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[codex] Add Medicaid medically frail CE exclusion#8578

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MaxGhenis merged 4 commits into
PolicyEngine:mainfrom
daphnehanse11:codex/8573-medicaid-medically-frail
Jun 14, 2026
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[codex] Add Medicaid medically frail CE exclusion#8578
MaxGhenis merged 4 commits into
PolicyEngine:mainfrom
daphnehanse11:codex/8573-medicaid-medically-frail

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Summary

Closes #8573.

This adds a distinct Medicaid community engagement input for people who are medically frail or have special medical needs, then treats that input as satisfying the federal Medicaid community engagement eligibility check.

The input is intentionally direct rather than derived: the June 1, 2026 CMS IFC ties the full medically frail/special medical needs definition to state condition lists and case review, which is broader than existing disability variables.

Changes

  • Add is_medically_frail_or_has_special_medical_needs_for_medicaid_ce.
  • Include that input in medicaid_work_requirement_eligible.
  • Add YAML cases proving a medically frail adult passes even when is_disabled is false, while the same adult fails without the exclusion.

Validation

  • /Users/daphnehansell/Documents/GitHub/policyengine-us/.venv/bin/ruff format policyengine_us/variables/gov/hhs/medicaid/eligibility/is_medically_frail_or_has_special_medical_needs_for_medicaid_ce.py policyengine_us/variables/gov/hhs/medicaid/eligibility/medicaid_work_requirement_eligible.py
  • /Users/daphnehansell/Documents/GitHub/policyengine-us/.venv/bin/ruff check policyengine_us/variables/gov/hhs/medicaid/eligibility/is_medically_frail_or_has_special_medical_needs_for_medicaid_ce.py policyengine_us/variables/gov/hhs/medicaid/eligibility/medicaid_work_requirement_eligible.py
  • uv run python -m policyengine_core.scripts.policyengine_command test policyengine_us/tests/policy/baseline/gov/hhs/medicaid/eligibility/medicaid_work_requirement_eligible.yaml -c policyengine_us

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codecov Bot commented Jun 2, 2026

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Codecov Report

✅ All modified and coverable lines are covered by tests.
✅ Project coverage is 100.00%. Comparing base (bd1ae42) to head (a9b5f58).
⚠️ Report is 26 commits behind head on main.

Additional details and impacted files
@@             Coverage Diff              @@
##             main     #8578       +/-   ##
============================================
+ Coverage   77.77%   100.00%   +22.22%     
============================================
  Files           1         2        +1     
  Lines           9        50       +41     
============================================
+ Hits            7        50       +43     
+ Misses          2         0        -2     
Flag Coverage Δ
unittests 100.00% <100.00%> (+22.22%) ⬆️

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@daphnehanse11 daphnehanse11 force-pushed the codex/8573-medicaid-medically-frail branch from 487f611 to 0fc72e1 Compare June 2, 2026 20:26
daphnehanse11 and others added 2 commits June 5, 2026 12:22
Pair the permanent statute (Pub. L. 119-21 sec. 71119, page 242 -
"(V) who is medically frail or otherwise has special medical needs")
and the CMS community engagement CIB with the existing IFC anchors,
for parity with the sibling Medicaid CE exemption variables.

Co-Authored-By: Claude Opus 4.8 (1M context) <noreply@anthropic.com>
@daphnehanse11 daphnehanse11 marked this pull request as ready for review June 9, 2026 15:58
@daphnehanse11 daphnehanse11 requested a review from hua7450 June 9, 2026 16:03

@MaxGhenis MaxGhenis left a comment

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Reviewed: adds a direct medically-frail / special-medical-needs input as a Medicaid community-engagement exclusion and wires it into medicaid_work_requirement_eligible, with YAML cases covering both the frail-passes and not-frail-fails paths. Input defaults to false so there's no baseline impact. Matches the June 2026 CMS IFC framing of the exclusion as state-list/case-review based. LGTM.

@MaxGhenis MaxGhenis merged commit 8760a15 into PolicyEngine:main Jun 14, 2026
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Model Medicaid community engagement medically frail exclusion

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