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Medicaid medically needy test sums income and resources over the tax unit instead of the individual or couple #10367
Description
Summary
is_medically_needy_for_medicaid sums ssi_countable_income minus medicaid_medically_needy_medical_expenses, and ssi_countable_resources, over person.tax_unit. It picks the couple limits from tax_unit_is_joint. Non-MAGI Medicaid follows SSI's financial responsibility rules instead: only the individual and a spouse living with them count (a parent's income already reaches a child through SSI deeming in ssi_countable_income). The optional aged, blind and disabled pathway already uses the marital unit (is_optional_senior_or_disabled_income_eligible, medicaid_optional_senior_or_disabled_income_limit).
Law
42 CFR 435.602(a)(2)(i): "Except for a spouse of an individual or a parent for a child who is under age 21 or blind or disabled, the agency must not consider income and resources of any relative as available to an individual."
Examples
Massachusetts, 2026: $522 / $650 a month and $2,000 / $3,000 in resources.
| Household | main |
Correct |
|---|---|---|
| Aged parent claimed as a dependent by a married adult child who has $20,000 in savings | Couple limits, and the couple's savings count | The parent's own income and resources against the individual limits |
| Aged filer (70) with $17,760 countable income and $13,000 in medical expenses, who claims their 92-year-old parent ($3,760 countable pension, $1,800 resources) | 8,520 > 6,264 and 2,300 > 2,000: ineligible | 4,760 ≤ 6,264 and 500 ≤ 2,000: eligible |
| Aged married couple filing separately | Each spouse alone against the individual limit | Combined income against the couple limit |
A local review of #10240 found the same aggregation; it becomes visible once that PR counts the income of noncitizens who fail SSI's alien test.
Proposed fix
Sum over person.marital_unit and use marital_unit.nb_persons() == 2 for the couple limits, as the optional aged, blind and disabled pathway does.
Activity