As Americans struggle with rising costs, Rep. Adam Schiff, D-Calif. is making a pitch to help put more dollars in some of the lowest income Americans while cutting costs of federal healthcare spending.

In a copy of the bill first obtained by Spectrum News, the Guaranteed Additional Income for Families in Need Act, or GAINS Act, proposes the creation of 10 pilot programs in cities across the country that would give participants an extra $500 a month to help them make ends meet. Over the course of five years, the pilot program would collect research as to whether the cash payments improved the health outcomes among the participants. The only stipulation would be that the recipients of the cash be enrolled in Medicaid, the government program that provides health insurance for individuals and their families with limited income.


What You Need To Know

  • The Guaranteed Additional Income for Families in Need Act, or GAINS Act, proposes the creation of 10 pilot programs in cities across the country that would give participants an extra $500 a month to help them make ends meet

  • Over the course of five years, the pilot program would collect research as to whether the cash payments improved the health outcomes among the participants.

  • Similar programs in Stockton, Calif., and Cambridge, Mass. have shown successful outcomes in improving health outcomes

“I was speaking with a woman in her 30s in the north of the state, and she was telling me how she did everything she was supposed to do: she was told to get a good education, so she went to college. She got a lot of student debt along with it. Ten years later, she's still paying back that debt. Her rent is going up and up and up, she has nothing set aside – nothing to set aside. She has health insurance, but it doesn't cover that much. And she's terrified,” Schiff, who is currently running for Senate in California, told Spectrum News.

“She said, ‘I live alone, there's nobody to help me with this.’ Having a certain basic income would not only relieve a lot of that stress, but make sure that a car problem or some other problem didn't prevent her from going to work, it didn't cost her her job,” Schiff continued. “And so you can see, certainly based on conversations I had, how extra help would help mitigate a lot of these challenges.”

Schiff compared the pilot program with the small business assistance loans and the stimulus checks that people received during the COVID-19 pandemic as proof this type of program could be successful on a larger scale. 

“We got essentially a big experiment in guaranteed income during the pandemic, when we had a number of programs that helped people keep their doors open if they were small restaurant, provided emergency loans – it was a kind of guaranteed income for many families. this would do it on a much more scientific basis where we can measure outcomes,” explained Schiff. “​​I think the time is right now that we're post-pandemic to see whether in a post-pandemic world, we can have similar results.”

Similar programs to the one Schiff is proposing have been enacted in Stockton, Calif., and Cambridge, Mass., among other cities. The Stockton program provided 131 residents with $500 monthly cash payments for two years, beginning in early 2019. Known as the Stockton Economic Empowerment Demonstration, or SEED, each recipient household had an income of $46,033 or less and were allowed to use the money however they wished. A study found it was successful in helping to alleviate anxiety and depression and improving overall wellbeing in participants,

Dr. Amy Castro, the director of the University of Pennsylvania's Center for Guaranteed Income Research, co-authored a study on the Stockton plan.

“Our findings show that guaranteed income programs mitigate the negative financial and health consequences associated with income volatility,” she said in a statement at the time the study was released. “A national guaranteed income program that complements our nation’s current social safety net could profoundly impact people’s overall health and economic well-being.” 

Former Stockton Mayor Michael Tubbs, who is now the founder and chair of Mayors and Counties for a Guaranteed Income, told Spectrum News that guaranteed income is not a novel idea, just one he saw needed to be put into action. 

“When I started this work around guaranteed income, it was seen as a crazy idea, despite the fact that Thomas Paine had talked about this in the late 17th century, Dr. [Martin Luther] King, Richard Nixon – lots of folks, the Black Panther Party – had all seen that for capitalism to work, there had to be a floor that everyone has,” said Tubbs. “Literally every month we have a new study coming out from one of our mayors or one of our county officials that shows that, no, when you give people money, you allow them to breathe, they don't become lazy, they don't spend on drugs and alcohol, but they spend the money like how you and I spend money.”

In the Cambridge pilot, the Cambridge Community Foundation reported that the 130 families that received $500 a month for a year and a half “found that despite the pandemic-related stressors and inflation, as well as the associated increased cost of living, participants benefited from guaranteed income in several ways,” including higher employment, improvement in financial health, enhanced housing and food security, and increased time for parenting.

Tubbs said part of the issue when talking about assisting those with the lowest income is how society thinks of those individuals.

“Folks are really trying to pay bills. Folks are really trying to buy formula. Folks are really trying to pay rent. They don't have time to waste extra money, they don't have time to spend on items that aren't necessities,” said Tubbs. “It's not about some other person. It's about you and your family and your community and your neighbors. And what would you do with the extra $500 or extra $750 a month?”

According to the Centers for Medicare & Medicaid Services, “83,387,167 individuals were enrolled in Medicaid and CHIP in the 51 states and the District of Columbia that reported enrollment data for February 2024.” Schiff believes that the additional income could improve outcomes, as seen with the Cambridge and Stockton trials, and subsequently save the government money.

“It also may just save the federal government money by reducing health care costs, because in a study, for example, in Boston, giving people some supplementary income has been shown to improve health outcomes as well," he said. "Because if you have a child, for example, with cancer, being able to defray the added transportation costs or bring in the hospital or have child care for other children while they're at the hospital, these things, could be very helpful in terms of health outcomes and cost.” 

But for advocates like Tubbs, it’s more than an opportunity for the federal government to cut costs. It’s a symbol of hope for what tomorrow could look like.

“We can live in a country where everyone's basic needs are met. We can live in a country where everyone has something like, no one deserves to have nothing,” said Tubbs. "And when we do that, we're safer, we're healthier, we're more prosperous, and all the things we complain about on Facebook are more solvable. So this is a great step towards not a utopian, but a very pragmatic and practical and I would argue, civilized future, like literally a future where everyone has a slower, that no one has nothing. And that's the type of country I want to live in.” 

In a Republican controlled House, the bill will likely face steep opposition. In addition to Schiff, Rep. Bonnie Watson Coleman, D-N.J. is a cosponsor on the bill.

“Study after study has shown that direct cash assistance is the most effective way to reduce poverty permanently in America. The targeted distribution laid out in the GAIN Act makes sure those who need support can get it. Direct aid pilot programs have shown that most people spend the additional income on child care, food, and rent — freeing up families to actually escape the cycle of poverty. I’m very proud to co-lead this legislation with Rep. Schiff, and strongly encourage the House to pass it,” Coleman said in a statement.