Templates & Toolkits | Feb 28, 2014

Consumer Assistance Resource Guide: Household Composition Eligibility Rules

Manatt Health Solutions

Early evidence from across the nation suggests that consumer assisters are playing a vital role in helping people enroll in the new coverage options made possible by the Affordable Care Act. The following resource guide on Household Composition Eligibility Rules is part of a Consumer Assistance Resource Guide series  developed to help consumer assisters answer some of the most common eligibility and enrollment questions.

To be eligible for Medicaid, CHIP or Advance Premium Tax Credits and Cost Sharing Reductions, an applicant’s total household income must be below a certain level for the number of people in his or her household. This guide, prepared by Manatt Heath Solutions, explains how to determine who is included in an applicant’s household and covers special Medicaid household composition rules for households that include a pregnant woman; grandparents; unmarried, divorced, separated or non-custodial parents; or institutionalized or incarcerated family members. Additionally, the guide explains how eligibility is re-determined when an applicant’s household size changes during the year.


Expert Perspectives

November 18, 2019

Standardizing Health Plan Benefit Design: Opportunities and Implications for States

Sabrina Corlette, Georgetown University Center on Health Insurance Reforms

In 2019, the Washington legislature enacted a bill requiring insurers on the state’s health insurance exchange to offer plans with standardized benefit designs, beginning in 2021. Colorado and Maryland are considering similar requirements. As these and other states consider the option of standardized health plans, they can benefit from the experiences of California, the District of Columbia (D.C.), Connecticut, Massachusetts, New York, Oregon, and Vermont, all of which require insurers to offer standardized benefit designs. This Expert Perspective outlines benefits and risks of plan standardization, and raises critical questions that states will need to consider, and offers a decision roadmap for states implementing a standardized benefit design requirement.

November 16, 2019

More States Looking to Section 1332 Waivers

In the absence of federal legislation, states are actively seeking tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states to stabilize their health insurance marketplace. SHVS is tracking state activity and has many resources, including a template, for states interested in pursuing a Section 1332 waiver.

More information

October 18, 2019

New Policy Regarding Uninsured Noncitizens

On October 4, the President issued a proclamation that requires immigrants to show that they have health insurance or can pay medical expenses out of pocket in order to receive a visa. The proclamation will impact individuals applying for a visa with the Department of State (DOS) through consular offices abroad. In this expert perspective, Manatt Health reviews this latest policy regarding uninsured noncitizens and provides their take on implications for states.