[hua7450]

Part of #9734: the dollar-standard states. #10361 handles the SSI-only states and #10373 handles West Virginia.

What and why

Five states test aged, blind and disabled people who don't receive SSI against a monthly dollar standard of their own. The model used a share of the poverty guideline for each of them. A share can't match a state's individual and couple amounts at once, so couples came out furthest off.

State	Model before (2026, monthly)	Standard (2026, monthly)	What it is
AK	0.83 FPL: $1,380 / $1,871	$1,845 / $2,732	7 AAC 40.310 standard; since 2020 the cap of a state plan disregard above the APA standard
ID	0.78 FPL: $1,037 / $1,407	$1,027 / $1,491, income must be below	AABD basic allowance: SSI + $33 / SSI couple rate
NH	0.75 FPL: $998 / $1,353	$1,008 / $1,492	Standard of need: SSI + $14 / + $1
VT	0.80 FPL: $1,064 / $1,443	$1,049.68 / $1,596.80	SSI + AABD supplement ($55.68 / $105.80)
WI	1.00 FPL: $1,330 / $1,803	$1,077.78 / $1,623.05	SSI + state supplement ($83.78 / $132.05); flat from August 2020

New Hampshire's 209(b) SSI-recipient test (is_209b_ssi_recipient_income_eligible_for_medicaid) reads the same limit. SSI couples there with countable income between $1,353 and $1,492 now qualify without spenddown.

Changes

• New income/limit/uses_state_standard (by state): true for AK, ID, NH and VT from 2018-01-01, and for WI from 2020-08-01.
• New income/limit/state_standard/individual and couple (monthly dollars), plus state_standard/adds_ssi_rate. Four states set their standard as the SSI rate plus a state amount, so only that amount is stored and SSI cost-of-living increases flow through. Alaska's standard is indexed to the Social Security COLA percentage, so its full yearly amounts are stored instead.
• Formula: one more branch in the select of medicaid_optional_senior_or_disabled_income_limit. Monthly amounts are multiplied by 12.
• requires_income_below_limit: ID is now true (IDAPA 16.03.05.500, below).
• income/limit/individual.yaml and couple.yaml: AK, ID, NH and VT shares are removed, since the new standards replace them in every year. WI keeps its shares for 2018 to 2020.
• test_medicaid_abd_ssi_rate_standard_properties.py: the five states are excluded from the check that unflagged states keep their poverty-guideline share, and ID is accepted as a below-only state.

Where the issue's description changed after reading the sources

• Idaho is not tested at the SSI rate. § 777 covers SSI recipients and sets no limit for anyone else. § 301.01 says "To get AABD-Medicaid, the participant does not have to apply for SSI benefits." Eligibility follows the AABD allowance test in § 500-501.
  • The allowance is $545 raised by each dollar SSI increase since 2001, which is the SSI rate plus $33. The couple allowance equals the SSI couple rate in every published year (2017, 2018 and 2022-2026).
  • § 500 is strict: a person has need only if "their allowances ... are more than their income". ID is flagged below-only.
• Alaska's Medicaid limit is above the APA standard. The APA standard is $1,356 / $2,019, which is SSI plus the APA supplement.
  • Since January 2020 the state plan disregards countable income between that standard and $1,845 / $2,732 (AK-26-0001). DPA publishes these caps as the "Expanded Refused Cash Income Limits".
  • Those caps are the 7 AAC 40.310 standards ($1,047 / $1,551 in 2004, raised each January by the Social Security COLA). 7 AAC 100.400(a)(17) applies them to aged and disabled Medicaid.
  • In 2018 and 2019 the same amounts were the APA need standard ($1,393 / $2,063 and $1,432 / $2,121).
  • So adds_ssi_rate is false for AK, and the AK SSP parameter is not used.
• Wisconsin uses a dollar standard only from 2020-08-01.
  • DHS 103.04(1)(c) makes the categorically needy standard "the maximum SSI payment including state supplement".
  • Until July 2020 that standard was a base amount plus the person's shelter costs up to a cap (Ops Memo 20-13). 2018 to July 2020 keep the existing poverty-guideline share, which is close to the cap.
  • The state supplement rose to $92.16 / $145.26 on 2026-05-01 (Ops Memo 26-12). The variable is annual, so the model uses that amount from 2027.

Sources

Page numbers are PDF file pages. Every 2026 amount was re-read at the source on 2026-10-21.

State	Source	Text
AK	7 AAC 40.310, 7 AAC 100.400	Income "may not exceed (1) $1,047 for an eligible individual living independently ... (2) $1,551 for an eligible couple", raised each January by the Social Security COLA percentage. 100.400(a)(17) applies it to aged and disabled Medicaid.
AK	ADLTC Manual Addendum 1 (2020-2021, 2022-2024) and ADLTC 530 C	Expanded Refused Cash Income Limits: 2026 "$1,845" for an individual and "$2,732" for a couple, one or both eligible. 530 C gives Medicaid "starting January 2020" to income above the APA standard "but equal to or below" these limits.
AK	AK-26-0001, APA standards 2018-2021	Disregard bands "$1,356 - $1,845" and "$2,019 - $2,732". The 2018 and 2019 need standards were $1,393 / $2,063 and $1,432 / $2,121.
ID	IDAPA 16.03.05 (pages 28, 39)	§ 301.01, § 500 "allowances ... are more than their income", and § 501 basic allowance
ID	State Plan TN 18-0002 (pages 5-6), DHW income limits	2018 "Medicaid Income Limit": $783 and $1,125, and "The couple's net income level is equal to the SSI couple's amount". January 2026: $1,047 and $1,511, including the $20 disregard.
NH	He-W 802.04(b)(1), 858.03, MAM 601 Table A, SR 26-01, SR 18-01	The standard of need is set from the SSI maximum benefit. Independent living: $1,008 / $1,492 (2026) and $764 / $1,126 (2018). SR 19-01 through SR 25-01 give the same SSI + $14 / + $1 every year.
VT	HBEE § 8.05(b) (pages 10-11)	Income "at or below the SSI/AABD payment level"
VT	DVHA 2026 (pages 2, 7), DVHA 2024, DCF B17-26 (pages 4, 11)	Independent living: "994.00 55.68 1,049.68" and "1,491.00 105.80 1,596.80". The supplement was $52.04 / $98.88 from 2018 through 2023.
WI	DHS 103.04(1)(c), MEH 24.1, MEH 39.4	"the maximum SSI payment including state supplement". Above it, income "is then compared to the medically needy limit of 100% FPL". MEH 39.4.1: $1,077.78 / $1,623.05 from January 2026.
WI	Ops Memo 20-13 (pages 1-2), Ops Memo 26-12	"Effective for the August 2020 benefit month ... $866.78 ... $1,307.05", "fixed amounts". The supplement rose to $92.16 / $145.26 on May 1, 2026.

None of the five state plans covers the poverty-level group of 42 U.S.C. 1396a(m), which is where a share of the poverty guideline would come from.

Depends on, and works with

• Wisconsin medically needy (Update Medicaid medically needy limits and switch on AR, IA, IL, NJ and ND #10374). Wisconsin's medically needy limit is 100% FPL from 2019-09-01, with no deductible up to that limit (MEH 24.1; Ops Memo 19-26). This PR leaves medically needy parameters alone. People between SSI + supplement and 100% FPL rely on Update Medicaid medically needy limits and switch on AR, IA, IL, NJ and ND #10374's update to keep coverage, so Update Medicaid medically needy limits and switch on AR, IA, IL, NJ and ND #10374 should merge first or together with this PR.
• Vermont and Wisconsin SSP (Add Vermont state supplementation for 2026 #10171, Add Wisconsin state supplementation for 2026 #10173). Their supplement parameters start in 2026, so this PR stores the supplements it needs from 2018 and 2020 in state_standard. Once those PRs merge with their history, the two states could read the SSP parameters instead.
• Merges. Test merges with Turn off the Medicaid optional aged/disabled pathway in 14 states that cover only SSI recipients #10361, Update Medicaid aged, blind and disabled pathway disregards and asset limits (CA, CT, MO, AR, OK, SC) #10364, Count blind people and use the individual or couple in the Medicaid medically needy test #10370, Use the SSI rate as the Medicaid aged/disabled income limit in West Virginia and North Dakota #10373 and Update Medicaid medically needy limits and switch on AR, IA, IL, NJ and ND #10374 are clean in every order. Of those PRs, only Use the SSI rate as the Medicaid aged/disabled income limit in West Virginia and North Dakota #10373 touches the same files, and its hunks don't overlap.

Not changed here

• New York (rest of Medicaid optional senior/disabled pathway: SSI-only states, 209(b) states, and SSI-plus-supplement standards encoded as shares of poverty #9734). It needs a design decision. Its non-SSI group could use SSI plus the state supplement ($1,081 / $1,595 in 2026), with 138% FPL treated as medically needy. New York stays at 0.82.
• North Dakota and the SSI-only states. North Dakota is Use the SSI rate as the Medicaid aged/disabled income limit in West Virginia and North Dakota #10373, and the SSI-only states are Turn off the Medicaid optional aged/disabled pathway in 14 states that cover only SSI recipients #10361.
• West Virginia. This is Use the SSI rate as the Medicaid aged/disabled income limit in West Virginia and North Dakota #10373.
• Medically needy limits and categories. These are Count blind people and use the individual or couple in the Medicaid medically needy test #10370 and Update Medicaid medically needy limits and switch on AR, IA, IL, NJ and ND #10374.
• Known limits:
  • In 2018 and 2019, an Alaska couple with only one eligible spouse had a lower need standard ($1,673 / $1,720). The model gives every married pair the couple standard, as it does elsewhere.
  • Idaho uses the single allowance plus deeming when the spouse is ineligible. The model doesn't make that distinction in any state.
  • Living arrangements other than independent living are not modeled.

Test plan

• YAML tests with expected values from the sources above:
  • medicaid_optional_senior_or_disabled_income_limit.yaml, 2026:
    • an Alaska couple at $2,732 a month is eligible;
    • a Vermont couple at $1,596.80 is eligible;
    • a Wisconsin individual at $12,934 a year, just over the $12,933.36 standard, is ineligible;
    • an Idaho individual at exactly the $1,027 allowance is ineligible;
    • Wisconsin in 2020 keeps 0.83 FPL.
  • is_209b_ssi_recipient_income_eligible_for_medicaid.yaml: a New Hampshire SSI couple with $1,420 a month of countable income is under the $1,492 standard and qualifies without spenddown.
  • Each case also fails under the old shares, except the Wisconsin 2020 case, which pins the start date.
• Tests were not run locally; CI validates.
• Source-conflict register: not applicable.
  • Alaska's regulation and DPA's APA tables differ on the APA cash standard, but they give the same Medicaid limit.
  • New Hampshire's cash grant rule says "less than" and its Medicaid manual says "cannot exceed". The model follows the Medicaid manual, which already matches requires_income_below_limit.
  • No statute is involved in either.
• ruff format on the changed Python files.
• Changelog fragment in changelog.d/.

No partner test has an aged, blind or disabled person in these states. The microsimulation impact was not run.

axiom: n/a: state income standards (7 AAC 40.310, IDAPA 16.03.05.500-501, He-W 858.03, Vermont HBEE § 8.05(b), Wis. Admin. Code DHS 103.04(1)(c)); rulespec-us's 42 CFR 435.210 module takes the state standard as an input

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