Webinar: Determining Household Size and Income

Key Elements of Eligibility and Enrollment

In this webinar presented on September 29, 2016, Shelby Gonzales, Senior Health Policy Analyst, and Tara Straw, Senior Health 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

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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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Tax filing statuses

Marital status and premium tax credits


Determining Households for Premium Tax Credits

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Households for PTCs

Determining tax dependents (video section, slides)

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


Determining Households for MAGI Medicaid

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Households for Medicaid

Summary of Medicaid household rules


What Counts as Income for PTCs and Medicaid

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Definition of MAGI

General rules about counting income

When to count a dependent’s income (video section, slides)

  • 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




Additional Resources

Part I: Premium Tax Credits | View webinar

Part III: Plan Design | View webinar

Part IV: Exemptions and Penalties | 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