Fix CA Medi-Cal immigration eligibility for DACA/TPS in 2026

[hua7450]

Summary

Fixes #7141

Fixes two issues with is_ca_medicaid_immigration_status_eligible:

1. Pre-2026: Now properly filters by immigration status (only UNDOCUMENTED, DACA, TPS, DACA_TPS) instead of returning True for everyone in CA
2. 2026+: DACA/TPS holders now correctly remain eligible because they are exempt from the enrollment freeze

Regulatory Authority

• California Welfare and Institutions Code Section 14007.8
• WCLP - Medi-Cal Immigration Changes Practice Tip (Jan 2026)

Problem

Per WCLP Practice Tip, the January 2026 enrollment freeze only affects:

• Adults with no immigration status (undocumented)
• Adults with unverified status
• Adults with non-immigrant visas (student, work, tourist)

DACA/TPS holders are explicitly NOT affected:

"All immigrants with other statuses are not affected by this change! This includes: ... DACA recipients; refugees; asylees; ..."

Changes

New Parameters

1. ca_state_funded_immigration_statuses.yaml

   • UNDOCUMENTED, DACA, TPS, DACA_TPS

2. medi_cal_enrollment_freeze/affected_statuses.yaml

   • Only UNDOCUMENTED

Updated Formula

• Checks if person's status is in CA state-funded list
• For 2026+: distinguishes freeze-affected (UNDOCUMENTED) vs exempt (DACA/TPS)
• Freeze-affected: need continuous coverage or age exemption (children)
• Freeze-exempt: always eligible (Health4All covered all ages by 2024)

Test Results

Person	Before Fix	After Fix	Correct
DACA, age 50, 2026	❌ False	✅ True	✅
TPS, age 50, 2026	❌ False	✅ True	✅
UNDOCUMENTED, age 50, 2026 (no prior)	❌ False	❌ False	✅
UNDOCUMENTED, age 50, 2026 (has prior)	✅ True	✅ True	✅
CITIZEN, age 30, 2024	✅ True	❌ False	✅ (use federal)
DACA, age 30, 2019	❌ False	❌ False	✅ (age not covered)

Note on Oct 2026 (OBBBA)

After October 2026, federal OBBBA removes refugees, asylees, parolees, PRUCOL, and others from federal Medicaid funding. Whether CA will cover these groups with state funds is uncertain as of January 2026:

• Current state law: keep full-scope Medi-Cal with dental
• DHCS interpretation: move to Medi-Cal with no dental + premiums
• Governor's proposed budget (Jan 9, 2026): restricted-scope only

A TODO comment has been added to the parameter file to update when legislation clarifies.

🤖 Generated with Claude Code

Co-Authored-By: Claude noreply@anthropic.com

[codecov]

Codecov Report

✅ All modified and coverable lines are covered by tests.
✅ Project coverage is 100.00%. Comparing base (1ceb893) to head (3b1ad3a).
⚠️ Report is 10 commits behind head on main.

Additional details and impacted files

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  Files            1         1             
  Lines         3175        22   -3153     
  Branches         0         1      +1     
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- Hits          3175        22   -3153     

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[PavelMakarchuk]

we should use the separate DACA and TPS inputs

[PavelMakarchuk]

Active voice

[PavelMakarchuk]

lets make empty list pre-2026