From ecb28ed4ccd837249e6ebddb4c50bc93512e7128 Mon Sep 17 00:00:00 2001 From: Ziming Date: Wed, 21 Oct 2026 18:18:15 -0400 Subject: [PATCH 1/4] Use state dollar standards for the Medicaid aged, blind and disabled limit Alaska, Idaho, New Hampshire, Vermont and Wisconsin test aged, blind and disabled people who do not receive SSI against a monthly dollar standard of their own, not a share of the poverty guideline. Add uses_state_standard and state_standard parameters (with adds_ssi_rate for the four states whose standard is the SSI rate plus a state amount), one select branch in medicaid_optional_senior_or_disabled_income_limit, and Idaho's below-the-standard income test. Co-Authored-By: Claude Opus 5.5 --- ...dicaid-abd-state-dollar-standards.fixed.md | 1 + .../income/limit/couple.yaml | 13 +- .../income/limit/individual.yaml | 13 +- .../limit/requires_income_below_limit.yaml | 4 +- .../limit/state_standard/adds_ssi_rate.yaml | 29 ++++ .../income/limit/state_standard/couple.yaml | 72 ++++++++++ .../limit/state_standard/individual.yaml | 72 ++++++++++ .../income/limit/uses_state_standard.yaml | 134 ++++++++++++++++++ ...ecipient_income_eligible_for_medicaid.yaml | 34 +++++ ...ional_senior_or_disabled_income_limit.yaml | 128 +++++++++++++++++ ...dicaid_abd_ssi_rate_standard_properties.py | 18 ++- ...ptional_senior_or_disabled_income_limit.py | 15 +- 12 files changed, 503 insertions(+), 30 deletions(-) create mode 100644 changelog.d/medicaid-abd-state-dollar-standards.fixed.md create mode 100644 policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/adds_ssi_rate.yaml create mode 100644 policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml create mode 100644 policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml create mode 100644 policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/uses_state_standard.yaml diff --git a/changelog.d/medicaid-abd-state-dollar-standards.fixed.md b/changelog.d/medicaid-abd-state-dollar-standards.fixed.md new file mode 100644 index 00000000000..da5e0826cb9 --- /dev/null +++ b/changelog.d/medicaid-abd-state-dollar-standards.fixed.md @@ -0,0 +1 @@ +Use state dollar standards, not shares of the poverty guideline, as the Medicaid income limit for aged, blind and disabled people who do not receive SSI in Alaska, Idaho, New Hampshire, Vermont and Wisconsin (from August 2020), and require income below Idaho's standard. diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml index 0eb1c1e8aaa..ed905fc42ef 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml @@ -1,4 +1,4 @@ -description: Maximum countable income limit for a couple to qualify for Medicaid under the optional senior or disabled pathway, as percent of Federal Poverty Line. States whose limit is the SSI federal benefit rate are listed in uses_ssi_federal_benefit_rate and omitted here. +description: Maximum countable income limit for a couple to qualify for Medicaid under the optional senior or disabled pathway, as percent of Federal Poverty Line. States whose limit is the SSI federal benefit rate (uses_ssi_federal_benefit_rate) or a dollar standard of their own (uses_state_standard) in every year are omitted here. metadata: unit: /1 label: Medicaid senior or disabled income limit (couple) @@ -17,9 +17,6 @@ metadata: - title: Connecticut CHOICES Benefits Quick Guide (Rev 04.04.2025) href: https://portal.ct.gov/ads/-/media/ads-beta/choices/choices-benefits-quick-guide.pdf?rev=3b8c59ca12224218bc4c4438649e7ac7#page=1 -AK: - 2018-01-01: 0.74 - 2021-01-01: 0.83 AL: 2018-01-01: 0.75 AZ: @@ -45,9 +42,6 @@ GA: 2018-01-01: 0.75 HI: 2018-01-01: 1.00 -ID: - 2018-01-01: 0.80 - 2021-01-01: 0.78 IL: 2018-01-01: 1.00 IN: @@ -75,8 +69,6 @@ NE: 2018-01-01: 1.00 NV: 2018-01-01: 0.75 -NH: - 2018-01-01: 0.75 NJ: 2018-01-01: 1.00 NM: @@ -103,9 +95,6 @@ TX: 2018-01-01: 0.75 UT: 2018-01-01: 1.00 -VT: - 2018-01-01: 0.74 - 2021-01-01: 0.80 VA: 2018-01-01: 0.80 WV: diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml index 489de5e9165..e16b9a522c5 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml @@ -1,4 +1,4 @@ -description: Maximum countable income limit for an individual to qualify for Medicaid under the optional senior or disabled pathway, as percent of Federal Poverty Line. States whose limit is the SSI federal benefit rate are listed in uses_ssi_federal_benefit_rate and omitted here. +description: Maximum countable income limit for an individual to qualify for Medicaid under the optional senior or disabled pathway, as percent of Federal Poverty Line. States whose limit is the SSI federal benefit rate (uses_ssi_federal_benefit_rate) or a dollar standard of their own (uses_state_standard) in every year are omitted here. metadata: unit: /1 label: Medicaid senior or disabled income limit (individual) @@ -17,9 +17,6 @@ metadata: - title: Connecticut CHOICES Benefits Quick Guide (Rev 04.04.2025) href: https://portal.ct.gov/ads/-/media/ads-beta/choices/choices-benefits-quick-guide.pdf?rev=3b8c59ca12224218bc4c4438649e7ac7#page=1 -AK: - 2018-01-01: 0.74 - 2021-01-01: 0.83 AL: 2018-01-01: 0.75 AZ: @@ -45,9 +42,6 @@ GA: 2018-01-01: 0.75 HI: 2018-01-01: 1.00 -ID: - 2018-01-01: 0.80 - 2021-01-01: 0.78 IL: 2018-01-01: 1.00 IN: @@ -75,8 +69,6 @@ NE: 2018-01-01: 1.00 NV: 2018-01-01: 0.75 -NH: - 2018-01-01: 0.75 NJ: 2018-01-01: 1.00 NM: @@ -103,9 +95,6 @@ TX: 2018-01-01: 0.75 UT: 2018-01-01: 1.00 -VT: - 2018-01-01: 0.74 - 2021-01-01: 0.80 VA: 2018-01-01: 0.80 WV: diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/requires_income_below_limit.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/requires_income_below_limit.yaml index f89e1442506..42781c44f4d 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/requires_income_below_limit.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/requires_income_below_limit.yaml @@ -28,6 +28,8 @@ metadata: href: https://secure.ssa.gov/apps10/poms.nsf/lnx/0502005001 - title: 42 U.S. Code § 1396a(m)(1)(B) - poverty-level aged and disabled group (income that "does not exceed" the state's standard) href: https://www.law.cornell.edu/uscode/text/42/1396a#m_1_B + - title: IDAPA 16.03.05.500 - Financial Need ("The participant has financial need if their allowances ... are more than their income") + href: https://adminrules.idaho.gov/rules/current/16/160305.pdf#page=39 AK: 2018-01-01: false @@ -56,7 +58,7 @@ HI: IA: 2018-01-01: false ID: - 2018-01-01: false + 2018-01-01: true IL: 2018-01-01: false IN: diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/adds_ssi_rate.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/adds_ssi_rate.yaml new file mode 100644 index 00000000000..4f44bc80cc6 --- /dev/null +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/adds_ssi_rate.yaml @@ -0,0 +1,29 @@ +description: The state's Medicaid income standard for aged, blind, or disabled people who do not receive SSI is the SSI federal benefit rate plus the state's amount, rather than the state's amount alone, if this is true. +metadata: + unit: bool + period: year + label: Medicaid senior or disabled state standard adds the SSI rate + breakdown: + - state_code + reference: + - title: 7 AAC 40.310(a) and (c) - Income Eligibility Standards (dollar amounts raised each January by the Social Security cost-of-living percentage) + href: https://www.law.cornell.edu/regulations/alaska/7-AAC-40.310 + - title: IDAPA 16.03.05.501 - Basic Allowance (raised by the dollar amount of each SSI cost-of-living increase) + href: https://adminrules.idaho.gov/rules/current/16/160305.pdf#page=39 + - title: N.H. Code Admin. R. He-W 858.03(c)-(e) - Adult Category Standard of Need (set from the SSI maximum benefit amount) + href: https://gc.nh.gov/rules/state_agencies/he-w800.html + - title: Vermont DVHA, Standards Change for Healthcare 2026, SSI/AABD Payment Maximums (SSI plus the AABD supplement) + href: https://dvha.vermont.gov/sites/dvha/files/documents/Standards_Change_for_Healthcare_2026.pdf#page=7 + - title: Wis. Admin. Code DHS 103.04(1)(c) - SSI-related categorically needy income standard ("the maximum SSI payment including state supplement") + href: https://docs.legis.wisconsin.gov/code/admin_code/dhs/101/103/04/1/c + +AK: + 2018-01-01: false +ID: + 2018-01-01: true +NH: + 2018-01-01: true +VT: + 2018-01-01: true +WI: + 2018-01-01: true diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml new file mode 100644 index 00000000000..82302fce096 --- /dev/null +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml @@ -0,0 +1,72 @@ +description: The state sets this monthly amount as its Medicaid income standard for an aged, blind, or disabled married couple who do not receive SSI, on top of the SSI federal benefit rate for a couple in states that add the two. +metadata: + unit: currency-USD + period: month + label: Medicaid senior or disabled state income standard (couple) + breakdown: + - state_code + reference: + - title: 7 AAC 40.310(a) and (c) - Income Eligibility Standards ($1,047 for an individual and $1,551 for a couple, raised each January by the Social Security cost-of-living percentage) + href: https://www.law.cornell.edu/regulations/alaska/7-AAC-40.310 + - title: Alaska DPA, Adult Public Assistance Need and Maximum Payment Standards, 2018-2021 (need standards for 2018 and 2019) + href: https://web.archive.org/web/20210102211125/http://dpaweb.hss.state.ak.us/POLICY/PDF/APA-Standards.pdf#page=1 + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2020-2021 (archived January 2, 2021) + href: https://web.archive.org/web/20210102215241/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2022-2024 (archived March 9, 2024) + href: https://web.archive.org/web/20240309020647/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2024-2026 + href: http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Medicaid State Plan Amendment AK-26-0001, income disregard between the Adult Public Assistance standard and $1,845 (individual) or $2,732 (couple), effective January 1, 2026 + href: https://www.medicaid.gov/medicaid/spa/downloads/AK-26-0001.pdf#page=13 + - title: IDAPA 16.03.05.501 - Basic Allowance ($545 single and $768 couple, each raised by the dollar amount of each SSI cost-of-living increase since January 1, 2001) + href: https://adminrules.idaho.gov/rules/current/16/160305.pdf#page=39 + - title: "Idaho Medicaid State Plan TN 18-0002, Supplement 6 to Attachment 2.6-A, Income Limits by Living Situation ($783 single and $1,125 couple from April 1, 2018) #page 5-6" + href: https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/ID/ID-18-0002.pdf#page=5 + - title: Idaho Department of Health and Welfare, Medicaid Program Income Limits, AABD Cash and AABD Medicaid (January 2026, $1,047 and $1,511 including the $20 disregard) + href: https://healthandwelfare.idaho.gov/medicaid-program-income-limits + - title: New Hampshire DHHS Supervisory Release SR 18-01, January 2018 Mass Change (standard of need $764 and $1,126; SSI $750 and $1,125) + href: https://www.dhhs.nh.gov/sr_htm/html/sr_18-01_dated_01_18.htm + - title: New Hampshire DHHS Supervisory Release SR 26-01, January 2026 Mass Change (standard of need $1,008 and $1,492; SSI $994 and $1,491) + href: https://www.dhhs.nh.gov/sr_htm/html/sr_26-01_dated_01_26.htm + - title: New Hampshire Medical Assistance Manual 601 Table A, Income Limits (SR 26-01) + href: https://www.dhhs.nh.gov/mam_htm/html/601_table_a_income_limits_mam.htm + - title: "Vermont DCF Bulletin 17-26, SSI/AABD payment levels and P-2740A (effective January 1, 2018) #page 4,11" + href: https://outside.vermont.gov/dept/DCF/Shared%20Documents/ESD/Rules-Adopted/B17-26.pdf#page=4 + - title: Vermont DVHA, 2024 Standards Change for Healthcare, SSI/AABD Payment Maximums (effective January 1, 2024) + href: https://dvha.vermont.gov/sites/dvha/files/documents/2024%20Standards%20Change%20for%20Healthcare%20FINAL%20Corrected%2012.19.pdf#page=7 + - title: "Vermont DVHA, Standards Change for Healthcare 2026, SSI/AABD payment levels and maximums (effective January 1, 2026) #page 2,7" + href: https://dvha.vermont.gov/sites/dvha/files/documents/Standards_Change_for_Healthcare_2026.pdf#page=2 + - title: "Wisconsin DHS Operations Memo 20-13, SSI-Related Medicaid Categorically Needy Income Limit Changes ($866.78 and $1,307.05 from the August 2020 benefit month) #page 1-2" + href: https://www.dhs.wisconsin.gov/dms/memos/ops/dms-ops-2020-13.pdf#page=1 + - title: Wisconsin Medicaid Eligibility Handbook 39.4 - Elderly, Blind, or Disabled Assets and Income Table and SSI Reference Values + href: https://www.emhandbooks.wisconsin.gov/meh-ebd/policy_files/39/39.4.htm + - title: Wisconsin DHS Operations Memo 26-12, State Supplementary Payment increase (effective May 1, 2026) + href: https://www.dhs.wisconsin.gov/dms/memos/ops/dms-ops-2026-12.pdf#page=2 + +# Alaska: the 7 AAC 40.310 standard. Until 2019 it was the Adult Public +# Assistance need standard; since January 2020 the state plan disregards +# income between the Adult Public Assistance standard and this amount. +AK: + 2018-01-01: 2_063 + 2019-01-01: 2_121 + 2020-01-01: 2_155 + 2021-01-01: 2_183 + 2022-01-01: 2_312 + 2023-01-01: 2_513 + 2024-01-01: 2_593 + 2025-01-01: 2_658 + 2026-01-01: 2_732 +# Idaho: the AABD basic allowance, equal to the SSI couple rate. +ID: + 2018-01-01: 0 +# New Hampshire: the standard of need, $1 above the SSI couple rate in every year from 2018. +NH: + 2018-01-01: 1 +# Vermont: the AABD supplement for independent living. +VT: + 2018-01-01: 98.88 + 2024-01-01: 105.8 +# Wisconsin: the state supplementary payment for an eligible couple. +WI: + 2020-08-01: 132.05 + 2026-05-01: 145.26 diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml new file mode 100644 index 00000000000..52bc391a012 --- /dev/null +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml @@ -0,0 +1,72 @@ +description: The state sets this monthly amount as its Medicaid income standard for an aged, blind, or disabled individual who does not receive SSI, on top of the SSI federal benefit rate for an individual in states that add the two. +metadata: + unit: currency-USD + period: month + label: Medicaid senior or disabled state income standard (individual) + breakdown: + - state_code + reference: + - title: 7 AAC 40.310(a) and (c) - Income Eligibility Standards ($1,047 for an individual and $1,551 for a couple, raised each January by the Social Security cost-of-living percentage) + href: https://www.law.cornell.edu/regulations/alaska/7-AAC-40.310 + - title: Alaska DPA, Adult Public Assistance Need and Maximum Payment Standards, 2018-2021 (need standards for 2018 and 2019) + href: https://web.archive.org/web/20210102211125/http://dpaweb.hss.state.ak.us/POLICY/PDF/APA-Standards.pdf#page=1 + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2020-2021 (archived January 2, 2021) + href: https://web.archive.org/web/20210102215241/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2022-2024 (archived March 9, 2024) + href: https://web.archive.org/web/20240309020647/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2024-2026 + href: http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Medicaid State Plan Amendment AK-26-0001, income disregard between the Adult Public Assistance standard and $1,845 (individual) or $2,732 (couple), effective January 1, 2026 + href: https://www.medicaid.gov/medicaid/spa/downloads/AK-26-0001.pdf#page=13 + - title: IDAPA 16.03.05.501 - Basic Allowance ($545 single and $768 couple, each raised by the dollar amount of each SSI cost-of-living increase since January 1, 2001) + href: https://adminrules.idaho.gov/rules/current/16/160305.pdf#page=39 + - title: "Idaho Medicaid State Plan TN 18-0002, Supplement 6 to Attachment 2.6-A, Income Limits by Living Situation ($783 single and $1,125 couple from April 1, 2018) #page 5-6" + href: https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/ID/ID-18-0002.pdf#page=5 + - title: Idaho Department of Health and Welfare, Medicaid Program Income Limits, AABD Cash and AABD Medicaid (January 2026, $1,047 and $1,511 including the $20 disregard) + href: https://healthandwelfare.idaho.gov/medicaid-program-income-limits + - title: New Hampshire DHHS Supervisory Release SR 18-01, January 2018 Mass Change (standard of need $764 and $1,126; SSI $750 and $1,125) + href: https://www.dhhs.nh.gov/sr_htm/html/sr_18-01_dated_01_18.htm + - title: New Hampshire DHHS Supervisory Release SR 26-01, January 2026 Mass Change (standard of need $1,008 and $1,492; SSI $994 and $1,491) + href: https://www.dhhs.nh.gov/sr_htm/html/sr_26-01_dated_01_26.htm + - title: New Hampshire Medical Assistance Manual 601 Table A, Income Limits (SR 26-01) + href: https://www.dhhs.nh.gov/mam_htm/html/601_table_a_income_limits_mam.htm + - title: "Vermont DCF Bulletin 17-26, SSI/AABD payment levels and P-2740A (effective January 1, 2018) #page 4,11" + href: https://outside.vermont.gov/dept/DCF/Shared%20Documents/ESD/Rules-Adopted/B17-26.pdf#page=4 + - title: Vermont DVHA, 2024 Standards Change for Healthcare, SSI/AABD Payment Maximums (effective January 1, 2024) + href: https://dvha.vermont.gov/sites/dvha/files/documents/2024%20Standards%20Change%20for%20Healthcare%20FINAL%20Corrected%2012.19.pdf#page=7 + - title: "Vermont DVHA, Standards Change for Healthcare 2026, SSI/AABD payment levels and maximums (effective January 1, 2026) #page 2,7" + href: https://dvha.vermont.gov/sites/dvha/files/documents/Standards_Change_for_Healthcare_2026.pdf#page=2 + - title: "Wisconsin DHS Operations Memo 20-13, SSI-Related Medicaid Categorically Needy Income Limit Changes ($866.78 and $1,307.05 from the August 2020 benefit month) #page 1-2" + href: https://www.dhs.wisconsin.gov/dms/memos/ops/dms-ops-2020-13.pdf#page=1 + - title: Wisconsin Medicaid Eligibility Handbook 39.4 - Elderly, Blind, or Disabled Assets and Income Table and SSI Reference Values + href: https://www.emhandbooks.wisconsin.gov/meh-ebd/policy_files/39/39.4.htm + - title: Wisconsin DHS Operations Memo 26-12, State Supplementary Payment increase (effective May 1, 2026) + href: https://www.dhs.wisconsin.gov/dms/memos/ops/dms-ops-2026-12.pdf#page=2 + +# Alaska: the 7 AAC 40.310 standard. Until 2019 it was the Adult Public +# Assistance need standard; since January 2020 the state plan disregards +# income between the Adult Public Assistance standard and this amount. +AK: + 2018-01-01: 1_393 + 2019-01-01: 1_432 + 2020-01-01: 1_455 + 2021-01-01: 1_474 + 2022-01-01: 1_561 + 2023-01-01: 1_697 + 2024-01-01: 1_751 + 2025-01-01: 1_795 + 2026-01-01: 1_845 +# Idaho: the AABD basic allowance, $33 above the SSI rate. +ID: + 2018-01-01: 33 +# New Hampshire: the standard of need, $14 above the SSI rate in every year from 2018. +NH: + 2018-01-01: 14 +# Vermont: the AABD supplement for independent living. +VT: + 2018-01-01: 52.04 + 2024-01-01: 55.68 +# Wisconsin: the state supplementary payment for an eligible individual. +WI: + 2020-08-01: 83.78 + 2026-05-01: 92.16 diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/uses_state_standard.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/uses_state_standard.yaml new file mode 100644 index 00000000000..cac2a3aadf3 --- /dev/null +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/uses_state_standard.yaml @@ -0,0 +1,134 @@ +description: The state tests the Medicaid income of aged, blind, or disabled people who do not receive SSI against a monthly dollar standard of its own, rather than a share of the federal poverty guideline, if this is true. +metadata: + unit: bool + period: year + label: Medicaid senior or disabled income limit is a state dollar standard + breakdown: + - state_code + reference: + - title: 42 CFR 435.210 - Optional eligibility for individuals who meet the income and resource requirements of the cash assistance programs + href: https://www.ecfr.gov/current/title-42/section-435.210 + - title: 7 AAC 100.400(a)(17) - Applies the Adult Public Assistance income eligibility standards of 7 AAC 40.310 to Medicaid for aged and disabled people + href: https://www.law.cornell.edu/regulations/alaska/7-AAC-100.400 + - title: 7 AAC 100.410(c) - Medicaid for an individual eligible for SSI or Adult Public Assistance who chooses not to receive the cash benefit + href: https://www.law.cornell.edu/regulations/alaska/7-AAC-100.410 + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual 530 C - Use of the Refused Cash Medicaid subtype (from January 2020) + href: http://dpaweb.hss.state.ak.us/manuals/adltc/530_ssi_and_apa_related_categories/530_ssi_and_apa_related_categories.htm + - title: "IDAPA 16.03.05.301.01 (AABD-Medicaid without applying for SSI), 16.03.05.500 (financial need) and 16.03.05.501 (basic allowance) #page 28,39" + href: https://adminrules.idaho.gov/rules/current/16/160305.pdf#page=28 + - title: "Idaho Medicaid State Plan TN 18-0002, Supplement 6 to Attachment 2.6-A, Income Limits by Living Situation #page 5-6" + href: https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/ID/ID-18-0002.pdf#page=5 + - title: N.H. Code Admin. R. He-W 802.04(b)(1) (categorically needy group of 42 CFR 435.210) and He-W 858.03 (adult category standard of need) + href: https://gc.nh.gov/rules/state_agencies/he-w800.html + - title: "Vermont Health Benefits Eligibility and Enrollment Rules § 8.05(b) - Individual who is SSI-eligible (income \"at or below the SSI/AABD payment level\") #page 10-11" + href: https://humanservices.vermont.gov/sites/ahsnew/files/documents/HBEE-Part-2-Eligibility-Standards.pdf#page=10 + - title: Wis. Admin. Code DHS 103.04(1)(c) - SSI-related categorically needy income standard ("the maximum SSI payment including state supplement") + href: https://docs.legis.wisconsin.gov/code/admin_code/dhs/101/103/04/1/c + - title: "Wisconsin DHS Operations Memo 20-13, SSI-Related Medicaid Categorically Needy Income Limit Changes (fixed amounts from the August 2020 benefit month) #page 1-2" + href: https://www.dhs.wisconsin.gov/dms/memos/ops/dms-ops-2020-13.pdf#page=1 + +AK: + 2018-01-01: true +AL: + 2018-01-01: false +AR: + 2018-01-01: false +AZ: + 2018-01-01: false +CA: + 2018-01-01: false +CO: + 2018-01-01: false +CT: + 2018-01-01: false +DC: + 2018-01-01: false +DE: + 2018-01-01: false +FL: + 2018-01-01: false +GA: + 2018-01-01: false +HI: + 2018-01-01: false +IA: + 2018-01-01: false +ID: + 2018-01-01: true +IL: + 2018-01-01: false +IN: + 2018-01-01: false +KS: + 2018-01-01: false +KY: + 2018-01-01: false +LA: + 2018-01-01: false +MA: + 2018-01-01: false +MD: + 2018-01-01: false +ME: + 2018-01-01: false +MI: + 2018-01-01: false +MN: + 2018-01-01: false +MO: + 2018-01-01: false +MS: + 2018-01-01: false +MT: + 2018-01-01: false +NC: + 2018-01-01: false +ND: + 2018-01-01: false +NE: + 2018-01-01: false +NH: + 2018-01-01: true +NJ: + 2018-01-01: false +NM: + 2018-01-01: false +NV: + 2018-01-01: false +NY: + 2018-01-01: false +OH: + 2018-01-01: false +OK: + 2018-01-01: false +OR: + 2018-01-01: false +PA: + 2018-01-01: false +RI: + 2018-01-01: false +SC: + 2018-01-01: false +SD: + 2018-01-01: false +TN: + 2018-01-01: false +TX: + 2018-01-01: false +UT: + 2018-01-01: false +VA: + 2018-01-01: false +VT: + 2018-01-01: true +WA: + 2018-01-01: false +# Until July 2020 Wisconsin's standard added the person's shelter costs up to a +# cap, so the share of the poverty guideline is kept for those years. +WI: + 2018-01-01: false + 2020-08-01: true +WV: + 2018-01-01: false +WY: + 2018-01-01: false diff --git a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_209b_ssi_recipient_income_eligible_for_medicaid.yaml b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_209b_ssi_recipient_income_eligible_for_medicaid.yaml index dd728b65cfc..82e395efa81 100644 --- a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_209b_ssi_recipient_income_eligible_for_medicaid.yaml +++ b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_209b_ssi_recipient_income_eligible_for_medicaid.yaml @@ -161,3 +161,37 @@ # 22,000 - 400 = 21,600, within the 21,648 blind couple standard # (ceil(21,640 / 12) x 12) but over the 18,396 aged/disabled standard. is_209b_ssi_recipient_income_eligible_for_medicaid: [true, true] + +# New Hampshire tests SSI recipients against its standard of need for an +# independent couple, $1,492 a month in 2026 (SR 26-01; MAM 601 Table A; +# He-W 858.03), the SSI couple rate plus $1. This couple has $720 a month of +# Social Security each: $1,420 of countable income after the $20 couple +# disregard, so they receive $71 a month of SSI. 75% of the 2026 two-person +# poverty guideline ($1,353 a month) would deny them unless they spent down. +- name: Case 10, New Hampshire SSI couple under the standard of need qualifies without spenddown. + period: 2026 + input: + people: + person1: + age: 72 + medicaid_optional_senior_or_disabled_countable_income: 8_520 + medicaid_medically_needy_medical_expenses: 0 + person2: + age: 70 + medicaid_optional_senior_or_disabled_countable_income: 8_520 + medicaid_medically_needy_medical_expenses: 0 + tax_units: + tax_unit: + members: [person1, person2] + tax_unit_is_joint: true + marital_units: + marital_unit: + members: [person1, person2] + households: + household: + members: [person1, person2] + state_code: NH + output: + # (1,491 + 1) x 12 = 17,904; combined income 17,040. + medicaid_optional_senior_or_disabled_income_limit: [17_904, 17_904] + is_209b_ssi_recipient_income_eligible_for_medicaid: [true, true] diff --git a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml index 0b6ce7ffb1f..72b96ab0dc2 100644 --- a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml +++ b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml @@ -409,3 +409,131 @@ output: # 967 x 12 medicaid_optional_senior_or_disabled_income_limit: [11_604] + +# Alaska tests these people against the 7 AAC 40.310 standard, which the +# state plan reaches by disregarding income between the Adult Public +# Assistance standard ($1,356 and $2,019 a month in 2026) and $1,845 for an +# individual or $2,732 for a couple (AK-26-0001; ADLTC Manual Addendum 1). +# The couple here has $1,376 a month of Social Security each, $2,732 of +# countable income after the $20 disregard: exactly the couple standard, +# which "may not exceed" allows (7 AAC 40.230). 83% of Alaska's 2026 +# two-person poverty guideline would be $1,871 a month. +- name: Alaska couple with income at the 2026 couple standard is eligible + period: 2026 + input: + people: + person1: + age: 70 + medicaid_optional_senior_or_disabled_countable_income: 16_392 + person2: + age: 68 + medicaid_optional_senior_or_disabled_countable_income: 16_392 + tax_units: + tax_unit: + members: [person1, person2] + tax_unit_is_joint: true + marital_units: + marital_unit: + members: [person1, person2] + households: + household: + members: [person1, person2] + state_code: AK + output: + # 2,732 x 12 + medicaid_optional_senior_or_disabled_income_limit: [32_784, 32_784] + is_optional_senior_or_disabled_income_eligible: [true, true] + +# Vermont tests these people against the SSI/AABD payment level, "at or +# below" (HBEE § 8.05(b)): the SSI couple rate of $1,491 plus the $105.80 +# AABD supplement, $1,596.80 a month in 2026 (DVHA Standards Change for +# Healthcare 2026). The couple here has $808.40 a month of Social Security +# each, $1,596.80 of countable income after the $20 disregard. 80% of the +# 2026 two-person poverty guideline would be $1,443 a month. +- name: Vermont couple with income at the 2026 SSI/AABD couple level is eligible + period: 2026 + input: + people: + person1: + age: 72 + medicaid_optional_senior_or_disabled_countable_income: 9_580.8 + person2: + age: 70 + medicaid_optional_senior_or_disabled_countable_income: 9_580.8 + tax_units: + tax_unit: + members: [person1, person2] + tax_unit_is_joint: true + marital_units: + marital_unit: + members: [person1, person2] + households: + household: + members: [person1, person2] + state_code: VT + output: + # (1,491 + 105.80) x 12 + medicaid_optional_senior_or_disabled_income_limit: + [19_161.6, 19_161.6] + is_optional_senior_or_disabled_income_eligible: [true, true] + +# Wisconsin's categorically needy standard is "the maximum SSI payment +# including state supplement" (DHS 103.04(1)(c)): $994 plus the $83.78 +# supplement, $1,077.78 a month from January 2026 (MEH 39.4.1). 100% of the +# poverty guideline ($1,330) is Wisconsin's medically needy limit, so a +# person with $1,097.83 a month of Social Security ($1,077.83 countable) is +# over the categorically needy standard by five cents a month. +- name: Wisconsin individual just over the 2026 categorically needy standard is ineligible + period: 2026 + input: + people: + person1: + age: 70 + medicaid_optional_senior_or_disabled_countable_income: 12_934 + households: + household: + members: [person1] + state_code: WI + output: + # (994 + 83.78) x 12 + medicaid_optional_senior_or_disabled_income_limit: [12_933.36] + is_optional_senior_or_disabled_income_eligible: [false] + +# Until July 2020 Wisconsin's standard was a base amount plus the person's +# shelter costs up to a cap (DHS Operations Memo 20-13), so 2020 keeps the +# share of the poverty guideline: 0.83 x 12,760. +- name: Wisconsin keeps the poverty guideline share before August 2020 + period: 2020 + input: + people: + person1: + age: 70 + households: + household: + members: [person1] + state_code: WI + output: + medicaid_optional_senior_or_disabled_income_limit: [10_590.8] + +# Idaho tests these people against the AABD basic allowance (IDAPA +# 16.03.05.301.01 and 501): $545 raised by each dollar SSI increase since +# 2001, $1,027 a month in 2026, $33 above the SSI rate. DHW publishes it as +# a $1,047 gross limit including the $20 disregard. A person has financial +# need only if the allowance is "more than their income" (IDAPA +# 16.03.05.500), so $1,047 of Social Security ($1,027 countable) does not +# qualify. 78% of the 2026 one-person guideline would be $1,037 a month. +- name: Idaho individual with income equal to the 2026 AABD allowance is ineligible + period: 2026 + input: + people: + person1: + age: 70 + medicaid_optional_senior_or_disabled_countable_income: 12_324 + households: + household: + members: [person1] + state_code: ID + output: + # (994 + 33) x 12 + medicaid_optional_senior_or_disabled_income_limit: [12_324] + is_optional_senior_or_disabled_income_eligible: [false] diff --git a/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py b/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py index f9f38924c16..929105cea3b 100644 --- a/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py +++ b/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py @@ -38,7 +38,9 @@ of income gets Medicaid without SSI at or above the rate. A last test checks that states which are not flagged keep the share of the -poverty guideline that their parameter gives. +poverty guideline that their parameter gives. States with a dollar standard +of their own (`uses_state_standard`) are tested in +medicaid_optional_senior_or_disabled_income_limit.yaml. """ import numpy as np @@ -91,6 +93,12 @@ # Annual dollars around the standard: far below, one month's dollar below, # exactly at, one dollar above, and well above. OFFSETS = [-6_000, -12, -1, 0, 1, 12, 42, 600, 6_000] +# States with a dollar standard of their own (uses_state_standard.yaml). Of +# these, Idaho also requires income below the standard: a person has +# financial need if "their allowances ... are more than their income" +# (IDAPA 16.03.05.500). +STATE_STANDARD_STATES = ["AK", "ID", "NH", "VT", "WI"] +STATE_STANDARD_BELOW_ONLY_STATES = ["ID"] SYSTEM = CountryTaxBenefitSystem() @@ -140,7 +148,9 @@ def test_ssi_rate_states_match_their_rules(year): @pytest.mark.parametrize("year", YEARS) def test_below_only_states_match_their_rules(year): flags = limit_parameters(year).requires_income_below_limit - assert states_where(flags) == BELOW_ONLY_STATES + assert states_where(flags) == sorted( + BELOW_ONLY_STATES + STATE_STANDARD_BELOW_ONLY_STATES + ) @pytest.mark.parametrize("couple", [False, True]) @@ -236,7 +246,9 @@ def test_unflagged_states_keep_their_share_of_the_poverty_guideline(year, couple # Missouri publishes whole-dollar monthly standards and is tested in # medicaid_optional_senior_or_disabled_income_limit.yaml. states = [ - state for state in STATES if state not in SSI_RATE_STATES and state != "MO" + state + for state in STATES + if state not in SSI_RATE_STATES + STATE_STANDARD_STATES and state != "MO" ] simulation = unit_simulation(year, states, couple) limit = simulation.calculate( diff --git a/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py b/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py index cb5260bda63..cb5653ff04c 100644 --- a/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py +++ b/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py @@ -52,8 +52,19 @@ def formula(person, period, parameters): ssi = parameters(period).gov.ssa.ssi.amount ssi_rate = where(is_couple, ssi.couple, ssi.individual) * MONTHS_IN_YEAR uses_ssi_rate = p.income.limit.uses_ssi_federal_benefit_rate[state].astype(bool) + # Other states set a monthly dollar standard of their own. In most it + # is the SSI rate plus a state amount, such as the state supplement. + standard = p.income.limit.state_standard + state_amount = where( + is_couple, standard.couple[state], standard.individual[state] + ) + adds_ssi_rate = standard.adds_ssi_rate[state].astype(bool) + state_standard = state_amount * MONTHS_IN_YEAR + where( + adds_ssi_rate, ssi_rate, 0 + ) + uses_state_standard = p.income.limit.uses_state_standard[state].astype(bool) return select( - [is_mo, uses_ssi_rate], - [mo_monthly_limit * MONTHS_IN_YEAR, ssi_rate], + [is_mo, uses_ssi_rate, uses_state_standard], + [mo_monthly_limit * MONTHS_IN_YEAR, ssi_rate, state_standard], default=limit_pct * unit_fpg, ) From c0b3ed4acccdf84147e7842aa69e821a40e032cf Mon Sep 17 00:00:00 2001 From: Ziming Date: Mon, 26 Oct 2026 17:13:46 -0400 Subject: [PATCH 2/4] Fix issues from review: reuse state supplement parameters, index Alaska Read New Hampshire, Vermont and Wisconsin amounts from their state supplement parameters on main (adding Vermont's 2017-2023 history), move Alaska to its own 7 AAC 40.310 parameter uprated by the Social Security COLA, keep only Idaho in state_standard, move the Wisconsin boundary test to 2025 and add 2021 and Vermont 2023 cases, check the state-standard flags in the unit test, and name Idaho as a below-only state. Co-Authored-By: Claude Opus 5.5 --- ...dicaid-abd-state-dollar-standards.fixed.md | 2 +- .../income/limit/couple.yaml | 1 - .../income/limit/individual.yaml | 1 - .../limit/state_standard/adds_ssi_rate.yaml | 29 ---------- .../income/limit/state_standard/couple.yaml | 58 +------------------ .../limit/state_standard/individual.yaml | 58 +------------------ .../income_eligibility_standard/couple.yaml | 39 +++++++++++++ .../individual.yaml | 39 +++++++++++++ .../gov/states/vt/dcf/aabd/amount/couple.yaml | 8 +++ .../states/vt/dcf/aabd/amount/individual.yaml | 8 +++ ...ional_senior_or_disabled_income_limit.yaml | 56 ++++++++++++++---- ...dicaid_abd_ssi_rate_standard_properties.py | 34 +++++++++-- ...onal_senior_or_disabled_income_eligible.py | 8 ++- ...ptional_senior_or_disabled_income_limit.py | 41 ++++++++++--- 14 files changed, 211 insertions(+), 171 deletions(-) delete mode 100644 policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/adds_ssi_rate.yaml create mode 100644 policyengine_us/parameters/gov/states/ak/dpa/ssp/income_eligibility_standard/couple.yaml create mode 100644 policyengine_us/parameters/gov/states/ak/dpa/ssp/income_eligibility_standard/individual.yaml diff --git a/changelog.d/medicaid-abd-state-dollar-standards.fixed.md b/changelog.d/medicaid-abd-state-dollar-standards.fixed.md index da5e0826cb9..c8ab69bd484 100644 --- a/changelog.d/medicaid-abd-state-dollar-standards.fixed.md +++ b/changelog.d/medicaid-abd-state-dollar-standards.fixed.md @@ -1 +1 @@ -Use state dollar standards, not shares of the poverty guideline, as the Medicaid income limit for aged, blind and disabled people who do not receive SSI in Alaska, Idaho, New Hampshire, Vermont and Wisconsin (from August 2020), and require income below Idaho's standard. +Use state dollar standards, not shares of the poverty guideline, as the Medicaid income limit for aged, blind and disabled people who do not receive SSI in Alaska, Idaho, New Hampshire, Vermont and Wisconsin (from August 2020), require income below Idaho's standard, and add Vermont's 2017-2023 AABD independent-living supplement ($52.04 individual, $98.88 couple). diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml index ed905fc42ef..e9959692eee 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml @@ -101,6 +101,5 @@ WV: 2018-01-01: 0.75 WI: 2018-01-01: 0.83 - 2021-01-01: 1.00 WY: 2018-01-01: 0.75 diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml index e16b9a522c5..24c1c747521 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml @@ -101,6 +101,5 @@ WV: 2018-01-01: 0.75 WI: 2018-01-01: 0.83 - 2021-01-01: 1.00 WY: 2018-01-01: 0.75 diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/adds_ssi_rate.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/adds_ssi_rate.yaml deleted file mode 100644 index 4f44bc80cc6..00000000000 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/adds_ssi_rate.yaml +++ /dev/null @@ -1,29 +0,0 @@ -description: The state's Medicaid income standard for aged, blind, or disabled people who do not receive SSI is the SSI federal benefit rate plus the state's amount, rather than the state's amount alone, if this is true. -metadata: - unit: bool - period: year - label: Medicaid senior or disabled state standard adds the SSI rate - breakdown: - - state_code - reference: - - title: 7 AAC 40.310(a) and (c) - Income Eligibility Standards (dollar amounts raised each January by the Social Security cost-of-living percentage) - href: https://www.law.cornell.edu/regulations/alaska/7-AAC-40.310 - - title: IDAPA 16.03.05.501 - Basic Allowance (raised by the dollar amount of each SSI cost-of-living increase) - href: https://adminrules.idaho.gov/rules/current/16/160305.pdf#page=39 - - title: N.H. Code Admin. R. He-W 858.03(c)-(e) - Adult Category Standard of Need (set from the SSI maximum benefit amount) - href: https://gc.nh.gov/rules/state_agencies/he-w800.html - - title: Vermont DVHA, Standards Change for Healthcare 2026, SSI/AABD Payment Maximums (SSI plus the AABD supplement) - href: https://dvha.vermont.gov/sites/dvha/files/documents/Standards_Change_for_Healthcare_2026.pdf#page=7 - - title: Wis. Admin. Code DHS 103.04(1)(c) - SSI-related categorically needy income standard ("the maximum SSI payment including state supplement") - href: https://docs.legis.wisconsin.gov/code/admin_code/dhs/101/103/04/1/c - -AK: - 2018-01-01: false -ID: - 2018-01-01: true -NH: - 2018-01-01: true -VT: - 2018-01-01: true -WI: - 2018-01-01: true diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml index 82302fce096..6ea123b6c6f 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml @@ -1,72 +1,18 @@ -description: The state sets this monthly amount as its Medicaid income standard for an aged, blind, or disabled married couple who do not receive SSI, on top of the SSI federal benefit rate for a couple in states that add the two. +description: The state sets its Medicaid income standard for an aged, blind, or disabled married couple who do not receive SSI at this monthly amount above the SSI federal benefit rate for a couple, where no state program parameter in the model holds that amount. metadata: unit: currency-USD period: month - label: Medicaid senior or disabled state income standard (couple) + label: Medicaid senior or disabled state amount above the SSI couple rate breakdown: - state_code reference: - - title: 7 AAC 40.310(a) and (c) - Income Eligibility Standards ($1,047 for an individual and $1,551 for a couple, raised each January by the Social Security cost-of-living percentage) - href: https://www.law.cornell.edu/regulations/alaska/7-AAC-40.310 - - title: Alaska DPA, Adult Public Assistance Need and Maximum Payment Standards, 2018-2021 (need standards for 2018 and 2019) - href: https://web.archive.org/web/20210102211125/http://dpaweb.hss.state.ak.us/POLICY/PDF/APA-Standards.pdf#page=1 - - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2020-2021 (archived January 2, 2021) - href: https://web.archive.org/web/20210102215241/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm - - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2022-2024 (archived March 9, 2024) - href: https://web.archive.org/web/20240309020647/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm - - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2024-2026 - href: http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm - - title: Alaska Medicaid State Plan Amendment AK-26-0001, income disregard between the Adult Public Assistance standard and $1,845 (individual) or $2,732 (couple), effective January 1, 2026 - href: https://www.medicaid.gov/medicaid/spa/downloads/AK-26-0001.pdf#page=13 - title: IDAPA 16.03.05.501 - Basic Allowance ($545 single and $768 couple, each raised by the dollar amount of each SSI cost-of-living increase since January 1, 2001) href: https://adminrules.idaho.gov/rules/current/16/160305.pdf#page=39 - title: "Idaho Medicaid State Plan TN 18-0002, Supplement 6 to Attachment 2.6-A, Income Limits by Living Situation ($783 single and $1,125 couple from April 1, 2018) #page 5-6" href: https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/ID/ID-18-0002.pdf#page=5 - title: Idaho Department of Health and Welfare, Medicaid Program Income Limits, AABD Cash and AABD Medicaid (January 2026, $1,047 and $1,511 including the $20 disregard) href: https://healthandwelfare.idaho.gov/medicaid-program-income-limits - - title: New Hampshire DHHS Supervisory Release SR 18-01, January 2018 Mass Change (standard of need $764 and $1,126; SSI $750 and $1,125) - href: https://www.dhhs.nh.gov/sr_htm/html/sr_18-01_dated_01_18.htm - - title: New Hampshire DHHS Supervisory Release SR 26-01, January 2026 Mass Change (standard of need $1,008 and $1,492; SSI $994 and $1,491) - href: https://www.dhhs.nh.gov/sr_htm/html/sr_26-01_dated_01_26.htm - - title: New Hampshire Medical Assistance Manual 601 Table A, Income Limits (SR 26-01) - href: https://www.dhhs.nh.gov/mam_htm/html/601_table_a_income_limits_mam.htm - - title: "Vermont DCF Bulletin 17-26, SSI/AABD payment levels and P-2740A (effective January 1, 2018) #page 4,11" - href: https://outside.vermont.gov/dept/DCF/Shared%20Documents/ESD/Rules-Adopted/B17-26.pdf#page=4 - - title: Vermont DVHA, 2024 Standards Change for Healthcare, SSI/AABD Payment Maximums (effective January 1, 2024) - href: https://dvha.vermont.gov/sites/dvha/files/documents/2024%20Standards%20Change%20for%20Healthcare%20FINAL%20Corrected%2012.19.pdf#page=7 - - title: "Vermont DVHA, Standards Change for Healthcare 2026, SSI/AABD payment levels and maximums (effective January 1, 2026) #page 2,7" - href: https://dvha.vermont.gov/sites/dvha/files/documents/Standards_Change_for_Healthcare_2026.pdf#page=2 - - title: "Wisconsin DHS Operations Memo 20-13, SSI-Related Medicaid Categorically Needy Income Limit Changes ($866.78 and $1,307.05 from the August 2020 benefit month) #page 1-2" - href: https://www.dhs.wisconsin.gov/dms/memos/ops/dms-ops-2020-13.pdf#page=1 - - title: Wisconsin Medicaid Eligibility Handbook 39.4 - Elderly, Blind, or Disabled Assets and Income Table and SSI Reference Values - href: https://www.emhandbooks.wisconsin.gov/meh-ebd/policy_files/39/39.4.htm - - title: Wisconsin DHS Operations Memo 26-12, State Supplementary Payment increase (effective May 1, 2026) - href: https://www.dhs.wisconsin.gov/dms/memos/ops/dms-ops-2026-12.pdf#page=2 -# Alaska: the 7 AAC 40.310 standard. Until 2019 it was the Adult Public -# Assistance need standard; since January 2020 the state plan disregards -# income between the Adult Public Assistance standard and this amount. -AK: - 2018-01-01: 2_063 - 2019-01-01: 2_121 - 2020-01-01: 2_155 - 2021-01-01: 2_183 - 2022-01-01: 2_312 - 2023-01-01: 2_513 - 2024-01-01: 2_593 - 2025-01-01: 2_658 - 2026-01-01: 2_732 # Idaho: the AABD basic allowance, equal to the SSI couple rate. ID: 2018-01-01: 0 -# New Hampshire: the standard of need, $1 above the SSI couple rate in every year from 2018. -NH: - 2018-01-01: 1 -# Vermont: the AABD supplement for independent living. -VT: - 2018-01-01: 98.88 - 2024-01-01: 105.8 -# Wisconsin: the state supplementary payment for an eligible couple. -WI: - 2020-08-01: 132.05 - 2026-05-01: 145.26 diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml index 52bc391a012..12fbad1f8c6 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml @@ -1,72 +1,18 @@ -description: The state sets this monthly amount as its Medicaid income standard for an aged, blind, or disabled individual who does not receive SSI, on top of the SSI federal benefit rate for an individual in states that add the two. +description: The state sets its Medicaid income standard for an aged, blind, or disabled individual who does not receive SSI at this monthly amount above the SSI federal benefit rate for an individual, where no state program parameter in the model holds that amount. metadata: unit: currency-USD period: month - label: Medicaid senior or disabled state income standard (individual) + label: Medicaid senior or disabled state amount above the SSI individual rate breakdown: - state_code reference: - - title: 7 AAC 40.310(a) and (c) - Income Eligibility Standards ($1,047 for an individual and $1,551 for a couple, raised each January by the Social Security cost-of-living percentage) - href: https://www.law.cornell.edu/regulations/alaska/7-AAC-40.310 - - title: Alaska DPA, Adult Public Assistance Need and Maximum Payment Standards, 2018-2021 (need standards for 2018 and 2019) - href: https://web.archive.org/web/20210102211125/http://dpaweb.hss.state.ak.us/POLICY/PDF/APA-Standards.pdf#page=1 - - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2020-2021 (archived January 2, 2021) - href: https://web.archive.org/web/20210102215241/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm - - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2022-2024 (archived March 9, 2024) - href: https://web.archive.org/web/20240309020647/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm - - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2024-2026 - href: http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm - - title: Alaska Medicaid State Plan Amendment AK-26-0001, income disregard between the Adult Public Assistance standard and $1,845 (individual) or $2,732 (couple), effective January 1, 2026 - href: https://www.medicaid.gov/medicaid/spa/downloads/AK-26-0001.pdf#page=13 - title: IDAPA 16.03.05.501 - Basic Allowance ($545 single and $768 couple, each raised by the dollar amount of each SSI cost-of-living increase since January 1, 2001) href: https://adminrules.idaho.gov/rules/current/16/160305.pdf#page=39 - title: "Idaho Medicaid State Plan TN 18-0002, Supplement 6 to Attachment 2.6-A, Income Limits by Living Situation ($783 single and $1,125 couple from April 1, 2018) #page 5-6" href: https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/ID/ID-18-0002.pdf#page=5 - title: Idaho Department of Health and Welfare, Medicaid Program Income Limits, AABD Cash and AABD Medicaid (January 2026, $1,047 and $1,511 including the $20 disregard) href: https://healthandwelfare.idaho.gov/medicaid-program-income-limits - - title: New Hampshire DHHS Supervisory Release SR 18-01, January 2018 Mass Change (standard of need $764 and $1,126; SSI $750 and $1,125) - href: https://www.dhhs.nh.gov/sr_htm/html/sr_18-01_dated_01_18.htm - - title: New Hampshire DHHS Supervisory Release SR 26-01, January 2026 Mass Change (standard of need $1,008 and $1,492; SSI $994 and $1,491) - href: https://www.dhhs.nh.gov/sr_htm/html/sr_26-01_dated_01_26.htm - - title: New Hampshire Medical Assistance Manual 601 Table A, Income Limits (SR 26-01) - href: https://www.dhhs.nh.gov/mam_htm/html/601_table_a_income_limits_mam.htm - - title: "Vermont DCF Bulletin 17-26, SSI/AABD payment levels and P-2740A (effective January 1, 2018) #page 4,11" - href: https://outside.vermont.gov/dept/DCF/Shared%20Documents/ESD/Rules-Adopted/B17-26.pdf#page=4 - - title: Vermont DVHA, 2024 Standards Change for Healthcare, SSI/AABD Payment Maximums (effective January 1, 2024) - href: https://dvha.vermont.gov/sites/dvha/files/documents/2024%20Standards%20Change%20for%20Healthcare%20FINAL%20Corrected%2012.19.pdf#page=7 - - title: "Vermont DVHA, Standards Change for Healthcare 2026, SSI/AABD payment levels and maximums (effective January 1, 2026) #page 2,7" - href: https://dvha.vermont.gov/sites/dvha/files/documents/Standards_Change_for_Healthcare_2026.pdf#page=2 - - title: "Wisconsin DHS Operations Memo 20-13, SSI-Related Medicaid Categorically Needy Income Limit Changes ($866.78 and $1,307.05 from the August 2020 benefit month) #page 1-2" - href: https://www.dhs.wisconsin.gov/dms/memos/ops/dms-ops-2020-13.pdf#page=1 - - title: Wisconsin Medicaid Eligibility Handbook 39.4 - Elderly, Blind, or Disabled Assets and Income Table and SSI Reference Values - href: https://www.emhandbooks.wisconsin.gov/meh-ebd/policy_files/39/39.4.htm - - title: Wisconsin DHS Operations Memo 26-12, State Supplementary Payment increase (effective May 1, 2026) - href: https://www.dhs.wisconsin.gov/dms/memos/ops/dms-ops-2026-12.pdf#page=2 -# Alaska: the 7 AAC 40.310 standard. Until 2019 it was the Adult Public -# Assistance need standard; since January 2020 the state plan disregards -# income between the Adult Public Assistance standard and this amount. -AK: - 2018-01-01: 1_393 - 2019-01-01: 1_432 - 2020-01-01: 1_455 - 2021-01-01: 1_474 - 2022-01-01: 1_561 - 2023-01-01: 1_697 - 2024-01-01: 1_751 - 2025-01-01: 1_795 - 2026-01-01: 1_845 # Idaho: the AABD basic allowance, $33 above the SSI rate. ID: 2018-01-01: 33 -# New Hampshire: the standard of need, $14 above the SSI rate in every year from 2018. -NH: - 2018-01-01: 14 -# Vermont: the AABD supplement for independent living. -VT: - 2018-01-01: 52.04 - 2024-01-01: 55.68 -# Wisconsin: the state supplementary payment for an eligible individual. -WI: - 2020-08-01: 83.78 - 2026-05-01: 92.16 diff --git a/policyengine_us/parameters/gov/states/ak/dpa/ssp/income_eligibility_standard/couple.yaml b/policyengine_us/parameters/gov/states/ak/dpa/ssp/income_eligibility_standard/couple.yaml new file mode 100644 index 00000000000..dfb56155322 --- /dev/null +++ b/policyengine_us/parameters/gov/states/ak/dpa/ssp/income_eligibility_standard/couple.yaml @@ -0,0 +1,39 @@ +description: Alaska sets this amount as the income eligibility standard for a couple living independently under the Adult Public Assistance program. +values: + # The 2018 and 2019 amounts are the Adult Public Assistance need standard. + # Since January 2020, Medicaid disregards income between the Adult Public + # Assistance payment standard and this amount (ADLTC 530 C; AK-26-0001). + 2018-01-01: 2_063 + 2019-01-01: 2_121 + 2020-01-01: 2_155 + 2021-01-01: 2_183 + 2022-01-01: 2_312 + 2023-01-01: 2_513 + 2024-01-01: 2_593 + 2025-01-01: 2_658 + 2026-01-01: 2_732 + +metadata: + unit: currency-USD + period: month + label: Alaska APA income eligibility standard (couple) + # 7 AAC 40.310(c) raises the standards each January 1 by the Social Security + # cost-of-living percentage. + uprating: + parameter: gov.ssa.uprating + rounding: + type: nearest + interval: 1 + reference: + - title: 7 AAC 40.310(a) and (c) - Income Eligibility Standards ($1,047 for an individual and $1,551 for a couple, raised each January by the Social Security cost-of-living percentage) + href: https://www.law.cornell.edu/regulations/alaska/7-AAC-40.310 + - title: Alaska DPA, Adult Public Assistance Need and Maximum Payment Standards, 2018-2021 (need standards for 2018 and 2019) + href: https://web.archive.org/web/20210102211125/http://dpaweb.hss.state.ak.us/POLICY/PDF/APA-Standards.pdf + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2020-2021 (archived January 2, 2021) + href: https://web.archive.org/web/20210102215241/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2022-2024 (archived March 9, 2024) + href: https://web.archive.org/web/20240309020647/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2024-2026 + href: http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Medicaid State Plan Amendment AK-26-0001, income disregard between the Adult Public Assistance standard and $1,845 (individual) or $2,732 (couple), effective January 1, 2026 + href: https://www.medicaid.gov/medicaid/spa/downloads/AK-26-0001.pdf#page=13 diff --git a/policyengine_us/parameters/gov/states/ak/dpa/ssp/income_eligibility_standard/individual.yaml b/policyengine_us/parameters/gov/states/ak/dpa/ssp/income_eligibility_standard/individual.yaml new file mode 100644 index 00000000000..b7c2890fdc9 --- /dev/null +++ b/policyengine_us/parameters/gov/states/ak/dpa/ssp/income_eligibility_standard/individual.yaml @@ -0,0 +1,39 @@ +description: Alaska sets this amount as the income eligibility standard for an individual living independently under the Adult Public Assistance program. +values: + # The 2018 and 2019 amounts are the Adult Public Assistance need standard. + # Since January 2020, Medicaid disregards income between the Adult Public + # Assistance payment standard and this amount (ADLTC 530 C; AK-26-0001). + 2018-01-01: 1_393 + 2019-01-01: 1_432 + 2020-01-01: 1_455 + 2021-01-01: 1_474 + 2022-01-01: 1_561 + 2023-01-01: 1_697 + 2024-01-01: 1_751 + 2025-01-01: 1_795 + 2026-01-01: 1_845 + +metadata: + unit: currency-USD + period: month + label: Alaska APA income eligibility standard (individual) + # 7 AAC 40.310(c) raises the standards each January 1 by the Social Security + # cost-of-living percentage. + uprating: + parameter: gov.ssa.uprating + rounding: + type: nearest + interval: 1 + reference: + - title: 7 AAC 40.310(a) and (c) - Income Eligibility Standards ($1,047 for an individual and $1,551 for a couple, raised each January by the Social Security cost-of-living percentage) + href: https://www.law.cornell.edu/regulations/alaska/7-AAC-40.310 + - title: Alaska DPA, Adult Public Assistance Need and Maximum Payment Standards, 2018-2021 (need standards for 2018 and 2019) + href: https://web.archive.org/web/20210102211125/http://dpaweb.hss.state.ak.us/POLICY/PDF/APA-Standards.pdf + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2020-2021 (archived January 2, 2021) + href: https://web.archive.org/web/20210102215241/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2022-2024 (archived March 9, 2024) + href: https://web.archive.org/web/20240309020647/http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Aged, Disabled and Long Term Care Medicaid Manual, Addendum 1 - Expanded Refused Cash Income Limits, 2024-2026 + href: http://dpaweb.hss.state.ak.us/manuals/adltc/addenda/addendum_1.htm + - title: Alaska Medicaid State Plan Amendment AK-26-0001, income disregard between the Adult Public Assistance standard and $1,845 (individual) or $2,732 (couple), effective January 1, 2026 + href: https://www.medicaid.gov/medicaid/spa/downloads/AK-26-0001.pdf#page=13 diff --git a/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/couple.yaml b/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/couple.yaml index 2615a7a89f6..e958c2d9479 100644 --- a/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/couple.yaml +++ b/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/couple.yaml @@ -9,8 +9,16 @@ metadata: reference: - title: POMS SI 01415.058 M.2.b, Vermont January 2026 couple payment levels href: https://secure.ssa.gov/poms.nsf/lnx/0501415058#m2b + - title: Vermont DCF Bulletin 17-26, P-2740A SSI/AABD Payment Maximums (effective January 1, 2017 and 2018) + href: https://outside.vermont.gov/dept/DCF/Shared%20Documents/ESD/Rules-Adopted/B17-26.pdf#page=11 + - title: Vermont DVHA, 2024 Standards Change for Healthcare, SSI/AABD Payment Maximums (effective January 1, 2023 and 2024) + href: https://dvha.vermont.gov/sites/dvha/files/documents/2024%20Standards%20Change%20for%20Healthcare%20FINAL%20Corrected%2012.19.pdf#page=7 +# The earlier values are recorded for independent living, which the Medicaid +# aged, blind and disabled standard also uses. INDEPENDENT: + 2017-01-01: 98.88 + 2024-01-01: 105.8 2026-01-01: 105.8 HOUSEHOLD_OF_ANOTHER: diff --git a/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/individual.yaml b/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/individual.yaml index 7db6c2a8d35..e328bb5a980 100644 --- a/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/individual.yaml +++ b/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/individual.yaml @@ -9,8 +9,16 @@ metadata: reference: - title: POMS SI 01415.058 M.2.a, Vermont January 2026 recipient payment levels href: https://secure.ssa.gov/poms.nsf/lnx/0501415058#m2a + - title: Vermont DCF Bulletin 17-26, P-2740A SSI/AABD Payment Maximums (effective January 1, 2017 and 2018) + href: https://outside.vermont.gov/dept/DCF/Shared%20Documents/ESD/Rules-Adopted/B17-26.pdf#page=11 + - title: Vermont DVHA, 2024 Standards Change for Healthcare, SSI/AABD Payment Maximums (effective January 1, 2023 and 2024) + href: https://dvha.vermont.gov/sites/dvha/files/documents/2024%20Standards%20Change%20for%20Healthcare%20FINAL%20Corrected%2012.19.pdf#page=7 +# The earlier values are recorded for independent living, which the Medicaid +# aged, blind and disabled standard also uses. INDEPENDENT: + 2017-01-01: 52.04 + 2024-01-01: 55.68 2026-01-01: 55.68 HOUSEHOLD_OF_ANOTHER: diff --git a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml index 72b96ab0dc2..3256d4caed9 100644 --- a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml +++ b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml @@ -478,25 +478,25 @@ is_optional_senior_or_disabled_income_eligible: [true, true] # Wisconsin's categorically needy standard is "the maximum SSI payment -# including state supplement" (DHS 103.04(1)(c)): $994 plus the $83.78 -# supplement, $1,077.78 a month from January 2026 (MEH 39.4.1). 100% of the -# poverty guideline ($1,330) is Wisconsin's medically needy limit, so a -# person with $1,097.83 a month of Social Security ($1,077.83 countable) is -# over the categorically needy standard by five cents a month. -- name: Wisconsin individual just over the 2026 categorically needy standard is ineligible - period: 2026 +# including state supplement" (DHS 103.04(1)(c)): $967 plus the $83.78 +# supplement, $1,050.78 a month from January 2025 (MEH 39.4.1). 100% of the +# 2025 one-person poverty guideline would be $15,650 a year. A person with +# $1,070.83 a month of Social Security ($1,050.83 countable) is over the +# categorically needy standard by five cents a month. +- name: Wisconsin individual just over the 2025 categorically needy standard is ineligible + period: 2025 input: people: person1: age: 70 - medicaid_optional_senior_or_disabled_countable_income: 12_934 + medicaid_optional_senior_or_disabled_countable_income: 12_610 households: household: members: [person1] state_code: WI output: - # (994 + 83.78) x 12 - medicaid_optional_senior_or_disabled_income_limit: [12_933.36] + # (967 + 83.78) x 12 + medicaid_optional_senior_or_disabled_income_limit: [12_609.36] is_optional_senior_or_disabled_income_eligible: [false] # Until July 2020 Wisconsin's standard was a base amount plus the person's @@ -537,3 +537,39 @@ # (994 + 33) x 12 medicaid_optional_senior_or_disabled_income_limit: [12_324] is_optional_senior_or_disabled_income_eligible: [false] + +# From August 2020 Wisconsin's standard is the fixed SSI payment plus the +# state supplement (DHS Operations Memo 20-13), which the model reads from +# January 2021: $794 plus the $83.78 supplement, $877.78 a month in 2021. +# The 0.83 share of the poverty guideline would be 0.83 x 12,880 = 10,690.40. +- name: Wisconsin uses the SSI rate plus the state supplement from 2021 + period: 2021 + input: + people: + person1: + age: 70 + households: + household: + members: [person1] + state_code: WI + output: + # (794 + 83.78) x 12 + medicaid_optional_senior_or_disabled_income_limit: [10_533.36] + +# Before 2024 Vermont's AABD supplement for an individual living +# independently was $52.04 (DCF Bulletin 17-26), so the 2023 SSI/AABD +# payment level was $914 plus $52.04, $966.04 a month (DVHA 2024 Standards +# Change for Healthcare). +- name: Vermont uses the $52.04 AABD supplement before 2024 + period: 2023 + input: + people: + person1: + age: 70 + households: + household: + members: [person1] + state_code: VT + output: + # (914 + 52.04) x 12 + medicaid_optional_senior_or_disabled_income_limit: [11_592.48] diff --git a/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py b/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py index 929105cea3b..199a109d514 100644 --- a/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py +++ b/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py @@ -93,13 +93,29 @@ # Annual dollars around the standard: far below, one month's dollar below, # exactly at, one dollar above, and well above. OFFSETS = [-6_000, -12, -1, 0, 1, 12, 42, 600, 6_000] -# States with a dollar standard of their own (uses_state_standard.yaml). Of -# these, Idaho also requires income below the standard: a person has -# financial need if "their allowances ... are more than their income" -# (IDAPA 16.03.05.500). -STATE_STANDARD_STATES = ["AK", "ID", "NH", "VT", "WI"] +# States with a dollar standard of their own (uses_state_standard.yaml), by +# the first year it applies. Wisconsin's standard became a fixed amount in +# August 2020 (DHS Operations Memo 20-13), read from January 2021. Of these, +# Idaho also requires income below the standard: a person has financial need +# if "their allowances ... are more than their income" (IDAPA 16.03.05.500). +STATE_STANDARD_FIRST_YEARS = { + "AK": 2018, + "ID": 2018, + "NH": 2018, + "VT": 2018, + "WI": 2021, +} STATE_STANDARD_BELOW_ONLY_STATES = ["ID"] + +def state_standard_states(year): + return sorted( + state + for state, first_year in STATE_STANDARD_FIRST_YEARS.items() + if year >= first_year + ) + + SYSTEM = CountryTaxBenefitSystem() @@ -153,6 +169,12 @@ def test_below_only_states_match_their_rules(year): ) +@pytest.mark.parametrize("year", YEARS) +def test_state_standard_states_match_their_rules(year): + flags = limit_parameters(year).uses_state_standard + assert states_where(flags) == state_standard_states(year) + + @pytest.mark.parametrize("couple", [False, True]) @pytest.mark.parametrize("year", YEARS) def test_limit_is_twelve_times_the_published_ssi_rate(year, couple): @@ -248,7 +270,7 @@ def test_unflagged_states_keep_their_share_of_the_poverty_guideline(year, couple states = [ state for state in STATES - if state not in SSI_RATE_STATES + STATE_STANDARD_STATES and state != "MO" + if state not in SSI_RATE_STATES + state_standard_states(year) and state != "MO" ] simulation = unit_simulation(year, states, couple) limit = simulation.calculate( diff --git a/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/is_optional_senior_or_disabled_income_eligible.py b/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/is_optional_senior_or_disabled_income_eligible.py index 859510b9a7b..ba67aa1fcef 100644 --- a/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/is_optional_senior_or_disabled_income_eligible.py +++ b/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/is_optional_senior_or_disabled_income_eligible.py @@ -15,12 +15,13 @@ class is_optional_senior_or_disabled_income_eligible(Variable): "for its optional pathway for aged, blind, or disabled individuals who " "are not otherwise SSI-eligible. The limits are income maxima, so " "income exactly equal to the limit qualifies, except in states whose " - "rules require income below the limit (Oregon)." + "rules require income below the limit (Idaho and Oregon)." ) definition_period = YEAR reference = ( "https://www.law.cornell.edu/uscode/text/42/1396a#m", "https://ch461rules.odhs.oregon.gov/rules/461-155-0250.pdf#page=1", + "https://adminrules.idaho.gov/rules/current/16/160305.pdf#page=39", ) def formula(person, period, parameters): @@ -33,8 +34,9 @@ def formula(person, period, parameters): income_limit = person( "medicaid_optional_senior_or_disabled_income_limit", period ) - # Most states cover income at or below the limit; Oregon requires - # adjusted income "below the standard" (OAR 461-155-0250(3)). + # Most states cover income at or below the limit; Idaho requires + # allowances that "are more than their income" (IDAPA 16.03.05.500) + # and Oregon adjusted income "below the standard" (OAR 461-155-0250(3)). state = person.household("state_code_str", period) p = parameters( period diff --git a/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py b/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py index cb5653ff04c..948084bab6e 100644 --- a/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py +++ b/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py @@ -16,6 +16,8 @@ class medicaid_optional_senior_or_disabled_income_limit(Variable): "https://www.ecfr.gov/current/title-42/section-435.210", "https://dssmanuals.mo.gov/mo-healthnet-for-the-aged-blind-and-disabled/0805-000-00/0805-015-00/0805-015-45-income-maximum/", "https://dssmanuals.mo.gov/wp-content/uploads/2022/07/mhabd-appendix-j.pdf#page=1", + "https://www.law.cornell.edu/regulations/alaska/7-AAC-40.310", + "https://gc.nh.gov/rules/state_agencies/he-w800.html", ) def formula(person, period, parameters): @@ -52,15 +54,38 @@ def formula(person, period, parameters): ssi = parameters(period).gov.ssa.ssi.amount ssi_rate = where(is_couple, ssi.couple, ssi.individual) * MONTHS_IN_YEAR uses_ssi_rate = p.income.limit.uses_ssi_federal_benefit_rate[state].astype(bool) - # Other states set a monthly dollar standard of their own. In most it - # is the SSI rate plus a state amount, such as the state supplement. - standard = p.income.limit.state_standard - state_amount = where( - is_couple, standard.couple[state], standard.individual[state] + # Other states set a monthly dollar standard of their own: Alaska's + # 7 AAC 40.310 standard, or the SSI rate plus the amount above it in + # New Hampshire's standard of need (He-W 858.03(e)), the Vermont AABD + # or Wisconsin state supplement, or state_standard elsewhere. + states = parameters(period).gov.states + ak = states.ak.dpa.ssp.income_eligibility_standard + nh = states.nh.dhhs.ssp + vt = states.vt.dcf.aabd.amount + wi = states.wi.dhs.ssp.amount + nh_amount = ( + where( + is_couple, + nh.minimum_payment_level.two_person, + nh.minimum_payment_level.one_person.INDEPENDENT, + ) + - nh.standard_disregard[where(is_couple, 2, 1)] ) - adds_ssi_rate = standard.adds_ssi_rate[state].astype(bool) - state_standard = state_amount * MONTHS_IN_YEAR + where( - adds_ssi_rate, ssi_rate, 0 + other = p.income.limit.state_standard + monthly_amount = select( + [state == "NH", state == "VT", state == "WI"], + [ + nh_amount, + where(is_couple, vt.couple.INDEPENDENT, vt.individual.INDEPENDENT), + where(is_couple, wi.couple, wi.individual), + ], + default=where(is_couple, other.couple[state], other.individual[state]), + ) + ak_standard = where(is_couple, ak.couple, ak.individual) * MONTHS_IN_YEAR + state_standard = where( + state == "AK", + ak_standard, + ssi_rate + monthly_amount * MONTHS_IN_YEAR, ) uses_state_standard = p.income.limit.uses_state_standard[state].astype(bool) return select( From 928c372043172511188e82dea6c13624d2cb2550 Mon Sep 17 00:00:00 2001 From: Ziming Date: Mon, 26 Oct 2026 20:24:58 -0400 Subject: [PATCH 3/4] Apply verification fixes: Wisconsin from 2018, Medicaid disregard for NH Use Wisconsin's SSI rate plus state supplement from 2018, which equals the base plus the shelter cap that applied until July 2020 (MEH 39.4.1 Releases 18-01 and 19-02; Ops Memo 20-13), and drop its poverty-guideline shares. Take New Hampshire's standard disregard from the Medicaid parameter (He-W 854.16, as He-W 858.03(e)(2) names), point Idaho's state_standard at the AABD basic allowance (issue 10462), drop Vermont's repeated 2026 entries, and add a 2026 case for the NH and AK individual and ID and WI couple paths. Co-Authored-By: Claude Opus 5.5 --- ...dicaid-abd-state-dollar-standards.fixed.md | 2 +- .../income/limit/couple.yaml | 2 - .../income/limit/individual.yaml | 2 - .../income/limit/state_standard/couple.yaml | 6 +- .../limit/state_standard/individual.yaml | 6 +- .../income/limit/uses_state_standard.yaml | 12 ++- .../gov/states/vt/dcf/aabd/amount/couple.yaml | 1 - .../states/vt/dcf/aabd/amount/individual.yaml | 1 - ...ional_senior_or_disabled_income_limit.yaml | 89 ++++++++++++++----- ...dicaid_abd_ssi_rate_standard_properties.py | 32 ++----- ...ptional_senior_or_disabled_income_limit.py | 19 ++-- 11 files changed, 104 insertions(+), 68 deletions(-) diff --git a/changelog.d/medicaid-abd-state-dollar-standards.fixed.md b/changelog.d/medicaid-abd-state-dollar-standards.fixed.md index c8ab69bd484..08f810ed214 100644 --- a/changelog.d/medicaid-abd-state-dollar-standards.fixed.md +++ b/changelog.d/medicaid-abd-state-dollar-standards.fixed.md @@ -1 +1 @@ -Use state dollar standards, not shares of the poverty guideline, as the Medicaid income limit for aged, blind and disabled people who do not receive SSI in Alaska, Idaho, New Hampshire, Vermont and Wisconsin (from August 2020), require income below Idaho's standard, and add Vermont's 2017-2023 AABD independent-living supplement ($52.04 individual, $98.88 couple). +Use state dollar standards, not shares of the poverty guideline, as the Medicaid income limit for aged, blind and disabled people who do not receive SSI in Alaska, Idaho, New Hampshire, Vermont and Wisconsin, require income below Idaho's standard, and add Vermont's 2017-2023 AABD independent-living supplement ($52.04 individual, $98.88 couple). diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml index e9959692eee..c5b498307dd 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/couple.yaml @@ -99,7 +99,5 @@ VA: 2018-01-01: 0.80 WV: 2018-01-01: 0.75 -WI: - 2018-01-01: 0.83 WY: 2018-01-01: 0.75 diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml index 24c1c747521..e5f9077cd32 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/individual.yaml @@ -99,7 +99,5 @@ VA: 2018-01-01: 0.80 WV: 2018-01-01: 0.75 -WI: - 2018-01-01: 0.83 WY: 2018-01-01: 0.75 diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml index 6ea123b6c6f..28a7b1e1191 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml @@ -1,4 +1,4 @@ -description: The state sets its Medicaid income standard for an aged, blind, or disabled married couple who do not receive SSI at this monthly amount above the SSI federal benefit rate for a couple, where no state program parameter in the model holds that amount. +description: The state adds this monthly amount to the SSI federal benefit rate for a couple to set its Medicaid income standard for aged, blind, or disabled people who do not receive SSI, in states whose standard has no state program parameter in the model. metadata: unit: currency-USD period: month @@ -14,5 +14,9 @@ metadata: href: https://healthandwelfare.idaho.gov/medicaid-program-income-limits # Idaho: the AABD basic allowance, equal to the SSI couple rate. +# NOTE: gov.states.id.dhw.aabd.payment.basic_allowance holds the same +# allowance for Idaho's AABD cash program, still at the 2000 base amounts +# without the 501 increases (PolicyEngine/policyengine-us#10462). Once that +# is fixed, Idaho's Medicaid standard can read from it. ID: 2018-01-01: 0 diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml index 12fbad1f8c6..81b0603dc54 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml @@ -1,4 +1,4 @@ -description: The state sets its Medicaid income standard for an aged, blind, or disabled individual who does not receive SSI at this monthly amount above the SSI federal benefit rate for an individual, where no state program parameter in the model holds that amount. +description: The state adds this monthly amount to the SSI federal benefit rate for an individual to set its Medicaid income standard for aged, blind, or disabled people who do not receive SSI, in states whose standard has no state program parameter in the model. metadata: unit: currency-USD period: month @@ -14,5 +14,9 @@ metadata: href: https://healthandwelfare.idaho.gov/medicaid-program-income-limits # Idaho: the AABD basic allowance, $33 above the SSI rate. +# NOTE: gov.states.id.dhw.aabd.payment.basic_allowance holds the same +# allowance for Idaho's AABD cash program, still at the 2000 base amounts +# without the 501 increases (PolicyEngine/policyengine-us#10462). Once that +# is fixed, Idaho's Medicaid standard can read from it. ID: 2018-01-01: 33 diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/uses_state_standard.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/uses_state_standard.yaml index cac2a3aadf3..101e0cbbefe 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/uses_state_standard.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/uses_state_standard.yaml @@ -26,6 +26,10 @@ metadata: href: https://docs.legis.wisconsin.gov/code/admin_code/dhs/101/103/04/1/c - title: "Wisconsin DHS Operations Memo 20-13, SSI-Related Medicaid Categorically Needy Income Limit Changes (fixed amounts from the August 2020 benefit month) #page 1-2" href: https://www.dhs.wisconsin.gov/dms/memos/ops/dms-ops-2020-13.pdf#page=1 + - title: Wisconsin Medicaid Eligibility Handbook 39.4.1, Release 18-01 (2018 categorically needy limits, $583.78 and $882.05 plus actual shelter up to $250.00 and $375.00) + href: https://www.emhandbooks.wisconsin.gov/meh-ebd/history/18-01/18-01_39.4.htm + - title: Wisconsin Medicaid Eligibility Handbook 39.4.1, Release 19-02 (2019 categorically needy limits, $597.78 and $903.38 plus actual shelter up to $257.00 and $385.67; SSI payment level with the supplement $854.78 and $1,289.05) + href: https://www.emhandbooks.wisconsin.gov/meh-ebd/history/19-02/19-02_39.4.htm AK: 2018-01-01: true @@ -123,11 +127,11 @@ VT: 2018-01-01: true WA: 2018-01-01: false -# Until July 2020 Wisconsin's standard added the person's shelter costs up to a -# cap, so the share of the poverty guideline is kept for those years. +# Until July 2020 Wisconsin's standard was a base amount plus the person's +# shelter costs up to a cap; the base plus the cap equals the SSI rate plus the +# state supplement, which the model uses for those years too. WI: - 2018-01-01: false - 2020-08-01: true + 2018-01-01: true WV: 2018-01-01: false WY: diff --git a/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/couple.yaml b/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/couple.yaml index e958c2d9479..e1df2690011 100644 --- a/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/couple.yaml +++ b/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/couple.yaml @@ -19,7 +19,6 @@ metadata: INDEPENDENT: 2017-01-01: 98.88 2024-01-01: 105.8 - 2026-01-01: 105.8 HOUSEHOLD_OF_ANOTHER: 2026-01-01: 51.69 diff --git a/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/individual.yaml b/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/individual.yaml index e328bb5a980..8194d89589c 100644 --- a/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/individual.yaml +++ b/policyengine_us/parameters/gov/states/vt/dcf/aabd/amount/individual.yaml @@ -19,7 +19,6 @@ metadata: INDEPENDENT: 2017-01-01: 52.04 2024-01-01: 55.68 - 2026-01-01: 55.68 HOUSEHOLD_OF_ANOTHER: 2026-01-01: 42.05 diff --git a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml index 3256d4caed9..905a97a41da 100644 --- a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml +++ b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.yaml @@ -500,9 +500,11 @@ is_optional_senior_or_disabled_income_eligible: [false] # Until July 2020 Wisconsin's standard was a base amount plus the person's -# shelter costs up to a cap (DHS Operations Memo 20-13), so 2020 keeps the -# share of the poverty guideline: 0.83 x 12,760. -- name: Wisconsin keeps the poverty guideline share before August 2020 +# shelter costs up to a cap: $605.78 plus up to $261.00 in 2020 (DHS +# Operations Memo 20-13). The model uses the base plus the cap, $866.78 a +# month, which equals the $783 SSI rate plus the $83.78 supplement. The 0.83 +# share of the poverty guideline would be 0.83 x 12,760 = 10,590.80. +- name: Wisconsin uses the shelter cap, the SSI rate plus the supplement, before August 2020 period: 2020 input: people: @@ -513,7 +515,8 @@ members: [person1] state_code: WI output: - medicaid_optional_senior_or_disabled_income_limit: [10_590.8] + # (783 + 83.78) x 12 + medicaid_optional_senior_or_disabled_income_limit: [10_401.36] # Idaho tests these people against the AABD basic allowance (IDAPA # 16.03.05.301.01 and 501): $545 raised by each dollar SSI increase since @@ -538,24 +541,6 @@ medicaid_optional_senior_or_disabled_income_limit: [12_324] is_optional_senior_or_disabled_income_eligible: [false] -# From August 2020 Wisconsin's standard is the fixed SSI payment plus the -# state supplement (DHS Operations Memo 20-13), which the model reads from -# January 2021: $794 plus the $83.78 supplement, $877.78 a month in 2021. -# The 0.83 share of the poverty guideline would be 0.83 x 12,880 = 10,690.40. -- name: Wisconsin uses the SSI rate plus the state supplement from 2021 - period: 2021 - input: - people: - person1: - age: 70 - households: - household: - members: [person1] - state_code: WI - output: - # (794 + 83.78) x 12 - medicaid_optional_senior_or_disabled_income_limit: [10_533.36] - # Before 2024 Vermont's AABD supplement for an individual living # independently was $52.04 (DCF Bulletin 17-26), so the 2023 SSI/AABD # payment level was $914 plus $52.04, $966.04 a month (DVHA 2024 Standards @@ -573,3 +558,63 @@ output: # (914 + 52.04) x 12 medicaid_optional_senior_or_disabled_income_limit: [11_592.48] + +# The remaining 2026 branches: New Hampshire's individual standard of need, +# $994 + $27 - $13 = $1,008 (SR 26-01; MAM 601 Table A); Alaska's individual +# standard, $1,845 (ADLTC Manual Addendum 1); Idaho's couple allowance, +# $1,491 (DHW's $1,511 less the $20 disregard); and Wisconsin's couple +# standard, $1,491 + $132.05 = $1,623.05 (MEH 39.4.1, Release 26-01). +- name: Individual and couple standards in New Hampshire, Alaska, Idaho and Wisconsin in 2026 + period: 2026 + input: + people: + person1: + age: 70 + person2: + age: 70 + person3: + age: 72 + person4: + age: 70 + person5: + age: 72 + person6: + age: 70 + tax_units: + tax_unit1: + members: [person1] + tax_unit2: + members: [person2] + tax_unit3: + members: [person3, person4] + tax_unit_is_joint: true + tax_unit4: + members: [person5, person6] + tax_unit_is_joint: true + marital_units: + marital_unit1: + members: [person1] + marital_unit2: + members: [person2] + marital_unit3: + members: [person3, person4] + marital_unit4: + members: [person5, person6] + households: + household1: + members: [person1] + state_code: NH + household2: + members: [person2] + state_code: AK + household3: + members: [person3, person4] + state_code: ID + household4: + members: [person5, person6] + state_code: WI + output: + # NH (994 + 27 - 13) x 12; AK 1,845 x 12; ID 1,491 x 12; + # WI (1,491 + 132.05) x 12 + medicaid_optional_senior_or_disabled_income_limit: + [12_096, 22_140, 17_892, 17_892, 19_476.6, 19_476.6] diff --git a/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py b/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py index 199a109d514..4c9064aa283 100644 --- a/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py +++ b/policyengine_us/tests/unit/test_medicaid_abd_ssi_rate_standard_properties.py @@ -93,29 +93,15 @@ # Annual dollars around the standard: far below, one month's dollar below, # exactly at, one dollar above, and well above. OFFSETS = [-6_000, -12, -1, 0, 1, 12, 42, 600, 6_000] -# States with a dollar standard of their own (uses_state_standard.yaml), by -# the first year it applies. Wisconsin's standard became a fixed amount in -# August 2020 (DHS Operations Memo 20-13), read from January 2021. Of these, -# Idaho also requires income below the standard: a person has financial need -# if "their allowances ... are more than their income" (IDAPA 16.03.05.500). -STATE_STANDARD_FIRST_YEARS = { - "AK": 2018, - "ID": 2018, - "NH": 2018, - "VT": 2018, - "WI": 2021, -} +# States with a dollar standard of their own (uses_state_standard.yaml) in +# every year. Before August 2020 Wisconsin's standard was a base amount plus +# shelter costs up to a cap; the model uses the base plus the cap, the SSI +# rate plus the state supplement (DHS Operations Memo 20-13). Of these, Idaho +# also requires income below the standard: a person has financial need if +# "their allowances ... are more than their income" (IDAPA 16.03.05.500). +STATE_STANDARD_STATES = ["AK", "ID", "NH", "VT", "WI"] STATE_STANDARD_BELOW_ONLY_STATES = ["ID"] - -def state_standard_states(year): - return sorted( - state - for state, first_year in STATE_STANDARD_FIRST_YEARS.items() - if year >= first_year - ) - - SYSTEM = CountryTaxBenefitSystem() @@ -172,7 +158,7 @@ def test_below_only_states_match_their_rules(year): @pytest.mark.parametrize("year", YEARS) def test_state_standard_states_match_their_rules(year): flags = limit_parameters(year).uses_state_standard - assert states_where(flags) == state_standard_states(year) + assert states_where(flags) == STATE_STANDARD_STATES @pytest.mark.parametrize("couple", [False, True]) @@ -270,7 +256,7 @@ def test_unflagged_states_keep_their_share_of_the_poverty_guideline(year, couple states = [ state for state in STATES - if state not in SSI_RATE_STATES + state_standard_states(year) and state != "MO" + if state not in SSI_RATE_STATES + STATE_STANDARD_STATES and state != "MO" ] simulation = unit_simulation(year, states, couple) limit = simulation.calculate( diff --git a/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py b/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py index 948084bab6e..b80742551ae 100644 --- a/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py +++ b/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py @@ -56,20 +56,19 @@ def formula(person, period, parameters): uses_ssi_rate = p.income.limit.uses_ssi_federal_benefit_rate[state].astype(bool) # Other states set a monthly dollar standard of their own: Alaska's # 7 AAC 40.310 standard, or the SSI rate plus the amount above it in - # New Hampshire's standard of need (He-W 858.03(e)), the Vermont AABD - # or Wisconsin state supplement, or state_standard elsewhere. + # New Hampshire's standard of need (He-W 858.03(e): the minimum payment + # level less the He-W 854.16 Medicaid standard disregard), the Vermont + # AABD or Wisconsin state supplement, or state_standard elsewhere. states = parameters(period).gov.states ak = states.ak.dpa.ssp.income_eligibility_standard - nh = states.nh.dhhs.ssp + nh_level = states.nh.dhhs.ssp.minimum_payment_level vt = states.vt.dcf.aabd.amount wi = states.wi.dhs.ssp.amount - nh_amount = ( - where( - is_couple, - nh.minimum_payment_level.two_person, - nh.minimum_payment_level.one_person.INDEPENDENT, - ) - - nh.standard_disregard[where(is_couple, 2, 1)] + disregard = p.income.disregard + nh_amount = where( + is_couple, + nh_level.two_person - disregard.couple[state], + nh_level.one_person.INDEPENDENT - disregard.individual[state], ) other = p.income.limit.state_standard monthly_amount = select( From 62b72f6a93d53565a781c61fb8d4feaf5130bd9d Mon Sep 17 00:00:00 2001 From: Ziming Date: Tue, 27 Oct 2026 17:19:10 -0400 Subject: [PATCH 4/4] Make Idaho's Medicaid ABD amount above the SSI rate a scalar parameter state_standard broke down by state but held only Idaho, which the single-member breakdown guard rejects. Move the amounts to state_standard/id and select Idaho alongside New Hampshire, Vermont and Wisconsin. Results are unchanged. Co-Authored-By: Claude Opus 5.5 --- .../limit/state_standard/{ => id}/couple.yaml | 21 ++++++++----------- .../state_standard/{ => id}/individual.yaml | 21 ++++++++----------- ...ptional_senior_or_disabled_income_limit.py | 9 ++++---- 3 files changed, 23 insertions(+), 28 deletions(-) rename policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/{ => id}/couple.yaml (77%) rename policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/{ => id}/individual.yaml (77%) diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/id/couple.yaml similarity index 77% rename from policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml rename to policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/id/couple.yaml index 28a7b1e1191..9d0e3b02d70 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/couple.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/id/couple.yaml @@ -1,10 +1,15 @@ -description: The state adds this monthly amount to the SSI federal benefit rate for a couple to set its Medicaid income standard for aged, blind, or disabled people who do not receive SSI, in states whose standard has no state program parameter in the model. +description: Idaho adds this monthly amount to the SSI federal benefit rate for a couple to set its Medicaid income standard for aged, blind, or disabled people who do not receive SSI. +# Idaho: the AABD basic allowance, equal to the SSI couple rate. +# NOTE: gov.states.id.dhw.aabd.payment.basic_allowance holds the same +# allowance for Idaho's AABD cash program, still at the 2000 base amounts +# without the 501 increases (PolicyEngine/policyengine-us#10462). Once that +# is fixed, Idaho's Medicaid standard can read from it. +values: + 2018-01-01: 0 metadata: unit: currency-USD period: month - label: Medicaid senior or disabled state amount above the SSI couple rate - breakdown: - - state_code + label: Idaho Medicaid senior or disabled amount above the SSI couple rate reference: - title: IDAPA 16.03.05.501 - Basic Allowance ($545 single and $768 couple, each raised by the dollar amount of each SSI cost-of-living increase since January 1, 2001) href: https://adminrules.idaho.gov/rules/current/16/160305.pdf#page=39 @@ -12,11 +17,3 @@ metadata: href: https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/ID/ID-18-0002.pdf#page=5 - title: Idaho Department of Health and Welfare, Medicaid Program Income Limits, AABD Cash and AABD Medicaid (January 2026, $1,047 and $1,511 including the $20 disregard) href: https://healthandwelfare.idaho.gov/medicaid-program-income-limits - -# Idaho: the AABD basic allowance, equal to the SSI couple rate. -# NOTE: gov.states.id.dhw.aabd.payment.basic_allowance holds the same -# allowance for Idaho's AABD cash program, still at the 2000 base amounts -# without the 501 increases (PolicyEngine/policyengine-us#10462). Once that -# is fixed, Idaho's Medicaid standard can read from it. -ID: - 2018-01-01: 0 diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/id/individual.yaml similarity index 77% rename from policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml rename to policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/id/individual.yaml index 81b0603dc54..0dc14fc6547 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/individual.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/income/limit/state_standard/id/individual.yaml @@ -1,10 +1,15 @@ -description: The state adds this monthly amount to the SSI federal benefit rate for an individual to set its Medicaid income standard for aged, blind, or disabled people who do not receive SSI, in states whose standard has no state program parameter in the model. +description: Idaho adds this monthly amount to the SSI federal benefit rate for an individual to set its Medicaid income standard for aged, blind, or disabled people who do not receive SSI. +# Idaho: the AABD basic allowance, $33 above the SSI rate. +# NOTE: gov.states.id.dhw.aabd.payment.basic_allowance holds the same +# allowance for Idaho's AABD cash program, still at the 2000 base amounts +# without the 501 increases (PolicyEngine/policyengine-us#10462). Once that +# is fixed, Idaho's Medicaid standard can read from it. +values: + 2018-01-01: 33 metadata: unit: currency-USD period: month - label: Medicaid senior or disabled state amount above the SSI individual rate - breakdown: - - state_code + label: Idaho Medicaid senior or disabled amount above the SSI individual rate reference: - title: IDAPA 16.03.05.501 - Basic Allowance ($545 single and $768 couple, each raised by the dollar amount of each SSI cost-of-living increase since January 1, 2001) href: https://adminrules.idaho.gov/rules/current/16/160305.pdf#page=39 @@ -12,11 +17,3 @@ metadata: href: https://www.medicaid.gov/State-resource-center/Medicaid-State-Plan-Amendments/Downloads/ID/ID-18-0002.pdf#page=5 - title: Idaho Department of Health and Welfare, Medicaid Program Income Limits, AABD Cash and AABD Medicaid (January 2026, $1,047 and $1,511 including the $20 disregard) href: https://healthandwelfare.idaho.gov/medicaid-program-income-limits - -# Idaho: the AABD basic allowance, $33 above the SSI rate. -# NOTE: gov.states.id.dhw.aabd.payment.basic_allowance holds the same -# allowance for Idaho's AABD cash program, still at the 2000 base amounts -# without the 501 increases (PolicyEngine/policyengine-us#10462). Once that -# is fixed, Idaho's Medicaid standard can read from it. -ID: - 2018-01-01: 33 diff --git a/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py b/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py index b80742551ae..19d55ab4a1d 100644 --- a/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py +++ b/policyengine_us/variables/gov/hhs/medicaid/eligibility/categories/medicaid_optional_senior_or_disabled_income_limit.py @@ -58,7 +58,7 @@ def formula(person, period, parameters): # 7 AAC 40.310 standard, or the SSI rate plus the amount above it in # New Hampshire's standard of need (He-W 858.03(e): the minimum payment # level less the He-W 854.16 Medicaid standard disregard), the Vermont - # AABD or Wisconsin state supplement, or state_standard elsewhere. + # AABD or Wisconsin state supplement, or Idaho's AABD basic allowance. states = parameters(period).gov.states ak = states.ak.dpa.ssp.income_eligibility_standard nh_level = states.nh.dhhs.ssp.minimum_payment_level @@ -70,15 +70,16 @@ def formula(person, period, parameters): nh_level.two_person - disregard.couple[state], nh_level.one_person.INDEPENDENT - disregard.individual[state], ) - other = p.income.limit.state_standard + id_amount = p.income.limit.state_standard.id monthly_amount = select( - [state == "NH", state == "VT", state == "WI"], + [state == "ID", state == "NH", state == "VT", state == "WI"], [ + where(is_couple, id_amount.couple, id_amount.individual), nh_amount, where(is_couple, vt.couple.INDEPENDENT, vt.individual.INDEPENDENT), where(is_couple, wi.couple, wi.individual), ], - default=where(is_couple, other.couple[state], other.individual[state]), + default=0, ) ak_standard = where(is_couple, ak.couple, ak.individual) * MONTHS_IN_YEAR state_standard = where(