The Advocate's Guide to MAGI

One of the significant changes brought about by the Affordable Care Act (ACA) is the introduction of a new methodology to evaluate eligibility for Insurance Affordability Programs (IAPs): Modified Adjusted Gross Income (MAGI). MAGI will be used to evaluate available income for most Medicaid and Children’s Health Insurance Program (CHIP) applicants and enrollees beginning in 2014. MAGI will also be used to determine eligibility for Advance Premium Tax Credits (APTCs) and Cost Sharing Reductions (CSRs) through the health insurance Marketplaces.  This Advocate’s Guide explains how MAGI works, and sets forth the guidelines that CMS has developed to implement and govern this new methodology.  The Guide will be an ongoing reference for advocates providing direct services to clients who have questions or problems pertaining to eligibility for health care affordability programs. While this Guide is meant for national use, it points out the few areas where states have leeway to shape policies that affect the MAGI calculations.