CLEAN Act
- Sponsor
- Rep. Steube, W. Gregory [R-FL-17]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Feb 9, 2026
Bottom line
The bill aims to restrict access to federal health care subsidies and Medicaid for registered sex offenders, giving states discretion over Medicaid eligibility for this population.
What it actually does
This bill amends the Internal Revenue Code of 1986 and the Social Security Act to make individuals identified as sex offenders under the Adam Walsh Child Protection and Safety Act of 2006 ineligible for the refundable premium tax credit for health insurance coverage and for Federally funded medical assistance under the Medicaid program. Additionally, it grants states the option to elect not to provide any medical assistance to such individuals under their Medicaid programs.
Proponents argue
Proponents argue that individuals who have committed serious sex offenses should not be eligible for taxpayer-funded benefits, including health care subsidies and Medicaid. They emphasize public safety, justice, and fiscal responsibility, asserting that public resources should be prioritized for law-abiding citizens and that denying these benefits serves as a just consequence for severe crimes.
Opponents contend
Opponents might argue that denying essential health care access to any group, including sex offenders, raises humanitarian concerns and could lead to broader public health issues if individuals with medical needs are left untreated. They may also question the effectiveness of such measures in achieving public safety goals and highlight the potential for increased emergency room costs and uncompensated care burdens on hospitals.
The bill is very short and clearly written, allowing for a quick and thorough understanding of its provisions and implications.
Section 2(a), amending Section 36B(c)(1) of the Internal Revenue Code of 1986
Denial of Refundable Health Plan Credit to Sex Offenders
This provision amends the Internal Revenue Code to make individuals who are sex offenders (as defined by the Adam Walsh Child Protection and Safety Act of 2006), or their spouses in the case of a joint return, ineligible for the refundable premium tax credit. This credit helps eligible individuals pay for health insurance purchased through the Affordable Care Act marketplaces, meaning affected individuals would lose this financial assistance.
Supporters argue
Supporters argue that taxpayer funds should not be used to subsidize health insurance for individuals convicted of sex offenses, aligning with principles of justice and responsible use of public resources by prioritizing law-abiding citizens.
Critics contend
Critics may contend that denying access to health insurance subsidies could lead to a decline in health among this population, potentially increasing public health risks and shifting costs to emergency services, which are often more expensive than preventative care.
Tradeoffs
This provision balances the desire to penalize sex offenders and conserve public funds against concerns about universal access to healthcare and potential public health consequences of denying care, such as increased reliance on emergency rooms.
Section 3(a), amending Section 1903(i) of the Social Security Act
Denial of Federally Funded Medicaid Assistance to Sex Offenders
This provision amends the Social Security Act to prohibit federal matching funds for medical assistance provided under Medicaid to individuals who are sex offenders, as defined by the Adam Walsh Act. This means that states would no longer receive federal reimbursement for the costs of providing Medicaid benefits to these individuals, effectively discouraging states from covering them.
Section 3(b), amending Section 1902(a) of the Social Security Act
State Option to Deny Medicaid to Sex Offenders
This provision explicitly states that, notwithstanding other requirements of the Social Security Act, a State *may elect* not to make medical assistance available to an individual who is a sex offender as defined in the Adam Walsh Act. This grants states the discretion to fully exclude sex offenders from their Medicaid programs, beyond just losing federal matching funds, allowing for varied approaches across states.
The bill defines 'sex offender' by reference to 'section 111 of the Adam Walsh Child Protection and Safety Act of 2006.' This external reference dictates the specific criteria for who is subject to the new ineligibility rules.
Sections 2(a)(F) and 3(a)(28)
Why it matters:This is standard legislative practice to avoid reprinting lengthy definitions already established in law, promoting brevity and consistency across statutes. It is not necessarily an attempt to obscure the provision.
Case for: Referencing existing definitions streamlines legislation and ensures consistency with established legal frameworks for identifying sex offenders, avoiding redundant text and potential definitional conflicts.
Case against: Relying on external definitions can make a bill less self-contained and harder for the average reader to fully comprehend without additional research, potentially obscuring the full scope of its impact and requiring specialized legal knowledge.
Estimated impact: The impact is significant as this external definition determines the entire class of individuals affected by the bill's provisions regarding health care credit and Medicaid eligibility.