Add at-interview health coverage rule inputs

changelog.d/health-coverage-rules.added.md

@@ -0,0 +1 @@
+Added reported current health coverage inputs and ACA/Medicaid coverage reconciliation helpers.

policyengine_us/tests/policy/baseline/gov/aca/eligibility/coverage_report_model_conflict.yaml

@@ -0,0 +1,27 @@
+- name: Case 1, Marketplace plus Medicaid conflict is flagged.
+  period: 2025
+  input:
+    has_marketplace_health_coverage_at_interview: true
+    has_medicaid_health_coverage_at_interview: true
+  output:
+    coverage_report_model_conflict: true
+
+- name: Case 2, Marketplace without conflicting coverage is not flagged.
+  period: 2025
+  input:
+    age: 40
+    medicaid_enrolled: false
+    is_chip_eligible: false
+    medicare_enrolled: false
+    has_esi: false
+    has_marketplace_health_coverage_at_interview: true
+  output:
+    coverage_report_model_conflict: false
+
+- name: Case 3, non-Marketplace coverage without reported Marketplace is not flagged.
+  period: 2025
+  input:
+    has_marketplace_health_coverage_at_interview: false
+    has_non_marketplace_direct_purchase_health_coverage_at_interview: true
+  output:
+    coverage_report_model_conflict: false

policyengine_us/tests/policy/baseline/gov/aca/eligibility/has_qualifying_non_marketplace_health_coverage_at_interview.yaml

@@ -0,0 +1,25 @@
+- name: Case 1, Medicaid enrollment counts as qualifying non-Marketplace coverage.
+  period: 2025
+  input:
+    medicaid_enrolled: true
+  output:
+    has_qualifying_non_marketplace_health_coverage_at_interview: true
+
+- name: Case 2, IHS-only coverage does not count as qualifying non-Marketplace coverage.
+  period: 2025
+  input:
+    age: 40
+    medicaid_enrolled: false
+    is_chip_eligible: false
+    medicare_enrolled: false
+    has_esi: false
+    has_indian_health_service_coverage_at_interview: true
+  output:
+    has_qualifying_non_marketplace_health_coverage_at_interview: false
+
+- name: Case 3, off-exchange coverage counts as qualifying non-Marketplace coverage.
+  period: 2025
+  input:
+    has_non_marketplace_direct_purchase_health_coverage_at_interview: true
+  output:
+    has_qualifying_non_marketplace_health_coverage_at_interview: true

policyengine_us/tests/policy/baseline/gov/hhs/medicaid/medicaid_enrolled.yaml

@@ -103,3 +103,28 @@
     is_medicaid_eligible: [true]
     medicaid_enrolled: [true]
     takes_up_medicaid_if_eligible: [true]
+
+- name: Case 5, current Medicaid coverage preserves CA continuous coverage.
+  period: 2026
+  input:
+    people:
+      person1:
+        age: 35
+        employment_income: 15_000
+        immigration_status: UNDOCUMENTED
+        has_medicaid_health_coverage_at_interview: true
+    tax_units:
+      tax_unit:
+        members: [person1]
+    spm_units:
+      spm_unit:
+        members: [person1]
+    households:
+      household:
+        members: [person1]
+        state_code: CA
+  output:
+    receives_medicaid: [false]
+    is_ca_medicaid_immigration_status_eligible: [true]
+    is_medicaid_eligible: [true]
+    medicaid_enrolled: [true]

policyengine_us/variables/gov/aca/eligibility/coverage_report_model_conflict.py

@@ -0,0 +1,14 @@
+from policyengine_us.model_api import *
+
+
+class coverage_report_model_conflict(Variable):
+    value_type = bool
+    entity = Person
+    label = "Marketplace coverage conflicts with modeled qualifying non-Marketplace coverage"
+    definition_period = YEAR
+
+    def formula(person, period, parameters):
+        return person("has_marketplace_health_coverage_at_interview", period) & person(
+            "has_qualifying_non_marketplace_health_coverage_at_interview",
+            period,
+        )

policyengine_us/variables/gov/aca/eligibility/has_qualifying_non_marketplace_health_coverage_at_interview.py

@@ -0,0 +1,17 @@
+from policyengine_us.model_api import *
+
+
+class has_qualifying_non_marketplace_health_coverage_at_interview(Variable):
+    value_type = bool
+    entity = Person
+    label = "Person has qualifying non-Marketplace health coverage at interview"
+    definition_period = YEAR
+
+    def formula(person, period, parameters):
+        return (
+            person(
+                "qualifying_non_marketplace_health_coverage_type_count_at_interview",
+                period,
+            )
+            > 0
+        )

policyengine_us/variables/gov/aca/eligibility/qualifying_non_marketplace_health_coverage_type_count_at_interview.py

@@ -0,0 +1,20 @@
+from policyengine_us.model_api import *
+
+
+class qualifying_non_marketplace_health_coverage_type_count_at_interview(Variable):
+    value_type = int
+    entity = Person
+    label = "Count of qualifying non-Marketplace health coverage types at interview"
+    definition_period = YEAR
+    adds = [
+        "has_esi",
+        "medicaid_enrolled",
+        "has_medicaid_health_coverage_at_interview",
+        "is_chip_eligible",
+        "medicare_enrolled",
+        "has_non_marketplace_direct_purchase_health_coverage_at_interview",
+        "has_other_means_tested_health_coverage_at_interview",
+        "has_tricare_health_coverage_at_interview",
+        "has_champva_health_coverage_at_interview",
+        "has_va_health_coverage_at_interview",
+    ]

policyengine_us/variables/gov/states/ca/chhs/is_ca_medicaid_immigration_status_eligible.py

@@ -45,15 +45,17 @@ def formula(person, period, parameters):
                 immigration_status_str,
                 p.medi_cal_enrollment_freeze.affected_statuses,
             )
-            receives_medicaid = person("receives_medicaid", period)
+            current_medicaid_coverage = person("receives_medicaid", period) | person(
+                "has_medicaid_health_coverage_at_interview", period
+            )
 
             # Freeze-affected (UNDOCUMENTED): standard age eligibility OR
             #   continuous coverage (already enrolled)
             # Not freeze-affected (DACA/TPS/others): always eligible
             #   (Health4All covered all ages by 2024, freeze doesn't apply)
             return is_ca_state_funded_status & where(
                 is_freeze_affected,
-                standard_eligible | receives_medicaid,
+                standard_eligible | current_medicaid_coverage,
                 True,
             )
 

policyengine_us/variables/household/expense/health/has_champva_health_coverage_at_interview.py

@@ -0,0 +1,8 @@
+from policyengine_us.model_api import *
+
+
+class has_champva_health_coverage_at_interview(Variable):
+    value_type = bool
+    entity = Person
+    label = "Person currently has CHAMPVA health coverage"
+    definition_period = YEAR

policyengine_us/variables/household/expense/health/has_indian_health_service_coverage_at_interview.py

@@ -0,0 +1,8 @@
+from policyengine_us.model_api import *
+
+
+class has_indian_health_service_coverage_at_interview(Variable):
+    value_type = bool
+    entity = Person
+    label = "Person currently has Indian Health Service coverage"
+    definition_period = YEAR

policyengine_us/variables/household/expense/health/has_marketplace_health_coverage.py

@@ -4,6 +4,12 @@
 class has_marketplace_health_coverage(Variable):
     value_type = bool
     entity = Person
-    label = "Is eligible for health insurance from an ACA Marketplace plan because has no employer-sponsored health insurance coverage."
+    label = "Person has modeled Marketplace health coverage"
     definition_period = YEAR
     default_value = True
+    documentation = """
+    Legacy modeled Marketplace coverage status.
+
+    Use has_marketplace_health_coverage_at_interview for reported current
+    Marketplace coverage from survey data.
+    """

policyengine_us/variables/household/expense/health/has_marketplace_health_coverage_at_interview.py

@@ -0,0 +1,8 @@
+from policyengine_us.model_api import *
+
+
+class has_marketplace_health_coverage_at_interview(Variable):
+    value_type = bool
+    entity = Person
+    label = "Person currently has Marketplace health coverage"
+    definition_period = YEAR

policyengine_us/variables/household/expense/health/has_medicaid_health_coverage_at_interview.py

@@ -0,0 +1,8 @@
+from policyengine_us.model_api import *
+
+
+class has_medicaid_health_coverage_at_interview(Variable):
+    value_type = bool
+    entity = Person
+    label = "Person currently has Medicaid health coverage"
+    definition_period = YEAR

policyengine_us/variables/household/expense/health/has_non_marketplace_direct_purchase_health_coverage_at_interview.py

@@ -0,0 +1,8 @@
+from policyengine_us.model_api import *
+
+
+class has_non_marketplace_direct_purchase_health_coverage_at_interview(Variable):
+    value_type = bool
+    entity = Person
+    label = "Person currently has non-Marketplace direct-purchase health coverage"
+    definition_period = YEAR

policyengine_us/variables/household/expense/health/has_other_means_tested_health_coverage_at_interview.py

@@ -0,0 +1,8 @@
+from policyengine_us.model_api import *
+
+
+class has_other_means_tested_health_coverage_at_interview(Variable):
+    value_type = bool
+    entity = Person
+    label = "Person currently has other means-tested health coverage"
+    definition_period = YEAR

policyengine_us/variables/household/expense/health/has_tricare_health_coverage_at_interview.py

@@ -0,0 +1,8 @@
+from policyengine_us.model_api import *
+
+
+class has_tricare_health_coverage_at_interview(Variable):
+    value_type = bool
+    entity = Person
+    label = "Person currently has TRICARE health coverage"
+    definition_period = YEAR

policyengine_us/variables/household/expense/health/has_va_health_coverage_at_interview.py

@@ -0,0 +1,8 @@
+from policyengine_us.model_api import *
+
+
+class has_va_health_coverage_at_interview(Variable):
+    value_type = bool
+    entity = Person
+    label = "Person currently has VA health coverage"
+    definition_period = YEAR