[hua7450]

Part of #9734. #9735 made the same change for CO, IA, LA, MT, OH, OR and WA. #10361 keeps West Virginia's optional aged, blind and disabled group on and leaves its income standard to this PR. It also leaves North Dakota on and lists ND's 209(b) standard under the rest of #9734; this PR covers that standard too.

What and why

Both states set the income level for aged, blind and disabled Medicaid at the SSI payment level: $994 a month for one person and $1,491 for a couple in 2026. The model used 0.75 of the poverty guideline for both.

• uses_ssi_federal_benefit_rate: WV and ND are now true from 2018-01-01.
• income/limit/individual.yaml and couple.yaml: WV's and ND's 0.75 entries are removed. Use the SSI rate as the aged/disabled Medicaid income limit in MT, CO, IA, LA, OH, OR and WA #9735 removed the seven states' entries the same way, and these files say SSI-rate states are omitted.
• requires_income_below_limit: WV and ND stay false, so income equal to the SSI rate qualifies (see below). The file now cites both states' sources.
• No formula changes. medicaid_optional_senior_or_disabled_income_limit already reads the flag.

In 2026 the individual limit falls from $11,970 to $11,928 a year. The couple limit rises from $16,230 to $17,892, because 75% of the two-person guideline is below the SSI couple rate.

West Virginia

West Virginia covers aged, blind and disabled people who don't receive SSI through its "SSI-Related/Non-Cash Assistance" group. West Virginia is a 1634 state, so the 209(b) path does not apply.

Each source was read on 2026-10-21. The current manual is the consolidated PDF dated 2026-10-05. Page numbers are PDF file pages.

Source	Text
IMM § 23.9	Lists "SSI Related/Non-Cash Assistance" among the optional categorically needy aged, blind or disabled groups
IMM § 23.11.4	Income: "SSI Payment Level". Assets: $2,000 individual, $3,000 couple. "This coverage group is not subject to the spenddown provision." The § 4.14 method "applies to this coverage group"
IMM Chapter 4, Appendix A	"SSI Max": 994 for one person, 1491 for two
Archived IMM § 16.7.H (rev. 10/13)	The same group, with "Income: SSI Payment Level" and the same asset limits
KFF 2018 survey, Appendix Tables 1 and 2	West Virginia has not adopted the pathway up to 100% FPL. Its limit is $750 / $1,125 (74% FPL), the 2018 SSI rates

Income exactly at the standard

Two passages of the manual read differently:

Passage	Text
§ 23.11.4 (the group)	"Countable income must be under the SSI Maximum Payment level"
§ 4.14.3 Step 5 (the method § 23.11.4 applies)	"If the net countable monthly income is equal to or less than the appropriate SSI Maximum Payment Level, the assistance group (AG) is eligible"
Archived § 16.7.H (rev. 10/13)	"Countable income is under the SSI Maximum Payment level"
Archived § 10.23.C Step 5 (rev. 5/13) (the method § 16.7.H applied)	"If the net countable monthly income is equal to or less than the appropriate SSI Maximum Payment Level, the AG is eligible."

This PR follows Step 5, along with SSI's own income test: income "at a rate of not more than" the benefit rate (42 U.S.C. 1382(a)(1)(A) and (2)(A); POMS SI 02005.001.C.3). #9735 treated Colorado and Iowa the same way. The manual uses "under" the same way for the medically needy limit: § 23.11.3 says "under the Medically Needy Income Limit (MNIL)", while § 4.14.3 Step 6 makes income "equal to or less than the appropriate MNIL" eligible without a spenddown.

North Dakota

North Dakota is a 209(b) state. is_209b_ssi_recipient_income_eligible_for_medicaid tests SSI recipients against the same limit, so the flag also corrects that test. SSI couples with countable income between $1,353 and $1,491 a month now qualify without spenddown.

Each source was read on 2026-10-22.

Source	Text
N.D.A.C. 75-02-02.1-40(1)(a)(2)	"Except for individuals subject to the nursing care income level, the income level for categorically needy aged, blind, or disabled recipients is that which establishes supplemental security income eligibility." The February 2017 edition has the same text, so the change applies from 2018-01-01.
Non-ACA Medicaid Policy Manual 510-05-85-40 (rev. 7/1/2026)	The same rule for "Categorically needy aged, blind, and disabled recipients"
N.D.A.C. 75-02-02.1-41.1	"Recipient liability is the amount of monthly net income remaining after all appropriate deductions, disregards, and Medicaid income levels have been allowed." Income equal to the level leaves no liability, so the test is at or below, like SSI's own test.

Coverage for people who don't receive SSI is not changed here. N.D.A.C. 75-02-02.1-05 puts aged, blind or disabled SSI recipients in the categorically needy group ((1)(n)). Those "who are not in receipt of supplemental security income" are in the medically needy group ((3)(e)), with an income level of 90% of the poverty guideline. The model still runs ND's optional non-SSI pathway; this PR only moves its individual limit from $998 to $994 a month. Turning that pathway off belongs with #10361's covers_non_ssi_recipients.

Readers checked

• is_optional_senior_or_disabled_for_medicaid and medicaid_category follow the new limit.
• is_209b_ssi_recipient_income_eligible_for_medicaid also reads the income test. In ND it now uses the SSI rate. In WV it doesn't apply, because WV is a 1634 state (section_209b false).
• The $20 disregard (WV § 4.14.2.B.1) and the asset limits are unchanged.

Test plan

• For policy changes: YAML tests whose expected values come from an external source. The amounts are from WV IMM Chapter 4 Appendix A, N.D.A.C. 75-02-02.1-40 and SSA's SSI payment table. All cases use 2026.
  • is_optional_senior_or_disabled_income_eligible.yaml:
    • a WV individual at $11,928 is eligible;
    • a WV individual at $11,929 is ineligible, although $11,929 is under 75% of the guideline ($11,970);
    • a WV couple at $17,892 combined is eligible;
    • an ND individual at $11,952 is ineligible, although $11,952 is under 75% of the guideline.
  • is_209b_ssi_recipient_for_medicaid.yaml, Case 18: an ND SSI couple with $1,400 a month of combined countable income qualifies without spenddown.
  • test_medicaid_abd_ssi_rate_standard_properties.py: WV and ND are added to SSI_RATE_STATES, so the existing property tests cover both for 2018-2026. They check that:
    • the limit is 12 times SSA's individual and couple rates;
    • income eligibility holds exactly at or below the standard;
    • nobody over the SSI rate gets the pathway, and everyone under it gets SSI.
  • The docstring and comments now say nine states and quote both states' rules.
  • Tests were not run locally; CI validates.
• Source-conflict register: not applicable. The WV passages are both in the WV manual, and the reading taken agrees with the federal SSI income test. The ND sources agree with each other.
• Formatting: ruff format --check on the changed Python file.
• Changelog fragment in changelog.d/.

No partner test has a West Virginia or North Dakota household. Test merges with #10361 and #10378 are clean. The microsimulation impact was not run.

Not changed here

• The rest of Medicaid optional senior/disabled pathway: SSI-only states, 209(b) states, and SSI-plus-supplement standards encoded as shares of poverty #9734: the AK, ID, NH, VT and WI standards are in Use state dollar standards for the Medicaid aged, blind and disabled income limit in AK, ID, NH, VT and WI #10378, and NY is not covered here.
• North Dakota's non-SSI coverage (see above).
• Senior-or-disabled disregards and asset limits, which are being worked on under Medicaid aged, blind and disabled pathway: outdated disregards and asset limits in CA, CT, AR, MO, OK and SC #10356-Medicare Savings Programs: outdated asset rules in WA, CA and MN, and state income exclusions in IL and MS #10359.

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