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Fix NY Child Health Plus full-premium tier #8342

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Fix NY Child Health Plus full-premium tier #8342

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d81a7c8
Fix NY CHIP full premium tier
daphnehanse11 May 18, 2026
138468d
Add NY CHIP full premium per-child regression
daphnehanse11 May 19, 2026
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1 change: 1 addition & 0 deletions changelog.d/fixed/8097.md
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Original file line number Diff line number Diff line change
@@ -0,0 +1 @@
Fixed New York Child Health Plus premiums above 400 percent FPL.
7 changes: 7 additions & 0 deletions policyengine_us/parameters/gov/states/ny/hhs/chip/premium/family_cap.yaml
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Expand Up @@ -12,6 +12,10 @@ metadata:
href: https://web.archive.org/web/20200118155511/https://www.health.ny.gov/health_care/child_health_plus/eligibility_and_cost.htm
- title: Child Health Plus page captured February 2023 (restructured schedule)
href: https://web.archive.org/web/20230207084107/https://www.health.ny.gov/health_care/child_health_plus/eligibility_and_cost.htm
- title: New York Child Health Plus CY 2025 Rate Development, CY 2025 Rate Summary
href: https://mmcor.phpcoalition.org/docs/Rate%20Setting%20Documents/CY25/NY%20CY25%20CHPlus%20Rate%20Presentation%20-%202024.11.08.pdf#page=14
- title: New York Child Health Plus CY 2026 Rate Development, CY 2026 Rate Summary
href: https://mmcor.phpcoalition.org/docs/Rate%20Setting%20Documents/CY26/NY%20CY26%20CHPlus%20Rate%20Presentation%20-%202025.11.10_FINAL.pdf#page=16
brackets:
- threshold:
2020-01-01: -.inf
Expand Down Expand Up @@ -51,3 +55,6 @@ brackets:
amount:
2020-01-01: 180
2023-02-01: 0
2024-01-01: 801.18
2025-01-01: 817.05
2026-01-01: 810.42
7 changes: 7 additions & 0 deletions policyengine_us/parameters/gov/states/ny/hhs/chip/premium/per_child.yaml
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Expand Up @@ -14,6 +14,10 @@ metadata:
href: https://web.archive.org/web/20230207084107/https://www.health.ny.gov/health_care/child_health_plus/eligibility_and_cost.htm
- title: Child Health Plus page captured February 2024 (first page using "Effective for applications received on or after" caption)
href: https://web.archive.org/web/20240229061759/https://www.health.ny.gov/health_care/child_health_plus/eligibility_and_cost.htm
- title: New York Child Health Plus CY 2025 Rate Development, CY 2025 Rate Summary
href: https://mmcor.phpcoalition.org/docs/Rate%20Setting%20Documents/CY25/NY%20CY25%20CHPlus%20Rate%20Presentation%20-%202024.11.08.pdf#page=14
- title: New York Child Health Plus CY 2026 Rate Development, CY 2026 Rate Summary
href: https://mmcor.phpcoalition.org/docs/Rate%20Setting%20Documents/CY26/NY%20CY26%20CHPlus%20Rate%20Presentation%20-%202025.11.10_FINAL.pdf#page=16
brackets:
- threshold:
2020-01-01: -.inf
Expand Down Expand Up @@ -53,3 +57,6 @@ brackets:
amount:
2020-01-01: 60
2023-02-01: 0
2024-01-01: 267.06
2025-01-01: 272.35
2026-01-01: 270.14
45 changes: 45 additions & 0 deletions policyengine_us/tests/policy/baseline/gov/states/ny/hhs/chip/ny_chip_premium.yaml
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Expand Up @@ -78,3 +78,48 @@
state_code: NY
output:
ny_chip_premium: 1620

- name: Case 5, New York Child Health Plus above 400 percent FPL pays the representative full premium.
period: 2026
input:
people:
person1:
is_chip_eligible: true
is_chip_eligible_child: true
person2:
is_chip_eligible: true
is_chip_eligible_child: true
person3:
is_chip_eligible: true
is_chip_eligible_child: true
person4:
is_chip_eligible: true
is_chip_eligible_child: true
tax_units:
tax_unit:
members: [person1, person2, person3, person4]
tax_unit_medicaid_income_level: 4.10
households:
household:
members: [person1, person2, person3, person4]
state_code: NY
output:
ny_chip_premium: 9_725.04

- name: Case 6, New York Child Health Plus above 400 percent FPL with one child pays the per-child full premium.
period: 2026
input:
people:
person1:
is_chip_eligible: true
is_chip_eligible_child: true
tax_units:
tax_unit:
members: [person1]
tax_unit_medicaid_income_level: 4.10
households:
household:
members: [person1]
state_code: NY
output:
ny_chip_premium: 3_241.68
5 changes: 3 additions & 2 deletions policyengine_us/variables/gov/states/ny/hhs/chip/ny_chip_premium.py
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Expand Up @@ -10,8 +10,9 @@ class ny_chip_premium(Variable):
"Annual New York Child Health Plus (separate CHIP) premium paid by "
"the tax unit. Per-child monthly premium capped at a three-child "
"family maximum, tiered by the tax unit's income as a fraction of "
"the federal poverty line. Families above 400 percent FPL pay the "
"full plan cost, which varies by health plan and is not modeled."
"the federal poverty line. Families above 400 percent FPL pay a "
"statewide average full plan premium, because the actual premium "
"varies by health plan."
)
definition_period = YEAR
defined_for = StateCode.NY
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