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Affordable Care Act Income/Resources

Affordable Care Act Income/Resources. Session 3 Presented by Tokie Moriel & John Tvedt. Objective. Present a high level overview of changes affecting types of income and resources under ACA. MAGI in Medicaid and CHIP Myth or Reality. Myth

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Affordable Care Act Income/Resources

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  1. Affordable Care ActIncome/Resources Session 3 Presented by Tokie Moriel & John Tvedt DHS/DFO/IMTA/2013-07-15

  2. Objective • Present a high level overview of changes affecting types of income and resources under ACA DHS/DFO/IMTA/2013-07-15

  3. MAGI in Medicaid and CHIPMyth or Reality • Myth • MAGI is a number on a tax return which DHS can get and know what someone’s income is for purposes of Medicaid or CHIP • Reality • MAGI is a methodology which identifies whose income is counted in determining somebody else’s eligibility and what kind of income is counted DHS/DFO/IMTA/2013-07-15

  4. Myth or Reality • Myth • Financial eligibility rules are affected for EVERYONE • Reality • MAGI will be used to determine the financial eligibility for: • Iowa Health and Wellness Plan • Children • Pregnant women • Parents and caretaker relatives DHS/DFO/IMTA/2013-07-15

  5. Myth or Reality • Myth • Coverage through the Marketplace • Reality • Coverage through the Marketplace DHS/DFO/IMTA/2013-07-15

  6. MAGI-Based MethodologiesTypes of Income • Today • All income/money received, unless excluded, minus any deductions, disregards or diversions • MAGI-based income • Tax rules apply with exceptions • No income disregards, except 5% DHS/DFO/IMTA/2013-07-15

  7. MAGI-Based MethodologiesWhose Income Is Counted • Today • Consider all income of the members in the eligible group unless the income is exempted, disregarded, deducted or diverted • MAGI-based income • Income of adults, parents and spouses always counted (stepparents will be treated like parents) • Income of children in parents’ household counted if required to file a tax return DHS/DFO/IMTA/2013-07-15

  8. MAGI-Based MethodologiesHousehold Composition & Size • Today • Based on legal responsibility; parents and children living together, but prohibited deeming rules apply • MAGI-based households • Medicaid and tax households the same for most families • Certain exceptions apply • Rules for non-filers mirror rules for filers DHS/DFO/IMTA/2013-07-15

  9. MAGI-Based Methodologies • Household Composition and Size • Key changes for Medicaid: • Stepparents and stepchildren • Children/siblings with income • Children ages 21+ claimed as tax dependent DHS/DFO/IMTA/2013-07-15

  10. MAGI-Based Methodologies • Exceptions to adoption of tax household • Individuals other than biological, adopted or step children claimed as tax dependent • Children claimed by non-custodial parent • Married couples and children of parents not filing jointly • Pregnant women DHS/DFO/IMTA/2013-07-15

  11. Budget Periods (Point-In-Time) • Today • Current monthly income • Budget period under MAGI • New applicants/enrollees –current monthly income • State flexibility to account for predictable fluctuations in income DHS/DFO/IMTA/2013-07-15

  12. Income Standard Conversion • Today • Net income standard after deductions, diversions and disregards • Under MAGI • States to convert current net income standards to new equivalent “gross income” standards such that individuals do not lose coverage DHS/DFO/IMTA/2013-07-15

  13. MAGI Screen • First step: Eligibility based on MAGI • Everyone is first evaluated for eligibility based on MAGI-based income • Determination based on other factors for those not eligible based on MAGI • Same process regardless of application door DHS/DFO/IMTA/2013-07-15

  14. Income Exempted under ACA • Child support income • Depreciation of business expenses, including capital losses • Scholarships, fellowship grants and awards used for education purposes • Worker’s compensation • Veteran’s benefits • American Indian and Alaska Native (AI/AN) income derived from distributions, payments, ownership interests, and real property usage rights • Non-recurring lump sum DHS/DFO/IMTA/2013-07-15

  15. Asset Test for MAGI Households • There is no asset test for MAGI households • There are no changes to the asset limits for non-MAGI households DHS/DFO/IMTA/2013-07-15

  16. Conclusion • Additional ACA webinars • Session review – Income Maintenance Workers ONLY DHS/DFO/IMTA/2013-07-15

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