119-hr1279

[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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