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Medicaid CE: model full AI/AN and IHS exclusion #8269

@daphnehanse11

Description

@daphnehanse11

Parent issue: #7751

PR #8257 adds the currently available Indian Health Service coverage proxy, has_indian_health_service_coverage_at_interview, to the Medicaid community engagement exclusion rollup. That still does not fully model the American Indian and Alaska Native exclusion described in the guidance.

Scope:

  • Confirm whether the modeled exclusion should be AI/AN status, IHS eligibility, IHS receipt, tribal health service eligibility, or some combination.
  • Decide whether PolicyEngine needs a new person-level input for AI/AN status or IHS eligibility.
  • Avoid using is_on_tribal_land as a person-level proxy unless the limitation is explicit.
  • Extend Medicaid CE tests to cover the chosen input and keep the existing IHS coverage case.

Out of scope:

  • State-specific outreach or verification workflow.
  • County or geography-based approximations unless explicitly documented as a proxy.

Sources:

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