PolicyEngine / PolicyEngine/policyengine-us

NY Basic Health Program: 200–250% FPL tier ended 2026-07-01, parameter keeps it all year

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Description

**Observed** (API, 2026): a single 30-year-old in New York at $36,000 (≈226% FPL) gets Essential Plan treatment: `premium_tax_credit` $0, `spm_unit_medical_out_of_pocket_expenses` $0. `gov/hhs/basic_health_program/eligibility/expanded_income_limit_states.yaml` keeps `NY` for all of 2026 and reverts only at `2027-01-01`.

**Expected**: New York ended the Essential Plan 200–250% FPL tier effective **2026-07-01** (coverage end 6/30/2026). CMS approved the §1332 waiver termination on 2026-03-20; the state reactivated the §1331 Basic Health Program, which caps eligibility at 200% FPL. Enrollees between 200% and 250% moved to marketplace coverage with APTC/CSR.

With NY removed from the list, the same household gets `premium_tax_credit` $5,387 and a net premium of $2,773.

**Suggested change**: add `2026-07-01: []` to the parameter (or otherwise end NY's expanded limit mid-year).

**Sources**: NY State of Health, "Changes for 2026" webinar (2026-06-17), slides 6–9 https://info.nystateofhealth.ny.gov/sites/default/files/June%20Webinar%20-%20NY%20State%20of%20Health%20Changes%20for%202026.pdf · Issuer Q&A, "Essential Plan (EP) 200–250 Transition" https://info.nystateofhealth.ny.gov/sites/default/files/NY%20State%20of%20Health%20Issuer%20Q&A%20Essential%20Plan%20200%E2%80%93250%20Transition.pdf

Contributor guide

Open the contributing guide

Research direction

Start with gov/hhs/basic_health_program/eligibility/expanded_income_limit_states.yaml and inspect the dated NY entries for 2026. Update the parameter so NY's expanded limit ends on 2026-07-01, then reproduce the described New York household API case to confirm it receives marketplace APTC/CSR treatment rather than Essential Plan treatment.

Written by the indexing model from the issue text.

Assessment

Tech stack
python
Domain
backend
Issue type
Bug
Difficulty
1/5
Estimated time
Under an hour
Activity status
Active
Clarity
Clearly specified
Newbie friendliness
90/100

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