{
  "id": "R43861",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "R43861",
  "active": true,
  "source": "EveryCRSReport.com, University of North Texas Libraries Government Documents Department",
  "versions": [
    {
      "source": "EveryCRSReport.com",
      "id": 588379,
      "date": "2018-12-06",
      "retrieved": "2019-04-18T13:17:49.102628",
      "title": "The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs",
      "summary": "Certain portions of federal health programs rely on means testing for eligibility and other purposes. Medicare premiums, the individual mandate exemptions and penalties, eligibility and amounts for tax credits for health insurance exchange coverage, and Medicaid eligibility are determined, in part, using modified adjusted gross income (MAGI). MAGI is a concept that is used throughout federal tax law and certain federal programs. There is no uniform definition of MAGI; rather, the term has different definitions depending on the purpose for which it is being calculated.\nFor each of these federal health programs, MAGI begins with adjusted gross income (AGI) as calculated for tax purposes. From there, various types of income are included (or, in the case of Medicaid, subtracted) to calculate MAGI for each particular program. The different health programs do not necessarily define household income using the same groupings of people. For example, married couples living together are counted as the same Medicaid household regardless of whether they file a joint tax return. By contrast, married couples must file a joint tax return to be eligible for premium credits. \nThe Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) established Section 36B of the Internal Revenue Code (IRC) to authorize a tax credit to assist eligible taxpayers with the purchase of coverage through health insurance exchanges. \u201cHousehold income\u201d is used, among other factors, to determine eligibility for and amount of the premium tax credit. IRC Section 36B includes a definition of household income, which is calculated using the MAGI amount (subject to certain adjustments) for eligible taxpayers and tax dependents. \nThe MAGI definition in IRC Section 36B also is used as a basis in determining (1) whether an individual is exempted from the individual mandate, (2) the penalty amount owed if a person does not comply with the individual mandate, and (3) Medicaid income eligibility for certain populations. However, in each case the MAGI definition in IRC Section 36B is modified differently. Finally, a MAGI definition that differs from that in IRC Section 36B is used to determine which Medicare beneficiaries pay high-income premiums.\nThis report explores the different MAGI definitions across health programs, including Medicare, the individual mandate, premium tax credits on the health insurance exchanges, and Medicaid. It also addresses why MAGI is used and how it is applied, specific to each program.",
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      "typeId": "REPORTS",
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      "topics": [
        {
          "source": "IBCList",
          "id": 4790,
          "name": "Private Health Insurance"
        },
        {
          "source": "IBCList",
          "id": 4819,
          "name": "Medicaid & CHIP"
        },
        {
          "source": "IBCList",
          "id": 4912,
          "name": "Medicare"
        }
      ]
    },
    {
      "source": "EveryCRSReport.com",
      "id": 450116,
      "date": "2016-02-25",
      "retrieved": "2016-04-06T17:01:53.616222",
      "title": "The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs",
      "summary": "The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) created Section 36(B) of the Internal Revenue Code (IRC) to define household income, based on modified adjusted gross income (MAGI). MAGI is used to determine (1) penalty amounts owed if a person does not comply with the individual mandate or whether an individual is exempt from the individual mandate; (2) eligibility for and the amount of a premium credit to purchase coverage through a health insurance exchange; and (3) Medicaid income eligibility for certain populations. MAGI is also used to determine which Medicare beneficiaries pay high-income premiums. However, MAGI has many different definitions, depending on the purpose for which it is being calculated. \nFor these government health programs, MAGI begins with adjusted gross income (AGI) as calculated for tax purposes. From there, various types of income are included (or, in the case of Medicaid, subtracted) to calculate MAGI for each particular program. Although the different health programs use the word \u201chousehold,\u201d they do not necessarily refer to the same groupings of people. For example, married couples living together are counted as the same Medicaid household regardless of whether they file a joint tax return. By contrast, married couples must file a joint tax return to be eligible for premium credits. \nThis report explores the different MAGI definitions across health programs, including Medicare, the health insurance exchanges under the ACA, and Medicaid. It also addresses why MAGI is used, and how it is applied, specific to each program.",
      "type": "CRS Report",
      "typeId": "REPORTS",
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          "images": null
        }
      ],
      "topics": [
        {
          "source": "IBCList",
          "id": 3746,
          "name": "Health Care Reform"
        },
        {
          "source": "IBCList",
          "id": 594,
          "name": "Medicaid and CHIP"
        }
      ]
    },
    {
      "source": "University of North Texas Libraries Government Documents Department",
      "sourceLink": "https://digital.library.unt.edu/ark:/67531/metadc807368/",
      "id": "R43861_2015Apr22",
      "date": "2015-04-22",
      "retrieved": "2016-03-19T13:57:26",
      "title": "The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs",
      "summary": null,
      "type": "CRS Report",
      "typeId": "REPORT",
      "active": false,
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      "topics": []
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  "topics": [
    "Health Policy"
  ]
}