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Limit Arkansas's Medicaid aged, blind and disabled pathway to aged people, and apply Maine's savings exclusion and couple disregard - #10386

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@hua7450 hua7450 commented Oct 22, 2026

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Closes #10385

Stacked on #10361. Until #10361 merges, the diff also shows its three commits. This PR's own change is commit 08cfcae.

What and why

Arkansas: ARSeniors covers only aged people

is_optional_senior_or_disabled_for_medicaid accepts anyone who is is_ssi_aged_blind_disabled. Arkansas's group for this pathway, ARSeniors, covers only people aged 65 or older.

  • New parameter senior_or_disabled.covers_blind_or_disabled, by state. It is false for Arkansas from 2002-10-01, when ARSeniors started (Policy Directive MS 02-07), and true elsewhere from 2018-01-01. That date matches the other senior_or_disabled files.
  • is_optional_senior_or_disabled_for_medicaid: where the flag is false, the person must be is_ssi_aged (65 or older) instead of is_ssi_aged_blind_disabled.

Maine: savings exclusion

Maine excludes up to $8,000 of savings for an individual and $12,000 for a couple. Only the excess counts toward the $2,000 / $3,000 limit. The model counted all of ssi_countable_resources.

  • New parameters gov.states.me.dhhs.medicaid.savings_exclusion.individual ($8,000) and .couple ($12,000), from 2002-01-01, the date in 22 M.R.S. § 3174-AA.
  • is_optional_senior_or_disabled_asset_eligible subtracts the exclusion from the marital unit's resources in Maine, floored at zero, before the existing limit test. The couple amount applies when the marital unit has two people. That covers an eligible couple and an eligible person with an ineligible spouse, whose assets are deemed (Part 7, § 7-1, Section 1.3).

Definition of savings. Part 16, § 16-4, Section 4.47 counts as savings: savings and checking accounts, IRAs, Keoghs, annuity cash value, stocks, bonds, mutual funds and life insurance cash surrender value. One exclusion covers all of these accounts together. ssi_countable_resources adds bank_account_assets, stock_assets and bond_assets, all of which are savings under that list. So the exclusion applies to the whole of ssi_countable_resources, and no new inputs are needed. The model doesn't count IRAs, Keoghs, annuities or life insurance as resources at all, so leaving them out of the exclusion changes nothing.

Maine: couple income disregard

Chart 3.1 sets a $20 federal disregard plus a state disregard of $55 for an individual and $80 for a couple, effective July 1, 1987. The individual value ($75) was already right. The couple value changes from $75 to $100, dated 1987-07-01. The ME line stays its own hunk; #10364 edits only the CA, CT and SC lines and appends its references after the Connecticut entries, and the Maine references sit after the KFF entry.

The couple value also feeds medicaid_optional_senior_or_disabled_income_deemed_from_ineligible_spouse. So when SSI deeming applies, an eligible person with an ineligible spouse also gets $100. That matches Part 7, § 7-4, Section 4.3, which uses the "State Disregard for two" for "a couple or an eligible individual with an ineligible spouse".

Sources

Each was read on 2026-10-22.

Rule Source Text
AR aged only Ark. Code R. 016.20.02-014, Policy Directive MS 02-07 (effective October 1, 2002), MS 23110 "The individual must be Aged to qualify for ARSeniors."
AR aged only AR DHS Health Care Eligibility Quick Reference (January 2025) "ARSeniors is only for individuals aged 65 or older."
ME savings 22 M.R.S. § 3174-AA(2), PL 2001, c. 450 "Beginning January 1, 2002 ... Savings. An amount up to $8,000 for an individual and up to $12,000 for a household of more than one person."
ME savings 10-144 C.M.R. ch. 332, Part 16, § 16-4, Section 4.47 "Up to $8,000 of savings for an individual, $12,000 for an assistance unit of two or more. Any amount over the excluded amount is counted toward the asset limit." It applies to the SSI-related categories, except State Supplement.
ME savings 2023 MaineCare Eligibility Guidelines The Aged and Disabled rows' footnote says the same.
ME disregard 10-144 C.M.R. ch. 332, Chart 3.1 "Disregards (eff. 7/1/87) $20.00 Federal disregard $55.00 State disregard for Individual $80.00 State disregard for Couple"
ME disregard 10-144 C.M.R. ch. 332, Part 7, § 7-4, Section 4.3 "Subtract the State Disregard for two ($80.00) ... If countable income is equal to or below 100% of the Federal Poverty Level for two ... the individual or couple is Medicaid eligible."

The AR Quick Reference returns 403 to scripts. It was read through the Wayback Machine capture of 2025-10-30.

Readers checked

Reader Effect
medicaid_category ADULT comes before SENIOR_OR_DISABLED. So blind or disabled Arkansans under 65 who leave the pathway are mostly people on Medicare, who are outside the adult group. They fall to MEDICALLY_NEEDY where they qualify (#10374 switches Arkansas's group on), or to NONE. In Maine, more people with savings, and some couples, now land in SENIOR_OR_DISABLED.
is_209b_ssi_recipient_for_medicaid Reads is_optional_senior_or_disabled_asset_eligible, but neither Arkansas nor Maine is a 209(b) state. Unchanged.
medicaid_group, is_medicaid_eligible and their readers (ACA PTC, Lifeline, CHIP and others) Follow the category. Microsimulation results change for AR and ME.

No partner test has an Arkansas or Maine household. No existing YAML case asserts an output that these changes move.

Tests

  • is_optional_senior_or_disabled_for_medicaid.yaml
    • Case 6: a disabled Arkansan aged 50 with $900 a month of SSDI who doesn't take up SSI. Income-eligible ($10,560 countable, under 80% of the guideline, $12,768) but not covered.
    • Case 7: an Arkansan aged 70 with the same income is covered.
  • is_optional_senior_or_disabled_asset_eligible.yaml
    • A Mainer with $9,000 in the bank is eligible: $1,000 counts, under $2,000.
    • A Mainer with $10,000 is ineligible: $2,000 counts, which is not under $2,000. With the first case, this pins the exclusion at more than $7,000 and at most $8,000.
    • A Maine couple with $9,000 in the bank and $5,000 in stocks is eligible: $2,000 counts, under $3,000. The individual exclusion would leave $6,000.
  • medicaid_optional_senior_or_disabled_countable_income.yaml
    • A Maine couple aged 72 and 70 with $1,100 and $790 a month of Social Security has $1,790 a month countable, or $21,480 a year. That is under the 2026 guideline for two ($21,640), so the couple is income-eligible. With a $75 disregard it would be $21,780, over the guideline.
  • Tests were not run locally; CI validates.

Not changed here

What Source Why
Order of Maine's disregards Part 7, § 7-2, Section 2.1 Maine subtracts the $20 federal disregard, then the $65 and one-half earned income exclusion, then the $55 / $80 state disregard. The model subtracts the combined $75 / $100 as the SSI general exclusion before the earned income exclusion. For unearned income the results match. For someone with only earnings, the model's countable income is $27.50 a month higher for an individual and $40 for a couple.
Maine couple income without SSI deeming's threshold Part 7, § 7-4, Section 4.3 Maine combines all of a couple's gross income for an eligible person with an ineligible spouse. The model follows SSI deeming, which deems spouse income only above a threshold.
ARSeniors' Medicare Savings Program conditions MS 23110 ARSeniors also requires QMB eligibility (Medicare Part A entitlement or conditional eligibility, except for some qualified noncitizens). Not modeled before or after.
Arkansas's asset limit — #10364 updates it.
New York 18 NYCRR 360-4.6(a)(2)(vii) Its deductions, income level and asset limit are left for later.

Merge order

Merge this after #10361 and #10364.

Test merges of this branch (08cfcae) on 2026-10-22:

PR Head Result
#10364 d42beea Conflicts in two test files, both end-of-file appends: is_optional_senior_or_disabled_asset_eligible.yaml and medicaid_optional_senior_or_disabled_countable_income.yaml. Keep both sides. The disregard file and is_optional_senior_or_disabled_asset_eligible.py merge cleanly, and the merged formula applies the Maine exclusion before #10364's MSP-limit selection. Maine's uses_msp_limit is false there.
#10370 a45d7aa Clean
#10373 4e8bfcd Clean
#10374 c8de307 Clean
#10378 ecb28ed Clean

Test plan

  • YAML tests with expected values from the Maine statute and manual and the Arkansas rule (amounts from the 2026 poverty guideline already in the model)
  • Source-conflict register: not applicable (the Maine statute and manual agree; no Arkansas statute is involved)
  • ruff format
  • Changelog fragment in changelog.d/

🤖 Generated with Claude Code

hua7450 and others added 4 commits October 21, 2026 16:57
…SSI recipients

Add gov.hhs.medicaid.eligibility.categories.senior_or_disabled.covers_non_ssi_recipients,
false for AL, DE, GA, KS, KY, MD, MS, NV, NM, SD, TN, TX and WY, and require it in
is_optional_senior_or_disabled_for_medicaid. The 209(b) SSI-recipient path is unchanged.

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
N.D. Admin. Code 75-02-02.1-05 covers aged, blind and disabled people as
categorically needy only if they receive SSI; those who do not are medically
needy under (3)(e). The 209(b) SSI-recipient path does not read the gated
variable, so North Dakota's SSI recipients are unaffected.

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
… exclusion and couple disregard

Arkansas's ARSeniors group covers only people aged 65 or older (MS 23110).
Maine excludes up to $8,000 / $12,000 of savings from countable assets
(22 M.R.S. § 3174-AA(2)), and its couple disregard is $20 plus $80
(10-144 C.M.R. ch. 332, Chart 3.1).

Closes PolicyEngine#10385

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>

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Medicaid ABD pathway: Arkansas aged-only and Maine savings exclusion and couple disregard

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