Combine an SSI couple's income by each month's facility status

changelog.d/ssi-part-year-couple-income.fixed.md

@@ -0,0 +1 @@
+Combine an SSI couple's income by each month's facility status, so a part-year medical facility stay no longer changes SSI in the other months of the year.

policyengine_us/tests/policy/baseline/gov/hhs/medicaid/income/medicaid_optional_senior_or_disabled_countable_income.yaml

@@ -33,7 +33,7 @@
   absolute_error_margin: 0.01
   input:
     age: 70
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     state_code: CT
   output:
     medicaid_optional_senior_or_disabled_countable_income: 5_580
@@ -98,7 +98,7 @@
   absolute_error_margin: 0.01
   input:
     age: 70
-    ssi_marital_unearned_income: 13_821
+    ssi_unearned_income: 13_821
     state_code: MO
   output:
     # Monthly, 1,151.75 - 20 = 1,131.75, rounded down to 1,131. Without
@@ -112,7 +112,7 @@
   input:
     age: 70
     medicare_enrolled: false
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     state_code: CA
   output:
     # DHCS ACWDL 20-24, no Part B or other premiums: (1,000 - 20) x 12 = 11,760.
@@ -123,7 +123,7 @@
   absolute_error_margin: 0.01
   input:
     age: 70
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     state_code: CT
   output:
     # (1,000 - 562) x 12 = 5,256.
@@ -134,7 +134,7 @@
   absolute_error_margin: 0.01
   input:
     age: 70
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     state_code: SC
   output:
     # (1,000 - 50) x 12 = 11,400.
@@ -146,7 +146,7 @@
   input:
     age: 70
     medicare_enrolled: true
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     state_code: CA
   output:
     # DHCS ACWDL 20-24 deducts Part B regardless of how it is paid; the
@@ -161,7 +161,7 @@
     age: 70
     medicare_enrolled: true
     medicare_part_b_enrolled: false
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     state_code: CA
   output:
     # No Part B enrollment, so no Part B premium to disregard:
@@ -250,7 +250,7 @@
   input:
     age: 70
     medicare_enrolled: false
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     state_code: CA
   output:
     # ACWDL 20-24 ended the 230 disregard on December 1, 2020, which first
@@ -263,7 +263,7 @@
   input:
     age: 70
     medicare_enrolled: true
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     state_code: CA
   output:
     # ACWDL 00-57 MC 176 lines 8 and 16. 2020 reads January 1, 2020: the 230
@@ -307,7 +307,7 @@
   input:
     age: 70
     medicare_enrolled: false
-    ssi_marital_earned_income: 12_000
+    ssi_earned_income: 12_000
     state_code: CA
   output:
     # ACWDL 00-57 MC 176 lines 10-16: the unused 20-dollar deduction joins the
@@ -347,7 +347,7 @@
   input:
     age: 70
     medicare_enrolled: false
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     health_insurance_premiums_without_medicare_part_b: 1_800
     state_code: CA
   output:
@@ -360,7 +360,7 @@
   input:
     age: 70
     medicare_enrolled: true
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     state_code: CA
   output:
     # The December 2020 Part B disregard first applies in 2021 annual
@@ -374,7 +374,7 @@
   input:
     age: 70
     medicare_enrolled: false
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     health_insurance_premiums: 1_200
     state_code: CA
   output:
@@ -468,7 +468,7 @@
     age: 70
     medicare_enrolled: true
     health_insurance_premiums_without_medicare_part_b: 3_000
-    ssi_marital_unearned_income: 1_200
+    ssi_unearned_income: 1_200
     state_code: CA
   output:
     # (100 - 20) x 12 = 960, less 2,434.80 Part B and 3,000 premiums, floored at 0.
@@ -512,7 +512,7 @@
     age: 70
     medicare_enrolled: true
     health_insurance_premiums_without_medicare_part_b: 1_200
-    ssi_marital_unearned_income: 12_000
+    ssi_unearned_income: 12_000
     state_code: NC
   output:
     # Only California deducts premiums: (1,000 - 20) x 12 = 11,760.
@@ -523,7 +523,7 @@
   absolute_error_margin: 0.01
   input:
     age: 70
-    ssi_marital_earned_income: 12_000
+    ssi_earned_income: 12_000
     state_code: MN
   output:
     # Minn. Stat. 256B.056, subd. 1b: no $20, so none moves to earned income.
@@ -1098,3 +1098,44 @@
     # The spouse's own countable income stays 0 to avoid counting it twice.
     medicaid_optional_senior_or_disabled_countable_income: [25_370, 0]
     is_optional_senior_or_disabled_income_eligible: [false, false]
+
+- name: A spouse's facility stay from July counts by December's status for the whole year, as an annual approximation.
+  period: 2025
+  absolute_error_margin: 0.01
+  input:
+    people:
+      person1:
+        age: 72
+        is_tax_unit_head: true
+        ssi_unearned_income: 12_000
+      person2:
+        age: 70
+        is_tax_unit_spouse: true
+        ssi_unearned_income: 6_000
+        ssi_lives_in_medical_treatment_facility:
+          2025-01: false
+          2025-07: true
+        ssi_medicaid_pays_majority_of_care:
+          2025-01: false
+          2025-07: true
+    marital_units:
+      marital_unit:
+        members: [person1, person2]
+    households:
+      household:
+        members: [person1, person2]
+        state_code: NC
+  output:
+    # person2 is in a Medicaid-funded facility from July through December,
+    # so the couple computation applies through June and not from July.
+    ssi_couple_computation_applies:
+      2025-06: [true, true]
+      2025-07: [false, false]
+    # This annual formula applies December's status, separate, to the whole
+    # year, so each spouse counts their own income in all twelve months,
+    # including January to June, when SSI combines the couple's income:
+    # (1,000 - 20) x 12 = 11,760 and (500 - 20) x 12 = 5,760.
+    # Summing the monthly ssi_marital_unearned_income instead would combine
+    # 1,500 a month through June: 15,000 - 240 = 14,760 and
+    # 12,000 - 240 = 11,760.
+    medicaid_optional_senior_or_disabled_countable_income: [11_760, 5_760]

policyengine_us/tests/policy/baseline/gov/ssa/ssi/income/ssi_marital_earned_income.yaml

@@ -61,3 +61,34 @@
         members: [head, spouse]
   output:
     ssi_marital_earned_income: [10, 10]
+
+- name: Earned income is combined only in the months before one spouse enters a medical facility
+  period: 2026
+  absolute_error_margin: 0.01
+  input:
+    people:
+      person1:
+        age: 68
+        ssi_earned_income: 12_000
+      person2:
+        age: 62
+        meets_ssi_disability_criteria: true
+        ssi_lives_in_medical_treatment_facility:
+          2026-07: true
+        ssi_medicaid_pays_majority_of_care:
+          2026-07: true
+    marital_units:
+      marital_unit:
+        members: [person1, person2]
+    households:
+      household:
+        members: [person1, person2]
+        state_code: TX
+  output:
+    # 20 CFR 416.1802(b)(1) combines an eligible couple's income through
+    # June, so person1's 1,000 a month of wages counts for both spouses.
+    # 20 CFR 416.414(b)(3) counts each spouse's own income from July, the
+    # first month person2 spends throughout in the facility (416.414(a)(1)).
+    ssi_marital_earned_income:
+      2026-06: [1_000, 1_000]
+      2026-07: [1_000, 0]

policyengine_us/tests/policy/baseline/gov/ssa/ssi/income/ssi_marital_unearned_income.yaml

@@ -61,3 +61,37 @@
         members: [head, spouse]
   output:
     ssi_marital_unearned_income: [10, 10]
+
+- name: Unearned income is combined only in the months before one spouse enters a medical facility
+  period: 2026
+  absolute_error_margin: 0.01
+  input:
+    people:
+      person1:
+        age: 68
+        ssi_unearned_income: 12_000
+      person2:
+        age: 62
+        meets_ssi_disability_criteria: true
+        ssi_unearned_income: 18_000
+        ssi_lives_in_medical_treatment_facility:
+          2026-07: true
+        ssi_medicaid_pays_majority_of_care:
+          2026-07: true
+    marital_units:
+      marital_unit:
+        members: [person1, person2]
+    households:
+      household:
+        members: [person1, person2]
+        state_code: TX
+  output:
+    # 20 CFR 416.1802(b)(1) combines an eligible couple's income through
+    # June: 1,000 + 1,500 = 2,500 a month for each spouse.
+    # 20 CFR 416.414(b)(3) counts each spouse's own income from July, the
+    # first month person2 spends throughout in the facility
+    # (416.414(a)(1)). The stay runs through December, and the months
+    # before it are still combined.
+    ssi_marital_unearned_income:
+      2026-06: [2_500, 2_500]
+      2026-07: [1_000, 1_500]

policyengine_us/tests/policy/baseline/gov/ssa/ssi/ssi_countable_income.yaml

@@ -191,3 +191,43 @@
     # countable income stays 0.
     ssi_countable_income: [25_370, 0]
     ssi: [0, 0]
+
+- name: A couple is paid as a couple through the month one spouse enters a Medicaid facility and as individuals from the first full month.
+  period: 2000
+  absolute_error_margin: 0.01
+  input:
+    people:
+      person1:
+        age: 70
+        ssi_unearned_income: 4_800
+        ssi_lives_in_medical_treatment_facility:
+          2000-07: true
+        ssi_medicaid_pays_majority_of_care:
+          2000-07: true
+      person2:
+        age: 70
+        ssi_unearned_income: 2_400
+    marital_units:
+      marital_unit:
+        members: [person1, person2]
+    households:
+      household:
+        members: [person1, person2]
+        state_code: TX
+  output:
+    # POMS SI 02005.050 D.1: Allen (person1) has $400 a month of Social
+    # Security and Martha (person2) a $200 spouse's benefit. Allen enters a
+    # Title XIX facility on June 10, 2000 and stays.
+    # June, "the last month for which payment is computed for a couple":
+    # 400 + 200 - 20 = 580 of countable income against the 769 couple rate
+    # leaves 189, or 94.50 each.
+    # July, "computed as if Allen and Martha are individuals": Allen has
+    # 30 - 380, so no payment. Martha has 513 - 180 = 333. POMS shows 332
+    # from the 512 individual rate first set for 2000; SSA's rate table has
+    # 513 for 2000 after Public Law 106-554.
+    ssi_countable_income:
+      2000-06: [290, 290]
+      2000-07: [380, 180]
+    ssi:
+      2000-06: [94.5, 94.5]
+      2000-07: [0, 333]

policyengine_us/tests/policy/baseline/gov/states/md/dhs/fia/paa/md_paa_countable_income.yaml

@@ -45,3 +45,46 @@
     # $2,500 monthly SSDI - $20 general exclusion.
     ssi_countable_income: 0
     md_paa_countable_income: 2_480
+
+- name: Case 4, a spouse's facility stay from July counts by December's status for the whole year, as an annual approximation.
+  period: 2025
+  absolute_error_margin: 0.01
+  input:
+    people:
+      person1:
+        age: 72
+        is_tax_unit_head: true
+        ssi_unearned_income: 12_000
+      person2:
+        age: 70
+        is_tax_unit_spouse: true
+        ssi_unearned_income: 6_000
+        ssi_lives_in_medical_treatment_facility:
+          2025-01: false
+          2025-07: true
+        ssi_medicaid_pays_majority_of_care:
+          2025-01: false
+          2025-07: true
+    marital_units:
+      marital_unit:
+        members: [person1, person2]
+    households:
+      household:
+        members: [person1, person2]
+        state_code: MD
+  output:
+    # person2 is in a Medicaid-funded facility from July through December,
+    # so the couple computation applies through June and not from July.
+    ssi_couple_computation_applies:
+      2025-06: [true, true]
+      2025-07: [false, false]
+    # This annual formula applies December's status, separate, to the whole
+    # year, so each spouse counts their own income in all twelve months,
+    # including January to June, when SSI combines the couple's income:
+    # (1,000 - 20) x 12 = 11,760 and (500 - 20) x 12 = 5,760.
+    # Both spouses are aged, so neither is an ineligible spouse and no
+    # income is deemed.
+    # Summing the monthly ssi_marital_unearned_income instead would combine
+    # 1,500 a month through June: 15,000 - 240 = 14,760 and
+    # 12,000 - 240 = 11,760.
+    md_paa_countable_income: [11_760, 5_760]