Missouri voters are deciding three constitutional amendments this year, and they land on two different ballots. Amendments 4 and 5 are on the August 4 primary. Amendment 3 is in November. NASW-Missouri opposes all three, and not just as a matter of politics. Amendment 3 conflicts directly with NASW's stated national policy on reproductive rights and gender-affirming care. Amendments 4 and 5 conflict with the professional values our work is built on, self-determination, social justice, and the basic capacity of a state to fund the services our clients rely on, and threaten outcomes those values have already helped deliver.
1. You're voting on two different dates, not one.
Amendment 4 and Amendment 5 go before voters on August 4, a primary election where turnout is historically low. Amendment 3 waits until November, a general election with far higher turnout. That gap isn't an accident. Two of the three measures are timed for the electorate least likely to show up, which matters for a profession that spends a lot of its time thinking about who gets heard and who doesn't.
2. Amendment 3 would repeal a right voters approved two years ago.
In 2024, Missouri voters approved a constitutional amendment protecting reproductive health care rights, including abortion through fetal viability. Amendment 3 repeals that amendment outright. Nothing about the medical or legal landscape has changed since then. The legislature just didn't like how the vote came out, and it's asking voters to reverse a decision that's barely two years old.
3. Amendment 3 replaces it with a much narrower set of exceptions.
In place of the 2024 protections, Amendment 3 allows abortion for medical emergencies, fetal anomalies, and, within the first twelve weeks, rape and incest. It adds parental or judicial consent requirements for minors and allows the legislature to pass its own laws regulating abortion. Client self-determination is one of the field's founding principles. This measure moves reproductive decisions out of the hands of patients and their doctors and into the hands of lawmakers.
It's not only abortion access at stake. The ACLU of Missouri has argued in litigation over the ballot language that repealing the 2024 amendment also strips out explicit constitutional protections for prenatal care, childbirth, postpartum care, birth control, and respectful birthing conditions, along with protections against prosecuting physicians over pregnancy outcomes. None of that shows up in the amendment's official summary, which is part of why the ACLU has fought the wording in court.
4. Amendment 3 also bans gender-affirming care for transgender youth.
The ballot language calls this a ban on “gender transition procedures for minors,” but in practice it means cutting transgender young people off from the hormone therapy and other gender-affirming care that every major medical association, including the American Academy of Pediatrics and the American Medical Association, recognizes as medically necessary and evidence-based treatment. It's a separate policy question bolted onto the same ballot measure as the abortion question, so voters don't get to weigh in on the two issues separately. It's one yes or one no for both.
For social workers, this isn't a side issue. Decisions about gender-affirming care belong with transgender youth, their families, and their medical providers, not with state lawmakers. Cutting off access to care doesn't make trans kids stop being trans. It takes away a treatment that's been shown to protect their mental health and removes a source of support that many families rely on to keep their kids safe.
5. Amendment 4 wraps a few popular ideas around one that isn't.
The ballot question bundles five things: barring foreign nationals from funding ballot campaigns, criminalizing initiative petition signature fraud, requiring public hearings before petitions hit the ballot, requiring full initiative text be available to voters, and requiring citizen-led constitutional amendments to win a majority in every congressional district, not just statewide. The first four sound like reasonable process fixes. The fifth is the one doing the actual work, and it's the one voters are least likely to notice buried in a list that otherwise sounds like good government.
6. That district requirement would have killed every recent citizen amendment.
Medicaid expansion. Reproductive rights. The minimum wage and paid sick leave increase. Every citizen-led constitutional amendment Missourians have passed since 2020 would have failed under Amendment 4's rule, because none of them carried all eight congressional districts. A single district representing a fraction of the state's voters would gain veto power over policy the rest of the state supports. The initiative process is one of the only tools Missourians have used to expand health coverage and raise wages when the legislature wouldn't act on its own, and this measure targets that tool directly.
7. Amendment 4 comes with its own price tag.
The Department of Corrections estimates the measure adds up to $21,817 a year in costs. The Office of State Public Defender projects an unknown fiscal impact, tied to the new criminal provisions the amendment creates.
8. Amendment 5 phases out the tax that funds 60 percent of the state budget.
Missouri's individual income tax generates $8.4 billion a year, 60 percent of general revenue. Amendment 5 phases it out. The state is already running a $2 billion structural deficit, and the surplus currently covering that gap is expected to run out in 2027.
9. The replacement plan shifts the burden to sales tax, with the guardrails stripped out.
To make up the lost revenue, the amendment gives the legislature authority to expand the sales tax to any goods or services, and the Senate version removes the revenue triggers and the 2032 deadline that were originally built in as limits. That expansion can happen for five years without another public vote. Local governments, meanwhile, are required to roll back at least 97 percent of new sales tax revenue. School funding gets explicit protection in the amendment's language. Every other local service doesn't.
10. This is where it hits social work clients directly.
Sales taxes take a bigger bite out of income for people who spend most of what they earn on necessities, so the shift lands hardest on clients living on fixed or limited incomes. Because the constitutional language doesn't carve out specific categories, health care, child care, and housing costs could end up taxed despite assurances otherwise. A budget shortfall this size would likely force cuts to Medicaid, mental health programs, and other safety-net services social workers depend on every day to serve their clients. And because the local tax protection only covers schools, county services, transit, and libraries are all exposed too. A profession built on social justice and the importance of stable, well-resourced communities has a direct stake in whether the state can still afford to fund them.
NASW-Missouri is asking members and Missouri voters to reject all three amendments: vote no on 4 and 5 on August 4, and vote no on 3 in November.
How to Vote in These Elections
Register. You need to be registered at least 27 days before each election. That's July 8, 2026 for the August 4 primary and October 7, 2026 for the November 3 general election. You can register online, by mail, or in person at your county clerk's office, and you can check your registration status at sos.mo.gov/elections or vote411.org/lwvmo.
Vote early, in person. Missouri allows no-excuse early in-person absentee voting for two weeks before each election. For the primary, that window runs July 21 through August 3, 2026. For the general, it runs October 20 through November 2, 2026. You'll vote at your local election authority's office, not your regular polling place, so check the location ahead of time.
Vote by mail. Missouri's traditional mail absentee ballot still requires one of the state's statutory excuses, things like illness or incapacity, being out of your county on election day, religious objection to voting in person, jury duty, or serving as an election judge. If one applies to you, mail requests are due by July 22, 2026 for the primary and October 21, 2026 for the general, and your completed ballot has to reach your local election authority by 7:00 p.m. on election day itself.
Vote on election day. Polls are open 6:00 a.m. to 7:00 p.m. on both August 4 and November 3.
Bring ID. Missouri requires a valid form of photo identification: a Missouri driver's license or state ID, a U.S. passport, a military ID, or another government-issued photo ID. If you show up without one, you still have the right to cast a provisional ballot.
If anything goes sideways at the polls, you have the right to ask questions, bring notes, and request a provisional ballot, and accessible voting options, including curbside and audio ballots, are available at every polling place.
If you run into a problem voting, call the Election Protection hotline at 866-OUR-VOTE (866-687-8683). It's staffed by the Lawyers' Committee for Civil Rights Under Law along with the NAACP, Common Cause, and other civil rights partners, and it covers Missouri specifically. Call if you're turned away at the polls, told you're not registered when you believe you are, run into an ID problem, or see anything that looks like voter intimidation or misinformation. The Missouri Voter Protection Coalition, a state-based group that's worked alongside the ACLU of Missouri, the League of Women Voters of Missouri, and the Missouri NAACP on voting rights cases here, is another resource worth knowing about if a problem needs to go beyond election day.
Resources:
NASW PACE Nonpartisan Factsheets: Missouri Amendments (2026)
Voting Information: LWVMO | VOTE411
Missouri Voter Protection Coalition: Missouri Voter Protection Coalition
In-Person Voting Information: MOVPC Election Day Voting
Voter Eligibility Information: 2026 Primary MOVPC Eligibility & Registration
Missouri Secretary of State: Missouri's Voting Center Home Page