Overlapping Eligibility and Enrollment: Human Services and Health Programs Under the Affordable Care Act. Average monthly eligibility vs. annual eligibility


Since TRIM determines eligibility on a monthly basis, aggregate eligibility estimates can be calculated on either an average monthly or annual basis. Annual estimates consider a person to be eligible for a particular program if he or she is eligible for that program in a least one month of the year, and no consideration is given to the actual number of months he or she is eligible (e.g. a person eligible for 12 months is treated the same as a person eligible for only 1 month). On the other hand, average monthly eligibility estimates adjust for months of eligibility by “pro-rating” each person by the number of months he or she is eligible (e.g. in the aggregate eligibility estimate, a person eligible for all 12 months will count 12 times as much as a person eligible for just 1 month).

The eligibility estimates presented in this report are all average monthly estimates, and reflect the overlap in monthly program eligibility. For example, a person who was eligible for UI for the first half of the year and Medicaid for the last half of the year would not be counted in table cells showing overlap in Medicaid and UI eligibility. However, if eligibility for these programs overlapped in one month, then 1/12 of the person’s weight would be counted in the table, and if eligibility overlapped in all months, then the person’s full weight would be counted. Note that eligibility for the EITC and LIHEAP is calculated based on annual income, so individuals eligible for those programs are counted as eligible for the entire year. Similarly, non-resident parent status is determined on an annual basis, so persons classified as non-resident parents are counted as such for the entire year.

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