Need help making sense of this bill?

This is not an official government website.

House Bill 1059HR 1059

Jobs and Opportunities for Medicaid Act

Health

3 pages

house
senate
president

Introduced February 6, 2025 by Daniel Crenshaw · Last progress February 6, 2025

Bill Summary

Summary

Allows states to deny Medicaid to "able-bodied adults" who do not meet a monthly work or volunteer requirement averaging at least 20 hours per week, beginning January 1, 2026. The bill amends federal Medicaid eligibility rules to let states make medical assistance ineligible for any month a qualifying adult fails to satisfy the requirement, while listing several specific exemptions (age, pregnancy, serious medical disability, primary caregiver for young children or a child with a serious condition, receiving unemployment benefits while complying with those rules, or participating in specified substance use treatment).

Key Points

Authorizes states to deny Medicaid to "able-bodied adults" who fail a monthly work/volunteer requirement averaging at least 20 hours per week.
Defines exemptions for those under 18 or over 65, pregnant people, medically unfit individuals, primary caregivers of young children or of children with serious conditions, those on qualifying unemployment, and people in certain substance use treatment programs.
Noncompliance can make an individual ineligible for Medicaid for the month(s) they fail to meet the requirement.
The eligibility restriction can take effect beginning January 1, 2026.
Implementation will require state systems to track hours, verify exemptions, and manage terminations and reinstatements monthly.
No new federal funding for implementing the requirement is provided in the text.
Likely effects include reduced Medicaid enrollment for affected adults, increased administrative burdens for states, and potential increases in uncompensated care for providers.
Similar work-requirement policies have prompted legal challenges and debate over public health and poverty impacts.
The change targets eligibility rules rather than benefit levels or provider payments.

Pros & Cons

The bill gives states authority to require 20 hours of monthly work or volunteering for Medicaid adults—potentially encouraging work and allowing state tailoring—but risks cutting coverage for vulnerable low-income people, shifting costs to hospitals and creating new state administrative burdens.

Potential Benefits

2

Some low-income Medicaid beneficiaries may increase work or volunteering to meet the monthly 20-hour requirement, potentially improving employment skills and community engagement.
State governments gain greater flexibility to set and enforce eligibility rules, allowing them to tailor program administration to local conditions.

Potential Drawbacks

4

Low-income adults (including people with intermittent disabilities or chronic conditions) risk losing Medicaid coverage if they cannot meet the 20-hour monthly work/volunteer requirement or if states narrowly interpret medical exemptions.
Parents, caregivers, and people with unstable or irregular work hours are disproportionately likely to be cut off from care because they may be unable to reliably meet the monthly hour requirement.
Hospitals and local communities may face increased uncompensated care and higher costs if people lose Medicaid coverage, shifting costs onto providers and potentially raising healthcare costs locally.

AI Insights

Analyzed 2 of 2 sections

Categories & Tags

Agencies

State agency established or designated to administer or supervise the administration of the State plan (State Medicaid agency)

Subjects

Medicaid & CHIP

Procedural Corrections

Affected Groups

Medicaid Beneficiaries

Low-Income Individuals

State Governments

Parents & Families

+1 more

Sponsors (4)

Bill Summary

Summary

Allows states to deny Medicaid to "able-bodied adults" who do not meet a monthly work or volunteer requirement averaging at least 20 hours per week, beginning January 1, 2026. The bill amends federal Medicaid eligibility rules to let states make medical assistance ineligible for any month a qualifying adult fails to satisfy the requirement, while listing several specific exemptions (age, pregnancy, serious medical disability, primary caregiver for young children or a child with a serious condition, receiving unemployment benefits while complying with those rules, or participating in specified substance use treatment).

Key Points

Authorizes states to deny Medicaid to "able-bodied adults" who fail a monthly work/volunteer requirement averaging at least 20 hours per week.
Defines exemptions for those under 18 or over 65, pregnant people, medically unfit individuals, primary caregivers of young children or of children with serious conditions, those on qualifying unemployment, and people in certain substance use treatment programs.
Noncompliance can make an individual ineligible for Medicaid for the month(s) they fail to meet the requirement.
The eligibility restriction can take effect beginning January 1, 2026.
Implementation will require state systems to track hours, verify exemptions, and manage terminations and reinstatements monthly.
No new federal funding for implementing the requirement is provided in the text.
Likely effects include reduced Medicaid enrollment for affected adults, increased administrative burdens for states, and potential increases in uncompensated care for providers.
Similar work-requirement policies have prompted legal challenges and debate over public health and poverty impacts.
The change targets eligibility rules rather than benefit levels or provider payments.

Pros & Cons

The bill gives states authority to require 20 hours of monthly work or volunteering for Medicaid adults—potentially encouraging work and allowing state tailoring—but risks cutting coverage for vulnerable low-income people, shifting costs to hospitals and creating new state administrative burdens.

Potential Benefits

2

Some low-income Medicaid beneficiaries may increase work or volunteering to meet the monthly 20-hour requirement, potentially improving employment skills and community engagement.
State governments gain greater flexibility to set and enforce eligibility rules, allowing them to tailor program administration to local conditions.

Potential Drawbacks

4

Low-income adults (including people with intermittent disabilities or chronic conditions) risk losing Medicaid coverage if they cannot meet the 20-hour monthly work/volunteer requirement or if states narrowly interpret medical exemptions.
Parents, caregivers, and people with unstable or irregular work hours are disproportionately likely to be cut off from care because they may be unable to reliably meet the monthly hour requirement.
Hospitals and local communities may face increased uncompensated care and higher costs if people lose Medicaid coverage, shifting costs onto providers and potentially raising healthcare costs locally.

AI Insights

Analyzed 2 of 2 sections

Categories & Tags

Agencies

State agency established or designated to administer or supervise the administration of the State plan (State Medicaid agency)

Subjects

Medicaid & CHIP

Procedural Corrections

Affected Groups

Medicaid Beneficiaries

Low-Income Individuals

State Governments

Parents & Families

+1 more

All Legislation

House Bill 1059HR 1059

Jobs and Opportunities for Medicaid Act

Health

3 pages

house
senate
president

Introduced February 6, 2025 by Daniel Crenshaw · Last progress February 6, 2025

What do you think?