MAGI, Streamlined Applications, and Medicaid Family Planning Expansions

Executive Summary

The Affordable Care Act (ACA) requires states implement a uniform methodology for determining income – modified adjusted gross income (MAGI) – in their eligibility determinations for Medicaid and for premium subsidies in the health insurance marketplaces. The ACA also requires states to move to a single, streamlined application (SSA), which the federal and state insurance marketplaces use to gather and assess information necessary to determine the insurance coverage and assistance for which a person is eligible.

Consumer and provider groups have expressed concern about the impact of transitioning to MAGI and SSA on Medicaid family planning expansion programs. In recent months, representatives of NHeLP, NFPRHA, the Guttmacher Institute, NWLC, and PPFA met with representatives of the Centers for Medicare & Medicaid Services (CMS) to discuss these issues. This memo details the outcomes of those conversations with CMS regarding MAGI, SSA, and Medicaid family planning expansions.