Webinar OE6: Determining Households and Income

For the Premium Tax Credit and Medicaid

In this Health Reform: Beyond the Basics webinar presented on September 18, 2018, Tara Straw, Senior Policy Analyst, and Shelby Gonzales, Senior Policy Analyst, detail the rules used to determine household size and explain what counts as income when determining eligibility for the premium tax credit and Medicaid.

This is Part II is a four-part series on core 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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Overview of tax filing statuses

Marital status and the premium tax credit

  • Exceptions to the joint filing rule


Determining Households for the Premium Tax Credit

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Households for the PTC

  • Determining tax dependents (video section, slides)
  • Examples: Who can be claimed as a tax dependent?


Determining Households for MAGI Medicaid

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Rules to determine households for Medicaid using MAGI rules

Examples: (video section, slides)

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


What Counts as Income for PTCs and Medicaid

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Definition of modified adjusted gross income (MAGI)

General rules about counting income

  • Tips when dealing with self-employment income
  • 2017 tax law changes
  • When to count a dependent’s income


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

Resources | View resources links

Reference Guide: Medicaid Household Rules

Reference Guide: Yearly Guidelines and Thresholds

Guide: Health Assister’s Guide to Tax Rules

Key Facts:

Webinar OE6: Premium Tax Credits

Beyond the Basics Webinar Series | View all webinars

Key Facts About Health Reform | View all key facts

Tools and Resources | View all tools and resources

Frequently Asked Questions | View FAQs