Add Medicaid LTSS financial eligibility screen (TX, DE, WA) - #9184
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MaxGhenis wants to merge 5 commits into
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Add Medicaid LTSS financial eligibility screen (TX, DE, WA)#9184MaxGhenis wants to merge 5 commits into
MaxGhenis wants to merge 5 commits into
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Codecov Report✅ All modified and coverable lines are covered by tests. Additional details and impacted files@@ Coverage Diff @@
## main #9184 +/- ##
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Coverage 100.00% 100.00%
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Files 3 25 +22
Lines 63 338 +275
Branches 3 0 -3
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+ Hits 63 338 +275
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Adds an opt-in Medicaid long-term services and supports (LTSS) financial-eligibility screen: an effective-dated 2026 federal chassis with Texas, Delaware, and Washington parameters covering the special income limit routes (300% of SSI in TX/WA; Delaware's 250% route with the $20-disregard mechanics), qualified income trusts, institutional medically-needy budgeting (WA), resource limits, home-equity caps, and spousal impoverishment protections (CSRA floor/half/maximum regimes and MMMNA).
Six new variables (
medicaid_ltss_financial_pathway,is_medicaid_ltss_income_eligible,medicaid_ltss_csra_resource_eligible,medicaid_ltss_home_equity_eligible,medicaid_ltss_mmmna,is_medicaid_ltss_financial_threshold_eligible) — deliberately not integrated intois_medicaid_eligible, enrollment/take-up, or Medicaid benefit values. Functional/level-of-care eligibility is out of scope and labeled as such; QIT-adjusted income and countable resources are trusted inputs with the limitation in metadata; unknown HCBS waivers fail closed tounmodeledrather than inheriting statewide rules.Every parameter value traces to a cited primary source (Texas HHS Appendix XXXI, Delaware's 2026 income-standards notice and LTC regulation, Washington's 2026 standards and WACs) with reference URLs in the YAML metadata; where a state document does not establish a value (e.g., Delaware's numeric home-equity cap), it remains unmodeled rather than inferred.
35 YAML contract tests cover every SIL/resource/home-equity boundary, TX QIT sufficiency both ways, DE's 250% + disregard, WA SIL-failure→institutional-MN, all three CSRA control regimes, an MMMNA non-conversion assertion, home-equity exceptions, identical-household cross-state comparisons, fail-closed unknown-waiver, and vectorized cases.
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