Eligibility & Enrollment Archive

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  • Marketplace MAGI Webinar Part I – Income

    Part I of a two-part series on rules for determining a consumer's Modified Adjusted Gross Income (MAGI). MAGI applies when determining eligibility for advance payments of the premium tax credit (APTC) and cost-sharing reductions (CSRs) for health coverage purchased through the Marketplace, as well as eligibility for the Children's…

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  • Due Process in Duals Demonstrations: A Closer Look at New York

    New York is one of several states working to better integrate care and services for individuals dually eligible for Medicare and Medicaid through a duals demonstration. In addition to integrating care, New York is working to integrate the Medicare and Medicaid appeals processes for individuals participating in its duals…

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  • Comments on Draft IRS Forms 1095 A-C

    The Affordable Care Act's individual shared responsibility provision requires individuals to have minimum essential health coverage (MEC), qualify for an exemption, or pay a penalty. This coming tax season will be the first in which all tax filers need to show that every member of the tax household had…

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  • Medicaid and Medicare: Aging, Access and Affordability

    Affordability is a cornerstone of any efficient and effective health care system. Discussions of healthcare affordability often center on the premiums - the upfront monthly cost of purchasing insurance. But equally important are the back-end deductibles, copays and coinsurance associated with actually accessing services. Cost sharing is especially important…

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  • CMS’s guidance on EPSDT Services for Children with ASD

    In July, 2014, the Centers for Medicare and Medicaid Services (CMS) issued guidance clarifying that evidence-based treatments for children with autism spectrum disorders (ASD), including behavioral and communication approaches to treatment, are eligible for federal financial participation under three State Plan authorities. CMS explained that states are obligated to cover…

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  • NHeLP Comments on IRS regulations for domestic violence survivors

    Erin Armstrong and

    NHeLP provides the following comments on IRS Temporary and Proposed Rules allowing married persons who experience domestic abuse or spousal abandonment to file their federal income taxes separately. The proposed IRS rules allow such individuals to be deemed to have satisfied the Affordable Care Act's joint filing requirement to…

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