Amendment 3 on the Nov. 3 ballot asks Missouri voters to undo the abortion-rights amendment they approved two years ago and put a narrower set of rules in its place. It is the second statewide measure in three years to carry the number 3 and deal with abortion; the 2024 version passed with 51.6% of the vote.
The 2024 amendment, now Article I, Section 36 of the Missouri Constitution, made reproductive health care, including abortion through fetal viability, a constitutional right. It took effect after the election, and abortion access returned to Missouri in February 2025. A yes vote this year repeals that section.
In its place, the amendment would allow abortion in four situations: medical emergencies, cases of rape or incest before 12 weeks of gestation, and fetal anomalies. It would let the legislature pass laws regulating abortion providers and facilities, require informed consent, require a parent’s or a judge’s consent for minors, and bar public funding of abortion except in limited circumstances. The certified fair ballot language also says a yes vote continues access to care for medical emergencies, ectopic pregnancies, and miscarriages.
The measure carries a second subject. It would write into the constitution a ban on gender transition procedures for minors, covering surgery, cross-sex hormones, and puberty blockers, with exceptions for specific medical conditions. Missouri already bars that care for minors by statute under a 2023 law; the constitutional ban would not have that law’s expiration dates.
Rep. Ed Lewis sponsored the measure as House Joint Resolution 73, and the legislature passed it in May 2025. Its ballot wording went through three rounds in court. A Cole County judge ordered the first version rewritten because it did not tell voters the amendment would ban most abortions, then approved the secretary of state’s second draft in October 2025. The Missouri Court of Appeals, Western District, rejected that version in December 2025, finding it did not tell voters the amendment would repeal and replace the 2024 amendment, and wrote the summary and fair ballot language voters will see. The courts upheld the measure against a claim that abortion and gender procedures for minors are two separate subjects.
Supporters, including anti-abortion groups and the Republican lawmakers who placed it on the ballot, say the 2024 amendment went further than voters understood and left the state unable to regulate abortion. They say the new language keeps exceptions for rape, incest, emergencies, and fetal anomalies while restoring parental consent and protecting minors from transition procedures.
Opponents, including the Stop the Ban Missouri campaign and the ACLU of Missouri, say the measure overturns a decision voters made in 2024 and would return the state to a near-total ban. They argue the 12-week limit for rape and incest is narrow in practice and that pairing abortion with transition care for minors was meant to draw votes from people who support only one half.
A Saint Louis University/YouGov poll of likely voters taken in August found the measure close, with 43% in favor, 44% opposed, and 13% undecided.
ON THE BALLOT
Official ballot title:
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?
A YES VOTE repeals the 2024 abortion-rights amendment; limits abortion to medical emergencies, rape and incest before 12 weeks, and fetal anomalies; allows abortion regulation by statute; requires parental or judicial consent for minors; and bans gender transition procedures for minors in the constitution.
A NO VOTE leaves the 2024 amendment in place, with abortion available through fetal viability, and adds no constitutional ban on transition procedures for minors.
COST: State entities estimate no costs or savings. Greene County estimates an unknown increase in tax revenue. The measure does not raise or lower taxes.
HOW IT GOT HERE: House Joint Resolution 73 (Rep. Ed Lewis), passed May 2025; ballot language rewritten twice by court order, final version certified by the Western District Court of Appeals in December 2025.