Constitutional Amendment 3

November 5, 2024
Right to Reproductive Freedom Initiative
Results
Choice Votes % Yes 1,538,659 51.60% No 1,443,022 48.40%
County results Congressional district results Yes   80–90%   70–80%   60–70%   50–60% No   70–80%   60–70%   50–60%

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2024 Missouri Constitutional Amendment 3, also known as the Right to Reproductive Freedom Initiative, was a constitutional amendment that appeared on the ballot on November 5, 2024. The initiative amended the Constitution of Missouri to legalize abortion in Missouri until fetal viability.^[1] The amendment narrowly passed.^[2]

Per NBC News, the amendment received majority support in Buchanan, Platte, Clay, Jackson, Benton, Boone, St. Charles, and St. Louis counties, as well as the independent city of St. Louis.^[3] These were nearly the same exact counties that had voted for 2020 Missouri Amendment 2 to expand Medicaid under the Affordable Care Act, except Buchanan County voted for legal abortion but against Medicaid expansion, while Greene County voted against legal abortion but for Medicaid expansion.

Per the map, the amendment received majority support in Boone County, home to Columbia and the University of Missouri, as well as the Kansas City and Greater St. Louis metropolitan areas along the Missouri River. It was most strongly opposed in the Ozarks in southern Missouri.

Following the Supreme Court's ruling in Dobbs v. Jackson Women's Health Organization, Missouri's trigger law banning abortion went into effect.^[4] Following this, in 2024, the group Missourians for Constitutional Freedom launched Amendment 3, and gathered the necessary signatures to place the amendment on the ballot in November.^[5]

During its journey to the ballot, Amendment 3 faced several roadblocks. A bill to increase the threshold required to approve constitutional amendments, including Amendment 3, was narrowly rejected by the Missouri General Assembly.^[6] Additionally, a lawsuit to remove Amendment 3 from the ballot was filed, but ultimately rejected by the Supreme Court of Missouri.^[7]

Notice: The proposed amendment revises Article I of the Constitution by adopting one new Section to be known as Article I, Section 36.

Be it resolved by the people of the state of Missouri that the Constitution be amended:

Section A. Article I of the Constitution is revised by adopting one new Section to be known as Article I, Section 36 to read as follows:

Section 36.

1. This Section shall be known as "The Right to Reproductive Freedom Initiative".
2. The Government shall not deny or infringe upon a person's fundamental right to reproductive freedom, which is the right to make and carry out decisions about all matters relating to reproductive health care, including, but not limited to, prenatal care, childbirth, postpartum care, birth control, abortion care, miscarriage care, and respectful birthing conditions.
3. The right to reproductive freedom shall not be denied, interfered with, delayed, or otherwise restricted, unless the Government demonstrates that such action is justified by a compelling governmental interest achieved by the least restrictive means. Any denial, interference, delay, or restriction of the right to reproductive freedom shall be presumed invalid. For purposes of this Section, a governmental interest is compelling only if it is for the limited purpose, and has the limited effect of improving or maintaining the health of a person seeking care, is consistent with widely accepted clinical standards of practice and evidence-based medicine, and does not infringe on that person's autonomous decision-making.
4. Notwithstanding subsection 3 of this Section, the general assembly may enact laws that regulate the provision of abortion after fetal viability, provided that under no circumstance shall the Government deny, interfere with, delay, or otherwise restrict an abortion that, in the good-faith judgment of a treating health care professional, is needed to protect the life or physical or mental health of the pregnant person.
5. No person shall be penalized, prosecuted, or otherwise subjected to adverse action based on their actual, potential, perceived, or alleged pregnancy outcomes, including, but not limited to, miscarriage, stillbirth, or abortion. Nor shall any person assisting a person in exercising their right to reproductive freedom with that person's consent be penalized, prosecuted, or otherwise subjected to adverse action for doing so.
6. The Government shall not discriminate against persons providing or obtaining reproductive health care or assisting another person in doing so.
7. If any provision of this Section or the application thereof to anyone or to any circumstance is held invalid, the remainder of those provisions and the application of such provisions to others or other circumstances shall not be affected thereby.
8. For purposes of this Section, the following terms mean:
   1. "Fetal Viability", the point in pregnancy when, in the good-faith judgment of a treating health care professional and based on the particular facts of the case, there is significant likelihood of the fetus's sustained survival outside the uterus without the application of extraordinary medical measures.
   2. "Government",
      1. the state of Missouri; or
      2. any municipality, city, town, village, township, district, authority, public subdivision, or public corporation having the power to tax or regulate, or any portion of two or more such entities within the state of Missouri.

Amendment 3

Choice	Votes	%
Yes	1,538,659	51.60
No	1,443,022	48.40
Total votes	2,981,681	100.00
Source: Secretary of State of Missouri

Despite losing the state, "No" won 5 of 8 congressional districts, with "Yes" winning the remaining three, including one that elected a Republican.^[12]

Partisan clients

• "2024 Ballot Measures". www.sos.mo.gov. Retrieved August 25, 2024.
• Missouri Right to Reproductive Freedom Initiative (2024) at Ballotpedia
• Amendment 3 full text