Axiom Foundation

loading…

us/statute/42/1396a/m — Description of individuals · Axiom

(1) Individuals described in this paragraph are individuals— (A) who are 65 years of age or older or are disabled individuals (as determined under section 1382c(a)(3) of this title ), (B) whose income (as determined under section 1382a of this title for purposes of the supplemental security income program, except as provided in paragraph (2)(C)) does not exceed an income level established by the State consistent with paragraph (2)(A), and (C) whose resources (as determined under section 1382b of this title for purposes of the supplemental security income program) do not exceed (except as provided in paragraph (2)(B)) the maximum amount of resources that an individual may have and obtain benefits under that program.

(2) (A) The income level established under paragraph (1)(B) may not exceed a percentage (not more than 100 percent) of the official poverty line (as defined by the Office of Management and Budget, and revised annually in accordance with section 9902(2) of this title ) applicable to a family of the size involved. (B) In the case of a State that provides medical assistance to individuals not described in subsection (a)(10)(A) and at the State’s option, the State may use under paragraph (1)(C) such resource level (which is higher than the level described in that paragraph) as may be applicable with respect to individuals described in paragraph (1)(A) who are not described in subsection (a)(10)(A). (C) The provisions of section 1396d(p)(2)(D) of this title shall apply to determinations of income under this subsection in the same manner as they apply to determinations of income under section 1396d(p) of this title .

(3) Notwithstanding subsection (a)(17), for individuals described in paragraph (1) who are covered under the State plan by virtue of subsection (a)(10)(A)(ii)(X)— (A) the income standard to be applied is the income standard described in paragraph (1)(B), and (B) except as provided in section 1382a(b)(4)(B)(ii) of this title , costs incurred for medical care or for any other type of remedial care shall not be taken into account in determining income. Any different treatment provided under this paragraph for such individuals shall not, because of subsection (a)(17), require or permit such treatment for other individuals.

(4) Notwithstanding subsection (a)(17), for qualified medicare beneficiaries described in section 1396d(p)(1) of this title — (A) the income standard to be applied is the income standard described in section 1396d(p)(1)(B) of this title , and (B) except as provided in section 1382a(b)(4)(B)(ii) of this title , costs incurred for medical care or for any other type of remedial care shall not be taken into account in determining income. Any different treatment provided under this paragraph for such individuals shall not, because of subsection (a)(17), require or permit such treatment for other individuals.

in view

Whole section

Encodings · 7

optional_senior_age_threshold_years42 USC § 1396a (m) · parameter

42 U.S.C. 1396a(m)(1)(A)

name: optional_senior_age_threshold_years
kind: parameter
dtype: Count
source: 42 U.S.C. 1396a(m)(1)(A)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: parameter
        source:
          corpus_citation_path: us/statute/42/1396a/m
          excerpt: 65 years of age or older
versions:
  - effective_from: '2024-01-01'
    formula: '65'

open in graph ↗

optional_senior_or_disabled_income_level_maximum_rate42 USC § 1396a (m) · parameter

42 U.S.C. 1396a(m)(2)(A)

name: optional_senior_or_disabled_income_level_maximum_rate
kind: parameter
dtype: Rate
source: 42 U.S.C. 1396a(m)(2)(A)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: parameter
        source:
          corpus_citation_path: us/statute/42/1396a/m
          excerpt: not more than 100 percent
versions:
  - effective_from: '2024-01-01'
    formula: '1.00'

open in graph ↗

meets_optional_senior_or_disabled_age_or_disability_condition42 USC § 1396a (m) · derived

42 U.S.C. 1396a(m)(1)(A)

name: meets_optional_senior_or_disabled_age_or_disability_condition
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 U.S.C. 1396a(m)(1)(A)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: condition
        source:
          corpus_citation_path: us/statute/42/1396a/m
          excerpt: who are 65 years of age or older or are disabled individuals
      - path: versions[0].formula
        kind: import
        import:
          target: us:statutes/42/1396a/m#optional_senior_age_threshold_years
          output: optional_senior_age_threshold_years
          hash: sha256:local
versions:
  - effective_from: '2024-01-01'
    formula: |-
      individual_age_years >= optional_senior_age_threshold_years
      or disabled_as_determined_under_section_1382c_a_3

open in graph ↗

state_income_level_within_federal_maximum42 USC § 1396a (m) · derived

42 U.S.C. 1396a(m)(2)(A)

name: state_income_level_within_federal_maximum
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 U.S.C. 1396a(m)(2)(A)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/statute/42/1396a/m
          excerpt: >-
            may not exceed a percentage (not more than 100 percent) of the
            official poverty line
      - path: versions[0].formula
        kind: import
        import:
          target: >-
            us:statutes/42/1396a/m#optional_senior_or_disabled_income_level_maximum_rate
          output: optional_senior_or_disabled_income_level_maximum_rate
          hash: sha256:local
versions:
  - effective_from: '2024-01-01'
    formula: >-
      state_established_income_level_poverty_line_rate <=
      optional_senior_or_disabled_income_level_maximum_rate

open in graph ↗

income_does_not_exceed_state_optional_senior_or_disabled_level42 USC § 1396a (m) · derived

42 U.S.C. 1396a(m)(1)(B), (2)(A), (2)(C)

name: income_does_not_exceed_state_optional_senior_or_disabled_level
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 U.S.C. 1396a(m)(1)(B), (2)(A), (2)(C)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/statute/42/1396a/m
          excerpt: >-
            whose income ... does not exceed an income level established by the
            State
      - path: versions[0].formula
        kind: import
        import:
          target: us:statutes/42/1396a/m#state_income_level_within_federal_maximum
          output: state_income_level_within_federal_maximum
          hash: sha256:local
versions:
  - effective_from: '2024-01-01'
    formula: >-
      income_determined_for_this_subsection <=
      state_established_income_level_amount

      and state_income_level_within_federal_maximum

open in graph ↗

resources_do_not_exceed_optional_senior_or_disabled_resource_level42 USC § 1396a (m) · derived

42 U.S.C. 1396a(m)(1)(C), (2)(B)

name: resources_do_not_exceed_optional_senior_or_disabled_resource_level
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 U.S.C. 1396a(m)(1)(C), (2)(B)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: formula
        source:
          corpus_citation_path: us/statute/42/1396a/m
          excerpt: >-
            whose resources ... do not exceed ... the maximum amount of
            resources
      - path: versions[0].formula
        kind: exception
        source:
          corpus_citation_path: us/statute/42/1396a/m
          excerpt: >-
            the State may use under paragraph (1)(C) such resource level ...
            which is higher
versions:
  - effective_from: '2024-01-01'
    formula: >-
      resources_determined_for_supplemental_security_income_program <=
      maximum_resources_for_supplemental_security_income_program

      or (
        state_provides_medical_assistance_to_individuals_not_described_in_subsection_a_10_A
        and state_elects_higher_resource_level_for_non_a10A_individuals
        and individual_not_described_in_subsection_a_10_A
        and state_optional_resource_level_amount_for_non_a10A_individuals > maximum_resources_for_supplemental_security_income_program
        and resources_determined_for_supplemental_security_income_program <= state_optional_resource_level_amount_for_non_a10A_individuals
      )

open in graph ↗

is_optional_senior_or_disabled_for_medicaid42 USC § 1396a (m) · derived

42 U.S.C. 1396a(m)(1)

name: is_optional_senior_or_disabled_for_medicaid
kind: derived
entity: Person
dtype: Judgment
period: Month
source: 42 U.S.C. 1396a(m)(1)
metadata:
  proof:
    atoms:
      - path: versions[0].formula
        kind: definition
        source:
          corpus_citation_path: us/statute/42/1396a/m
      - path: versions[0].formula
        kind: import
        import:
          target: >-
            us:statutes/42/1396a/m#meets_optional_senior_or_disabled_age_or_disability_condition
          output: meets_optional_senior_or_disabled_age_or_disability_condition
          hash: sha256:local
      - path: versions[0].formula
        kind: import
        import:
          target: >-
            us:statutes/42/1396a/m#income_does_not_exceed_state_optional_senior_or_disabled_level
          output: income_does_not_exceed_state_optional_senior_or_disabled_level
          hash: sha256:local
      - path: versions[0].formula
        kind: import
        import:
          target: >-
            us:statutes/42/1396a/m#resources_do_not_exceed_optional_senior_or_disabled_resource_level
          output: resources_do_not_exceed_optional_senior_or_disabled_resource_level
          hash: sha256:local
versions:
  - effective_from: '2024-01-01'
    formula: |-
      meets_optional_senior_or_disabled_age_or_disability_condition
      and income_does_not_exceed_state_optional_senior_or_disabled_level
      and resources_do_not_exceed_optional_senior_or_disabled_resource_level

open in graph ↗

▸rulespec code

Shown source

statutes/42/1396a/m.yaml

Displaying the canonical repository encoding.

View on GitHub

Rules

optional_senior_age_threshold_years

Parameter

source: 42 U.S.C. 1396a(m)(1)(A)

- name: optional_senior_age_threshold_years
  kind: parameter
  dtype: Count
  source: 42 U.S.C. 1396a(m)(1)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/m
            excerpt: 65 years of age or older
  versions:
    - effective_from: '2024-01-01'
      formula: '65'

optional_senior_or_disabled_income_level_maximum_rate

Parameter

source: 42 U.S.C. 1396a(m)(2)(A)

- name: optional_senior_or_disabled_income_level_maximum_rate
  kind: parameter
  dtype: Rate
  source: 42 U.S.C. 1396a(m)(2)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: parameter
          source:
            corpus_citation_path: us/statute/42/1396a/m
            excerpt: not more than 100 percent
  versions:
    - effective_from: '2024-01-01'
      formula: '1.00'

meets_optional_senior_or_disabled_age_or_disability_condition

Derived

source: 42 U.S.C. 1396a(m)(1)(A)

- name: meets_optional_senior_or_disabled_age_or_disability_condition
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 U.S.C. 1396a(m)(1)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: condition
          source:
            corpus_citation_path: us/statute/42/1396a/m
            excerpt: who are 65 years of age or older or are disabled individuals
        - path: versions[0].formula
          kind: import
          import:
            target: us:statutes/42/1396a/m#optional_senior_age_threshold_years
            output: optional_senior_age_threshold_years
            hash: sha256:local
  versions:
    - effective_from: '2024-01-01'
      formula: |-
        individual_age_years >= optional_senior_age_threshold_years
        or disabled_as_determined_under_section_1382c_a_3

state_income_level_within_federal_maximum

Derived

source: 42 U.S.C. 1396a(m)(2)(A)

- name: state_income_level_within_federal_maximum
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 U.S.C. 1396a(m)(2)(A)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396a/m
            excerpt: may not exceed a percentage (not more than 100 percent) of the official poverty line
        - path: versions[0].formula
          kind: import
          import:
            target: us:statutes/42/1396a/m#optional_senior_or_disabled_income_level_maximum_rate
            output: optional_senior_or_disabled_income_level_maximum_rate
            hash: sha256:local
  versions:
    - effective_from: '2024-01-01'
      formula: >-
        state_established_income_level_poverty_line_rate <=
        optional_senior_or_disabled_income_level_maximum_rate

income_does_not_exceed_state_optional_senior_or_disabled_level

Derived

source: 42 U.S.C. 1396a(m)(1)(B), (2)(A), (2)(C)

- name: income_does_not_exceed_state_optional_senior_or_disabled_level
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 U.S.C. 1396a(m)(1)(B), (2)(A), (2)(C)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396a/m
            excerpt: whose income ... does not exceed an income level established by the State
        - path: versions[0].formula
          kind: import
          import:
            target: us:statutes/42/1396a/m#state_income_level_within_federal_maximum
            output: state_income_level_within_federal_maximum
            hash: sha256:local
  versions:
    - effective_from: '2024-01-01'
      formula: |-
        income_determined_for_this_subsection <= state_established_income_level_amount
        and state_income_level_within_federal_maximum

resources_do_not_exceed_optional_senior_or_disabled_resource_level

Derived

source: 42 U.S.C. 1396a(m)(1)(C), (2)(B)

- name: resources_do_not_exceed_optional_senior_or_disabled_resource_level
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 U.S.C. 1396a(m)(1)(C), (2)(B)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: formula
          source:
            corpus_citation_path: us/statute/42/1396a/m
            excerpt: whose resources ... do not exceed ... the maximum amount of resources
        - path: versions[0].formula
          kind: exception
          source:
            corpus_citation_path: us/statute/42/1396a/m
            excerpt: the State may use under paragraph (1)(C) such resource level ... which is higher
  versions:
    - effective_from: '2024-01-01'
      formula: >-
        resources_determined_for_supplemental_security_income_program <=
        maximum_resources_for_supplemental_security_income_program

        or (
          state_provides_medical_assistance_to_individuals_not_described_in_subsection_a_10_A
          and state_elects_higher_resource_level_for_non_a10A_individuals
          and individual_not_described_in_subsection_a_10_A
          and state_optional_resource_level_amount_for_non_a10A_individuals > maximum_resources_for_supplemental_security_income_program
          and resources_determined_for_supplemental_security_income_program <= state_optional_resource_level_amount_for_non_a10A_individuals
        )

is_optional_senior_or_disabled_for_medicaid

Derived

source: 42 U.S.C. 1396a(m)(1)

- name: is_optional_senior_or_disabled_for_medicaid
  kind: derived
  entity: Person
  dtype: Judgment
  period: Month
  source: 42 U.S.C. 1396a(m)(1)
  metadata:
    proof:
      atoms:
        - path: versions[0].formula
          kind: definition
          source:
            corpus_citation_path: us/statute/42/1396a/m
        - path: versions[0].formula
          kind: import
          import:
            target: us:statutes/42/1396a/m#meets_optional_senior_or_disabled_age_or_disability_condition
            output: meets_optional_senior_or_disabled_age_or_disability_condition
            hash: sha256:local
        - path: versions[0].formula
          kind: import
          import:
            target: us:statutes/42/1396a/m#income_does_not_exceed_state_optional_senior_or_disabled_level
            output: income_does_not_exceed_state_optional_senior_or_disabled_level
            hash: sha256:local
        - path: versions[0].formula
          kind: import
          import:
            target: >-
              us:statutes/42/1396a/m#resources_do_not_exceed_optional_senior_or_disabled_resource_level
            output: resources_do_not_exceed_optional_senior_or_disabled_resource_level
            hash: sha256:local
  versions:
    - effective_from: '2024-01-01'
      formula: |-
        meets_optional_senior_or_disabled_age_or_disability_condition
        and income_does_not_exceed_state_optional_senior_or_disabled_level
        and resources_do_not_exceed_optional_senior_or_disabled_resource_level

▸citations (10)

References

This rule cites 10 other rules.

42 USC § 1382c (a)(3)inferredUS Federal › Statutes › Title 42 › § 1382c › (a)(3)
42 USC § 1382ainferredUS Federal › Statutes › Title 42 › § 1382a
42 USC § 1382binferredUS Federal › Statutes › Title 42 › § 1382b
42 USC § 9902 (2)inferredUS Federal › Statutes › Title 42 › § 9902 › (2)
42 USC § 1396d (p)(2)(D)inferredUS Federal › Statutes › Title 42 › § 1396d › (p)(2)(D)
42 USC § 1396d (p)inferredUS Federal › Statutes › Title 42 › § 1396d › (p)
42 USC § 1382a (b)(4)(B)(ii)inferredUS Federal › Statutes › Title 42 › § 1382a › (b)(4)(B)(ii)
42 USC § 1396d (p)(1)inferredUS Federal › Statutes › Title 42 › § 1396d › (p)(1)
42 USC § 1396d (p)(1)(B)inferredUS Federal › Statutes › Title 42 › § 1396d › (p)(1)(B)
42 USC § 1382a (b)(4)(B)(ii)inferredUS Federal › Statutes › Title 42 › § 1382a › (b)(4)(B)(ii)

Description of individuals

Description of individuals

(1)#

(2)#

(3)#

(4)#

optional_senior_age_threshold_years

optional_senior_or_disabled_income_level_maximum_rate

meets_optional_senior_or_disabled_age_or_disability_condition

state_income_level_within_federal_maximum

income_does_not_exceed_state_optional_senior_or_disabled_level

resources_do_not_exceed_optional_senior_or_disabled_resource_level

is_optional_senior_or_disabled_for_medicaid