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Fix WV Medicaid spouse standards and ND medically needy coverage - #10394

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hua7450:medicaid-wv-nd-eligibility-followups
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hua7450:medicaid-wv-nd-eligibility-followups

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@hua7450 hua7450 commented Oct 22, 2026

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Part of #9734. Stacked on #10373. The base branch stack/pr-10373 points to its synced head eb50e2e02a; this PR contains only the follow-up fixes. Retarget to main after #10373 merges.

What and why

A West Virginia applicant with an ineligible spouse and no deemed income could receive the SSI couple standard merely because they were married. Use the existing SSI spouse-eligibility and deeming calculations to select the individual or couple standard for community applicants. A 70-year-old with $1,400 monthly countable income and a younger spouse with no income is now compared with $994, rather than $1,491, in 2026.

North Dakota's medically needy category flags excluded seniors and disabled people, and the category formula omitted blind-only applicants. Enable the supported aged, blind, and disabled coverage and update the existing monthly income tables to $1,174/$1,587 from April 1, 2025 and $1,197/$1,623 from April 1, 2026. The $995-monthly-income senior and an aged couple above the SSI rate now retain Medicaid through medically needy coverage.

Policy sources and scope

The existing annual medically needy formula reads standards at the start of its calculation period. Calendar 2026 therefore uses the April 2025 amounts; rolling-year cases beginning in April 2026 exercise the new 2026 amounts. The actual effective dates are preserved. Earlier income values remain unchanged.

ND's optional non-SSI pathway remains with #10361's separate scope.

Test plan

  • 107 targeted YAML tests pass across the five affected variable test files.

  • All 81 existing SSI-rate property tests pass.

  • Regression check: 12 added cases fail against the synced Use the SSI rate as the Medicaid aged/disabled income limit in West Virginia and North Dakota #10373 parent and pass with these fixes.

  • Policy expectations come from the official sources above; cases cover spouse eligibility/deeming, mixed states, ND aged/disability/blindness, income boundaries, the March/April effective-date boundary, and final Medicaid eligibility.

  • Source-conflict register: not applicable; no conflicting-source reading is taken.

  • make format

  • Changelog fragment in changelog.d/

No partner test files changed. No CI monitoring, full-suite run, or dataset microsimulation was performed.

axiom: needed

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