Skip to content

Project Medicare premiums and IRMAA past the last announced year - #10103

Draft
MaxGhenis wants to merge 13 commits into
mainfrom
medicare-part-b-premium-uprating
Draft

Project Medicare premiums and IRMAA past the last announced year#10103
MaxGhenis wants to merge 13 commits into
mainfrom
medicare-part-b-premium-uprating

Conversation

@MaxGhenis

@MaxGhenis MaxGhenis commented Oct 11, 2026

Copy link
Copy Markdown
Contributor

WIP. Stacked on #10085 (base premium-inputs-cms-uprating), which adds the Part B standard premium series this PR uprates by. It retargets to main once #10085 merges.

gov.hhs.medicare.part_b.base_premium stops at 2026 and has no uprating, so modeled Part B premiums, IRMAA, MSP benefits, SPM medical out-of-pocket spending and every downstream consumer hold $202.90 a month from 2027 on. The Part A premiums, the Part A deductible (still at 2025), the Part B and D IRMAA amounts and the IRMAA thresholds have the same freeze.

Plan

  • Part B standard premium and Part B IRMAA amounts: uprate by the Trustees' projected standard premium (Uprate premium inputs by premium series, not CMS out-of-pocket spending #10085's calibration series), rounded to 10 cents.
  • Part A full and reduced premiums and deductible: Trustees Table V.E1 series, with statutory rounding.
  • IRMAA thresholds (Parts B and D): 42 U.S.C. 1395r(i)(5) CPI-U schedule.
  • Part D IRMAA amounts: 42 U.S.C. 1395w-113(a)(7)(B) on the Trustees' base beneficiary premium, with the IRA's 2030 reset to 20%.
  • Tests: Hypothesis properties, differential tests against Trustees Tables V.E1–V.E4 and CMS's published thresholds, YAML integration tests.
  • Microsimulation impact for 2027 and 2034 under the hub heavy lock.
  • Axiom parity issue.
  • Independent review.

🤖 Generated with Claude Code

MaxGhenis and others added 13 commits October 11, 2026 06:48
@MaxGhenis @claude
Uprate ESI premium inputs by CMS ESI premium per enrollee
b076456 
employer_sponsored_insurance_premiums uprated by CBO employment income
(per capita after the per-capita conversion), and
pre_tax_health_insurance_premiums by CMS out-of-pocket spending per
capita, which by CMS's own definition excludes premiums. Both are shares
of employer plan premiums, so both now follow CMS NHE Table 17's
employer-sponsored insurance spending per enrollee (2013-2034, 2025-2034
projections release), extended past 2034 at the 2033-2034 growth rate.

The per-capita classifier now treats per_enrollee paths as per-person
rates, like per_capita ones, so they are neither divided by population
nor rejected as unclassified.

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
@MaxGhenis @claude
Address review: route engine tests to microsimulation, tighten classi…
5b30a11 
…fier

- Split the ESI tests: parameter and property checks stay in tests/core;
  the Simulation and dataset-extension checks move to
  tests/microsimulation (fewer Hypothesis examples, one vectorized
  simulation each).
- Assert the 22 published Table 17 values exactly, keeping the
  spending-over-enrollment consistency check.
- Per-person markers count only in a path's last segment, so a marker
  in an ancestor folder no longer hides a national total.
- Cite the methodology paper's file page 29 in the href, the ZIP as the
  Table 17 source, and the 2035-2100 extension endpoint.
- Describe the index as a premium-growth proxy at fixed coverage per
  policy and roughly constant employer share.

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
@MaxGhenis @claude
Uprate reported premium inputs by CMS premium series
9e6b734 
health_insurance_premiums_without_medicare_part_b and
other_health_insurance_premiums follow CMS ESI premium per enrollee, like
pre_tax_health_insurance_premiums; health_insurance_premiums follows a new
CMS direct purchase premium per enrollee series (NHE projections Table 17).
CMS out-of-pocket spending excludes premiums by definition.

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
@MaxGhenis @claude
Test premium input uprating: transcription, employee share, move neut…
907d344 
…rality

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
@MaxGhenis @claude
Uprate long-term care premiums by CPI-U medical care
b091ef6 
No dataset fills long_term_health_insurance_premiums and no CMS series
measures long-term care insurance premiums; 26 U.S.C. 213(d)(10)(B)
indexes the deductible limits on them by the medical care CPI. Adds
gov.bls.cpi.cpi_u_medical_care: BLS annual means to 2022, CBO's February
2026 calendar-year series for 2023-2036, extended at its 2035-2036 rate.

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
@MaxGhenis @claude
Uprate reported Part B premiums by the Part B standard premium
517726c 
Adds calibration.gov.hhs.cms.medicare_part_b_premium_per_enrollee: the
standard monthly premium for 2013-2026 (2026 Trustees Report Table III.C2)
and the Trustees' intermediate estimates for 2027-2035 (Table V.E2),
extended at the 2034-2035 rate. A premium with any income-related
adjustment is a fixed multiple of the standard premium (42 U.S.C.
1395r(i)(3)).

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
@MaxGhenis @claude
Test and document every premium input's series
caf654d 
Core tests cover transcription, the Part B statutory components, agreement
with the model's Part B premium, Hypothesis bounds and extension rules for
each index; the microsimulation test covers all five inputs. The SPM
methodology page says which inputs follow which premium series.

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
@MaxGhenis
Merge remote-tracking branch 'upstream/main' into premium-inputs-cms-…
63cd7f1 
…uprating

# Conflicts:
#	docs-quarto/methodology/spm-poverty.qmd
#	policyengine_us/parameters/uprating_extensions.py
#	policyengine_us/tests/core/test_per_capita_uprating.py
#	policyengine_us/tests/core/test_uprating_series.py
#	policyengine_us/tests/policy/baseline/parameters/test_uprating_extensions.py
@MaxGhenis @claude
Drop #10083's changelog fragment, already compiled on main
62fd874 
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
@MaxGhenis @claude
Project Medicare premiums and IRMAA past the last announced year
432d5ee 
The Part B standard premium, Part A premiums and deductible, and the Part B
and Part D income-related adjustment amounts and thresholds held their 2026
values in every later year.

- Part B standard premium and Part B IRMAA amounts uprate by the Trustees'
  projected standard premium (calibration series from #10085), rounded to
  10 cents (42 U.S.C. 1395r(c)).
- Part A full and reduced premiums uprate by the Trustees' projected Part A
  premium (Table V.E1), rounded to $1; the Part A deductible gains its 2026
  value ($1,736) and uprates by the Trustees' projected deductible, rounded
  to $4 (1395e(b)(1)).
- IRMAA thresholds (Parts B and D) follow 1395r(i)(5)'s CPI-U schedule,
  computed from the statutory amounts; the $500,000 tier is indexed from
  2028.
- Part D IRMAA amounts follow 1395w-113(a)(7)(B) applied to the Trustees'
  projected base beneficiary premium, with the (a)(9) percent of 20% from
  2030; this reproduces Trustees Table V.E4 for 2027-2035.

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
@MaxGhenis @claude
Test Medicare premium and IRMAA projections
a9658c3 
Property tests (Hypothesis) for statutory rounding, proportionality,
monotonicity and threshold structure in every projected year; differential
tests against the 2026 Trustees Report Tables V.E1-V.E4 and CMS's published
2020-2026 IRMAA thresholds; a precedence test showing a CMS amount added to
the YAML replaces only its own year; and YAML household cases for 2027-2034.

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
@MaxGhenis @claude
Say how to update the projection tests when CMS announces a year
16eafba 
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
@MaxGhenis @claude
Note Medicare's projected years in the program registry
ce75b4a 
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
This was referenced Oct 11, 2026
Merged
Open
Open
Open
@MaxGhenis

MaxGhenis commented Oct 11, 2026

Copy link
Copy Markdown
Contributor Author

Coordination note from #10112, which adds the 2015–2023 IRMAA schedules and the 2015–2020 standard Part B premium.

This was referenced Oct 11, 2026
Draft
Merged
Merged
Open
@MaxGhenis

MaxGhenis commented Oct 11, 2026

Copy link
Copy Markdown
Contributor Author

Heads-up from #10117, which adds the 2015–2020 Part A premiums and the 2015–2023 and 2026 Part A deductibles to the same three files.

Base automatically changed from premium-inputs-cms-uprating to main October 13, 2026 19:26

This branch has not been deployed

No deployments
Sign up for free to join this conversation on GitHub. Already have an account? Sign in to comment

Reviewers

No reviews

Assignees

No one assigned

Labels

None yet

Projects

None yet

Milestone

No milestone

Development

Successfully merging this pull request may close these issues.

1 participant

@MaxGhenis