Here are several facts sheet explaining how to calculate an individual or family’s Modified Adjusted Gross Income (MAGI) to determine income eligibility for expanded Medicaid and for health insurance marketplace premium and cost-sharing subsidies under the Patient Protection and Affordable Care Act. There are many differences between the current calculation of income eligibility for Medicaid and the new income eligibility rules under the ACA, that will apply both to Medicaid and health insurance marketplace premium and cost-sharing subsidies. Among the differences are how certain foreign earned income, tax-exempt interest, child support received, alimony paid, Social Security benefits, workers’ compensation, gifts and inheritances, and dependent care expenses, are counted or not counted as income, or as deductions from gross income. One of the changes established by the ACA with this new definition of Modified Adjusted Gross Income was the intent to establish national uniformity across all states, rather than even more complex state-by-state rules on income eligibility. The ACA also established uniform, national rules on how a “family” is defined (based on tax rules about the number of dependents claimed). However, with many states declining to expand Medicaid, there will continue to be multiple methodologies used to calculate income eligibility.
From the University of California, Berkeley Labor Center:
From Families USA:
And from the State Health Access Reform Evaluation program funded by the Robert Wood Johnson Foundation: