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West Virginia Income Maintenance Manual Chapter 22

West Virginia Income Maintenance Manual Page 14 Chapter 22 West Virginia Children’s Health Insurance Program (WVCHIP)

22.5 INCOME 22.5.1 MODIFIED ADJUSTED GROSS INCOME (MAGI) METHODOLOGY The Patient Protection and Affordable Care Act, enacted March 23, 2010, amended by the Health Care and Education Reconciliation Act of 2010, enacted March 30, 2010, are together referred to as the Affordable Care Act (ACA). The ACA required a new methodology for determining how income is counted and how household composition and size are determined when establishing financial eligibility for all three Insurance Affordability Programs (IAP)— Medicaid, Children’s Health Insurance Program (CHIP) and Advance Premium Tax Credits (APTC) through the Marketplace. MAGI Methodology is used to determine financial eligibility for the West Virginia Children’s Health Insurance Program (WVCHIP) and the following Medicaid eligibility groups: • Adults • Parents and Other Caretaker Relatives • Pregnant Women • Children Under Age 19 The same methodology is used to determine WVCHIP eligibility as is used for MAGI Medicaid groups. See Section 4.7. 22.5.1.A Determining the Household Size for WVCHIP For the WVCHIP MAGI household, a pregnant woman is counted as herself, plus the number of unborn children she is expected to deliver. 22.5.1.B MAGI Income Disregard for WVCHIP Note that the 5% FPL disregard is not applied to every MAGI eligibility determination and should not be used to determine the MAGI coverage group for which an individual may be eligible. The 5% FPL disregard will be applied to the highest MAGI income limit for which an individual may be determined eligible.