diff --git a/changelog.d/fixed/8097.md b/changelog.d/fixed/8097.md new file mode 100644 index 00000000000..4dc73326001 --- /dev/null +++ b/changelog.d/fixed/8097.md @@ -0,0 +1 @@ +Fixed New York Child Health Plus premiums above 400 percent FPL. diff --git a/policyengine_us/parameters/gov/states/ny/hhs/chip/premium/family_cap.yaml b/policyengine_us/parameters/gov/states/ny/hhs/chip/premium/family_cap.yaml index d70b52713cf..47969a2a7b5 100644 --- a/policyengine_us/parameters/gov/states/ny/hhs/chip/premium/family_cap.yaml +++ b/policyengine_us/parameters/gov/states/ny/hhs/chip/premium/family_cap.yaml @@ -1,4 +1,4 @@ -description: New York caps the total Child Health Plus monthly premium per family at three children's worth, based on the tax unit's modified adjusted gross income as a fraction of the federal poverty line. +description: New York caps the total subsidized Child Health Plus monthly premium per family at three children's worth, based on the tax unit's modified adjusted gross income as a fraction of the federal poverty line. metadata: type: single_amount threshold_unit: /1 @@ -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 @@ -51,3 +55,4 @@ brackets: amount: 2020-01-01: 180 2023-02-01: 0 + 2024-01-01: .inf diff --git a/policyengine_us/parameters/gov/states/ny/hhs/chip/premium/per_child.yaml b/policyengine_us/parameters/gov/states/ny/hhs/chip/premium/per_child.yaml index 191cd1fece0..48985f96eb7 100644 --- a/policyengine_us/parameters/gov/states/ny/hhs/chip/premium/per_child.yaml +++ b/policyengine_us/parameters/gov/states/ny/hhs/chip/premium/per_child.yaml @@ -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 @@ -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 diff --git a/policyengine_us/tests/policy/baseline/gov/states/ny/hhs/chip/ny_chip_premium.yaml b/policyengine_us/tests/policy/baseline/gov/states/ny/hhs/chip/ny_chip_premium.yaml index 9d46ad74abe..d828911a3c2 100644 --- a/policyengine_us/tests/policy/baseline/gov/states/ny/hhs/chip/ny_chip_premium.yaml +++ b/policyengine_us/tests/policy/baseline/gov/states/ny/hhs/chip/ny_chip_premium.yaml @@ -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 per child. + 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: 12_966.72 + +- 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 diff --git a/policyengine_us/variables/gov/states/ny/hhs/chip/ny_chip_premium.py b/policyengine_us/variables/gov/states/ny/hhs/chip/ny_chip_premium.py index 83ce078728a..cad39720d6f 100644 --- a/policyengine_us/variables/gov/states/ny/hhs/chip/ny_chip_premium.py +++ b/policyengine_us/variables/gov/states/ny/hhs/chip/ny_chip_premium.py @@ -8,10 +8,11 @@ class ny_chip_premium(Variable): unit = USD documentation = ( "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 tax unit. Subsidized per-child monthly premiums are capped at " + "a three-child family maximum and tiered by the tax unit's income " + "as a fraction of the federal poverty line. Families above 400 " + "percent FPL pay an uncapped statewide average full plan premium, " + "because the actual premium varies by health plan." ) definition_period = YEAR defined_for = StateCode.NY