CRS paper identifies potential issues with MAGI redefinition

Posted on October 25, 2011 | No Comments
Filed under Congressional Documents, Congressional Research Service, Health Insurance, Library, Medicaid and CHIP

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The Congressional Research Service (CRS) released a paper pertaining to Congress’s moves to redefine modified adjusted gross income (MAGI) to include Social Security income. CRS cites three issues that Congress should consider if the definition of income is changed. First, because MAGI can be computed largely from federal tax return information, verification of income is streamlined. Thus, by including additional provisions, there will be increased administrative complexity involved with calculating an individual’s MAGI. Second, the original definition was developed to promote coordination between Medicaid and premium credits in the health insurance exchange. Thus, this definition change should not only apply to income definition for Medicaid, but also should apply to premium credits. Third, bill proposals have focused largely on the inclusion of Social Security benefits in MAGI for eligibility purposes. However, many other low-income programs include other types of income and asset holdings that are also excluded from MAGI.

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RWJF and Urban paper examines coverage trends among different groups targeted by the ACA

March 15, 2012

In a report entitled, "A Decade of Coverage Losses: Implications for the Affordable Care Act," the Robert Wood Johnson Foundation (RWJF) and the Urban Institute analyze coverage trends among children, parents, and adults without dependent children as a guide to coverage changes that could be expected in coming years without the Affordable Care Act. The report uses the 2000 to 2010 Annual Social and Economic (ASEC) Supplement to the Current Population Surveys (CPS) to project such trends. The study provides overall trends and trends by income, using the ACA's modified-adjusted gross income (MAGI) to categorize individuals. The paper also explores the extent to which changes in income distribution contributed to the last decade's coverage patterns.

The Center on Budget and Policy Priorities reports on Social Security "glitch" in ACA

July 18, 2011

A report released by the Center on Budget and Policy Priorities, "A Tempest in a Teapot: New Accounts, Policymakers' Statements Mischaracterize Supposed 'Glitch' in Health Reform Law," discusses a measure under the Affordable Care Act (ACA) regarding Medicaid eligibility for those who receive Social Security benefits. The ACA provision dictates that, in determining eligibility, Medicaid would no longer fully count Social Security benefits of applicants under the age of 65. House Majority Leader Eric Cantor (R-VA) claimed that this measure would cost taxpayers $450 billion over the next decade. However, according to the Center on Budget and Policy Priorities, the provision is neither unintended, nor is it very costly.

New NBER paper highlights importance of being covered by insurance

July 11, 2011

A new study released by the National Bureau of Economic Research (NBER) compares care seeking behavior and health outcomes of individuals covered by insurance with those who are uniunsured, and found better self-reported physical and mental health among those with insurance. The study, "The Oregon Health Insurance Experiment: Evidence from the First Year," offered Oregon Medicaid on a randomly-assigned, lottery basis to an experimental group of uninsured individuals, while the control group received no coverage. Lower out of pocket medical costs were also noted among the group receiving coverage.

Update: Health Insurance Premium Tax Credits

September 2, 2011

This Update is the third in a series on a group of three regulations, all of which are summarized at HealthReformGPS.org. Together the rules are designed to implement both the Medicaid eligibility expansions, the process of determining eligibility for premium tax credits and cost sharing assistance in the Exchange individual market, and standards for employers purchasing coverage in Exchanges. Collectively, the rules are designed to allow individuals and families to acquire and keep coverage and move more seamlessly among publicly-supported sources of health insurance as family income and circumstances change.

Update to Health Insurance Exchanges--Exchange Functions in the Individual Market: Eligibility Determinations and Exchange Standards for Employers

September 1, 2011

This Update to the health insurance Exchange Implementation Brief examines a proposed regulation issued on August 17, 2011 as part of three proposed rules to implement provisions of the Affordable Care Act related to health insurance affordability. Companion Updates explain the proposed Medicaid eligibility rule and the proposed rule related to health insurance premium tax credits; this Update focuses on Exchange functions related to determinations of eligibility for “Exchange participation and insurance affordability programs,” as well as standards for employer participation.

Update: Medicaid Program Eligibility Changes under the Affordable Care Act

August 31, 2011

This update to the Medicaid Implementation and health insurance Exchange Briefs reviews a Notice of Proposed Rulemaking (NPRM) implementing the Medicaid and CHIP eligibility, enrollment simplification, and coordination provisions of the Affordable Care Act. Issued by the United States Department of Health and Human Services on August 17, 2011, the rule is comprehensive in scope; its public comment period ends October 31, 2011. The Medicaid NPRM is part of a group of three regulations, all of which are summarized at HealthReformGPS.org. Together the rules are designed to implement both the Medicaid eligibility expansions, the process of determining eligibility for premium tax credits and cost sharing assistance in the Exchange individual market, and standards for employers purchasing coverage in Exchanges. Collectively, the rules are designed to allow individuals and families to acquire and keep coverage and move more seamlessly among publicly-supported sources of health insurance as family income and circumstances change.

HHS and IRS release NPRMs on exchange eligibility, tax credits, medicaid expansion

August 12, 2011

The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have released Notices of Proposed Rulemaking (NPRM) on Exchange eligibility and insurance premium tax credits, respectively. Additionally, the Centers for Medicare and Medicaid Services (CMS) has released an NPRM related to the Medicaid eligibility expansion authorized by the Affordable Care Act (ACA). All three NPRMs are designed to simplify Exchange eligibility and enrollment by coordinating with state Medicaid agencies and the IRS to determine eligibility for premium tax credits and Medicaid under the new expanded eligibility rules laid out in the ACA. Also addressed in the proposed rules is the eligibility and calculation of tax credits for small businesses. For more information on the Medicaid eligibility expansion, click here. For more information on tax credits, click here. For more information on Exchange eligibility, click here. Finally, for more information on tax credits for small businesses, click here.