From 8cbbbf561432621e35b22f492e0293560fa92380 Mon Sep 17 00:00:00 2001 From: PavelMakarchuk Date: Fri, 16 Oct 2026 15:45:47 -0400 Subject: [PATCH 1/2] Set 2024-2025 parent Medicaid limits for TX, FL, MS, WY and CT's 138% cut Texas, Florida, Mississippi and Wyoming kept their 2021 parent and caretaker limits through 2025; #9475 updated them from 2026 only. Add 2024 and 2025 entries from each state's family-of-three standard over that year's guideline, with the 5-point MAGI disregard, as the 2026 entries do. Lower Connecticut to 1.38 from October 1, 2024 (Public Act 24-81). Co-Authored-By: Claude Opus 5.5 --- ...-parent-medicaid-limits-2024-2025.fixed.md | 1 + .../categories/parent/income_limit.yaml | 40 +++++ .../categories/is_parent_for_medicaid.yaml | 72 ++++++++ .../parent/medicaid_parent_income_limit.yaml | 170 ++++++++++++++++++ 4 files changed, 283 insertions(+) create mode 100644 changelog.d/fix-10151-parent-medicaid-limits-2024-2025.fixed.md diff --git a/changelog.d/fix-10151-parent-medicaid-limits-2024-2025.fixed.md b/changelog.d/fix-10151-parent-medicaid-limits-2024-2025.fixed.md new file mode 100644 index 00000000000..c1655784c4e --- /dev/null +++ b/changelog.d/fix-10151-parent-medicaid-limits-2024-2025.fixed.md @@ -0,0 +1 @@ +Updated the 2024 and 2025 parent and caretaker Medicaid income limits for Texas, Florida, Mississippi and Wyoming from their 2021 values to each state's published standard for those years, and lowered Connecticut's limit to 138 percent of the federal poverty guidelines from October 1, 2024 (Public Act 24-81). diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/parent/income_limit.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/parent/income_limit.yaml index 7ce8fe41abb..80c9169dd8e 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/parent/income_limit.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/parent/income_limit.yaml @@ -39,6 +39,14 @@ metadata: href: https://www.scdhhs.gov/sites/dhhs/files/waivers/2025-06-23%20Palmetto%20Pathways%20to%20Independence%20Submission%20(1).pdf - title: IDAPA 16.03.01.411, Income Limits for Parents and Caretaker Relatives, Table 411 | Idaho Department of Health and Welfare - $365/month for a household of three href: https://adminrules.idaho.gov/rules/current/16/160301.pdf#page=14 + - title: Eligibility Policy and Procedures Manual Appendix A-3, MAGI Income Limits 2014 to present | Mississippi Division of Medicaid - COE-075 parents and caretaker relatives, $492/month (effective March 1, 2024) and $495/month (effective March 1, 2025) for a household of three, 5% disregard included + href: https://medicaid.ms.gov/wp-content/uploads/2026/03/Appendix-A-3-MAGI-Income-Limits.-2014-to-present.pdf + - title: 2026 Healthcare Coverage Options in Wyoming | Wyoming Department of Health - footnote 3, "Wyoming's Family Care population is based on the 1996 AFDC standard" + href: https://health.wyo.gov/wp-content/uploads/2026/03/Healthcare-Coverage-Options-in-Wyoming-2026.pdf + - title: Information about the 2024 HUSKY A Parents and Caretaker Relatives Transition | Connecticut DSS - Public Act 24-81 lowers the HUSKY A parent and caretaker relative limit from 160% to 138% FPL starting October 1, 2024 + href: https://portal.ct.gov/dss/health-and-home-care/information-about-the-2024-husky-a-parents-and-caretaker-relatives-transition + - title: Medicaid Income Eligibility Limits for Parents, 2002-2026 | KFF State Health Facts - family of three, 5-point disregard included (May 2024 and January 2025 columns) + href: https://www.kff.org/affordable-care-act/state-indicator/medicaid-income-eligibility-limits-for-parents/ # Most of the states carrying a 2026 entry below set the section 1931 # parent/caretaker standard as a frozen dollar amount, so its share of the @@ -75,6 +83,11 @@ CO: CT: 2018-01-01: 1.38 2021-01-01: 1.60 + # Public Act 24-81 lowered HUSKY A parents and caretaker relatives from + # 160% to 138% of the guidelines for applicants from October 1, 2024 (CT + # DSS). The variable is annual and reads the January 1 value, so 2024 keeps + # 1.60 and 1.38 applies from 2025. + 2024-10-01: 1.38 DC: 2018-01-01: 2.21 2026-01-01: 1.38 @@ -84,6 +97,13 @@ DE: FL: 2018-01-01: 0.34 2021-01-01: 0.32 + # The $303 standard is dated April 1992 and the $486 MNIL it forms with the + # $183 standard disregard is dated January 2014 (DCF ESS Appendix A-7), so + # both held in 2024 and 2025. $486/month = $5,832/year, plus the 5-point + # MAGI disregard: $5,832 / $25,820 + 0.05 = 0.276 (2024) and + # $5,832 / $26,650 + 0.05 = 0.269 (2025). + 2024-01-01: 0.276 + 2025-01-01: 0.269 # $303 standard + $183 standard disregard + $114 5% MAGI disregard = # $600/month = $7,200/year for a family of three. The appendix publishes # the three components, not the $600 total (DCF ESS Appendix A-7). @@ -144,6 +164,13 @@ MO: MS: 2018-01-01: 0.28 2021-01-01: 0.26 + # COE-075 for a household of three, disregard included (MS DOM Appendix + # A-3): $492/month = $5,904/year from March 1, 2024, and $495/month = + # $5,940/year from March 1, 2025. $5,904 / $25,820 = 0.229 and + # $5,940 / $26,650 = 0.223. All three years are the same standard of about + # $384 plus that year's 5% disregard. + 2024-01-01: 0.229 + 2025-01-01: 0.223 # $498/month = $5,976/year, disregard included (MS DOM, eff. 2026-03-01) 2026-01-01: 0.219 MT: @@ -224,6 +251,12 @@ TN: TX: 2018-01-01: 0.20 2021-01-01: 0.19 + # The $230/month C-131.2 standard is Revision 15-4, effective October 1, + # 2015, so it held in 2024 and 2025. $2,760/year plus the 5-point disregard: + # $2,760 / $25,820 + 0.05 = 0.157 (2024) and $2,760 / $26,650 + 0.05 = + # 0.154 (2025). + 2024-01-01: 0.157 + 2025-01-01: 0.154 # $230/month + $113.85 disregard = $4,126/year (Texas Works Handbook C-131) 2026-01-01: 0.151 UT: @@ -246,6 +279,13 @@ WV: WY: 2018-01-01: 0.59 2021-01-01: 0.56 + # Family Care rests on the 1996 AFDC standard (WDH, 2026 Healthcare + # Coverage Options in Wyoming, footnote 3), so the $873/month held in 2024 + # and 2025. $10,476/year plus the 5-point disregard, as in the 2026 entry: + # $10,476 / $25,820 + 0.05 = 0.456 (2024) and $10,476 / $26,650 + 0.05 = + # 0.443 (2025). + 2024-01-01: 0.456 + 2025-01-01: 0.443 # $873/month = $10,476/year, 0.383 of the guidelines for a family of three, # plus the 5-point disregard (WDH Family MAGI column). That column is the # only one the page publishes for this group, with no disregard column, so diff --git a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_parent_for_medicaid.yaml b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_parent_for_medicaid.yaml index 496ea077719..ce131c01c86 100644 --- a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_parent_for_medicaid.yaml +++ b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_parent_for_medicaid.yaml @@ -676,3 +676,75 @@ state_code: OH output: is_parent_for_medicaid_fc: [true, false, true, false] + +# Issue #10151: Connecticut cut HUSKY A parents and caretaker relatives from +# 160% to 138% of the guidelines on October 1, 2024 (Public Act 24-81). A +# parent at 1.414 qualifies under 1.60 in 2024 (the January 1 value) but not +# under 1.38 in 2025. +- name: Connecticut parent at 1.414 FPL is a Medicaid parent in 2024 under the 1.60 limit + period: 2024 + input: + people: + parent: + age: 30 + is_tax_unit_head: true + medicaid_income_level: 1.414 + child: + age: 3 + is_tax_unit_dependent: true + medicaid_income_level: 1.414 + tax_units: + tax_unit: + members: [parent, child] + households: + household: + members: [parent, child] + state_code: CT + output: + is_parent_for_medicaid: [true, false] + +- name: Connecticut parent at 1.414 FPL is not a Medicaid parent in 2025 under the 1.38 limit + period: 2025 + input: + people: + parent: + age: 30 + is_tax_unit_head: true + medicaid_income_level: 1.414 + child: + age: 3 + is_tax_unit_dependent: true + medicaid_income_level: 1.414 + tax_units: + tax_unit: + members: [parent, child] + households: + household: + members: [parent, child] + state_code: CT + output: + is_parent_for_medicaid: [false, false] + +# Florida's 2025 limit is ($303 + $183) x 12 / $26,650 + 0.05 = 0.269, so a +# parent at 0.30 no longer qualifies; the stale 0.32 admitted them. +- name: Florida parent at 0.30 FPL is not a Medicaid parent in 2025 under the 0.269 limit + period: 2025 + input: + people: + parent: + age: 30 + is_tax_unit_head: true + medicaid_income_level: 0.30 + child: + age: 3 + is_tax_unit_dependent: true + medicaid_income_level: 0.30 + tax_units: + tax_unit: + members: [parent, child] + households: + household: + members: [parent, child] + state_code: FL + output: + is_parent_for_medicaid: [false, false] diff --git a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/parent/medicaid_parent_income_limit.yaml b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/parent/medicaid_parent_income_limit.yaml index ee7566669ea..0143fac2c58 100644 --- a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/parent/medicaid_parent_income_limit.yaml +++ b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/parent/medicaid_parent_income_limit.yaml @@ -366,3 +366,173 @@ output: medicaid_parent_income_limit: 0.21 absolute_error_margin: 0.0001 + +# Issue #10151: the 2024 and 2025 values for TX, FL, MS and WY were still the +# 2021 ones (0.19, 0.32, 0.26, 0.56). Each value below is the state's standard +# for a family of three over that year's guideline for three ($25,820 in +# 2024, $26,650 in 2025), inclusive of the 5-point MAGI disregard. + +- name: Case 24, Texas parent limit stays at the 2021 value of 0.19 FPL in 2023. + period: 2023 + input: + people: + person1: + age: 30 + households: + household: + members: [person1] + state_code: TX + output: + medicaid_parent_income_limit: 0.19 + absolute_error_margin: 0.0001 + +# $230 x 12 = $2,760; $2,760 / $25,820 = 0.1069 + 0.05 = 0.157. +- name: Case 25, Texas parent limit is 0.157 FPL in 2024 ($230 per month plus the disregard). + period: 2024 + input: + people: + person1: + age: 30 + households: + household: + members: [person1] + state_code: TX + output: + medicaid_parent_income_limit: 0.157 + absolute_error_margin: 0.0001 + +# $2,760 / $26,650 = 0.1036 + 0.05 = 0.154. +- name: Case 26, Texas parent limit is 0.154 FPL in 2025 ($230 per month plus the disregard). + period: 2025 + input: + people: + person1: + age: 30 + households: + household: + members: [person1] + state_code: TX + output: + medicaid_parent_income_limit: 0.154 + absolute_error_margin: 0.0001 + +# ($303 + $183) x 12 = $5,832; $5,832 / $25,820 = 0.2259 + 0.05 = 0.276. +- name: Case 27, Florida parent limit is 0.276 FPL in 2024 ($486 per month plus the disregard). + period: 2024 + input: + people: + person1: + age: 30 + households: + household: + members: [person1] + state_code: FL + output: + medicaid_parent_income_limit: 0.276 + absolute_error_margin: 0.0001 + +# $5,832 / $26,650 = 0.2188 + 0.05 = 0.269. +- name: Case 28, Florida parent limit is 0.269 FPL in 2025 ($486 per month plus the disregard). + period: 2025 + input: + people: + person1: + age: 30 + households: + household: + members: [person1] + state_code: FL + output: + medicaid_parent_income_limit: 0.269 + absolute_error_margin: 0.0001 + +# $492 x 12 = $5,904 (disregard included); $5,904 / $25,820 = 0.229. +- name: Case 29, Mississippi parent limit is 0.229 FPL in 2024 ($492 per month for three). + period: 2024 + input: + people: + person1: + age: 30 + households: + household: + members: [person1] + state_code: MS + output: + medicaid_parent_income_limit: 0.229 + absolute_error_margin: 0.0001 + +# $495 x 12 = $5,940 (disregard included); $5,940 / $26,650 = 0.223. +- name: Case 30, Mississippi parent limit is 0.223 FPL in 2025 ($495 per month for three). + period: 2025 + input: + people: + person1: + age: 30 + households: + household: + members: [person1] + state_code: MS + output: + medicaid_parent_income_limit: 0.223 + absolute_error_margin: 0.0001 + +# $873 x 12 = $10,476; $10,476 / $25,820 = 0.4057 + 0.05 = 0.456. +- name: Case 31, Wyoming parent limit is 0.456 FPL in 2024 ($873 per month plus the disregard). + period: 2024 + input: + people: + person1: + age: 30 + households: + household: + members: [person1] + state_code: WY + output: + medicaid_parent_income_limit: 0.456 + absolute_error_margin: 0.0001 + +# $10,476 / $26,650 = 0.3931 + 0.05 = 0.443. +- name: Case 32, Wyoming parent limit is 0.443 FPL in 2025 ($873 per month plus the disregard). + period: 2025 + input: + people: + person1: + age: 30 + households: + household: + members: [person1] + state_code: WY + output: + medicaid_parent_income_limit: 0.443 + absolute_error_margin: 0.0001 + +# Connecticut lowered HUSKY A parents and caretaker relatives from 160% to +# 138% of the guidelines on October 1, 2024 (Public Act 24-81). The annual +# variable reads the January 1 value, so 2024 keeps 1.60. +- name: Case 33, Connecticut parent limit stays at 1.60 FPL in 2024. + period: 2024 + input: + people: + person1: + age: 30 + households: + household: + members: [person1] + state_code: CT + output: + medicaid_parent_income_limit: 1.60 + absolute_error_margin: 0.0001 + +- name: Case 34, Connecticut parent limit is 1.38 FPL in 2025. + period: 2025 + input: + people: + person1: + age: 30 + households: + household: + members: [person1] + state_code: CT + output: + medicaid_parent_income_limit: 1.38 + absolute_error_margin: 0.0001 From 4d963798141b91b20f68e962b63cfd0c7be959ed Mon Sep 17 00:00:00 2001 From: PavelMakarchuk Date: Tue, 27 Oct 2026 11:16:59 -0400 Subject: [PATCH 2/2] Address review: anchor MS Appendix A-3, cite PA 24-81 and SPA CT-24-0025 - Mississippi Appendix A-3 reference opens file page 2 and lists pages 2-3 (the 2025 and 2024 COE-075 tables). - Connecticut: cite Public Act 24-81, section 38 (CGS 17b-261(a), 133% from October 1, 2024) and SPA CT-24-0025 (160% to 138% with the disregard), and state that the cut also covered current enrollees. - Mississippi comment: the State Set Income Limit is exactly $384 from 2020 to 2026; each table takes effect March 1. - Case 24: name the stale 2021 entry and point to issue 10491 for 2018-2023. Co-Authored-By: Claude Opus 5.5 --- .../categories/parent/income_limit.yaml | 33 +++++++++++++------ .../parent/medicaid_parent_income_limit.yaml | 4 ++- 2 files changed, 26 insertions(+), 11 deletions(-) diff --git a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/parent/income_limit.yaml b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/parent/income_limit.yaml index 80c9169dd8e..26fdc6936f7 100644 --- a/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/parent/income_limit.yaml +++ b/policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/parent/income_limit.yaml @@ -39,12 +39,16 @@ metadata: href: https://www.scdhhs.gov/sites/dhhs/files/waivers/2025-06-23%20Palmetto%20Pathways%20to%20Independence%20Submission%20(1).pdf - title: IDAPA 16.03.01.411, Income Limits for Parents and Caretaker Relatives, Table 411 | Idaho Department of Health and Welfare - $365/month for a household of three href: https://adminrules.idaho.gov/rules/current/16/160301.pdf#page=14 - - title: Eligibility Policy and Procedures Manual Appendix A-3, MAGI Income Limits 2014 to present | Mississippi Division of Medicaid - COE-075 parents and caretaker relatives, $492/month (effective March 1, 2024) and $495/month (effective March 1, 2025) for a household of three, 5% disregard included - href: https://medicaid.ms.gov/wp-content/uploads/2026/03/Appendix-A-3-MAGI-Income-Limits.-2014-to-present.pdf + - title: "Eligibility Policy and Procedures Manual Appendix A-3, MAGI Income Limits 2014 to present | Mississippi Division of Medicaid - COE-075 parents and caretaker relatives, $492/month (effective March 1, 2024) and $495/month (effective March 1, 2025) for a household of three, 5% disregard included #page 2-3" + href: https://medicaid.ms.gov/wp-content/uploads/2026/03/Appendix-A-3-MAGI-Income-Limits.-2014-to-present.pdf#page=2 - title: 2026 Healthcare Coverage Options in Wyoming | Wyoming Department of Health - footnote 3, "Wyoming's Family Care population is based on the 1996 AFDC standard" href: https://health.wyo.gov/wp-content/uploads/2026/03/Healthcare-Coverage-Options-in-Wyoming-2026.pdf - title: Information about the 2024 HUSKY A Parents and Caretaker Relatives Transition | Connecticut DSS - Public Act 24-81 lowers the HUSKY A parent and caretaker relative limit from 160% to 138% FPL starting October 1, 2024 href: https://portal.ct.gov/dss/health-and-home-care/information-about-the-2024-husky-a-parents-and-caretaker-relatives-transition + - title: "Public Act 24-81, section 38, amending CGS 17b-261(a) effective October 1, 2024 | Connecticut General Assembly - parents and needy caretaker relatives qualify with household income not exceeding 133% (formerly 155%) of the federal poverty level #page 68-69" + href: https://www.cga.ct.gov/2024/ACT/PA/PDF/2024PA-00081-R00HB-05523-PA.PDF#page=68 + - title: "State Plan Amendment CT-24-0025 (approved March 14, 2025, effective October 1, 2024) | CMS - HUSKY A parents and caretakers from 155% to 133% of the FPL, or from 160% to 138% including the 5% income disregard #page 2,5,11" + href: https://www.medicaid.gov/medicaid/spa/downloads/CT-24-0025.pdf#page=2 - title: Medicaid Income Eligibility Limits for Parents, 2002-2026 | KFF State Health Facts - family of three, 5-point disregard included (May 2024 and January 2025 columns) href: https://www.kff.org/affordable-care-act/state-indicator/medicaid-income-eligibility-limits-for-parents/ @@ -83,10 +87,15 @@ CO: CT: 2018-01-01: 1.38 2021-01-01: 1.60 - # Public Act 24-81 lowered HUSKY A parents and caretaker relatives from - # 160% to 138% of the guidelines for applicants from October 1, 2024 (CT - # DSS). The variable is annual and reads the January 1 value, so 2024 keeps - # 1.60 and 1.38 applies from 2025. + # Public Act 24-81, section 38, amended CGS 17b-261(a) from October 1, + # 2024: HUSKY A parents and needy caretaker relatives qualify with income + # up to 133% of the guidelines, down from 155%. With the 5-point MAGI + # disregard that is 138%, down from 160% (SPA CT-24-0025). The cut covers + # new applicants and current enrollees: DSS changed or ended coverage + # above 138% on October 31, 2024, and earners could keep up to one more + # year of Transitional Medical Assistance. The variable is annual and + # reads the January 1 value, so 2024 keeps 1.60 and 1.38 applies from + # 2025. 2024-10-01: 1.38 DC: 2018-01-01: 2.21 @@ -165,10 +174,14 @@ MS: 2018-01-01: 0.28 2021-01-01: 0.26 # COE-075 for a household of three, disregard included (MS DOM Appendix - # A-3): $492/month = $5,904/year from March 1, 2024, and $495/month = - # $5,940/year from March 1, 2025. $5,904 / $25,820 = 0.229 and - # $5,940 / $26,650 = 0.223. All three years are the same standard of about - # $384 plus that year's 5% disregard. + # A-3): $492/month = $5,904/year in the table effective March 1, 2024, and + # $495/month = $5,940/year in the table effective March 1, 2025. + # $5,904 / $25,820 = 0.229 and $5,940 / $26,650 = 0.223. The State Set + # Income Limit is exactly $384 in every table from 2020 to 2026; each + # year's figure is $384 plus that year's 5% disregard. The variable is + # annual and reads the January 1 value, so each entry applies that year's + # March table to the whole year, although in January and February 2024 + # the 2023 table's $488 (0.227) still applied. 2024-01-01: 0.229 2025-01-01: 0.223 # $498/month = $5,976/year, disregard included (MS DOM, eff. 2026-03-01) diff --git a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/parent/medicaid_parent_income_limit.yaml b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/parent/medicaid_parent_income_limit.yaml index 0143fac2c58..f5c26af4119 100644 --- a/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/parent/medicaid_parent_income_limit.yaml +++ b/policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/parent/medicaid_parent_income_limit.yaml @@ -372,7 +372,9 @@ # for a family of three over that year's guideline for three ($25,820 in # 2024, $26,650 in 2025), inclusive of the 5-point MAGI disregard. -- name: Case 24, Texas parent limit stays at the 2021 value of 0.19 FPL in 2023. +# The 2021 entry is a rounded share above the $230 standard (0.161 for 2023); +# the 2018-2023 values are tracked in issue 10491. +- name: Case 24, Texas 2023 parent limit still reads the 2021 entry of 0.19 FPL. period: 2023 input: people: