HB 1807 — 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
 1   Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
 2      act to consolidate, editorially revise, and codify the public
 3      welfare laws of the Commonwealth," in public assistance,
 4      providing for work requirements for Medicaid enrollees.
 5      The General Assembly of the Commonwealth of Pennsylvania
 6   hereby enacts as follows:
 7      Section 1.    The act of June 13, 1967 (P.L.31, No.21), known
 8   as the Human Services Code, is amended by adding a section to
 9   read:
10      Section 441.10.    Work Requirements for Medicaid Enrollees.--
11   No later than March 1, 2026, and by March 1 of each year
12   thereafter, the secretary shall apply to the Centers for
13   Medicare and Medicaid Services of the United States Department
14   of Health and Human Services for a waiver under 42 U.S.C. § 1315
15   (relating to demonstration projects) for the following purposes:
16      (1)   Instituting a work requirement for a Medicaid enrollee
17   who is eighteen years of age or older and physically and
18   mentally capable of work. The work requirement shall require a
19   Medicaid enrollee to become employed, actively seek employment
 1   as verified by the department or attend a job training program
 2   in accordance with the following:
 3      (i)    In the case of a Medicaid enrollee who is employed or
 4   attending job training programs in order to maintain enrollment
 5   in the Medicaid program, the Medicaid enrollee shall work twenty
 6   hours a week or complete twelve job training program-related
 7   activities a month.
 8      (ii)    A Medicaid enrollee who complies with the work
 9   requirement under subparagraph (i) may have Medicaid premiums or
10   cost-sharing reduced or other incentives beginning in year two
11   of employment.
12      (iii)    A Medicaid enrollee who has failed to comply with the
13   work requirement under subparagraph (i) shall relinquish
14   Medicaid program eligibility for the following time periods:
15      (A)    Three months beginning in year two of employment.
16      (B)    Six months beginning after the time period under clause
17   (A) expires.
18      (C)    Nine months beginning after the time period under clause
19   (B) expires.
20      (2)    Requiring an able-bodied Medicaid enrollee who is
21   eighteen years of age or older to verify on a biannual basis or
22   by request of the department the Medicaid enrollee's family
23   income or the Medicaid enrollee's compliance with the provisions
24   under paragraph (1) for the purpose of determining the Medicaid
25   enrollee's eligibility.
26      (3)    Banning an individual from enrolling in a Medicaid
27   program if the individual has failed to comply with paragraphs
28   (1) and (2).
29      (4)    Exempting a Medicaid enrollee from the requirements
30   under paragraphs (1) and (2) under any of the following

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 1   conditions:
 2      (i)    The Medicaid enrollee is attending high school as a
 3   full-time student.
 4      (ii)    The Medicaid enrollee is currently receiving temporary
 5   or permanent long-term disability benefits.
 6      (iii)    The Medicaid enrollee is an individual twenty years of
 7   age or younger or sixty-five years of age or older.
 8      (iv)    The Medicaid enrollee is a pregnant woman.
 9      (v)    The Medicaid enrollee receives Supplemental Security
10   Income benefits.
11      (vi)    The Medicaid enrollee resides in a mental health
12   institution or correctional institution.
13      (vii)    The Medicaid enrollee is experiencing a crisis,
14   serious medical condition or temporary condition that prevents
15   the Medicaid enrollee from actively seeking employment,
16   including domestic violence or substance use treatment.
17      Section 2.    This act shall take effect in 60 days.




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