On November 25, 2020, the U.S. Departments of Health & Human Services (HHS) and Treasury released the proposed 2022 “Notice of Benefit & Payment Parameters” (NBPP), the annual rule governing core provisions of the Affordable Care Act (ACA), including the operation of the marketplaces, standards for insurers, and the risk adjustment program. This expert perspective focuses on several provisions that have implications for state oversight of insurance markets and the state-based marketplaces. Comments on the proposed rule are due by December 30, 2020.
Consumer Assistance Resource Guide: MAGI Household Income 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 MAGI Household Income 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 an Insurance Affordability Program (IAP) — Medicaid, CHIP or Advance Premium Tax Credits and Cost Sharing Reductions — an applicant’s income must be below a certain eligibility level. Modified Adjusted Gross Income (MAGI) rules—primarily based on federal tax rules—are used to calculate income eligibility when an individual is applying for an IAP. This guide, prepared by Manatt Health Solutions, explains the types of income included and excluded when determining eligibility.