Count income of aged, blind, or disabled people who fail SSI's noncitizen test

changelog.d/medicaid-abd-noncitizen-countable-income.fixed.md

@@ -0,0 +1 @@
+Count the own income of aged, blind, or disabled people who fail SSI's noncitizen test in SSI-methodology countable income, so Medicaid's optional aged, blind, and disabled and medically needy income tests, CAPI, and other programs no longer treat it as zero; the California state supplement no longer counts a CAPI-eligible member's income, and Maryland PAA no longer imputes SSI or deems spouse income for people SSI bars by alien status.

policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medically_needy/is_medically_needy_for_medicaid.yaml

@@ -50,3 +50,39 @@
     state_code: MA
   output:
     is_medically_needy_for_medicaid: false
+
+- name: Case 3, aged permanent resident without 40 SSI quarters has pension counted.
+  period: 2026
+  input:
+    age: 70
+    immigration_status: LEGAL_PERMANENT_RESIDENT
+    years_since_us_entry: 10
+    ssi_qualifying_quarters_earnings: 20
+    pension_income: 60_000
+    is_in_medicaid_medically_needy_category: true
+    is_adult_for_medicaid: false
+    is_optional_senior_or_disabled_for_medicaid: false
+    medicaid_medically_needy_medical_expenses: 6_000
+    ssi_countable_resources: 1_000
+    state_code: MA
+  output:
+    # 60,000 - 20 x 12 = 59,760; 59,760 - 6,000 = 53,760 > 522 x 12 = 6,264.
+    is_medically_needy_for_medicaid: false
+
+- name: Case 4, aged permanent resident without 40 SSI quarters qualifies after medical spenddown.
+  period: 2026
+  input:
+    age: 70
+    immigration_status: LEGAL_PERMANENT_RESIDENT
+    years_since_us_entry: 10
+    ssi_qualifying_quarters_earnings: 20
+    pension_income: 18_000
+    is_in_medicaid_medically_needy_category: true
+    is_adult_for_medicaid: false
+    is_optional_senior_or_disabled_for_medicaid: false
+    medicaid_medically_needy_medical_expenses: 12_000
+    ssi_countable_resources: 1_000
+    state_code: MA
+  output:
+    # 18,000 - 20 x 12 = 17,760; 17,760 - 12,000 = 5,760 <= 522 x 12 = 6,264.
+    is_medically_needy_for_medicaid: true

policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/is_medicaid_eligible.yaml

@@ -314,3 +314,48 @@
     medicaid_category: SECTION_1115_MEC_ADULT
     is_medicaid_work_requirement_applicable_adult: true
     is_medicaid_eligible: true
+
+- name: Case 17, aged permanent resident without 40 SSI quarters is over the Massachusetts income limit.
+  period: 2025
+  input:
+    age: 70
+    immigration_status: LEGAL_PERMANENT_RESIDENT
+    years_since_us_entry: 10
+    ssi_qualifying_quarters_earnings: 20
+    pension_income: 60_000
+    state_code: MA
+  output:
+    # The optional aged, blind, and disabled pathway counts 59,760 of
+    # income, above 100% of the poverty guideline, even though the person
+    # fails SSI's 40-quarter test.
+    is_medicaid_immigration_status_eligible: true
+    is_optional_senior_or_disabled_for_medicaid: false
+    is_medicaid_eligible: false
+
+- name: Case 18, aged permanent resident without 40 SSI quarters with a small pension is eligible.
+  period: 2025
+  input:
+    age: 70
+    immigration_status: LEGAL_PERMANENT_RESIDENT
+    years_since_us_entry: 10
+    ssi_qualifying_quarters_earnings: 20
+    pension_income: 12_000
+    state_code: MA
+  output:
+    # 12,000 - 20 x 12 = 11,760, under 100% of the poverty guideline.
+    is_optional_senior_or_disabled_for_medicaid: true
+    is_medicaid_eligible: true
+
+- name: Case 19, aged undocumented resident of the District of Columbia is over the income limit.
+  period: 2025
+  input:
+    age: 70
+    immigration_status: UNDOCUMENTED
+    pension_income: 60_000
+    state_code: DC
+  output:
+    # The District covers undocumented residents, but the optional aged,
+    # blind, and disabled pathway still counts 59,760 of income.
+    is_medicaid_immigration_status_eligible: true
+    is_optional_senior_or_disabled_for_medicaid: false
+    is_medicaid_eligible: false

policyengine_us/tests/policy/baseline/gov/hhs/medicaid/income/deemed/from_ineligible_spouse/medicaid_optional_senior_or_disabled_income_deemed_from_ineligible_spouse.yaml

@@ -120,3 +120,36 @@
     # (17,004 - 20 * 12 - 65 * 12) / 2 = 7,992 deemed and countable.
     medicaid_optional_senior_or_disabled_income_deemed_from_ineligible_spouse: [7_992, 0, 0]
     medicaid_optional_senior_or_disabled_countable_income: [7_992, 0, 0]
+
+- name: Spouse income is deemed to an aged permanent resident without 40 SSI quarters.
+  period: 2025
+  absolute_error_margin: 0.01
+  input:
+    people:
+      person1:
+        age: 70
+        is_tax_unit_head: true
+        immigration_status: LEGAL_PERMANENT_RESIDENT
+        years_since_us_entry: 10
+        ssi_qualifying_quarters_earnings: 20
+        pension_income: 6_000
+      person2:
+        age: 55
+        is_tax_unit_spouse: true
+        employment_income: 40_000
+    tax_units:
+      tax_unit:
+        members: [person1, person2]
+    marital_units:
+      marital_unit:
+        members: [person1, person2]
+    households:
+      household:
+        members: [person1, person2]
+        state_code: MA
+  output:
+    # SSI's noncitizen test does not stop deeming (42 CFR 435.601).
+    # Spouse wages 40,000 > (1,450 - 967) x 12 = 5,796.
+    # Couple: (500 - 20) x 12 + (40,000 - 65 x 12) / 2 = 25,370.
+    # Alone: (500 - 20) x 12 = 5,760. Deemed: 25,370 - 5,760 = 19,610.
+    medicaid_optional_senior_or_disabled_income_deemed_from_ineligible_spouse: [19_610, 0]

policyengine_us/tests/policy/baseline/gov/hhs/medicaid/income/medicaid_optional_senior_or_disabled_countable_income.yaml

@@ -105,3 +105,54 @@
     # rounding, 1,131.75 would exceed the $1,131 standard.
     medicaid_optional_senior_or_disabled_countable_income: 13_572
     is_optional_senior_or_disabled_income_eligible: true
+
+- name: An aged permanent resident without 40 SSI quarters has their pension counted.
+  period: 2025
+  absolute_error_margin: 0.01
+  input:
+    age: 70
+    immigration_status: LEGAL_PERMANENT_RESIDENT
+    years_since_us_entry: 10
+    ssi_qualifying_quarters_earnings: 20
+    pension_income: 60_000
+    state_code: MA
+  output:
+    # Failing SSI's noncitizen test does not zero income under SSI
+    # methodology (42 CFR 435.601): 60,000 - 20 x 12 = 59,760.
+    medicaid_optional_senior_or_disabled_countable_income: 59_760
+    is_optional_senior_or_disabled_income_eligible: false
+
+- name: Spouse income is deemed to an aged permanent resident without 40 SSI quarters.
+  period: 2025
+  absolute_error_margin: 0.01
+  input:
+    people:
+      person1:
+        age: 70
+        is_tax_unit_head: true
+        immigration_status: LEGAL_PERMANENT_RESIDENT
+        years_since_us_entry: 10
+        ssi_qualifying_quarters_earnings: 20
+        pension_income: 6_000
+      person2:
+        age: 55
+        is_tax_unit_spouse: true
+        employment_income: 40_000
+    tax_units:
+      tax_unit:
+        members: [person1, person2]
+    marital_units:
+      marital_unit:
+        members: [person1, person2]
+    households:
+      household:
+        members: [person1, person2]
+        state_code: MA
+  output:
+    # Own income: 6,000 - 20 x 12 = 5,760.
+    # Deemed from the spouse who is not aged, blind, or disabled:
+    # 40,000 > (1,450 - 967) x 12 = 5,796, so the couple total is
+    # 5,760 + (40,000 - 65 x 12) / 2 = 25,370, and 25,370 - 5,760 = 19,610.
+    # The spouse's own countable income stays 0 to avoid counting it twice.
+    medicaid_optional_senior_or_disabled_countable_income: [25_370, 0]
+    is_optional_senior_or_disabled_income_eligible: [false, false]

policyengine_us/tests/policy/baseline/gov/local/ca/sf/caap/ca_sf_caap.yaml

@@ -316,8 +316,8 @@
     # size-1 grant ($714) is paid through the top-level benefit, not the GA $578.
     ca_sf_caap: 714
 
-- name: Case 15, aged TPS member with a CAPI payment is excluded from the
-    budget unit along with her income.
+- name: Case 15, aged TPS member whose pension rules out CAPI stays in the
+    budget unit with her income.
   period: 2026-01
   absolute_error_margin: 0.01
   input:
@@ -339,22 +339,14 @@
         spm_unit_cash_assets: 0
   output:
     # person2 is categorically CAPI-eligible (aged 68 + noncitizen + TPS is not
-    # an SSI-qualified status) and the model pays her unit CAPI, so the
-    # receipt-based bar (ca_capi > 0) drops her from the budget unit and her
-    # pension is masked out of countable income; the remaining member collects
-    # the size-1 grant.
-    # NOTE: in real life her 2,000/month pension is roughly double the CAPI
-    # payment standard, so she would receive no CAPI and would stay in the
-    # CAAP budget unit (size 2, max grant 1,036), where her income fails the
-    # strict income test: ca_sf_caap = 0. The model currently pays her CAPI
-    # regardless of income because ca_capi's income test reads
-    # ssi_countable_income, which is zeroed for anyone failing the SSI
-    # immigration test (CAPI's entire target population) -- an upstream CAPI
-    # limitation. When that is fixed upstream, this case's expectations flip
-    # to budget_unit_size 2, countable_income 2_000, ca_sf_caap 0.
-    ca_sf_caap_budget_unit_size: 1
-    ca_sf_caap_countable_income: 0
-    ca_sf_caap: 578
+    # an SSI-qualified status), but CAPI counts her pension: her countable
+    # pension (2,000 - 20 = 1,980/month) exceeds CAPI's payment standard, so
+    # ca_capi = 0. The receipt-based bar (ca_capi > 0) does not apply, and she
+    # stays in the CAAP budget unit (size 2, max grant 1,036), where her
+    # income fails the strict income test.
+    ca_sf_caap_budget_unit_size: 2
+    ca_sf_caap_countable_income: 2_000
+    ca_sf_caap: 0
 
 - name: Case 16, one spouse receiving SSI and only one spouse applying yields
     the full one-person grant against the applicant's own income.

policyengine_us/tests/policy/baseline/gov/ssa/ssi/eligibility/income/deemed/from_ineligible_spouse/ssi_income_deemed_from_ineligible_spouse.yaml

@@ -224,3 +224,33 @@
         members: [person1, person2]
   output:
     ssi_income_deemed_from_ineligible_spouse: [0, 0]
+
+- name: Spouse income is deemed to an aged permanent resident without 40 SSI quarters (2025)
+  period: 2025
+  absolute_error_margin: 0.01
+  input:
+    people:
+      person1:
+        age: 70
+        is_tax_unit_head: true
+        immigration_status: LEGAL_PERMANENT_RESIDENT
+        years_since_us_entry: 10
+        ssi_qualifying_quarters_earnings: 20
+        pension_income: 6_000
+      person2:
+        age: 55
+        is_tax_unit_spouse: true
+        employment_income: 40_000
+    tax_units:
+      tax_unit:
+        members: [person1, person2]
+    marital_units:
+      marital_unit:
+        members: [person1, person2]
+  output:
+    # Deeming turns on aged, blind, or disabled status, not on SSI's
+    # noncitizen test: spouse wages 40,000 > (1,450 - 967) x 12 = 5,796.
+    # Couple: (500 - 20) x 12 + (40,000 - 65 x 12) / 2 = 25,370.
+    # Alone: (500 - 20) x 12 = 5,760. Deemed: 25,370 - 5,760 = 19,610.
+    is_ssi_spousal_deeming_applies: [true, false]
+    ssi_income_deemed_from_ineligible_spouse: [19_610, 0]

policyengine_us/tests/policy/baseline/gov/ssa/ssi/ssi_countable_income.yaml

@@ -147,3 +147,47 @@
     # No earned income, so earned exclusions don't apply
     # Countable = 3_868
     ssi_countable_income: 3_868
+
+- name: An aged permanent resident without 40 SSI quarters has their pension counted.
+  period: 2025
+  absolute_error_margin: 0.01
+  input:
+    age: 70
+    immigration_status: LEGAL_PERMANENT_RESIDENT
+    years_since_us_entry: 10
+    ssi_qualifying_quarters_earnings: 20
+    pension_income: 60_000
+  output:
+    # The noncitizen test bars SSI itself but does not zero the income
+    # that Medicaid and state programs count: 60,000 - 20 x 12 = 59,760.
+    ssi_countable_income: 59_760
+    ssi: 0
+
+- name: Spouse income is deemed to an aged permanent resident without 40 SSI quarters.
+  period: 2025
+  absolute_error_margin: 0.01
+  input:
+    people:
+      person1:
+        age: 70
+        is_tax_unit_head: true
+        immigration_status: LEGAL_PERMANENT_RESIDENT
+        years_since_us_entry: 10
+        ssi_qualifying_quarters_earnings: 20
+        pension_income: 6_000
+      person2:
+        age: 55
+        is_tax_unit_spouse: true
+        employment_income: 40_000
+    tax_units:
+      tax_unit:
+        members: [person1, person2]
+    marital_units:
+      marital_unit:
+        members: [person1, person2]
+  output:
+    # Own: (500 - 20) x 12 = 5,760. Deemed from the spouse who is not aged,
+    # blind, or disabled: 19,610 (20 CFR 416.1163). The spouse's own
+    # countable income stays 0.
+    ssi_countable_income: [25_370, 0]
+    ssi: [0, 0]

policyengine_us/tests/policy/baseline/gov/states/ca/cdss/capi/ca_capi.yaml

@@ -98,3 +98,27 @@
     ca_state_supplement_aged_blind_disabled_amount: 0
     ca_state_supplement: 0
     ca_capi: 11_306
+
+- name: Integration test, aged permanent resident without 40 SSI quarters whose pension exceeds the CAPI standard
+  period: 2025
+  absolute_error_margin: 0.01
+  input:
+    people:
+      person1:
+        age: 70
+        immigration_status: LEGAL_PERMANENT_RESIDENT
+        years_since_us_entry: 10
+        ssi_qualifying_quarters_earnings: 0
+        pension_income: 24_000 # 2,000 a month
+    households:
+      household:
+        members: [person1]
+        state_code: CA
+  output:
+    ssi: 0
+    ca_capi_eligible_person: true
+    # (2,000 - 20) x 12 = 23,760 of countable income.
+    ssi_countable_income: 23_760
+    # 1,980 a month exceeds CAPI's individual payment standard, which is at
+    # most the 1,335.81 SSI/SSP no-cooking standard, so CAPI pays nothing.
+    ca_capi: 0

policyengine_us/tests/policy/baseline/gov/states/ca/cdss/state_supplement/ca_state_supplement.yaml

@@ -355,3 +355,57 @@
     # 2,098.83 - 1,491 = 607.83; 2,098.83 - 2,098.83 = 0;
     # 2,356.57 - 2,098.83 = 257.74; 2,356.57 - 2,356.57 = 0.
     ca_state_supplement: [7_293.96, 0, 3_092.88, 0]
+
+# A CAPI-eligible member's income does not reduce the state supplement: CAPI
+# budgets its own members' income (CAPI regulations MPP 49-035), and SSI/SSP
+# counts another member's income only when it is deemed (20 CFR 416.1160(a)).
+# 2025: federal SSI is $967; the no-cooking individual standard is
+# $1,206.94 + $128.87 = $1,335.81.
+- name: Case 10, 2025 aged citizen sharing an SPM unit with a CAPI-eligible sibling keeps the supplement.
+  period: 2025
+  absolute_error_margin: 0.01
+  input:
+    people:
+      person1:
+        age: 70
+        is_tax_unit_head: true
+        immigration_status: CITIZEN
+        social_security_retirement: 6_000 # 500 a month
+      person2:
+        age: 72
+        is_tax_unit_head: true
+        immigration_status: LEGAL_PERMANENT_RESIDENT
+        years_since_us_entry: 10
+        ssi_qualifying_quarters_earnings: 0
+        pension_income: 6_000 # 500 a month
+    tax_units:
+      tax_unit1:
+        members: [person1]
+      tax_unit2:
+        members: [person2]
+    marital_units:
+      marital_unit1:
+        members: [person1]
+      marital_unit2:
+        members: [person2]
+    spm_units:
+      spm_unit:
+        members: [person1, person2]
+    households:
+      household:
+        members: [person1, person2]
+        state_code: CA
+  output:
+    # person2 is an LPR with fewer than 40 quarters, so SSI and the state
+    # supplement bar her and she is CAPI-eligible.
+    ca_capi_eligible_person: [false, true]
+    # Each has 500 - 20 = 480 a month of countable income.
+    ssi_countable_income: [5_760, 5_760]
+    # person1's SSI is 967 - 480 = 487 a month.
+    ssi: [5_844, 0] # 487 * 12
+    # One eligible aged member, and living_arrangements_allow_for_food_preparation
+    # defaults to false, so the standard is 1,206.94 + 128.87 = 1,335.81.
+    ca_state_supplement_payment_standard: 16_029.72 # 1,335.81 * 12
+    # The supplement is 1,335.81 - 487 - 480 = 368.81 a month; person2's 480
+    # is not counted.
+    ca_state_supplement: 4_425.72 # 368.81 * 12