Bill Details
Status
Latest action
2025-02-13 - Referred to the House Committee on Energy and Commerce.
Introduced Date
2025-02-13
Policy Area
Health
Committees
View committees (1)
Sponsors
Cosponsors
8
0
0
AI Summary This summary was generated by AI from the bill text. AI can get information wrong.
This bill would add a work or community service requirement for some adults covered by Medicaid. In general, a person would need to work, do community service, or take part in an approved work program for at least 80 hours a month to keep Medicaid coverage under this rule. Certain people would be exempt, such as children, older adults, pregnant people, caregivers, people with disabilities or serious health limits, students, and people already meeting similar rules in another federal program. States would also be allowed to remove someone from Medicaid for a month if they do not meet the requirement and federal money would not be available for that coverage.
- To count as meeting the rule, a person could work 80 hours a month, do 80 hours of community service, take part in a work program for 80 hours, or combine those activities to reach 80 hours.
- States would be told to check compliance using existing records first, such as payroll data, state agency records, or address databases, before asking the person for more proof.
- The rule would apply only to certain adults who are not under 18 or over 65 and who do not fall into listed exempt groups.
- People would not be subject to the rule if they are pregnant, caring for a dependent child or an incapacitated person, medically unfit to work, in drug or alcohol treatment, or enrolled at least half-time in an approved education program.
Official Summaries
This bill establishes community engagement requirements (i.e., work requirements) for certain adults under Medicaid.
Specifically, the bill requires individuals ages 18 through 65 to work, engage in community service, or participate in a work program (or a combination of these) for at least 80 hours per month. The bill prohibits federal payments for, and allows state Medicaid programs to disenroll, individuals who do not meet these requirements for three or more months in a year.
The requirements do not apply to individuals who are (1) physically or mentally unfit to work, (2) pregnant, (3) parents or caretakers of children or incapacitated individuals, (4) complying with work requirements for other federal programs, (5) participating in a drug or alcohol treatment and rehabilitation program, or (6) enrolled at least half-time in school.
Current Full Text
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1279 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 1279
To amend title XIX of the Social Security Act to establish a community
engagement requirement for certain individuals under the Medicaid
program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 13, 2025
Mr. Bean of Florida (for himself, Mr. Weber of Texas, Mr. Kennedy of
Utah, and Mr. Scott Franklin of Florida) introduced the following bill;
which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend title XIX of the Social Security Act to establish a community
engagement requirement for certain individuals under the Medicaid
program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. COMMUNITY ENGAGEMENT REQUIREMENT FOR APPLICABLE INDIVIDUALS.
(a) In General.--Section 1903(i) of the Social Security Act (42
U.S.C. 1396b(i)) is amended--
(1) in paragraph (26), by striking ``; or'' and inserting a
semicolon;
(2) in paragraph (27), by striking the period at the end
and inserting ``; or'';
(3) by inserting after paragraph (27) the following new
paragraph:
``(28) with respect to any amount expended for medical
assistance for an applicable individual for a month in a
calendar year if such individual did not meet the community
engagement requirement under section 1905(kk) for 3 or more
preceding months during such calendar year while such
individual was an applicable individual and was enrolled in a
State plan (or waiver of such plan) under this title.''; and
(4) in the flush left matter at the end, by striking ``and
(18),'' and inserting ``(18), and (28)''.
(b) Community Engagement Requirement.--Section 1905 of the Social
Security Act (42 U.S.C. 1396d) is amended by adding at the end the
following new subsection:
``(kk) Community Engagement Requirement for Applicable
Individuals.--
``(1) Community engagement requirement described.--For
purposes of section 1903(i)(28), the community engagement
requirement described in this subsection with respect to an
applicable individual and a month is that such individual
satisfies at least one of the following with respect to such
month:
``(A) The individual works 80 hours or more per
month, or has a monthly income that is at least equal
to the Federal minimum wage under section 6 of the Fair
Labor Standards Act of 1938, multiplied by 80 hours.
``(B) The individual completes 80 hours or more of
community service per month.
``(C) The individual participates in a work program
for at least 80 hours per month.
``(D) The individual participates in a combination
of work, including community service, and a work
program for a total of at least 80 hours per month.
``(2) Verification.--For purposes of verifying the
compliance of an applicable individual with the community
engagement requirement under paragraph (1), a State Medicaid
agency shall, whenever possible, prioritize the utilization of
existing databases or other verification measures, including
the National Change of Address Database Maintained by the
United States Postal Service, State health and human services
agencies, payroll databases, or other reliable sources of
information, prior to seeking additional verification from such
individual.
``(3) Definitions.--In this subsection:
``(A) Applicable individual.--The term `applicable
individual' means any individual who is not--
``(i) under 18 years of age or over 65
years of age;
``(ii) physically or mentally unfit for
employment, as determined by a physician or
other medical professional;
``(iii) pregnant;
``(iv) the parent or caretaker of a
dependent child;
``(v) the parent or caretaker of an
incapacitated person;
``(vi) complying with work requirements
under a different program under Federal law;
``(vii) participating in a drug or alcohol
treatment and rehabilitation program (as
defined in section 3(h) of the Food and
Nutrition Act of 2008); or
``(viii) enrolled in an educational program
at least half time.
``(B) Educational program.--The term `educational
program' means--
``(i) an institution of higher education
(as defined in section 101(a) of the Higher
Education Act of 1965);
``(ii) a program of career and technical
education (as defined in section 3 of the Carl
D. Perkins Career and Technical Education Act
of 2006); or
``(iii) any other educational program
approved by the Secretary.
``(C) State medicaid agency.--The term `State
Medicaid agency' means the State agency responsible for
administering the State Medicaid plan.
``(D) Work program.--The term `work program' has
the meaning given such term in section 6(o)(1) of the
Food and Nutrition Act of 2008.''.
(c) State Option To Disenroll Certain Individuals.--Section 1902(a)
of the Social Security Act (42 U.S.C. 1396a(a)) is amended by adding at
the end of the flush left text following paragraph (87) the following:
``Notwithstanding any of the preceding provisions of this subsection,
at the option of a State, such State may elect to disenroll an
applicable individual for a month if, with respect to medical
assistance furnished to such individual for such month, no Federal
financial participation would be available, pursuant to section
1903(i)(28).''.
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