I 

118TH CONGRESS 

2D SESSION H. R. 8697 

To direct the Secretary of Health and Human Services to conduct a demonstration project to test the impact of a guaranteed monthly income 

on the health of individuals enrolled for medical assistance under the 

Medicaid program. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 11, 2024 

Mr. SCHIFF (for himself, Mrs. WATSON COLEMAN, Ms. NORTON, Mr. 

MULLIN, and Mr. ROBERT GARCIA of California) introduced the following 

bill; which was referred to the Committee on Ways and Means 

A BILL 

To direct the Secretary of Health and Human Services to 

conduct a demonstration project to test the impact of 

a guaranteed monthly income on the health of individuals 

enrolled for medical assistance under the Medicaid program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Guaranteed Additional 

5 Income for families in Need Act of 2024’’ or the ‘‘GAIN 

6 Act of 2024’’. 


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1 SEC. 2. FINDINGS. 

2 Congress makes the following findings: 

3 (1) Medical research in recent decades has dem4 onstrated the significant impact of income volatility 

5 on individuals’ health. 

6 (2) Research has found that income volatility 

7 can lead to increased incidence of cardiovascular dis8 ease, depression and anxiety, and cognitive decline. 

9 (3) From February 2019 to January 2021, the 

10 city of Stockton, California implemented a universal 

11 basic income pilot program. Participants reported 

12 improved physical, mental, and emotional health as 

13 a result of increased financial assistance, according 

14 to the final program evaluation published in the 

15 Journal of Urban Health. 

16 SEC. 3. GUARANTEED MONTHLY INCOME DEMONSTRATION 

17 PROJECT. 

18 (a) IN GENERAL.—Not later than 1 year after the 

19 date of enactment of this Act, the Secretary of Health and 

20 Human Services (in this section referred to as the ‘‘Sec21 retary’’) shall conduct a 5-year demonstration project (in 

22 this section referred to as the ‘‘Project’’) under which a 

23 participating eligible entity shall provide a guaranteed 

24 monthly income to individuals enrolled for medical assist25 ance under the Medicaid program under title XIX of the 

26 Social Security Act (42 U.S.C. 1396 et seq.), and measure 


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1 the impact of such guaranteed monthly income on the 

2 health of such participants. 

3 (b) APPLICATION.—An eligible entity seeking to par4 ticipate in the Project under this section shall submit to 

5 the Secretary an application at such time, in such manner, 

6 and containing such information as the Secretary may re7 quire, including information with respect to the manner 

8 in which such entity will distribute the guaranteed month9 ly income. 

10 (c) PROJECT DESIGN.— 

11 (1) IN GENERAL.—The Secretary shall award 

12 not less than 10 grants to eligible entities on a com13 petitive basis to provide participants in the Project 

14 with a guaranteed monthly income. 

15 (2) OPTION TO TARGET SUBPOPULATION.—An 

16 eligible entity participating in the Project may 

17 choose to focus on a particular subpopulation of in18 dividuals enrolled for medical assistance under title 

19 XIX of the Social Security Act. 

20 (3) GUARANTEED MONTHLY INCOME.— 

21 (A) PARTICIPANT REQUIREMENTS.—To 

22 participate in the Project, a participant shall be 

23 enrolled for medical assistance under title XIX 

24 at the time such participant is selected for par25 ticipation. 


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1 (B) DISTRIBUTION OF MONTHLY IN2 COME.— 

3 (i) IN GENERAL.—Each participant 

4 shall receive a monthly payment, in an 

5 amount of not less than $500, as deter6 mined by the eligible entity through which 

7 such participant is enrolled for participa8 tion in the Project. 

9 (ii) METHOD OF DISTRIBUTION.— 

10 Monthly payments made under the Project 

11 shall be made by direct deposit or paper 

12 check. 

13 (iii) NO TAX LIABILITY.—Any pay14 ments made to a participant under clause 

15 (i) shall not be considered income for pur16 poses of the Internal Revenue Code of 

17 1986. 

18 (iv) NO CONDITIONS ON USE OF PAY19 MENTS.—An eligible entity may not put 

20 any conditions on how participants spend 

21 the monthly payments made under the 

22 Project, and the manner in which a partic23 ipant spends such payments shall not im24 pact the eligibility of such participant to 

25 participate in the Project. 


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1 (4) LIMITATION ON USE OF FUNDS.—Not more 

2 than 20 percent of the total funds awarded to an eli3 gible entity under this section may used for adminis4 trative costs incurred by such eligible entity in im5 plementing the Project, or for outreach and edu6 cation efforts made by such entity with respect to 

7 such Project. 

8 (d) ELIGIBLE ENTITY.—For purposes of this sub9 section, an eligible entity means one of the following enti10 ties: 

11 (1) Any of the following units of local govern12 ment: 

13 (A) A county. 

14 (B) A borough. 

15 (C) A municipality. 

16 (D) A city. 

17 (E) A town. 

18 (F) A township. 

19 (G) A parish. 

20 (H) A local public authority, including any 

21 public housing agency (as defined in section 

22 3(b) of the United States Housing Act of 1937 

23 (42 U.S.C. 1437(b)). 

24 (I) A special district. 

25 (J) A school district. 


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1 (K) An intrastate district. 

2 (L) A council of governments, without re3 gard to whether such council is incorporated as 

4 a nonprofit corporation under State law. 

5 (M) Any other agency or instrumentality 

6 of a multi-State, regional, or intra-State or 

7 local government. 

8 (2) An Indian Tribe or Tribal organization (as 

9 such terms are defined in section 4 of the Indian 

10 Self-Determination and Education Assistance Act). 

11 (3) A nonprofit organization. 

12 (e) SURVEYS.— 

13 (1) BASELINE SURVEY.—Prior to the first dis14 tribution of guaranteed monthly income payment 

15 under the Project, each eligible entity shall conduct 

16 a baseline survey of the participants receiving such 

17 income from such entity that includes— 

18 (A) the demographic data of each partici19 pant, including the age, race, ethnicity, employ20 ment status, marital status, income (including 

21 individual income and total household income) 

22 and number of dependents with respect to such 

23 participant; and 

24 (B) the financial circumstances of each 

25 participant and the impact of those cirVerDate Sep 11 2014 19:18 Sep 06, 2024 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H8697.IH H8697

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1 cumstances on such participant’s mental health 

2 and physical health. 

3 (2) ONGOING SURVEY.—Not less than 3 times 

4 during each calendar year in which an entity is par5 ticipating in the project under this subsection, each 

6 such entity shall survey each participant receiving 

7 monthly payments from such entity to determine— 

8 (A) how the monthly payments are spent, 

9 including groceries, rent, utility bills, or other 

10 expenses; and 

11 (B) the impact, if any, on— 

12 (i) the employment status of each par13 ticipant; 

14 (ii) the mental health and physical 

15 health of each participant; 

16 (iii) the mental health and physical 

17 health of the members of each partici18 pant’s household; and 

19 (iv) the status of each participant’s fi20 nancial circumstances, including any im21 pact to such participant’s credit score, abil22 ity to grow savings, or ability to make fi23 nancial investments. 

24 (3) GUIDANCE.—Prior to the first distribution 

25 of guaranteed monthly income payment under the 


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1 Project, the Secretary shall issue guidance to each 

2 eligible entity participating in the Project on con3 ducting the surveys required under this subsection. 

4 Such guidance shall include recommendations for 

5 how to determine the financial circumstances, men6 tal health, and physical health of a participant for 

7 purposes of such surveys. 

8 (f) REPORTS.— 

9 (1) REPORTS TO SECRETARY.—Not later than 

10 1 year after the date on which the first guaranteed 

11 monthly income funds are distributed in accordance 

12 with subsection (c)(3)(B), and annually thereafter, 

13 each eligible entity shall submit to the Secretary a 

14 report on the Project, including the information col15 lected from the surveys described in subsection (e). 

16 (2) REPORTS TO CONGRESS.—Not later than 2 

17 years after the first report is submitted under para18 graph (1), and every 2 years thereafter, the Sec19 retary shall submit to Congress a report on the 

20 Project, including a year-over-year analysis of the 

21 survey data submitted to the Secretary under para22 graph (1), and any recommendations with respect to 

23 potential legislative action. 

Æ 


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