loading…

us/regulation/42/435/119 — Coverage for individuals age 19 or older and under age 65 at or below 133 percent FPL · Axiom

Coverage for individuals age 19 or older and under age 65 at or below 133 percent FPL

8 rules2 of 3 subsections

Official source

graph ↗build calculator ↗

(a)Basis. This section implements section…#

(a) Basis. This section implements section 1902(a)(10)(A)(i)(VIII) of the Act.

(b)Eligibility. Effective January 1, 2014, the agency must…∀ 5#

(b) Eligibility. Effective January 1, 2014, the agency must provide Medicaid to individuals who:

(1) Are age 19 or older and under age 65;

(2) Are not pregnant;

(3) Are not entitled to or enrolled for Medicare benefits under part A or B of title XVIII of the Act;

(4) Are not otherwise eligible for and enrolled for mandatory coverage under a State's Medicaid State plan in accordance with subpart B of this part; and

(5) Have household income that is at or below 133 percent FPL for the applicable family size.

(c)Coverage for dependent children.∀ 3#

in view

Whole section

Encodings · 8

adult_group_minimum_age42 CFR § 435.119 (b) · parameter

42 CFR 435.119(b)(1)

name: adult_group_minimum_age
kind: parameter
dtype: Integer
source: 42 CFR 435.119(b)(1)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: amount
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: Are age 19 or older and under age 65
versions:
  - effective_from: '2014-01-01'
    formula: '19'

open in graph ↗

adult_group_maximum_age42 CFR § 435.119 (b) · parameter

42 CFR 435.119(b)(1)

name: adult_group_maximum_age
kind: parameter
dtype: Integer
source: 42 CFR 435.119(b)(1)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: amount
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: Are age 19 or older and under age 65
versions:
  - effective_from: '2014-01-01'
    formula: '65'

open in graph ↗

adult_group_income_limit_fpl_ratio42 CFR § 435.119 (b) · parameter

42 CFR 435.119(b)(5)

name: adult_group_income_limit_fpl_ratio
kind: parameter
dtype: Rate
source: 42 CFR 435.119(b)(5)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: amount
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: >-
            Have household income that is at or below 133 percent FPL for the
            applicable family size
versions:
  - effective_from: '2014-01-01'
    formula: '1.33'

open in graph ↗

dependent_child_default_age_threshold42 CFR § 435.119 (c) · parameter

42 CFR 435.119(c)(2)

name: dependent_child_default_age_threshold
kind: parameter
dtype: Integer
source: 42 CFR 435.119(c)(2)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: amount
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: the age specified is under age 19
versions:
  - effective_from: '2014-01-01'
    formula: '19'

open in graph ↗

dependent_child_age_threshold42 CFR § 435.119 (c) · derived

42 CFR 435.119(c)(2)

name: dependent_child_age_threshold
kind: derived
entity: Person
dtype: Integer
period: Year
source: 42 CFR 435.119(c)(2)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: >-
            unless the State had elected as of March 23, 2010 to provide
            Medicaid to individuals under age 20 or 21 under § 435.222 of this
            part, in which case the age specified is such higher age
versions:
  - effective_from: '2014-01-01'
    formula: >-
      if state_elected_435_222_higher_age_as_of_march_23_2010:
      state_elected_435_222_higher_age else:
      dependent_child_default_age_threshold

open in graph ↗

adult_group_age_eligible42 CFR § 435.119 (b) · derived

42 CFR 435.119(b)(1)

name: adult_group_age_eligible
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.119(b)(1)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: condition
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: Are age 19 or older and under age 65
versions:
  - effective_from: '2014-01-01'
    formula: >-
      person_age >= adult_group_minimum_age and person_age <
      adult_group_maximum_age

open in graph ↗

parent_or_caretaker_relative_blocked_by_dependent_child42 CFR § 435.119 (c) · derived

42 CFR 435.119(c)(1)

name: parent_or_caretaker_relative_blocked_by_dependent_child
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.119(c)(1)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: condition
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: >-
            A State may not provide Medicaid under this section to a parent or
            other caretaker relative living with a dependent child if the child
            is under the age specified in paragraph (c)(2) of this section,
            unless such child is receiving benefits under Medicaid, the
            Children's Health Insurance Program under subchapter D of this
            chapter, or otherwise is enrolled in minimum essential coverage as
            defined in § 435.4 of this part.
versions:
  - effective_from: '2014-01-01'
    formula: |-
      person_is_parent_or_caretaker_relative
      and person_lives_with_dependent_child_under_age_threshold
      and not dependent_child_receiving_medicaid
      and not dependent_child_receiving_chip
      and not dependent_child_enrolled_in_minimum_essential_coverage

open in graph ↗

adult_group_eligible42 CFR § 435.119 (b) · derived

42 CFR 435.119(b)

name: adult_group_eligible
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.119(b)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: condition
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: >-
            Effective January 1, 2014, the agency must provide Medicaid to
            individuals who: (1) Are age 19 or older and under age 65; (2) Are
            not pregnant; (3) Are not entitled to or enrolled for Medicare
            benefits under part A or B of title XVIII of the Act; (4) Are not
            otherwise eligible for and enrolled for mandatory coverage under a
            State's Medicaid State plan in accordance with subpart B of this
            part; and (5) Have household income that is at or below 133 percent
            FPL for the applicable family size.
versions:
  - effective_from: '2014-01-01'
    formula: >-
      adult_group_age_eligible

      and not person_is_pregnant

      and not person_entitled_to_or_enrolled_in_medicare_part_a_or_b

      and not
      person_eligible_and_enrolled_for_mandatory_medicaid_under_subpart_b

      and household_income_as_fraction_of_fpl <=
      adult_group_income_limit_fpl_ratio

      and not parent_or_caretaker_relative_blocked_by_dependent_child

open in graph ↗

▸rulespec code

Shown source

regulations/42-cfr/435/119.yaml

Displaying the canonical repository encoding.

View on GitHub

Rules

adult_group_minimum_age

Parameter(b) in text ↖

source: 42 CFR 435.119(b)(1)

- name: adult_group_minimum_age
  kind: parameter
  dtype: Integer
  source: 42 CFR 435.119(b)(1)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: Are age 19 or older and under age 65
  versions:
    - effective_from: '2014-01-01'
      formula: '19'

adult_group_maximum_age

Parameter(b) in text ↖

source: 42 CFR 435.119(b)(1)

- name: adult_group_maximum_age
  kind: parameter
  dtype: Integer
  source: 42 CFR 435.119(b)(1)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: Are age 19 or older and under age 65
  versions:
    - effective_from: '2014-01-01'
      formula: '65'

adult_group_income_limit_fpl_ratio

Parameter(b) in text ↖

source: 42 CFR 435.119(b)(5)

- name: adult_group_income_limit_fpl_ratio
  kind: parameter
  dtype: Rate
  source: 42 CFR 435.119(b)(5)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: >-
              Have household income that is at or below 133 percent FPL for the applicable family
              size
  versions:
    - effective_from: '2014-01-01'
      formula: '1.33'

dependent_child_default_age_threshold

Parameter(c) in text ↖

source: 42 CFR 435.119(c)(2)

- name: dependent_child_default_age_threshold
  kind: parameter
  dtype: Integer
  source: 42 CFR 435.119(c)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: the age specified is under age 19
  versions:
    - effective_from: '2014-01-01'
      formula: '19'

dependent_child_age_threshold

Derived(c) in text ↖

source: 42 CFR 435.119(c)(2)

- name: dependent_child_age_threshold
  kind: derived
  entity: Person
  dtype: Integer
  period: Year
  source: 42 CFR 435.119(c)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: >-
              unless the State had elected as of March 23, 2010 to provide Medicaid to individuals
              under age 20 or 21 under § 435.222 of this part, in which case the age specified is
              such higher age
  versions:
    - effective_from: '2014-01-01'
      formula: >-
        if state_elected_435_222_higher_age_as_of_march_23_2010: state_elected_435_222_higher_age
        else: dependent_child_default_age_threshold

adult_group_age_eligible

Derived(b) in text ↖

source: 42 CFR 435.119(b)(1)

- name: adult_group_age_eligible
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.119(b)(1)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: Are age 19 or older and under age 65
  versions:
    - effective_from: '2014-01-01'
      formula: person_age >= adult_group_minimum_age and person_age < adult_group_maximum_age

parent_or_caretaker_relative_blocked_by_dependent_child

Derived(c) in text ↖

source: 42 CFR 435.119(c)(1)

- name: parent_or_caretaker_relative_blocked_by_dependent_child
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.119(c)(1)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: >-
              A State may not provide Medicaid under this section to a parent or other caretaker
              relative living with a dependent child if the child is under the age specified in
              paragraph (c)(2) of this section, unless such child is receiving benefits under
              Medicaid, the Children's Health Insurance Program under subchapter D of this chapter,
              or otherwise is enrolled in minimum essential coverage as defined in § 435.4 of this
              part.
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        person_is_parent_or_caretaker_relative
        and person_lives_with_dependent_child_under_age_threshold
        and not dependent_child_receiving_medicaid
        and not dependent_child_receiving_chip
        and not dependent_child_enrolled_in_minimum_essential_coverage

adult_group_eligible

Derived(b) in text ↖

source: 42 CFR 435.119(b)

- name: adult_group_eligible
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.119(b)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: >-
              Effective January 1, 2014, the agency must provide Medicaid to individuals who: (1)
              Are age 19 or older and under age 65; (2) Are not pregnant; (3) Are not entitled to or
              enrolled for Medicare benefits under part A or B of title XVIII of the Act; (4) Are
              not otherwise eligible for and enrolled for mandatory coverage under a State's
              Medicaid State plan in accordance with subpart B of this part; and (5) Have household
              income that is at or below 133 percent FPL for the applicable family size.
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        adult_group_age_eligible
        and not person_is_pregnant
        and not person_entitled_to_or_enrolled_in_medicare_part_a_or_b
        and not person_eligible_and_enrolled_for_mandatory_medicaid_under_subpart_b
        and household_income_as_fraction_of_fpl <= adult_group_income_limit_fpl_ratio
        and not parent_or_caretaker_relative_blocked_by_dependent_child

▸citations (2)

References

This rule cites 2 other rules.

42 CFR § 435.4inferredUS Federal › Regulations › Title 42 › § 435 › (4)
42 CFR § 435.222inferredUS Federal › Regulations › Title 42 › § 435 › (222)

loading…

Coverage for individuals age 19 or older and under age 65 at or below 133 percent FPL

8 rules2 of 3 subsections

Official source

graph ↗build calculator ↗

(a)Basis. This section implements section…#

(a) Basis. This section implements section 1902(a)(10)(A)(i)(VIII) of the Act.

(b)Eligibility. Effective January 1, 2014, the agency must…∀ 5#

(b) Eligibility. Effective January 1, 2014, the agency must provide Medicaid to individuals who:

(1) Are age 19 or older and under age 65;

(2) Are not pregnant;

(3) Are not entitled to or enrolled for Medicare benefits under part A or B of title XVIII of the Act;

(4) Are not otherwise eligible for and enrolled for mandatory coverage under a State's Medicaid State plan in accordance with subpart B of this part; and

(5) Have household income that is at or below 133 percent FPL for the applicable family size.

(c)Coverage for dependent children.∀ 3#

in view

Whole section

Encodings · 8

adult_group_minimum_age42 CFR § 435.119 (b) · parameter

42 CFR 435.119(b)(1)

name: adult_group_minimum_age
kind: parameter
dtype: Integer
source: 42 CFR 435.119(b)(1)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: amount
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: Are age 19 or older and under age 65
versions:
  - effective_from: '2014-01-01'
    formula: '19'

open in graph ↗

adult_group_maximum_age42 CFR § 435.119 (b) · parameter

42 CFR 435.119(b)(1)

name: adult_group_maximum_age
kind: parameter
dtype: Integer
source: 42 CFR 435.119(b)(1)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: amount
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: Are age 19 or older and under age 65
versions:
  - effective_from: '2014-01-01'
    formula: '65'

open in graph ↗

adult_group_income_limit_fpl_ratio42 CFR § 435.119 (b) · parameter

42 CFR 435.119(b)(5)

name: adult_group_income_limit_fpl_ratio
kind: parameter
dtype: Rate
source: 42 CFR 435.119(b)(5)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: amount
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: >-
            Have household income that is at or below 133 percent FPL for the
            applicable family size
versions:
  - effective_from: '2014-01-01'
    formula: '1.33'

open in graph ↗

dependent_child_default_age_threshold42 CFR § 435.119 (c) · parameter

42 CFR 435.119(c)(2)

name: dependent_child_default_age_threshold
kind: parameter
dtype: Integer
source: 42 CFR 435.119(c)(2)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: amount
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: the age specified is under age 19
versions:
  - effective_from: '2014-01-01'
    formula: '19'

open in graph ↗

dependent_child_age_threshold42 CFR § 435.119 (c) · derived

42 CFR 435.119(c)(2)

name: dependent_child_age_threshold
kind: derived
entity: Person
dtype: Integer
period: Year
source: 42 CFR 435.119(c)(2)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: >-
            unless the State had elected as of March 23, 2010 to provide
            Medicaid to individuals under age 20 or 21 under § 435.222 of this
            part, in which case the age specified is such higher age
versions:
  - effective_from: '2014-01-01'
    formula: >-
      if state_elected_435_222_higher_age_as_of_march_23_2010:
      state_elected_435_222_higher_age else:
      dependent_child_default_age_threshold

open in graph ↗

adult_group_age_eligible42 CFR § 435.119 (b) · derived

42 CFR 435.119(b)(1)

name: adult_group_age_eligible
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.119(b)(1)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: condition
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: Are age 19 or older and under age 65
versions:
  - effective_from: '2014-01-01'
    formula: >-
      person_age >= adult_group_minimum_age and person_age <
      adult_group_maximum_age

open in graph ↗

parent_or_caretaker_relative_blocked_by_dependent_child42 CFR § 435.119 (c) · derived

42 CFR 435.119(c)(1)

name: parent_or_caretaker_relative_blocked_by_dependent_child
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.119(c)(1)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: condition
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: >-
            A State may not provide Medicaid under this section to a parent or
            other caretaker relative living with a dependent child if the child
            is under the age specified in paragraph (c)(2) of this section,
            unless such child is receiving benefits under Medicaid, the
            Children's Health Insurance Program under subchapter D of this
            chapter, or otherwise is enrolled in minimum essential coverage as
            defined in § 435.4 of this part.
versions:
  - effective_from: '2014-01-01'
    formula: |-
      person_is_parent_or_caretaker_relative
      and person_lives_with_dependent_child_under_age_threshold
      and not dependent_child_receiving_medicaid
      and not dependent_child_receiving_chip
      and not dependent_child_enrolled_in_minimum_essential_coverage

open in graph ↗

adult_group_eligible42 CFR § 435.119 (b) · derived

42 CFR 435.119(b)

name: adult_group_eligible
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 CFR 435.119(b)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: condition
        source:
          corpus_citation_path: us/regulation/42/435/119
          excerpt: >-
            Effective January 1, 2014, the agency must provide Medicaid to
            individuals who: (1) Are age 19 or older and under age 65; (2) Are
            not pregnant; (3) Are not entitled to or enrolled for Medicare
            benefits under part A or B of title XVIII of the Act; (4) Are not
            otherwise eligible for and enrolled for mandatory coverage under a
            State's Medicaid State plan in accordance with subpart B of this
            part; and (5) Have household income that is at or below 133 percent
            FPL for the applicable family size.
versions:
  - effective_from: '2014-01-01'
    formula: >-
      adult_group_age_eligible

      and not person_is_pregnant

      and not person_entitled_to_or_enrolled_in_medicare_part_a_or_b

      and not
      person_eligible_and_enrolled_for_mandatory_medicaid_under_subpart_b

      and household_income_as_fraction_of_fpl <=
      adult_group_income_limit_fpl_ratio

      and not parent_or_caretaker_relative_blocked_by_dependent_child

open in graph ↗

▸rulespec code

Shown source

regulations/42-cfr/435/119.yaml

Displaying the canonical repository encoding.

View on GitHub

Rules

adult_group_minimum_age

Parameter(b) in text ↖

source: 42 CFR 435.119(b)(1)

- name: adult_group_minimum_age
  kind: parameter
  dtype: Integer
  source: 42 CFR 435.119(b)(1)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: Are age 19 or older and under age 65
  versions:
    - effective_from: '2014-01-01'
      formula: '19'

adult_group_maximum_age

Parameter(b) in text ↖

source: 42 CFR 435.119(b)(1)

- name: adult_group_maximum_age
  kind: parameter
  dtype: Integer
  source: 42 CFR 435.119(b)(1)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: Are age 19 or older and under age 65
  versions:
    - effective_from: '2014-01-01'
      formula: '65'

adult_group_income_limit_fpl_ratio

Parameter(b) in text ↖

source: 42 CFR 435.119(b)(5)

- name: adult_group_income_limit_fpl_ratio
  kind: parameter
  dtype: Rate
  source: 42 CFR 435.119(b)(5)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: >-
              Have household income that is at or below 133 percent FPL for the applicable family
              size
  versions:
    - effective_from: '2014-01-01'
      formula: '1.33'

dependent_child_default_age_threshold

Parameter(c) in text ↖

source: 42 CFR 435.119(c)(2)

- name: dependent_child_default_age_threshold
  kind: parameter
  dtype: Integer
  source: 42 CFR 435.119(c)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: amount
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: the age specified is under age 19
  versions:
    - effective_from: '2014-01-01'
      formula: '19'

dependent_child_age_threshold

Derived(c) in text ↖

source: 42 CFR 435.119(c)(2)

- name: dependent_child_age_threshold
  kind: derived
  entity: Person
  dtype: Integer
  period: Year
  source: 42 CFR 435.119(c)(2)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: >-
              unless the State had elected as of March 23, 2010 to provide Medicaid to individuals
              under age 20 or 21 under § 435.222 of this part, in which case the age specified is
              such higher age
  versions:
    - effective_from: '2014-01-01'
      formula: >-
        if state_elected_435_222_higher_age_as_of_march_23_2010: state_elected_435_222_higher_age
        else: dependent_child_default_age_threshold

adult_group_age_eligible

Derived(b) in text ↖

source: 42 CFR 435.119(b)(1)

- name: adult_group_age_eligible
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.119(b)(1)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: Are age 19 or older and under age 65
  versions:
    - effective_from: '2014-01-01'
      formula: person_age >= adult_group_minimum_age and person_age < adult_group_maximum_age

parent_or_caretaker_relative_blocked_by_dependent_child

Derived(c) in text ↖

source: 42 CFR 435.119(c)(1)

- name: parent_or_caretaker_relative_blocked_by_dependent_child
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.119(c)(1)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: >-
              A State may not provide Medicaid under this section to a parent or other caretaker
              relative living with a dependent child if the child is under the age specified in
              paragraph (c)(2) of this section, unless such child is receiving benefits under
              Medicaid, the Children's Health Insurance Program under subchapter D of this chapter,
              or otherwise is enrolled in minimum essential coverage as defined in § 435.4 of this
              part.
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        person_is_parent_or_caretaker_relative
        and person_lives_with_dependent_child_under_age_threshold
        and not dependent_child_receiving_medicaid
        and not dependent_child_receiving_chip
        and not dependent_child_enrolled_in_minimum_essential_coverage

adult_group_eligible

Derived(b) in text ↖

source: 42 CFR 435.119(b)

- name: adult_group_eligible
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 CFR 435.119(b)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/regulation/42/435/119
            excerpt: >-
              Effective January 1, 2014, the agency must provide Medicaid to individuals who: (1)
              Are age 19 or older and under age 65; (2) Are not pregnant; (3) Are not entitled to or
              enrolled for Medicare benefits under part A or B of title XVIII of the Act; (4) Are
              not otherwise eligible for and enrolled for mandatory coverage under a State's
              Medicaid State plan in accordance with subpart B of this part; and (5) Have household
              income that is at or below 133 percent FPL for the applicable family size.
  versions:
    - effective_from: '2014-01-01'
      formula: |-
        adult_group_age_eligible
        and not person_is_pregnant
        and not person_entitled_to_or_enrolled_in_medicare_part_a_or_b
        and not person_eligible_and_enrolled_for_mandatory_medicaid_under_subpart_b
        and household_income_as_fraction_of_fpl <= adult_group_income_limit_fpl_ratio
        and not parent_or_caretaker_relative_blocked_by_dependent_child

▸citations (2)

References

This rule cites 2 other rules.

42 CFR § 435.4inferredUS Federal › Regulations › Title 42 › § 435 › (4)
42 CFR § 435.222inferredUS Federal › Regulations › Title 42 › § 435 › (222)