Restore the part-year facility-stay test cases now that SSI follows each month's facility status

changelog.d/msp-post-merge-followups.changed.md

@@ -0,0 +1 @@
+Let the Medicare Savings Program guideline test's facility stay run through December now that SSI combines a couple's income by each month's facility status, assert SSI countable income again in the New York medically needy part-year case, add earned income to the part-year couple cases for Maryland PAA and the Medicaid optional senior or disabled pathway, and date the Texas Medicare Savings Program deeming-allowance source conflict candidate from 2025.

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

@@ -1201,13 +1201,13 @@
     is_medically_needy_for_medicaid: [false, false]
 
 # A year reads this month-defined status in December, when the couple is home, so
-# the couple is tested together: 8,000 + 34,000 - 240 = 41,760 is above 12 x 2,489 =
-# 29,868. Tested alone for the stay, person2's 33,760 is also above 12 x 1,836 =
-# 22,032. The ssi_countable_income assertion is left out until
-# PolicyEngine/policyengine-us#10820 merges. Until then SSI counts the couple's whole
-# income for each spouse in the months of the stay (PolicyEngine/policyengine-us#10818),
-# giving 31,320 each where (8,000 + 34,000 - 240) / 2 = 20,880 is right. Restore
-# ssi_countable_income: [20_880, 20_880] once the fix merges.
+# the couple is tested together against 12 x 2,489 = 29,868. ssi_countable_income
+# follows each month's status. During the stay each spouse counts their own income
+# less 20 (20 CFR 416.414(b)(3)): (8,000 / 12 - 20) x 6 = 3,880 and
+# (34,000 / 12 - 20) x 6 = 16,880. At home from July each counts half of the
+# couple's 42,000 / 12 - 20 = 3,480 (20 CFR 416.1802(b)(1)): 1,740 x 6 = 10,440.
+# That gives 3,880 + 10,440 = 14,320 and 16,880 + 10,440 = 27,320, together 41,640,
+# above 29,868. Tested alone, person2's 27,320 is also above 12 x 1,836 = 22,032.
 - name: Case 45, a facility stay that ends within the year tests the couple on its December status.
   period: 2026
   absolute_error_margin: 0.01
@@ -1248,6 +1248,7 @@
     ssi_couple_computation_applies:
       2026-01: [false, false]
       2026-12: [true, true]
+    ssi_countable_income: [14_320, 27_320]
     medicaid_medically_needy_uses_couple_standard: [true, true]
     medicaid_medically_needy_income_limit: [29_868, 29_868]
     is_medically_needy_for_medicaid: [false, false]

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

@@ -1110,6 +1110,7 @@
       person1:
         age: 72
         is_tax_unit_head: true
+        ssi_earned_income: 12_000
         ssi_unearned_income: 12_000
       person2:
         age: 70
@@ -1136,12 +1137,15 @@
       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]
+    # including January to June, when SSI combines the couple's income.
+    # person1: (1,000 - 20) + (1,000 - 65) / 2 = 980 + 467.50 = 1,447.50,
+    # x 12 = 17,370. person2: (500 - 20) x 12 = 5,760.
+    # Summing the monthly ssi_marital_* variables instead would combine the
+    # couple's income through June. Unearned, 1,500 a month: person1
+    # 15,000 - 240 + 5,610 = 20,370 and person2 12,000 - 240 = 11,760.
+    # Earned, 1,000 a month: person2 gets 6,000 a year, so
+    # 5,760 + (500 - 65) / 2 x 12 = 8,370.
+    medicaid_optional_senior_or_disabled_countable_income: [17_370, 5_760]
 
 - name: A California couple who are tax dependents do not take the filer's other dependents' premiums.
   period: 2026

policyengine_us/tests/policy/baseline/gov/hhs/medicare/savings_programs/income/msp_fpg.yaml

@@ -70,10 +70,8 @@
         meets_ssi_disability_criteria: true
         ssi_lives_in_medical_treatment_facility:
           2026-07: true
-          2026-12: false
         ssi_medicaid_pays_majority_of_care:
           2026-07: true
-          2026-12: false
         ssi_unearned_income: 18_000
     tax_units:
       tax_unit:
@@ -86,14 +84,14 @@
         members: [person1, person2]
         state_code: TX
   output:
-    # June, both at home: each spouse's income is above 497 and is deemed:
-    # 1,000 + 1,500 - 20 = 2,480, above 1.35 x 21,640 / 12 = 2,434.50.
+    # The stay runs from July through December.
+    # June, both at home: SSI combines the couple's income (20 CFR
+    # 416.1802(b)(1)), 1,000 + 1,500 - 20 = 2,480, above the 1,491 couple rate,
+    # so neither spouse is eligible for SSI. Each spouse's income is above 497
+    # and is deemed: 2,480, above 1.35 x 21,640 / 12 = 2,434.50.
     # July, person2 in a facility (20 CFR 416.414(b)(3)): each is tested alone.
     # person1: 1,000 - 20 = 980, at or below 15,960 / 12 = 1,330, so QMB.
     # person2: 1,500 - 20 = 1,480, and not on Medicare.
-    # The stay ends before December because SSI attributes a couple's income
-    # by the year's last month (ssi_marital_unearned_income): a stay lasting
-    # through December would leave their June income uncombined.
     msp_fpg:
       2026-06: [1_803.33, 1_803.33]
       2026-07: [1_330, 1_330]

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

@@ -62,7 +62,7 @@
   output:
     ssi_marital_earned_income: [10, 10]
 
-- name: Earned income is combined only in the months before one spouse enters a medical facility
+- name: Earned income is combined only in the months before one spouse's first full month in a medical facility
   period: 2026
   absolute_error_margin: 0.01
   input:

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

@@ -62,7 +62,7 @@
   output:
     ssi_marital_unearned_income: [10, 10]
 
-- name: Unearned income is combined only in the months before one spouse enters a medical facility
+- name: Unearned income is combined only in the months before one spouse's first full month in a medical facility
   period: 2026
   absolute_error_margin: 0.01
   input:

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

@@ -54,6 +54,7 @@
       person1:
         age: 72
         is_tax_unit_head: true
+        ssi_earned_income: 12_000
         ssi_unearned_income: 12_000
       person2:
         age: 70
@@ -80,11 +81,14 @@
       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.
+    # including January to June, when SSI combines the couple's income.
+    # person1: (1,000 - 20) + (1,000 - 65) / 2 = 980 + 467.50 = 1,447.50,
+    # x 12 = 17,370. person2: (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]
+    # Summing the monthly ssi_marital_* variables instead would combine the
+    # couple's income through June. Unearned, 1,500 a month: person1
+    # 15,000 - 240 + 5,610 = 20,370 and person2 12,000 - 240 = 11,760.
+    # Earned, 1,000 a month: person2 gets 6,000 a year, so
+    # 5,760 + (500 - 65) / 2 x 12 = 8,370.
+    md_paa_countable_income: [17_370, 5_760]

policyengine_us/variables/gov/hhs/medicare/savings_programs/income/_msp_spouse_income.py

@@ -33,10 +33,6 @@ def msp_spouse_income(person: Population, period: Period, spouse: ArrayLike) ->
     # 416.1801(c); POMS SI 00501.154 A.1), not only aged, blind or disabled:
     # uncapped_ssi above zero adds the income test that is_ssi_eligible leaves
     # out.
-    # NOTE: SSI attributes a couple's income by the year's last month
-    # (ssi_marital_unearned_income). In the months before a facility stay that
-    # lasts through December, uncapped_ssi can be above zero for spouses whose
-    # combined income rules SSI out, and nothing is then deemed between them.
     year = period.this_year
     spouse_eligible_for_ssi = msp_spouse_value(
         person("uncapped_ssi", period) > 0, spouse

source_conflicts/candidates.yaml

@@ -11661,32 +11661,43 @@ candidates:
 - id: us-tx:msp-spouse-deeming-allowance
   program: medicare-savings-programs
   years:
-    from: 2026
+    from: 2025
     type: calendar
   question: When Texas deems an ineligible spouse's income for the Medicare Savings Programs, is the deeming threshold,
     and each ineligible child's allocation, MEPD Appendix XXIX's program-specific living allowance ($474 for QMB, $568
-    for SLMB and $639 for QI-1 in 2026) or SSI's $497 difference between the couple and individual benefit rates?
+    for SLMB and $639 for QI-1 in 2026; $458, $550 and $619 in 2025) or SSI's difference between the couple and
+    individual benefit rates ($497 in 2026; $483 in 2025)?
   sources:
   - kind: statute
     citation: 42 U.S.C. 1396d(p)(1)(B)
     url: https://www.law.cornell.edu/uscode/text/42/1396d
+  - kind: statute
+    citation: 42 U.S.C. 1396a(r)(2)(A)
+    url: https://www.law.cornell.edu/uscode/text/42/1396a#r_2
   - kind: regulation
     citation: 20 CFR 416.1163(b)(1) and (d)
     url: https://www.law.cornell.edu/cfr/text/20/416.1163
   - kind: manual
     citation: Texas MEPD Handbook, Appendix XXIX (Rev. 26-2)
     url: https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/appendix-xxix-special-deeming-eligibility-test-spouse-spouse
+  - kind: manual
+    citation: Texas MEPD Handbook, Revision 25-2 (archived), Appendix XXIX
+    url: https://fhb.hhs.texas.gov/sites/default/files/documents/mepd-25-2.pdf#page=488
   readings:
     statute: 'Section 1396d(p)(1)(B) measures income "as determined under section 1382a of this title for purposes of
       the supplemental security income program". 20 CFR 416.1163(b)(1) sets each ineligible child''s allocation at "the
       difference between the Federal benefit rate for an eligible couple and the Federal benefit rate for an eligible
       individual", and (d) deems nothing from a spouse whose income after allocations "is not more than" that
-      difference: $1,491 - $994 = $497 a month in 2026, the same for every program.'
+      difference: $1,491 - $994 = $497 a month in 2026 and $1,450 - $967 = $483 in 2025, the same for every program.
+      Section 1396a(r)(2)(A) says the methodology for individuals "under section 1396d(p) of this title may be less
+      restrictive, and shall be no more restrictive, than the methodology" of the supplemental security income program
+      for aged, blind or disabled groups.'
     other: 'Appendix XXIX (Rev. 26-2, information effective March 1, 2026) gives a "Program-Specific Living Allowance
       Allocation: Community MEPD $497,CAS $497, QMB $474,SLMB $568, QI-1 $639", deducts it for each ineligible child
       (step 3), deems nothing when the spouse''s remaining income "is no more than the program- specific living
       allowance" (step 4a), and tells the worker to "re-budget for SLMB or QI-1 if applicable" when an applicant who
-      passes the QMB pretest fails QMB in the deeming test (step 8).'
+      passes the QMB pretest fails QMB in the deeming test (step 8). Revision 25-2 (information effective March 1,
+      2025) has the same steps with 2025 amounts: "Community MEPD $483, CAS $483, QMB $458, SLMB $550, QI-1 $619".'
   example: A Texas applicant, 68, on Medicare with $1,340 a month and a spouse, 50, with $497 a month is QMB under the
     regulation, because $497 is not more than $497, so nothing is deemed and $1,320 is within the one-person $1,330.
     Under Appendix XXIX, $497 is above $474, so it is deemed for QMB, and $1,340 + $497 - $20 = $1,817 is above the