’ gestation; and fetal anomalies. Other situations that exist under the 2024 “through fetal viability” framing would not be in that list. (SOS yes language)
• The General Assembly gets a clearer constitutional green light to regulate abortion providers and facilities for health and safety. The House’s truly agreed summary of HCS HJR 73 gives examples of the kind of laws the referred text discusses (hospital admitting privileges, facility licensing and inspection, exams to determine gestational age, who may perform ultrasounds). Those details live in the resolution text and House summary, not in the short SOS title.
• Consent stays a yes/no gate. Adults: informed and voluntary consent, except where the referred text carves out emergencies. Minors: parental consent, or a judicial path, as the SOS yes language states (“parental or judicial consent for minors”).
• Public money. Abortions would not be paid with public funds except in “limited circumstances” (SOS). The House summary of the referred text names medical emergency, rape, or incest as the public-funding exceptions. (House HJR 73 summary)
• Minors and gender-transition procedures. Surgeries, cross-sex hormones, and puberty-blocking drugs for gender transition would be prohibited for minors, with “exceptions for specific medical conditions” (SOS yes language). The SOS page does not print the exception list. The full resolution is the place to read those exceptions.
• Older statutes. The House summary says any statute a court found unenforceable because of the 2024 Right to Reproductive Freedom Initiative “will once again be enforceable” if this amendment is approved. That is a legislative-summary statement about the referred text, not a list of which statutes snap back. A lawyer or the official text — not this site — is where that inventory lives. (House HJR 73 summary)
• Where lawsuits would be filed. The House summary says challenges to state reproductive-health-care laws would have to be brought in the Circuit Court of Cole County, with extra pleading rules. That is about courthouse venue, not about how you vote. (House HJR 73 summary)

If Amendment 3 is rejected (the SOS no path):

• Article I, Section 36 stays. The 2024 decision-making right, the compelling-interest test, the post-viability regulation rule, and the no-penalty / no-discrimination clauses remain the constitutional text unless something else changes them later. (SOS no language; Revisor)
• The SOS no language says abortion access remains “through fetal viability,” rather than the new emergency / rape-incest-under-12-weeks / fetal-anomaly list.
• The new constitutional ban on gender-transition procedures for minors would not be added by this measure. Other Missouri statutes or future measures could still exist or appear; this page only reports what the SOS says this no does.
• The extra HJR 73 items (Cole County venue, the House summary’s public-funding exceptions list, the “statutes become enforceable again” clause) would not be added by this ballot question if it fails.

What does not get decided by this page: whether a clinic will take a given patient, how a doctor will apply “medical emergency” or “fetal anomaly,” or how a court will read a later statute. Those are case-by-case. The official text plus your clinician and, if needed, a lawyer are the next stops.

If this measure is adopted, lawsuits or how agencies write the rules can still change when parts apply. This page is not a live clock. Refresh the SOS 2026 Ballot Measures listing near Election Day.

A few official pieces of context sit around Amendment 3. None of them is a scorecard.

Federal baseline. In 2022 the U.S. Supreme Court held in Dobbs v. Jackson Women’s Health Organization that the federal Constitution does not confer a right to abortion and that the authority to regulate abortion belongs to the people and their elected representatives in the states. The opinion is on the Supreme Court’s site. After Dobbs, Missouri’s state constitution and statutes are the rules that matter for this topic unless Congress or a later Court decision says otherwise. This site does not predict those later cases.

How Amendment 3 got on the ballot. This is not a citizen initiative. The SOS listing says it was “Proposed by 103rd General Assembly (First Regular Session) HCS HJR 73.” The General Assembly referred a constitutional amendment to the November 3, 2026 general election. The referred instrument is HCS HJR 73.

Ballot language can be reviewed in court. Missouri’s Secretary of State publishes official titles and fair-ballot language. Those statements can be challenged. In 2025 the SOS announced that a Cole County judge upheld a second revised summary and fair-ballot statement for HJR 73 as “fair and sufficient,” under a process the office ties to Senate Bill 22. That is a process story, not a recommendation. Read the SOS news release and then trust the language actually printed on the 2026 Ballot Measures page and on your sample ballot.

Other 2026 Missouri measures are separate. The same SOS page lists other November 3, 2026 amendments (for example Amendment 7 and Amendment 8) and measures that already appeared at the August 4, 2026 primary. Each has its own title. Do not mix them up with Amendment 3.

Your local election office still runs the election. Deadlines, how you get a mail ballot, and what your sample ballot looks like come from Missouri election officials, not from this explainer. Start at the Missouri SOS elections hub or USA.gov’s election-office finder.

Answers stay inside official text. If the official text is quiet, we say so.

What about miscarriage or an ectopic pregnancy?

The SOS yes language says a yes will “continue to ensure women’s ability to access medical care for medical emergencies, ectopic pregnancies, and miscarriages.” (SOS 2026 Ballot Measures)

The House’s truly agreed summary of HCS HJR 73 says the same idea in legislative-summary words: “a woman’s right to access health care in cases of miscarriages, ectopic pregnancies, and other medical emergencies cannot be infringed by the State.” (House HJR 73 summary)

The 2024 section already lists “miscarriage care” among the reproductive-health-care decisions it protects. (Revisor, Art. I § 36.2) The SOS no language leaves that 2024 section in place.

This page cannot tell you how a specific ER will code a specific case. It can tell you the official ballot language names miscarriage and ectopic pregnancy as care that remains available under the yes description.

What if the pregnant person is a minor?

The official ballot title includes: “Ensure parental consent for minors’ abortions.” The SOS yes language adds that a yes will require “informed and voluntary consent for an abortion, including parental or judicial consent for minors.” (SOS 2026 Ballot Measures)

“Judicial” means there is a court path in the official yes description, not only a parent-signature path. The House summary says the referred amendment “further specifies how the consent of a minor must be obtained.” Those mechanics are in the full HJR 73 text, not in the short title.

The SOS no language does not add that parental/judicial consent rule; it leaves Article I, Section 36 in place. Section 36 does not, in the Revisor text, write a parental-consent clause. Other Missouri statutes might. This explainer does not inventory every statute.

Does a yes ban birth control?

The 2024 section lists “birth control” as one example of reproductive health care inside the fundamental-right definition. (Revisor, Art. I § 36.2)

The SOS official title and fair-ballot yes/no paragraphs for 2026 Amendment 3 do not mention birth control and do not describe a contraception ban. The House summary says the 2024 initiative includes the right to make decisions about birth control and abortion care, and that this amendment would repeal that initiative. Repealing a section is not the same sentence as “contraception is banned.” Read the full referred text if that is the question you need answered. This site will not invent a ban the SOS language does not state.

What does “fetal anomaly” mean here?

The SOS title and yes language list “fetal anomalies” as one of the situations in which abortion would still be allowed under a yes. They do not define the phrase on the listing page. (SOS 2026 Ballot Measures)

The House summary of the referred text adds a related limit: “No abortion shall be performed or induced upon a woman based on a prenatal diagnosis, test, or screening indicating a disability in an unborn child, except in cases of a fetal anomaly.” (House HJR 73 summary) That is a legislative summary of HJR 73, not a medical textbook. The definition, if any, is in the full resolution.

What about public funding?

SOS yes language: “prohibit public funding of abortions except in limited circumstances.” (SOS 2026 Ballot Measures)

House summary of the referred text: “No public funds can be used to pay for abortions, except in cases of medical emergency, rape, or incest.” (House HJR 73 summary)

If you need to know whether a specific program (Medicaid, a hospital district, a university) is “public funds,” that is a program rule plus the full amendment text — not something this page can certify.

What about gender-transition care for minors?

SOS title: “Prohibit gender transition procedures for minors?”

SOS yes: prohibit “gender transition procedures for minors including gender transition surgeries, cross-sex hormones or puberty-blocking drugs, with exceptions for specific medical conditions.”

SOS no: “will not prohibit gender transition procedures for minors.”

(SOS 2026 Ballot Measures)

The House summary states the prohibition without printing the exception list in the short summary paragraph. Exceptions, if you need them, are in the full HJR 73 PDF. This page does not guess which diagnoses count.

Does the official language mention fetal-tissue rules or extra court rules?

The SOS fair-ballot paragraph on the 2026 listing page does not mention fetal-organ harvesting or Cole County venue. The House truly agreed summary does: it says fetal organ harvesting after an abortion is prohibited, and that challenges to state reproductive-health-care laws would be brought in the Circuit Court of Cole County. (House HJR 73 summary) Those are provisions of the referred resolution as the House summarized it. They are a reason to open the full text, not a reason to treat the short SOS title as complete.

Will this tell me what my doctor must do on a given day?

No. Official ballot language sets constitutional text. It does not schedule appointments or interpret every emergency. If a rule affects your care, ask the clinician and confirm the statute or constitution with the Revisor or the HJR 73 text. This site is unofficial and is not legal or medical advice.

Use these first. They are the official record this explainer is built from.

• Missouri Secretary of State — 2026 Ballot Measures — official ballot title, fair-ballot yes/no, fiscal note, and links the SOS labels “full text” and “Certificate of Official Ballot Title.”
• Missouri Secretary of State — Elections & Voting — state elections hub (how to vote, not how to mark Amendment 3).
• Missouri Revisor — Constitution Article I, Section 36 — current rule (2024 section), official text.
• HCS HJR 73 truly agreed text (PDF) — the referred amendment the General Assembly sent to the ballot.
• HCS HJR 73 truly agreed summary (PDF) — official House summary of that resolution.
• U.S. Supreme Court — Dobbs opinion (PDF) — federal context only.
• USA.gov — find your election office — if you need a local clerk, not a legal memo.

Always match what you read here to the sample ballot your local election office gives you. If they differ, the official ballot and the SOS listing are the ones that count.