A Missouri appeals court has issued new ballot language for a constitutional amendment that would ban abortions.
The panel of three judges heard arguments Wednesday in Kansas City over whether the Republican-led Missouri Legislature erred in the crafting of the amendment and whether Secretary of State Denny Hoskins wrote ballot language that sufficiently informed voters of the changes it would impose.
Hoskins already rewrote the language once, as ordered by a Cole County judge who subsequently approved it. Afterward, Dr. Anna Fitz-James, who submitted a 2023 petition to enshrine the right to an abortion, disagreed, and appealed the decision.
In Thursday's decision, the appellate court granted many points made by attorneys for Fitz-James, and denied only one — her argument that the amendment was unconstitutional because it contains two subjects.
"While we agree with the circuit court that (the amendment) passes constitutional muster, we conclude that both statements fail to sufficiently advise voters that (the amendment), if enacted, would repeal and replace article I, section 36, as well as inform voters of its additional effects," wrote Judge Janet Sutton in the majority opinion, cosigned by presiding Judge Douglas Thomson and Judge Thomas Chapman.
The rewritten summary statement now reads:
"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?"
The previous and now-defunct ballot language written by Hoskins stated the amendment would "Repeal Article I, section 36, approved in 2024" but did not specify what that referred to. Hoskins' previous ballot language added that the amendment would "allow for abortions for medical emergencies, fetal anomalies, rape and incest."
Fitz-James' attorneys tore into that summary statement, and described it as "a mess" that suggested to voters a right was being established, rather than that an existing right was being taken away.
Tori Schafer, director of policy and campaigns at the ACLU of Missouri, said in a statement that the changes are crucial to Missourians' understanding of the measure's implications.
"This amendment 3 not only imposes strict bans on health care for Missourians but allows the anti-abortion politicians to impose similar restrictions on abortion that prevented access to care," Schafer said.
The ACLU of Missouri was one of the parties that originally filed the lawsuit challenging Hoskins' ballot language.
Attorneys from Hoskins' office argued Fitz-James was exhibiting "doctrinal amnesia" and ignoring precedent set in defense of the 2023 petition, which was passed by voters the next year. They also suggested Hoskins simply needs to write language that is sufficient, not perfect.
While the appellate judges deviated from the lower courts in most regards, they affirmed the lower courts' assertion that the amendment was constitutional and can include a provision on gender-affirming care.
"Because gender transition surgeries or hormone therapies may affect the ability to reproduce, gender transition surgeries and hormone therapies may be connected with, or incident to, reproductive health care," Thursday's decision reads.
Gender-affirming health care for minors is already banned in Missouri.
The judges did take issue with Hoskins' interchangeable use of the words "gender" and "sex" and revised the section to reduce the misuse of terms.
A law passed earlier this year allows the secretary of state to write ballot language up to three times. So far, Hoskins has done so twice but, with this ruling, won't be given a third attempt.
Despite Thursday's ruling, the matter is likely still unfinished. Hoskins has the option to appeal the decision in the Missouri Supreme Court.
Voters will take up the measure on the November 2026 ballot.
Copyright 2025 KCUR
