I 
118TH CONGRESS 
2D SESSION 
H. R. 8697 
To direct the Secretary of Health and Human Services to conduct a dem-
onstration 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 pro-
gram. 
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 ‘‘Guaranteed Additional 
Income for families in Need Act of 2024’’ or the ‘‘GAIN 
Act of 2024’’. 
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SEC. 2. FINDINGS. 
Congress makes the following findings: 
(1) Medical research in recent decades has dem-
onstrated the significant impact of income volatility 
on individuals’ health. 
(2) Research has found that income volatility 
can lead to increased incidence of cardiovascular dis-
ease, depression and anxiety, and cognitive decline. 
(3) From February 2019 to January 2021, the 
city of Stockton, California implemented a universal 
basic income pilot program. Participants reported 
improved physical, mental, and emotional health as 
a result of increased financial assistance, according 
to the final program evaluation published in the 
Journal of Urban Health. 
SEC. 3. GUARANTEED MONTHLY INCOME DEMONSTRATION 
PROJECT. 
(a) IN GENERAL.—Not later than 1 year after the 
date of enactment of this Act, the Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall conduct a 5-year demonstration project (in 
this section referred to as the ‘‘Project’’) under which a 
participating eligible entity shall provide a guaranteed 
monthly income to individuals enrolled for medical assist-
ance under the Medicaid program under title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.), and measure 
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the impact of such guaranteed monthly income on the 
health of such participants. 
(b) APPLICATION.—An eligible entity seeking to par-
ticipate in the Project under this section shall submit to 
the Secretary an application at such time, in such manner, 
and containing such information as the Secretary may re-
quire, including information with respect to the manner 
in which such entity will distribute the guaranteed month-
ly income. 
(c) PROJECT DESIGN.— 
(1) IN GENERAL.—The Secretary shall award 
not less than 10 grants to eligible entities on a com-
petitive basis to provide participants in the Project 
with a guaranteed monthly income. 
(2) OPTION TO TARGET SUBPOPULATION.—An 
eligible entity participating in the Project may 
choose to focus on a particular subpopulation of in-
dividuals enrolled for medical assistance under title 
XIX of the Social Security Act. 
(3) GUARANTEED MONTHLY INCOME.— 
(A) 
PARTICIPANT
REQUIREMENTS.—To 
participate in the Project, a participant shall be 
enrolled for medical assistance under title XIX 
at the time such participant is selected for par-
ticipation. 
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(4) LIMITATION ON USE OF FUNDS.—Not more 
than 20 percent of the total funds awarded to an eli-
gible entity under this section may used for adminis-
trative costs incurred by such eligible entity in im-
plementing the Project, or for outreach and edu-
cation efforts made by such entity with respect to 
such Project. 
(d) ELIGIBLE ENTITY.—For purposes of this sub-
section, an eligible entity means one of the following enti-
ties: 
(1) Any of the following units of local govern-
ment: 
(A) A county. 
(B) A borough. 
(C) A municipality. 
(D) A city. 
(E) A town. 
(F) A township. 
(G) A parish. 
(H) A local public authority, including any 
public housing agency (as defined in section 
3(b) of the United States Housing Act of 1937 
(42 U.S.C. 1437(b)). 
(I) A special district. 
(J) A school district. 
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(K) An intrastate district. 
(L) A council of governments, without re-
gard to whether such council is incorporated as 
a nonprofit corporation under State law. 
(M) Any other agency or instrumentality 
of a multi-State, regional, or intra-State or 
local government. 
(2) An Indian Tribe or Tribal organization (as 
such terms are defined in section 4 of the Indian 
Self-Determination and Education Assistance Act). 
(3) A nonprofit organization. 
(e) SURVEYS.— 
(1) BASELINE SURVEY.—Prior to the first dis-
tribution of guaranteed monthly income payment 
under the Project, each eligible entity shall conduct 
a baseline survey of the participants receiving such 
income from such entity that includes— 
(A) the demographic data of each partici-
pant, including the age, race, ethnicity, employ-
ment status, marital status, income (including 
individual income and total household income) 
and number of dependents with respect to such 
participant; and 
(B) the financial circumstances of each 
participant and the impact of those cir-
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cumstances on such participant’s mental health 
and physical health. 
(2) ONGOING SURVEY.—Not less than 3 times 
during each calendar year in which an entity is par-
ticipating in the project under this subsection, each 
such entity shall survey each participant receiving 
monthly payments from such entity to determine— 
(A) how the monthly payments are spent, 
including groceries, rent, utility bills, or other 
expenses; and 
(B) the impact, if any, on— 
(i) the employment status of each par-
ticipant; 
(ii) the mental health and physical 
health of each participant; 
(iii) the mental health and physical 
health of the members of each partici-
pant’s household; and 
(iv) the status of each participant’s fi-
nancial circumstances, including any im-
pact to such participant’s credit score, abil-
ity to grow savings, or ability to make fi-
nancial investments. 
(3) GUIDANCE.—Prior to the first distribution 
of guaranteed monthly income payment under the 
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Project, the Secretary shall issue guidance to each 
eligible entity participating in the Project on con-
ducting the surveys required under this subsection. 
Such guidance shall include recommendations for 
how to determine the financial circumstances, men-
tal health, and physical health of a participant for 
purposes of such surveys. 
(f) REPORTS.— 
(1) REPORTS TO SECRETARY.—Not later than 
1 year after the date on which the first guaranteed 
monthly income funds are distributed in accordance 
with subsection (c)(3)(B), and annually thereafter, 
each eligible entity shall submit to the Secretary a 
report on the Project, including the information col-
lected from the surveys described in subsection (e). 
(2) REPORTS TO CONGRESS.—Not later than 2 
years after the first report is submitted under para-
graph (1), and every 2 years thereafter, the Sec-
retary shall submit to Congress a report on the 
Project, including a year-over-year analysis of the 
survey data submitted to the Secretary under para-
graph (1), and any recommendations with respect to 
potential legislative action. 
Æ 
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