PRINTER'S NO. 2222
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1800
Session of
2023
INTRODUCED BY SCIALABBA, ROWE, KEPHART, HAMM, KAUFFMAN, IRVIN,
WARNER, ZIMMERMAN, KEEFER, GILLEN AND GROVE, OCTOBER 30, 2023
REFERRED TO COMMITTEE ON HUMAN SERVICES, OCTOBER 30, 2023
AN ACT
Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
act to consolidate, editorially revise, and codify the public
welfare laws of the Commonwealth," in public assistance,
providing for work requirements for Medicaid enrollees.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of June 13, 1967 (P.L.31, No.21), known
as the Human Services Code, is amended by adding a section to
read:
Section 441.10. Work Requirements for Medicaid Enrollees.--
(a) No later than March 1 of each year, the secretary shall
apply to the Centers for Medicare and Medicaid Services of the
Department of Health and Human Services for a waiver under 42
U.S.C. § 1315 (relating to demonstration projects) for the
following purposes:
(1) Instituting work requirements for a Medicaid enrollee
who is eighteen years of age or older and physically and
mentally capable of work. The work requirements shall comply
with the following:
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(i) In order to maintain enrollment in the Medicaid program,
a Medicaid enrollee shall be gainfully employed or self-employed
for at least twenty hours a week, complete twelve job training
program-related activities a month or be actively seeking
employment as verified by the department.
(ii) A Medicaid enrollee who complies with subparagraph (i)
may receive Medicaid premiums or cost sharing reductions or
other incentives beginning in year two of employment.
(iii) A Medicaid enrollee who has failed to comply with
subparagraph (i) shall cease to be eligible for enrollment in
the Medicaid program and to receive Medicaid benefits for the
following periods:
(A) For a first violation, a period of three months.
(B) For a second violation, a period of six months.
(C) For a third violation, a period of one year.
(D) For a fourth violation, a period of two years or greater
as determined necessary by the department for the purpose of
this section.
(2) Requiring a Medicaid enrollee who is eighteen years of
age or older and physically and mentally capable of work to
verify on a biannual basis or by request of the department the
Medicaid enrollee's family income or the Medicaid enrollee's pay
stubs or equivalent documentation with the department for the
purpose of ensuring compliance with paragraph (1).
(3) Except as provided under paragraph (4), prohibiting an
individual from enrolling in the Medicaid program and receiving
Medicaid benefits if the individual has failed to comply with
paragraphs (1) and (2).
(4) Exempting a Medicaid enrollee from the requirements
under paragraphs (1) and (2) under any of the following
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conditions:
(i) The Medicaid enrollee is attending high school as a
full-time student.
(ii) The Medicaid enrollee is currently receiving temporary
or permanent long-term disability benefits.
(iii) The Medicaid enrollee is an individual sixty-five
years of age or older.
(iv) The Medicaid enrollee is a pregnant woman.
(v) The Medicaid enrollee receives Supplemental Security
Income (SSI) benefits.
(vi) The Medicaid enrollee permanently or temporarily
resides in a mental health institution or correctional
institution.
(vii) The Medicaid enrollee is experiencing a serious health
condition that prevents the Medicaid enrollee from complying
with paragraph (1).
(viii) The Medicaid enrollee is experiencing a temporary
condition that prevents the Medicaid enrollee from complying
with paragraph (1), including domestic violence or residential
or inpatient substance abuse treatment.
(b) As used in this section, the following words and phrases
shall have the meanings given to them in this subsection unless
the context clearly indicates otherwise:
"Cost sharing" means out-of-pocket spending requirements for
a Medicaid enrollee.
"Serious health condition" means as defined in 29 U.S.C. §
2611(11) (relating to definitions).
Section 2. This act shall take effect in 60 days.
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