Key Elements of Eligibility and Enrollment

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In this webinar presented on September 21, 2017, Shelby Gonzales, Senior Policy Analyst, and Tara Straw, Senior Policy Analyst, detail the rules used to determine household size and explain what counts as income when determining eligibility for premium tax credits and Medicaid.

This is Part II in a four-part series on key elements of eligibility and enrollment.

Presentation Slides

↓ View presentation slides (PDF)

Note: The December 2017 tax law changed some minor aspects of calculating MAGI for 2018. The relevant slides have been updated as of June 19, 2018. The webinar video has not been updated. For more information on the changes, please see Update: How the Tax Bill Affects MAGI in 2018.

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Why Household Size Matters

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Calculating percent of federal poverty line (FPL)

• Effect on expected premium contribution

 

Why Tax Filing Status Matters

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Overview of tax filing statuses

• Marital status and premium tax credits

 

Determining Households for Premium Tax Credits

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Households for PTC

Determining tax dependents (video section, slides)

• Example: Who can be claimed as a tax dependent?

 

Determining Households for MAGI Medicaid

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Which eligibility groups use MAGI rules?

Determining households for Medicaid (video section, slides)

• Example: Married couple with children
• Example: Three-generation household
• Example: Non-married parents

 

What Counts as Income for PTC and Medicaid

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Definition of MAGI

General rules about counting income

When to count a dependent’s income (video section, slides) *slides updated June 19, 2018

• Example: Single adult with dependent

 

How Marketplaces and Medicaid Combine Household and Income Rules to Determine Eligibility

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Example: Three-generation household

Example: Non-married parents

 

Q&A

 

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Additional Resources

Part I: Premium Tax Credits | View webinar

Part III: Plan Design and Selection | View webinar

Part IV: Exemptions | View webinar

Key Facts: Income Definitions for Marketplace and Medicaid Coverage | View key facts

Key Facts: Determining Household Size | View key facts on Medicaid Households and PTC Households

Health Care Assister’s Guide to Tax Rules | View guide

Beyond the Basics Webinar Series | View all webinars

Key Facts About Health Reform | View all key facts