OE8 Webinar: Part I Households & Income

Determining Households and Income for Premium Tax Credits and Medicaid

In this Health Reform: Beyond the Basics webinar presented on September 15, 2020, Tara Straw, Senior Policy Analyst, and Shelby Gonzales, Director of Immigration Policy, detail the rules used to determine household size and explain what counts as income when determining eligibility for premium tax credits and Medicaid.

View Presentation Slides (PDF)

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Why Household Size & Income Matter

  • Calculating percent of federal poverty line (FPL)
  • How FPL effects expected premium contribution

Why Tax Filing Status Matters

  • Overview of tax filing statuses
  • Marital status and premium tax credits
  • New head of household questions

Determining Households for Premium Tax Credits

  • Types of tax dependents

Determining Households for MAGI Medicaid

  • Medicaid household rules

What Counts as Income for PTC and Medicaid

  • Modified Adjusted Gross Income (MAGI)
  • Rules for counting income
  • Tips for counting self-employment income

How Income Time Periods Differ between Medicaid and Premium Tax Credits

  • Income time periods
  • Example with fluctuating income

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

  • Examples

Additional Resources

Yearly Income Guidelines and Thresholds

Medicaid Household Rules

Determining Households for Medicaid and CHIP

Determining Households for PTC

Income Definitions for Marketplace and Medicaid Coverage

Self-Employment Income Estimator Tool

Health Care Assister’s Guide to Tax Rules