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Approval Period: October 1, 2022 – September 30, 2027 Amended November 14, 2024 11

demonstration approval. If the state’s WW hypothetical spending exceeds the Hypothetical Budget Neutrality Test’s expenditure limit, the state agrees (as a condition of CMS approval) to offset that excess spending through savings elsewhere in the demonstration or to refund the FFP to CMS. 5.3 Hypothetical Budget Neutrality Test 2: Continuous Eligibility: The table below identifies the MEGs that are used for Hypothetical Budget Neutrality Test 2. MEGs that are designated "WOW Only" or "Both" are the components used to calculate the budget neutrality expenditure limit. The Composite Federal Share for the Hypothetical Budget Neutrality Test is calculated based on all MEGs indicated as "WW Only" or "Both." MEGs that are indicated as "WW Only" or "Both" are counted as expenditures against this budget neutrality expenditure limit. Any expenditure in excess of the limit from Hypothetical Budget Neutrality Test 2 are counted as WW expenditures under the Main Budget Neutrality Test. Table 4: Hypothetical Budget Neutrality Test 2 MEG PC or AGG WOW Only, WW Only, or Both Base Year Trend Rate DY06 10/1/22- 9/30/23 DY07 10/1/23- 9/30/24 DY08 10/1/24- 9/30/25 DY09 10/1/25- 9/30/26 DY10 10/1/26- 9/30/27 CE – Children Age 0 to 6 TANF/MAGI PC Both $473.92 4.8% $0 $0 $496.67 $520.51 $545.49 CE – Children Age 0 to 6 SSI/HH and Other Disabled PC Both $794.65 4.8% $0 $0 $832.80 $872.77 $914.66 CE - Formerly incarcerated At Risk PC Both $717.11 5% $0 $0 $752.97 $790.62 $830.15 BN – budget neutrality; MEG – Medicaid expenditure group; WOW – without waiver; WW – with waiver