Add Medicaid LTSS financial eligibility screen (TX, DE, WA)

changelog.d/ltss-financial-eligibility.added.md

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+Add an opt-in 2026 Medicaid LTSS financial-threshold screen for selected institutional and named-waiver pathways in Texas, Delaware, and Washington.

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/de/csra/state_minimum.yaml

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+description: Delaware uses this state spousal share as the minimum when calculating the community spouse resource allowance for Medicaid LTSS financial eligibility, though the higher federal minimum resource allowance supersedes it.
+values:
+  2026-01-01: 25_000
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Delaware minimum Medicaid LTSS community spouse resource allowance
+  reference:
+    - title: DSSM 20910.10 - Community Spouse Resource Allowance, 16 DE Admin Code 20000
+      href: https://regulations.delaware.gov/api/AdminCode/title16/20000/13aee487-1cd1-4726-addf-63603af28a78

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/de/income/general_disregard.yaml

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+description: Delaware disregards up to this amount of monthly general income when applying the Medicaid LTSS special income limit.
+values:
+  2026-01-01: 20
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Delaware Medicaid LTSS general income disregard
+  reference:
+    - title: Delaware DMMA Administrative Notice A-14-2025, 2026 SSI-Related Income Standards and Medicare Premiums
+      href: https://dhss.delaware.gov/wp-content/uploads/sites/11/2026/06/2026-SSI-Related-Income-Standards-and-Medicare-Premiums.pdf
+    - title: DSSM 20240.1 - Gross Income; DSSM 20990 - Income Rules, 16 DE Admin Code 20000
+      href: https://regulations.delaware.gov/api/AdminCode/title16/20000/13aee487-1cd1-4726-addf-63603af28a78

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/de/resources/couple.yaml

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+description: Delaware limits countable resources to this amount for a couple using the Medicaid LTSS financial screen.
+values:
+  2026-01-01: 3_000
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Delaware Medicaid LTSS resource limit for a couple
+  reference:
+    - title: Delaware DMMA Administrative Notice A-14-2025, 2026 SSI-Related Income Standards and Medicare Premiums
+      href: https://dhss.delaware.gov/wp-content/uploads/sites/11/2026/06/2026-SSI-Related-Income-Standards-and-Medicare-Premiums.pdf
+    - title: DSSM 20100.2.2 - Individuals Whose Income is 250% of SSI, 16 DE Admin Code 20000
+      href: https://regulations.delaware.gov/api/AdminCode/title16/20000/13aee487-1cd1-4726-addf-63603af28a78

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/de/resources/individual.yaml

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+description: Delaware limits countable resources to this amount for an individual using the Medicaid LTSS financial screen.
+values:
+  2026-01-01: 2_000
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Delaware Medicaid LTSS resource limit for an individual
+  reference:
+    - title: Delaware DMMA Administrative Notice A-14-2025, 2026 SSI-Related Income Standards and Medicare Premiums
+      href: https://dhss.delaware.gov/wp-content/uploads/sites/11/2026/06/2026-SSI-Related-Income-Standards-and-Medicare-Premiums.pdf
+    - title: DSSM 20100.2.2 - Individuals Whose Income is 250% of SSI, 16 DE Admin Code 20000
+      href: https://regulations.delaware.gov/api/AdminCode/title16/20000/13aee487-1cd1-4726-addf-63603af28a78

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/de/special_income_limit/couple.yaml

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+description: Delaware limits monthly income before its applicable general disregard to this amount for a couple using the Medicaid LTSS special income pathway.
+values:
+  2026-01-01: 3_727.50
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Delaware Medicaid LTSS special income limit for a couple
+  reference:
+    - title: Delaware DMMA Administrative Notice A-14-2025, 2026 SSI-Related Income Standards and Medicare Premiums
+      href: https://dhss.delaware.gov/wp-content/uploads/sites/11/2026/06/2026-SSI-Related-Income-Standards-and-Medicare-Premiums.pdf
+    - title: DSSM 20100.2.2 - Individuals Whose Income is 250% of SSI, 16 DE Admin Code 20000
+      href: https://regulations.delaware.gov/api/AdminCode/title16/20000/13aee487-1cd1-4726-addf-63603af28a78

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/de/special_income_limit/individual.yaml

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+description: Delaware limits monthly income before its applicable general disregard to this amount for an individual using the Medicaid LTSS special income pathway.
+values:
+  2026-01-01: 2_485
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Delaware Medicaid LTSS special income limit for an individual
+  reference:
+    - title: Delaware DMMA Administrative Notice A-14-2025, 2026 SSI-Related Income Standards and Medicare Premiums
+      href: https://dhss.delaware.gov/wp-content/uploads/sites/11/2026/06/2026-SSI-Related-Income-Standards-and-Medicare-Premiums.pdf
+    - title: DSSM 20100.2.2 - Individuals Whose Income is 250% of SSI, 16 DE Admin Code 20000
+      href: https://regulations.delaware.gov/api/AdminCode/title16/20000/13aee487-1cd1-4726-addf-63603af28a78

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/federal/csra/maximum.yaml

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+description: The federal maximum community spouse resource allowance for Medicaid LTSS financial eligibility.
+values:
+  2026-01-01: 162_660
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Federal maximum Medicaid LTSS community spouse resource allowance
+  reference:
+    - title: Updated 2026 SSI and Spousal Impoverishment Standards, CMCS Informational Bulletin, April 27, 2026
+      href: https://www.medicaid.gov/sites/default/files/2026-04/cib04272026.pdf#page=2

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/federal/csra/minimum.yaml

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+description: The federal minimum community spouse resource allowance for Medicaid LTSS financial eligibility.
+values:
+  2026-01-01: 32_532
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Federal minimum Medicaid LTSS community spouse resource allowance
+  reference:
+    - title: Updated 2026 SSI and Spousal Impoverishment Standards, CMCS Informational Bulletin, April 27, 2026
+      href: https://www.medicaid.gov/sites/default/files/2026-04/cib04272026.pdf#page=2

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/federal/mmmna/maximum.yaml

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+description: The federal maximum monthly maintenance needs allowance for a community spouse.
+values:
+  2026-01-01: 4_066.50
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Federal maximum Medicaid LTSS monthly maintenance needs allowance
+  reference:
+    - title: Updated 2026 SSI and Spousal Impoverishment Standards, CMCS Informational Bulletin, April 27, 2026
+      href: https://www.medicaid.gov/sites/default/files/2026-04/cib04272026.pdf#page=2

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/federal/mmmna/minimum.yaml

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+description: The federal minimum monthly maintenance needs allowance for a community spouse in the contiguous states and District of Columbia.
+values:
+  2026-07-01: 2_705
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Federal minimum Medicaid LTSS monthly maintenance needs allowance
+  reference:
+    - title: Updated 2026 SSI and Spousal Impoverishment Standards, CMCS Informational Bulletin, April 27, 2026
+      href: https://www.medicaid.gov/sites/default/files/2026-04/cib04272026.pdf#page=2

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/federal/mmmna/shelter_threshold_rate.yaml

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+description: The share of the minimum monthly maintenance needs allowance used as the community spouse excess shelter expense threshold.
+values:
+  2026-07-01: 0.3
+
+metadata:
+  unit: /1
+  period: month
+  label: Medicaid LTSS community spouse shelter expense threshold rate
+  reference:
+    - title: 42 USC 1396r-5(d)(4) - Excess shelter allowance
+      href: https://www.law.cornell.edu/uscode/text/42/1396r-5#d_4

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/tx/csra/state_minimum.yaml

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+description: Texas adopts the minimum resource amount set by federal law when calculating the community spouse resource allowance for Medicaid LTSS financial eligibility.
+values:
+  2026-01-01: 32_532
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Texas minimum Medicaid LTSS community spouse resource allowance
+  reference:
+    - title: Texas Medicaid for the Elderly and People with Disabilities Handbook, Appendix XXXI - Budget Reference Chart, Revision 26-2, Effective June 1, 2026
+      href: https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/appendix-xxxi-budget-reference-chart

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/tx/resources/couple.yaml

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+description: Texas limits countable resources to this amount for a couple using the Medicaid LTSS financial screen.
+values:
+  2026-01-01: 3_000
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Texas Medicaid LTSS resource limit for a couple
+  reference:
+    - title: Texas Medicaid for the Elderly and People with Disabilities Handbook, Appendix XXXI - Budget Reference Chart, Revision 26-2, Effective June 1, 2026
+      href: https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/appendix-xxxi-budget-reference-chart

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/tx/resources/individual.yaml

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+description: Texas limits countable resources to this amount for an individual using the Medicaid LTSS financial screen.
+values:
+  2026-01-01: 2_000
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Texas Medicaid LTSS resource limit for an individual
+  reference:
+    - title: Texas Medicaid for the Elderly and People with Disabilities Handbook, Appendix XXXI - Budget Reference Chart, Revision 26-2, Effective June 1, 2026
+      href: https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/appendix-xxxi-budget-reference-chart

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/tx/special_income_limit/couple.yaml

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+description: Texas limits monthly income to this amount for a couple using the Medicaid LTSS special income pathway.
+values:
+  2026-01-01: 5_964
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Texas Medicaid LTSS special income limit for a couple
+  reference:
+    - title: Texas Medicaid for the Elderly and People with Disabilities Handbook, Appendix XXXI - Budget Reference Chart, Revision 26-2, Effective June 1, 2026
+      href: https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/appendix-xxxi-budget-reference-chart

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/tx/special_income_limit/individual.yaml

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+description: Texas limits monthly income to this amount for an individual using the Medicaid LTSS special income pathway.
+values:
+  2026-01-01: 2_982
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Texas Medicaid LTSS special income limit for an individual
+  reference:
+    - title: Texas Medicaid for the Elderly and People with Disabilities Handbook, Appendix XXXI - Budget Reference Chart, Revision 26-2, Effective June 1, 2026
+      href: https://fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/appendix-xxxi-budget-reference-chart

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/wa/csra/state_minimum.yaml

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+description: Washington uses this minimum, which its standards chart stamps July 1, 2025 and revises on a July odd-year cycle, when calculating the community spouse resource allowance for Medicaid LTSS financial eligibility.
+values:
+  2026-01-01: 72_529
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Washington minimum Medicaid LTSS community spouse resource allowance
+  reference:
+    - title: Washington Apple Health Income and Resource Standards, January 1, 2026
+      href: https://www.hca.wa.gov/assets/free-or-low-cost/income-standards-20260101.pdf#page=3

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/wa/medically_needy/income_level.yaml

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+description: Washington uses this monthly income level for a single person in the institutional medically needy pathway.
+values:
+  2026-01-01: 994
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Washington institutional medically needy income level for a single person
+  reference:
+    - title: Washington Apple Health Income and Resource Standards, January 1, 2026
+      href: https://www.hca.wa.gov/assets/free-or-low-cost/income-standards-20260101.pdf#page=3
+    - title: WAC 182-513-1395 - Institutional SSI-related medically needy eligibility
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-513-1395
+    - title: WAC 182-515-1508 - HCS waiver financial eligibility using institutional rules
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1508

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/wa/resources/individual.yaml

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+description: Washington limits countable resources to this amount for an individual using the Medicaid LTSS financial screen.
+values:
+  2026-01-01: 2_000
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Washington Medicaid LTSS resource limit for an individual
+  reference:
+    - title: Washington Apple Health Income and Resource Standards, January 1, 2026
+      href: https://www.hca.wa.gov/assets/free-or-low-cost/income-standards-20260101.pdf#page=3
+    - title: WAC 182-513-1395 - Institutional SSI-related medically needy eligibility
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-513-1395
+    - title: WAC 182-515-1508 - HCS waiver financial eligibility using institutional rules
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1508

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/wa/special_income_limit/individual.yaml

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+description: Washington limits monthly income to this amount for an individual using the Medicaid LTSS special income pathway.
+values:
+  2026-01-01: 2_982
+
+metadata:
+  unit: currency-USD
+  period: month
+  label: Washington Medicaid LTSS special income limit for an individual
+  reference:
+    - title: Washington Apple Health Income and Resource Standards, January 1, 2026
+      href: https://www.hca.wa.gov/assets/free-or-low-cost/income-standards-20260101.pdf#page=3
+    - title: WAC 182-513-1395 - Institutional SSI-related medically needy eligibility
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-513-1395
+    - title: WAC 182-515-1508 - HCS waiver financial eligibility using institutional rules
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1508
+    - title: WAC 182-513-1100 - Definitions, special income level (SIL)
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-513-1100

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/wa/waivers/copes/enabled.yaml

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+description: Washington models COPES as a named Home and Community Services Medicaid HCBS waiver for the LTSS financial screen.
+values:
+  2026-01-01: true
+
+metadata:
+  unit: bool
+  period: month
+  label: Washington Medicaid LTSS COPES waiver enabled
+  reference:
+    - title: WAC 182-515-1505 - HCB waiver services authorized by Home and Community Services
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1505
+    - title: WAC 182-515-1508 - HCS waiver financial eligibility using institutional rules
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1508

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/wa/waivers/new_freedom/enabled.yaml

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+description: Washington models New Freedom as a named Home and Community Services Medicaid HCBS waiver for the LTSS financial screen.
+values:
+  2026-01-01: true
+
+metadata:
+  unit: bool
+  period: month
+  label: Washington Medicaid LTSS New Freedom waiver enabled
+  reference:
+    - title: WAC 182-515-1505 - HCB waiver services authorized by Home and Community Services
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1505
+    - title: WAC 182-515-1508 - HCS waiver financial eligibility using institutional rules
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1508

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/financial/wa/waivers/rsw/enabled.yaml

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+description: Washington models RSW as a named Home and Community Services Medicaid HCBS waiver for the LTSS financial screen.
+values:
+  2026-01-01: true
+
+metadata:
+  unit: bool
+  period: month
+  label: Washington Medicaid LTSS RSW waiver enabled
+  reference:
+    - title: WAC 182-515-1505 - HCB waiver services authorized by Home and Community Services
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1505
+    - title: WAC 182-515-1508 - HCS waiver financial eligibility using institutional rules
+      href: https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1508

policyengine_us/parameters/gov/hhs/medicaid/eligibility/long_term_care/home_equity/minimum_limit.yaml

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+description: The Department of Health and Human Services applies this federal minimum limit on home equity for Medicaid long-term care eligibility in states that do not elect a higher limit.
+values:
+  2025-01-01: 730_000
+  2026-01-01: 752_000
+
+metadata:
+  unit: currency-USD
+  period: year
+  label: Medicaid long-term care federal minimum home equity limit
+  reference:
+    - title: 42 USC 1396p(f)(1)(A) and (C) - Disqualification for long-term care assistance for individuals with substantial home equity
+      href: https://www.law.cornell.edu/uscode/text/42/1396p#f_1
+    - title: Updated 2025 SSI and Spousal Impoverishment Standards, CMCS Informational Bulletin, May 28, 2025
+      href: https://www.medicaid.gov/federal-policy-guidance/downloads/cib05282025.pdf#page=2
+    - title: Updated 2026 SSI and Spousal Impoverishment Standards, CMCS Informational Bulletin, April 27, 2026
+      href: https://www.medicaid.gov/sites/default/files/2026-04/cib04272026.pdf#page=2