diff --git a/changelog.d/added/8349.md b/changelog.d/added/8349.md new file mode 100644 index 00000000000..123066d919d --- /dev/null +++ b/changelog.d/added/8349.md @@ -0,0 +1 @@ +End New York's expanded Basic Health Program income limit after the 2026 waiver termination. diff --git a/policyengine_us/parameters/gov/hhs/basic_health_program/eligibility/expanded_income_limit_states.yaml b/policyengine_us/parameters/gov/hhs/basic_health_program/eligibility/expanded_income_limit_states.yaml index 967ec496792..6227575c10a 100644 --- a/policyengine_us/parameters/gov/hhs/basic_health_program/eligibility/expanded_income_limit_states.yaml +++ b/policyengine_us/parameters/gov/hhs/basic_health_program/eligibility/expanded_income_limit_states.yaml @@ -5,10 +5,14 @@ values: [] # New York's 250% FPL Essential Plan expansion launched 2024-04-01 under # the approved section 1332 waiver; first full coverage year is 2025. - # The model carries that expanded ceiling forward in this BHP-like path, - # even though the formal BHP restarts later. 2025-01-01: - NY + # CMS approved termination of New York's section 1332 waiver effective + # 2026-07-01. Because this eligibility variable is annual, we keep NY on + # the 250% FPL expanded ceiling through 2026 (the waiver still applies for + # H1 2026) and revert to the standard 200% FPL BHP ceiling starting 2027. + 2027-01-01: + [] metadata: unit: list @@ -23,3 +27,5 @@ metadata: href: https://www.medicaid.gov/basic-health-program/downloads/ny-bhp-suspension-appvl-ltr-mar-2024.pdf - title: New York BHP Blueprint revision | CMS href: https://www.medicaid.gov/basic-health-program/downloads/ny-bhp-blueprint-revision-feb2026.pdf + - title: New York State Department of Health Provides Update on Federal Approval to Preserve Health Coverage for 1.3 Million New Yorkers + href: https://www.health.ny.gov/press/releases/2026/2026-03-23_federal_approval_to_preserve_health_coverage.htm diff --git a/policyengine_us/tests/policy/baseline/gov/aca/eligibility/is_aca_ptc_eligible.yaml b/policyengine_us/tests/policy/baseline/gov/aca/eligibility/is_aca_ptc_eligible.yaml index 9c12cb09af2..3c866337807 100644 --- a/policyengine_us/tests/policy/baseline/gov/aca/eligibility/is_aca_ptc_eligible.yaml +++ b/policyengine_us/tests/policy/baseline/gov/aca/eligibility/is_aca_ptc_eligible.yaml @@ -391,3 +391,28 @@ aca_magi_fraction: 2.50 output: is_aca_ptc_eligible: [true, true, true, true, false] + +- name: New York Essential Plan expansion group can qualify for ACA PTC in 2027 + period: 2027 + input: + people: + person1: + age: 40 + immigration_status: CITIZEN + medicaid_income_level: 2.3 + is_aca_eshi_eligible: false + is_medicare_eligible: false + is_chip_eligible: false + tax_units: + tax_unit: + members: [person1] + aca_magi_fraction: 2.3 + filing_status: SINGLE + households: + household: + members: [person1] + state_code: NY + output: + is_medicaid_eligible: [false] + is_basic_health_program_eligible: [false] + is_aca_ptc_eligible: [true] diff --git a/policyengine_us/tests/policy/baseline/gov/hhs/basic_health_program/is_basic_health_program_eligible.yaml b/policyengine_us/tests/policy/baseline/gov/hhs/basic_health_program/is_basic_health_program_eligible.yaml index c53d0fef2f7..eb51e110278 100644 --- a/policyengine_us/tests/policy/baseline/gov/hhs/basic_health_program/is_basic_health_program_eligible.yaml +++ b/policyengine_us/tests/policy/baseline/gov/hhs/basic_health_program/is_basic_health_program_eligible.yaml @@ -350,3 +350,60 @@ state_code: NY output: is_basic_health_program_eligible: [false] + +- name: New York expanded 250 percent FPL ceiling remains effective in 2026 annual simulation + period: 2026 + input: + people: + person: + age: 40 + immigration_status: CITIZEN + medicaid_income_level: 2.3 + is_medicaid_eligible: false + is_chip_eligible: false + is_aca_eshi_eligible: false + is_medicare_eligible: false + households: + household: + members: [person] + state_code: NY + output: + is_basic_health_program_eligible: [true] + +- name: New York at 230 percent FPL in 2027 is above the standard 200 percent BHP limit + period: 2027 + input: + people: + person: + age: 40 + immigration_status: CITIZEN + medicaid_income_level: 2.3 + is_medicaid_eligible: false + is_chip_eligible: false + is_aca_eshi_eligible: false + is_medicare_eligible: false + households: + household: + members: [person] + state_code: NY + output: + is_basic_health_program_eligible: [false] + +- name: New York at 190 percent FPL in 2027 remains within the standard BHP limit + period: 2027 + input: + people: + person: + age: 40 + immigration_status: CITIZEN + medicaid_income_level: 1.9 + is_medicaid_eligible: false + is_chip_eligible: false + is_aca_eshi_eligible: false + is_medicare_eligible: false + households: + household: + members: [person] + state_code: NY + output: + is_basic_health_program_eligible: [true]