Illinois medicaid for undocumented immigrants

changelog_entry.yaml

@@ -0,0 +1,4 @@
+- bump: minor
+  changes:
+    added:
+    - Illinois Health Benefits for Immigrants (HBI) program covering All Kids, HBIA (adults 42-64), and HBIS (seniors 65+).

policyengine_us/parameters/gov/hhs/medicaid/eligibility/undocumented_immigrant.yaml

@@ -41,8 +41,9 @@ HI:
 ID:
   2021-01-01: false
 IL:
+  # Illinois coverage handled separately via il_hbi program
+  # (Health Benefits for Immigrant Adults/Seniors/All Kids)
   2021-01-01: false
-  2022-01-01: true
 IN:
   2021-01-01: false
 IA:

policyengine_us/parameters/gov/states/il/hfs/hbi/eligibility/adult/in_effect.yaml

@@ -0,0 +1,17 @@
+description: Illinois determines whether the Health Benefits for Immigrant Adults program is active.
+metadata:
+  unit: bool
+  period: year
+  label: Illinois HBIA program in effect
+  reference:
+    - title: Illinois DHS - HBIA and HBIS Policy
+      href: https://www.dhs.state.il.us/page.aspx?item=161600
+    - title: Illinois HFS - HBIA FAQ
+      href: https://hfs.illinois.gov/medicalclients/healthbenefitsforimmigrants/hbiafaq.html
+
+values:
+  2020-01-01: false
+  # HBIA program started May 2022
+  2022-05-01: true
+  # Program terminated July 1, 2025
+  2025-07-01: false

policyengine_us/parameters/gov/states/il/hfs/hbi/eligibility/adult/income_limit.yaml

@@ -0,0 +1,14 @@
+description: Illinois limits income to this share of the federal poverty level under the Health Benefits for Immigrant Adults program.
+metadata:
+  unit: /1
+  period: year
+  label: Illinois HBIA income limit
+  reference:
+    - title: Illinois DHS - HBIA and HBIS Policy
+      href: https://www.dhs.state.il.us/page.aspx?item=161600
+    - title: Illinois HFS - Health Benefits for Immigrant Adults
+      href: https://hfs.illinois.gov/medicalclients/healthbenefitsforimmigrants/healthbenefitsforimmigrantadults.html
+
+values:
+  # HBIA uses MAGI methodology at 138% FPL
+  2022-01-01: 1.38

policyengine_us/parameters/gov/states/il/hfs/hbi/eligibility/adult/max_age.yaml

@@ -0,0 +1,14 @@
+description: Illinois sets the maximum age to this threshold under the Health Benefits for Immigrant Adults program.
+metadata:
+  unit: year
+  period: year
+  label: Illinois HBIA maximum age
+  reference:
+    - title: Illinois DHS - HBIA and HBIS Policy
+      href: https://www.dhs.state.il.us/page.aspx?item=161600
+    - title: Illinois HFS - Health Benefits for Immigrant Adults
+      href: https://hfs.illinois.gov/medicalclients/healthbenefitsforimmigrants/healthbenefitsforimmigrantadults.html
+
+values:
+  # HBIA covers adults aged 42-64
+  2022-01-01: 64

policyengine_us/parameters/gov/states/il/hfs/hbi/eligibility/adult/min_age.yaml

@@ -0,0 +1,15 @@
+description: Illinois sets the minimum age to this threshold under the Health Benefits for Immigrant Adults program.
+metadata:
+  unit: year
+  period: year
+  label: Illinois HBIA minimum age
+  reference:
+    - title: Illinois DHS - HBIA and HBIS Policy
+      href: https://www.dhs.state.il.us/page.aspx?item=161600
+    - title: Illinois HFS - Health Benefits for Immigrant Adults
+      href: https://hfs.illinois.gov/medicalclients/healthbenefitsforimmigrants/healthbenefitsforimmigrantadults.html
+
+values:
+  # HBIA covers adults aged 42-64
+  2022-05-01: 55
+  2022-07-01: 42

policyengine_us/parameters/gov/states/il/hfs/hbi/eligibility/child/in_effect.yaml

@@ -0,0 +1,12 @@
+description: Illinois determines whether All Kids immigrant coverage is active.
+metadata:
+  unit: bool
+  period: year
+  label: Illinois All Kids immigrant coverage in effect
+  reference:
+    - title: Illinois HFS - About All Kids
+      href: https://hfs.illinois.gov/medicalprograms/allkids/about.html
+
+values:
+  # All Kids has been covering immigrant children since program inception
+  2006-01-01: true

policyengine_us/parameters/gov/states/il/hfs/hbi/eligibility/child/income_limit.yaml

@@ -0,0 +1,13 @@
+description: Illinois limits income to this share of the federal poverty level for children under the All Kids program.
+metadata:
+  unit: /1
+  period: year
+  label: Illinois All Kids income limit
+  reference:
+    - title: Illinois HFS - About All Kids
+      href: https://hfs.illinois.gov/medicalprograms/allkids/about.html
+
+values:
+  # All Kids program covers children regardless of immigration status
+  # Up to 318% FPL (Premium Level 2 ceiling)
+  2006-01-01: 3.18

policyengine_us/parameters/gov/states/il/hfs/hbi/eligibility/child/max_age.yaml

@@ -0,0 +1,11 @@
+description: Illinois sets the maximum age to this threshold for children under the All Kids program.
+metadata:
+  unit: year
+  period: year
+  label: Illinois All Kids maximum age
+  reference:
+    - title: Illinois HFS - About All Kids
+      href: https://hfs.illinois.gov/medicalprograms/allkids/about.html
+
+values:
+  2006-01-01: 18

policyengine_us/parameters/gov/states/il/hfs/hbi/eligibility/senior/in_effect.yaml

@@ -0,0 +1,16 @@
+description: Illinois determines whether the Health Benefits for Immigrant Seniors program is active.
+metadata:
+  unit: bool
+  period: year
+  label: Illinois HBIS program in effect
+  reference:
+    - title: Illinois DHS - HBIA and HBIS Policy
+      href: https://www.dhs.state.il.us/page.aspx?item=161600
+    - title: Illinois HFS - Health Benefits for Immigrants
+      href: https://hfs.illinois.gov/medicalclients/healthbenefitsforimmigrants.html
+
+values:
+  2020-01-01: false
+  # HBIS program started December 2020
+  2020-12-01: true
+  # Program remains in effect for existing enrollees (enrollment paused but not terminated)

policyengine_us/parameters/gov/states/il/hfs/hbi/eligibility/senior/income_limit.yaml

@@ -0,0 +1,14 @@
+description: Illinois limits income to this share of the federal poverty level under the Health Benefits for Immigrant Seniors program.
+metadata:
+  unit: /1
+  period: year
+  label: Illinois HBIS income limit
+  reference:
+    - title: Illinois DHS - HBIA and HBIS Policy
+      href: https://www.dhs.state.il.us/page.aspx?item=161600
+    - title: Illinois HFS - Health Benefits for Immigrants
+      href: https://hfs.illinois.gov/medicalclients/healthbenefitsforimmigrants.html
+
+values:
+  # HBIS follows Aid to the Aged, Blind or Disabled criteria at 100% FPL
+  2020-12-01: 1.00

policyengine_us/parameters/gov/states/il/hfs/hbi/eligibility/senior/min_age.yaml

@@ -0,0 +1,14 @@
+description: Illinois sets the minimum age to this threshold under the Health Benefits for Immigrant Seniors program.
+metadata:
+  unit: year
+  period: year
+  label: Illinois HBIS minimum age
+  reference:
+    - title: Illinois DHS - HBIA and HBIS Policy
+      href: https://www.dhs.state.il.us/page.aspx?item=161600
+    - title: Illinois HFS - Health Benefits for Immigrants
+      href: https://hfs.illinois.gov/medicalclients/healthbenefitsforimmigrants.html
+
+values:
+  # HBIS covers seniors aged 65 and older
+  2020-12-01: 65

policyengine_us/parameters/gov/states/il/hfs/hbi/eligibility/senior/resource_limit.yaml

@@ -0,0 +1,14 @@
+description: Illinois limits non-exempt resources to this amount per household under the Health Benefits for Immigrant Seniors program.
+metadata:
+  unit: currency-USD
+  period: year
+  label: Illinois HBIS resource limit
+  reference:
+    - title: Illinois DHS - HBIA and HBIS Policy
+      href: https://www.dhs.state.il.us/page.aspx?item=161600
+    - title: Illinois HFS - Health Benefits for Immigrants
+      href: https://hfs.illinois.gov/medicalclients/healthbenefitsforimmigrants.html
+
+values:
+  # Non-exempt resources of $17,500 or less per household
+  2020-12-01: 17_500

policyengine_us/tests/policy/baseline/gov/states/il/hfs/hbi/eligibility/il_hbi_age_eligible.yaml

@@ -0,0 +1,79 @@
+- name: Child age 10 eligible (All Kids)
+  period: 2024
+  input:
+    state_code: IL
+    age: 10
+  output:
+    il_hbi_age_eligible: true
+
+- name: Child age 18 eligible (All Kids max age)
+  period: 2024
+  input:
+    state_code: IL
+    age: 18
+  output:
+    il_hbi_age_eligible: true
+
+- name: Young adult age 19 NOT eligible (gap age)
+  period: 2024
+  input:
+    state_code: IL
+    age: 19
+  output:
+    il_hbi_age_eligible: false
+
+- name: Adult age 30 NOT eligible (gap age)
+  period: 2024
+  input:
+    state_code: IL
+    age: 30
+  output:
+    il_hbi_age_eligible: false
+
+- name: Adult age 41 NOT eligible (gap age)
+  period: 2024
+  input:
+    state_code: IL
+    age: 41
+  output:
+    il_hbi_age_eligible: false
+
+- name: Adult age 42 eligible (HBIA minimum)
+  period: 2024
+  input:
+    state_code: IL
+    age: 42
+  output:
+    il_hbi_age_eligible: true
+
+- name: Adult age 50 eligible (HBIA)
+  period: 2024
+  input:
+    state_code: IL
+    age: 50
+  output:
+    il_hbi_age_eligible: true
+
+- name: Adult age 64 eligible (HBIA maximum)
+  period: 2024
+  input:
+    state_code: IL
+    age: 64
+  output:
+    il_hbi_age_eligible: true
+
+- name: Senior age 65 eligible (HBIS minimum)
+  period: 2024
+  input:
+    state_code: IL
+    age: 65
+  output:
+    il_hbi_age_eligible: true
+
+- name: Senior age 75 eligible (HBIS)
+  period: 2024
+  input:
+    state_code: IL
+    age: 75
+  output:
+    il_hbi_age_eligible: true

policyengine_us/tests/policy/baseline/gov/states/il/hfs/hbi/eligibility/il_hbi_eligible.yaml

@@ -0,0 +1,136 @@
+# Tests for il_hbi_eligible
+# Children and adults use MAGI (medicaid_income_level)
+# Seniors use AABD methodology (actual income with exemptions)
+
+- name: Undocumented child at 200% FPL eligible
+  period: 2024
+  input:
+    state_code: IL
+    age: 10
+    immigration_status: UNDOCUMENTED
+    medicaid_income_level: 2.00
+  output:
+    il_hbi_eligible: true
+
+- name: DACA adult age 50 at 100% FPL eligible
+  period: 2024
+  input:
+    state_code: IL
+    age: 50
+    immigration_status: DACA
+    medicaid_income_level: 1.00
+  output:
+    il_hbi_eligible: true
+
+- name: Undocumented senior age 70 with low income eligible
+  period: 2024
+  input:
+    state_code: IL
+    age: 70
+    immigration_status: UNDOCUMENTED
+    social_security: 12_000  # ~80% FPL after AABD exemptions
+  output:
+    il_hbi_eligible: true
+
+- name: Citizen child not eligible (uses regular Medicaid)
+  period: 2024
+  input:
+    state_code: IL
+    age: 10
+    immigration_status: CITIZEN
+    medicaid_income_level: 1.00
+  output:
+    il_hbi_eligible: false
+
+- name: Undocumented adult age 30 not eligible (gap age)
+  period: 2024
+  input:
+    state_code: IL
+    age: 30
+    immigration_status: UNDOCUMENTED
+    medicaid_income_level: 1.00
+  output:
+    il_hbi_eligible: false
+
+- name: Undocumented adult over income limit not eligible
+  period: 2024
+  input:
+    state_code: IL
+    age: 50
+    immigration_status: UNDOCUMENTED
+    medicaid_income_level: 1.50
+  output:
+    il_hbi_eligible: false
+
+- name: LPR senior not eligible (not covered immigration status)
+  period: 2024
+  input:
+    state_code: IL
+    age: 70
+    immigration_status: LEGAL_PERMANENT_RESIDENT
+    social_security: 10_000
+  output:
+    il_hbi_eligible: false
+
+- name: HBIA adult eligible in 2024 (program still in effect)
+  period: 2024
+  input:
+    state_code: IL
+    age: 50
+    immigration_status: UNDOCUMENTED
+    medicaid_income_level: 1.00
+  output:
+    il_hbi_eligible: true
+
+- name: HBIA adult not eligible in 2026 (program ended July 2025)
+  period: 2026
+  input:
+    state_code: IL
+    age: 50
+    immigration_status: UNDOCUMENTED
+    medicaid_income_level: 1.00
+  output:
+    il_hbi_eligible: false
+
+- name: HBIS senior still eligible in 2026 (program continues)
+  period: 2026
+  input:
+    state_code: IL
+    age: 70
+    immigration_status: UNDOCUMENTED
+    social_security: 12_000  # Under 100% FPL
+  output:
+    il_hbi_eligible: true
+
+- name: HBIS senior with resources above limit not eligible
+  period: 2024
+  input:
+    state_code: IL
+    age: 70
+    immigration_status: UNDOCUMENTED
+    social_security: 12_000
+    spm_unit_assets: 20_000
+  output:
+    il_hbi_eligible: false
+
+- name: HBIS senior with resources at limit eligible
+  period: 2024
+  input:
+    state_code: IL
+    age: 70
+    immigration_status: UNDOCUMENTED
+    social_security: 12_000
+    spm_unit_assets: 17_500
+  output:
+    il_hbi_eligible: true
+
+- name: HBIA adult with high resources still eligible (no resource test)
+  period: 2024
+  input:
+    state_code: IL
+    age: 50
+    immigration_status: UNDOCUMENTED
+    medicaid_income_level: 1.00
+    spm_unit_assets: 100_000
+  output:
+    il_hbi_eligible: true