This detailed research brief from the Department of Health and Human Services Assistant Secretary for Evaluation and Planning describes potential methodologies that states may use for calculating Modified Adjusted Gross Income for income eligibility for expanded Medicaid and health insurance marketplace premium and cost-sharing subsidies under the Patient Protection and Affordable Care Act (ACA). While the ACA intended to establish national, uniform rules to define income and family, states retain some flexibility in applying those rules to their Medicaid programs and state-based health insurance marketplaces.

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