diff --git a/changelog.d/ca-medi-cal-asset-limit-2027.fixed.md b/changelog.d/ca-medi-cal-asset-limit-2027.fixed.md new file mode 100644 index 00000000000..8ef1392b9b2 --- /dev/null +++ b/changelog.d/ca-medi-cal-asset-limit-2027.fixed.md @@ -0,0 +1 @@ +California's non-MAGI Medi-Cal asset limit falls to $21,000 for one person and $31,000 for two on July 1, 2027 (SB 164) in the aged, blind and disabled, medically needy, Medicare Savings Program and 250% Working Disabled Program limits; the Working Disabled Program also adds $1,550 for each person beyond two. diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/medically_needy/limit/assets/couple.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/medically_needy/limit/assets/couple.yaml index dc218d5281d..bbbf0333027 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/medically_needy/limit/assets/couple.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/medically_needy/limit/assets/couple.yaml @@ -24,6 +24,8 @@ metadata: href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/22-25.pdf#page=1 - title: "California DHCS All County Welfare Directors Letter 25-14, Reinstatement of Asset Limits for Non-MAGI Medi-Cal Programs #page 1,8-9" href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/25-14.pdf#page=1 + - title: California Senate Bill 164 (Statutes of 2026, Chapter 27), Section 69 - Welfare and Institutions Code 14005.62(a), operative July 1, 2027 + href: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB164 - title: Illinois Department of Human Services Policy Manual PM 07-02-01 - Asset Limits href: https://www.dhs.state.il.us/page.aspx?Item=14876 - title: New York DOH GIS 22 MA/01, Attachment I, 2022 SSI-Related Medicaid Income and Resource Levels @@ -52,6 +54,8 @@ CA: 2022-07-01: 195_000 2024-01-01: .inf 2026-01-01: 195_000 + # Annual calculations read parameters on January 1, so the July 1, 2027 value first applies in 2028. + 2027-07-01: 31_000 CO: 2018-01-01: -.inf CT: diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/medically_needy/limit/assets/individual.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/medically_needy/limit/assets/individual.yaml index 671d6701178..90db6b04853 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/medically_needy/limit/assets/individual.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/medically_needy/limit/assets/individual.yaml @@ -24,6 +24,8 @@ metadata: href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/22-25.pdf#page=1 - title: "California DHCS All County Welfare Directors Letter 25-14, Reinstatement of Asset Limits for Non-MAGI Medi-Cal Programs #page 1,8-9" href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/25-14.pdf#page=1 + - title: California Senate Bill 164 (Statutes of 2026, Chapter 27), Section 69 - Welfare and Institutions Code 14005.62(a), operative July 1, 2027 + href: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB164 - title: Illinois Department of Human Services Policy Manual PM 07-02-01 - Asset Limits href: https://www.dhs.state.il.us/page.aspx?Item=14876 - title: New York DOH GIS 22 MA/01, Attachment I, 2022 SSI-Related Medicaid Income and Resource Levels @@ -52,6 +54,8 @@ CA: 2022-07-01: 130_000 2024-01-01: .inf 2026-01-01: 130_000 + # Annual calculations read parameters on January 1, so the July 1, 2027 value first applies in 2028. + 2027-07-01: 21_000 CO: 2018-01-01: -.inf CT: diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/assets/limit/couple.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/assets/limit/couple.yaml index afea68f27d3..c958037b41f 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/assets/limit/couple.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/assets/limit/couple.yaml @@ -12,6 +12,8 @@ metadata: href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/21-31.pdf#page=2 - title: "Asset Limit Changes for Non-MAGI Medi-Cal | California DHCS (asset limit reinstated at $130,000 plus $65,000 per additional household member effective January 1, 2026)" href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Asset-Limit-Changes-for-Non-MAGI-Medi-Cal.aspx + - title: California Senate Bill 164 (Statutes of 2026, Chapter 27), Section 69 - Welfare and Institutions Code 14005.62(a), operative July 1, 2027 + href: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB164 - title: "California DHCS All County Welfare Directors Letter 25-14 (reinstatement of the non-MAGI Medi-Cal asset limit)" href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/25-14.pdf - title: Missouri DSS MO HealthNet for the Aged, Blind and Disabled Appendix J - Eligibility Standards for Non-MAGI Programs (10/2026 edition; spend down resource maximum effective July 1, 2026) @@ -54,6 +56,8 @@ CA: 2022-07-01: 195_000 2024-01-01: .inf 2026-01-01: 195_000 + # Annual calculations read parameters on January 1, so the July 1, 2027 value first applies in 2028. + 2027-07-01: 31_000 CO: 2015-01-01: 3_000 CT: diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/assets/limit/individual.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/assets/limit/individual.yaml index 5f2cd8074a8..f61179a3cc0 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/assets/limit/individual.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/assets/limit/individual.yaml @@ -12,6 +12,8 @@ metadata: href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/21-31.pdf#page=2 - title: "Asset Limit Changes for Non-MAGI Medi-Cal | California DHCS (asset limit reinstated at $130,000 for an individual effective January 1, 2026)" href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Asset-Limit-Changes-for-Non-MAGI-Medi-Cal.aspx + - title: California Senate Bill 164 (Statutes of 2026, Chapter 27), Section 69 - Welfare and Institutions Code 14005.62(a), operative July 1, 2027 + href: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB164 - title: "California DHCS All County Welfare Directors Letter 25-14 (reinstatement of the non-MAGI Medi-Cal asset limit)" href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/25-14.pdf - title: Missouri DSS MO HealthNet for the Aged, Blind and Disabled Appendix J - Eligibility Standards for Non-MAGI Programs (10/2026 edition; spend down resource maximum effective July 1, 2026) @@ -54,6 +56,8 @@ CA: 2022-07-01: 130_000 2024-01-01: .inf 2026-01-01: 130_000 + # Annual calculations read parameters on January 1, so the July 1, 2027 value first applies in 2028. + 2027-07-01: 21_000 CO: 2015-01-01: 2_000 CT: diff --git a/policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/asset/state_limit/couple.yaml b/policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/asset/state_limit/couple.yaml index 287c32e9b49..64b6ec4cec9 100644 --- a/policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/asset/state_limit/couple.yaml +++ b/policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/asset/state_limit/couple.yaml @@ -14,6 +14,10 @@ metadata: href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/25-27.pdf#page=1 - title: California Welfare and Institutions Code 14005.62(a), (c), (d) href: https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=14005.62 + - title: California Senate Bill 164 (Statutes of 2026, Chapter 27), Sections 69 and 71 - Welfare and Institutions Code 14005.62(a) and 14005.11(a), operative July 1, 2027 + href: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB164 + - title: California Assembly Bill 173 (Statutes of 2026, Chapter 252), Section 16 - Welfare and Institutions Code 14005.11(h), inoperative July 1, 2027 + href: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260AB173 - title: Minnesota Statutes 256B.057, subdivision 3(a)(3) - Qualified Medicare beneficiaries href: https://www.revisor.mn.gov/statutes/cite/256B.057#stat.256B.057.3 - title: Laws of Minnesota 2000, chapter 488, article 9, section 15 @@ -22,6 +26,7 @@ metadata: CA: 0000-01-01: 0 2022-07-01: 195_000 + 2027-07-01: 31_000 MN: 0000-01-01: 0 2000-10-01: 18_000 diff --git a/policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/asset/state_limit/individual.yaml b/policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/asset/state_limit/individual.yaml index 64d882e884b..78841f5e249 100644 --- a/policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/asset/state_limit/individual.yaml +++ b/policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/asset/state_limit/individual.yaml @@ -14,6 +14,10 @@ metadata: href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/25-27.pdf#page=1 - title: California Welfare and Institutions Code 14005.62(a), (c), (d) href: https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=14005.62 + - title: California Senate Bill 164 (Statutes of 2026, Chapter 27), Sections 69 and 71 - Welfare and Institutions Code 14005.62(a) and 14005.11(a), operative July 1, 2027 + href: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB164 + - title: California Assembly Bill 173 (Statutes of 2026, Chapter 252), Section 16 - Welfare and Institutions Code 14005.11(h), inoperative July 1, 2027 + href: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260AB173 - title: Minnesota Statutes 256B.057, subdivision 3(a)(3) - Qualified Medicare beneficiaries href: https://www.revisor.mn.gov/statutes/cite/256B.057#stat.256B.057.3 - title: Laws of Minnesota 2000, chapter 488, article 9, section 15 @@ -22,6 +26,7 @@ metadata: CA: 0000-01-01: 0 2022-07-01: 130_000 + 2027-07-01: 21_000 MN: 0000-01-01: 0 2000-10-01: 10_000 diff --git a/policyengine_us/parameters/gov/states/ca/chhs/wdp/eligibility/asset/additional_person.yaml b/policyengine_us/parameters/gov/states/ca/chhs/wdp/eligibility/asset/additional_person.yaml index da5c8f9244b..95796e49d44 100644 --- a/policyengine_us/parameters/gov/states/ca/chhs/wdp/eligibility/asset/additional_person.yaml +++ b/policyengine_us/parameters/gov/states/ca/chhs/wdp/eligibility/asset/additional_person.yaml @@ -1,11 +1,21 @@ -description: California increases the asset limit by this amount for each additional person under the Medi-Cal 250 Percent Working Disabled Program. +description: California increases the asset limit by this amount for each person beyond two under the Medi-Cal 250 Percent Working Disabled Program. values: 2022-07-01: 65_000 + # Annual calculations read parameters on January 1, so the July 1, 2027 value first applies in 2028. + 2027-07-01: 1_550 metadata: unit: currency-USD period: year - label: California 250 Percent Working Disabled Program additional-person asset limit + label: California 250 Percent Working Disabled Program asset limit for each person beyond two reference: - title: Working Disabled Program | Department of Health Care Services href: https://www.dhcs.ca.gov/services/working-disabled-program/ + - title: "California DHCS All County Welfare Directors Letter 21-31, Increases to the Asset Limits for Non-Modified Adjusted Gross Income Medi-Cal Programs #page 2,4" + href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/21-31.pdf#page=2 + - title: "California DHCS All County Welfare Directors Letter 25-14, Reinstatement of Asset Limits for Non-MAGI Medi-Cal Programs #page 1,9" + href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/25-14.pdf#page=1 + - title: California Senate Bill 164 (Statutes of 2026, Chapter 27), Section 69 - Welfare and Institutions Code 14005.62(a), operative July 1, 2027 + href: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB164 + - title: California Welfare and Institutions Code 14007.9(a)(1)(C) + href: https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=14007.9.&lawCode=WIC diff --git a/policyengine_us/parameters/gov/states/ca/chhs/wdp/eligibility/asset/base.yaml b/policyengine_us/parameters/gov/states/ca/chhs/wdp/eligibility/asset/base.yaml index 78b43af2edb..a9bc8c44119 100644 --- a/policyengine_us/parameters/gov/states/ca/chhs/wdp/eligibility/asset/base.yaml +++ b/policyengine_us/parameters/gov/states/ca/chhs/wdp/eligibility/asset/base.yaml @@ -3,6 +3,8 @@ values: 2022-07-01: 130_000 2024-01-01: .inf 2026-01-01: 130_000 + # Annual calculations read parameters on January 1, so the July 1, 2027 value first applies in 2028. + 2027-07-01: 21_000 metadata: unit: currency-USD @@ -15,3 +17,7 @@ metadata: href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/Eligibility-and-Enrollment-Plan-Asset-Test-Changes-for-Non-MAGI-MC.pdf - title: Medi-Cal Program Changes 2026-2028 | Department of Health Care Services href: https://www.dhcs.ca.gov/medi-cal/help/medi-cal-changes/ + - title: California Senate Bill 164 (Statutes of 2026, Chapter 27), Section 69 - Welfare and Institutions Code 14005.62(a), operative July 1, 2027 + href: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB164 + - title: California Welfare and Institutions Code 14007.9(a)(1)(C) + href: https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=14007.9.&lawCode=WIC diff --git a/policyengine_us/parameters/gov/states/ca/chhs/wdp/eligibility/asset/two_people.yaml b/policyengine_us/parameters/gov/states/ca/chhs/wdp/eligibility/asset/two_people.yaml new file mode 100644 index 00000000000..68d98ea4d55 --- /dev/null +++ b/policyengine_us/parameters/gov/states/ca/chhs/wdp/eligibility/asset/two_people.yaml @@ -0,0 +1,25 @@ +description: California limits assets to this amount for two people under the Medi-Cal 250 Percent Working Disabled Program. +values: + 2022-07-01: 195_000 + 2024-01-01: .inf + 2026-01-01: 195_000 + # Annual calculations read parameters on January 1, so the July 1, 2027 value first applies in 2028. + 2027-07-01: 31_000 + +metadata: + unit: currency-USD + period: year + label: California 250 Percent Working Disabled Program two-person asset limit + reference: + - title: Working Disabled Program | Department of Health Care Services + href: https://www.dhcs.ca.gov/services/working-disabled-program/ + - title: "California DHCS All County Welfare Directors Letter 21-31, Increases to the Asset Limits for Non-Modified Adjusted Gross Income Medi-Cal Programs #page 2-4" + href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/21-31.pdf#page=2 + - title: "California DHCS All County Welfare Directors Letter 22-25, Elimination of Asset Limits for Non-MAGI Medi-Cal Programs #page 2,5" + href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/22-25.pdf#page=2 + - title: "California DHCS All County Welfare Directors Letter 25-14, Reinstatement of Asset Limits for Non-MAGI Medi-Cal Programs #page 2,8-9" + href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/25-14.pdf#page=2 + - title: California Senate Bill 164 (Statutes of 2026, Chapter 27), Section 69 - Welfare and Institutions Code 14005.62(a), operative July 1, 2027 + href: https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB164 + - title: California Welfare and Institutions Code 14007.9(a)(1)(C) + href: https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=14007.9.&lawCode=WIC diff --git a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_optional_senior_or_disabled_asset_eligible.yaml b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_optional_senior_or_disabled_asset_eligible.yaml index 9e2242f8c26..b972b8694d6 100644 --- a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_optional_senior_or_disabled_asset_eligible.yaml +++ b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_optional_senior_or_disabled_asset_eligible.yaml @@ -760,3 +760,102 @@ # 15,000 minus 12,000 leaves 3,000, not under 3,000. An 8,000 # exclusion per spouse would leave 2,000 + 0 = 2,000. is_optional_senior_or_disabled_asset_eligible: [false, false] + +# California's limit falls to 21,000 for one person and 31,000 for two on +# July 1, 2027. This annual variable reads the January 1 value, so the lower +# limits first apply in 2028. +- name: assets above the July 2027 CA limit in 2028, ineligible + period: 2028 + input: + ssi_countable_resources: 21_001 + state_code: CA + output: + is_optional_senior_or_disabled_asset_eligible: false + +# Each spouse is under the 21,000 individual limit; combined resources of +# 31,001 are over the 31,000 couple limit. +- name: joint filers above the July 2027 CA couple limit in 2028, ineligible + period: 2028 + input: + people: + person1: + ssi_countable_resources: 15_500 + person2: + ssi_countable_resources: 15_501 + marital_units: + marital_unit1: + members: [person1, person2] + households: + household: + members: [person1, person2] + state_code: CA + tax_units: + tax_unit: + members: [person1, person2] + tax_unit_is_joint: true + output: + is_optional_senior_or_disabled_asset_eligible: [false, false] + +- name: assets at the July 2027 CA limit in 2028, eligible + period: 2028 + input: + ssi_countable_resources: 21_000 + state_code: CA + output: + # Resources may not exceed 21,000 (WIC 14005.40(c)(5)). + is_optional_senior_or_disabled_asset_eligible: true + +- name: joint filers at the July 2027 CA couple limit in 2028, eligible + period: 2028 + input: + people: + person1: + ssi_countable_resources: 15_500 + person2: + ssi_countable_resources: 15_500 + marital_units: + marital_unit1: + members: [person1, person2] + households: + household: + members: [person1, person2] + state_code: CA + tax_units: + tax_unit: + members: [person1, person2] + tax_unit_is_joint: true + output: + # 15,500 + 15,500 = 31,000 does not exceed the couple limit. + is_optional_senior_or_disabled_asset_eligible: [true, true] + +- name: assets above the July 2027 CA limit in 2027, still eligible + period: 2027 + input: + ssi_countable_resources: 21_001 + state_code: CA + output: + # January 1, 2027 still reads the 130,000 limit; 21,000 first applies in 2028. + is_optional_senior_or_disabled_asset_eligible: true + +- name: joint filers above the July 2027 CA couple limit in 2027, still eligible + period: 2027 + input: + people: + person1: + ssi_countable_resources: 15_500 + person2: + ssi_countable_resources: 15_501 + marital_units: + marital_unit1: + members: [person1, person2] + households: + household: + members: [person1, person2] + state_code: CA + tax_units: + tax_unit: + members: [person1, person2] + tax_unit_is_joint: true + output: + # January 1, 2027 still reads the 195,000 couple limit; 31,000 first applies in 2028. + is_optional_senior_or_disabled_asset_eligible: [true, true] diff --git a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medically_needy/is_medically_needy_for_medicaid.yaml b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medically_needy/is_medically_needy_for_medicaid.yaml index 7703179e97a..a3934f084f7 100644 --- a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medically_needy/is_medically_needy_for_medicaid.yaml +++ b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/medically_needy/is_medically_needy_for_medicaid.yaml @@ -776,3 +776,167 @@ output: # WAG 25-03-02(2): 1,803 x 12 = 21,636 (21,640 / 12 = 1,803.33, cents dropped). is_medically_needy_for_medicaid: [false, false] + +- name: Case 31, California senior with assets above the July 2027 limit is ineligible in 2028. + period: 2028 + input: + age: 70 + is_adult_for_medicaid: false + is_optional_senior_or_disabled_for_medicaid: false + is_ssi_recipient_for_medicaid: false + ssi_countable_income: 9_000 + medicaid_medically_needy_medical_expenses: 2_000 + ssi_countable_resources: 21_001 + state_code: CA + output: + # Limit 600 x 12 = 7,200. 9,000 - 2,000 = 7,000 is under it, but assets + # of 21,001 are over the 21,000 limit that applies from July 2027. + is_in_medicaid_medically_needy_category: true + is_medically_needy_for_medicaid: false + +- name: Case 32, California senior couple with assets above the July 2027 couple limit is ineligible in 2028. + period: 2028 + input: + people: + person1: + age: 72 + is_adult_for_medicaid: false + is_optional_senior_or_disabled_for_medicaid: false + is_ssi_recipient_for_medicaid: false + ssi_countable_income: 9_000 + medicaid_medically_needy_medical_expenses: 4_000 + ssi_countable_resources: 15_500 + person2: + age: 70 + is_adult_for_medicaid: false + is_optional_senior_or_disabled_for_medicaid: false + is_ssi_recipient_for_medicaid: false + ssi_countable_income: 9_000 + medicaid_medically_needy_medical_expenses: 4_000 + ssi_countable_resources: 15_501 + 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: CA + output: + # Limit 934 x 12 = 11,208. (9,000 - 4,000) x 2 = 10,000 is under it, but + # combined assets of 31,001 are over the 31,000 couple limit. + is_in_medicaid_medically_needy_category: [true, true] + is_medically_needy_for_medicaid: [false, false] + +- name: Case 33, California senior with assets at the July 2027 limit is eligible in 2028. + period: 2028 + input: + age: 70 + is_adult_for_medicaid: false + is_optional_senior_or_disabled_for_medicaid: false + is_ssi_recipient_for_medicaid: false + ssi_countable_income: 9_000 + medicaid_medically_needy_medical_expenses: 2_000 + ssi_countable_resources: 21_000 + state_code: CA + output: + # Limit 600 x 12 = 7,200. 9,000 - 2,000 = 7,000 is under it, and assets + # of 21,000 are at the 21,000 limit that applies from July 2027; resources + # may not exceed it. + is_in_medicaid_medically_needy_category: true + is_medically_needy_for_medicaid: true + +- name: Case 34, California senior couple with assets at the July 2027 couple limit is eligible in 2028. + period: 2028 + input: + people: + person1: + age: 72 + is_adult_for_medicaid: false + is_optional_senior_or_disabled_for_medicaid: false + is_ssi_recipient_for_medicaid: false + ssi_countable_income: 9_000 + medicaid_medically_needy_medical_expenses: 4_000 + ssi_countable_resources: 15_500 + person2: + age: 70 + is_adult_for_medicaid: false + is_optional_senior_or_disabled_for_medicaid: false + is_ssi_recipient_for_medicaid: false + ssi_countable_income: 9_000 + medicaid_medically_needy_medical_expenses: 4_000 + ssi_countable_resources: 15_500 + 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: CA + output: + # Limit 934 x 12 = 11,208. (9,000 - 4,000) x 2 = 10,000 is under it, and + # combined assets of 15,500 + 15,500 = 31,000 are at the 31,000 couple + # limit; resources may not exceed it. + is_in_medicaid_medically_needy_category: [true, true] + is_medically_needy_for_medicaid: [true, true] + +- name: Case 35, California senior with assets above the July 2027 limit is still eligible in 2027. + period: 2027 + input: + age: 70 + is_adult_for_medicaid: false + is_optional_senior_or_disabled_for_medicaid: false + is_ssi_recipient_for_medicaid: false + ssi_countable_income: 9_000 + medicaid_medically_needy_medical_expenses: 2_000 + ssi_countable_resources: 21_001 + state_code: CA + output: + # Limit 600 x 12 = 7,200. 9,000 - 2,000 = 7,000 is under it. January 1, + # 2027 still reads the 130,000 asset limit; 21,000 first applies in 2028. + is_in_medicaid_medically_needy_category: true + is_medically_needy_for_medicaid: true + +- name: Case 36, California senior couple with assets above the July 2027 couple limit is still eligible in 2027. + period: 2027 + input: + people: + person1: + age: 72 + is_adult_for_medicaid: false + is_optional_senior_or_disabled_for_medicaid: false + is_ssi_recipient_for_medicaid: false + ssi_countable_income: 9_000 + medicaid_medically_needy_medical_expenses: 4_000 + ssi_countable_resources: 15_500 + person2: + age: 70 + is_adult_for_medicaid: false + is_optional_senior_or_disabled_for_medicaid: false + is_ssi_recipient_for_medicaid: false + ssi_countable_income: 9_000 + medicaid_medically_needy_medical_expenses: 4_000 + ssi_countable_resources: 15_501 + 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: CA + output: + # Limit 934 x 12 = 11,208. (9,000 - 4,000) x 2 = 10,000 is under it. January 1, + # 2027 still reads the 195,000 couple limit; 31,000 first applies in 2028. + is_in_medicaid_medically_needy_category: [true, true] + is_medically_needy_for_medicaid: [true, true] diff --git a/policyengine_us/tests/policy/baseline/gov/hhs/medicare/savings_programs/eligibility/msp_asset_eligible.yaml b/policyengine_us/tests/policy/baseline/gov/hhs/medicare/savings_programs/eligibility/msp_asset_eligible.yaml index 8d1555c36b1..feaba98d662 100644 --- a/policyengine_us/tests/policy/baseline/gov/hhs/medicare/savings_programs/eligibility/msp_asset_eligible.yaml +++ b/policyengine_us/tests/policy/baseline/gov/hhs/medicare/savings_programs/eligibility/msp_asset_eligible.yaml @@ -349,3 +349,91 @@ msp_asset_eligible: 2022-06: [false, false] 2022-07: [true, true] + +- name: Case 22, California's MSP individual asset limit falls to 21,000 in July 2027. + period: 2027 + input: + age: 67 + bank_account_assets: 21_001 + spm_unit_is_married: false + state_code: CA + output: + # 21,001 is under 130,000 in June and over 21,000 from July; the federal + # limit is lower than both. + msp_asset_eligible: + 2027-06: true + 2027-07: false + +- name: Case 23, California's MSP couple asset limit falls to 31,000 in July 2027. + period: 2027 + input: + people: + person1: + age: 70 + bank_account_assets: 15_500 + person2: + age: 68 + bank_account_assets: 15_501 + tax_units: + tax_unit: + members: [person1, person2] + marital_units: + marital_unit: + members: [person1, person2] + spm_units: + spm_unit: + members: [person1, person2] + spm_unit_is_married: true + households: + household: + members: [person1, person2] + state_code: CA + output: + # Combined 31,001 is under 195,000 in June and over 31,000 from July; the + # federal couple limit is lower than both. + msp_asset_eligible: + 2027-06: [true, true] + 2027-07: [false, false] + +- name: Case 24, California's MSP individual asset limit admits assets at 21,000 in July 2027. + period: 2027 + input: + age: 67 + bank_account_assets: 21_000 + spm_unit_is_married: false + state_code: CA + output: + # 21,000 is at the 21,000 limit that applies from July 2027; resources may + # not exceed it. + msp_asset_eligible: + 2027-07: true + +- name: Case 25, California's MSP couple asset limit admits combined assets at 31,000 in July 2027. + period: 2027 + input: + people: + person1: + age: 70 + bank_account_assets: 15_500 + person2: + age: 68 + bank_account_assets: 15_500 + tax_units: + tax_unit: + members: [person1, person2] + marital_units: + marital_unit: + members: [person1, person2] + spm_units: + spm_unit: + members: [person1, person2] + spm_unit_is_married: true + households: + household: + members: [person1, person2] + state_code: CA + output: + # 15,500 + 15,500 = 31,000 is at the 31,000 couple limit that applies from + # July 2027; resources may not exceed it. + msp_asset_eligible: + 2027-07: [true, true] diff --git a/policyengine_us/tests/policy/baseline/gov/states/ca/chhs/wdp/eligibility/ca_wdp_asset_eligible.yaml b/policyengine_us/tests/policy/baseline/gov/states/ca/chhs/wdp/eligibility/ca_wdp_asset_eligible.yaml new file mode 100644 index 00000000000..17efb758a5e --- /dev/null +++ b/policyengine_us/tests/policy/baseline/gov/states/ca/chhs/wdp/eligibility/ca_wdp_asset_eligible.yaml @@ -0,0 +1,338 @@ +- name: Case 1, two-person tax unit at the 2026 two-person limit is eligible. + period: 2026 + input: + people: + person1: + age: 45 + ssi_countable_resources: 100_000 + person2: + age: 43 + ssi_countable_resources: 95_000 + tax_units: + tax_unit: + members: [person1, person2] + households: + household: + members: [person1, person2] + state_code: CA + output: + # 100,000 + 95,000 = 195,000 is at the 195,000 two-person limit; resources + # may not exceed it. + ca_wdp_asset_eligible: [true, true] + +- name: Case 2, one person at the July 2027 one-person limit is eligible in 2028. + period: 2028 + input: + people: + person1: + age: 45 + ssi_countable_resources: 21_000 + tax_units: + tax_unit: + members: [person1] + households: + household: + members: [person1] + state_code: CA + output: + # 21,000 is at the 21,000 limit; resources may not exceed it. + ca_wdp_asset_eligible: true + +- name: Case 3, one person above the July 2027 one-person limit is ineligible in 2028. + period: 2028 + input: + people: + person1: + age: 45 + ssi_countable_resources: 21_001 + tax_units: + tax_unit: + members: [person1] + households: + household: + members: [person1] + state_code: CA + output: + # 21,001 is over the 21,000 limit. + ca_wdp_asset_eligible: false + +- name: Case 4, two-person tax unit at the July 2027 two-person limit is eligible in 2028. + period: 2028 + input: + people: + person1: + age: 45 + ssi_countable_resources: 15_500 + person2: + age: 43 + ssi_countable_resources: 15_500 + tax_units: + tax_unit: + members: [person1, person2] + households: + household: + members: [person1, person2] + state_code: CA + output: + # 15,500 + 15,500 = 31,000 is at the 31,000 two-person limit; resources + # may not exceed it. + ca_wdp_asset_eligible: [true, true] + +- name: Case 5, two-person tax unit above the July 2027 two-person limit is ineligible in 2028. + period: 2028 + input: + people: + person1: + age: 45 + ssi_countable_resources: 15_500 + person2: + age: 43 + ssi_countable_resources: 15_501 + tax_units: + tax_unit: + members: [person1, person2] + households: + household: + members: [person1, person2] + state_code: CA + output: + # 15,500 + 15,501 = 31,001 is over the 31,000 two-person limit. + ca_wdp_asset_eligible: [false, false] + +- name: Case 6, three-person tax unit at the July 2027 three-person limit is eligible in 2028. + period: 2028 + input: + people: + person1: + age: 45 + ssi_countable_resources: 16_000 + person2: + age: 43 + ssi_countable_resources: 16_550 + person3: + age: 10 + tax_units: + tax_unit: + members: [person1, person2, person3] + households: + household: + members: [person1, person2, person3] + state_code: CA + output: + # Limit 31,000 + 1 x 1,550 = 32,550. 16,000 + 16,550 + 0 = 32,550 is at + # it; resources may not exceed it. + ca_wdp_asset_eligible: [true, true, true] + +- name: Case 7, three-person tax unit above the July 2027 three-person limit is ineligible in 2028. + period: 2028 + input: + people: + person1: + age: 45 + ssi_countable_resources: 16_000 + person2: + age: 43 + ssi_countable_resources: 16_551 + person3: + age: 10 + tax_units: + tax_unit: + members: [person1, person2, person3] + households: + household: + members: [person1, person2, person3] + state_code: CA + output: + # Limit 31,000 + 1 x 1,550 = 32,550. 16,000 + 16,551 + 0 = 32,551 is over + # it. + ca_wdp_asset_eligible: [false, false, false] + +- name: Case 8, one person above the July 2027 one-person limit is still eligible in 2027. + period: 2027 + input: + people: + person1: + age: 45 + ssi_countable_resources: 21_001 + tax_units: + tax_unit: + members: [person1] + households: + household: + members: [person1] + state_code: CA + output: + # January 1, 2027 still reads the 130,000 limit; 21,000 first applies in 2028. + ca_wdp_asset_eligible: true + +- name: Case 9, three-person tax unit at the 2026 three-person limit is eligible. + period: 2026 + input: + people: + person1: + age: 45 + ssi_countable_resources: 130_000 + person2: + age: 43 + ssi_countable_resources: 130_000 + person3: + age: 10 + tax_units: + tax_unit: + members: [person1, person2, person3] + households: + household: + members: [person1, person2, person3] + state_code: CA + output: + # Limit 195,000 + 1 x 65,000 = 260,000. 130,000 + 130,000 + 0 = 260,000 is + # at it; resources may not exceed it. + ca_wdp_asset_eligible: [true, true, true] + +- name: Case 10, eleven-person tax unit at the ten-person cap limit is eligible in 2028. + period: 2028 + input: + people: + person1: + age: 45 + ssi_countable_resources: 21_700 + person2: + age: 43 + ssi_countable_resources: 21_700 + person3: + age: 17 + person4: + age: 16 + person5: + age: 15 + person6: + age: 14 + person7: + age: 12 + person8: + age: 10 + person9: + age: 8 + person10: + age: 6 + person11: + age: 3 + tax_units: + tax_unit: + members: [person1, person2, person3, person4, person5, person6, person7, person8, person9, person10, person11] + households: + household: + members: [person1, person2, person3, person4, person5, person6, person7, person8, person9, person10, person11] + state_code: CA + output: + # Size is capped at 10: 31,000 + 8 x 1,550 = 43,400. 21,700 + 21,700 = + # 43,400 is at it; resources may not exceed it. + ca_wdp_asset_eligible: [true, true, true, true, true, true, true, true, true, true, true] + +- name: Case 11, eleven-person tax unit above the ten-person cap limit is ineligible in 2028. + period: 2028 + input: + people: + person1: + age: 45 + ssi_countable_resources: 21_700 + person2: + age: 43 + ssi_countable_resources: 21_701 + person3: + age: 17 + person4: + age: 16 + person5: + age: 15 + person6: + age: 14 + person7: + age: 12 + person8: + age: 10 + person9: + age: 8 + person10: + age: 6 + person11: + age: 3 + tax_units: + tax_unit: + members: [person1, person2, person3, person4, person5, person6, person7, person8, person9, person10, person11] + households: + household: + members: [person1, person2, person3, person4, person5, person6, person7, person8, person9, person10, person11] + state_code: CA + output: + # Size is capped at 10: 31,000 + 8 x 1,550 = 43,400. 21,700 + 21,701 = + # 43,401 is over it. + ca_wdp_asset_eligible: [false, false, false, false, false, false, false, false, false, false, false] + +- name: Case 12, two-person tax unit above the July 2027 two-person limit is still eligible in 2027. + period: 2027 + input: + people: + person1: + age: 45 + ssi_countable_resources: 15_500 + person2: + age: 43 + ssi_countable_resources: 15_501 + tax_units: + tax_unit: + members: [person1, person2] + households: + household: + members: [person1, person2] + state_code: CA + output: + # January 1, 2027 still reads the 195,000 two-person limit; 31,000 first + # applies in 2028. + ca_wdp_asset_eligible: [true, true] + +- name: Case 13, three-person tax unit at the 2027 three-person limit is eligible. + period: 2027 + input: + people: + person1: + age: 45 + ssi_countable_resources: 130_000 + person2: + age: 43 + ssi_countable_resources: 130_000 + person3: + age: 10 + tax_units: + tax_unit: + members: [person1, person2, person3] + households: + household: + members: [person1, person2, person3] + state_code: CA + output: + # January 1, 2027 reads 195,000 + 1 x 65,000 = 260,000. 130,000 + 130,000 + # + 0 = 260,000 is at it; resources may not exceed it. + ca_wdp_asset_eligible: [true, true, true] + +- name: Case 14, two-person tax unit with large assets is eligible in 2025, when no asset limit applied. + period: 2025 + input: + people: + person1: + age: 45 + ssi_countable_resources: 500_000 + person2: + age: 43 + ssi_countable_resources: 500_000 + tax_units: + tax_unit: + members: [person1, person2] + households: + household: + members: [person1, person2] + state_code: CA + output: + # ACWDL 22-25 eliminated the limit from January 1, 2024; ACWDL 25-14 + # reinstated it from January 1, 2026. + ca_wdp_asset_eligible: [true, true] diff --git a/policyengine_us/variables/gov/states/ca/chhs/wdp/eligibility/ca_wdp_asset_eligible.py b/policyengine_us/variables/gov/states/ca/chhs/wdp/eligibility/ca_wdp_asset_eligible.py index 9ad8d1ec58f..6c1033ef7f6 100644 --- a/policyengine_us/variables/gov/states/ca/chhs/wdp/eligibility/ca_wdp_asset_eligible.py +++ b/policyengine_us/variables/gov/states/ca/chhs/wdp/eligibility/ca_wdp_asset_eligible.py @@ -6,7 +6,11 @@ class ca_wdp_asset_eligible(Variable): entity = Person label = "California 250 Percent Working Disabled Program asset eligible" definition_period = YEAR - reference = "https://www.dhcs.ca.gov/services/working-disabled-program/" + reference = ( + "https://www.dhcs.ca.gov/services/working-disabled-program/", + "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=14007.9.&lawCode=WIC", + "https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB164", + ) defined_for = StateCode.CA def formula(person, period, parameters): @@ -16,5 +20,9 @@ def formula(person, period, parameters): ) tax_unit_size = person.tax_unit("tax_unit_size", period) capped_size = min_(tax_unit_size, p.max_people) - asset_limit = p.base + max_(capped_size - 1, 0) * p.additional_person + asset_limit = where( + capped_size >= 2, + p.two_people + (capped_size - 2) * p.additional_person, + p.base, + ) return countable_resources <= asset_limit