H.R. 1279 — To amend title XIX of the Social Security Act to establish a community engagement requirement for certain individuals under the Medicaid program.

This section establishes a Medicaid community engagement requirement for certain adults and authorizes States to disenroll those individuals for months in which they do not satisfy it. It amends the Medicaid payment exclusion rules under 42 U.S.C. 1396b(i) to bar federal matching funds for medical assistance furnished to an applicable individual for a month if the individual did not meet the community engagement requirement for 3 or more preceding months in that calendar year while enrolled in Medicaid. It also adds a new 42 U.S.C. 1396d(kk) requirement under which an applicable individual must, for a month, do at least one of the following: work 80 hours or more, earn monthly income equal to the federal minimum wage multiplied by 80 hours, complete 80 hours or more of community service, participate in a work program for at least 80 hours, or combine work, community service, and work program participation for at least 80 hours total. As background, Medicaid is a joint federal-state program that provides medical assistance to eligible low-income individuals. The section defines an applicable individual as a person who is not under 18 or over 65 years old, physically or mentally unfit for employment, pregnant, a parent or caretaker of a dependent child or incapacitated person, complying with another federal work requirement, participating in a drug or alcohol treatment and rehabilitation program, or enrolled at least half time in an educational program. It defines an educational program to include an institution of higher education, a career and technical education program, or another program approved by the Secretary. It directs State Medicaid agencies, when verifying compliance, to prioritize existing databases and other reliable sources, including the U.S. Postal Service National Change of Address Database, State health and human services agency records, and payroll databases, before seeking additional verification from the individual. Finally, it amends 42 U.S.C. 1396a to allow States, at their option, to disenroll an applicable individual for a month if no federal financial participation would be available for that month under the new exclusion rule.