Simulation of Medicaid and SCHIP Eligibility: Implications of Findings From 10 States. Final Report.. 1. Gross and Net Income Tests


When determining income eligibility for Medicaid and SCHIP, states have the option of using a net income test, a gross income text, or both.4 Table II.1 shows the use of these tests by state and by program. In our sample of 10 states, all states use a net income test for their TANF programs; all but Massachusetts use a net income test for their Medicaid 1931 and expansion programs (including both poverty and M-SCHIP expansions).5 S-SCHIP programs, however, often use gross income tests.6 In our sample, the S-SCHIP programs in Alabama, California, Florida, Massachusetts, New Jersey, and New York use gross income tests.7


  Medicaid SCHIP Other
TANF 1931/AFDC Poverty Expansion Medicaid Expansion
Alabama Net Both Net Net Gross NA
Arkansas Net Net Net Net NA Gross
California Net Net Net Net Gross NA
Colorado Both Both Gross NA Net NA
Connecticut Both Both Net Net Net NA
Florida Both Both Net Net Botha NA
Massachusetts Both Gross Gross Gross Gross NA
Michigan Net Net Net Net Net NA
New Jersey Both Both Net Net Gross NA
New York Both Both Net Net Gross NA
SOURCE: MPR State Income Eligibility Requirements Database.

NOTE: NA = Not applicable

aThe MediKids program for preschool children uses a net income test. The Healthy Kids program for school-age children and their siblings uses a gross income test.