Apply state Medicare Savings Program asset limits and income exclusions (WA, CA, MN, IL, MS)

changelog.d/msp-state-asset-income-rules.fixed.md

@@ -0,0 +1 @@
+Applied state Medicare Savings Program rules: no asset test in Washington from 2023 or in Mississippi from July 1999; California asset limits of $130,000 / $195,000 (July 2022 to 2023, and again from 2026); Minnesota asset limits of $10,000 / $18,000; and general income exclusions of $25 in Illinois (one for each spouse with income other than SSI and contributions such as alimony and child support) and $50 in Mississippi (once for a couple).

policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/asset/applies.yaml

@@ -14,8 +14,25 @@ metadata:
       href: https://legislature.maine.gov/statutes/22/title22sec3174-LLL.html
     - title: MassHealth EOM 24-03, Medicare Savings Programs
       href: https://www.mass.gov/doc/eom-24-03-medicare-savings-programs-formerly-known-as-masshealth-senior-buy-in-and-masshealth-buy-in-programs-0/download
-# Federal MSP rules apply the asset test by default; states that have
-# eliminated it in current law are set to false from 2024.
+    - title: California DHCS All County Welfare Directors Letter 22-25, Elimination of Asset Limits for Non-MAGI Medi-Cal Programs
+      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
+      href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/25-14.pdf#page=2
+    - title: "Washington State Register 22-21-043, amending WAC 182-517-0100 to remove Medicare Savings Program resource limits #page 1-2"
+      href: https://lawfilesext.leg.wa.gov/law/wsrpdf/2022/21/22-21-043.pdf#page=1
+    - title: Washington Administrative Code 182-517-0100(2)(d) - Federal Medicare savings programs
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-517-0100
+    - title: Mississippi Division of Medicaid Eligibility Manual Volume III, page 7220, Qualified Medicare Beneficiaries (revised July 1, 1999)
+      href: https://web.archive.org/web/20140514180548id_/https://www.medicaid.ms.gov/wp-content/uploads/2014/03/Pages-7220-7223-Qualified-Medicare-Beneficiaries.pdf#page=1
+    - title: 23 Mississippi Administrative Code Part 103, Rule 1.8(A)(1) - Reduced Coverage Groups
+      href: https://www.law.cornell.edu/regulations/mississippi/23-Miss-Code-R-SS-103-1-8
+    - title: "Laws of Washington 2022, chapter 297, sections 205(26) and 211(79) #page 274,312"
+      href: https://lawfilesext.leg.wa.gov/biennium/2021-22/Pdf/Bills/Session%20Laws/Senate/5693-S.SL.pdf#page=274
+    - title: California Welfare and Institutions Code 14005.62(a), (c), (d)
+      href: https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC&sectionNum=14005.62
+# Federal MSP rules apply the asset test by default. States that have
+# eliminated it are set to false from 2024 where no state source dates the
+# change; WA, CA and MS follow their own sources.
 AL:
   0000-01-01: true
   2024-01-01: false
@@ -31,6 +48,7 @@ AR:
 CA:
   0000-01-01: true
   2024-01-01: false
+  2026-01-01: true
 CO:
   0000-01-01: true
   2024-01-01: true
@@ -90,7 +108,8 @@ MN:
   2024-01-01: true
 MS:
   0000-01-01: true
-  2024-01-01: false
+  # Eligibility Manual page 7220 (revised 07-01-99); 23 Miss. Code R. 103-1.8(A)(1).
+  1999-07-01: false
 MO:
   0000-01-01: true
   2024-01-01: true
@@ -159,7 +178,7 @@ VA:
   2024-01-01: true
 WA:
   0000-01-01: true
-  2024-01-01: true
+  2023-01-01: false
 WV:
   0000-01-01: true
   2024-01-01: true

policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/asset/state_limit/couple.yaml

@@ -0,0 +1,27 @@
+description: States limit resources to this amount for a couple under the Medicare Savings Programs when it is higher than the federal limit.
+metadata:
+  unit: currency-USD
+  period: year
+  label: MSP state couple asset limit
+  breakdown:
+    - state_code
+  reference:
+    - 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 2,8-9"
+      href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/25-14.pdf#page=2
+    - title: California DHCS All County Welfare Directors Letter 25-27, 2026 Medicare Savings Program Property Limits
+      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&sectionNum=14005.62
+    - 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
+      href: https://www.revisor.mn.gov/laws/2000/0/488/#a9
+
+CA:
+  0000-01-01: 0
+  2022-07-01: 195_000
+MN:
+  0000-01-01: 0
+  2000-10-01: 18_000

policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/asset/state_limit/individual.yaml

@@ -0,0 +1,27 @@
+description: States limit resources to this amount for an individual under the Medicare Savings Programs when it is higher than the federal limit.
+metadata:
+  unit: currency-USD
+  period: year
+  label: MSP state individual asset limit
+  breakdown:
+    - state_code
+  reference:
+    - 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 2,8-9"
+      href: https://www.dhcs.ca.gov/services/medi-cal/eligibility/letters/Documents/25-14.pdf#page=2
+    - title: California DHCS All County Welfare Directors Letter 25-27, 2026 Medicare Savings Program Property Limits
+      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&sectionNum=14005.62
+    - 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
+      href: https://www.revisor.mn.gov/laws/2000/0/488/#a9
+
+CA:
+  0000-01-01: 0
+  2022-07-01: 130_000
+MN:
+  0000-01-01: 0
+  2000-10-01: 10_000

policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/income/contribution_sources.yaml

@@ -0,0 +1,16 @@
+description: The Medicare Savings Programs treat these income sources as contributions, which are income from a person outside the medical unit, when a state excludes contributions from its general income exclusion.
+values:
+  # Same start as the SSI unearned income source list these come from.
+  1975-01-01:
+    - alimony_income
+    - child_support_received
+    - financial_assistance
+metadata:
+  unit: list
+  period: year
+  label: MSP contribution income sources
+  reference:
+    - title: Illinois Department of Human Services Policy Manual PM 15-04-03-a - AABD Income Disregard (Community Cases)
+      href: https://www.dhs.state.il.us/page.aspx?item=16387
+    - title: 89 Illinois Administrative Code 120.335(a)(1) - Exempt Unearned Income
+      href: https://www.ilga.gov/ftp/JCAR/AdminCode/089/089001200H03350R.html

policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/income/state_general_exclusion.yaml

@@ -0,0 +1,33 @@
+description: States exclude this amount of monthly income, in place of the Supplemental Security Income general income exclusion, under the Medicare Savings Programs.
+metadata:
+  unit: currency-USD
+  period: month
+  label: MSP state general income exclusion
+  breakdown:
+    - state_code
+  reference:
+    - title: Illinois Department of Human Services Policy Manual PM 06-12-01-c - Income Exemption
+      href: https://www.dhs.state.il.us/page.aspx?item=14179
+    - title: Illinois Department of Human Services Policy Manual PM 15-04-03-a - AABD Income Disregard (Community Cases)
+      href: https://www.dhs.state.il.us/page.aspx?item=16387
+    - title: Illinois Department of Human Services Policy Manual PM 15-05-03 - AABD Community
+      href: https://www.dhs.state.il.us/page.aspx?item=16446
+    - title: Illinois Department of Human Services Policy Manual PM 06-13-01-b - SLIB Income Limit
+      href: https://www.dhs.state.il.us/page.aspx?item=14218
+    - title: Illinois Department of Human Services Policy Manual PM 06-14-01-b - QI-1 Income Limit
+      href: https://www.dhs.state.il.us/page.aspx?item=14250
+    - title: 89 Illinois Administrative Code 120.335(a)(1) - Exempt Unearned Income
+      href: https://www.ilga.gov/ftp/JCAR/AdminCode/089/089001200H03350R.html
+    - title: "23 Mississippi Administrative Code Part 104, Rules 1.1(C)(2)(b) and 4.2 - Income Rules and General Income Exclusion #page 9,21-22"
+      href: https://www.sos.ms.gov/adminsearch/ACCode/00000278c.pdf#page=9
+    - title: Mississippi Division of Medicaid Eligibility Manual Volume III, Countable Income (revised July 1, 1999)
+      href: https://web.archive.org/web/20140514175849id_/https://www.medicaid.ms.gov/wp-content/uploads/2014/03/Pages-5400-5401-Countable-Income.pdf#page=2
+
+IL:
+  0000-01-01: 0
+  # PM 06-12-01-c revision date; the exemption is in effect no later than this.
+  1997-03-01: 25
+MS:
+  0000-01-01: 0
+  # Eligibility Manual p. 5401 sets the break-even point at FPL + 50 from this date.
+  1999-07-01: 50

policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/income/state_general_exclusion_excludes_contributions.yaml

@@ -0,0 +1,29 @@
+description: States exclude contributions from the income that the state general income exclusion applies to under the Medicare Savings Programs, if this is true.
+metadata:
+  unit: bool
+  period: year
+  label: MSP state general income exclusion excludes contributions
+  breakdown:
+    - state_code
+  reference:
+    - title: Illinois Department of Human Services Policy Manual PM 15-04-03-a - AABD Income Disregard (Community Cases)
+      href: https://www.dhs.state.il.us/page.aspx?item=16387
+    - title: Illinois Department of Human Services Policy Manual PM 06-12-01-b - QMB Income Limit
+      href: https://www.dhs.state.il.us/page.aspx?item=14177
+    - title: Illinois Department of Human Services Policy Manual PM 15-05-03 - AABD Community
+      href: https://www.dhs.state.il.us/page.aspx?item=16446
+    - title: 89 Illinois Administrative Code 120.74 - Qualified Medicare Beneficiary (QMB) Income Standard
+      href: https://www.ilga.gov/ftp/JCAR/AdminCode/089/089001200D00740R.html
+    - title: 89 Illinois Administrative Code 120.335(a)(1) - Exempt Unearned Income
+      href: https://www.ilga.gov/ftp/JCAR/AdminCode/089/089001200H03350R.html
+    - title: "23 Mississippi Administrative Code Part 104, Rule 4.2(C)(1) and (C)(5) - General Income Exclusion #page 22-23"
+      href: https://www.sos.ms.gov/adminsearch/ACCode/00000278c.pdf#page=22
+
+IL:
+  0000-01-01: false
+  # Same start as state_general_exclusion.
+  1997-03-01: true
+MS:
+  # Rule 4.2(C)(5) withholds the exclusion only from income based on need,
+  # so alimony and other contributions keep it.
+  0000-01-01: false

policyengine_us/parameters/gov/hhs/medicare/savings_programs/eligibility/income/state_general_exclusion_per_spouse.yaml

@@ -0,0 +1,24 @@
+description: States apply the general income exclusion to each applying spouse's own income, instead of once to the couple's combined income, under the Medicare Savings Programs, if this is true.
+metadata:
+  unit: bool
+  period: year
+  label: MSP state general income exclusion per spouse
+  breakdown:
+    - state_code
+  reference:
+    - title: Illinois Department of Human Services Policy Manual PM 15-04-03-a - AABD Income Disregard (Community Cases)
+      href: https://www.dhs.state.il.us/page.aspx?item=16387
+    - title: Illinois Department of Human Services Policy Manual PM 06-12-01-c - Income Exemption
+      href: https://www.dhs.state.il.us/page.aspx?item=14179
+    - title: 89 Illinois Administrative Code 120.335(a)(1) - Exempt Unearned Income
+      href: https://www.ilga.gov/ftp/JCAR/AdminCode/089/089001200H03350R.html
+    - title: 23 Mississippi Administrative Code Part 104, Rule 4.2(C)(2) - General Income Exclusion
+      href: https://www.sos.ms.gov/adminsearch/ACCode/00000278c.pdf#page=22
+
+IL:
+  0000-01-01: false
+  # PM 06-12-01-c revision date; the exemption is in effect no later than this.
+  1997-03-01: true
+MS:
+  # Rule 4.2(C)(2): one general exclusion for a couple's combined income.
+  0000-01-01: false