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HR 1279

Commending Joy Chanslor for her service as a legislative intern in the office of State Representative Yvonne Davis.

89th Legislature (2025) Introduced by Yvonne Davis

H.R. 1279 requires Medicaid adults to meet an 80-hour/month community engagement rule or lose federal funding for months when not met, with possible state disenrollment.

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Bill Summary · HR 1279

Summary — H.R. 1279 (Introduced Feb 13, 2025)

Overview / Purpose
H.R. 1279 would add a new federal “community engagement” requirement to Medicaid law and make Federal Financial Participation (FFP) unavailable for months in which an eligible adult has not met that requirement for at least three prior months in the same calendar year. The measure also authorizes states, at their option, to disenroll such adults for months when no federal match is available. (Note: bill metadata supplied alongside the text lists a congratulatory resolution title for “Joy Chanslor,” which conflicts with the substantive statutory text below. This summary treats the substantive statutory text amending the Social Security Act.)

Key provisions (substantive statutory changes)

  • Amends section 1903(i) of the Social Security Act to add paragraph (28) making FFP unavailable for medical assistance for a month if an “applicable individual” failed to meet the community engagement requirement for 3 or more preceding months in that calendar year while enrolled in a State plan or waiver.
  • Adds new subsection 1905(kk) defining the community engagement requirement and related terms:
    • Requirement: For each month, an “applicable individual” must satisfy one of:
    • Work 80+ hours/month (or have monthly earnings ≥ federal minimum wage × 80 hours);
    • Complete 80+ hours/month of community service;
    • Participate in a work program 80+ hours/month; or
    • A combination of the above totaling 80+ hours/month.
    • Verification: States should prioritize existing databases and reliable sources (e.g., USPS National Change of Address, state HHS databases, payroll records) before asking individuals for additional documentation.
    • Defines “applicable individual” and exemptions (not subject to the requirement) to include persons: under 18, over 65, medically unfit for employment, pregnant, parents/caretakers of dependent or incapacitated persons, those complying with other federal work requirements, participants in drug/alcohol treatment, or enrolled half‑time in an educational program.
    • Adopts the SNAP definition of “work program” (refers to Food and Nutrition Act section 6(o)(1)).
  • Amends section 1902(a) to allow a state, at its option, to disenroll an applicable individual for a month when no FFP would be available under the new 1903(i)(28).

Who would be affected

  • Non‑elderly, non‑exempt adults enrolled in Medicaid who are not pregnant, not primary caretakers, not disabled/unfit for work, and not otherwise exempt.
  • State Medicaid agencies (administration, verification, potential disenrollment actions).
  • Potentially health care providers and local safety‑net systems if coverage is suspended or lost.

State options & implementation

  • The requirement is implemented via changes to federal Medicaid statute; states would need to incorporate the requirement into their State Plans or waivers and establish verification and reporting mechanisms.
  • States have the option — but are not required — to disenroll individuals for months where no FFP is available.
  • Verification guidance prioritizes use of existing electronic databases to reduce documentation burdens.

Procedural status & sponsors

  • Introduced in House: Feb 13, 2025; referred to House Committee on Energy and Commerce.
  • House actions: Filed May 16; placed on Local & Consent Calendars May 20; Rules suspended, adopted, and reported enrolled May 21, 2025.
  • Sponsor(s): Rep. Aaron Bean (primary); cosponsors Scott Franklin, Harriet M. Hageman, Mike Kennedy.

Potential impacts & considerations

  • Could lead to coverage losses or temporary disenrollments for low‑income adults who do not meet monthly participation thresholds.
  • Administrative burden on states to verify compliance and potentially to process disenrollments and appeals.
  • Fiscal effects: may reduce federal Medicaid outlays for affected months but could increase state administrative costs and shift costs to hospitals and other safety‑net providers.
  • Legal and policy considerations: previous federal Medicaid work‑requirement proposals have faced litigation; implementation would likely involve plan or waiver approvals and possible legal scrutiny.

Note: Because the bill text amends core Medicaid statutes, implementation timing would depend on state plan/waiver changes and any regulatory or judicial developments.

Compiled from official sources — confirm details with the bill’s official record.

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