Getting MAGI Right: Current Monthly Income Vs. Projected Annual Income

Under the Affordable Care Act, new rules for counting household size and income for purposes of Medicaid and CHIP eligibility were aligned with the calculation of Marketplace subsidies. Following up on a primer she drafted on the basics of MAGI, our colleague at Georgetown’s Center for Children and Families, Tricia Brooks, drills down on income eligibility for Medicaid, CHIP, and premium tax credits. Continue reading

New “Halbig Provision” in Health Plan Agreements Poses Little Threat to Consumers

Insurers that sell coverage through the ACA’s federally facilitated marketplaces must sign a privacy and security agreement with the federal government. New language gives insurers greater flexibility to end that agreement if premium tax credits cease to be available to marketplace enrollees. Justin Giovannelli explores the significance of this development for consumers. Continue reading

Do Nothing to Renew or Get an Updated Eligibility Determination? CMS Puts out Final Marketplace Renewal Rules

Last week the federal Centers for Medicare and Medicaid Services (CMS) published final rules for the health insurance marketplaces and participating insurers to renew consumers into coverage for 2015. Our colleague from Georgetown’s Center for Children and Families, Tricia Brooks, discusses what the rule means for consumers and their families. Continue reading

After Halbig: Considerations for States Revisiting the Option to Establish a State-Based Marketplace

A federal appeals court’s ruling that premium subsidies aren’t available for consumers who purchase health coverage through one of the ACA’s federally run insurance marketplaces could have drastic consequences. But policymakers in the 34 states with a federal marketplace have options for protecting their residents. In one of CHIR’s blogs for the Commonwealth Fund, Kevin Lucia and Justin Giovannelli discuss those options here. Continue reading

Help for Consumers Who Faced Marketplace Glitches

The Obama administration recently announced that the health insurance Marketplaces can offer consumers retroactive coverage and financial assistance, if technical problems prevented them from enrolling. But the administration’s guidance also leaves some unanswered questions. Sabrina Corlette takes a look and helps us understand what the new policy actually means for consumers. Continue reading

How Do Updated 2014 Federal Poverty Level Thresholds Impact Medicaid, CHIP & Premium Tax Credit Eligibility?

The Administration recently released updated federal poverty level thresholds for 2014. With eligibility for Medicaid, CHIP and premium tax credits under the Affordable Care Act at stake, consumers and those assisting them need to understand what these new thresholds mean. Here to explain is our colleague at Georgetown University’s Center for Children and Families, Martha Heberlein. Continue reading