What This Bill Does
This bill changes Medicaid (a government health insurance program) by requiring able-bodied adults to meet a work requirement in order to receive medical assistance. States must stop providing Medicaid coverage for a month to any able-bodied adult who does not meet the work requirement for that month.
Who It Affects
Able-bodied adults enrolled in state Medicaid programs, state Medicaid administrators, and the Secretary of Labor.
Key Provisions
• Able-bodied adults must satisfy at least one of these options each month: work 120 hours or more per month, or earn monthly income equal to the federal minimum wage multiplied by 120 hours (Sec. 2(1)(A))
• Able-bodied adults may also meet the requirement by volunteering for 80 or more hours per month (Sec. 2(1)(B))
• Able-bodied adults may meet the requirement by participating in a work program for at least 80 hours per month (Sec. 2(1)(C))
• Able-bodied adults may meet the requirement through a combination of work, volunteer work, and participation in a work program totaling at least 80 hours per month (Sec. 2(1)(D))
• States cannot provide Medicaid medical assistance for a month to an able-bodied adult who has not met the work requirement for that month (Sec. 2(a)(88))
What Changes
States will be required to stop providing Medicaid coverage to able-bodied adults for any month in which those adults do not meet one of the four work requirement options listed above.
Important Definitions
"Able-bodied adult" means an individual who is NOT: under 18 or over 65 years old, physically or mentally unfit for employment as determined by a physician or medical professional, pregnant, a parent or caretaker of a dependent child under 6 years old, a parent or caretaker of an incapacitated person, complying with work requirements under a different state or federal program, participating in a drug or alcohol treatment program, or enrolled at least half-time in college, university, or a training program.
"Incapacitated person" means an individual who cannot make decisions about providing, withholding, or withdrawing food, liquid, or medical treatment under applicable law.
"Work program" means either a program approved by the Secretary of Labor under the Trade Act of 1974 or an employment or training program operated by a state or local government.
Effective Date
October 1, 2023.
I
118TH CONGRESS
1ST SESSION H. R. 1079
To amend title XIX of the Social Security Act to implement a minimum
work requirement for able-bodied adults enrolled in State Medicaid programs.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 17, 2023
Mr. GAETZ 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 implement
a minimum work requirement for able-bodied adults en-
rolled in State Medicaid programs.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE.
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This Act may be cited as the ‘‘Medicaid Work Re-
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quirements Act’’.
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SEC. 2. WORK REQUIREMENTS FOR ABLE-BODIED ADULTS.
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Section 1902 of the Social Security Act (42 U.S.C.
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1396a) is amended—
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(1) in subsection (a)—
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(A) by striking ‘‘and’’ at the end of para-
1
graph (86);
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(B) by striking the period at the end of
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paragraph (87) and inserting ‘‘; and’’; and
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(C) by inserting after paragraph (87) the
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following new paragraph:
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‘‘(88) beginning October 1, 2023, not provide
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medical assistance with respect to a month to an
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able-bodied adult (as defined in subsection (uu)(2))
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that has not met the work requirement described in
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subsection (uu)(1) for such month.’’; and
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(2) by adding at the end the following new sub-
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section:
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‘‘(uu) WORK
REQUIREMENT
FOR
ABLE-BODIED
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ADULTS.—
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‘‘(1) WORK
REQUIREMENT
DESCRIBED.—For
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purposes of subsection (a)(88), the work require-
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ment described in this subsection with respect to an
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able-bodied adult and a month is that such adult
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satisfies at least one of the following with respect to
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such month:
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‘‘(A) The adult works 120 hours or more
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per month, or has a month income that is at
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least equal to the federal minimum wage, multi-
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plied by 120 hours.
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‘‘(B) The adult volunteers for 80 hours or
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more per month.
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‘‘(C) The adult participates in a work pro-
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gram for at least 80 hours a month.
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‘‘(D) The adult participates in a combina-
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tion of work, including volunteer work, and a
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work program for a total of at least 80 hours
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per month.
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‘‘(2) DEFINITIONS.—In this subsection:
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‘‘(A) ABLE-BODIED
ADULT.—The term
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‘able-bodied adult’ means any individual who is
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not—
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‘‘(i) under 18 years of age or over 65
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years of age;
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‘‘(ii) physically or mentally unfit for
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employment, as determined by a physician
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or other medical professional;
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‘‘(iii) pregnant;
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‘‘(iv) the parent or caretaker of a de-
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pendent child under 6 years of age;
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‘‘(v) the parent or caretaker of an in-
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capacitated person;
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‘‘(vi) complying with work require-
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ments under a different program under
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State or Federal law;
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‘‘(vii) participating in a drug or alco-
1
hol treatment and rehabilitation program
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(as defined in section 3(h) of the Food and
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Nutrition Act of 2008); or
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‘‘(viii) enrolled in a college or univer-
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sity, or a training program, at least half
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time.
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‘‘(B) INCAPACITATED PERSON.—The term
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‘incapacitated person’ means an individual who
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is incapable of making decisions concerning the
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provision, withholding, or withdrawal of foods,
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liquid, or medical treatment under applicable
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law.
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‘‘(C) WORK
PROGRAM.—The term ‘work
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program’ means—
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‘‘(i) a program approved by the Sec-
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retary of Labor pursuant to section 236(a)
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of the Trade Act of 1974; or
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‘‘(ii) an employment or training pro-
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gram operated by a State or a political
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subdivision of a State.’’.
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Æ
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