diff --git a/changelog.d/ssi-institutional-single-source.removed.md b/changelog.d/ssi-institutional-single-source.removed.md new file mode 100644 index 00000000000..d918d0a1c9f --- /dev/null +++ b/changelog.d/ssi-institutional-single-source.removed.md @@ -0,0 +1 @@ +Remove the duplicate `gov.ssa.ssi.amount.institutional` parameters; the Texas SSI supplement and its eligibility test now read `gov.ssa.ssi.amount.medical_facility`, the reduced federal rate federal SSI uses. Results are unchanged from July 1988; for earlier months the eligibility test applies the $25 rate then in force instead of raising `ParameterNotFoundError`. diff --git a/policyengine_us/parameters/gov/ssa/ssi/amount/institutional/couple.yaml b/policyengine_us/parameters/gov/ssa/ssi/amount/institutional/couple.yaml deleted file mode 100644 index 75c194fb60b..00000000000 --- a/policyengine_us/parameters/gov/ssa/ssi/amount/institutional/couple.yaml +++ /dev/null @@ -1,14 +0,0 @@ -description: The Social Security Administration provides this reduced Supplemental Security Income amount for an eligible couple both residing in a Medicaid-funded institution. - -values: - 1988-07-01: 60 - -metadata: - unit: currency-USD - period: month - label: Federal SSI reduced institutional payment for couples - reference: - - title: 42 USC 1382(e)(1)(B) - href: https://www.law.cornell.edu/uscode/text/42/1382 - - title: HHSC MEPD Handbook Section H-6000 - Co-Payment for SSI Cases - href: https://www.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/h-6000-co-payment-ssi-cases diff --git a/policyengine_us/parameters/gov/ssa/ssi/amount/institutional/individual.yaml b/policyengine_us/parameters/gov/ssa/ssi/amount/institutional/individual.yaml deleted file mode 100644 index 386d859f571..00000000000 --- a/policyengine_us/parameters/gov/ssa/ssi/amount/institutional/individual.yaml +++ /dev/null @@ -1,14 +0,0 @@ -description: The Social Security Administration provides this reduced Supplemental Security Income amount for an eligible individual residing in a Medicaid-funded institution. - -values: - 1988-07-01: 30 - -metadata: - unit: currency-USD - period: month - label: Federal SSI reduced institutional payment for individuals - reference: - - title: 42 USC 1382(e)(1)(B) - href: https://www.law.cornell.edu/uscode/text/42/1382 - - title: HHSC MEPD Handbook Section H-6000 - Co-Payment for SSI Cases - href: https://www.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/h-6000-co-payment-ssi-cases diff --git a/policyengine_us/parameters/gov/ssa/ssi/amount/medical_facility.yaml b/policyengine_us/parameters/gov/ssa/ssi/amount/medical_facility.yaml index 3a0a43f1d6f..405dff3c1fa 100644 --- a/policyengine_us/parameters/gov/ssa/ssi/amount/medical_facility.yaml +++ b/policyengine_us/parameters/gov/ssa/ssi/amount/medical_facility.yaml @@ -1,6 +1,12 @@ description: SSA sets this amount as the monthly federal SSI payment for an eligible individual residing in a medical treatment facility where Medicaid pays more than half the cost of care. values: + # 42 USC 1382(e)(1)(B)(i) sets "$360 per year". Pub. L. 100-203 section + # 9119(a) substituted that for "$300 per year", effective July 1, 1988 + # (section 9119(c)). 20 CFR 416.414(b)(1): "For months after June 1988, the + # benefit rate for an eligible individual with no eligible spouse is $30 per + # month." Clause (iii) sets $720 per year for a couple both in a facility; + # ssi_amount_if_eligible applies this per-person amount to each spouse. 1975-01-01: 25 1988-07-01: 30 @@ -9,7 +15,7 @@ metadata: period: month label: SSI medical treatment facility monthly payment reference: - - title: 42 U.S.C. § 1382(e)(1)(A) - Amount of benefits for individuals in medical treatment facilities - href: https://www.law.cornell.edu/uscode/text/42/1382#e_1_A + - title: 42 U.S.C. § 1382(e)(1)(B) - Benefits for individuals in medical treatment facilities + href: https://www.law.cornell.edu/uscode/text/42/1382#e_1_B - title: 20 CFR § 416.414 - Amount of benefits; eligible individual or eligible couple in a medical treatment facility href: https://www.law.cornell.edu/cfr/text/20/416.414 diff --git a/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.yaml b/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.yaml index 4d48d38aed6..692350cf5b8 100644 --- a/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.yaml +++ b/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.yaml @@ -338,3 +338,62 @@ ssi: 30 tx_ssi_state_supplement_eligible: true tx_ssi_state_supplement: 540 + +- name: Case 29, 2011 facility resident whose countable income equals the $30 reduced standard. + # A $50/month pension less the $20 general exclusion is $30 of countable + # income. Federal SSI and the eligibility test read the same $30 standard + # (gov.ssa.ssi.amount.medical_facility): SSI pays $30 - $30 = $0 and the + # resident still gets the $30 supplement ($60 PNA less $30). + period: 2011 + input: + people: + person1: + age: 80 + pension_income: 600 + is_in_medicaid_facility: true + ssi_lives_in_medical_treatment_facility: true + ssi_medicaid_pays_majority_of_care: true + tax_units: + tax_unit: + members: [person1] + spm_units: + spm_unit: + members: [person1] + households: + household: + members: [person1] + state_code: TX + output: + ssi_countable_income: 360 + ssi: 0 + tx_ssi_state_supplement_eligible: true + # ($60 - $30) * 12 = $360/year + tx_ssi_state_supplement: 360 + +- name: Case 30, 2011 facility resident whose countable income exceeds the $30 reduced standard. + # A $51/month pension gives $31 of countable income, so neither SSI nor the + # supplement is paid. + period: 2011 + input: + people: + person1: + age: 80 + pension_income: 612 + is_in_medicaid_facility: true + ssi_lives_in_medical_treatment_facility: true + ssi_medicaid_pays_majority_of_care: true + tax_units: + tax_unit: + members: [person1] + spm_units: + spm_unit: + members: [person1] + households: + household: + members: [person1] + state_code: TX + output: + ssi_countable_income: 372 + ssi: 0 + tx_ssi_state_supplement_eligible: false + tx_ssi_state_supplement: 0 diff --git a/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement_eligible.yaml b/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement_eligible.yaml index 37defc1922a..28b478081da 100644 --- a/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement_eligible.yaml +++ b/policyengine_us/tests/policy/baseline/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement_eligible.yaml @@ -138,3 +138,31 @@ state_code: TX output: tx_ssi_state_supplement_eligible: false + +- name: Case 12, countable income equal to the $25 reduced standard before July 1988. + # 42 USC 1382(e)(1)(B)(i) said "$300 per year" until Pub. L. 100-203 + # section 9119(a) substituted "$360 per year", effective July 1, 1988 + # (section 9119(c)). $300/year = $25/month. + period: 1987 + input: + is_ssi_eligible: true + ssi_countable_income: 300 + is_in_medicaid_facility: true + ssi_lives_in_medical_treatment_facility: true + ssi_medicaid_pays_majority_of_care: true + state_code: TX + output: + tx_ssi_state_supplement_eligible: true + +- name: Case 13, countable income above the $25 reduced standard before July 1988. + # $312/year = $26/month. + period: 1987 + input: + is_ssi_eligible: true + ssi_countable_income: 312 + is_in_medicaid_facility: true + ssi_lives_in_medical_treatment_facility: true + ssi_medicaid_pays_majority_of_care: true + state_code: TX + output: + tx_ssi_state_supplement_eligible: false diff --git a/policyengine_us/variables/gov/ssa/ssi/ssi_amount_if_eligible.py b/policyengine_us/variables/gov/ssa/ssi/ssi_amount_if_eligible.py index bfe5cdf394a..480f7e72483 100644 --- a/policyengine_us/variables/gov/ssa/ssi/ssi_amount_if_eligible.py +++ b/policyengine_us/variables/gov/ssa/ssi/ssi_amount_if_eligible.py @@ -65,6 +65,6 @@ def formula(person, period, parameters): base_amount, ) - # 42 USC § 1382(e)(1)(A), 20 CFR § 416.414: Medical treatment + # 42 USC § 1382(e)(1)(B), 20 CFR § 416.414: Medical treatment # facility, $30/month per person. return where(is_medical_facility, p.medical_facility, base_amount) diff --git a/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.py b/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.py index ef6f2e4c6fa..a4089b06579 100644 --- a/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.py +++ b/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement.py @@ -31,5 +31,5 @@ def formula(person, period, parameters): # the $30 standard, so the allowance less both is the same amount. p = parameters(period).gov.states.tx.hhsc.ssi_state_supplement pna = p.personal_needs_allowance - federal_reduced = parameters(period).gov.ssa.ssi.amount.institutional.individual + federal_reduced = parameters(period).gov.ssa.ssi.amount.medical_facility return max_(pna - federal_reduced, 0) diff --git a/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement_eligible.py b/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement_eligible.py index 9e8ef04d513..dbd74169175 100644 --- a/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement_eligible.py +++ b/policyengine_us/variables/gov/states/tx/hhsc/ssi_state_supplement/tx_ssi_state_supplement_eligible.py @@ -43,7 +43,7 @@ def formula(person, period, parameters): - person("ssi_income_deemed_from_ineligible_spouse", period), 0, ) - within_reduced_rate = own_countable_income <= p.amount.institutional.individual + within_reduced_rate = own_countable_income <= p.amount.medical_facility eligible_for_ssi = ( person("is_ssi_eligible", period) & person("takes_up_ssi_if_eligible", period.this_year)