An Act amending the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code, in public assistance, providing for work requirements for Medicaid enrollees.

PRINTER'S NO. 2222
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1807
Session of
2025
INTRODUCED BY BURNS AND GILLEN, AUGUST 15, 2025
REFERRED TO COMMITTEE ON HUMAN SERVICES, AUGUST 19, 2025
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.--
No later than March 1, 2026, and by March 1 of each year
thereafter, the secretary shall apply to the Centers for
Medicare and Medicaid Services of the United States 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 a work requirement for a Medicaid enrollee
who is eighteen years of age or older and physically and
mentally capable of work. The work requirement shall require a
Medicaid enrollee to become employed, actively seek employment
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as verified by the department or attend a job training program
in accordance with the following:
(i) In the case of a Medicaid enrollee who is employed or
attending job training programs in order to maintain enrollment
in the Medicaid program, the Medicaid enrollee shall work twenty
hours a week or complete twelve job training program-related
activities a month.
(ii) A Medicaid enrollee who complies with the work
requirement under subparagraph (i) may have Medicaid premiums or
cost-sharing reduced or other incentives beginning in year two
of employment.
(iii) A Medicaid enrollee who has failed to comply with the
work requirement under subparagraph (i) shall relinquish
Medicaid program eligibility for the following time periods:
(A) Three months beginning in year two of employment.
(B) Six months beginning after the time period under clause
(A) expires.
(C) Nine months beginning after the time period under clause
(B) expires.
(2) Requiring an able-bodied Medicaid enrollee who is
eighteen years of age or older to verify on a biannual basis or
by request of the department the Medicaid enrollee's family
income or the Medicaid enrollee's compliance with the provisions
under paragraph (1) for the purpose of determining the Medicaid
enrollee's eligibility.
(3) Banning an individual from enrolling in a Medicaid
program 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 twenty years of
age or younger or sixty-five years of age or older.
(iv) The Medicaid enrollee is a pregnant woman.
(v) The Medicaid enrollee receives Supplemental Security
Income benefits.
(vi) The Medicaid enrollee resides in a mental health
institution or correctional institution.
(vii) The Medicaid enrollee is experiencing a crisis,
serious medical condition or temporary condition that prevents
the Medicaid enrollee from actively seeking employment,
including domestic violence or substance use treatment.
Section 2. This act shall take effect in 60 days.
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