[hua7450]

Closes #10385

Stacked on #10361. This branch merges #10361 at b078376278 and main at 9ee14cdb43, so until #10361 merges the diff also shows its commits. This PR's own changes are commits 08cfcae (the change), 4e94e07 (review fixes), 084e198 (drops the Maine spouse-deeming case) and 372bb19 (SSI income test at or below the rate); the other merge commits bring in #10361 and main.

What and why

Arkansas: ARSeniors covers only aged people

is_optional_senior_or_disabled_for_medicaid accepted anyone who is is_ssi_aged_blind_disabled. Arkansas's group for this pathway, ARSeniors, covers only people aged 65 or older.

• New parameter senior_or_disabled.covers_blind_or_disabled, by state. It is false for Arkansas from 2002-10-01, when ARSeniors started (Policy Directive MS 02-07), and true elsewhere from 2018-01-01, the date the other senior_or_disabled files use.
• is_optional_senior_or_disabled_for_medicaid: where the flag is false, the person must be is_ssi_aged (65 or older).
• Noncitizen exception. Turn off the Medicaid optional aged/disabled pathway in 14 states that cover only SSI recipients #10361 keeps noncitizens who fail the Medicaid immigration test in this pathway, so emergency Medicaid still has a category for them (42 U.S.C. 1396b(v)(2)(B) waives only the receipt of SSI). In Arkansas a blind or disabled noncitizen under 65 would get emergency Medicaid through the SSI group, not ARSeniors. So they keep the pathway only if they also meet SSI's income test (ssi_countable_income at or below the SSI rate: "not more than" the benefit rate under 42 U.S.C. 1382(a)(1)(A), and POMS SI 02005.001 C.3) and resource test (meets_ssi_resource_test). The aged-only rule applies to everyone who passes the immigration test.

Maine: savings exclusion

Maine excludes up to $8,000 of savings for an individual and $12,000 for a couple, and counts only the excess toward the $2,000 / $3,000 limit. The model counted all of ssi_countable_resources.

• New parameters gov.states.me.dhhs.medicaid.savings_exclusion.individual ($8,000) and .couple ($12,000), from 2002-01-01, the date in 22 M.R.S. § 3174-AA.
• is_optional_senior_or_disabled_asset_eligible subtracts the exclusion from the marital unit's resources in Maine, floored at zero, before the limit test. The couple amount applies when the marital unit has two people: an eligible couple, or an eligible person with an ineligible spouse, whose assets are deemed (Part 7, § 7-1, Section 1.3).

Definition of savings. Part 16, § 16-4, Section 4.47 counts as savings: savings and checking accounts, IRAs, Keoghs, annuity cash value, stocks, bonds, mutual funds and life insurance cash surrender value. One exclusion covers all of them together. ssi_countable_resources adds bank_account_assets, stock_assets and bond_assets, all of which are savings, so the exclusion applies to the whole of it and no new inputs are needed. The model does not count IRAs, Keoghs, annuities or life insurance as resources at all.

Maine: couple income disregard

Chart 3.1 sets a $20 federal disregard plus a state disregard of $55 for an individual and $80 for a couple, effective July 1, 1987. The couple value changes from $75 to $100, dated 1987-07-01. The individual value ($75) was already right; its date moves from 2015-01-01 to 1987-07-01, which changes no output. The ME lines are their own hunks; #10364 edits only the CA, CT and SC lines and appends its references after the Connecticut entries, while the Maine references sit after the KFF entry.

The couple value also feeds medicaid_optional_senior_or_disabled_income_deemed_from_ineligible_spouse, so when SSI deeming applies the couple budget there uses $100 too. That deeming does not follow Maine's rule for an eligible person with an ineligible spouse: Maine first excludes the Chart 3.5 ineligible spouse standard from the spouse's income (Part 7, Section 2.2.2.I.D), which the model does not apply (#10474). No test here pins a deemed amount.

Sources

Each was read on 2026-10-22 or 2026-10-26.

Rule	Source	Text
AR aged only	Arkansas Medical Services Policy Manual, B-321 ARSeniors (September 2026 edition)	"This group consists of individuals sixty-five (65) years of age or over whose income is equal to or below eighty percent (80%) of the Federal Poverty Levels (FPL)."
AR start date	Ark. Code R. 016.20.02-014, Policy Directive MS 02-07, MS 23110	"Effective October 1, 2002 ..."; "The individual must be Aged to qualify for ARSeniors."
AR aged only	AR DHS Health Care Eligibility Quick Reference (January 2025)	"ARSeniors is only for individuals aged 65 or older."
Noncitizen exception	42 U.S.C. 1396b(v)(2)	"(B) such alien otherwise meets the eligibility requirements for medical assistance under the State plan ... (other than the requirement of the receipt of ... supplemental security income benefits under subchapter XVI ...)"
ME savings	22 M.R.S. § 3174-AA(2), PL 2001, c. 450	"Beginning January 1, 2002 ... Savings. An amount up to $8,000 for an individual and up to $12,000 for a household of more than one person."
ME savings	10-144 C.M.R. ch. 332, Part 16, § 16-4, Section 4.47	"Up to $8,000 of savings for an individual, $12,000 for an assistance unit of two or more. Any amount over the excluded amount is counted toward the asset limit." It applies to the SSI-related categories, except State Supplement.
ME savings	2023 MaineCare Eligibility Guidelines	The Aged and Disabled rows' footnote says the same.
ME disregard	10-144 C.M.R. ch. 332, Chart 3.1	"Disregards (eff. 7/1/87) $20.00 Federal disregard $55.00 State disregard for Individual $80.00 State disregard for Couple"
ME disregard	10-144 C.M.R. ch. 332, Part 7, § 7-4, Section 4.3	"Subtract the State Disregard for two ($80.00) ... If countable income is equal to or below 100% of the Federal Poverty Level for two ... the individual or couple is Medicaid eligible."

The official text of 10-144 C.M.R. ch. 332 (filing 2025-101, effective April 29, 2025) on maine.gov matches the Cornell copies. The AR DHS site returns 403 to scripts; the Quick Reference was read through a Wayback capture of 2025-10-30 and the manual with browser headers.

Readers checked

Reader	Effect
medicaid_category	ADULT comes before SENIOR_OR_DISABLED. So blind or disabled Arkansans under 65 who leave the pathway are mostly people on Medicare, who are outside the adult group. They fall to MEDICALLY_NEEDY where they qualify (#10374 switches Arkansas's group on), or to NONE. In Maine, more people with savings, and some couples, now land in SENIOR_OR_DISABLED.
is_209b_ssi_recipient_for_medicaid	Reads is_optional_senior_or_disabled_asset_eligible, but neither Arkansas nor Maine is a 209(b) state. Unchanged.
medicaid_group, is_medicaid_eligible, is_emergency_medicaid_eligible and their readers (ACA PTC, Lifeline, CHIP and others)	Follow the category. Microsimulation results change for AR and ME.

No partner test has an Arkansas or Maine household. No existing YAML case asserts an output that these changes move.

Tests

• is_optional_senior_or_disabled_for_medicaid.yaml (Cases 6-8 are Turn off the Medicaid optional aged/disabled pathway in 14 states that cover only SSI recipients #10361's Alabama cases)
  • Case 9: a disabled Arkansan aged 50 with $900 a month of SSDI who doesn't take up SSI. Income-eligible ($10,560 countable, under 80% of the guideline, $12,768) but not covered.
  • Case 10: an Arkansan aged 70 with the same income is covered.
  • Case 11: a disabled undocumented Arkansan aged 50 with no income or resources keeps the group: they fail the immigration test and meet SSI's tests ($0 below the $994 rate; $0 within $2,000).
  • Case 12: a disabled permanent resident 10 years after entry passes the immigration test, so the aged-only rule applies and they are not covered.
  • Case 13: a disabled undocumented Arkansan with $5,000 in the bank is under Arkansas's pathway asset limit but over SSI's $2,000 limit, so they are not covered.
  • Case 14: a disabled permanent resident 2 years after entry (in the five-year bar, so failing the Medicaid immigration test) with $1,014 a month of SSDI has (1,014 - 20) x 12 = $11,928 countable, equal to the 2026 SSI rate ($994 x 12), so they keep the group.
  • Case 15: the same person with $1,015 a month has $11,940 countable, over the SSI rate though under Arkansas's 80% of the guideline, so they are not covered.
• is_optional_senior_or_disabled_asset_eligible.yaml
  • A Mainer with $9,000 in the bank is eligible: $1,000 counts, under $2,000.
  • A Mainer with $10,000 is ineligible: $2,000 counts, which is not under $2,000 (Part 7, § 7-1: assets "must be under" the limits).
  • A Maine couple with $9,000 in the bank and $5,000 in stocks is eligible: $2,000 counts, under $3,000. The individual exclusion would leave $6,000.
• medicaid_optional_senior_or_disabled_countable_income.yaml: a Maine couple aged 72 and 70 with $1,100 and $790 a month of Social Security has (1,890 - 100) x 12 = $21,480 countable, under the 2026 guideline for two ($21,640). With a $75 disregard it would be $21,780, over the guideline.
• Tests were not run locally; CI validates.

Not changed here

What	Source	Why
Maine's ineligible spouse standard	Part 7, Section 4.3 and Section 2.2.2.I.D; Chart 3.5	Maine excludes the Chart 3.5 ineligible spouse standard (half the SSI individual rate, $497 a month in 2026) from the spouse's income, unearned income first, uses the $80 couple disregard whether or not anything is deemed, and tests the total against 100% of the guideline for two. The model deems only when the spouse's income is above the SSI couple-minus-individual differential, and then deems all of it. For example, $1,000 of Social Security with a spouse's $600 pension is $12,036 a year under Maine's rule and $18,000 in the model. Follow-up issue #10474.
Order of Maine's disregards	Part 7, Section 2.1	Maine subtracts the $20 federal disregard, then the $65 and one-half earned income exclusion, then the $55 / $80 state disregard. The model subtracts the combined $75 / $100 as the SSI general exclusion before the earned income exclusion. For unearned income the results match; for earners the model's countable income is up to $27.50 a month higher for an individual and $40 for a couple. Follow-up issue #10474.
Maine blind-only applicants	Part 7, Section 3.3 Note and Section 4.3 Note; Chart 3.4	They must meet the State Supplement income standard (the SSI rate plus $10 for an individual or $15 for a couple living alone or with others), strictly below it, not 100% of the guideline. Follow-up issue #10474.
Maine parent deeming	Part 7, Section 3.4	Maine takes only the $20 federal disregard from the parents' income and the state disregard once, from the child's countable income; the model applies Maine's $75 to the parents' income. Follow-up issue #10474.
Zero countable income for some noncitizens	—	On main, ssi_countable_income and medicaid_optional_senior_or_disabled_countable_income are 0 for anyone who is not an SSI-eligible individual or spouse, for example an undocumented person, whatever their income. Until that changes, the SSI income test here binds only for noncitizens SSI treats as qualified; the resource test binds for everyone. #10240 (draft) counts that income.
ARSeniors' Medicare condition	B-321	A person entitled to Medicare must enroll in it. Not modeled before or after.
Arkansas's asset limit	—	#10364 updates it.
New York	18 NYCRR 360-4.6(a)(2)(vii)	Its deductions, income level and asset limit are a follow-up issue.

Merge order

Merge after #10361, then #10364.

Test merges of this branch at 372bb19 on 2026-10-26 (main has since moved 4 commits):

PR	Head	Result
#10361	b078376	Already merged in
#10364	d331416	Conflicts in is_optional_senior_or_disabled_asset_eligible.yaml and medicaid_optional_senior_or_disabled_countable_income.yaml, both cases appended at the end of the file by each branch. Keep both. The disregard files and is_optional_senior_or_disabled_asset_eligible.py merge cleanly; the merged formula applies the Maine exclusion before #10364's limit tests, and Maine's uses_msp_limit is false there.
#10240	56dc11f	Conflict in medicaid_optional_senior_or_disabled_countable_income.yaml, cases appended at the end by each branch. Keep both.
#10370	5434a6c	Clean
#10373	2cd7a27	Clean
#10374	7ff3614	Clean
#10378	928c372	Conflict in medicaid_optional_senior_or_disabled_income_limit.py, which comes from #10361 (#10361 and #10378 conflict with each other directly); this PR does not change that file.

Test plan

• YAML tests with expected values from the Maine statute and manual, the Arkansas manual and rule, and 42 U.S.C. 1396b(v) (amounts from the 2026 poverty guideline and SSI rate already in the model)
• Source-conflict register: not applicable (the Maine statute and manual agree; the Arkansas sources agree)
• ruff format
• Changelog fragment in changelog.d/

axiom: TheAxiomFoundation/rulespec-us#1930 queued

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