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 Decade: 2010-2019
 Collection: Congressional Research Service Reports
The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs

The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs

Date: February 25, 2016
Creator: Baumrucker, Evelyne P.; Davis, Patricia A.; Fernandez, Bernadette; Mach, Annie L. & Pettit, Carol A.
Description: This report explores how modified adjusted gross income (MAGI) is defined differently across health programs such as Medicare, the health insurance exchanges under the Affordable Care Act (ACA), and Medicaid. It also discusses why MAGI is used, and how it is applied, specific to each program. The report covers that 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.
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Discretionary Spending Under the Affordable Care Act (ACA)

Discretionary Spending Under the Affordable Care Act (ACA)

Date: January 13, 2016
Creator: Redhead, C. Stephen; Colello, Kirsten J.; Heisler, Elayne J.; Lister, Sarah A. & Sarata, Amanda K.
Description: This report examines the Affordable Care Act's (ACA's) effects on discretionary spending. It first discusses all the ACA authorizations (and reauthorizations) of appropriations for grant and other programs; this information, along with actual funding amounts, is summarized in a series of tables. The report then reviews the ACA administrative costs borne by CMS and the IRS.
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The Ebola Outbreak: Quarantine and Isolation Authority

The Ebola Outbreak: Quarantine and Isolation Authority

Date: October 28, 2014
Creator: unknown
Description: This legal sidebar discusses recent quarantine policies announced by several states, including New York and New Jersey, for travelers arriving from areas affected by the outbreak of Ebola Virus Disease, which have raised legal and constitutional questions about federal and state authority to order quarantine and isolation measures.
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Puerto Rico and Health Care Finance: Frequently Asked Questions

Puerto Rico and Health Care Finance: Frequently Asked Questions

Date: February 3, 2016
Creator: Mach, Annie L.
Description: This report provides answers to frequently asked questions (FAQs) about how federal health care programs and requirements are implemented in Puerto Rico, including information about eligibility, coverage, program requirements, and payment rules. Examples provided in the FAQs illustrate that in many circumstances, some health programs in Puerto Rico differ from programs in the US, while in other circumstances, Puerto Rico is treated the same as the states. As such, these questions and answers should be viewed as a discussion of the complexity of health care financing as it relates to Puerto Rico under current law.
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Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Date: April 6, 2012
Creator: Staman, Jennifer; Brougher, Cynthia; Liu, Edward C.; Lunder, Erika K. & Thomas, Kenneth R.
Description: This report discusses the Patient Protection and Affordable Care Act (ACA), P.L. 111-148, as amended, Congress enacted a “minimum coverage provision,” which compels certain individuals to have a minimum level of health insurance. This report provides an analysis of the constitutionality of this provision requiring individuals to obtain health insurance.
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Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System

Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System

Date: February 15, 2013
Creator: Hahn, Jim & Janemarie Mulvey
Description: This report provides a background on the Medicare fee schedule, the Sustainable Growth Rate (SGR) system, and the annual updates and discusses recent proposals to address this issue.
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Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System

Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System

Date: December 27, 2011
Creator: Hahn, Jim & Mulvey, Janemarie
Description: This report provides a background on the Medicare fee schedule, the Sustainable Growth Rate (SGR) system and the annual updates, and discusses recent proposal to address this issue.
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Public Health, Workforce, Quality, and Related Provisions in H.R. 3590, as Passed by the Senate

Public Health, Workforce, Quality, and Related Provisions in H.R. 3590, as Passed by the Senate

Date: March 1, 2010
Creator: Redhead, C. Stephen & Williams, Erin D.
Description: This report summarizes the workforce, prevention, quality, and related provisions in H.R. 3590, as passed by the Senate. It begins with some background on health care delivery reform, followed by an overview of the report’s content and organization
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Medicaid and CHIP Maintenance of Effort (MOE): Requirements and Responses

Medicaid and CHIP Maintenance of Effort (MOE): Requirements and Responses

Date: May 25, 2011
Creator: Baumrucker, Evelyne P.
Description: This report summarizes the MOE requirements enacted under American Recovery and Reinvestment Act of 2009 and the Patient Protection and Affordable Care Act as modified by the Health Care and Education Reconciliation Act of 2010 and what these requirements have meant for states in terms of their actions to restrict Medicaid and/or CHIP eligibility. It also summarizes recent legislative activity to repeal the MOE requirements.
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Self-Insured Health Insurance Coverage

Self-Insured Health Insurance Coverage

Date: June 25, 2010
Creator: Fernandez, Bernadette
Description: This report provides background information on private health insurance coverage, state and federal regulation of private coverage, and self-insured health plans. It includes data on the prevalence of self-insurance and discusses the employer decision to self-insure. Lastly, it describes selected private health insurance provisions under federal health reform, and application of such provisions on self-insured plans.
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Self-Insured Health Insurance Coverage

Self-Insured Health Insurance Coverage

Date: May 12, 2010
Creator: Fernandez, Bernadette
Description: This report provides background information on private health insurance coverage, state and federal regulation of private coverage, and self-insured health plans. It includes data on the prevalence of self-insurance and discusses the employer decision to self-insure. Lastly, it describes selected private health insurance provisions under federal health reform, and application of such provisions on self-insured plans.
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Centers for Medicare & Medicaid Services (CMS) Proposed Rule on Medicaid Managed Care: Frequently Asked Questions

Centers for Medicare & Medicaid Services (CMS) Proposed Rule on Medicaid Managed Care: Frequently Asked Questions

Date: July 15, 2015
Creator: Blom, Kirstin B.
Description: This report responds to a series of frequently asked questions (FAQs) identified to address some of the major updates included in the proposed rule. The FAQs summarize provisions such as the introduction of a minimum medical loss ratio (MLR), guidance on enrolling the long-term services and supports (LTSS) population in managed care, and network adequacy.
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Health Savings Accounts: Overview of Rules for 2012

Health Savings Accounts: Overview of Rules for 2012

Date: December 20, 2011
Creator: Mulvey, Janemarie
Description: This report provides a summary of the principal rules governing Health Savings Accounts (HSAs), covering such matters as eligibility, qualifying health insurance, contributions, and withdrawals.
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Mental Health Parity and the Patient Protection and Affordable Care Act of 2010

Mental Health Parity and the Patient Protection and Affordable Care Act of 2010

Date: December 28, 2011
Creator: Sarata, Amanda K.
Description: This report provides a brief background on mental health parity and the policy discussion around parity in health insurance coverage; an overview of federal mental health parity law prior to the enactment of the ACA; and an analysis of the impact of the ACA.
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Mental Health Parity and the Patient Protection and Affordable Care Act of 2010

Mental Health Parity and the Patient Protection and Affordable Care Act of 2010

Date: January 7, 2011
Creator: Sarata, Amanda K.
Description: This report provides a brief background on mental health parity and the policy discussion around parity in health insurance coverage; an overview of federal mental health parity law prior to the enactment of the ACA; and an analysis of the impact of the ACA.
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Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Date: February 1, 2011
Creator: Staman, Jennifer; Brougher, Cynthia; Liu, Edward C.; Lunder, Erika K. & Thomas, Kenneth R.
Description: This report first analyzes the authority of Congress to enact the minimum essential coverage requirement contained in Patient Protection and Affordable Care Act (PPACA), as well as how a court might analyze this provision if challenged based on various provisions of the Fifth and Tenth Amendments. This report discusses whether there must be exceptions to a requirement to purchase health insurance based on First Amendment freedom of religion, and finally, discusses some of the legal challenges to this federal requirement.
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Community Living Assistance Services and Supports (CLASS) Provisions in the Patient Protection and Affordable Care Act (PPACA)

Community Living Assistance Services and Supports (CLASS) Provisions in the Patient Protection and Affordable Care Act (PPACA)

Date: January 5, 2011
Creator: Mulvey, Janemarie & Colello, Kirsten J.
Description: This report first discusses the cost and financing for long-term care (LTC) services as well as the current market for private LTC insurance. It then details those CLASS program requirements for enrollment, premiums, eligibility, benefits, administration, and oversight. The report also discusses federal budget implications, as estimated by the Congressional Budget Office (CBO) and the Centers for Medicare and Medicaid Services (CMS). Finally, the report provides a timeline of the CLASS program provisions enacted under PPACA.
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Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Date: December 16, 2010
Creator: Staman, Jennifer; Brougher, Cynthia; Liu, Edward C.; Lunder, Erika K. & Thomas, Kenneth R.
Description: This report first analyzes the authority of Congress to enact the minimum essential coverage requirement contained in the Patient Protection and Affordable Care Act (PPACA), as well as how a court might analyze this provision if challenged based on various provisions of the Fifth and Tenth Amendments. This report discusses whether there must be exceptions to a requirement to purchase health insurance based on First Amendment freedom of religion, and finally, discusses some of the legal challenges to this federal requirement.
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Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Date: May 7, 2010
Creator: Staman, Jennifer; Brougher, Cynthia; Liu, Edward C.; Lunder, Erika K. & Thomas, Kenneth R.
Description: This report first analyzes the authority of Congress to pass a law of this nature, as well as how a court could analyze this provision in light of a constitutional challenge based on various provisions of the Fifth and Tenth Amendments. Finally, this report discusses whether the exceptions to the individual responsibility requirement to purchase health insurance satisfy First Amendment freedom of religion protections.
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Long-Term Care (LTC): Financing Overview and Issues for Congress

Long-Term Care (LTC): Financing Overview and Issues for Congress

Date: February 1, 2010
Creator: Stone, Julie
Description: This report provides an overview of long-term care (LTC) and an explanation of the nation’s complex financing system of public and private payers. It also describes some of the major challenges facing Congress as it contemplates LTC reform and whether and how to include LTC in health reform legislation.
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Medicare Primer

Medicare Primer

Date: April 24, 2012
Creator: Davis, Patricia A.; Binder, Cliff; Hahn, Jim; Morgan, Paulette C.; Mulvey, Janemarie; Talaga, Scott R. et al.
Description: This report provides an overview of Medicare, the nation's federal insurance program, which pays for covered health care services of qualified beneficiaries.
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Medicare Home Health Benefit Primer: Benefit Basics and Issues

Medicare Home Health Benefit Primer: Benefit Basics and Issues

Date: March 14, 2013
Creator: Talaga, Scott R.
Description: This report describes home health eligibility criteria, home health services, characteristics of Medicare beneficiaries who use home health services, and home health providers. Further, this report describes in detail the Medicare home health prospective payment system (HH PPS), provides an overview of Medicare home health payments, and discusses issues for Congress related to the Medicare home health benefit.
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Medicare Home Health Benefit Primer: Benefit Basics and Issues

Medicare Home Health Benefit Primer: Benefit Basics and Issues

Date: February 6, 2014
Creator: Talaga, Scott R.
Description: This report describes home health eligibility criteria, home health services, characteristics of Medicare beneficiaries who use home health services, and home health providers. Further, this report describes in detail the Medicare home health prospective payment system (HH PPS), provides an overview of Medicare home health payments, and discusses issues for Congress related to the Medicare home health benefit.
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The ACA Medicaid Expansion

The ACA Medicaid Expansion

Date: December 30, 2014
Creator: Mitchell, Alison
Description: This report provides an overview of the ACA Medicaid expansion, and the impact of the Supreme Court decision on the ACA Medicaid expansion. Then, the report describes who is covered under the expansion, the expansion rules, and how the expansion is financed. In addition, enrollment and expenditure estimates for the ACA Medicaid expansion are provided. Finally, the report reviews state decisions whether or not to implement the ACA Medicaid expansion, and the implications of those decisions on certain individuals, employers, and hospitals.
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