I 
115TH CONGRESS 
1ST SESSION 
H. R. 829 
To amend title XIX of the Social Security Act to clarify the treatment 
of lottery winnings and other lump sum income for purposes of income 
eligibility under the Medicaid program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 2, 2017 
Mr. UPTON introduced the following bill; which was referred to the Committee 
on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to clarify 
the treatment of lottery winnings and other lump sum 
income for purposes of income eligibility under the Med-
icaid program, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Prioritizing the Most 
Vulnerable Over Lottery Winners Act of 2017’’. 
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SEC. 2. TREATMENT OF LOTTERY WINNINGS AND OTHER 
LUMP-SUM INCOME FOR PURPOSES OF IN-
COME ELIGIBILITY UNDER MEDICAID. 
(a) IN GENERAL.—Section 1902 of the Social Secu-
rity Act (42 U.S.C. 1396a) is amended— 
(1) in subsection (a)(17), by striking ‘‘(e)(14), 
(e)(14)’’ and inserting ‘‘(e)(14), (e)(15)’’; and 
(2) in subsection (e)— 
(A) in paragraph (14) (relating to modified 
adjusted gross income), by adding at the end 
the following new subparagraph: 
‘‘(J) TREATMENT
OF
CERTAIN
LOTTERY 
WINNINGS AND INCOME RECEIVED AS A LUMP 
SUM.— 
‘‘(i) IN GENERAL.—In the case of an 
individual who is the recipient of qualified 
lottery winnings (pursuant to lotteries oc-
curring on or after January 1, 2018) or 
qualified lump sum income (received on or 
after such date) and whose eligibility for 
medical assistance is determined based on 
the application of modified adjusted gross 
income under subparagraph (A), a State 
shall, in determining such eligibility, in-
clude such winnings or income (as applica-
ble) as income received— 
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‘‘(I) in the month in which such 
winnings or income (as applicable) is 
received if the amount of such 
winnings or income is less than 
$80,000; 
‘‘(II) over a period of 2 months 
if the amount of such winnings or in-
come (as applicable) is greater than or 
equal to $80,000 but less than 
$90,000; 
‘‘(III) over a period of 3 months 
if the amount of such winnings or in-
come (as applicable) is greater than or 
equal to $90,000 but less than 
$100,000; and 
‘‘(IV) over a period of 3 months 
plus 1 additional month for each in-
crement of $10,000 of such winnings 
or income (as applicable) received, not 
to exceed a period of 120 months (for 
winnings or income of $1,260,000 or 
more), if the amount of such winnings 
or income is greater than or equal to 
$100,000. 
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‘‘(ii) COUNTING IN EQUAL INSTALL-
MENTS.—For purposes of subclauses (II), 
(III), and (IV) of clause (i), winnings or 
income to which such subclause applies 
shall be counted in equal monthly install-
ments over the period of months specified 
under such subclause. 
‘‘(iii) HARDSHIP EXEMPTION.—An in-
dividual whose income, by application of 
clause (i), exceeds the applicable eligibility 
threshold established by the State, shall 
continue to be eligible for medical assist-
ance to the extent that the State deter-
mines, under procedures established by the 
State (in accordance with standards speci-
fied by the Secretary), that the denial of 
eligibility of the individual would cause an 
undue medical or financial hardship as de-
termined on the basis of criteria estab-
lished by the Secretary. 
‘‘(iv) NOTIFICATIONS
AND
ASSIST-
ANCE REQUIRED IN CASE OF LOSS OF ELI-
GIBILITY.—A State shall, with respect to 
an individual who loses eligibility for med-
ical assistance under the State plan (or a 
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waiver of such plan) by reason of clause 
(i)— 
‘‘(I) before the date on which the 
individual loses such eligibility, inform 
the individual— 
‘‘(aa) of the individual’s op-
portunity to enroll in a qualified 
health plan offered through an 
Exchange established under title 
I of the Patient Protection and 
Affordable Care Act during the 
special enrollment period speci-
fied in section 9801(f)(3) of the 
Internal Revenue Code of 1986 
(relating to loss of Medicaid or 
CHIP coverage); and 
‘‘(bb) of the date on which 
the individual would no longer be 
considered ineligible by reason of 
clause (i) to receive medical as-
sistance under the State plan or 
under any waiver of such plan 
and be eligible to reapply to re-
ceive such medical assistance; 
and 
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‘‘(II) provide technical assistance 
to the individual seeking to enroll in 
such a qualified health plan. 
‘‘(v) QUALIFIED LOTTERY WINNINGS 
DEFINED.—In this subparagraph, the term 
‘qualified lottery winnings’ means winnings 
from a sweepstakes, lottery, or pool de-
scribed in paragraph (3) of section 4402 of 
the Internal Revenue Code of 1986 or a 
lottery operated by a multistate or multi-
jurisdictional lottery association, including 
amounts awarded as a lump sum payment. 
‘‘(vi) QUALIFIED LUMP SUM INCOME 
DEFINED.—In this subparagraph, the term 
‘qualified lump sum income’ means income 
that is received as a lump sum from one 
of the following sources: 
‘‘(I) Monetary winnings from 
gambling (as defined by the Secretary 
and including gambling activities de-
scribed in section 1955(b)(4) of title 
18, United States Code). 
‘‘(II) Damages received, whether 
by suit or agreement and whether as 
lump sums or as periodic payments 
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