Let Missouri aged, blind and disabled people who don't receive SSI spend down

changelog.d/medicaid-mo-spend-down.fixed.md

@@ -0,0 +1 @@
+Let aged, blind and disabled people in Missouri who do not receive SSI deduct incurred medical expenses to reach the state's income standard, as 42 CFR 435.121(e)(4) requires in a section 209(b) state with no medically needy program. A child's 209(b) spend down now also counts the parents' medical expenses. In Missouri, a child's resource test now counts the parents' entire resources, and nonblind disabled children are covered.

policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/senior_or_disabled/assets/deems_entire_parental_resources.yaml

@@ -0,0 +1,117 @@
+description: The state uses the entire resources of a child's parents in the asset test under the Medicaid program, if this is true.
+metadata:
+  unit: bool
+  period: year
+  label: Medicaid senior or disabled asset test counts a child's entire parental resources
+  breakdown:
+  - state_code
+  reference:
+    - title: Missouri DSS MO HealthNet for the Aged, Blind and Disabled Manual 0805.020.10 Deeming Parental Resources
+      href: https://dssmanuals.mo.gov/mo-healthnet-for-the-aged-blind-and-disabled/0805-000-00/0805-020-00/0805-020-10/
+    - title: Missouri DSS MO HealthNet Eligibility for Non-MAGI Programs (Appendix K, 07/2026), MO HealthNet for Disabled Children
+      href: https://dssmanuals.mo.gov/wp-content/uploads/2018/10/appendix_k.pdf#page=2
+
+AK:
+  2015-01-01: false
+AL:
+  2015-01-01: false
+AR:
+  2015-01-01: false
+AZ:
+  2015-01-01: false
+CA:
+  2015-01-01: false
+CO:
+  2015-01-01: false
+CT:
+  2015-01-01: false
+DC:
+  2015-01-01: false
+DE:
+  2015-01-01: false
+FL:
+  2015-01-01: false
+GA:
+  2015-01-01: false
+HI:
+  2015-01-01: false
+IA:
+  2015-01-01: false
+ID:
+  2015-01-01: false
+IL:
+  2015-01-01: false
+IN:
+  2015-01-01: false
+KS:
+  2015-01-01: false
+KY:
+  2015-01-01: false
+LA:
+  2015-01-01: false
+MA:
+  2015-01-01: false
+MD:
+  2015-01-01: false
+ME:
+  2015-01-01: false
+MI:
+  2015-01-01: false
+MN:
+  2015-01-01: false
+MO:
+  # IM-48 (August 7, 2018) is the earliest memo MHABD 0805.020.10 lists.
+  # Earlier years read this value.
+  2018-08-07: true
+MS:
+  2015-01-01: false
+MT:
+  2015-01-01: false
+NC:
+  2015-01-01: false
+ND:
+  2015-01-01: false
+NE:
+  2015-01-01: false
+NH:
+  2015-01-01: false
+NJ:
+  2015-01-01: false
+NM:
+  2015-01-01: false
+NV:
+  2015-01-01: false
+NY:
+  2015-01-01: false
+OH:
+  2015-01-01: false
+OK:
+  2015-01-01: false
+OR:
+  2015-01-01: false
+PA:
+  2015-01-01: false
+RI:
+  2015-01-01: false
+SC:
+  2015-01-01: false
+SD:
+  2015-01-01: false
+TN:
+  2015-01-01: false
+TX:
+  2015-01-01: false
+UT:
+  2015-01-01: false
+VA:
+  2015-01-01: false
+VT:
+  2015-01-01: false
+WA:
+  2015-01-01: false
+WI:
+  2015-01-01: false
+WV:
+  2015-01-01: false
+WY:
+  2015-01-01: false

policyengine_us/parameters/gov/hhs/medicaid/eligibility/categories/ssi_recipient/section_209b/excludes_nonblind_disabled_children.yaml

@@ -8,6 +8,8 @@ metadata:
   reference:
     - title: SSA POMS SI 01715.010 Medicaid and the Supplemental Security Income Program
       href: https://secure.ssa.gov/apps10/poms.nsf/lnx/0501715010
+    - title: Missouri DSS MO HealthNet for the Aged, Blind and Disabled Manual 0805.020.00 MO HealthNet for Disabled Children (MHDC)
+      href: https://dssmanuals.mo.gov/mo-healthnet-for-the-aged-blind-and-disabled/0805-000-00/0805-020-00/
 
 AK:
   2024-01-01: false
@@ -58,7 +60,9 @@ MI:
 MN:
   2024-01-01: false
 MO:
-  2024-01-01: true
+  # MHABD 0805.020.00: "disabled children (under age 18) may receive MO
+  # HealthNet as spend down, non-spend down or vendor."
+  2024-01-01: false
 MS:
   2024-01-01: false
 MT:

policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/categories/is_209b_ssi_recipient_for_medicaid.yaml

@@ -152,7 +152,7 @@
   output:
     is_209b_ssi_recipient_for_medicaid: true
 
-- name: Case 15, Missouri nonblind child SSI recipient is excluded.
+- name: Case 15, Missouri nonblind child SSI recipient is covered.
   period: 2026
   input:
     state_code: MO
@@ -162,7 +162,7 @@
     is_optional_senior_or_disabled_income_eligible: true
     is_optional_senior_or_disabled_asset_eligible: true
   output:
-    is_209b_ssi_recipient_for_medicaid: false
+    is_209b_ssi_recipient_for_medicaid: true
 
 - name: Case 16, New Hampshire nonblind child SSI recipient is excluded.
   period: 2026
@@ -223,3 +223,79 @@
   output:
     # 16,800 combined is under the 17,892 couple standard.
     is_209b_ssi_recipient_for_medicaid: [true, true]
+
+# Deemed income is (70,000 / 12 - 85) / 2 x 12 = 34,490, less 11,928, or 22,562.
+# The child's budget is 22,562 / 12 - 20 = 1,860.17, so 1,860 a month or 22,320
+# a year, and 22,320 - 9,000 = 13,320 is within the 13,572 standard. The child's
+# SSI is the reported amount, as in Case 17; computed SSI is zero at this income.
+- name: Case 19, Missouri nonblind disabled child reporting SSI qualifies after spenddown.
+  period: 2026
+  input:
+    people:
+      person1:
+        age: 40
+        is_tax_unit_head: true
+        own_children_in_household: 1
+        employment_income_before_lsr: 70_000
+      person2:
+        age: 8
+        is_tax_unit_dependent: true
+        meets_ssi_disability_criteria: true
+        receives_ssi: true
+        other_medical_expenses: 9_000
+    tax_units:
+      tax_unit:
+        members: [person1, person2]
+    marital_units:
+      marital_unit1:
+        members: [person1]
+      marital_unit2:
+        members: [person2]
+    households:
+      household:
+        members: [person1, person2]
+        state_code: MO
+  output:
+    is_209b_ssi_recipient_for_medicaid: [false, true]
+    medicaid_category: [NONE, SSI_RECIPIENT]
+
+# 42 CFR 435.121(f)(1)(iii) deducts the expenses of financially responsible
+# relatives in every 209(b) state. Virginia's deemed income is (60,000 / 12
+# - 85) / 2 x 12 = 29,490, less 11,928, or 17,562. The child's income is
+# 17,562 - 240 = 17,322, above Virginia's 80% standard of 0.8 x 15,960 =
+# 12,768. The parent's 6,000 of expenses bring it to 11,322. In the model a
+# child with computed SSI is already under this standard, so the expense
+# decides the case only for reported SSI, as in Case 17.
+- name: Case 20, Virginia disabled child reporting SSI qualifies on the parent's medical expenses.
+  period: 2026
+  input:
+    people:
+      person1:
+        age: 40
+        is_tax_unit_head: true
+        own_children_in_household: 1
+        employment_income_before_lsr: 60_000
+        other_medical_expenses: 6_000
+      person2:
+        age: 8
+        is_tax_unit_dependent: true
+        meets_ssi_disability_criteria: true
+        receives_ssi: true
+    tax_units:
+      tax_unit:
+        members: [person1, person2]
+    marital_units:
+      marital_unit1:
+        members: [person1]
+      marital_unit2:
+        members: [person2]
+    households:
+      household:
+        members: [person1, person2]
+        state_code: VA
+  output:
+    medicaid_optional_senior_or_disabled_countable_income: [0, 17_322]
+    medicaid_parental_medical_expense_share: [0, 6_000]
+    is_optional_senior_or_disabled_income_eligible: [true, false]
+    is_209b_ssi_recipient_for_medicaid: [false, true]
+    medicaid_category: [NONE, SSI_RECIPIENT]