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Community engagement compliance described.—

“(2) Community engagement compliance described.— Subject to paragraph Determination. Criteria. Regulations. (3), an applicable individual demonstrates community engagement under this paragraph for a month if such individual meets 1 or more of the following conditions with respect to such month, as determined in accordance with criteria established by the Secretary through regulation: “(A) The individual works not less than 80 hours. “(B) The individual completes not less than 80 hours of community service. “(C) The individual participates in a work program for not less than 80 hours. “(D) The individual is enrolled in an educational program at least half-time. “(E) The individual engages in any combination of the activities described in subparagraphs (A) through (D), for a total of not less than 80 hours. “(F) The individual has a monthly income that is not less than the applicable minimum wage requirement under section 6 of the Fair Labor Standards Act of 1938, multiplied by 80 hours. “(G) The individual had an average monthly income over the preceding 6 months that is not less than the applicable minimum wage requirement under section 6 of the Fair Labor Standards Act of 1938 multiplied by 80 hours, and is a seasonal worker, as described in section 45R(d)(5)(B) of the Internal Revenue Code of 1986.

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statutes/42/1396a/xx.yaml

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Rules

monthly_activity_hours_requirement

Parameter

source: 42 USC 1396a(xx)(2)(A)-(E)

- name: monthly_activity_hours_requirement
  kind: parameter
  dtype: Decimal
  source: 42 USC 1396a(xx)(2)(A)-(E)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: not less than 80 hours
  versions:
    - effective_from: '2026-12-31'
      formula: '80'

seasonal_worker_income_lookback_months

Parameter

source: 42 USC 1396a(xx)(2)(G)

- name: seasonal_worker_income_lookback_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(xx)(2)(G)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: average monthly income over the preceding 6 months
  versions:
    - effective_from: '2026-12-31'
      formula: '6'

hardship_unemployment_rate_threshold

Parameter

source: 42 USC 1396a(xx)(3)(B)(ii)(II)(bb)(AA)

- name: hardship_unemployment_rate_threshold
  kind: parameter
  dtype: Rate
  source: 42 USC 1396a(xx)(3)(B)(ii)(II)(bb)(AA)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: 8 percent
  versions:
    - effective_from: '2026-12-31'
      formula: '0.08'

hardship_national_unemployment_rate_multiplier

Parameter

source: 42 USC 1396a(xx)(3)(B)(ii)(II)(bb)(BB)

- name: hardship_national_unemployment_rate_multiplier
  kind: parameter
  dtype: Decimal
  source: 42 USC 1396a(xx)(3)(B)(ii)(II)(bb)(BB)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: 1.5 times the national unemployment rate
  versions:
    - effective_from: '2026-12-31'
      formula: '1.5'

community_engagement_met_by_activity_or_income

Derived

source: 42 USC 1396a(xx)(2)

- name: community_engagement_met_by_activity_or_income
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: meets 1 or more of the following conditions
  versions:
    - effective_from: '2026-12-31'
      formula: >-
        monthly_work_hours >= monthly_activity_hours_requirement

        or monthly_community_service_hours >= monthly_activity_hours_requirement

        or monthly_work_program_hours >= monthly_activity_hours_requirement

        or enrolled_in_educational_program_at_least_half_time

        or monthly_combined_engagement_activity_hours >= monthly_activity_hours_requirement

        or monthly_income >= applicable_minimum_wage_hourly_rate *
        monthly_activity_hours_requirement

        or (seasonal_worker and average_monthly_income_over_preceding_6_months >=
        applicable_minimum_wage_hourly_rate * monthly_activity_hours_requirement)

educational_program

Derived

source: 42 USC 1396a(xx)(9)(B)

- name: educational_program
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(9)(B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/statute/42/1396a/xx
        - path: versions[0].formula
          kind: import
          import:
            target: us:statutes/26/3304#institution_of_higher_education
            output: institution_of_higher_education
            hash: sha256:86fc1e04b86968a3fea7737fce53a8297bc20be9c7896e4527512caed95bff86
  versions:
    - effective_from: '2026-12-31'
      formula: |-
        institution_of_higher_education
        or enrolled_in_career_and_technical_education_program

mandatory_community_engagement_deeming_applies

Derived

source: 42 USC 1396a(xx)(3)(A)

- name: mandatory_community_engagement_deeming_applies
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(3)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: |-
        was_specified_excluded_individual_for_part_or_all_of_month
        or was_under_age_19_for_part_or_all_of_month
        or was_entitled_to_or_enrolled_for_medicare_part_a_or_b_for_part_or_all_of_month
        or was_described_in_subsection_a_10_A_i_I_through_VII_for_part_or_all_of_month
        or was_inmate_of_public_institution_during_3_month_period_ending_first_day_of_month

short_term_hardship_event

Derived

source: 42 USC 1396a(xx)(3)(B)(ii)

- name: short_term_hardship_event
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(3)(B)(ii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: >-
        received_high_acuity_services_for_part_or_all_of_month

        or county_has_presidential_emergency_or_disaster_for_part_or_all_of_month

        or county_unemployment_rate >= min(hardship_unemployment_rate_threshold,
        hardship_national_unemployment_rate_multiplier * national_unemployment_rate)

        or
        individual_or_dependent_must_travel_outside_community_for_extended_medically_necessary_services

optional_hardship_deeming_applies

Derived

source: 42 USC 1396a(xx)(3)(B)(i)

- name: optional_hardship_deeming_applies
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(3)(B)(i)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: >-
        state_plan_provides_optional_short_term_hardship_deeming

        and short_term_hardship_event

        and (county_has_presidential_emergency_or_disaster_for_part_or_all_of_month or
        county_unemployment_rate >= min(hardship_unemployment_rate_threshold,
        hardship_national_unemployment_rate_multiplier * national_unemployment_rate) or
        individual_requested_hardship_deeming)

deemed_to_have_demonstrated_community_engagement

Derived

source: 42 USC 1396a(xx)(3)

- name: deemed_to_have_demonstrated_community_engagement
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(3)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: |-
        mandatory_community_engagement_deeming_applies
        or optional_hardship_deeming_applies

state_may_waive_verification_for_deemed_community_engagement

Derived

source: 42 USC 1396a(xx)(3)(C)

- name: state_may_waive_verification_for_deemed_community_engagement
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(3)(C)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: may elect to not require an individual to verify information resulting in such deeming
  versions:
    - effective_from: '2026-12-31'
      formula: |-
        state_elects_not_to_require_verification_for_deemed_community_engagement
        and deemed_to_have_demonstrated_community_engagement

demonstrated_community_engagement_for_month

Derived

source: 42 USC 1396a(xx)(2)-(3)

- name: demonstrated_community_engagement_for_month
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(2)-(3)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: |-
        community_engagement_met_by_activity_or_income
        or deemed_to_have_demonstrated_community_engagement

specified_excluded_individual

Derived

source: 42 USC 1396a(xx)(9)(A)(ii)

- name: specified_excluded_individual
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(9)(A)(ii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: >-
        described_in_subsection_a_10_A_i_IX

        or is_indian_urban_indian_california_indian_or_ihs_eligible_indian

        or
        is_parent_guardian_caretaker_relative_or_family_caregiver_of_dependent_child_age_13_or_under_or_disabled_individual

        or is_veteran_with_total_disability_rating

        or is_medically_frail_or_has_special_medical_needs

        or
        complies_with_tanf_work_requirements_or_is_nonexempt_snap_work_requirement_household_member

        or participates_in_drug_addiction_or_alcoholic_treatment_and_rehabilitation_program

        or is_inmate_of_public_institution

        or is_pregnant_or_entitled_to_postpartum_medical_assistance

applicable_individual

Derived

source: 42 USC 1396a(xx)(9)(A)(i)

- name: applicable_individual
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(9)(A)(i)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: >-
        not specified_excluded_individual

        and (eligible_or_enrolled_under_subsection_a_10_A_i_VIII or
        (eligible_or_enrolled_under_equivalent_minimum_essential_coverage_waiver and
        has_attained_age_19_and_is_under_age_65 and not pregnant and not
        entitled_to_or_enrolled_for_medicare_part_a_or_b and not
        otherwise_eligible_to_enroll_under_state_plan))

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us/statute/42/1396a/xx/2 — Community engagement compliance described.— · Axiom

Community engagement compliance described.—

Official source

in view

Whole section

▸rulespec code

Shown source

statutes/42/1396a/xx.yaml

Displaying the canonical repository encoding.

This encoding covers the parent provision us/statute/42/1396a/xx; no dedicated encoding exists for this exact provision yet.

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Rules

monthly_activity_hours_requirement

Parameter

source: 42 USC 1396a(xx)(2)(A)-(E)

- name: monthly_activity_hours_requirement
  kind: parameter
  dtype: Decimal
  source: 42 USC 1396a(xx)(2)(A)-(E)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: not less than 80 hours
  versions:
    - effective_from: '2026-12-31'
      formula: '80'

seasonal_worker_income_lookback_months

Parameter

source: 42 USC 1396a(xx)(2)(G)

- name: seasonal_worker_income_lookback_months
  kind: parameter
  dtype: Count
  source: 42 USC 1396a(xx)(2)(G)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: average monthly income over the preceding 6 months
  versions:
    - effective_from: '2026-12-31'
      formula: '6'

hardship_unemployment_rate_threshold

Parameter

source: 42 USC 1396a(xx)(3)(B)(ii)(II)(bb)(AA)

- name: hardship_unemployment_rate_threshold
  kind: parameter
  dtype: Rate
  source: 42 USC 1396a(xx)(3)(B)(ii)(II)(bb)(AA)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: 8 percent
  versions:
    - effective_from: '2026-12-31'
      formula: '0.08'

hardship_national_unemployment_rate_multiplier

Parameter

source: 42 USC 1396a(xx)(3)(B)(ii)(II)(bb)(BB)

- name: hardship_national_unemployment_rate_multiplier
  kind: parameter
  dtype: Decimal
  source: 42 USC 1396a(xx)(3)(B)(ii)(II)(bb)(BB)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: 1.5 times the national unemployment rate
  versions:
    - effective_from: '2026-12-31'
      formula: '1.5'

community_engagement_met_by_activity_or_income

Derived

source: 42 USC 1396a(xx)(2)

- name: community_engagement_met_by_activity_or_income
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: meets 1 or more of the following conditions
  versions:
    - effective_from: '2026-12-31'
      formula: >-
        monthly_work_hours >= monthly_activity_hours_requirement

        or monthly_community_service_hours >= monthly_activity_hours_requirement

        or monthly_work_program_hours >= monthly_activity_hours_requirement

        or enrolled_in_educational_program_at_least_half_time

        or monthly_combined_engagement_activity_hours >= monthly_activity_hours_requirement

        or monthly_income >= applicable_minimum_wage_hourly_rate *
        monthly_activity_hours_requirement

        or (seasonal_worker and average_monthly_income_over_preceding_6_months >=
        applicable_minimum_wage_hourly_rate * monthly_activity_hours_requirement)

educational_program

Derived

source: 42 USC 1396a(xx)(9)(B)

- name: educational_program
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(9)(B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/statute/42/1396a/xx
        - path: versions[0].formula
          kind: import
          import:
            target: us:statutes/26/3304#institution_of_higher_education
            output: institution_of_higher_education
            hash: sha256:86fc1e04b86968a3fea7737fce53a8297bc20be9c7896e4527512caed95bff86
  versions:
    - effective_from: '2026-12-31'
      formula: |-
        institution_of_higher_education
        or enrolled_in_career_and_technical_education_program

mandatory_community_engagement_deeming_applies

Derived

source: 42 USC 1396a(xx)(3)(A)

- name: mandatory_community_engagement_deeming_applies
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(3)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: |-
        was_specified_excluded_individual_for_part_or_all_of_month
        or was_under_age_19_for_part_or_all_of_month
        or was_entitled_to_or_enrolled_for_medicare_part_a_or_b_for_part_or_all_of_month
        or was_described_in_subsection_a_10_A_i_I_through_VII_for_part_or_all_of_month
        or was_inmate_of_public_institution_during_3_month_period_ending_first_day_of_month

short_term_hardship_event

Derived

source: 42 USC 1396a(xx)(3)(B)(ii)

- name: short_term_hardship_event
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(3)(B)(ii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: >-
        received_high_acuity_services_for_part_or_all_of_month

        or county_has_presidential_emergency_or_disaster_for_part_or_all_of_month

        or county_unemployment_rate >= min(hardship_unemployment_rate_threshold,
        hardship_national_unemployment_rate_multiplier * national_unemployment_rate)

        or
        individual_or_dependent_must_travel_outside_community_for_extended_medically_necessary_services

optional_hardship_deeming_applies

Derived

source: 42 USC 1396a(xx)(3)(B)(i)

- name: optional_hardship_deeming_applies
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(3)(B)(i)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: >-
        state_plan_provides_optional_short_term_hardship_deeming

        and short_term_hardship_event

        and (county_has_presidential_emergency_or_disaster_for_part_or_all_of_month or
        county_unemployment_rate >= min(hardship_unemployment_rate_threshold,
        hardship_national_unemployment_rate_multiplier * national_unemployment_rate) or
        individual_requested_hardship_deeming)

deemed_to_have_demonstrated_community_engagement

Derived

source: 42 USC 1396a(xx)(3)

- name: deemed_to_have_demonstrated_community_engagement
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(3)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: |-
        mandatory_community_engagement_deeming_applies
        or optional_hardship_deeming_applies

state_may_waive_verification_for_deemed_community_engagement

Derived

source: 42 USC 1396a(xx)(3)(C)

- name: state_may_waive_verification_for_deemed_community_engagement
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(3)(C)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/statute/42/1396a/xx
            excerpt: may elect to not require an individual to verify information resulting in such deeming
  versions:
    - effective_from: '2026-12-31'
      formula: |-
        state_elects_not_to_require_verification_for_deemed_community_engagement
        and deemed_to_have_demonstrated_community_engagement

demonstrated_community_engagement_for_month

Derived

source: 42 USC 1396a(xx)(2)-(3)

- name: demonstrated_community_engagement_for_month
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(2)-(3)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: |-
        community_engagement_met_by_activity_or_income
        or deemed_to_have_demonstrated_community_engagement

specified_excluded_individual

Derived

source: 42 USC 1396a(xx)(9)(A)(ii)

- name: specified_excluded_individual
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(9)(A)(ii)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: >-
        described_in_subsection_a_10_A_i_IX

        or is_indian_urban_indian_california_indian_or_ihs_eligible_indian

        or
        is_parent_guardian_caretaker_relative_or_family_caregiver_of_dependent_child_age_13_or_under_or_disabled_individual

        or is_veteran_with_total_disability_rating

        or is_medically_frail_or_has_special_medical_needs

        or
        complies_with_tanf_work_requirements_or_is_nonexempt_snap_work_requirement_household_member

        or participates_in_drug_addiction_or_alcoholic_treatment_and_rehabilitation_program

        or is_inmate_of_public_institution

        or is_pregnant_or_entitled_to_postpartum_medical_assistance

applicable_individual

Derived

source: 42 USC 1396a(xx)(9)(A)(i)

- name: applicable_individual
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 USC 1396a(xx)(9)(A)(i)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/statute/42/1396a/xx
  versions:
    - effective_from: '2026-12-31'
      formula: >-
        not specified_excluded_individual

        and (eligible_or_enrolled_under_subsection_a_10_A_i_VIII or
        (eligible_or_enrolled_under_equivalent_minimum_essential_coverage_waiver and
        has_attained_age_19_and_is_under_age_65 and not pregnant and not
        entitled_to_or_enrolled_for_medicare_part_a_or_b and not
        otherwise_eligible_to_enroll_under_state_plan))